Someone Collapsed: What to Do Step by Step

Watching someone collapse triggers a rush of adrenaline that can make even simple actions feel impossible. This guide walks you through the exact sequence recommended by the American Heart Association's Chain of Survival concept: recognize the emergency, call for help, start CPR, and use an AED, in that order. No equipment or certification is required to begin. That said, knowing basic CPR and AED use, the kind of skill built in a certified CPR course, makes each step feel far less overwhelming when it actually counts.

Step 1: Check the Scene Before You Approach

Before you take a single step toward the person on the ground, take three seconds to scan your surroundings. Is there traffic nearby? Downed power lines? Smoke, fire, or a leaking chemical smell? Is there an aggressive dog or an unstable crowd? Your instinct will be to run straight to the person, but a rescuer who becomes a second casualty helps no one and complicates the response for everyone else.

This step matters most in situations people don't expect, like a collapse near a busy road, a pool deck, a construction site, or a parking lot. If you spot a hazard, address it or route around it first. That might mean asking a bystander to redirect traffic, shutting off a piece of machinery, or simply approaching from a different angle. If the danger can't be controlled quickly, call 911 and describe the hazard so responders can bring the right equipment and personnel to secure the area before anyone goes in.

A common mistake is treating this check as optional because the person needs help "right now." In reality, this scan takes only a moment and prevents the kind of split-second injury that turns one emergency into two. Rescuers have been struck by cars, electrocuted, or pulled into dangerous water because they skipped this step in the rush to help. Slowing down for three seconds is not a delay in care, it is the first part of care.

Once you've confirmed the area is safe, or made it safe enough to approach, move in calmly. Note anything unusual near the person, such as medication bottles, a wet floor, or signs of a fall from height, since this information will be useful when you talk to 911 and later to paramedics. This initial read of the scene sets up everything that follows.

Step 2: Check Responsiveness and Breathing

Once you're safely at the person's side, kneel next to them and check for responsiveness. Tap their shoulder firmly, using more pressure than feels polite, and shout their name if you know it, or simply say, "Are you okay?" loudly and directly. You're looking for any purposeful response: eyes opening, a groan, movement toward you, or an attempt to speak. Unresponsive means none of that happens. No movement, no eye opening, no reaction to your voice or touch, even with a firm shake.

Next, check breathing. Look at the chest and stomach for 5 to 10 seconds, no longer, watching for the rise and fall of normal breathing. This is a step people frequently rush or misjudge. If the person is making occasional gasping sounds, gulping, or snorting noises that don't look like steady, regular breathing, that's a red flag rather than reassurance. This pattern is called agonal breathing, and it's actually a sign of cardiac arrest, not a sign that someone is fine. Agonal breaths are irregular, often slow, and can sound like snoring or gasping. They are not normal breathing, and they should be treated the same as no breathing at all.

If the person is unresponsive and breathing normally, keep monitoring them closely while you get help on the way, since their condition can change quickly. If they are unresponsive and not breathing normally, or you're not sure, treat it as cardiac arrest and move immediately to the next steps. Hesitating here to "make sure" costs valuable time. When in doubt, assume the worst-case scenario and act. Every guideline used by EMS and taught in CPR courses agrees on this point: it is far better to start CPR on someone who didn't strictly need it than to withhold it from someone who did.

Step 3: Call 911 Immediately

The moment you've determined the person is unresponsive, get emergency services on the line, but do it the right way. If other people are nearby, don't just yell "someone call 911." In a crowd, everyone tends to assume someone else has already made the call, a well-documented phenomenon known as the bystander effect. Instead, point at one specific person and say clearly, "You, in the blue shirt, call 911 now." That direct instruction removes the ambiguity and makes it far more likely the call actually happens.

If you're alone with the person, make the call yourself and put your phone on speaker immediately. This frees your hands for the next steps and lets the dispatcher walk you through CPR instructions in real time if you need them. Dispatchers are trained to guide untrained callers through compressions step by step, so don't hang up once you've given the basics.

When you or your assigned bystander connects with the dispatcher, give the key facts quickly: your exact location (street address, floor, or landmark if outdoors), what happened as best you understand it, and whether the person is breathing normally. Answer the dispatcher's follow-up questions honestly and stay on the line unless instructed otherwise. This call sets the entire emergency response in motion, and getting it right in the first ten seconds saves time later.

Step 4: Send Someone for an AED

If the person is not breathing normally, an automated external defibrillator, or AED, needs to get to the scene as fast as possible. If you have a second bystander available, send them to find one immediately while you stay with the person and begin CPR. AEDs are increasingly common in public spaces, mounted on walls in gyms, offices, schools, airports, malls, and community centers, often marked with a green or red sign showing a heart with a lightning bolt.

Tell the bystander clearly what they're looking for and to bring it back as fast as possible, even if that means checking with a front desk or security office along the way. If they've never used an AED, reassure them: these devices are built for untrained rescuers. Once turned on, an AED gives step-by-step voice prompts that walk anyone through pad placement and operation, no prior experience needed.

