Remote Emergency Response and Basic Life Support Awareness
Document control
Document owner: Registered Manager
Clinical approval: Nominated Individual
Version: 2.0
Approval date: 10 August 2026
Review date: 01 January 2027
Training renewal: Annually
Applicable staff: Administration staff who have no face-to-face contact with patients
Estimated completion time: 45–60 minutes
Assessment: 15 multiple-choice questions
Pass mark: 80%
Safety-critical questions: All must be reviewed if answered incorrectly
This module must also be reviewed following:
a serious emergency
a significant change to WMI Psychiatry’s services
a change to the emergency escalation procedure
a change to relevant national guidance
evidence that a member of staff did not understand or follow the procedure
Related WMI Psychiatry documents
This module should be read alongside:
Emergency Response Policy
Safeguarding Children Policy
Safeguarding Adults Policy
Suicide and Self-Harm Risk Policy
Incident Reporting Policy
Information Governance and Confidentiality Policy
Lone Working Policy
Complaints Policy
Business Continuity Plan
1. Purpose and training rationale
WMI Psychiatry administration staff communicate with patients and families by telephone, email and online systems. They do not have face-to-face contact with patients and are not expected to provide hands-on clinical care as part of their role.
An administrator may still become the first member of staff to learn that:
someone has collapsed
someone is not breathing normally
someone has taken an overdose
someone has seriously injured themselves
someone is about to end their life
a child or adult is in immediate danger
someone is threatening serious violence
an emergency is occurring during a video appointment
a worrying email or voicemail has been received
The administrator’s role is to recognise possible immediate danger, establish the person’s location, contact emergency services, support communication, alert the appropriate WMI clinician and make a factual record.
WMI Psychiatry’s first-aid needs assessment records that these administration staff do not work in a patient-facing environment. Their foreseeable patient emergency role is therefore remote emergency coordination rather than physical first aid.
HSE guidance requires employers to base first-aid arrangements on a needs assessment which considers the nature and location of the work as well as remote and lone workers. HSE first-aid needs assessment
This module does not:
qualify the learner as a first aider
provide practical CPR competence
authorise the learner to diagnose a medical condition
authorise the learner to give medication advice
replace safeguarding training
replace instructions from an emergency call handler
replace WMI Psychiatry’s emergency policies
Any administrator who begins attending the clinic, greeting patients or having other face-to-face patient contact must have their training requirements reviewed. Practical CPR and AED training may then be required.
2. Learning outcomes
By the end of this module staff should be able to:
Explain the administration team’s role in a remote emergency.
Recognise situations that may require emergency assistance.
Establish the person’s current physical location.
Contact 999 without waiting unnecessarily for clinical permission.
Provide relevant information to the emergency services.
Support a caller without giving advice beyond their competence.
Respond appropriately to collapse, overdose, immediate suicide risk and serious violence.
Escalate an emergency within WMI Psychiatry.
Share relevant information lawfully and proportionately.
Document an emergency accurately.
Explain what to do if the person’s location is unknown or they are outside the UK.
Identify when NHS 111 may be more appropriate than 999.
3. WMI Psychiatry emergency contacts
These details must be completed before issuing the module.
Clinical escalation
Duty or responsible clinician: Registered Manager or Nominated Individual
Safeguarding lead: Registered Manager
Deputy safeguarding lead: Nominated Individual
Incident reporting
Clinical record system: Zanda Health
Incident reporting form or system: Google Drive
Person responsible for reviewing incidents: Nominated Individual
Administration staff must save these contact details somewhere accessible while working. They must not rely on finding them during an emergency.
4. Your role during an emergency
You should
remain as calm as possible
establish the person’s current location
obtain a telephone number
identify what has happened
determine whether anyone is physically present
make sure the appropriate emergency service is contacted
support the caller to follow the emergency call handler’s instructions
alert the appropriate WMI clinician
record the information and actions
complete the incident reporting process
You should not
attempt to diagnose the problem
assume symptoms are caused by anxiety
conduct a detailed clinical assessment
provide medication or poisoning advice
tell someone to take additional medication
tell someone to make themselves vomit
promise that the person will be safe
promise to keep immediate danger confidential
provide improvised CPR instructions
wait for a clinician before contacting 999 when life may be at risk
assume someone else has called 999 without confirming this
travel to the person’s address
place yourself or anyone else in danger
You do not need permission from a clinician to call 999 when there appears to be an immediate danger to life.
