Severe blood loss leading to fatal shock within 60 to 90 seconds.
FIELD PROTOCOL (7 STEPS)
-
01
Apply a commercial tourniquet (CAT or SAM XT) immediately.
-
02
Under active threat or over clothing: Place the tourniquet HIGH AND TIGHT on the limb.
-
03
Under cover with exposed skin: Place the tourniquet 2 to 3 inches above the wound, avoiding joints.
-
04
Tighten the windlass until bright arterial bleeding stops and the distal pulse disappears.
-
05
Lock the windlass into the clip, secure the strap, and write the application time on the strap (e.g., TQ 14:22).
-
06
If bleeding continues, place a second tourniquet directly above and touching the first.
-
07
For groin or armpit wounds: Pack the wound cavity tightly with hemostatic or standard gauze, then hold firm direct pressure for 3 minutes.
PROHIBITED ACTIONS (DO NOT)
-
•
Do not place a tourniquet directly over a joint (elbow, knee, wrist, ankle).
-
•
Do not loosen or remove a tourniquet once secured.
-
•
Do not use wire, shoelaces, or zip ties as makeshift tourniquets.
-
•
Do not pull out packed gauze; if blood soaks through, add more gauze on top and apply a pressure wrap.
Trapped air in the chest cavity collapses the lung and restricts blood flow back to the heart.
FIELD PROTOCOL (5 STEPS)
-
01
Expose the chest and wipe away blood and sweat around the wound.
-
02
Apply a vented chest seal centered over the wound as the patient exhales.
-
03
Check the patient for both entry and exit wounds (inspect back, armpits, and neck); seal every puncture.
-
04
Burping the seal: If breathing worsens or the patient deteriorates after sealing, peel one edge of the seal back during exhalation to vent trapped air, then reseal.
-
05
Keep a conscious patient in a position of comfort or leaning toward the injured side.
PROHIBITED ACTIONS (DO NOT)
-
•
Do not use unvented tape or plastic unless actively monitoring for trapped pressure.
-
•
Do not pack gauze or dressings into chest or abdominal cavities.
-
•
Do not attempt needle decompression unless licensed and authorized under local medical direction.
Brain injury begins within 3 minutes of total airway blockage; cardiac arrest follows within 5 minutes.
FIELD PROTOCOL (5 STEPS)
-
01
Use a jaw-thrust maneuver to open the airway without tilting the head if a spinal injury is possible.
-
02
Clear the mouth with a gloved finger only to remove visible loose teeth, clots, or objects.
-
03
Insert a lubricated Nasopharyngeal Airway (NPA) into the right nostril with the bevel facing the septum, straight back along the nasal floor.
-
04
Roll an unconscious breathing patient without spinal trauma into the recovery position.
-
05
Let a conscious patient with facial injuries sit up and lean forward so blood drains out of the mouth.
PROHIBITED ACTIONS (DO NOT)
-
•
Do not insert an NPA if there are clear signs of a skull fracture (bruising around eyes, CSF leaking from nose/ears).
-
•
Do not perform blind finger sweeps down the throat.
-
•
Do not force a patient with facial trauma to lie flat on their back.
Active gunfire or weapons threat preventing immediate on-scene medical care.
FIELD PROTOCOL (5 STEPS)
-
01
Suppress the threat: Fire superiority stops further casualties.
-
02
Direct the casualty to return fire, find cover, or apply self-aid if conscious.
-
03
If the casualty cannot move: Approach only under ballistic shield, vehicle cover, or covering fire.
-
04
Apply a tourniquet high and tight over clothing for major extremity bleeding.
-
05
Move the casualty immediately to cover using drag straps, two-person drag, or carry.
PROHIBITED ACTIONS (DO NOT)
-
•
Do not stop to treat minor wounds or open airways while in the line of fire.
-
•
Do not remove body armor or protective gear in a direct threat zone.
