Pandemic context

Protect learners and facilitators through protective practices (e.g., wearing personal protective equipment, spacing, hand washing) while providing first aid education during a pandemic.

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During a pandemic or other health crisis, the disease is transmitted throughout populations and there can be widespread fear of infection. However, people still get injured or become ill and require help. It remains important that first aid providers continue to provide help safely, particularly life-saving help. Protecting the first aid provider, the ill or injured person, and bystanders remain central to first aid. Offering educational activities and providing first aid care during a pandemic also remains a priority, but it is challenging and comes with some risks.

 

 

Crisis Description Example
Pandemic Epidemic over a very large area; affecting a large proportion of a population. COVID-19 in 2020
Epidemic Prevalent among a people or a community at a special time and produced by some special causes not generally present in the affected locality.

Ebola virus disease (EVD) in 2014-2016 in West Africa

 

 

Outbreak A sudden increase in the incidence of a disease; an epidemic of infectious disease, esp. when relatively localised. Yellow fever in November of 2019 in Venezuela

Guidelines

Good practice points

 

  • First aid should not be delayed due to disease transmission concerns; however, actions may need to be modified to protect the first aid provider, the ill or injured person, and any bystanders.
  • When providing first aid to someone from outside their household first aid providers should maintain a physical distance (2 m or 6 feet is recommended) using verbal instructions to their ill or injured to help themselves. When this is not possible, appropriate personal protective equipment (e.g., gloves, face mask, eye protection) or other barriers should be used.
  • Training and practise of how to safely put on and take off personal protective equipment (PPE), and how to appropriately clean or dispose of PPE, may help reduce transmission.
  • First aid providers should wear medical-grade PPE (face mask, eye protection, gloves, etc) if possible.
  • If possible, first aid providers should use a buddy system for putting on and taking off PPE, where they ensure best practices for applying PPE are followed while maintaining their own physical distancing.
  • First aid providers should practise proper Hand hygiene after each interaction with an ill or injured person.
  • Where appropriate, the first aid provider may apply additional measures of risk mitigation during first aid, including:
    >   offering personal protective equipment to the ill or injured person
    >   identifying obvious signs and symptoms of infection
    >   asking if the ill or injured person has been in close contact with someone that is infected as defined by public health
    >   asking if the ill or injured person has returned from travel to a defined high-risk area as defined by public health.
  • Assessment of the person may begin from a safe distance by calling out to the person and observing them for signs of normal breathing (whether the abdomen and chest are moving regularly).
  • Programme designers should follow specific recommendations from the Global First Aid Reference Centre or local resuscitation council on how to safely provide CPR safely.