5. Recognising an emergency
Call 999 when someone may be in immediate danger
Examples include:
unresponsiveness or loss of consciousness
absent, abnormal or gasping breathing
severe difficulty breathing
choking
severe chest pain
possible stroke symptoms
a serious allergic reaction
severe or uncontrolled bleeding
a prolonged seizure or repeated seizures
serious injury
deliberate or potentially harmful overdose
suspected poisoning
serious self-harm
immediate suicide risk
immediate risk of serious violence
a weapon being used or threatened
a child or adult who cannot be kept safe
any situation where a delay could place someone’s life at risk
The NHS advises calling 999 when someone’s life is at risk, when there has been a serious injury or overdose or when someone cannot keep themselves or another person safe. Mental health emergencies should be treated as seriously as physical emergencies. NHS urgent mental health help
Calling the police
Call 999 and request police assistance when there is:
immediate violence
a weapon
an immediate threat to another person
a dangerous person attempting to enter a property
an abduction or immediate risk of abduction
another immediate situation requiring police intervention
If both medical and police assistance may be needed explain the circumstances to the 999 operator. The emergency services will coordinate the response.
Do not encourage the caller to confront someone who is violent or remove a weapon.
NHS 111
NHS 111 may be appropriate when:
medical advice is needed urgently
the person is conscious and medically stable
there is no immediate danger
there has been no deliberate overdose or serious injury
the person is unsure which health service they need
Administration staff should not use NHS 111 to avoid calling 999 when there may be immediate danger.
If you are genuinely unsure whether the situation is life-threatening call 999 and explain what has happened. The emergency call handler will decide the appropriate response.
6. The LOCATION–DANGER–999–SUPPORT procedure
Remember these four priorities:
1. LOCATION
Establish where the person is now.
2. DANGER
Identify what has happened and whether there is immediate danger.
3. 999
Call emergency services or make sure someone at the scene calls.
4. SUPPORT
Maintain appropriate communication, escalate internally and document the incident.
7. Step 1: Establish the location
Ask immediately:
“Please tell me the address where you are now.”
Confirm:
building or house number
street
town or city
postcode
flat number or floor
entry code
room or part of the building
nearby landmarks
whether someone can open the door
whether there are access difficulties
Do not rely only on the address recorded in the clinical system. The patient may be elsewhere.
Repeat the address:
“I have you at 25 Example Street, Salford, M1 2AB. Is that correct?”
Also obtain:
the person’s full name
the patient’s name if speaking to somebody else
a telephone number for the person at the scene
the name of anyone physically present
whether the person is alone
whether the door can be opened safely
If the person refuses or cannot provide their location
Use any information lawfully available to you including:
the recorded home address
the telephone number
information disclosed during the conversation
appointment notes
emergency contact information
details provided by a parent or family member
Tell 999 that the current location has not been confirmed and provide the last known or most likely address.
Do not delay contacting emergency services while trying to establish every detail.
8. Step 2: Establish what has happened
Use short questions:
“Tell me what has happened.”
“Is the person awake?”
“Are they responding?”
“Are they breathing normally?”
“Have they taken anything?”
“Have they injured themselves?”
“Is there immediate danger?”
“Is anyone else present?”
“Has anyone called 999?”
“Are there any weapons?”
Ask one question at a time.
Do not conduct a detailed psychiatric or medical assessment. Obtain enough information to recognise the emergency and inform the emergency services.
9. Step 3: Contact emergency services
If another responsible person is present
Say:
“Please call 999 now. Put your telephone on speaker and follow the emergency call handler’s instructions.”
Confirm that the call has been made.
If two WMI staff are available
one staff member should maintain communication
the other should call 999
one should notify the clinical team
both should state clearly which action they are undertaking
the 999 call must be confirmed
If you are working alone
If the person can call 999 tell them to do so immediately.
If they cannot call and another telephone is available call 999 while maintaining contact.
If you only have one telephone:
Obtain their location and contact number.
Explain that you need to contact emergency services.
Call 999 immediately.
Attempt to reconnect once emergency help has been arranged.
Calling about someone at another address
Begin with:
“I am calling from WMI Psychiatry. The patient is not with me. The emergency is at…”
Give the patient’s location before giving your location or WMI Psychiatry’s address.
Provide:
the emergency location
what has happened
whether the person is responding
whether they are breathing normally
any immediate danger
the person’s telephone number
the name of anyone at the scene
your name and role
relevant medication or risk information if known
Do not end the call until instructed.
10. Step 4: Support the person
If you remain connected:
speak slowly and clearly
use the person’s name
tell them emergency help is being arranged
ask them to follow the emergency call handler’s instructions
encourage them to unlock the door if safe
encourage them to ask a trusted adult or neighbour to attend
ask them to put pets in another room if this can be done safely
listen for changes
tell the emergency services if the situation changes
Suitable phrases include:
“You have done the right thing by telling me.”
“I am arranging emergency help.”
“Please tell me immediately if anything changes.”
“Please follow the instructions given by the emergency call handler.”
Do not say:
“Everything will be fine.”
