3.Is the person’s HEARTbeating? Feel for a
PULSEin the side of the neck, two finger-widths
below the notch toward the back of the lower
jaw. Listen, with the EARagainst the chest, for a
heart beat.
4.Is the person bleeding severely? External
bleeding is generally obvious; look at the per-
son’s front and back. Indications of internal
bleeding include unusual or rapid swelling.
It is essential to assess all four life-threatening
factors as well as the context of the situation
before initiating emergency care because the find-
ings determine the most appropriate response.
Multiple life-threatening injuries present a com-
plicated situation, especially when there is only
one responder and he or she may have to make
rapid decisions about what to do. It may be neces-
sary to stop severe bleeding before proceeding to
CARDIOPULMONARY RESUSCITATION(CPR), for example.
The first action of the responder—call 911 to sum-
mon emergency aid—is often the most crucial.
See also BLEEDING CONTROL; RESPONDER SAFETY AND
PERSONAL PROTECTION; SITE AND SITUATION ASSESSMENT.360 Emergency and First Aid