What does C.O.W.S stand for in first aid and how is it used to assess responsiveness?

C.O.W.S is a first aid acronym used to assess a casualty’s level of responsiveness during the initial steps of the DRSABCD action plan. Determining whether someone is conscious or responsive is critical for deciding the next steps in first aid and emergency care.

The acronym stands for:

• C – Can you hear me? (Check for auditory response)
• O – Open your eyes. (Check for visual response)
• W – What’s your name? (Check for verbal response)
• S – Squeeze my hand. (Check for motor response)

If the casualty does not respond to any of these prompts, they are considered unresponsive, and the first aider should call 000 and proceed with airway and breathing checks, following the DRSABCD protocol.

C.O.W.S is particularly useful in collapsing or unconscious casualty scenarios, such as after a fall, medical event, or suspected cardiac arrest. A clear and systematic approach like C.O.W.S helps first aiders make quick, informed decisions and start life-saving measures without delay.

Use C.O.W.S to quickly assess if a casualty is responsive.

How to use C.O.W.S:

• Approach safely and check for hazards (D in DRSABCD).

• Ask loudly: “Can you hear me?”

• Tell the person to open their eyes.

• Ask: “What’s your name?” to check verbal response.

• Ask them to squeeze your hand to test movement.

Takeaway to Remember

C.O.W.S is a simple first aid acronym used to check if a casualty is responsive: Can you hear me? Open your eyes. What’s your name? Squeeze my hand.