First Aid & Basic Life Support L1

First aid is the immediate, temporary help given to someone who is injured or suddenly unwell, before professional medical help arrives or takes over. The goal is to preserve life, prevent the condition worsening, and promote recovery, not to diagnose or treat.

Before you approach

• Check the scene is safe for you, then the casualty, then any bystanders. Do not become a second casualty.
• Check the casualty's response. Speak clearly and gently shake their shoulders. Note whether they respond, and how.
• Shout for help and send someone to call the emergency number for your country, or an appropriate site emergency contact, as soon as a serious problem is suspected.

A simple primary survey helps you work through priorities in order: Danger, Response, Airway, Breathing, Circulation. Some versions add Send for help early in the sequence. Follow the version taught in your accredited practical course and your site's emergency procedure.

• Danger: remove risks to yourself and the casualty where it is safe to do so, or move the casualty only if leaving them in place is more dangerous.
• Response: is the casualty alert, responding to voice, responding only to pain, or unresponsive?
• Airway: is it open and clear?
• Breathing: is it present, and is it normal?
• Circulation: is there severe bleeding or other obvious life-threatening injury?

Stay with the casualty, keep monitoring them, and pass on clear information when the emergency service or a more qualified responder arrives: what happened, when, what you have done, and how the casualty has changed.

If a casualty is unresponsive and not breathing normally, they need basic life support without delay. Occasional gasping is not normal breathing and should be treated as if the casualty is not breathing.

The general sequence taught by resuscitation councils

1. Confirm the scene is safe and the casualty is unresponsive.
2. Open the airway by gently tilting the head back and lifting the chin, then check for normal breathing for no more than about ten seconds.
3. If breathing is absent or not normal, call the emergency number (or have someone else call) and ask for an automated external defibrillator, or AED, if one is available nearby.
4. Begin chest compressions: push hard and fast in the centre of the chest, aiming for a rate of roughly 100 to 120 compressions per minute and a depth of around 5 to 6 centimetres in an adult, allowing the chest to fully recoil between compressions.
5. If trained and willing, give 30 compressions followed by 2 rescue breaths, and continue this cycle. Compression-only CPR is a reasonable alternative for an untrained or unwilling rescuer, following the guidance of the emergency call handler.
6. Attach and follow the voice prompts of an AED as soon as one arrives. It will analyse the heart rhythm and only advise a shock if one is needed.
7. Continue CPR until professional help takes over, the casualty shows signs of life, an AED advises otherwise, or you are too exhausted to continue safely.

Recovery position: if the casualty is unresponsive but breathing normally, place them in the recovery position taught in your practical course, keep monitoring their breathing, and be ready to begin CPR if their breathing stops or becomes abnormal.

These figures reflect the general adult guidance published by international and national resuscitation councils. Technique, hand placement, breath volume and the approach for infants and children are different and must be learned through supervised, hands-on practical training, not from this page.

Choking

Ask the casualty, "Are you choking?" A person who can speak, cough forcefully or breathe is having a mild obstruction. Encourage them to keep coughing and do nothing else unless their condition worsens.

For a severe obstruction, when the casualty cannot speak, cry, cough effectively or breathe:

1. Give up to 5 sharp back blows between the shoulder blades with the heel of your hand, checking after each one whether the obstruction has cleared.
2. If back blows do not work, give up to 5 abdominal thrusts, standing behind the casualty and pulling sharply inwards and upwards below the ribcage.
3. Alternate between 5 back blows and 5 abdominal thrusts, calling the emergency number if the obstruction has not cleared or if the casualty becomes unresponsive.
4. If the casualty becomes unresponsive, lower them carefully to the ground, call the emergency number if not already done, and begin CPR as taught in lesson 2, checking the mouth briefly before each set of breaths for any visible obstruction.

Abdominal thrusts are not used on infants, and technique differs by age, body size and pregnancy. Learn the correct method for each group in a supervised practical course before relying on it.

Severe bleeding

Life-threatening bleeding needs immediate direct action while help is called.

• Apply firm, direct pressure to the wound with a clean dressing or the cleanest available material, and maintain that pressure continuously.
• Do not remove an object embedded in a wound. Apply pressure around it and build up padding to control bleeding without pressing directly on the object.
• Where practical and not contraindicated by another injury, keep the injured area raised above the level of the heart to help slow blood loss.
• Watch for signs of shock, such as pale, cold or clammy skin, rapid weak pulse, rapid breathing, or the casualty becoming anxious, faint or confused. Keep them warm, reassured, and lying down with legs raised slightly if there is no injury that makes this unsafe.
• A tourniquet may control catastrophic limb bleeding that direct pressure cannot stop, but it should only be applied by someone trained in its correct use and timing, and its use should be recorded and reported to the arriving medical team.

A worker cuts their forearm deeply on site machinery and it is bleeding heavily. The correct immediate response is to apply firm direct pressure with the cleanest available dressing, call for emergency help, and keep monitoring the casualty for signs of shock while help is on its way.

Burns and scalds

• Stop the burning process first: remove the casualty from the heat source, and remove smouldering clothing and jewellery near the burn unless it is stuck to the skin.
• Cool the burn under cool, running water for about 20 minutes, as soon as possible after the injury.
• Do not apply ice, ointments, creams, oils or adhesive dressings to a burn.
• Cover loosely with clean, non-fluffy material or cling film laid rather than wrapped, once cooling is complete.
• Seek urgent medical attention for burns that are large, deep, on the face, hands, feet, genitals or major joints, caused by chemicals or electricity, or affecting a child, an older person or someone with other health conditions.

Other common injuries, in brief

Suspected fractures should be supported in the position found where possible, kept still, and left for trained personnel or emergency services to move and splint, unless immediate danger requires moving the casualty. Head injuries, chest injuries and suspected spinal injuries all carry serious risk and require emergency assessment; awareness training does not qualify you to assess or clear these injuries yourself.

The limits of this course

This course explains the general priorities and sequence used in first aid and basic life support. It is not a substitute for an accredited, practical course that includes supervised technique practice, manikin-based CPR training, assessment of competence and instruction on legal duties that apply in your country or workplace. Many jurisdictions require a designated, certified first aider and a stocked first aid kit appropriate to the risks of the workplace. Confirm and follow the specific legal requirements and your employer's first aid arrangements that apply to you.

Official references

• UK HSE: First aid at work
• Resuscitation Council UK: Adult basic life support guidelines
• International Liaison Committee on Resuscitation (ILCOR)
• US OSHA 29 CFR 1910.151: Medical services and first aid
• British Red Cross: First aid advice

This course uses original wording based on these official sources. Always check the first aid rules, provision requirements and training standards that apply to your country, industry and site.