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Someone is in trouble right now

Call for help first: 112 works on mobiles in much of the world · US/Canada 911 · UK 999 · EU 112 · Australia 000 · India 112 · Japan 119. Put the phone on speaker and act while you talk. Learn your local number today, while nothing is wrong.

Part I · Emergencies

Thirteen situations where an untrained bystander decides whether someone lives. Every procedure here is the standard consensus version. Read them once now; your hands will remember more than you think.

1 CPR — collapsed and not breathing CALL FIRST

They don't respond when you shake their shoulders and shout, and they aren't breathing normally. Gasping is not normal breathing — treat it as not breathing.

  1. Point at one specific person: "You — call an ambulance. You — find a defibrillator (AED)." Alone? Call on speaker first.
  2. Kneel beside them. Heel of one hand on the center of the chest, other hand on top, fingers interlocked, arms straight, shoulders over your hands.
  3. Push hard and fast: 100–120 per minute (the beat of "Stayin' Alive"), about 5–6 cm (2 inches) deep. Let the chest fully rise between pushes.
  4. Do not stop except to let an AED analyze, or when professionals take over, or the person moves. Swap with someone every 2 minutes if you can — quality drops fast.
  5. AED: turn it on and do what it says. Bare the chest, stick the pads where the pictures show, touch no one during analysis or shock. You cannot hurt them with it.
  6. Trained and willing: 30 compressions, then 2 breaths. Untrained: compressions alone, without stopping, is the right call — it can double or triple survival versus doing nothing.

Ribs sometimes crack. Keep going — broken ribs heal, a stopped heart doesn't. Children and infants: the cause is usually breathing, so breaths matter more; press about one-third of the chest depth (two fingers or two thumbs for a baby). If alone with a child, do 2 minutes of CPR before pausing to call. Take a real course — it's a few hours, once.

2 Choking

Hands at the throat, can't speak, cough, or breathe. Ask: "Are you choking?" If they can cough or talk, encourage coughing and wait — don't hit them yet.

  1. If the cough is silent or failing: bend them forward and give 5 sharp back blows between the shoulder blades with the heel of your hand.
  2. Then 5 abdominal thrusts: stand behind them, fist just above the navel, other hand over it, pull sharply inward and upward.
  3. Alternate 5 and 5 until the object comes out. Pregnant or in a wheelchair: thrust on the center of the chest instead.
  4. If they collapse: call for help and start CPR. Check the mouth between rounds and remove anything you can see.
  5. Baby under 1: face-down along your forearm, head low — 5 back slaps, then flip and give 5 chest thrusts with two fingers. Never abdominal thrusts on an infant.
  6. Alone and choking: thrust your own abdomen hard against a chair back.

Anyone who received abdominal thrusts should be checked by a doctor afterward, even if fine.

3 Severe bleeding

Blood that spurts, pools, or soaks through cloth. A person can bleed to death in minutes; pressure buys them everything.

  1. Push hard directly on the wound with a cloth, both hands, your full weight if needed. Harder than feels polite.
  2. Don't peek and don't remove soaked cloth — add layers on top and keep pressing, 10 minutes minimum.
  3. Arm or leg, and pressure isn't stopping it: tourniquet 5–7 cm above the wound (not on a joint) — a belt or folded cloth twisted tight with a stick until the bleeding stops. It should hurt. Note the time. Never loosen it.
  4. Keep them warm and lying down. Shock (pale, cold, confused, fast weak pulse) kills — treat it as part of the emergency.

After serious trauma with no visible blood — car crash, long fall — pain, swelling, or confusion can mean internal bleeding. That is a hospital trip, not a wait-and-see.

4 Stroke — FAST MINUTES = BRAIN

Sudden, one-sided, or strange: that's the signature. The treatments that prevent lifelong disability only work in the first hours.

  1. F — Face: ask them to smile. One side droops?
  2. A — Arms: ask them to raise both. One drifts down?
  3. S — Speech: ask them to repeat a simple sentence. Slurred, wrong, or missing?
  4. T — Time: any one sign → call an ambulance now and write down when they were last seen normal — hospitals decide treatment by that clock.

Also sudden: worst headache of their life, vision loss, numbness down one side, confusion, loss of balance. Do not give aspirin (some strokes are bleeds). Do not let them "sleep it off." Even if symptoms pass in minutes, go — that was a warning shot.

