What Paramedics Do First in an Emergency

Quick answer

In the first ten minutes of an emergency, paramedics do two things: they keep you alive, and they build a picture of who you are. The first is training. The second depends entirely on what they can find out — from you, from bystanders, or from something you are carrying. When they hand you over at hospital, the format they use has three fields a stranger cannot fill in: Allergies, Medications, Background history. That is the gap a medical ID closes.

Most articles about medical IDs argue from the patient’s side. This one is written from the other side of the stretcher — what actually happens when help arrives, in what order, and where your information does and does not fit.

What happens when they arrive

Nobody asks about your history first. The opening minutes are about immediate threats, in a fixed order that mirrors the DRSABCD sequence bystanders are taught:

Danger — is the scene safe to work in.
Response — are you conscious, and how deeply. See the COWS response check.
Airway and Breathing — is air moving.
Circulation — pulse, bleeding, perfusion.
Defibrillation if the heart has stopped.

Only once that is stable does anyone ask the questions that shape treatment. And that is precisely the point at which an unconscious patient becomes a problem to solve rather than a person to treat.

The handover format, and the three fields you can pre-fill

Australian paramedics hand patients over to the emergency department using a structured format, so the same information arrives in the same order every time. The widely used one is IMIST-AMBO.

Letter	What it covers	Who can supply it
I	Identification — name and age	You, a bystander, or ID you carry
M	Mechanism of injury, or medical complaint	The scene, witnesses
I	Injuries or information related to the complaint	Examination
S	Signs and symptoms	Examination
T	Treatment given, and trends	The crew
A	Allergies	Only you — unless it is written down
M	Medications	Only you — unless it is written down
B	Background history	Only you — unless it is written down
O	Other information	Anyone

Look at the pattern. Six of the nine fields can be observed. The three highlighted ones cannot — they have to come from the patient, from someone who knows them, or from something they are carrying. If you are unconscious and alone, those three arrive at the hospital blank.

The details that actually change treatment

Not everything in a medical history matters in the first hour. These do.

Blood thinners. Warfarin, apixaban, rivaroxaban, clopidogrel. A head knock or a bleed is managed completely differently — see severe bleeding first aid.
Drug allergies. Particularly to antibiotics or anaesthetic agents. The wrong drug creates a second emergency on top of the first — see anaphylaxis first aid.
Diabetes and insulin. A confused, sweating, aggressive patient may be having a hypo, not a stroke or a drug reaction — see diabetic emergency first aid.
Epilepsy. Turns an unexplained collapse into a recognised event with a known course — see seizure first aid.
Implanted devices. A pacemaker, defibrillator, insulin pump or shunt changes what can safely be done, including where pads are placed.
Advance care wishes. If they exist, they need to be findable at the time, not discovered afterwards.

Where the information has to be to be found

An emergency is a bad time to go through someone’s belongings, and often nobody does. Information only helps if it is somewhere obvious and quick.

On the body. A wristband or pendant stays with you when a bag does not, and the wrist and neck are the conventional places to wear medical identification — which is why they are where people look.
In a wallet. Useful, but a wallet can be in a bag, in a car, or at home.
On a phone. Lock-screen medical ID features help, but a phone can be locked, flat, smashed or in another room.
On the fridge. Common in aged care and useful at home — and useless anywhere else.

The realistic answer is more than one of these, with at least one physically attached to you. See what to put on your medical wristband and how to set up your emergency contacts.

Allergies. Medications. Background history. Three fields, and only you can fill them in.

A MedibandPlus profile answers all three from a membership number you carry — readable by a responder on any phone, with no app and no login.

Store your conditions, medications and emergency contacts — explore MedibandPlus

Part of the Mediband family. Designed in Australia since 2004.

If you are the bystander

You are not expected to diagnose anything. But you can hand the crew a great deal in thirty seconds:

What you saw, especially the very beginning — did they clutch their chest, go stiff, simply slump?
How long it has been. Guessing tends to overestimate, so check a clock if you can.
Whether anything changed — were they talking and then stopped?
Any medical ID you noticed, or medication near them. Do not hunt through pockets while they need attention, but do mention what is visible.
Stay. You are the only witness to the part nobody else saw.

See what to say when you call an ambulance for how that conversation usually goes.

What you can do about it today

Write down your allergies, medications and conditions — the three blank fields. Anywhere is better than nowhere.
Put a copy somewhere attached to you, not only in a bag or a phone.
Name an emergency contact who actually knows your history, not simply whoever is closest.
Keep it current. A medication list from three years ago can be worse than none — see what to include in your medical records.
Tell someone it exists. Information nobody knows to look for does not get looked for.

Related reading: what MedibandPlus is and how it works and the 10 most common medical emergencies. If you take a medication or have an allergy a responder would need to know, you can create your emergency profile in a few minutes.

FAQs

What do paramedics do first when they arrive?

They check the scene is safe, then assess response, airway, breathing and circulation, and defibrillate if the heart has stopped. It follows the same order as the DRSABCD sequence bystanders are taught. Questions about your medical history come after that, once immediate threats are managed.

What information do paramedics hand over at hospital?

Australian paramedics commonly use a structured format called IMIST-AMBO: Identification, Mechanism or medical complaint, Injuries or information, Signs and symptoms, Treatment given and trends, then Allergies, Medications, Background history and Other information. It means the same details arrive in the same order every time.

Which parts of a handover can a responder not work out for themselves?

Allergies, medications and background history. Six of the nine IMIST-AMBO fields can be observed at the scene or measured, but those three have to come from the patient, from someone who knows them, or from something the patient is carrying. If you are unconscious and alone, they arrive at the hospital blank.

What medical details change emergency treatment the most?

Blood thinners, drug allergies, diabetes and insulin use, epilepsy, implanted devices such as a pacemaker or insulin pump, and any advance care wishes. Each one changes what is safe to give you or what is likely to be happening, and none of them is visible from the outside.

Where should I keep my medical information so it is found?

Somewhere physically attached to you is the most reliable, because bags, wallets and phones get separated from people or arrive locked and flat. A wristband or pendant is conventional for exactly that reason. Keeping a copy in a wallet or on a phone as well is sensible, but should not be the only place.

What can I do as a bystander to help the paramedics?

Tell them what you saw, especially how it started, how long it has been, and whether anything changed while you watched. Mention any medical ID or medication you noticed. Stay with them, because you are often the only witness to the part nobody else saw. You are not expected to diagnose anything.

Does carrying a medical ID actually make a difference?

It fills the fields nobody else can. It does not treat you, call an ambulance or replace first aid, and it will not matter in every emergency. What it does is make sure that when the crew reaches the point of asking what you are allergic to and what you take, there is an answer available rather than a blank.

Sources

Australian Commission on Safety and Quality in Health Care — Clinical handover — why structured handover formats exist and what they are designed to prevent.
ANZCOR Guideline 4 — Airway — the Basic Life Support sequence that the first minutes of any response follow.
healthdirect — Emergencies — recognising an emergency and what happens when you call for help.
Triple Zero (000) — calling an ambulance and what the call taker will ask you.

Disclaimer: This article is general information about how emergency care works in Australia, not medical advice or a substitute for accredited first aid training. Practice varies between states and services. In an emergency, always call Triple Zero (000). For non-urgent health advice, call healthdirect on 1800 022 222 (NURSE-ON-CALL 1300 60 60 24 in Victoria, 13 HEALTH 13 43 25 84 in Queensland) or speak with your GP. MedibandPlus stores and provides access to a member’s own medical information; it does not assess, diagnose or treat any condition.