-
•
Do not enter an open kill zone alone without cover or covering fire.
Fatal lack of oxygen and respiratory arrest caused by central nervous system depression.
FIELD PROTOCOL (6 STEPS)
-
01
Insert Naloxone (Narcan) nozzle into one nostril until your fingers touch the bottom of the nose.
-
02
Press the plunger firmly to deliver the full 4mg dose.
-
03
Support breathing immediately: Provide rescue breaths using a pocket mask or bag-valve-mask (1 breath every 5 seconds).
-
04
If the subject does not breathe normally after 2 to 3 minutes, deliver a second 4mg dose in the other nostril.
-
05
Prepare for sudden withdrawal: Revived subjects may vomit or become disoriented; turn them onto their side.
-
06
Wash hands with soap and water after handling. Dry fentanyl powder does not absorb quickly through unbroken skin.
PROHIBITED ACTIONS (DO NOT)
-
•
Do not use alcohol-based hand sanitizers on fentanyl residue (alcohol increases skin absorption).
-
•
Do not self-administer Narcan for minor powder contact or smell; brief skin contact does not cause instant overdose.
-
•
Do not leave a revived subject unattended; fentanyl lasts longer than Narcan and overdose can return in 30 to 60 minutes.
Permanent brain damage begins after 4 minutes without blood flow.
FIELD PROTOCOL (6 STEPS)
-
01
Call dispatch for priority paramedics and announce CPR in progress.
-
02
Place the patient flat on their back on a hard, flat surface.
-
03
Start chest compressions immediately: Push hard and fast in the center of the chest (100–120 beats per minute, 2 to 2.4 inches deep).
-
04
Allow complete chest recoil between compressions; do not lean on the chest.
-
05
Turn on the AED immediately, bare the chest, dry sweat, and apply pads as shown on the diagrams.
-
06
Clear the patient when the AED analyzes or advises shock; press the shock button, then immediately resume compressions.
PROHIBITED ACTIONS (DO NOT)
-
•
Do not pause chest compressions for more than 10 seconds total.
-
•
Do not place AED pads directly over an implanted pacemaker or medication patch; place the pad at least 1 inch away.
-
•
Do not stop CPR to re-check pulse unless the patient clearly wakes up, moves, or breathes normally.
Sudden cardiac arrest and severe metabolic acidosis, especially when held in a prone position.
FIELD PROTOCOL (5 STEPS)
-
01
Treat as a medical emergency: Request paramedics immediately for medical sedation.
-
02
Use team control to secure the subject quickly and minimize prolonged physical struggle.
-
03
Immediate De-Prone Rule: As soon as handcuffs are applied, roll the subject onto their side or sit them upright immediately.
-
04
Maintain continuous visual and verbal monitoring of breathing throughout transport.
-
05
Cool the subject if safe to do so: Loosen tight collars, apply cool packs to neck or armpits.
PROHIBITED ACTIONS (DO NOT)
-
•
Do not leave a restrained subject face down (prone) on their stomach on the ground or in a squad car.
-
•
Do not apply body weight, knees, or shins to the back, neck, or chest once handcuffs are secured.
-
•
Do not assume sudden silence or stillness is compliance; sudden quietness can indicate respiratory collapse.
-
•
Do not transport a subject face down inside a patrol car without continuous officer monitoring.
Airway swelling closes the throat; severe drop in blood pressure causes circulatory collapse.
FIELD PROTOCOL (6 STEPS)
-
01
Administer an Epinephrine auto-injector (EpiPen 0.3mg adult / 0.15mg pediatric) immediately.
-
02
Inject into the middle outer thigh, through clothing if necessary.
-
03
Push firmly until it clicks, then hold in place for 3 to 5 seconds before removing.
-
04
Massage the injection site for 10 seconds to help absorption.
-
05
Keep the patient lying flat with legs elevated unless breathing requires sitting up.
