Someone is in trouble in front of me. What do I actually do?

Twenty people are looking and not moving, and one of them is you, not because you do not care but because twenty other people are not moving either. Five pages in this library are about that minute, in a station, at a pool, in a bathroom with your own heart going, and they agree on one thing before the details: the job is almost never the heroic one. It is the phone, the pointed finger, the pole held out from the side, and knowing the sign that does not look like the films.

Do not shout to the crowd. Look at one person, point, and say what they are to do. Name one person, give one job is built from eleven conversations and 359 accounts, and four separate conversations say the same thing from four directions: a general shout, “somebody call an ambulance!”, fails in a crowd, because responsibility spreads across it until it belongs to no one, and a pointed finger and a named task do not. “You, in the red shirt, call 999 and tell them where we are.” Six accounts in one note say this is what first-aid courses teach, and the St John Ambulance guidance on CPR, last reviewed April 2025, says it the same way: ask a helper to call 999 or 112, ask a helper to bring a defibrillator, and do not leave the person to fetch one yourself; if you are alone, put the phone on speaker and start chest compressions while you talk. One account adds the second sentence to have ready: not “has someone called?”, which causes confusion, but “who called?”, and if no one answers, you call. If the person you point at does nothing, two accounts say a crowd has watched a job go undone and is still there, so point again. Then the rule that sits over all of it, in three conversations and thirteen of the fourteen contraindications, in a record that agrees on almost nothing else: your job is the phone and the people, not the fight. Do not physically intervene in a fight if you are untrained, alone, smaller, drunk or outnumbered; four cautions with two accounts each say people who did were punched, cut with broken glass, stabbed, shot or killed, and one account was knifed for asking two men why they were fighting. If there is violence or a weapon, the one job you give is to the emergency operator. For harassment rather than injury, the page describes the pretend-to-know-them technique because its accounts used it and argued about it, and does not recommend it, since one of its own prerequisites is a willingness to tell a “half convincing lie”; what needs no pretence is to ask the person directly whether they are okay and keep your eyes on them, not on the one answering for them, to stand near, to ask the harasser for the time or for directions, or to be the person they can walk over to. Two contraindications set the edge: do not approach if you would frighten the person more than the harasser does, and do not use any of it on what looks like a couple’s argument, which the page names as a gap.

Drowning is quiet, so ask, and reach before you throw before you go. Drowning is quiet is from lifeguards, parents and people who have nearly drowned, and seven separate conversations say real drowning looks nothing like the films: no shouting, no waving, almost no splash. From the side of the pool it looks like someone treading water, or standing on tiptoe in water a little too deep, or a swimmer who has stopped making progress. The reason is physiology: breathing comes before speech, so the mouth that keeps dipping under never has the air to call, and the arms are taken over by the body and press down to lever the head up, so they cannot wave. The signs the page lists: head low, mouth at the water line, tipped back; eyes glassy or unfocused, or closed; hair over the face and not pushed away; the body upright, vertical, like a fence pole, with no kick from the legs; the invisible ladder with the arms; trying to swim and going nowhere, or trying to roll onto the back and failing; and a rhythm of going under and coming up that the research on the instinctive drowning response says lasts twenty to sixty seconds before the person slips under and stays there. The lifeguards insist on one thing: if you are not sure, ask. Say “are you okay?” across the water. Someone who is fine will answer, annoyed. Someone who just looks at you is drowning, and you act now. Two conversations say loud shouting and splashing usually means a child playing or a panicking swimmer who can still breathe, and the page says that is true and it is not a permission: take every call for help as real, and know that the silent person needs you more, not less. Then the order that saves the most lives: shout for a lifeguard and for someone to call the emergency number, 911 in the US, 999 in the UK; reach first, a pole, a branch, a towel, a rope; throw second, a ring, a cooler lid, anything that floats, and tell them to hold it; go last. Going in is a judgement about you, not a rule. A conscious drowning person will climb whoever arrives to reach air, and untrained helpers drown that way; nine separate warnings carry it, the lifeguards among them loudest. If reaching and throwing are not possible and you are a strong swimmer, go: take something that floats and hold it out in front so they grab that and not you, come at them from behind, and if you are grabbed, go under on purpose, because they let go of what sinks. If you are not a confident swimmer, your part is the shout, the call and the throw, and finding the person who can swim. Afterwards, two separate conversations insist: anyone who went under, or came out coughing or struggling to breathe, goes to a doctor the same day even if they seem fine an hour later, and coughing, breathlessness, unusual sleepiness or confusion later that day means emergency care now. Before: one adult is the watcher for a set stretch of time, doing nothing else, small children stay within arm’s reach in water, and inflatables and life jackets are not supervision.