Education considerations

Context considerations 
  • Emphasise to learners that providing first aid should be prioritised over the risk of infection if they are helping someone in their household because previous exposure to them may reduce any additional risk of infection. Using PPE and physical distancing can greatly reduce the risks of transmission.
Learner considerations 
  • Ensure classroom-based first aid education complies with distancing advice. Learners should be able to maintain a two-metre (six-foot) distance between participants at all times.
  • Ensure learners are advised they must wear appropriate PPE (e.g., a face mask and gloves) to enter the classroom and complete training.
  • Communicate to learners that if they become ill or are unable to wear appropriate PPE, that they cannot be admitted into the session.
  • Post information on the symptoms of the pandemic (as defined by public health) at entry points and ask visitors not to enter when experiencing any symptoms of illness.
  • Consider foot-traffic flow into the entry of the building to ensure social distancing can be maintained – this can include markers for those standing outside the premises or where to stand within the premises.
  • Consider that wearing PPE and keeping safe distance will cause additional stress on the learners and the facilitator alike. Try to mitigate this where possible (e.g. provide adequate breaks, ensure a comfortable room temperature).
Facilitation tips 
  • Spend extra time planning the session outline and how best to adapt the learning activities to the pandemic context.
  • Provide easy and visible access to sanitisation stations near the classroom space. Sanitisation stations must include a space to wash hands with soap and water, paper towels (instead of cloth towels), or hand sanitiser with at least 70% volume of ethanol or 60% of other alcohol. See Hand hygiene.
  • Thoroughly clean all non-disposable equipment and manikins used during the session before participant use. Clean the face, mouth, and chest plate of manikins. Please consult the manufacturer’s cleaning and disinfecting instructions.
  • Assign any triangular bandages, blankets or other fabrics used to specific learners at the start of the session, for their use only and then wash them immediately at the end of each day of use.
  • Clean and disinfect training materials (such as trainer auto-injectors or inhalers) using 70% volume of ethanol or 60% of other alcohol. Disinfect before and after each user has handled the item and also before storage.
  • First aid manuals or booklets should be for single person use rather than shared between learners or used in multiple sessions. Alternatively, encourage learners to bring their own tablet to the session and access the digital version of a manual during the session.
  • Be mindful of the other items used in the classroom (e.g., pens, trainer-defibrillators, floor mats, tables, chairs). Ensure any surfaces that may collect germs are regularly cleaned using a 70% volume of ethanol or 60% of other alcohol disinfecting wipe.
  • Do not place contaminated training aids into the clean carrying bags as this creates contamination. Bring a separate receptacle (e.g., garbage bag, laundry tub) to transport the contaminated training aids to the designated cleaning space.
  • Have learners do their skills practise on manikins or other props rather than other learners. For the brief periods of the sessions that have CPR practice, it is understood and accepted that the mask will have to be lowered.
  • Have learners reduce exposure by working with the same partners and groups for the entire class or course. Avoid mixing up groups and partners for activities.
Facilitation tools
  • Be alert to advice from the Global First Aid Reference Centre which will provide relevant and up to date information. See guidance on resuming training during COVID-19.
  • Use the Safe classroom checklist to check your education environment has mitigated risks related to the COVID-19 pandemic.
  • Consider increasing the use of blended and online learning courses.
  • Ensure every learner wears gloves during all skill practice and assessment scenarios.
  • At a minimum, hand hygiene should be performed at the following times by all learners and the facilitator:
    >    Beginning and end of class
    >    Before and after meals and snacks
    >    Before and after skill practice sessions. (When wearing gloves, hand hygiene should be done before putting on gloves and after removing them.) See Hand hygiene for more on critical times for handwashing
  • Non-medical or surgical masks can become contaminated on the outside or when touched by your hands. When wearing a mask, facilitators and learners should take the following precautions:
    >   avoid touching your face mask while using it
    >   change the mask for a fresh one as soon as it becomes damp or soiled
    >   non-medical face masks that cannot be washed should be discarded and replaced as soon as they get damp, soiled, or crumpled.

References

Global First Aid Reference Centre (2020) Covid-19: Guide for resuming first aid trainings. Retrieved from:
https://www.globalfirstaidcentre.org/brc_resource/covid-19-guide-for-resuming-trainings/

Couper, K., Taylor-Phillips, S., Grove, A., Freeman, K., Osokogu, O., Court, R., Mehrabian, A., … Escalante, R. (2020). COVID-19 infection risk to rescuers from patients in cardiac arrest. In Consensus on Science with Treatment Recommendations [Internet].
https://costr.ilcor.org/document/covid-19-infection-risk-to-rescuers-from-patients-in-cardiac-arrest

Pellegrino, Jeffrey (2020). COVID-19 First Aid Adaptations. International Journal of First Aid Education, 3(1) 1-5.
DOI: 10.21038/ijfa.2020.0101. Available from:
https://oaks.kent.edu/ijfae/vol3/iss1/covid-19-first-aid-adaptations

World Health Organisation (2010). What is a pandemic? Emergencies preparedness, response. 24 February 2010. Retrieved from:
https://www.who.int/csr/disease/swineflu/frequently_asked_questions/pandemic/en/

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Published: 15 February 2021

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About the guidelines

About the guidelines

Here you can find out about the process for developing these Guidelines, and access some tools to help you implement them locally.