How to respond to 5 emergency scenarios

How to respond to 5 emergency scenarios: first aid and treatment (i.e. heart attacks or strokes)

A woman sitting next to you on the train starts convulsing and falls to the floor. You don’t have time — or a signal — to Google “how to help someone having a seizure” on your smartphone. Would you know what to do?

Emergencies by definition are unexpected, so many of us are unprepared for such a scenario when it occurs — but you don’t have to be. Read through the following emergency situations — including heart attack, stroke, seizure, choking and fainting — so you can recognize the symptoms and know what to do if you, someone you know or someone around you experiences them.



Heart attacks strike more than a million Americans each year, and many wait too long to get help because they attribute the symptoms to something less serious.

Part of the reason so many people make this mistake is because we’re all so used to seeing the “Hollywood heart attack” onscreen. You know the drill — the guy stops mid-argument, dramatically clutches his chest and falls to his knees in excruciating pain. While this scenario isn’t unrealistic, it’s not always typical of the symptoms, which can vary from mild discomfort to extreme pain.

Signs to look out for:

  • Discomfort in the center or left side of the chest that lasts more than a few minutes, or that goes away and comes back — it can feel like uncomfortable pressure, squeezing, fullness or pain.
  • Pain or discomfort in other areas of the upper body, such as the arms, back, neck, jaw or stomach
  • Shortness of breath with or without chest discomfort (slightly more common in women)
  • Cold sweat, nausea, vomiting, lightheadedness or unexplained fatigue

The chest pain may feel like heartburn or indigestion, and women often experience a heart attack without the stereotypical chest pain. Instead, many have reported “shortness of breath, pressure or pain in the lower chest or upper abdomen, dizziness, lightheadedness or fainting, upper back pressure or extreme fatigue,” explained Nieca Goldberg, medical director for the Joan H. Tisch Center for Women’s Health at New York University’s Langone Center, on the American Heart Association’s website.

How to react:

  • DO call emergency medical help immediately — it could mean the difference between life and death, and can minimize the damage done to heart and brain tissue.
  • DON’T try driving yourself to the emergency room — call 911 and wait for medical personnel to arrive. If for some reason you can’t get through to 911, have someone else drive you.
  • DO chew and swallow an aspirin while you wait for medical assistance to arrive — chewed aspirin works the fastest.
  • DO stop what you’re doing, lie still and try to remain calm.
  • DO initiate CPR if someone experiencing a heart attack loses consciousness, stops breathing and doesn’t respond to stimulation like shaking. While this may be obvious advice, we’re going to say it anyway: The person administering CPR should be trained in CPR. If you are not, and no one around you is, a 911 dispatcher may be able to talk you through the steps until help arrives.

Many people don’t realize the enormous advantage of calling 911 over trying to get to a hospital on your own. 911 will get the person the necessary medical attention the fastest for three reasons: 1) Emergency personnel can start treatment — such as oxygen, heart medications and pain relievers — as soon as they reach the person. Unless you have a trained medical staff with you at all times, this isn’t happening in your car on the way to the hospital; 2) They can call the hospital ahead of time to begin preparations for tests and treatment; and 3) Have you ever been in an ER waiting room? That ambulance is your ticket to bypassing a lot of the waiting-area process and getting immediately treated.


If you suspect someone has had a stroke, ask them to raise both arms and note if one of them drifts downward.

You can think of a stroke like the brain’s version of a heart attack — it’s when arteries to the brain become blocked or rupture, killing brain cells and sometimes causing permanent brain damage and even paralysis. Acting quickly can make all the difference when it comes to minimizing the consequences.

Signs to look out for:

  • Sudden numbness or weakness of face, arm or leg — especially on one side of the body
  • Sudden confusion, trouble speaking or understanding
  • Sudden trouble seeing in one or both eyes
  • Sudden trouble walking, dizziness, loss of balance or coordination
  • Sudden severe headache with no known cause
  • Additionally, women may also report these unique symptoms:
    • Sudden face and limb pain
    • Sudden hiccups
    • Sudden nausea
    • Sudden general weakness
    • Sudden chest pain
    • Sudden shortness of breath
    • Sudden palpitations

How to react:

The National Stroke Association developed an easy way to remember what to do if you suspect someone you know may be experiencing a stroke. Act FAST:

  • Face: Ask the person to smile. Does one side of the face droop?
  • Arms: Ask the person to raise both arms. Does one arm drift downward?
  • Speech: Ask the person to repeat a simple phrase. Is their speech slurred or strange?
  • Time: If you observe any of these signs, call 911 immediately.

Also: Note the time when the symptoms first appear. The NSA says there is a clot-buster medication that could reduce long-term disability for the most common type of stroke if it’s administered within three hours of the first symptom.


If someone is having a seizure, do not try to force anything, including your fingers, into his or her mouth.

A seizure occurs when the brain is overloaded with unusual electrical activity. Since there are many types of seizures, symptoms can vary from the person seeming suddenly transfixed with a blank stare (i.e., absence seizure) to uncontrollable thrashing and loss of consciousness, which can occur in grand mal seizures. Seizures can be the result of a medical condition known as epilepsy, but they can also happen in people with no underlying health conditions.