5 Heart attack

Pressure, squeezing, or heaviness in the center of the chest for more than a few minutes — possibly spreading to arm, jaw, or back — with sweat, nausea, or breathlessness. Women, older people, and diabetics often get quieter versions: crushing fatigue, "indigestion," just feeling terribly wrong.

  1. Call an ambulance. Don't drive yourself; don't wait to be sure. Being wrong is fine — that's what emergency rooms are for.
  2. While waiting: chew one adult aspirin (325 mg, or 4 baby aspirin) — chewing gets it working faster — unless allergic or told not to.
  3. Sit or lie them down, loosen clothing, unlock the front door for the paramedics.
  4. If they collapse and stop breathing: CPR, immediately.

6 Anaphylaxis — severe allergic reaction

After food, sting, or medicine: hives or swelling plus trouble breathing, throat tightness, vomiting, or faintness — or any breathing trouble after a known allergen.

  1. Epinephrine first, immediately — auto-injector (EpiPen) into the outer thigh, through clothing if needed. When in doubt, inject: it's very safe, and waiting is what kills.
  2. Call an ambulance even if they improve — reactions rebound hours later.
  3. No better in 5–15 minutes and a second injector exists: use it.
  4. Lie them flat with legs raised; if breathing is hard, let them sit. Don't stand them up suddenly.

Antihistamines and asthma inhalers are not substitutes. They treat the itch, not the collapse.

7 Opioid overdose

Won't wake, breathing slow or stopped, pinpoint pupils, blue-grey lips or fingertips. In the fentanyl era, any non-pharmacy pill or powder can do this to anyone.

  1. Naloxone (Narcan) if available: spray in one nostril. It is harmless if you're wrong about the cause — give it.
  2. Call an ambulance. Many countries' Good Samaritan laws protect the caller — the person's life outranks everyone's fear.
  3. No response in 2–3 minutes: second dose, other nostril. Not breathing at all: CPR.
  4. Breathing again: recovery position, and stay — naloxone wears off before the opioid does and they can go back under.

8 Seizure

Convulsing, stiffening, unresponsive. Most seizures end on their own in 1–3 minutes; your job is protection, not intervention.

  1. Move hard objects away; put something soft under the head. Start timing.
  2. Do not restrain them. Do not put anything in their mouth — they cannot swallow their tongue; that's a myth that breaks teeth.
  3. When it stops: roll them into the recovery position, speak calmly — confusion afterward is normal.
  4. Call an ambulance if: it lasts over 5 minutes, repeats, they're injured, pregnant, diabetic, in water, don't wake up — or it's their first seizure ever.

9 Unconscious but breathing — recovery position

Out cold, but breathing normally. The danger is their own tongue and vomit blocking the airway.

  1. Kneel beside them. Nearest arm at a right angle, back of their far hand against their near cheek.
  2. Pull the far knee up and roll them toward you onto their side, bent knee stopping them face-down.
  3. Tilt the head back slightly so the airway stays open. Call an ambulance, and check breathing until it arrives.

10 Burns

  1. Cool running water, 20 full minutes. Not ice, not butter, not toothpaste — cool water, longer than feels necessary. It keeps helping even started an hour late.
  2. Remove rings and loose clothing near the burn now, before swelling — but never anything stuck to skin.
  3. Cover loosely: cling film or a clean non-fluffy cloth. Don't pop blisters.
  4. Go to hospital if: bigger than the person's palm, on face/hands/genitals/joints, deep or white/charred, a child or elderly person, electrical or chemical, or any smoke inhalation. Chemical: brush off dry powder, then rinse 20+ minutes.

11 Drowning

Drowning is silent — no waving, no yelling, just a vertical body, head low, slipping under. Children drown in seconds, in centimeters of water, at gatherings full of adults each assuming another is watching.

  1. Reach or throw — don't go. Pole, towel, rope, cooler, anything that floats. Untrained rescuers drown with the victim, routinely.
  2. Out of the water and not breathing: this is the case where rescue breaths matter most — trained: 5 breaths, then CPR; untrained: continuous compressions and let the dispatcher coach you.
  3. Anyone who nearly drowned gets medically checked, even if they seem fine.

Around water with kids: name one adult "on duty," phone away, rotate. Every "everyone was watching" drowning happened because no one specifically was.

12 Heatstroke & hypothermia

Heatstroke: hot day or exertion + confusion, staggering, or collapse — possibly no longer sweating. It cooks the brain; cooling cannot wait for the ambulance.