If you're alone with the person, your priority order is different. Call 911 first, since getting professional help en route matters most. After that call is made, start CPR right away rather than leaving the person to search for an AED yourself. Chest compressions started immediately are more valuable than a slight delay while you locate a device, and CPR should not stop for an extended AED search when no one else is around to help. If you happen to know an AED is within a few steps, a quick grab is reasonable, but don't wander far or lose critical compression time. The general rule taught in CPR and BLS courses is simple: get compressions going, and let the AED join the effort as soon as it physically can.

Step 5: Start CPR If There Is No Normal Breathing

With 911 called and, ideally, someone en route with an AED, begin chest compressions without delay. Position yourself beside the person, place the heel of one hand in the center of their chest (on the lower half of the breastbone), and place your other hand on top, interlocking your fingers. Position your shoulders directly over your hands and keep your arms straight.

Push hard and fast. Current guidance from the American Heart Association calls for a compression rate of 100 to 120 per minute, which is roughly the tempo of the Bee Gees song "Stayin' Alive," a reference point that's stuck around in CPR training for years because it works. Aim for a compression depth of at least 2 inches on an adult, and let the chest fully recoil, or rise back up, between each push. Since guidelines are periodically reviewed, it's worth confirming current depth and rate recommendations through an updated CPR course or the AHA's own materials.

One of the most common mistakes untrained rescuers make is pushing too gently out of fear of hurting the person. Broken ribs are a known, accepted risk of effective CPR and are far preferable to the alternative. Another common error is stopping compressions to check for a pulse. Untrained bystanders should not pause to hunt for a pulse at all: if the person is unresponsive and not breathing normally, keep compressing continuously until an AED arrives or paramedics take over.

If you have no CPR training, focus entirely on continuous, hard, fast compressions. This is often called hands-only CPR, and it's effective and simpler to sustain under stress. If you are trained in CPR, you can add rescue breaths at a ratio of 30 compressions to 2 breaths, tilting the head back slightly, lifting the chin, and giving two breaths that make the chest visibly rise. Don't let the search for perfect technique slow you down. Imperfect compressions delivered immediately beat perfect technique delivered late.

Step 6: Use the AED as Soon as It Arrives

When the AED reaches you, turn it on right away, most units power on with a single button and immediately begin speaking instructions aloud. Follow those voice prompts exactly, even if you feel unsure. The device is designed for lay rescuers and will tell you precisely where to place the adhesive pads, typically one on the upper right chest and one on the lower left side of the ribs. Diagrams on the pads themselves usually reinforce the placement.

Once the pads are attached, the AED will begin analyzing the person's heart rhythm. This is the one moment you need to stop chest compressions completely and make sure no one, including you, is touching the person. Say "clear" loudly so bystanders know to step back. The device will determine whether a shock is needed and will either prompt you to press a shock button or announce that no shock is advised.

If a shock is delivered, resume chest compressions immediately afterward. Don't pause to check for breathing or a pulse first, the AED and CPR work together as a cycle, not a sequence of stops and starts. If the AED advises no shock is needed, resume compressions right away as well, since "no shock advised" doesn't mean the person is fine, it means the current heart rhythm isn't one the device treats with electricity at that moment. Most AEDs will automatically prompt another analysis after a set interval, usually around two minutes, so keep working until it tells you to stop again. Trust the machine's prompts over your own uncertainty. It's reading the heart's electrical activity in a way you can't do by looking at the person.

Step 7: Continue Care Until Help Arrives or the Person Responds

Keep the cycle going: compressions, AED analysis, shock or no shock, compressions again. Don't stop to reassess unless the AED prompts you to or the person shows clear signs of recovery. If other trained rescuers are present, switch who's doing compressions roughly every two minutes. Fatigue sets in faster than people expect, and tired rescuers tend to push shallower without realizing it, which reduces the effectiveness of CPR even though it looks the same from the outside.

If at any point the person begins breathing normally on their own, opens their eyes, or starts moving purposefully, stop compressions and reassess. If they're breathing normally but still not fully alert, gently roll them onto their side into the recovery position: bend the knee closest to you, tuck their near arm under their head for support, and roll them toward you so their body is stable on its side. This position keeps the airway clear and lets fluids drain away rather than pool in the throat. Stay close and monitor their breathing continuously until paramedics arrive, since people can deteriorate again even after showing signs of improvement.

When EMS arrives, give a clear, concise handoff. Tell them approximately when the person collapsed, how long CPR was performed, how many shocks the AED delivered, and any changes you observed along the way, such as the person briefly regaining consciousness. This information helps paramedics pick up care without losing time repeating steps you've already completed.

Building the Skills Before You Need Them

Reading through these steps is a strong start, but real confidence comes from practicing them with your hands, on a mannequin, under guidance, before an actual emergency puts you on the spot. Muscle memory built in a training room translates directly into faster, steadier action when adrenaline is running high and seconds matter. Taylored Instruction offers hands-on CPR, BLS, and AED certification courses through both the American Red Cross and the American Heart Association, so you can train under whichever standard your workplace, license, or personal preference requires.

Don't wait until an emergency happens, get the life-saving certification you need today. Register for a CPR, First Aid, or Lifeguarding class and gain the confidence and skills to respond when it matters most.