When someone collapses or appears unresponsive, every second counts. Performing an assessment to check for a response before starting CPR is an important step in the DRSABCD Action Plan.

COWS is a simple, easy-to-remember acronym to help first responders check if a person is unconscious. If the person responds to any of these prompts, they are not fully unresponsive but may still need urgent medical care. If there is no response at all, continue with the next steps of DRSABCD.

What does COWS stand for?

Can you hear me?

Speak clearly and loudly to the person. Ask questions like “Can you hear me?” or “Are you okay?”

Open your eyes

Look for signs of eye movement or an attempting to open eyelids. Slow, random movements like what might be seen during sleep do not indicate consciousness.

What’s your name?

If the person can correctly state who they are, that’s a positive indicator of consciousness and cognitive function.

Squeeze my hand

Offer both your hands and ask them to squeeze. This can check for motor function even if the person cannot speak. A weak or one-sided response may also indicate a stroke.

Performing first aid on a casualty can be stressful, especially if it's someone you know. Using COWS gives you a structured approach to check for response and helps you stay calm and confident in an emergency.

Learn more about how to perform a primary assessment below.