-
06
If symptoms do not improve after 5 to 10 minutes and EMS has not arrived, administer a second auto-injector in the opposite thigh.
PROHIBITED ACTIONS (DO NOT)
-
•
Do not delay epinephrine to try oral allergy pills (antihistamines take 30 to 45 minutes to work).
-
•
Do not inject epinephrine into hands, feet, or buttocks.
-
•
Do not allow an anaphylactic patient to stand up or walk suddenly.
Heart rhythm failure and metabolic collapse when body temperature drops below 95°F.
FIELD PROTOCOL (5 STEPS)
-
01
Handle the patient gently. Rough movement can trigger fatal heart rhythms.
-
02
Cut off wet clothing rather than pulling if the patient is stiff.
-
03
Wrap the patient in dry blankets, sleeping bags, or thermal foil; cover the head.
-
04
Move the patient into a warm patrol car cabin with the heat turned up.
-
05
Start CPR if pulse and breathing are absent; continue CPR until warmed at hospital.
PROHIBITED ACTIONS (DO NOT)
-
•
Do not rub frostbitten hands, feet, or ears with snow or fabric.
-
•
Do not allow a severely hypothermic patient to stand or walk.
-
•
Do not apply direct hot water or boiling pads directly to bare skin.
Brain swelling and multi-organ failure when body core temperature exceeds 104°F.
FIELD PROTOCOL (4 STEPS)
-
01
Treat heat stroke as an immediate medical emergency: Remove body armor, uniform shirt, helmet, and boots.
-
02
Cool rapidly: Douse the patient with cool water and fan continuously to promote evaporation.
-
03
Place ice packs or cool wet towels over major blood vessels: Neck, armpits, and groin.
-
04
Turn patrol vehicle air conditioning to maximum cold and aim vents at the patient.
PROHIBITED ACTIONS (DO NOT)
-
•
Do not give drinks by mouth to anyone with confusion or altered mental state (choking risk).
-
•
Do not delay cooling to wait for an ambulance; cool immediately and transport rapidly.
-
•
Do not give aspirin or Tylenol (they do not treat environmental heat stroke and stress the liver/kidneys).
Loss of 2 million brain cells per minute during acute stroke; treatment window is under 4.5 hours.
FIELD PROTOCOL (4 STEPS)
-
01
Find the exact Last Known Well (LKW) time from the patient, family, or witnesses.
-
02
Transmit the LKW time immediately to dispatch so the hospital can prepare the stroke team.
-
03
Keep the patient's head elevated 15 to 30 degrees unless vomiting requires side-lying.
-
04
Check blood glucose if department glucometer is available to rule out low blood sugar.
PROHIBITED ACTIONS (DO NOT)
-
•
Do not give aspirin, food, or water (field testing cannot determine bleeding vs clot stroke).
-
•
Do not attempt to lower high blood pressure in the field.
Unconsciousness, seizures, or mistaken DUI arrest due to low blood sugar mimicking intoxication.
FIELD PROTOCOL (4 STEPS)
-
01
Confirm the patient is awake and able to swallow safely.
-
02
Give 15 to 20 grams of fast-acting sugar: Glucose gel tube, fruit juice, or regular soda.
-
03
Place glucose gel inside the cheek if the subject is conscious but uncooperative.
-
04
If the subject is drowsy, unconscious, or unable to swallow, place them on their side and call paramedics.
PROHIBITED ACTIONS (DO NOT)
-
•
Do not give food, liquids, or gel to an unconscious or seizing patient.
-
•
Do not administer insulin in the field under any circumstance.
-
•
Do not assume unusual behavior is criminal intoxication without checking for medical indicators.
Airway swelling closes the throat within 30 minutes; severe burns lead to hypothermia and shock.
FIELD PROTOCOL (5 STEPS)
-
01
Stop the burning process: Extinguish flames, remove smoldering clothing, flush liquid chemicals with water.
-
02
For dry chemicals: Brush off dry powder before rinsing with water.
