Checking responsiveness is the critical first assessment when determining if someone needs basic life support (BLS) or CPR. This essential step in the DRSABCD action plan confirms whether a casualty is conscious and able to respond, guiding your first aid response and potentially saving a life. Whether you’re at home, on the sports field or in your workplace, proper assessment of responsiveness is the foundation of effective emergency care before professional help arrives.
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Key Takeaways
- Checking responsiveness is the “R” in the Australian DRSABCD protocol (Danger, Response, Send for help, Airway, Breathing, CPR, Defibrillation)
- Use both verbal and tactile stimuli to assess responsiveness properly
- If there’s no response, immediately send for help by calling Triple Zero (000)
- In workplaces, regular first aid training that includes responsiveness assessment is required by Safe Work Australia
- Different industries have specific considerations when checking responsiveness
- When a casualty is unresponsive, proceed to check their airway and breathing before starting CPR if necessary
How to Check Responsiveness: DRSABCD Protocol
The DRSABCD action plan forms the foundation of adult basic life support in Australia. After checking for danger, assessing responsiveness is your critical next step. Proper assessment helps determine whether to proceed with further first aid measures, including whether you need to perform CPR.
Proper Technique for Checking Responsiveness
Interactive First Aid Training Module
When assessing a casualty, checking responsiveness is a critical first step. This process helps determine the level of consciousness and guides your next actions in providing first aid.
Key Principles:
- Always approach safely and calmly
- Use both verbal and tactile stimuli
- Be gentle but firm in your approach
- Never cause additional harm
Position yourself close to the casualty and speak in a loud, commanding voice.
- "Can you hear me?"
- "What's your name?"
- "Can you tell me where you are?"
Use a loud, commanding voice but avoid shouting directly into their ear, which could cause discomfort or hearing damage.
Use tactile stimulus only if there's no response to verbal questions.
Place your hands on the casualty's shoulders and gently squeeze whilst continuing to speak to them.
For children, tap the bottom of their foot instead of squeezing shoulders, as this is often more effective and less intimidating.
Remember the Sequence:
- Verbal First: Speak loudly and ask open questions
- Wait for Response: Give the casualty time to process
- Tactile Second: Gently squeeze shoulders (or tap foot for children)
- Assess Response: Determine level of consciousness
Key Safety Points:
- Never shake vigorously
- Be especially careful with suspected head/spine injuries
- Use appropriate techniques for different age groups
- Always prioritise casualty safety
Practice this technique regularly to ensure confidence in emergency situations.
Common Mistakes When Checking Responsiveness
| Common Mistake | Correct Approach |
|---|---|
| Whispering or speaking too quietly | Use a loud, clear voice |
| Shaking the casualty vigorously | Gently squeeze shoulders |
| Painful stimuli (pinching, pressing sternum) | Avoid causing pain - gentle shoulder squeeze is sufficient |
| Skipping verbal assessment | Always start with verbal before tactile |
| Moving the casualty unnecessarily | Assess in the position found if safe to do so |
The Australian Resuscitation Council Guidelines emphasise checking responsiveness before proceeding to airway assessment and checking for breathing. Without confirming unresponsiveness first, you may unnecessarily expose casualties to invasive procedures like CPR.
DRSABCD Check for Danger and Response Steps
The interconnection between checking for danger and checking for responsiveness cannot be overstated, especially in high-risk workplaces. Rushing to help without ensuring scene safety may result in multiple casualties.
Safe Approach to Casualties in Workplace Settings
- Visual danger assessment:
- Scan the environment for hazards (fire, electricity, chemicals, unstable structures)
- Look for mechanisms of injury (fallen ladders, machinery, vehicles)
- Assess for environmental risks (confined spaces, heights, water)
- Transition to response checking:
- Only approach when safe to do so
- Maintain awareness of surroundings while checking responsiveness
- Use appropriate personal protective equipment (PPE) if available
- Industry-specific danger considerations:
- Construction: Falling objects, unstable structures, electrical hazards
- Manufacturing: Machinery entrapment, chemical exposure, moving equipment
- Mining: Gas pockets, unstable ground, heavy equipment
- Healthcare: Bodily fluids, aggressive patients, sharps
If the scene is unsafe and cannot be made safe quickly, call emergency services (000) immediately and do not approach. Your safety as a first responder is paramount.
Australian Workplace First Aid Training DRSABCD Protocol
Australian workplaces must comply with specific requirements regarding first aid training and facilities as outlined by Safe Work Australia.