Signs to look out for:

You’re probably not going to know if your friend is having an absence seizure — unless it’s the result of an underlying condition, you’d probably assume he had 20 seconds of unusual but not unsettling absentmindedness. However, the signs of grand mal, partial (aka focal) and febrile seizures are usually more apparent — symptoms usually last for seconds to minutes.

  • Grand mal seizure:
    • Loss of consciousness
    • Sudden contracting of muscles
    • Person falls down
    • Convulsing
  • Partial (focal) seizure:
    • No loss of consciousness
    • Sudden jerking
    • Sensory phenomena
    • Transient weakness or loss of sensation
    • Unaware of environment
    • May wander
    • Amnesia for seizure events
    • Mild to moderate confusion during and sleepy after
  • Febrile seizure:
    • Occur in children with high fever
    • Can range from mild symptoms like rolling of the eyes to more severe shaking or tightening of the muscles
    • Possible loss of consciousness

How to react:

  • DO try to prevent the person from falling, or try to gently guide him to the floor.
  • DO put something soft and flat, like a folded jacket, under her head.
  • DO remove eyeglasses and loosen ties or anything around the neck that might make breathing difficult.
  • DO try to move furniture or other objects that might injure the person during the seizure.
  • DO try to gently position the person so that fluid can leak out of the mouth if she is on the ground, but be careful not to apply too much pressure to the body.
  • DON’T force anything, including your fingers, into the person’s mouth. This could result in chipped teeth or a fractured jaw for the individual having the seizure, or your fingers could get bitten.
  • DON’T try to hold down or move the person. This could cause injury, such as a dislocated shoulder.
  • DON’T attempt CPR except in the rare event that the person doesn’t start breathing again after the seizure has stopped.
  • DO remain with the person until the seizure subsides and he is fully awake.
  • DON’T offer the person food or water until she’s fully alert.
  • DO offer to call a taxi, friend or relative to help the person get home if he seems confused or unable to get home without help.
  • DO time the seizure with your watch.
  • DO call 911 if:
    • It lasts longer than five minutes without signs of slowing down or if a person has trouble breathing afterward, appears to be in pain or recovery is unusual in some way;
    • The person has another seizure soon after the first one;
    • The person cannot be awakened after the seizure activity has stopped;
    • The person was injured during the seizure;
    • The person becomes aggressive;
    • The seizure occurs in water; or
    • The person has a health condition, such as diabetes or heart disease, or is pregnant.



We see the tacky-looking posters on restaurant walls all the time, but would you know how to immediately react if someone near you was choking? Choking happens when food — or maybe something a kid wasn’t supposed to eat but thought looked interesting enough to put in his mouth — gets lodged in the throat and blocks airflow to the lungs. It accounts for more than 3,000 deaths each year, according to the American Red Cross.

What to look out for:

  • Coughing or gagging
  • Hand signals and panic (sometimes pointing to the throat)
  • Sudden inability to talk
  • Clutching the throat — this is the universal sign for choking and is a person’s natural response
  • Wheezing
  • Passing out
  • Turning blue

How to react:

  • Give five back blows: Firmly position yourself slightly behind the person. Provide support by placing one arm diagonally across the chest and lean the person forward. Firmly strike the person on the back between the shoulder blades with the heel of your other hand.
  • Give five abdominal thrusts (aka the Heimlich maneuver): Start by standing or kneeling behind the victim and wrapping your arms around his or her waist. Make a fist with one hand, and place the thumb side against the middle of the victim’s abdomen, just above the navel and well below the lower tip of the breastbone. Grab your fist with your other hand, and give quick inward and upward thrusts into the abdomen.
  • Alternate between the five blows and five thrusts until the blockage is dislodged.



Fainting occurs when your brain isn’t getting enough blood flow and you lose consciousness for a brief period of time. While this one may seem trivial compared with the four other emergency scenarios, it’s a tricky one since the cause can vary from stress or heat to a serious medical condition.

What to look out for:

  • Kind of a no-brainer here…

How to react:

If you feel faint:

  • DO lie down or sit down, and don’t get up too quickly.
  • DO place your head between your knees if you sit down.

If someone else faints:

  • DO position the person on her back.
  • DO — if they are breathing — restore blood flow to the brain by raising the person’s legs above heart level (about 12 inches) if possible.
  • DO loosen belts, collars or other constrictive clothing.
  • DON’T let them get up too quickly.
  • DO try to revive them — yelling or gently shaking if you have to. If they don’t regain consciousness within one minute, call 911 immediately.
  • DO check the person’s airway to be sure it’s clear. Watch for vomiting.
  • DO check for signs of circulation (e.g., breathing, coughing or movement). If he or she isn’t breathing, someone who is trained in CPR should attempt resuscitation. Call 911 or your local emergency number, and continue CPR until help arrives or the person responds and begins to breathe.