  1. Call, then cool aggressively now: shade, strip outer layers, drench with water, fan hard, ice packs to neck, armpits, groin — full cold-water immersion is best if possible.
  2. Merely sweaty, weak, nauseated (heat exhaustion): shade, sips of water, cool cloths — but watch for confusion, the line into emergency.

Hypothermia: violent shivering → clumsy, slurring, confused → stops shivering (critical). Handle gently, get them dry and insulated (wrap everything, including the head), warm sweet drinks only if fully alert. No alcohol, no rubbing limbs, no hot bath — gentle and gradual.

13 Poisoning

  1. Call poison control (US: 1-800-222-1222; elsewhere, search and save your national line today) or emergency services. With the container in your hand — they'll ask what, how much, when.
  2. Do not induce vomiting and don't give "antidotes" from folklore — some poisons burn twice on the way back up.
  3. Unconscious or struggling to breathe: ambulance, recovery position.

Most poisonings are small children and everyday products: medicines, cleaning gel packs, button batteries. A swallowed button battery is a burn-through-the-esophagus emergency — hospital immediately, even if the child seems fine.

Part II · Staying alive the boring way

Nothing in a hospital rivals what's on this list. These are the interventions with the largest, most replicated effects on how long and how well humans live. They are unglamorous, which is exactly why they're neglected.

1 · Smoking is still the big one

No other personal choice comes close. Quitting before ~40 wins back close to a decade of life, and quitting helps at any age — the body starts repairing within days. Willpower alone has a brutal failure rate; medication (varenicline, nicotine replacement) plus support roughly doubles or triples it. If vaping is the off-ramp that finally works, it's far less harmful than cigarettes — but not harmless, so land the plane. If you've never started: don't. That single non-decision outperforms everything else on this page.

2 · Move — anything, but especially strength

If exercise were a pill it would be the best-selling drug in history: it cuts heart disease, stroke, diabetes, several cancers, dementia, and depression. The biggest jump in benefit is from nothing to something — a daily brisk walk is not a consolation prize, it's most of the prize. Target if you want one: ~150 minutes a week of moderate effort plus two strength sessions. After 50, strength and balance are what keep you off the floor and out of the nursing home — a broken hip is a mortality event. The exercise you'll actually repeat beats the optimal one you'll quit.

3 · Sleep is not negotiable

Adults need 7–9 hours; chronically getting less associates with basically everything you don't want — heart disease, diabetes, depression, injuries, dementia. A regular schedule beats perfection. Dark, cool room; screens out of bed; caffeine has an ~6-hour half-life, so afternoon coffee is a midnight decision. Chronic insomnia's first-line treatment is CBT-I (a structured method, not pills). And if you snore hard and are exhausted all day, get tested for sleep apnea — untreated, it quietly shortens lives, and treatment transforms them.

4 · Eat a pattern, not a headline

Diet science looks chaotic in the news and boring in the data. What holds: mostly plants, mostly unprocessed, adequate protein, mostly water/tea/coffee to drink. Mediterranean-style eating has the strongest evidence of any named pattern. Sugary drinks are the clearest single harm — liquid sugar with no brakes. Supplements don't rescue a bad diet (exceptions: B12 for vegans, folate in pregnancy, vitamin D if you're actually deficient). For weight: crash diets reliably boomerang; small permanent changes, protein, and strength training are what stick.

5 · Alcohol: less is simply better

The old "a glass of wine is good for the heart" story has collapsed under better analysis — there's no clearly protective dose, and risk climbs steadily. This isn't a demand for zero; it's the honest curve: every step down is a win. If drinking has become a struggle, that's a medical condition, not a character verdict — naltrexone and structured treatment work, and asking for them is the strong move.

6 · Know your silent numbers

High blood pressure is the world's biggest treatable killer and it has no symptoms — the first sign is often the stroke. Check it yearly (pharmacy machines count); treatment is cheap, generic, and dramatically effective. Same for cholesterol and blood sugar. Do the screenings your local guidelines set (colon around 45–50, breast, cervical) — they exist because these cancers are curable early and lethal late. Dentistry is healthcare too, not cosmetics.

7 · Vaccines: keep the wins

Vaccination has saved more lives than almost any invention in history. The diseases feel gone because of the shots, not despite them — drop the shots and measles walks right back in, as it keeps demonstrating. Keep tetanus current (every 10 years), take flu/COVID shots seriously if you're older or vulnerable, vaccinate the kids on schedule.

