STEPS TO EMERGENCY EVALUATION OF AN INJURED PERSON

Check for responsiveness

Establish whether the victim is conscious by gently shaking him and asking "Are you O.K.?" (Take care not to move his neck or shoulders, which could result in paralysis is he has sustained an injury to his spine.)

Call for help

If there are other people within yelling distance, yell loudly for someone to call 911. If no one is nearby, you may have to make the difficult decision of when it is best to temporarily abandon resuscitationefforts in order to summon help. If possible, put your cell phone on "speaker" and dial 911 while you continuebresuscitation efforts. If no cell phone is available, quickly search the surrounding area for a land line. If a phone is not visible, it is best to continue resuscitation efforts for a few minutes, while intermittently yelling for help and scanning the landscape for possible phone locations.

Reposition

Whenever possible, carefully position the unconscious person so that he is lying on his back and on a firm surface. It is essential to avoid moving the victim any more than absolutely necessary, as any neck or spinal injuries may easily be exacerbated by further movement. If a victim isn't breathing, he must be placed in a supine position in order to facilitate airway evaluation and breathing rescue. Repositioning must be done with the utmost care, in order to avoid twisting of the neck or back. He should be moved "as a unit"--in other words, the head, neck and back should be repositioned together, in a single, smooth, rolling motion, as detailed below:

1. Straighten the victim's legs. Take the victim's arm that is nearest to you and move it so that it is straight and above his head. Repeat procedure for the other arm.

2. Kneel beside the victim with your knees near his shoulders (leave space to roll his body).

3. Place one hand behind his head and neck for support. With your other hand, grasp the victim under his far arm.

4. Roll the victim toward you using a steady and even pull. His head and neck should stay in line with his back.

5. Return the victim's arms to his side. Straighten his legs. Reposition yourself so that you are now kneeling at the level of the victim's shoulders.

6. If a neck injury is suspected, and the jaw thrust will be used, kneel at the victim's head, looking toward his feet.