How to Become a First-Aider

First aid not only prevents injuries and illnesses from worsening, it can also mean the difference between life and death. According to the NHS, thousands of people die or are seriously injured in incidents every year in the UK. Many deaths could be prevented if first aid was given before the emergency services arrive.

Prompt first aid is critical when someone has a cardiac arrest, and without it, they are unlikely to survive. The British Heart Foundation (BHF) estimates that there are more than 30,000 out-of-hospital cardiac arrests (OHCAs) in the UK each year.

Even when resuscitation is attempted, the overall survival rate in the UK is just 1 in 10. Every minute without CPR and defibrillation reduces the chances of survival by up to 10%. Therefore, when an individual has a cardiac arrest, every second really does count.

To further reiterate the importance of first aid, there are a significant number of different injuries and ill-health incidents every year at work.

The Health and Safety Executive’s (HSE) statistics (2019/2020) highlighted there were:

• 111 fatalities at work.
• 0.7 million workers who sustained a non-fatal injury.
• 65,427 non-fatal injuries to workers reported under RIDDOR.
• 1.6 million cases of work-related ill health (new or long-standing).
• 38.8 million working days lost due to work-related ill health (32.5 million) and non-fatal workplace injuries (6.3 million).

Employers have a legal duty to ensure there is adequate and appropriate first-aid provision in the workplace. A vital part of this provision is having a sufficient number of first-aid trained personnel to attend injuries or ill-health incidents.

Not having appropriate and adequate first-aid provision can have serious consequences for businesses. It can result in enforcement action, e.g. notices, fines and prosecution. Employees may also claim compensation if an employer has neglected their duty of care.

This article will look at first-aiders in more detail. It will cover how to become a first-aider, including the different levels of training. It will also go through the responsibilities of the role, and the skills first-aiders should possess.

What is a first-aider?

First aid is the immediate assistance given to an individual who is injured or taken ill. A first-aider’s role is to provide this assistance to keep the individual safe and prevent further harm until they receive medical attention. The type of assistance a first-aider provides to a casualty can range from dressing a wound to performing life-saving techniques, such as CPR.

According to the HSE, a first-aider is someone who has undertaken training appropriate to the workplace circumstances and level identified in the first-aid needs assessment. It is essentially a risk assessment, which helps employers identify the level of first-aid training required and the number of first-aiders needed. The First Aid at Work Approved Code of Practice (ACOP) (Regulation 3) provides guidelines on what employers should consider when assessing their first-aid needs.

The HSE has an optional four-layer framework for first-aid provision that employers can use to comply with the regulations, for example:

• Appointed person (AP).
• Emergency first aid at work (EFAW).
• First aid at work (FAW).
• Additional training.

Appointed person (AP)

Appointed persons are not first-aiders, as they do not possess the training and competence to carry out the role. An AP takes charge of first-aid equipment and facilities and calls the emergency services. However, if a first-aider is absent due to unforeseen circumstances, an AP can also provide emergency cover.

As a legal minimum requirement in workplaces, there should be an AP. Whether this is adequate and appropriate provision will depend on the findings of the first-aid needs assessment. The employer must show that a first-aider is not required and an AP is sufficient for their needs. This will often be the case for small, low-risk workplaces.

APs do not require formal first-aid training, although they should have information and instruction on their role and responsibilities. Emergency first aid at work (EFAW) training can be useful for APs, and some providers offer specific AP courses, but it is not mandatory.

If there are an adequate number of trained first-aiders in the workplace, an AP is not required.

First-aiders

The first-aid needs assessment will help employers decide whether a trained first-aider is required, the level of training, and the number of first-aiders needed.

There are different levels of first-aid training, for example:

• Emergency first aid at work (EFAW)
  – A 1-day course.
  – Typically for first-aiders in lower-risk workplaces.
  – Permits first-aiders to provide emergency first aid if a person is injured or taken ill whilst at work.
• First aid at work (FAW)
  – A 3-day course, which includes the EFAW syllabus.
  – Typically for first-aiders in higher-risk workplaces.
  – Permits first-aiders to provide first aid for many specific injuries and illnesses.
• Additional training or a qualification that is appropriate to the circumstances
  – Specific specialised training based on the needs assessment.
  – For example, training on safe defibrillator use, mental health first aid, delivering medical oxygen and paediatric first aid.

How many first-aiders?

The Health and Safety (First-Aid) Regulations 1981 apply to all workplaces, including those with less than five employees and the self-employed.