Workplace Compliance Requirements
Under the Work Health and Safety Regulations, employers must:
- Ensure adequate first aid equipment is accessible
- Provide access to facilities for administering first aid
- Ensure sufficient trained personnel are available
- Consider workplace-specific risks when determining first aid requirements
The Australian DRSABCD protocol has been adopted nationwide as the standard approach to basic life support and forms the core of workplace first aid training.
Ensure your workplace meets compliance requirements with CPR First Aid Professionals by FirstAidPro’s specialised workplace first aid training programs. Contact us to arrange corporate training tailored to your industry’s specific needs.
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How to Perform the Response Check in DRSABCD Properly
Detailed Response Assessment Techniques
When performing the checking responsiveness step according to Australian standards:
- Initial approach:
- Position yourself at the casualty’s shoulders
- Kneel beside them for stability
- Ensure you can observe their face and chest
- Verbal assessment (COWS technique):
- Can you hear me?
- Open your eyes
- What’s your name?
- Squeeze my hand
- Physical assessment:
- Place your hands firmly on both shoulders
- Apply gentle but firm pressure
- Look for any movement, eye opening, or verbal response
- Interpretation of responses:
Response Type | Meaning | Next Action |
Alert | Fully conscious | Assess for injuries, provide appropriate care |
Voice | Responds to verbal stimuli only | Continue assessment, monitor closely |
Pain | Responds only to tactile stimuli | Send for help, prepare for airway assessment |
Unresponsive | No response to voice or touch | Call 000, begin DRSABCD sequence |
DRSABCD Response Check
Interactive Training Module - Australian Standards
Click each step to mark as completed:
Click each component of the COWS technique:
| Response Type | Meaning | Next Action |
|---|---|---|
| Alert | Fully conscious | Assess for injuries, provide appropriate care |
| Voice | Responds to verbal stimuli only | Continue assessment, monitor closely |
| Pain | Responds only to tactile stimuli | Send for help, prepare for airway assessment |
| Unresponsive | No response to voice or touch | Call 000, begin DRSABCD sequence |
Test your knowledge with these scenarios:
Response Type: Pain response
Action Required: Send for help immediately and prepare for airway assessment as they are showing signs of altered consciousness.
Response Type: Alert
Action Required: Assess for injuries and provide appropriate first aid care whilst monitoring their condition.
Response Type: Unresponsive
Action Required: Immediately call 000 and begin the full DRSABCD emergency sequence.
Documentation of Response Assessment
For workplace incidents, documenting the initial response assessment is crucial:
- Note the exact time of assessment
- Record the specific responses observed
- Document any changes in responsiveness during care
- Include assessment details in incident reports
- Use the AVPU scale (Alert, Voice, Pain, Unresponsive) for standardised documentation
This documentation is valuable for emergency services and can have important implications for workplace incident investigations and insurance claims.
Safe Work Australia First Aid Requirements
Safe Work Australia provides specific guidance on first aid requirements for employers.
Legal Obligations for Employers
The Model Work Health and Safety Regulations require persons conducting a business or undertaking (PCBUs) to:
- Provide first aid equipment and ensure it is maintained
- Ensure access to facilities for administering first aid
- Ensure adequate number of workers trained to administer first aid
Industry-Specific Requirements
First aid requirements vary based on workplace risk levels:
Industry | Risk Level | First Aid Provision Requirements |
Office environments | Low risk | Minimum 1:50 ratio of first aiders to staff |
Retail | Low-medium risk | Minimum 1:50 ratio of first aiders to staff |
Manufacturing | Medium-high risk | Minimum 1:25 ratio of first aiders to staff |
Construction | High risk | Minimum 1:25 ratio of first aiders, additional trauma training |
Mining | Very high risk | Minimum 1:10 ratio, advanced first aid training |
Remote work | Variable | Additional equipment, satellite communication, extended care training |
Documentation Requirements
Safe Work Australia requires:
- Records of all workplace incidents requiring first aid
- Training records for workplace first aiders
- Regular inspections of first aid equipment and facilities
- First aid risk assessments
- First aid response plans
These records must be maintained for at least 5 years and may be requested during workplace safety inspections.
Checking for Response in Unconscious Casualty First Aid
Distinguishing Unconsciousness from Unresponsiveness
While often used interchangeably, unconsciousness and unresponsiveness have distinct clinical meanings:
- Unconsciousness: A state of being unaware of surroundings and unable to respond to stimuli due to interrupted brain function
- Unresponsiveness: The observable symptom of not responding to stimuli, which may be caused by unconsciousness or other factors
For first aid purposes, we assess responsiveness because it’s observable, whereas unconsciousness is a clinical state.
