Dry side skills as part of the rescue scenario

Primary Survey – Use DRS ABC

D – Danger / Ensure Safety
Before approaching: check the scene for hazards to yourself, bystanders, and the casualty (e.g. water, electricity, debris). Make it as safe as possible.

R – Response
Check if the casualty is responsive. Introduce yourself, ask “Are you OK?”, gently tap shoulders.
Use AVPU scale: Alert / responds to Voice / responds to Pain / Unresponsive.

S – Shout for Help / Send for Help
If no one else is around, shout loudly for assistance.
If possible, designate someone to call emergency services before you proceed, or call yourself if alone.

A – Airway

If the casualty is unresponsive, open the airway (head tilt – chin lift, unless spinal injury suspected; if suspected, use a jaw thrust).
Look inside the mouth; remove any obvious obstruction (only if visible, do not do blind finger sweeps).

B – Breathing
Check for normal breathing (look, listen, feel) for no more than 10 seconds.
Be aware that agonal gasps are not normal breathing — treat them as signs of cardiac arrest.

C – Circulation
If the casualty is unresponsive and not breathing normally: assume no circulation / cardiac arrest and begin CPR immediately.
If breathing but there is severe bleeding, treat that first.

Scenario: Casualty Not Breathing / Heart Has Stopped

• Swap to resuscitation manikin to practice / demonstrate.

• Simulate a Call 999 (or local equivalent) / ensure emergency response is activated.

• On the rescue manikin, Start CPR: 30 chest compressions : 5 initial rescue breaths, (assume this is a diver, in water, possible water in lungs). Perform cycles for 2 minutes. Use proper depth (≈ 5-6 cm in adults), rate (100-120/min), allow full recoil. Resuscitation Council UK+2SJA+2
  
  

When the Real Casualty Begins to Regain Consciousness & Is Choking

• If the casualty starts showing signs of choking (e.g., inability to speak, cough weakly, etc.):

  • Turn cautiously onto their side into recovery / safe airway (support head / neck; watch for spinal injuries).

  • Encourage or help to clear the airway (if visible foreign body).

• Reassure them (verbal comfort), check responses again (AVPU), monitor for changes.
  
  

Ongoing Care

• Place casualty in Recovery Position (safe airway position) if they are breathing normally but still unresponsive/sedated/unconscious. Continue to monitor breathing, pulse, and consciousness.

• Use bystanders as needed (assist with calling, fetching defibrillator, etc.), but ensure they return / stay close.

• Continue reassuring the casualty.

• When professionals arrive they may ask you to continue CPR whilst they prepare to take over. 

• DIVERS MUST NOT HAVE ENTONOX (not all medics are divers and may not know this).

Neurological Assessment

1. Consciousness: AVPU – Alert / Voice / Pain / Unresponsive
2. Orientation: Name – Place – Time
3. Speech: Listen for slurred or confused speech
4. Face: Ask to smile – look for droop
5. Arms/Legs: Hold both arms out (drift?), lift legs, check strength
6. Sensation: Ask if numb/tingly on either side
7. Balance: Stand (if safe) – watch for loss of balance

Any abnormal sign = give 100% O₂, keep flat/warm, urgent evacuation.

Additional Notes / Key Points (from current guidance)

• Recognise cardiac arrest: someone unresponsive and not breathing normally → start CPR. Agonal breathing is not normal. Resuscitation Council UK+1

• Call for help early (send someone / shout) so help, including defibrillator or EMS, can arrive while you begin resuscitation. Resuscitation Council UK+1

• In CPR: compression depth and rate are crucial; minimize interruptions. Resuscitation Council UK+1

• For choking: follow current first aid steps (encourage coughing, back blows, abdominal thrusts if needed for adults).

Debrief & Assessment

• After the scenario ends, debrief with examiner / assessor: what worked, what could be improved.

• Use any relevant assessment sheets (for example, your “5 minute neuro” or other checklists) to check for neurological signs, consciousness, etc.

Remember - We do on instinct what we have been trained to do.