Employers must:

• Provide adequate and appropriate first-aid personnel, equipment and facilities to ensure their employees receive immediate attention if they are injured or taken ill at work.
• Consider non-employees when assessing first-aid needs. They are not legally required to provide first aid to non-employees. However, the HSE strongly recommends including them. If employers include them, they must ensure that there are a sufficient number of first-aiders to cover.

So what is adequate and appropriate when it comes to the number of first-aiders required in the workplace? The Health and Safety (First-Aid) Regulations 1981 require employers to provide first-aid personnel, but there is not a specific number of first-aiders stipulated.

There is a minimum requirement for workplaces to have an appointed person to take charge of first-aid arrangements. However, the number of first-aiders required will depend on the specific circumstances within the workplace.

The First Aid at Work Approved Code of Practice (ACOP) (Appendix 3) has suggested numbers of first-aid personnel that should be available at all times when people are at work.

For example:

This can help employers decide on the number of first-aid personnel required when carrying out their needs assessment.

How to become a first-aider?

Am I right for the role? Before becoming a first-aider, a person must decide if they have the correct attitude, behaviour and skills to be able to deal with administering first aid. They will be faced with emergency situations and injuries, so they must be capable of carrying out their role and responsibilities confidently in often challenging circumstances. At work, an employer is investing in training for the employee. Therefore, they will also be involved in deciding if the person is correct for the role.

What level of training is needed? If an individual decides they want to become a first-aider, they will need the correct level of first-aid training. In the workplace, this should be based on the first-aid needs assessment, and it will usually be the employer who organises the training. The policies and procedures for first-aid training will be specific to each business. Employees should check this with their employer.

How do I enrol? To be able to enrol on a first aid at work (FAW) or an emergency first aid at work (EFAW) course, individuals must have a basic command of English (level 2). Some training providers can support individuals who do not possess English as their first language. However, employers should check available support before booking.

Which training course and provider? It is vital that the correct training course is chosen, as per the first-aid needs assessment. Employers must check that the training provider is competent and those delivering first-aid training are qualified. The HSE has guidance that can help employers select a first-aid training provider.

Where can training take place? Depending on how many first-aiders require training, employers can organise a trainer to carry out first-aid training at the workplace. Alternatively, the employee can attend a course at a designated location chosen by the training provider. Employees must be given the time off work, with pay, to do the training.

What happens after training? Once a first-aider has completed their training and received their certificate, they can administer first aid. However, learning should continue, including keeping skills fresh by frequently reviewing course manuals and materials. Employers must also ensure that all first-aiders have the necessary resources to carry out their role effectively and safely.

Responsibilities of a first-aider

First-aiders have many crucial responsibilities, and their actions in life-threatening situations can mean the difference between life and death. They need to assess and act quickly in an emergency to keep people safe and prevent harm from worsening.

Fundamentally, first-aiders must be made aware of what their role entails and what their responsibilities are. St John Ambulance outlines six responsibilities of a first-aider.

They should:

1) Assess the situation quickly and calmly

• Check for any danger to themselves or the casualty and ensure it is safe to approach.
• Determine the cause of the accident and the number of casualties at the scene.
• Find out more about the situation, i.e. what occurred, the number of people involved and their ages.

2) Protect themselves and the casualty from any danger

• A first-aider should always protect themselves first and never put themselves at risk.
• Only move the casualty if leaving them would result in more harm.
• Call for emergency assistance (999 or 112) if the area cannot be made safe.

3) Prevent infection between themselves and the casualty

• Ensure high standards of personal hygiene, e.g.:
  – Wash hands or use alcohol gel.
  – Wear disposable gloves that are latex-free or, if unavailable, clean plastic bags.
  – Do not breathe, sneeze or cough over the casualty or wounds.
  – Do not touch open wounds without gloves.
• Further precautions will be required to reduce the risk of COVID-19.

4) Comfort and reassure

• Remain calm and take charge of the situation.
• Introduce themselves to the casualty and explain what is happening and what they are doing before doing it.
• Always treat the casualty with respect and dignity.

5) Assess the casualty and give first aid treatment

• Those with life-threatening conditions must be assisted first if there are multiple casualties.
• Life-threatening conditions should be dealt with by using the primary survey. Only when these have been successfully dealt with should the first-aider move onto the secondary survey.
• Arrange for help if needed, which is the next step.