8 · The road is the most dangerous place you go

Crashes are a leading killer of the young everywhere. The seatbelt halves your odds of dying — every seat, every trip, no exceptions for the back seat or the five-minute drive (that's where the crashes are). Helmets on two wheels, always. Never drive drunk or drowsy — fatigue impairs like alcohol. And at highway speed, a 2-second glance at a phone is ~60 meters driven blind.

9 · If there's a gun in the house

Store it locked, unloaded, ammunition separate. This isn't politics; it's the arithmetic of impulsive moments — most gun deaths in many countries are suicides, often decided in minutes. The same logic covers medicines: during any household mental-health crisis, locking away the means saves lives, because crises pass and access decides what happens during one. See Part III.

10 · Loneliness is a medical risk factor

Weak social connection predicts early death on the same order as major classic risk factors — this is one of the most replicated findings in public health, and the longest-running study of human flourishing lands on one blunt conclusion: the quality of your relationships is the strongest predictor of a good life. Treat your small circle like training: schedule it, show up, repair fights instead of winning them, and say the grateful thing to people while they're alive to hear it. Nobody at 90 wishes they'd answered more email.

Part III · The mind

The mind fails like the body fails — commonly, treatably, and with no shame that survives scrutiny.

Depression and anxiety are treatable — actually

The majority of people who get proper treatment improve. Therapy (CBT and relatives) and medication perform comparably; for moderate-to-severe cases, together beats either. Exercise is a legitimately strong adjunct — not a platitude, a repeated trial result. Two mechanical insights worth their weight: for depression, motivation follows action, not the reverse — do the ten-minute version before you feel like it, because the feeling arrives during, not before. For anxiety, avoidance is the food supply — every avoided thing confirms the danger; approached gradually, the alarm recalibrates. Panic attacks feel like dying and never are; they crest and fall in minutes. And if weeks pass without daylight in your mood: that's a doctor visit, exactly like a fever that won't break.

If you are thinking about ending your life

Read this part slowly. The state you're in lies about being permanent — it is a storm, and storms end, and the overwhelming majority of people who survive a suicidal crisis are later glad they did. You don't have to fix your life tonight; you only have to get through tonight. Three moves: tell one person — out loud, today, imperfectly. Call or text a crisis line — US: call/text 988 · UK & Ireland: 116 123 · Australia: 13 11 14 · India: 14416 · anywhere: search "crisis line" + your country; they exist and they answer. Put distance between you and the means — give the pills or the weapon to someone else for now, because crises are short and access is what turns a bad night into a permanent answer. If someone tells you they're thinking about it: asking directly does not plant the idea — it opens the door. Take everything said seriously, stay, help them do the three moves.

Addiction is a condition, not a verdict

Relapse rates look like other chronic diseases, and treatment works like other chronic disease treatment: imperfectly, repeatedly, and far better than nothing. For opioids specifically, medication (buprenorphine, methadone) roughly halves death rates — it is the standard of care, not "replacing one addiction with another." Harm reduction — naloxone at hand, never using alone — keeps people alive long enough to recover, which is the entire point.

Ten tools for thinking straight

  • The stronger your emotional reaction to a claim, the harder you should check it. Outrage and fear are the business model of the feed you're reading.
  • Ask the base rate first. "How often does this happen in general?" deflates most scary stories and most miracle cures.
  • Ask "what would change my mind?" If the honest answer is "nothing," you're not holding a belief, you're wearing an identity.
  • Steelman before you dismiss. If you can't state the other side so they'd nod, you don't understand it yet — you've only met its worst spokesman.
  • Follow the incentive. Who profits if you believe this? Not proof of falsehood — but it sets how much verification the claim owes you.
  • Stories aren't statistics. "It worked for my cousin" is how every scam and every quack treatment has been sold since forever.
  • Confidence is not competence. The loudest person in the room is running a volume strategy, not an accuracy strategy.
  • Match speed to reversibility. Reversible decisions: decide fast, iterate. Irreversible ones: sleep on them — a night reliably beats an hour of rumination.
  • Run the pre-mortem. Before anything big: "It's a year from now and this failed — what killed it?" You'll find the hole while it's still cheap.
  • Changing your mind on evidence is winning. The person who updates ends up right; the person who never does merely ends up loud. This applies to everything in this file.