-
03
Remove tight rings, watches, belts, and body armor before swelling begins.
-
04
Cover burn areas with clean, dry sterile dressings or clean sheets.
-
05
Keep the patient warm: Large burns lose heat quickly. Cover dressings with dry blankets.
PROHIBITED ACTIONS (DO NOT)
-
•
Do not apply ice, ice water, or freezing compresses to burns.
-
•
Do not apply ointments, butter, petroleum jelly, or creams to major burns in the field.
-
•
Do not pop or puncture blisters.
-
•
Do not pull off melted clothing stuck to charred skin; cut around it.
Choking on saliva or vomit, head injury from impact, or continuous seizure lasting over 5 minutes.
FIELD PROTOCOL (5 STEPS)
-
01
Protect from injury: Clear hard furniture, sharp objects, duty gear, and weapons out of reach.
-
02
Place a soft folded jacket or padding under the head to protect against hard surfaces.
-
03
Time the seizure: Note the exact start time and how long it lasts.
-
04
When jerking stops, roll the patient onto their side in the recovery position so saliva drains.
-
05
Speak calmly and reassure the person as they regain consciousness; remind them where they are.
PROHIBITED ACTIONS (DO NOT)
-
•
Do not force any object, bite stick, or fingers between the person's teeth.
-
•
Do not hold down or restrain jerking limbs during a seizure.
-
•
Do not offer water, food, or pills until the person is fully awake and speaking normally.
Severe internal bleeding from an unstable pelvic fracture can hide up to 3 liters of blood.
FIELD PROTOCOL (4 STEPS)
-
01
Check pulse, movement, and feeling (PMS) beyond the break BEFORE and AFTER applying any splint.
-
02
Splint the bone in the position found, supporting both the joint above and the joint below the injury.
-
03
For open fractures: Cover exposed bone ends with a sterile, moist dressing without pushing bone back in.
-
04
For suspected pelvic fracture: Wrap a pelvic binder or tightly folded bedsheet centered around the hips, pull firm tension, and secure.
PROHIBITED ACTIONS (DO NOT)
-
•
Do not press down on or rock the pelvis to test for stability (this can cause severe internal bleeding).
-
•
Do not try to push exposed bone fragments back under the skin.
-
•
Do not straighten a deformed joint unless pulse is absent and EMS is far away.
Water in lungs, lack of oxygen, hypothermia, and rescuer danger from heavy duty gear.
FIELD PROTOCOL (5 STEPS)
-
01
Use the Rescuer Safety Hierarchy: Reach (pole/branch) -> Throw (rope/buoy) -> Row (boat) -> Go (last resort only).
-
02
Throw a throw rope, rescue ring, or spare tire to the subject.
-
03
If the subject is pulled out unresponsive: Start CPR immediately with 2 RESCUE BREATHS first, then 30 compressions.
-
04
Keep the subject flat during removal to avoid a sudden drop in blood pressure.
-
05
Remove wet clothes and wrap in dry blankets immediately upon removal from water.
PROHIBITED ACTIONS (DO NOT)
-
•
Do not enter deep water or walk onto thin ice while wearing body armor, duty belt, or heavy boots.
-
•
Do not use the Heimlich maneuver to try to clear water from the lungs (causes vomiting and choking).
-
•
Do not stop CPR early on cold-water drowning victims; cold water can protect brain function.
Complete windpipe blockage causes brain injury and cardiac arrest within 3 to 4 minutes.
FIELD PROTOCOL (7 STEPS)
-
01
Confirm complete blockage: Ask 'Are you choking? Can you speak?' If they nod yes and cannot speak, act immediately.
-
02
Conscious Adult or Child (>1 year): Stand behind them, wrap arms around waist, lean them forward slightly.
-
03
Deliver 5 sharp back blows between the shoulder blades with the heel of your hand.