Transition from Response Check to Airway Assessment
Once you’ve determined a casualty is unresponsive:
- Call for help immediately or ask a bystander to call 000
- Roll the casualty onto their back if they aren’t already
- Open their airway:
- Place one hand on their forehead
- Use two fingers of your other hand under the chin
- Gently tilt their head back to open their mouth and airway
- For children, maintain a neutral position
- Check for breathing by looking for chest rise, listening for breath sounds, and feeling for air on your cheek for 10 seconds
Timeline and Urgency Considerations
Timing is critical when managing an unresponsive casualty:
- Brain damage can begin within 4-6 minutes without oxygen
- Call 000 as soon as unresponsiveness is confirmed
- Begin CPR immediately if the casualty is not breathing normally
- Apply an Automated External Defibrillator (AED) as soon as available
- Continue CPR until emergency services arrive or the casualty shows signs of life
Australian First Aid Guidelines for Unresponsive Patients
Australian Resuscitation Council Guidelines
The Australian Resuscitation Council (ARC) publishes guidelines that inform all first aid practices in Australia, including response assessment protocols.
Key recommendations for checking responsiveness include:
- Use the DRSABCD sequence to check responsiveness
- Assess using touch and voice
- Avoid painful stimuli for response checking
- Ensure complete assessment before proceeding to airway checks
- Reassess responsiveness regularly while providing care
Latest Updates to Assessment Protocols
Recent updates to ARC guidelines emphasise:
- The importance of early defibrillation
- Prioritising chest compressions in CPR
- Using mobile phones to call emergency services while remaining with the casualty
- Modified approaches for pandemic conditions: Hands only CPR
- Simplified assessment techniques for lay responders
Evidence-Based Best Practices
Current best practices based on research evidence include:
First Aid Training for Unresponsive Casualty Assessment
Training Exercises for Response Assessment
Effective training for response assessment includes:
- Scenario-based learning:
- Realistic workplace simulations
- Various casualty presentations
- Different environmental challenges
- Skills practice:
- Proper verbal questioning techniques
- Appropriate touch stimulus
- Correct positioning of rescuer and casualty
- Decision-making exercises:
- When to call for help
- How to delegate tasks to bystanders
- Determining next steps based on assessment findings
Ready to master these vital skills? Enrol in CPR First Aid Professionals by FirstAidPro’s comprehensive first aid training courses to gain confidence in emergency response and ensure you’re prepared for any emergency.
Refresher Training Recommendations
To maintain competency in responsiveness assessment and BLS:
- CPR skills should be refreshed every 12 months
- Complete first aid certification renewal every 3 years
- Participate in regular workplace emergency drills
- Practice mental rehearsal of emergency scenarios
- Use online refresher modules between formal training
First Aid For Unresponsive Patients
Immediate Next Steps Following No Response
When a casualty doesn’t respond:
- Call for help:
- Shout for assistance if others are nearby
- Call 000 immediately or ask someone else to call
- Put phone on speaker if calling yourself
- Position the casualty:
- Roll onto back if necessary
- Ensure firm surface beneath for CPR if needed
- Open and check airway:
- Tilt head back (adults and children over 1 year)
- Keep head neutral for infants
- Check mouth for visible obstructions
- Check for breathing:
- Look for chest rise
- Listen for breath sounds
- Feel for exhaled air
- Take 10 seconds to check thoroughly
- Begin CPR if not breathing normally:
- 30 compressions to 2 breaths for adults & children
- Place the heel of one hand on the centre of the chest
- For adults and older children, place second hand on top of first
- Compress chest to one-third depth
- Maintain rate of 100-120 compressions per minute
- Apply AED as soon as available:
- Turn on the automated external defibrillator
- Follow voice prompts
- Minimise interruptions to CPR
Emergency Services Communication
When calling 000:
- Clearly state location with exact address if possible
- Describe the situation (unresponsive person)
- Answer the dispatcher’s questions
- Don’t hang up until instructed
- Send someone to direct emergency services to your location
Documentation for Workplace Incidents
For workplace incidents, document:
- Time of incident
- Initial and ongoing response assessment findings
- Actions taken (CPR, AED use)
- Response to interventions
- Time emergency services arrived
- Handover information provided
Industries at Highest Risk: Specialised Response Protocols
Different industries face unique challenges when implementing basic life support and checking responsiveness.