If the emergency is inside you, put your face in cool water. Put your face in cool water is for the minute a surge of panic arrives, and seven separate conversations describe the reflex: fill the basin with cool water, hold your breath, lower your face in to the temples for up to about half a minute, and the body assumes you have gone under, slows the heart, and shifts you out of the fight-or-flight state. Three separate conversations and two more say submerge, do not splash, and a correction says splashing does nothing for the reflex. Cool, not iced, because one account and the clinical guidance say very cold water sets off a different response that speeds the heart. If you cannot put your face in water, five separate conversations say the smaller versions work, if less strongly: cold water over the wrists, a cold wet cloth on the back of the neck. Two conversations and three cautions rated high say it is not a treatment for an anxiety disorder, which needs a doctor, therapy, sometimes medication, and cannot be managed by staying wet, and the page’s own position is to use the water to get through the next ten minutes and use the ten minutes to make the appointment. Its own caution, since the accounts left it open: if you have a heart condition, a heart rhythm problem, or take heart medication, ask before trying it, because the effect works by slowing the heart, which is the point for the rest of us and a question for you; those conversations name it as a gap and the page says it cannot answer it. Never in water you could pass out into, never while driving, and never force the time. The page refuses one method its own conversations used, squeezing ice until it hurts, because a researcher who studies self-injury says that is the mechanism proposed for why people cut themselves, that the evidence for the felt relief is weaker than claimed, and that advising pain as a coping tool is not good practice; if pain is what you want when the feeling comes, the page would rather you told a doctor or a therapist that sentence, and if it is urgent, a crisis line is for exactly this, today.

Know which small things are not small. Run the bite under warm water is about the ordinary mosquito bite, and its safety line is where the ordinary ends. Never use a flame, a cigarette, a spoon heated on a stove or in a microwave, or water hotter than a hot bath on skin, because the people there who did describe burns, one a spoon-shaped mark; the target is a flinch, not pain, and on a child’s skin lower still, or skip the heat and use cold. If a bite swells wide, wider than a couple of inches, or comes with fever, aches or a spreading rash, or the skin around it goes hot, oozes or shows red streaks in the days after, that is a doctor’s job. Any trouble breathing, swelling of the face, lips or tongue, or faintness after a bite is an emergency call, not an appointment. And if you did not see what bit you, do not heat it: a spider bite or a tick bite is a different problem, a tick still attached comes out with fine tweezers gripped close to the skin, and a tick bite followed by a fever or a ring-shaped rash needs a doctor promptly. Keep the napkins in the glove box adds the small honest line about the stack in the car: one contraindication and one caution say a pad or a napkin will soak up blood but is not a dressing for a serious wound, because it does not help clotting, so a deep cut, a head wound or worse gets a first-aid kit and 999 in the UK or 911 in the US, not the glove box; and napkins burn, so a small fire in a car is dealt with by getting out and calling for help, not with paper.

Who this is not for, and what these pages cannot give. None of them teaches CPR in a paragraph; the drowning page says the emergency dispatcher will walk you through it in real time, and a course will properly. None of them tells you to step into violence; thirteen of the fourteen contraindications on the bystander page say the opposite. If you are the one in the water, the drowning page says get onto your back and float, and shout when you can. If you are the one who feels threatened rather than the one watching, one account says people are often willing to walk with you if you ask directly. The pages name their gaps: what to do when the person will not leave with you, when the two people know each other, legal protection for people who intervene, and whether the cool-water reflex works for a full panic attack rather than a spike. The first follow-up below is this library’s page on what to have ready before any of it happens.