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What Is Triage? The ABCs of First Aid Before EMS Arrives

How responders decide who needs help first, and the simple order of checks anyone can use while waiting for an ambulance.

Last reviewed October 3, 2026 · Spiral Search editorial team
General information, not medical advice. Reading a guide is not a substitute for a hands-on first aid or CPR class (American Red Cross, American Heart Association, and local fire-rescue departments offer them). If someone may be in danger, call 911 and follow the dispatcher.

What triage means

Triage is sorting patients by how urgently they need help, so the most life-threatening problems are treated first. Paramedics use formal triage systems in crashes and disasters. As a bystander, the same idea applies: if there are several injured people, deal first with the one in the greatest danger, usually someone who is not breathing or is bleeding severely, and not the one making the most noise.

Step 0: Scene safety

Before you touch anyone, check for traffic, fire, smoke, fuel, downed power lines, unstable structures, violence, or unsafe water. You cannot help if you become a patient. Call 911.

The ABCs (and the first “C”)

The classic order of checks is Airway, Breathing, Circulation. Current practice puts severe bleeding first (some courses call it “catastrophic bleeding” or “X”), then airway and breathing.

  1. Severe bleeding: if blood is spurting or pooling, press hard, and use a tourniquet on a limb. See how to stop severe bleeding.
  2. Responsive? Tap the shoulder and shout, “Are you OK?”
  3. Airway: Is the mouth clear? If they are speaking or crying, the airway is open. If someone is unresponsive, gently tilt the head back and lift the chin, unless you suspect a neck injury.
  4. Breathing: Look for chest rise and listen for no more than 10 seconds. If they are not breathing normally, or only gasping, start CPR. See how and when to do CPR.
  5. Circulation: Look for signs of shock (pale, cold, sweaty, fast breathing, confusion). Lay the person down, keep them warm, and do not give food or drink.
  6. Disability: Is the person awake and aware? Could they have a head or spine injury?
  7. Exposure: Expose the injury, but keep the person from getting cold.

Who goes first?

PriorityExamples
1. ImmediateNot breathing, no pulse, severe bleeding, choking, unresponsive
2. UrgentBreathing difficulty, chest pain, signs of stroke, major burns, suspected spinal injury
3. DelayedBroken bones without severe bleeding, minor burns, sprains
4. MinorWalking wounded, cuts and scrapes

While you wait, stay with the person, keep reassuring them, and tell the dispatcher about any change.

Sources and further reading