A.S.S.E.S.S., D.E.C.I.D.E., and A.C.T.I.O.N
Emergencies rarely arrive with warning. One moment things are normal, the next you’re faced with someone hurt, in distress, or experiencing a crisis. In those moments, panic can creep in fast. What do you do first? Do you call 911 right away? Do you step in? Do you wait?
That’s where EQUIP’s three frameworks come in. Think of them as roadmaps for the unexpected:
A.S.S.E.S.S. gives you a clear first look at any situation (medical or mental health) so you can decide whether it’s safe and serious enough for immediate emergency action.
D.E.C.I.D.E. helps you sort out medical and trauma situations once you’ve gathered the facts, guiding you to the right level of care without overreacting or under-reacting.
A.C.T.I.O.N. is tailored for mental health crises, showing you how to step in calmly, de-escalate, and offer support while knowing when to bring in professional help.
These tools are simple, memorable, and designed for real people; not just medical professionals. They don’t make you a doctor, but they give you confidence and clarity in those crucial first moments when someone needs help.
A.S.S.E.S.S.
Before you rush in, stop and scan. Emergencies can trick us into tunnel vision, focusing only on the injured person and missing the bigger picture. A.S.S.E.S.S. makes sure you’re safe, you’ve got the facts, and you’re not missing critical warning signs.
Awareness (Is the Scene Safe?)
Check your surroundings to ensure it’s safe to approach. Hazards can put both you and the person at risk.
Things to check for:
Fire, smoke, chemical spills, or gas leaks.
Oncoming traffic, moving machinery, or unstable structures.
Live wires or downed power lines.
Aggressive people or animals.
Poor lighting or environmental hazards (ice, water, sharp objects).
Seriousness (Life-Threatening Injuries or Symptoms)
Evaluate if the person has any life-threatening conditions that require immediate intervention. Call 911 if you see:
No breathing or no pulse.
Severe bleeding that won’t stop with pressure.
Chest pain, pressure, or discomfort.
Sudden weakness, slurred speech, facial drooping (possible stroke).
Seizures lasting more than 5 minutes or repeated seizures.
Loss of consciousness with inability to wake up or altered level of consciousness upon waking.
Severe allergic reaction (swelling of face, tongue, throat; difficulty breathing).
Stability (Getting Worse, Staying the Same, or Getting Better)
Evaluate if the person’s current condition is stable or if it may worsen. Emergencies usually aren’t static. Monitor for:
Breathing changes: shallow, rapid, or labored breathing.
Confusion, disorientation, or unresponsiveness.
Skin/lip color: pale, bluish, clammy, or flushed.
Increasing pain or swelling.
Drop in energy, responsiveness, or alertness.
Other new or worsening symptoms.
Explanation (What Happened?)
Gather information from the person and/or bystanders about the events leading up to the emergency. Understanding the context can clarify the cause and guide response steps. Ask the person or witness:
“What happened?” (Gives the person/witness the opportunity to share what they think is important)
“Did they fall? Were they hit by something?”
“Did they take medication, alcohol, or substances?” or “Have they taken anything out of the ordinary for them?”
“Have they eaten today?” or “What did they eat last and when?”
“Do they have any medical conditions (diabetes, heart disease, epilepsy)?”
“Are they acting differently than they typically act?”
Symptoms (What Are They Feeling Now?)
Ask the person about any symptoms they are experiencing that don’t necessarily signal a life-threatening emergency but still may need attention. This could include a range of mild to moderate issues like fever, cold or flu symptoms, minor injuries, or discomforts that don’t pose an immediate danger. This is also where you can catch things you may have previously missed. Some issues may not be visible. Ask:
“What are you feeling?” (Gives the person the opportunity to share what is impacting them most)
“What feels different than what you normally feel?” (Different people have different baselines)
“Are you dizzy, lightheaded, or nauseous?”
“Do you have chest pain, pressure, or trouble breathing?”
“Do you have a headache, vision changes, or tingling in your arms/legs?”
“On a scale of 1-10, how bad does [injury or symptom] feel?”
Solution (Move to D.E.C.I.D.E. or A.C.T.I.O.N.)
Take next steps based on the information gathered:
Life-threatening? Call 911!
Medical/trauma but not life-threatening? Use D.E.C.I.D.E.
Emotional or mental health crisis? Use A.C.T.I.O.N.
D.E.C.I.D.E. (Medical Emergency)
Not every medical situation requires a 911 call. At the same time, brushing something off as “just fine” can be dangerous. D.E.C.I.D.E. helps you sort through those gray zones with a clear ladder of options.
Dangerous? (Call 911)
Look for life-threatening conditions that require immediate emergency intervention. The majority of these conditions should be flagged through A.S.S.E.S.S., and emergency responders should already be on the way if these conditions are present. You may also need to take action before additional help arrives in these situations.
Serious head injuries (loss of consciousness, vomiting, confusion).
Severe breathing difficulty or anaphylaxis (especially if this is the first anaphylactic response or if only one dose of epinephrine is available)
Person is unconscious or unresponsive.
Seizure that doesn’t stop.
More information on what to do before additional help arrives in these situations is linked above.
ER Needed?
For serious but non-immediately life-threatening issues take the person to the emergency room to receive urgent medical attention. If you or someone else are not able to bring them to the ER, call 911.
Broken bones with visible deformity. Stabilize in place before moving them. If unable to stabilize, call 911.
Large, deep wounds. Don't move someone with uncontrolled bleeding unless necessary (unsafe situation). Control bleeding before moving them. If unable to control bleeding within 1 to 2 minutes, call 911.
Major burns (burns skin, muscle, and sometimes bone; covers more than 15% of an adult’s body or 10% of a child's body, hand is about 1.5% of body) especially to face, hands, genitals, or major joints. Remove tight items and loosely cover the burn. If person is unable to move themself, or it is too painful to move them, call 911.