“It is probably anxiety.”
“The ambulance will be there in five minutes.”
“You definitely do not need hospital.”
“I promise I will not tell anyone.”
11. Step 5: Internal escalation
After 999 has been called or while another person is making the call:
Contact the responsible or duty clinician.
Contact the safeguarding lead where relevant.
Inform the Registered Manager.
Inform the Medical Director in accordance with the incident procedure.
Record unsuccessful contact attempts.
Follow the secondary escalation route if the first clinician cannot be reached.
Internal escalation must not delay emergency assistance.
Responsibility for clinical follow-up transfers to: Registered Manager
The administrator should not continue managing the clinical risk independently once an appropriate clinician has taken responsibility.
12. Cardiac arrest and CPR awareness
A person in cardiac arrest will be:
unresponsive
not breathing normally
Abnormal breathing can include:
occasional gasps
irregular breaths
slow laboured breaths
snorting
panting
unusual noisy breathing
These may be agonal breaths. They are not normal breathing.
Current Resuscitation Council UK guidance advises calling 999 for any unresponsive person. The emergency call handler can then help the caller assess breathing and recognise cardiac arrest. Resuscitation Council UK: Adult basic life support
Remote response
If a caller reports that someone is unresponsive:
Establish the location.
Make sure 999 is called immediately.
Tell the caller to use speaker mode.
Encourage them to follow the call handler’s instructions.
Do not ask them to wait for a WMI clinician.
Do not attempt to replace the emergency call handler.
The call handler may instruct the person at the scene to:
check for a response
assess breathing
place the person on their back
begin chest compressions
give rescue breaths where appropriate
locate an AED
follow the AED instructions
This module provides awareness only. Practical CPR competence requires appropriate practical instruction and assessment.
13. Emergency scenarios
Scenario 1: Collapse during a video appointment
A patient collapses during a video appointment. A family member is present.
Appropriate response:
Obtain the exact address.
Ask whether the patient is responding.
Ask whether they appear to be breathing normally.
Tell the family member to call 999.
Ask them to use speaker mode.
Encourage them to follow the call handler’s instructions.
Remain connected if this does not interfere with the 999 call.
Alert the responsible clinician.
Record what was seen and reported.
Confirm who is calling 999. Do not assume the clinician or family member has already done so.
Scenario 2: A child is unresponsive
A parent says their child will not wake up.
Ask:
“Where are you now?”
“Is your child responding?”
“Are they breathing normally?”
“Is anyone else with you?”
“Has 999 been called?”
Make sure 999 is contacted immediately.
Do not ask for a full developmental or medical history. Do not advise the parent to contact their GP first.
Scenario 3: Suspected overdose
A patient states that they have deliberately taken more medication than prescribed.
Appropriate response:
Obtain their exact location.
Ask what they took.
Ask approximately how much they took.
Ask when they took it.
Ask whether they have taken alcohol or anything else.
Ask whether anyone is present.
Call 999.
Keep them connected where possible.
Encourage them not to take anything else.
Encourage them to unlock the door if safe.
Ask them to move away from remaining medication if this can be done safely.
Alert the clinical team.
Document their words and the actions taken.
Do not tell them to make themselves vomit. Do not advise them to wait for symptoms.
The NHS advises emergency assessment where somebody may have swallowed, touched or breathed in something harmful. NHS poisoning guidance
A clear accidental medication query with no symptoms or evidence of deliberate self-harm may be directed to NHS 111 and escalated to a clinician. Administration staff must not decide that an uncertain amount is harmless. If uncertain call 999.
Scenario 4: Immediate suicide risk
A patient states:
“I am going to end my life now.”
They report having the means available.
Appropriate response:
Remain calm.
Establish their current location.
Ask whether they have already harmed themselves or taken anything.
Ask whether they are alone.
Ask whether there is a weapon or immediate danger to anyone else.
Call 999.
Request police assistance if there is a weapon or immediate threat of violence.
Continue speaking to the person where possible.
Encourage them to move away from the means if they can do so safely.
Encourage them to unlock the door.
Encourage them to contact someone nearby.
Alert a WMI clinician immediately.
Record the words used as accurately as possible.
Do not debate whether they are serious. Do not promise confidentiality. Do not leave a message for a clinician to review later.
Scenario 5: Worrying email or voicemail
An administrator finds a message saying:
“By the time you read this it will be too late.”
Appropriate response:
Check the time it was sent.
Attempt to telephone the person immediately.
Alert the duty clinician.
Check the record for location and emergency contact details.
Call 999 if there is a credible immediate risk.
Explain that WMI Psychiatry is a remote service.
Provide available information.
Record all contact attempts and actions.
Do not reply by email and wait.