Construction Industry
Construction sites present specific challenges:
- Hazard considerations: Falling objects, unstable structures, electrical dangers
- PPE implications: Hard hats, gloves may need to remain in place
- Access issues: Reaching casualties in incomplete structures
- Multiple trauma risk: Higher likelihood of combined injuries
- Dust and noise: May complicate verbal response assessment
First aid stations should be placed strategically throughout large construction sites, and all teams should have at least one trained first aider.
Mining Industry
Mining operations require specialised protocols:
- Remote location considerations: Extended care may be necessary
- Underground challenges: Limited access, communication difficulties
- Specialised equipment: Extraction devices, oxygen supplies
- Environmental factors: Heat, dust, confined spaces
- Chemical/gas exposure: May affect both casualty and rescuer
Mining first aiders typically require advanced training beyond standard workplace first aid certification.
Healthcare Settings
Healthcare environments have unique protocols:
- Clinical vs non-clinical staff roles: Different response expectations
- Infection control considerations: PPE requirements
- Patient handling procedures: Safe moving techniques
- Advanced equipment access: Resuscitation equipment availability
- Code team activation: When to call for specialised response teams
Even non-clinical staff in healthcare settings should have basic response assessment training.
Manufacturing Environment
Manufacturing presents specific challenges:
- Machinery entrapment: Safely powering down equipment
- Chemical exposure: Decontamination considerations
- Noise levels: Difficulty with verbal assessment
- Shift work implications: Fatigue as a factor
- Production pressure: Ensuring response isn’t delayed
Emergency stops and isolation procedures should be included in first aid training for manufacturing environments.
Agriculture Sector
Agricultural settings require adapted protocols:
- Isolation factors: Working alone or in small teams
- Distance from help: Extended care needs
- Vehicle and machinery hazards: Tractors, harvesters
- Animal involvement: Secondary dangers
- Weather exposure: Environmental illness considerations
Satellite phones or emergency beacons are essential first aid equipment in remote agricultural settings.
Checking Responsiveness Is a Vital Skill
Checking responsiveness forms the crucial foundation of basic life support, determining whether further emergency care is needed. As the “R” in the DRSABCD action plan, proper response assessment guides all subsequent actions and potentially saves lives in workplace emergencies across Australia.
For employers, ensuring staff are trained in proper response assessment techniques is not just a compliance requirement—it’s an investment in workplace safety culture that demonstrates commitment to employee wellbeing. Regular, high-quality training helps maintain these critical skills and builds confidence among staff to respond effectively during emergencies.
Remember that in the critical moments following an incident, your actions can make the difference between life and death. Proper responsiveness assessment forms the foundation of effective first aid response.
Don’t wait until an emergency happens to get trained. Contact us today to schedule nationally recognised first aid and CPR training for yourself or your workplace and ensure you’re prepared for any emergency.
References
Australian Resuscitation Council. (2023). ANZCOR Guideline 3 – Recognition and First Aid Management of the Unconscious Person. https://resus.org.au/guidelines/
Safe Work Australia. (2023). First Aid in the Workplace: Code of Practice. https://www.safeworkaustralia.gov.au/resources-publications/model-codes-practice/model-code-practice-first-aid-workplace
Australian Government Department of Health. (2023). Emergency Response in the Workplace. https://www.health.gov.au/resources/publications
Workplace Health and Safety Queensland. (2023). https://www.worksafe.qld.gov.au/
Frequently Asked Questions
What is the purpose of basic life support (BLS)?
The purpose of basic life support (BLS) is to provide the preservation or restoration of life until advanced life support can be administered. It involves techniques like cardiopulmonary resuscitation (CPR) and using an automated external defibrillator (AED) to help a person experiencing cardiac arrest.
How do I perform CPR on an adult?
To perform CPR on an adult, first, ensure the scene is safe and then check for responsiveness. If unresponsive, call emergency services and begin CPR by giving 30 chest compressions followed by 2 rescue breaths. Repeat this cycle until advanced help arrives or the person shows signs of life.
What does the DRSABCD action plan involve
The DRSABCD action plan is a systematic approach to first aid that stands for Danger, Response, Send for help, Airway, Breathing, Compressions, and Defibrillation. It helps responders remember the key steps to take when providing basic life support.
What should I do if the chest does not rise during rescue breaths?
If the chest does not rise during rescue breaths, it may indicate that the airway is blocked. You should reassess the airway by tilting the head back slightly and attempting another breath. If the airway remains obstructed, continue with chest compressions and check for visible obstructions.
What should I do after performing CPR?
After performing CPR, you should continue to monitor the person and maintain the recovery position if they regain consciousness. Always wait for emergency services to arrive and provide them with as much information as possible about the situation.