-
04
Deliver Abdominal Thrusts (Heimlich): Make a fist, thumb-side in just above the navel; grasp with other hand and pull inward and upward.
-
05
For pregnant or obese persons: Place hands on the center of the breastbone and deliver rapid chest thrusts straight back.
-
06
If the person becomes unconscious: Lower them to the floor, call paramedics, and begin CPR with 30 chest compressions.
-
07
Before giving breaths during CPR, look in the mouth and remove objects only if clearly visible.
PROHIBITED ACTIONS (DO NOT)
-
•
Do not perform blind finger sweeps in the mouth or throat.
-
•
Do not interfere if the person is coughing forcefully or speaking normally.
-
•
Do not use abdominal thrusts on infants under 1 year (use 5 back slaps followed by 5 chest thrusts).
-
•
Do not delay CPR if a choking person loses consciousness.
Puncture infection, broken barb left in skin, or missed medical emergency after high-stress restraint.
FIELD PROTOCOL (8 STEPS)
-
01
Make sure the subject is handcuffed and the scene is safe before touching probes or wires.
-
02
Remove cartridge from the CEW and confirm the safety switch is down.
-
03
Check probe locations: Probes in back, legs, arms, or buttocks can be removed in the field.
-
04
Sensitive area check: If probes are in the face, neck, eyes, groin, female breast, or a joint, DO NOT remove; call paramedics for hospital removal.
-
05
Removal technique: Hold skin flat with one hand, grasp the probe body firmly, and pull straight out at a 90-degree angle in one quick motion.
-
06
Inspect probes: Confirm the barb is intact on the probe; if broken, notify hospital staff.
-
07
Clean puncture wounds with antiseptic wipes, apply bandages, and secure probes in the spent cartridge as evidence.
-
08
Monitor the subject continuously for breathing, pulse, and responsiveness under SAFE-T Act requirements.
PROHIBITED ACTIONS (DO NOT)
-
•
Do not remove probes from eyes, face, neck, groin, female breasts, or joints in the field.
-
•
Do not leave a TASERed subject resting face down on their stomach.
-
•
Do not throw deployed probes into regular trash (treat as biohazard evidence).
-
•
Do not twist or bend probes during removal (pull straight out).
Hidden hip fracture, head bleed from striking the floor, muscle breakdown, or hypothermia from hours on a cold floor.
FIELD PROTOCOL (8 STEPS)
-
01
Check breathing, alertness, and ability to answer simple questions.
-
02
Keep the person in the position found; do not rush to lift them before checking for fractures and spine injury.
-
03
Inspect legs and hips: Look for shortened leg, outward turning, and localized tenderness.
-
04
Check for head injury: Feel gently for swelling; ask if they hit their head when falling.
-
05
Check for stroke signs (FAST screen) to see if a stroke caused the fall.
-
06
Insulate from cold floor: Slide warm blankets or coats under and over the person.
-
07
Support an injured leg: Place rolled blankets or pillows along the outside of the leg to prevent painful movement.
-
08
Gather medication lists, pill organizers, and emergency contacts for arriving paramedics.
PROHIBITED ACTIONS (DO NOT)
-
•
Do not force a fallen senior to stand or walk before paramedics arrive.
-
•
Do not pull on the person's arms or shoulders to lift them (can dislocate shoulders or tear fragile skin).
-
•
Do not give food or drink while lying flat (choking risk).
-
•
Do not assume a fall was simple tripping without checking for stroke or medical causes.
Delayed throat swelling can close the airway up to 36 hours after an assault.
FIELD PROTOCOL (7 STEPS)
-
01
Secure the scene and separate parties completely before medical assessment.
-
02
Assess the airway immediately: Listen for high-pitched breathing (stridor) or shortness of breath.
-
03
Inspect and document signs: Check eyes, throat, and face for petechiae and red marks.
-
04
Warn the victim: Explain that strangulation injuries are internal and can become life-threatening hours later even if marks look minor.
