A first aider's job is to give immediate, temporary help to someone injured or taken ill, and to stop the situation getting worse until proper medical help arrives or the person recovers. You are not there to diagnose or treat long-term - you preserve life, prevent deterioration, and promote recovery. Anything beyond that is for the ambulance service or a doctor.
Under the Health and Safety (First-Aid) Regulations 1981, a first aider is someone who holds a current First Aid at Work (FAW) or Emergency First Aid at Work (EFAW) certificate from a competent training provider. Certificates last 3 years. Refresher (requalification) training should happen before the certificate expires - if it lapses, the person is no longer classed as a qualified first aider until they retrain, though a full 3-day FAW retrain is only needed if it has fully expired.
There's no fixed legal list of contents, but HSE guidance sets a sensible minimum for a low-hazard workplace, typically including: a leaflet giving general first aid guidance, individually wrapped sterile plasters, sterile eye pads, individually wrapped triangular bandages, safety pins, sterile wound dressings of various sizes (including large), and disposable gloves. Higher-hazard workplaces need more, scaled to the risk assessment.
Key mistake to avoid: medicines (paracetamol, aspirin, antiseptic cream) should NOT be kept in a standard first aid kit - a first aider must never give tablets or medication to someone. That crosses into treatment, not first aid.
There's no single number set in law - it depends on the risk assessment, covering factors like the number of employees, the nature of the work, spread of sites, and shift patterns. HSE's benchmark guidance suggests roughly one appointed person or first aider for low-hazard workplaces with fewer than 25 employees, scaling up for higher risk or larger/more dispersed workforces.
Every injury treated must be logged in an accident book (BS 8599 compliant, or equivalent), noting what happened, what was done, and by whom - this protects both the casualty and the first aider, and feeds into RIDDOR reporting where required. Data protection rules (UK GDPR) mean accident records containing personal/health details must be stored securely, not left openly accessible.
The primary survey is the fast, structured check a first aider runs the moment they reach a casualty. It finds and treats life-threatening problems in priority order, before anything else. The standard UK sequence is DR ABC.
Used for an unresponsive casualty who IS breathing normally, to keep the airway open and let fluids drain away, preventing choking.
Remember: the primary survey is always DR ABC, always in that order, and CPR takes priority over everything else once you know breathing is absent or abnormal.
CPR keeps blood carrying oxygen moving to the brain and heart when someone is in cardiac arrest - not breathing normally, or not breathing at all, and unresponsive. Speed matters more than perfection: for every minute CPR and defibrillation are delayed, survival chances drop sharply.
Choking happens when the airway is partly or fully blocked. Ask 'Are you choking?' If they can cough, speak or breathe, encourage coughing - do not interfere.
For a mild blockage: encourage forceful coughing.
For a severe blockage (cannot speak, cough or breathe): give up to 5 back blows between the shoulder blades with the heel of your hand. Check the mouth after each blow. If it doesn't clear, give up to 5 abdominal thrusts (Heimlich manoeuvre) - stand behind, fist above the navel, sharp inward and upward pulls. Alternate 5 back blows and 5 abdominal thrusts until the object clears or the casualty becomes unresponsive.
If unresponsive: lower them to the ground and start CPR (chest compressions may help dislodge the object). Always advise a hospital check after abdominal thrusts, as they can cause internal injury.
Control bleeding by applying direct, firm pressure to the wound, ideally with a sterile dressing. Raise the injured limb above heart level where possible, unless a fracture is suspected. Do not remove embedded objects - build up padding around them and bandage without pressing down on the object itself.
For catastrophic (life-threatening) bleeding that direct pressure cannot control, use a tourniquet or wound packing if trained, noting the time it was applied.
Shock is a life-threatening drop in blood flow to vital organs, commonly from severe bleeding, burns, or fluid loss. Signs: pale, cold, clammy skin; rapid weak pulse; rapid shallow breathing; weakness, dizziness, nausea; anxiety or restlessness.
Treatment: lay the casualty down, raise their legs (unless injury prevents it), keep them warm with a blanket, and reassure them constantly. Do not give food or drink. Call 999/112 for suspected shock - it can worsen quickly and become fatal.
Clean minor wounds with water and cover with a sterile dressing. Watch for signs of infection: redness, swelling, heat, pus, or fever. Large, deep, or contaminated wounds need professional medical attention.
Cool a burn with cool (not iced) running water for at least 20 minutes, as soon as possible after the injury - even if you're already on your way to hospital. Remove jewellery and loosen clothing near the burn before swelling starts, but never remove clothing that is stuck to the skin. Cover with cling film (laid on, not wrapped round a limb) or a clean plastic bag for a hand.
Suspect a fracture if there's pain, swelling, deformity, or the casualty can't bear weight or use the limb. Do not move the casualty unless they are in immediate danger. Support the injury in the position found - use padding and, if trained, a sling or splint to stop movement. Never try to push a protruding bone back in; cover an open fracture with a clean dressing and pad around the bone to control bleeding without pressing on it directly.
For sprains and strains, remember RICE:
If in doubt whether it's a break or a sprain, treat it as a fracture and get medical help - you cannot reliably tell them apart by symptoms alone.
Any head injury with loss of consciousness, even briefly, needs emergency medical attention. Watch for danger signs after a knock to the head: confusion, drowsiness, vomiting, unequal pupils, clear fluid leaking from the nose or ears, or a worsening headache - these need urgent hospital assessment even if the casualty seemed fine at first.
Suspect a spinal injury after a fall from height, a diving accident, a heavy blow to the back or neck, or any road traffic collision. Signs include pain in the neck or back, loss of movement or sensation, or tingling in the limbs.
A heart attack is caused by a blockage in blood flow to the heart muscle. Signs include central chest pain that may spread to the jaw, arms or back, pale skin, sweating, breathlessness, and a sense of impending doom. The casualty often feels 'crushing' or 'vice-like' pain.
Use the FAST test: Face - has it dropped on one side, can they smile? Arms - can they raise both and keep them there? Speech - is it slurred or garbled? Time - call 999 immediately if any sign is present.
Most seizures last 1-3 minutes and stop on their own. Protect the casualty from injury by clearing the area, cushioning the head, and never restrain them or put anything in their mouth.
Signs are wheezing, tight chest, breathlessness and difficulty speaking in full sentences.
Low blood sugar (hypoglycaemia) develops fast: confusion, sweating, shaking, pale skin. Give a fast-acting sugary drink or snack, then a longer-acting carbohydrate like a sandwich once they improve. High blood sugar (hyperglycaemia) develops slowly with thirst, drowsiness and deep breathing - this needs medical help, not sugar.
A severe, whole-body allergic reaction with swelling of face/throat, hives, breathing difficulty and collapse.
Common mistakes: giving aspirin to allergic or under-16 casualties, feeding a stroke or seizure casualty, restraining a seizure, and delaying the 999 call while waiting to see if symptoms pass.