This is the best way to save your own life if you have a medical emergency at home, says doctor
Most of us probably try not to think too much about what it would be like to have a medical emergency at home while you’re on your own. But knowing what medical experts would recommend in the event of a heart attack, stroke, serious burn or choking alone is vital information to know. In the midst of panic or pain, certain quick actions can make all the difference.
While statistics for the exact number of medical emergencies that happen to people alone in their home in the UK aren’t tracked in one single metric, available data highlights that older people living alone have significantly higher rates of emergency hospital use.
That makes sense as older people are more likely to need medical care, but regardless of age, over a quarter of all deaths in the UK happen at home. In 2022, the exact figure was 28.7% of all deaths – a figure that has remained higher than pre-pandemic levels (24.4% in 2019).
‘Most of us know the basics of first aid when helping someone else, but very few people ever think about what to do if they suddenly become the casualty themselves, especially when there’s no one nearby to help,’ says Angela Marsh, Aesthetics Nurse Practitioner (specialised in Cardiology), Menopause & Nutrition Coach.
Medical emergencies can come on quickly, and the way you act in the first few minutes can make a critical difference. ‘Although each emergency is different, the most important principles are always the same: call 999 immediately [unless in the case of some types of burn, see below], get yourself somewhere safe and visible, and prepare for the possibility that you may become unconscious before help arrives.’
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Being found matters
Ali Cadili is a General Surgeon and clinical researcher, fellowship-trained in Surgical Critical Care at WVU Medicine, with frontline experience managing heart attacks, strokes, burns and choking, and translating emergency protocols into practical, actionable guidance for people on their own. He says, ‘Call 999 or 112 on speaker straight away, say you are alone, give your exact location and when symptoms began, unlock the door if you can, and stay on the line; if you cannot speak, use EmergencySMS or 999 BSL’ More on how we can set up our phones for emergency, below!
‘It makes sense to make it easier for people to come in, but not before calling 999,’ says Cadili. ‘Call first, then if you can safely manage it, unlock or prop the door, turn on lights, secure pets, and return to a safe position with the phone on speaker. Tell the call handler exactly how responders can get in, including any key safe code, entry system or helpful landmarks. If you cannot get to the door, stay on the line, and they will coordinate access or forced entry if needed.’
Remember: being found matters. ‘When you’re alone, it’s vital to think ahead,’ continues Marsh. ‘If you feel suddenly unwell, dizzy, faint or in pain, try to get yourself somewhere visible near a window, an open doorway, or a public area if you’re outside. If you can safely reach it, unlock your front door. This ensures that paramedics can enter quickly and that anyone nearby has a better chance of noticing if you collapse. Keep your phone with you and, if possible, use the loudspeaker function when calling 999. Call handlers are trained to listen for breathing changes, falls, or silence, and they can dispatch help even if you lose the ability to speak.’
In the event of a heart attack
A heart attack is unfortunately a very common medical emergency. In the UK, around 100,000 people are admitted to hospital every year due to heart attacks – that’s one person every five minutes.
Dr Deborah Lee from Dr Fox Online Pharmacy explains, ‘The heart is a muscle with its own blood supply. A heart attack occurs when the arterial blood supply to the heart becomes blocked, usually by a clot. This means oxygenated blood cannot get to the heart muscle. The medical term is “ischaemia”. Ischaemic muscle tissue is often extremely painful. Without urgent action, the part of heart muscle supplied by the blocked artery, dies. This is called myocardial infarction.’
‘The main underlying cause of a heart attack is ischaemic heart disease (IHD). This is very common in the Western world, probably due to a combination of poor diet, lack of exercise, family history, high blood pressure, raised cholesterol and smoking,’ Dr Lee continues.
‘As we get older, cholesterol deposits known as atheroma are laid down in artery walls, narrowing the lumen of the artery and obstructing blood flow. The artery wall becomes weakened and is more likely to become blocked by a blood clot or to rupture causing a haemorrhage. This is what happens in a heart attack or a stroke.’
So what does a heart attack feel like? ‘A heart attack often begins with a feeling of tightness, heaviness or pressure in the chest, which may spread to the arm, jaw, back or stomach,’ says Marsh. ‘You might feel sweaty, sick or short of breath. If these symptoms begin suddenly and you’re on your own, treat it as an emergency straight away.’
It’s not always easy to spot, however. ‘Although the pain is often severe, between 0.5-6.4% of heart attacks are painless,’ adds Dr Lee. ‘Not infrequently a heart attack is misdiagnosed as indigestion.’ So, if you feel a sudden sense of panic and any of the additional symptoms above, don’t ignore it – get help. It’s better to be safe than sorry.
