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First aid in an emergency situation

16.07.2025

First aid for injured persons is based on the priority principle. One of the most important measures, and one that everyone should and can carry out, is to call for professional help – in other words, to make an emergency call. It is also important to maintain the patient’s circulation and, if necessary, treat injuries until the emergency services arrive. The cABCDE scheme helps us to do this. It is a strategy for systematically providing first aid to an injured person.

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01

Principles of first aid

If you observe an accident or come across an injured person, the first thing you do is get an overview. Your own safety is always the top priority. Right from the start, this includes securing the scene of the accident and making it recognizable in order to prevent subsequent accidents. It is important to realistically assess the hazardous situation. Before you act, take 10 seconds to plan the next 10 minutes (“10 for 10”). After that, don’t get distracted and stick to your structure. If the situation at the accident site changes, for example due to the time of day, weather conditions or resources, reassess the safety and situation. It is a good idea to carry out another “10 for 10” in order to recognize the new situation and act accordingly.

Communication is an important part of first aid. Share information with the other helpers, with the injured person and, if necessary, with the control centre (the organized rescue). It makes sense for one person to take charge and coordinate tasks. As a general rule, the sooner professional help arrives, the better. So make an emergency call as early as possible.

© snow institute
© snow institute
02

First contact

If there is no danger to your own safety, approach the injured person and make contact with them. Approach the injured person from the front if possible, touch them carefully and say: “Hello, what happened?” – This will give you a first impression of whether the person is at all responsive, whether they have neurological deficits and whether and where they are in pain.

03

Emergency call

When the emergency call is made depends on the situation. Please note: The earlier an emergency call is made, the faster professional help will be on site. It is advisable to use the hands-free function on your cell phone or a headset so that you can continue to attend to the injured person at the same time.

Ideally, you should have saved the local emergency numbers or, even better, a regional emergency app on your smartphone.

Before you make an emergency call, however, you should briefly think about the following things in order to be able to answer the control center’s questions:

  • Where is the scene of the accident? For example: Nordkette ski area, two-person descent on the Ziehweg directly below the valley station of the 3-seater chairlift.
  • What has happened? For example: A 30-year-old female skier lies on the slope after a fall, complains of pain in her knee joint and can no longer get up.

Once you have dialed the emergency number, the call taker (dispatcher) follows a program that guides you through the relevant questions. If something is unclear, you will be asked further relevant questions and the person from the control center will always remain a contact person for further (first aid) measures.

If no contact via cell phone is possible (e.g. no network, no battery) and you are alone with the person involved in the accident, you must call for help immediately. Some rucksacks have a small whistle on the chest strap, which is a good and loud way of drawing attention to yourself.

If it is not possible to make an emergency call from the accident site, you or someone in your group/a passing winter sports enthusiast must call for help. In the ski area, go to the nearest lift or rest station and let them know that the piste rescue service is needed. All ski resorts have a piste rescue service that is on site and arrives quickly at the scene of the accident with skis or a snowmobile.

© snow institute
© snow institute

In most European countries, the international emergency number 112 (Euro emergency number) is the number you can dial in any emergency to alert the emergency services. The best way to reach 112 abroad is with your telephone (or your network card provider).

In Austria, 112 also works, but in addition and better for emergencies in alpine terrain – including emergencies on the ski slope – is the alpine emergency number 140. In addition, there are often local telephone numbers, e.g. piste rescue, cable car, etc., with which you can alert help even faster and more directly in the respective ski area.

In Switzerland, there is the Rega emergency number, which can be reached via 1414 (but only with a SIM card from Switzerland).

Regional emergency call apps:

If you make an emergency call via an emergency app, your pre-stored personal data and your location (coordinates) will be sent automatically. For Austria, Bavaria and South Tyrol, “SOS EU ALP” is the emergency app to use, the “144 Rettung” app from Notruf NÖ works throughout Austria and in Switzerland you can alert the emergency services directly with the “Rega” app.

04

Primary care

The cABCDE scheme is like a recipe for an emergency. It is an internationally recommended procedure that is structured according to the urgency of the vital functions and helps you not to forget anything in a stressful situation.

The aim of the structured procedure of the cABCDE scheme is to quickly recognize life-threatening conditions and react accordingly. The first three steps (ABC) are used to check the vital functions of the human body: Airway, breathing and circulation. Only if the check of these functions yields a positive result do we continue with steps D and E.

© snow institute
© snow institute

TAKE AWAY: First aid is administered according to the priority principle. This means that you follow the motto "treat first what kills first" and treat the injured person according to urgency. Unrestricted breathing is more important than positioning a broken leg correctly. At the same time, it does not make sense to start resuscitation in the event of circulatory arrest if the person is also bleeding in a life-threatening manner.

The individual letters stand for the following measures:

c (critical bleeding) – life-threatening bleeding

Severe external bleeding should be stopped first. However, only life-threatening and easily accessible bleeding should be treated. A cut from a ski or snowboard edge is a recurring theme in this context. If a lot of blood gushes or spurts out of a wound, it must be squeezed immediately or treated with a pressure bandage.

If there is no severe bleeding or you have treated it, it is important to check the vital bodily functions as quickly as possible or take measures to restore them.

A (Airway) – airways

The next question is whether the airways are clear. After looking into the oral cavity, it should be cleared if necessary. The head is then extended so that the tongue is lifted from the pharyngeal wall, thus clearing the airway. These activities are only relevant for people who are unresponsive, unconscious or unconscious. If the person is awake and responsive, these measures are not necessary.