Head injuries, especially if on blood thinning medication.
Severe allergic reactions needing epinephrine. Only transport them yourself if you are within 10 minutes or have additional doses of epinephrine.
Vaginal bleeding during pregnancy.
Children who are under 3 months old, immunocompromised, undergoing chemo, transplant recipients, have a central line/port, or are unvaccinated with a fever (100.4 °F).
Care Needed Quickly? (Urgent Care)
For less severe conditions, urgent care can provide the necessary treatment and is often quicker and less intensive (and less expensive) than the ER. Generally for pain/intensity 5 or higher on a scale of 1-10.
Moderate burns, sprains, or strains.
Cuts that may need stitches.
Ear infections, strep throat, or urinary infections.
Fevers not responding to medication.
Dehydration or heat related illness.
Vomiting, stomach cramping, and/or diarrhea lasting more than 24 hours for adults, 12 hours for children.
Migraines.
Information or Advice? (Call Nurse Line, Poison Control, Visit a Walk-In Clinic)
For minor injuries or non-urgent conditions, seek professional advice over the phone from a nurse line, Poison Control, or a walk-in clinic/fire station.
Nurse Line: Check on the back of your insurance card, go to your health insurance plan website, or call your health system (Allina Health, M Health Fairview, Hennepin Healthcare, etc) and request the nurse line
Poison Control: fill out a triage form online at triage.webpoisoncontrol.org or by phone at 1-800-222-1222
Walk-In Clinic/Same Day Appointment: MinuteClinic® at CVS®, Family Tree Clinic, etc
Fire Station: A lot of firefighters have at least some medical training and can provide minor guidance. Check in with your local station to build relationships and see what they are are to offer.
These options are for situations that don’t require immediate emergency intervention but still benefit from medical guidance or minor treatment. Generally for pain/intensity 4 or less on a scale of 1-10. If you have medical training, you may not need additional advice to manage or treat these conditions. Monitor for worsening symptoms.
Cold or flu like symptoms.
Ear or eye pain.
Mild burns, sprains, or strains.
Mild rashes or allergic reactions.
Painful urination.
Possible food poisoning.
Minor medication mix-ups.
Parents unsure about child’s symptoms.
Doctor Follow-Up Needed?
If the person requires ongoing care or monitoring, arrange for follow-up with a primary care provider or specialist.
Worsening chronic conditions (like asthma, diabetes, or high blood pressure).
Infections needing antibiotics.
Post-injury monitoring (like concussions).
Everyday Care (Self-Treat)
For minor injuries or conditions, provide basic first aid and monitor for improvement.
Small scrapes or bruises.
Headaches, mild colds, sore throats.
Minor stomach upset.
Rest, hydration, over-the-counter medications, and monitoring.
A.C.T.I.O.N. (Mental Health Crisis)
When the crisis isn’t physical but emotional, the response needs to shift. Mental health emergencies can feel less visible but just as urgent. The wrong approach (rushing in, talking down, or ignoring) can make things worse. A.C.T.I.O.N. gives you a compassionate playbook.
Assess the Situation
Evaluate the safety of the environment, the person in crisis, and your own emotional state. Before engaging, determine whether the situation is safe for you to step in and if you are in a calm and grounded state to help effectively.
Is the person in a safe environment, or are they near weapons, traffic, or other hazards?
Are you emotionally steady enough to engage without escalating? Will engaging in this situation harm your own mental health?
Is anyone else at risk?
Calm and Centered Approach
Approach the person slowly and calmly. Use open, non-threatening body language, and speak in a gentle tone. Avoid rushing or startling the person. If they are in an altered mental state but not presenting danger, “roll with their reality” instead of trying to force them back to your perception.
Get on their level, don't stand over them if they are sitting.
Speak softly, slowly, and respectfully. Consider alternative methods of communication (typing/texting, writing, yes/no questions with non-verbal response).
Maintain non-threatening body language (hands visible, relaxed posture).
Give personal space, don’t crowd them. Do not touch them unless it is requested.
Avoid sudden movements.
Talk and Listen Without Judgment
Engage the person with empathetic active listening.
Show you are present in the conversation with both verbal (I hear you, mmhm, yes/no, gasp) and nonverbal (nod, lean closer) communication.
Engage with curiosity instead of judgement.
Be mindful of your thoughts and initial reactions to what they are saying.
Let them share their thoughts and feelings without trying to fix the situation or telling them what they should do.
Avoid dismissive language like “calm down” or “you’re fine.” Instead, acknowledge what they are feeling. Use phrases like:
“I hear you.”
“That sounds really hard.”
“It is okay to feel that way.”
“What I understand is [paraphrase what you've heard them say].”
Identify Immediate Needs
Assess whether the person is a danger to themselves or others.
Signs of suicidal ideation: expressing hopelessness, talking about death, giving away belongings.
Self-harm behavior (cutting, burning, hitting themselves, harmful substance use).
Inability to care for themselves (not eating, sleeping, or responding).
Aggression or threats toward others.
If they are showing any of the signs above, consider call for professional help. Use neutral, non-confrontational language when seeking outside intervention.
Offer Support and Options
Give the person choices and let them feel in control of their decisions. Offering support without forcing action allows them to regain some agency during the crisis. Present options like:
Call or text a crisis hotline together.
Contact a trusted friend or family member.
Suggest calming actions (deep breathing, moving to a quiet space).
Remind them they have choices.
Next Steps (Crisis Intervention or Continued De-escalation)
If the situation remains unstable or the person is in immediate danger, call for professional intervention such as a mobile crisis unit or 911. If they stabilize, assist them in connecting with longer-term support, such as a crisis line, therapist, or trusted friend or family member.