Cadili says that if you suspect you’re having a heart attack, first call 999 and then take an aspirin (if you aren’t allergic or actively avoiding them for a medical reason) and get in a comfortable position. ‘Most people with a suspected heart attack feel and breathe best in a half‑sitting position with their back supported and knees bent,’ he says.
‘Lying flat can worsen breathlessness or chest discomfort, so avoid it unless you feel faint. If you do feel faint, lie on your side rather than flat on your back, and try to stay as still as possible while waiting for help. Keep the phone on speaker with 999 and follow the call handler’s guidance until responders arrive.’
Marsh adds that sitting down in the way described above also helps reduce the strain on the heart and prevents injury if you collapse. Lying on your side rather than your back if you need to lie down is also essential. ‘You can potentially stop breathing if you are on your back and unconscious,’ says Marsh. ‘Your tongue can block your airway if it becomes floppy and falls to the back of your throat or you may be sick.’
In addition, Dr Lee says it’s helpful to loosen any tight or restrictive clothing around the neck or the waist. All our experts recommend chewing and swallowing one adult aspirin (300 mg) after you have called 999, but only if you don’t need to exert yourself to do so, you have no allergy to aspirin, no active bleeding or recent stomach ulcers, and have not been told to avoid it.
‘Do not take aspirin for stroke‑like symptoms, and do not take multiple doses or substitute other painkillers,’ warns Cadili. ‘If you already take a daily low‑dose aspirin, the call handler or paramedics can advise whether to take an additional adult dose.’
Dr Lee adds that if you have diagnosed angina, you’ll have your own angina medication such as a GTN spray. ‘If you can, take some of this. After 5 minutes if help hasn’t arrived, take a second dose.’
In summary: ‘The priority is calling 999, staying still and keeping your airway safe,’ says Marsh.
For stroke, think FAST
Stroke is also a common medical emergency, with the same frequency as heart attacks – in the UK, someone has a stroke every 5 minutes. There are two types of stroke, as explained by Dr Lee: ‘There’s an ischaemic stroke which occurs when the blood supply to a part of the brain is blocked, or a haemorrhagic stroke which is due to sudden bleeding in the brain.
‘Both types of stroke mean that specific areas of brain tissue are starved of oxygen, and very quickly, this leads to death of brain cells. 90% of strokes are ischaemic strokes, and 10% are haemorrhagic. A stroke, just like a heart attack, is usually caused by atheromatous deposits being laid down in cerebral blood vessels. It’s caused by cerebrovascular disease.’
In addition, 46,000 people have a Transient Ischaemic Attack (TIA) or mini-stroke, every year. ‘In a TIA, the blocked artery has somehow cleared itself, so any neurological symptoms have reversed,’ says Dr Lee. ‘Recognising a TIA is important because 1 in 12 people will go on to have a full blown stroke in the next 7 days. In a TIA, by definition, symptoms resolve within 24 hours of onset.
‘Life-saving treatment can be given to those with ischaemic stroke, and the symptoms can be reversed, if an anticoagulant is administered within 4.5 hours of the onset of symptoms. This is why getting yourself to hospital as soon as possible is absolutely vital.’
Many of us will know the ‘FAST’ acronym for recognising a stroke from NHS awareness campaigns, but can you remember what each letter means? Marsh has a handy reminder: ‘Stroke symptoms often follow the FAST pattern: Face drooping, Arm weakness, Speech difficulty. The final letter T stands for Time to call 999, and that applies even more urgently if you are alone.
‘If you suspect a stroke in yourself, do not attempt to walk around, especially if you feel weak or unbalanced. You may fall and cause further harm. Call 999 immediately and, if you can, unlock the door or move into view while staying as close to the ground as possible.
Do not exert yourself if your condition is worsening. Do not take aspirin. Not all strokes are caused by a blocked artery; some are due to bleeding in the brain, and aspirin can make this worse. Avoid eating or drinking anything, as swallowing can be affected. The ambulance service will talk you through what happens next.’
Dr Lee adds that very often, a stroke affects just one side of the body or the face, although a stroke can cause sudden collapse and loss of consciousness, too. ‘The key to the diagnosis of stroke is the sudden onset,’ she says.
‘Symptoms often come on within minutes or may develop over a few hours. Symptoms can vary from being mild to severe. You should also look out for headache, weakness in an arm and/or a leg on one side of the body, paralysis (a complete inability to move one side of the body or the face, usually with the inability to walk), difficult chewing or swallowing, loss of or blurred vision and not understanding speech or simple commands.’
After calling 999, Cadili recommends that you lie on your side with the head slightly raised. ‘Lie on your weak side,’ adds Dr Lee. ‘You can support any weak arms or legs with a pillow if handy and try to loosen any tight or restrictive clothing while you wait for help.’
What’s best for burns?