6) Arrange for help if needed

• If it is serious, the first-aider should call for an ambulance (999 or 112).

Non-emergency responsibilities

When first-aiders are not dealing with emergencies, they may be required to carry out additional responsibilities, such as:

• Assisting employers with their first-aid needs assessments.
• Looking after first-aid equipment, such as first aid kits, and facilities, such as first-aid rooms. It can include checking stock, replenishing supplies and monitoring the test dates of equipment.
• Assisting with accident and incident reports.
• If trained in mental health first aid, carrying out the responsibilities relevant to the role.

The non-emergency responsibilities a first-aider may carry out will depend on their employer’s procedures and needs assessment.

Legal responsibilities

People often have concerns that first-aiders can be liable if something should happen whilst carrying out their role. According to the HSE, if a first-aider uses first aid as per their training, it is unlikely any legal action would be taken. However, the HSE recommends first-aiders check with their employer on whether their policies cover first-aiders’ liability. If a first-aider is not employed, they recommend seeking legal advice and guidance on insurance.

Range of skills that are beneficial

A first-aider must have the correct skill set to carry out their role effectively and safely in difficult situations.

Some of the qualities that are beneficial for first-aiders to have are (this list is not exhaustive):

• Communication – first-aiders must have strong communication skills, as they will need to communicate with the casualty, bystanders and the emergency services. They will need to ask questions, listen carefully and relay vital information. Effective communication can build trust with the casualty, which will reassure them at a difficult time.
• Interpersonal – a first-aider’s role is people-orientated. Therefore, they must have the confidence and be comfortable interacting with a range of people in potentially challenging situations. They should have a positive attitude to be able to give reassurance to the casualty and any bystanders.
• Ability to work under pressure – a first-aider must be able to think, judge and act quickly in emergencies. They must also remain calm, especially when there are time pressures in a life-threatening situation, e.g. a cardiac arrest. If a person is prone to panic, the role may not be suitable for them.
• Ability to work in a team and effective leadership – a first-aider may need to take charge of a situation, which requires them to be an effective leader. They may also have to take instruction from others, such as the emergency services, which requires cooperation and coordination. Being able to work in a team is essential for a first-aider.
• Ability to know their limits and level of competence – a first-aider must know when a situation is beyond their limits and competence and when to call for help. Carrying on regardless without the necessary competence can put themselves and the casualty at risk.

When do I need to renew my training?

If you don’t use it, you’ll lose it. Imagine having first-aid training and not using your skills for a year or more. Would you feel confident and know what to do? The answer is probably not, so refresher training is vital to keep skills up to date and for a first-aider to feel confident in what they are doing.

So how long do first-aid training certificates last? According to the HSE, all first-aid training certificates, whether first aid at work (FAW), emergency first aid at work (EFAW) or some other appropriate training, are valid for three years.

First-aiders must ensure that they are re-qualified before their certificate expires to remain competent. There is a two-day training re-qualification course for FAW. For EFAW, there is not a separate re-qualification course. The syllabus and duration are the same as the initial course, i.e. one-day. The HSE recommends first-aiders re-qualify within a month of the certificate expiry date.

The HSE strongly recommends that those with FAW/EFAW certificates undertake annual refresher training to help keep their basic skills up to date. If a first-aider’s certificate expires, they should not continue to be a workplace first-aider as they are no longer considered competent.

Only when they have renewed their certificate should they continue as a first-aider. If a FAW certificate has expired and a month has passed, it is recommended that individuals undertake the three-day course and not just the two-day re-qualification.

 If you are a first-aider, why not sign up for our workplace first aid course to keep your knowledge and skills fresh between face-to-face training.

Summary

Being a first-aider is a challenging but rewarding role. It can save lives, prevent further harm and improve the outcome for a casualty.

In the workplace, safe and healthy employees are vital for the smooth functioning of a business. Therefore, employers should protect their health and safety, which includes having adequate and appropriate first-aid provision. It is a legal requirement, but employers should also look at it as a worthwhile investment that protects their most valuable assets: their employees.

Employers should ensure that prospective first-aiders have the necessary training, skills and qualities to carry out their role and responsibilities. The individual must want to be a first-aider, and they have to be the right person for the role.

They will be responsible for dealing with injured and ill employees in often stressful situations. Therefore, the correct choice must be made when deciding on who will be a first-aider. The wrong choice can have serious consequences for the business, the first-aider and casualties.