  • Airways clear? No – then clear the oral cavity!
cABCDE - Scheme: Checking and clearing the airways © snow institute
cABCDE - Scheme: Checking and clearing the airways © snow institute

B (Breathing) – Breathing

What does breathing look like? Normal breathing is regular and noiseless. However, if you hear noises when breathing, this indicates that the person is having difficulty breathing. Positioning with the upper body elevated can improve the situation.

If you see a blue coloration on the face and/or no breathing, this may indicate respiratory arrest. Caution: To check the breathing of an unconscious person, you must hold their head up and then check their breathing by sight/hearing/feeling. Allow at least ten seconds to do this. If you suspect a respiratory arrest, start resuscitation immediately: 30 chest compressions and 2 breaths in regular succession.

  • Are you breathing? No – then start resuscitation!

cABCDE - Scheme: Breathing control ‘see - hear - feel’ © snow institute
cABCDE - Scheme: Breathing control ‘see - hear - feel’ © snow institute

C (Circulation) – Circulation

Once the airway and breathing have been secured, take care of the injured person’s circulation. Make sure, as far as possible, that there is no internal bleeding. Bleeding in the chest, abdomen, pelvis or thighs can be fatal. Palpate these areas with a firm grip and check whether the casualty reacts with pain.

Skin pallor and a poor general condition indicate a circulatory problem and the person is in a state of shock.

cABCDE - Scheme: Performing a body check © snow institute
cABCDE - Scheme: Performing a body check © snow institute

D (Disability) – Neurology deficit

A neurological deficit refers to injuries to the skull and spine. If something is squeezed or nerves are severed in this area, this can have serious consequences.

If the injured person does not feel any tingling in their arms and legs, can move their extremities without any abnormalities (motor function), perceives touch (sensory function) and can turn their head without difficulty, then a spinal injury is rather unlikely. If, on the other hand, anything appears abnormal in the body regions mentioned, do not move the person if possible.

Nausea, vomiting and loss of consciousness may indicate bleeding in the head or a concussion (craniocerebral trauma). In such a case, it is recommended to keep the upper body elevated.

  • Does the injured person have a head injury?

  • Is the injured person oriented, knows what has happened, where they are, etc.?

  • Are there any restrictions in the motor/sensory system?

cABCDE - Scheme: Check motor skills, sensory skills, orientation © snow institute
cABCDE - Scheme: Check motor skills, sensory skills, orientation © snow institute

E (Exposure) – final examination

The last step in the cABCDE scheme is to check the whole body for other injuries and treat them if possible. In doing so, run your hands over the injured person’s entire body and try to optimize positioning if there are any problems. Most casualties adopt the most comfortable position for themselves after the accident. In this case, you only need to support the person.

Heat preservation

Make sure you keep warm at an early stage. To do this, use the available clothing (hats, jackets, scarves, etc.) as well as the bivouac sack and rescue blankets to protect the patient from further cooling. Keep a constant eye on the status so that you can intervene immediately if necessary. If the condition changes, start again at A.

Injured persons (especially if unconscious) cool down very quickly. Cold has a negative effect on circulation and blood clotting. The colder the patient becomes, the thinner the blood and the worse the circulation. Maintaining warmth is a very important measure to prevent this.

The rescue blanket is an extremely effective aid to minimize further cooling. The rescue blanket reflects around 90 percent of the body’s own heat radiation and the injured person warms themselves up with their own warmth. The blanket also offers protection from wind and moisture.

Which side of the rescue blanket (gold or silver) is turned towards the injured person is irrelevant. However, the gold side of the rescue blanket has an advantage – it can be seen from a distance, which can make it easier for the rescue team to find. It is best to place the rescue blanket over the bottom layer of clothing. This way it is well secured, protected and most effective in terms of warmth.

cABCDE - Scheme: showing empathy, pain-reducing positioning, heat preservation © snow institute
cABCDE - Scheme: showing empathy, pain-reducing positioning, heat preservation © snow institute

Different positions for pain

Frequent injuries affect the shoulder area and/or the extremities (arms/legs). An improvised splint can be created using various materials. Placing a jacket or rucksack underneath or shaping snow are also good ways of immobilizing injured body parts as much as possible.

If a vertebral injury is suspected because the injured person has tingling or numbness in their arms or legs or is unable to move them, the injured person should not be moved if possible, unless they are unconscious or severely unconscious (see recovery position).

  • Positioning with raised upper body

If the casualty complains of nausea or dizziness after a fall, appears confused or even vomits, this indicates a possible head injury. In this case, the patient should be positioned with their upper body elevated or in a sitting position. In general, this position is recommended for all problems from the chest upwards (e.g. chest injuries, breathing problems, heart attacks and head injuries).

  • Positioning with raised legs

For patients with severely impaired circulation, elevating the legs can improve the circulatory situation. To do this, the patient is positioned flat on their broad ridge with their legs elevated.

  • Stable lateral position

Unconscious or severely unconscious persons are placed in the recovery position. This is to keep the airways open and to protect the patient from aspiration (vomit or blood getting into the lungs). As spinal trauma often cannot be ruled out, the injured person must be placed in the recovery position in an axial position, i.e. without twisting the spine.

The first step is to move the injured person’s knee to the hand on the same side without moving the spine. Then the person is turned onto their side in an axial position. Finally, the mouth is opened and turned towards the floor so that secretions can drain away.

It is often helpful to support the head of the injured person by placing the upper hand underneath it.

04

Conclusion: Preparation for emergency situations

Everyone is capable of caring for an injured person to a certain extent. These measures include: Securing the accident site, making an emergency call, positioning the injured person correctly, maintaining warmth and empathy. Carrying out further first aid measures, such as treating injuries, requires practice and regular training in a stressful situation. It is advisable to run through scenarios with the complete first aid procedure until the emergency services arrive and to memorize structured procedures in this way.

Cover picture: © snow institute | argonaut.pro

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