Part IV · Not getting robbed

Fraud is now industrial, AI-assisted, and aimed at everyone — the confident get taken as often as the naive. The defenses are structural, not cleverness.

The scam skeleton — memorize the shape

Nearly every scam on earth is the same three bones: urgency ("act now, tell no one, or else"), a channel they opened (they called/texted/emailed you), and an unusual way to pay (gift cards, crypto, wire transfer, "verification codes"). Any two of those together: stop. The single strongest defense is the callback rule — hang up and contact the organization through a number or site you find yourself. Real banks, police, and tax offices survive that test every time; scammers never do. Know the current classics: "your account is compromised, move money to a safe account" (banks never ask this — never); the romance that turns into an investment opportunity (that's a script, run by professionals, called pig-butchering); the panicked call in a loved one's cloned voice needing bail money — agree on a family code word today; the "guaranteed" high-return investment (guaranteed + high return = fraud, by definition, no exceptions). Urgency is the tell: everything legitimate survives 24 hours and a second opinion.

Digital locks that actually matter

  • Password manager + a unique password per site. Reuse is how one leaked account becomes all of them.
  • Two-factor authentication on email and bank first — email is the master key that resets everything else. An authenticator app beats SMS codes.
  • Install updates promptly. Most hacks walk through holes that were patched months earlier.
  • Back up what you can't lose — one copy elsewhere (cloud or a drive not plugged in). Ransomware and dead phones are a when, not an if.
  • Never enter a password from a link someone sent you. Type the address yourself. That one habit defeats most phishing outright.

Money in six sentences

Spend less than you earn — every other rule is decoration on this one. Build an emergency fund (aim at 3–6 months of expenses) — it converts disasters into inconveniences and changes how boldly you can negotiate with life. High-interest debt is a house fire: extinguish it before any investing. After that, boring wins: broad, low-cost index funds plus time outperform the vast majority of professional stock-pickers over the long run — decades of scorekeeping confirm it — and compounding means every year you start early counts roughly double. Insure only catastrophes (health, liability, term life if people depend on you) and skip the extended warranties. And anyone who contacts you first with a way to grow your money is not your friend; see the skeleton above.

Part V · Learning anything

Cognitive science has clear answers here, and almost no one uses them.

  • Test yourself; don't reread. Retrieval — closing the book and forcing recall — is the single most effective technique known. Rereading produces fluency, which feels like knowledge and isn't.
  • Space it out. Five separated half-hours beat one 2.5-hour cram, dramatically and durably. (Flashcard apps with spaced repetition automate this.)
  • Difficulty is the signal, not the problem. If practice feels smooth, you're rehearsing what you already know. The strain of almost-getting-it is what learning feels like from the inside.
  • Explain it to someone. Nothing exposes the gap between "familiar" and "understood" faster. The gaps you find are the lesson plan.
  • Sleep is where memory is written. The all-nighter sacrifices consolidation for exposure — it destroys the thing it's for.
  • For skills: small and daily beats big and rarely. Twenty focused hours makes you genuinely decent at most hobby-level things. The barrier is never talent at that stage; it's starting, and tolerating being bad for the first ten.

Part VI · For everyone else

The highest-leverage things one ordinary person can do for people they'll never meet.

  • Take a real CPR/first-aid course. A few hours, once. Part I gives you the knowledge; the course gives your hands the reflex for the day someone drops in front of you — most likely someone you love, since most arrests happen at home.
  • Give blood. An hour of your time, up to three people helped per donation, perpetual shortage everywhere.
  • Register as an organ donor — and tell your family, because in the worst moment they'll be asked, and knowing your wish is what lets them say yes. One donor can save eight lives.
  • If you give money, aim it. The best charities do on the order of 100× more good per dollar than the average — the gap between "fine" and "best" is the whole game. Independent evaluators (GiveWell is one) publish the math: malaria nets, childhood vitamin A, direct cash transfers — unglamorous, verified, absurdly cheap per life improved.
  • Vote, every time, including the boring local ones — those decide more of daily life than the famous ones, and your vote is thousands of times weightier there.
  • Spend kindness at the margins. The tired cashier, the new person eating alone, the friend gone quiet. You will never find out which small decency was load-bearing in someone's day — that's the deal. Do it anyway.
  • Give this file away. It's public domain by design. Send it to someone younger; better, walk them through Part I once.

No rights reserved — this file is dedicated to the public domain. Copy it, translate it, improve it, hand it on.