WMI Psychiatry’s email, voicemail and website should make clear that these services are not continuously monitored and direct people to 999 when there is immediate danger.
Scenario 6: Severe difficulty breathing
A caller can only speak in single words. You hear gasping or severe wheezing.
Appropriate response:
Obtain the location.
Make sure 999 is called.
Encourage the caller to follow the call handler’s instructions.
Encourage them to unlock the door if safe.
Do not advise them to drive.
Alert the clinical team once emergency help is arranged.
Scenario 7: Seizure during a video call
Appropriate response:
Obtain the location.
Make sure 999 is called.
Encourage the person present to follow the call handler’s instructions.
Do not advise them to restrain the person.
Do not advise them to put anything in the person’s mouth.
If movements stop ask whether the person is responding and breathing normally.
Report abnormal breathing immediately.
Scenario 8: A caller suddenly becomes silent
A patient reporting immediate suicide risk suddenly stops responding.
Appropriate response:
Call their name.
Listen for speech, breathing, movement or background sounds.
Attempt to reconnect if the call ends.
use the clinical record to identify their address and contact details.
Call 999 and provide the available location.
Inform the clinical team.
Document what happened.
Do not assume it was a technical failure.
Scenario 9: Immediate threat to another person
A patient states that they are about to attack someone and reports having a weapon.
Appropriate response:
Obtain their location.
Ask where the potential victim is if this can be established without prolonging the call.
Call 999 and request police assistance.
Provide the person’s words and known information.
Do not encourage anyone to approach or disarm them.
Alert the duty clinician.
Alert the safeguarding lead where appropriate.
document the incident.
Scenario 10: The patient is outside the U
Ask for:
country
full address
local telephone number
who is physically present
the local emergency number if known
UK emergency services cannot dispatch assistance outside the UK. Tell the patient or person present to call the local emergency service immediately.
If the person cannot do this:
keep them connected where possible
alert the duty clinician
use reliable available information to identify the appropriate local emergency service
provide the exact location and telephone number
document the limitations and actions taken
Do not assume that 999 or NHS 111 operates in another country.
14. Confidentiality and information sharing
Confidentiality remains important during an emergency. It should not prevent necessary and proportionate action to protect life or prevent serious harm.
Information shared may include:
the person’s name
their location
their telephone number
what they reported
symptoms observed or reported
relevant medication information
known immediate risks
emergency contact details
relevant safeguarding information
Only share information relevant to the emergency.
ICO guidance confirms that necessary and proportionate information can be shared during an emergency involving a risk of serious harm to human life. ICO emergency data-sharing guidance
Record:
what information was shared
who received it
why it was shared
the date and time
15. Documentation
Complete a factual record as soon as possible.
Record:
date and time
method of contact
name of the caller
patient’s name
location provided
telephone number
what was reported
relevant words used
symptoms described or observed
whether 999 was called
who called
time of the call
information provided
instructions given by the emergency call handler if known
staff notified
attempts to contact the patient
unsuccessful escalation attempts
outcome if known
responsibility for follow-up
incident report reference
Suitable wording includes:
“The patient stated, ‘I have taken all the tablets.’”
“The patient stopped responding at approximately 14:12. Breathing could not be assessed over the telephone.”
“999 was called at 14:14. The patient’s reported location and telephone number were provided.”
Do not write:
“The patient was attention-seeking.”
“It was probably anxiety.”
“The patient did not sound genuinely suicidal.”
“They were clearly exaggerating.”
Documentation should distinguish between:
what you heard or observed
what someone reported
what you did
what the emergency services or clinician advised
16. Follow-up after an emergency
Once responsibility has transferred to the emergency services and an appropriate WMI clinician:
complete the clinical record
complete an incident report
notify the appropriate manager
preserve relevant emails, messages or call records
follow safeguarding procedures
identify any outstanding administrative actions
participate in a debrief if requested
raise any procedural concerns
access staff support if needed
An administrator should not attempt to obtain confidential information from emergency services unless directed and authorised to do so.
Emergency incidents can be distressing. Staff should be offered an opportunity to discuss what happened with a manager.
17. Key learning points
Establish the person’s current location first.
Call 999 when someone may be in immediate danger.
Do not wait for a clinician’s permission before contacting emergency services.
Gasping or irregular breathing is not normal breathing.
Allow the emergency call handler to provide first-aid instructions.
Treat deliberate or potentially harmful overdose as an emergency.
Treat immediate suicide risk as seriously as a physical emergency.
Request police assistance where there is immediate violence or a weapon.
Do not allow confidentiality concerns to delay necessary emergency action.
Share only information relevant to the emergency.
Escalate internally after or alongside contacting emergency services.
Document reported words, observed facts and actions accurately.
This module provides remote emergency response and BLS awareness. It does not provide a practical BLS qualification.