Scalding water or steam, burns from flames, electrical burns or chemical burns can all be life-threatening depending on the severity and the part of your body you burn. ‘Burns can happen in an instant due to boiling water, cooking oil, hot pans and even a small burn can be serious depending on where it is,’ says Marsh.
‘If you sustain a significant burn when alone, your first action should be to cool the burn with cool running water – not ice-cold water – for a minimum of 20 minutes – this is one of the most effective ways to limit damage. Never submerge yourself in a cold bath. If the clothing is stuck do not pull it off – run the water over the clothing. If you can, try to cut clothing off rather than pulling it over your head to prevent spillage of the hot product on the face and head or any other areas.
‘Do this before anything else, including calling for help, unless your condition is quickly worsening or the burn is extensive. Remove jewellery or tight clothing as long as it is not stuck to the skin, because swelling develops quickly. Once cooling has begun, you can call 999 if necessary.’
Dr Lee adds that if you’re at all in doubt about whether to call 999 or not, this is your checklist: ‘Call emergency services if the area of the burn is the size of your hand or larger;
if the skin is charred or white, which signifies a deep burn; if it is affecting your face, hands, feet, genital area or any major joints; if you have also inhaled any smoke or fumes and for all chemical or electrical burns.’
After you’ve called 999, and the area has cooled, this is the stage at which to cover the area with cling film. Marsh recommends you do this loosely to avoid restriction from swelling. ‘If you feel faint or dizzy – common reactions to pain or shock – try to move into a place where you can sit back against the wall and be easily seen if you collapse,’ she adds.
Chemical burns need a slightly different approach, says Dr Lee. ‘It’s important that you wear gloves before removing any clothing that has been in contact with the chemical, that you apply running water to the area for an hour and you do not apply any creams or lotions.’
In fact, you should avoid creams and lotions for all burns and don’t pop any blisters or apply any adhesive dressings either, as you’ll be at risk of making things worse.
Choking when alone
This is perhaps the hardest emergency to face when alone. ‘Choking occurs when an object such as a piece of food gets into the trachea (windpipe) instead of the oesophagus (throat),’ says Dr Lee. ‘Your cough reflex will kick into action in an effort to expel it, but you will find it hard to swallow or speak.’
This will obviously make it difficult to request help but call 999 anyway. ‘If you can cough, keep coughing while you call 999,’ says Cadili. ‘If you cannot breathe or speak, call on speaker and leave the line open.’ The call handler will be able to detect you are in distress.
‘Choking while alone is frightening, and acting quickly is vital,’ adds Marsh. ‘If you can still cough, your cough is your best tool – keep coughing as forcefully as you can while dialling 999. The rule is: “Cough it out – slap it out – squeeze it out!”
‘If you are unable to cough, speak or breathe properly, and no one is nearby, you may need to perform a self-administered abdominal thrust – place your fist below your ribcage under your diaphragm and push inward and upward to help force air from the lungs and expel the blockage or lean your upper abdomen forcefully against the back of a sturdy chair, countertop or similar surface, driving your body weight inward and upward to mimic an abdominal thrust.
'Repeat this up to 5 times then you can bend forward and attempt to deliver up to 5 strong back blows between your shoulder blades using the heel of your hand, bracing yourself against a surface for support repeat this sequence.’
As with other medical emergencies, if you can, try to move towards a place where you are visible to others. If you collapse, the open call line can help emergency services find you and respond immediately, should you become unconscious and stop breathing they can commence CPR if in a public area or someone is passing by in time.
If you clear the object, Cadili says you should make sure you seek medical advice soon after. He also has a warning: ‘Anti‑choking devices are not a substitute and should only be considered after standard methods and if trained.’
Your phone can save your life
There are clever features on your mobile for emergencies exactly as described above. ‘Modern mobile phones have features that can contact 999 even if you cannot,’ says Marsh. ‘Setting up these tools ahead of time is one of the most effective ways to prepare for emergencies. Most smartphones sold in the UK include an Emergency SOS function. On many iPhones and Android devices, pressing the power button rapidly several times will automatically call 999 and send your location to emergency contacts.
You can also store essential medical information such as allergies, medications and conditions in the phone’s Medical ID or ICE (In Case of Emergency) section, which can be viewed from the lock screen. Keeping your phone charged, within reach, and switched on at all times is a simple but potentially life-saving habit.’
Cadili agrees: ‘Enable Emergency SOS and learn the shortcut, turn on location services, and add a Medical ID or emergency information card with allergies, conditions, medications and emergency contacts on the lock screen. Register for EmergencySMS so you can text 999 if you cannot speak, know how to use the 999 BSL app if you sign, and keep the line open during 999 or 112 calls so Advanced Mobile Location can send your precise position.’
Be prepared and should the worst start to happen, you can divert disaster by remaining as calm as possible and following these steps.
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