-
05
Request paramedics for on-scene medical evaluation.
-
06
Photograph injuries in good light: Take wide and close-up photos of neck, face, and eyes before marks fade.
-
07
Document exact statements: Record victim descriptions of pressure, how long it lasted, dizziness, or passing out.
PROHIBITED ACTIONS (DO NOT)
-
•
Do not dismiss strangulation reports because there are no obvious exterior bruises.
-
•
Do not press firmly on the victim's neck or windpipe during examination.
-
•
Do not let a victim who lost consciousness refuse medical care without warning them of delayed airway swelling.
Internal chest/abdominal injuries, neck and spinal trauma, and glass cuts from impact.
FIELD PROTOCOL (7 STEPS)
-
01
Make scene safe: Position squad car to block traffic, set flares, and turn off vehicle ignitions.
-
02
Reassure occupants about powder: Explain that white residue is harmless cornstarch/talc lubricant, not smoke.
-
03
Hold manual neck stabilization: Approach from the front; hold the head gently to keep the neck still.
-
04
Check for seatbelt bruising: Unbutton outer jacket to inspect chest and stomach for bruise marks.
-
05
Control glass cuts: Apply direct pressure with sterile gauze to bleeding cuts on scalp or face.
-
06
If glass particles might be in the eyes, tell the person to keep eyes closed gently without rubbing.
-
07
Keep the driver seated until paramedics arrive with a cervical collar, unless the vehicle is on fire.
PROHIBITED ACTIONS (DO NOT)
-
•
Do not allow occupants with neck or back pain to walk around roadside.
-
•
Do not rub eyes if glass powder is present.
-
•
Do not cut or tamper with undeployed airbag canisters.
-
•
Do not move patients quickly unless the vehicle is on fire or in immediate danger.
Positional asphyxia, choking on vomit in cell, or missed head injury/diabetic emergency masked by alcohol smell.
FIELD PROTOCOL (7 STEPS)
-
01
Screen for medical problems before assuming the person is only drunk.
-
02
Check pupils with penlight: Confirm they are equal and react to light.
-
03
Inspect head: Part hair to check for hidden cuts, soft spots, or bumps from a fall.
-
04
Look for medical alert tags: Check wrists, neck, and abdomen for bracelets, necklaces, or glucose monitors.
-
05
Place in recovery position: If drowsy or lying down, place on their side so they cannot choke on vomit.
-
06
Check in-custody detainees visually and verbally at least every 15 minutes under Illinois standards.
-
07
Call paramedics if the subject cannot be woken up, cannot answer simple questions, or has uneven pupils.
PROHIBITED ACTIONS (DO NOT)
-
•
Do not place an intoxicated person face down (prone) in a cell or squad car.
-
•
Do not assume alcohol odor explains unconsciousness without checking for head trauma and diabetes.
-
•
Do not leave an intoxicated detainee unmonitored.
-
•
Do not accept an unrousable person into lockup without hospital medical clearance.
Progression to heat stroke (>104°F) and organ damage if cooling is delayed.
FIELD PROTOCOL (6 STEPS)
-
01
Move immediately into shade or an air-conditioned squad car.
-
02
Remove heavy gear: Take off body armor, duty belt, helmet, and outer uniform shirt.
-
03
Lay the person down with feet elevated 8 to 12 inches.
-
04
Apply cool, wet towels or ice packs to neck, armpits, and forehead; fan continuously.
-
05
Give cool water or electrolyte drinks in small, slow sips if alert and not nauseous.
-
06
Monitor mental state: If confusion, combativeness, or hot dry skin develops, switch immediately to the Heat Stroke protocol and call paramedics.
PROHIBITED ACTIONS (DO NOT)
-
•
Do not let the person chug large amounts of water quickly (causes vomiting and stomach cramps).
-
•
Do not allow an officer or subject with heat exhaustion to return to duty in direct sun on the same shift.
