ILS Care Library

Part 2 · Health and medication

Warning signs: when to call emergency services

Content under professional review before publication.

1Recognizing a stroke: the quick test

The problem

In a stroke, every minute counts: the treatment that prevents permanent damage has a window of only a few hours. Recognizing it quickly and calling right away is what changes the outcome.

What is happening underneath

A stroke comes on suddenly. There is a quick, easy-to-remember test that checks five things. If any one fails, even just one, call emergency services immediately.

Step by step

  1. Balance: did they suddenly lose their balance or have trouble walking?
  2. Eyes: did their vision suddenly go or blur, in one or both eyes?
  3. Face: ask them to smile. Does one side of the face droop?
  4. Arms: ask them to raise both arms. Does one drift down or can they not lift it?
  5. Speech: ask them to repeat a simple sentence. Is speech slurred or unable to come out?

Time: if any of these signs appears, even if it then goes away, call emergency services now. Note the time the symptoms started: that detail helps the doctor choose the treatment.

What you must never do

  • Never wait to see if it passes: in a stroke, lost time is damage.
  • Never drive them to the hospital yourself: call the ambulance, which starts treating on the way.
  • Never give them food, drink, or medication while you wait.

When to ask for help

At any of these signs, call your country's emergency number immediately. Even if the symptoms last only briefly and disappear, you still have to get them checked: it may have been a warning of something more serious.

2Recognizing a heart attack and cardiac arrest

The problem

A heart attack is not always the chest-clutching of the movies. In older adults, in women, and in people with diabetes, the signs can be mild or unusual, and so they get ignored.

What is happening underneath

A heart attack is a lack of blood to the heart. The classic signs and the mild ones count the same: when in doubt, call. If the heart stops (cardiac arrest), the person collapses and stops responding: there, every second counts.

Step by step

  1. Heart attack signs: chest discomfort (pressure, tightness, heaviness, or pain) lasting more than a few minutes or coming and going; pain spreading to the arm, the back, the neck, the jaw, or the pit of the stomach; shortness of breath; cold sweat, nausea, or dizziness.
  2. In older adults, women, and people with diabetes, there may be only unusual fatigue, shortness of breath, or nausea, with no chest pain. Take it seriously all the same.
  3. At those signs, call emergency services immediately. Do not drive them yourself or wait to see if it improves.
  4. Do not give aspirin or any other medication on your own: only if emergency staff or the doctor tell you to.
  5. Cardiac arrest: if the person collapses, does not respond, and is not breathing normally, call emergency services right away. The person answering the phone can guide you step by step until the ambulance arrives.

What you must never do

  • Never minimize mild signs in an older adult: they may be a heart attack all the same.
  • Never drive them to the hospital yourself in a possible heart attack or cardiac arrest: call the ambulance.
  • Never give medication on your own while you wait.

When to ask for help

Call emergency services at any suspicion of a heart attack or cardiac arrest. And do yourself a favor: taking a first-aid and CPR course prepares you for those minutes when help is still on the way.

3Other emergencies and what to do while help arrives

The problem

There are other situations that also do not wait, and in all of them the first step is the same: call emergency services and stay with the person until help arrives.

What is happening underneath

In an emergency, what you do in the first minutes matters, but doing too much can harm. Almost always the best thing is to call, stay calm, and not move or give anything on your own.

Step by step

  1. Call emergency services immediately at: severe difficulty breathing, bleeding that will not stop, an allergic reaction with swelling of the face or throat, a person who does not respond, a seizure, or choking that does not resolve (see the feeding chapter).
  2. Also at a fall with a head hit or a suspected fracture (see the chapter "After a fall").
  3. While you wait: stay with the person, speak calmly, loosen tight clothing, and keep them warm and comfortable where they are.
  4. Do not give them food, drink, or medication, unless emergency services tell you to.
  5. Have the medication list and the health conditions within reach (the emergency folder from the medication chapter), and leave the door unlocked so the ambulance can get in quickly.

What you must never do

  • Never hesitate to call for fear of being a bother: it is better to be evaluated than to have help arrive too late.
  • Never move the person if you suspect a spinal injury or a fracture.
  • Never give food, drink, or medicines while you wait, unless instructed.

When to ask for help

The simple rule: when in doubt, call. Emergency staff would rather take a call that turns out to be nothing than have help arrive too late.

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