2020 International 

first aid Guidelines

There is an unlimited number of specific contexts for providing first aid, however, they have been summarised here in a set of overarching contexts. These include urban, remote, disaster, and conflict. While some of these contexts could overlap, the purpose of these categories of contexts is to describe commonalities and differences within the context and ultimately start to identify how providing first aid in that context may differ from that which is described in the Guidelines.

Much of the evidence for the Guidelines comes from studies conducted in western contexts during peacetime, where access to emergency medical care services is possible. Yet internationally the burden of trauma falls on countries with limited access to resources where first aid providers might have to act with limited access to first aid equipment or healthcare.

Understanding the contexts in which people give first aid is fundamental to making first aid education effective. Program designers need to contextualise their approaches according to the risks that learners face, their environment and access to the healthcare they have. These Guidelines are not comprehensive in covering all possible contexts, but we have included contexts which are common for the Movement. In addition to the overarching contexts described here, there is additional information for providing first aid education in workplaces, aquatic environments, and in a pandemic.

Urban

The urban context describes where access to resources is likely high and medical care is readily available within a short time frame. This context differs from the workplace context in that there is no designated first aid provider. The urban context indicates there are structures in place to provide care (governmental, non-governmental, private) that will respond when requested. Urban is the common level for which the Guidelines are provided.  

Key considerations
• Bystanders may be a significant factor (see the Bystander Effect in the General approach).
• No dedicated first aid providers in this context.
• First aid providers are likely providing care to family and community members.
• Urban scene safety may be a consideration (e.g., traffic, downed power lines, etc.).
• The public can access emergency care and may have to decide which type of medical care is relevant (community health centre, hospital, walk-in clinics, etc.).
 

Remote 

Remote refers to a delay in medical care and access to additional resources. Like the urban context, there is no designated first aider that is responsible for your care and medical care could be hours or days away. The remote context does assume that structures for medical care are available, but that they will be delayed in reaching the person that needs care.  

Key considerations
• In serious incidents, transportation of the ill or injured person will be important.
• The remote context will require additional planning for emergencies (e.g., additional supplies (food,
medication, ability to shelter somewhere until medical care arrives).
• Safety of first aid providers should be given additional consideration in unknown environments.
• There are often visitors to remote environments that may not be accustomed to delays in care (e.g.,
expeditions, voyages).
• First aid providers may be required to provide medical care under direction from a medical
professional through communications devices.
• The length of time for medical care to arrive will vary considerably according to the specific context.

See the Education chapter for specific evidence and practices for this Remote context.
 

Disaster

The disaster context is more complex than urban or remote contexts in that the infrastructure that may have existed prior to the disaster is either temporarily or permanently disabled. This means that access to medical resources or care is often delayed for an extended period of time.
Additionally, the instability of the environment may pose significant safety risks (e.g., likelihood of aftershocks following an earthquake).  

Key considerations
• There is likely the requirement to coordinate with other agencies providing relief.
• The IFRC has a Global Disaster Preparedness Centre which houses research, practices, and resources.
• Safety of the first aid providers should be given additional consideration in unknown environments.
• There may be a requirement for improvisation for first aid (e.g., improvised splints).
• Triage will be important where there are multiple casualty incidents and first aid providers may need to make difficult decisions in the days following a disaster.
• Temporary treatment infrastructure may be required. This will include access to shelter, water, food, spiritual services, etc.
• First aid providers are more likely to encounter death and therefore psychological wellness should be considered.
• Natural disasters are increasing significantly due to climate change.

See the Education chapter for specific evidence and practices for this Disaster context.

Conflict

The conflict context is yet more complex: it is likely that all infrastructure that existed before the conflict is permanently disabled and will not be able to provide care. In addition, there is a significant security risk (threats from intentional harm) for anyone providing care as they will be vulnerable if they are not seen as a neutral.  

Key considerations
• Security of first aid providers must be considered before providing care.
• Mobility to access medical care may be limited or different (e.g., you may have to transport very large distances to reach professional care).
• Temporary treatment infrastructure may not be recommended due to needing the ability to change locations quickly. This will include access to shelter, water, food, spiritual services, etc.
• Neutrality is of particular importance in providing first aid education.
• Placement of equipment must be considered due to threats of destruction, theft, or use to cause harm (e.g., oxygen tanks).
• First aid providers are more likely to encounter death and therefore psychological wellness should be considered.
• First aid providers must consider the safety of the person, themselves and their team when transporting.
• First aid providers may be required to provide medical care under direction from a medical professional through communications devices.
• Easy identification of first aid providers (their units, establishments and material) by use of a Red Cross Red crescent emblem (distinctive emblem) is highly recommended in conflict. 

See the Education chapter for specific evidence and practices for this Conflict context.

Identify the contexts in which your National Society provides first aid education. 

Explore the guidelines

Published: 15 February 2021