-
•
Do not give ice-cold water to drink (triggers stomach cramps); use cool water.
-
•
Do not hesitate to call paramedics if symptoms do not improve after 15 minutes of cooling.
Rapidly spreading bacterial infection, tendon damage, and potential rabies exposure.
FIELD PROTOCOL (7 STEPS)
-
01
Make sure the dog or animal is securely contained before approaching the victim.
-
02
Flush puncture wounds thoroughly with sterile saline or clean running water for 5 minutes to rinse out saliva and bacteria.
-
03
Apply direct pressure with sterile gauze to control bleeding; elevate the limb if possible.
-
04
Cover wounds with clean, sterile dressings and loose bandage wrap.
-
05
Check pulse and finger/toe movement beyond the bite site.
-
06
Identify the animal owner, address, and rabies vaccination status; notify Animal Control for mandatory 10-day quarantine under Illinois law.
-
07
Advise the victim to seek medical evaluation for antibiotics and wound care.
PROHIBITED ACTIONS (DO NOT)
-
•
Do not tightly tape or seal bite puncture wounds (traps bacteria inside tissue).
-
•
Do not try to butterfly-bandage or close bite puncture wounds in the field.
-
•
Do not damage the animal's head if euthanasia is required, as brain tissue is needed for rabies testing.
-
•
Do not delay washing the wound; thorough washing is the most effective step against infection.
Swallowing large amounts of blood causes nausea, vomiting, or choking; severe blood loss in hypertensive crisis.
FIELD PROTOCOL (7 STEPS)
-
01
Have the person sit upright and lean forward slightly at the waist.
-
02
Instruct the person to breathe through their mouth and spit out blood rather than swallowing it.
-
03
Pinch the soft, lower part of the nose below the bone firmly with thumb and forefinger.
-
04
Hold unbroken pressure for 10 to 15 full minutes by the clock without releasing to check.
-
05
Place an ice pack or cold damp cloth across the bridge of the nose and back of the neck.
-
06
After 15 minutes, release gently; if bleeding has stopped, advise the person not to blow their nose or bend over for several hours.
-
07
If bleeding continues after 20 minutes of firm direct pressure, call paramedics.
PROHIBITED ACTIONS (DO NOT)
-
•
Do not tilt the head backward (causes blood to run down the throat, triggering vomiting and choking).
-
•
Do not pack dirty tissues, paper towels, or cotton balls deep into the nose.
-
•
Do not release pressure every 2 minutes to check if bleeding stopped.
-
•
Do not let the person blow their nose right after bleeding stops.
Severe asthma attack closes airways; hyperventilation causes dizziness and muscle cramping from panic.
FIELD PROTOCOL (7 STEPS)
-
01
Check if the person is wheezing (asthma) or hyperventilating with clear airflow.
-
02
Asthma care: Help the person use their prescribed rescue inhaler (Albuterol — 2 puffs, spaced 1 minute apart).
-
03
Asthma position: Have the person sit upright leaning forward with hands on knees (tripod position) to help breathing.
-
04
Hyperventilation coaching: Use a calm, steady voice; make eye contact.
-
05
Box breathing exercise: 'Breathe in through your nose for 4 seconds... hold for 4 seconds... breathe out through your mouth for 4 seconds... hold for 4 seconds.'
-
06
Have the person cup their hands loosely over mouth and nose to safely rebreathe carbon dioxide.
-
07
Call paramedics immediately if an asthma attack fails to improve after using an inhaler or if breath sounds go silent.
PROHIBITED ACTIONS (DO NOT)
-
•
Do not have the person breathe into a paper bag (if the person actually has asthma or heart trouble, a paper bag causes dangerous oxygen loss).
-
•
Do not tell a hyperventilating person to 'just calm down'; use structured breathing counts instead.
-
•
Do not make an asthmatic patient lie flat on their back.
-
•
Do not give another person's inhaler if the subject is not prescribed one.