Recognising the unwell person, calling 999, and the first response

When someone suddenly looks ill in a pharmacy, the priority is to recognise the problem and follow a structured response. Many serious emergencies begin with a person who is pale, clammy, confused, breathless, weak, drowsy, shaky, or otherwise "not right".

Start with scene safety and a rapid ABCDE approach

Resuscitation Council UK's first-aid guidance uses an ABCDE approach. In a pharmacy, keep it simple:

• A - Airway: can the person speak, cry out, or move air?
• B - Breathing: are they breathing normally, struggling, wheezing, gasping, or becoming blue or grey?
• C - Circulation: do they look pale, collapsed, sweaty, shocked, or faint?
• D - Disability: are they alert, confused, fitting, drowsy, or suddenly weak?
• E - Exposure: is there a rash, swelling, vomiting, obvious injury, or another clue to the cause?

If the person is unresponsive and not breathing normally, move immediately to the cardiac arrest response and follow your pharmacy's CPR and AED process.

Call 999 early and use speakerphone where possible

Do not wait for a firm diagnosis. Call 999 early for airway compromise, severe breathing difficulty, altered consciousness, major allergic reaction, stroke signs, prolonged seizure, suspected overdose, or if the person is not recovering quickly.

• Use speakerphone: the whole team can hear the call handler's instructions.
• Give the exact location: include the pharmacy name, full address, and any access details.
• Send someone to meet the crew: this is important in shopping centres, health centres, or locked premises.
• Assign roles: caller, responder, runner, and recorder if enough staff are present.

Current first-aid guidance is clear: call 999 early and only use medicines or equipment you have been trained to use. In a pharmacy emergency, clarity and speed matter more than trying to appear calm by doing too little.