Gary should first check if Paula is breathing by tilting her head back and looking, listening, and feeling for breaths. Since Paula is unresponsive and not breathing, Gary should immediately call emergency services (911 or 999) and then start chest compressions (CPR) by pushing firmly in the middle of the chest at a rate of about 2 compressions per second. This will help keep blood flowing to vital organs until professional help arrives. If an AED (automated external defibrillator) is available, it should be used as soon as possible according to its instructions.