READY SET RESCUE FIRST AID MANUAL

INTRODUCTION

“Good morning everyone.

My name is Jerson, and on behalf of Ready Set Rescue WA, thank you all for coming today and completing your CPR and First Aid refresher course with us.

Just a little bit about myself—I currently work as a full-time on-road paramedic with St John WA and have been working on road for the past five years.

One of the reasons I decided to move into teaching is because I’ve seen firsthand how much members of the community can influence a patient’s outcome before we even arrive.

There’s a statistic we often talk about in emergency care: for every minute a person in cardiac arrest doesn’t receive CPR, their chance of survival decreases by approximately 10%.

I’ve attended jobs where bystanders have started CPR immediately, and those patients often arrive at hospital in a much better position than patients who unfortunately didn’t receive any CPR before we got there.

So if there was one life skill I wish every person knew, it would be first aid and CPR.

Hopefully by the end of today you’ll feel much more confident if you’re ever faced with that situation.”

What is First Aid?

First Aid is defined as the immediate care provided to a person who has been injured or suddenly becomes ill. Its concept prioritises on preventing further harm, promoting recovery and preserving life to a casualty.

Examples of first aid include:

• cardiac arrest: heart attack or cardiac arrest (well known immediate first aid we can apply CPR)

• breathing emergencies: asthma, anaphylaxis, choking or near drowning incidents

• trauma: fractures, burns or wounds (first aid can help manage pain, prevent further injuries to facilitate healing process)

• exposure to harmful substances or poisoning: safety for yourself and the patient whilst awaiting professional medical help

• seizures:

* it is important that first aid does not replace professional medical help.

INTRODUCTION TO DRSABCD

.Now when providing first aid to a casualty, does anybody remember the mnemonic we use whenever we approach a medical emergency?”

(Student: DRSABCD.)

“Perfect.

DRSABCD is something we still use as paramedics today.

When you’re placed in a stressful emergency, it’s very easy for adrenaline to take over.

Having a simple step-by-step process helps you stay calm and ensures you don’t miss anything important.”

DRSABCD

D — DANGER

“So what’s the D stand for?”

(Student: Danger.)

“Exactly.

Danger means looking for anything that could harm yourself, the casualty or anyone else nearby.

We don’t just look.

We also listen and smell.

Could there be electricity?

Fire?

Traffic?

Gas?

Aggressive people?

Broken glass?

Another thing we assess is whether the casualty is in a workable environment.

If someone has collapsed in a tight corner and it’s safe to do so, move them into a more open space before starting CPR.”

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R — RESPONSE

“What comes after Danger?”

(Student: Response.)

“Correct.

We’re checking whether the casualty is alert.

I use the mnemonic AVPU.

A — Alert

V — Responds to Voice

P — Responds to Pain

U — Unresponsive

Everyone here is alert because you’re listening to me without any prompting.

If someone only responds when you speak loudly or touch them, they’re not fully alert.

That tells us something could be seriously wrong.”

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S — SEND FOR HELP

“So what’s next?”

(Student: Send for help.)

“Exactly.

Call Triple Zero.

One app I recommend downloading is the St John WA First Responder App.

It allows you to call Triple Zero quickly, helps identify your location and shows nearby AED locations.

If other people are around, don’t be afraid to delegate.

You call Triple Zero.

You—grab the AED.

You—bring the first aid kit.

The more help available, the better.”

⸻

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WE ARE GOING TO GO THROUGH THE ABC APPROACH FOR ADULTS FIRST AND THEN PAEDIATRICS AS BOTH HAVE SOME DIFFERENT DISTINCTION WHEN IT COMES TO SOME OF THE FIRST AID TECHNIQUES.

ADULT ABC PRINCIPLES

A — AIRWAY

“So what’s A?”

(Student: Airway.)

“Correct.

One saying we often use is:

‘If you don’t have an airway, you don’t have a patient.’

Before opening the airway, quickly look inside.

Is there blood?

Vomit?

Food?

Foreign objects?

If the airway is obviously blocked with vomit or fluid, roll the patient onto their side and allow gravity to drain the airway before performing a head tilt–chin lift.

Once the airway is clear, use the head tilt–chin lift to open the airway and quickly check for any remaining obstruction.”

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B — BREATHING

“What comes next?”

(Student: Breathing.)

“Correct.

We look, listen and feel for normal breathing for up to 10 seconds.

Look for chest rise.

Listen for breathing.

Feel for air on your cheek.

Now here’s a question.

If somebody takes one shallow breath during those 10 seconds, would we consider that normal breathing?”

(Student: No.)

“Exactly.

Normal adult breathing is approximately 12–20 breaths per minute.

One shallow breath every 10 seconds is only about six breaths per minute and isn’t considered normal.

Agonal gasps are also not normal breathing.

If they’re not breathing normally—we start CPR.”

PAEDIATRIC ABC PRINCIPLES

👶 Paediatric ABC Principles — Adult vs Baby

Introduction

“Now we’re going to talk about paediatric casualties. The good news is that the basic ABC principles don’t change—we still assess the airway, breathing and circulation.”

“What does change is the anatomy and physiology of a baby. Babies aren’t simply small adults, so there are a few important differences we need to understand.”

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🅰 A — Airway

👶 1. Proportionally larger tongue

Ask:

“Does anyone know why an unconscious baby’s airway can become obstructed more easily?”

“One of the reasons is that babies have a proportionally larger tongue compared with the size of their mouth and airway.”

When muscle tone is lost during unconsciousness, the tongue can fall backwards and obstruct the airway.

“That’s why airway positioning is so important—but we need to be careful not to overextend a baby’s head.”

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👶 2. Large head

“Babies also have a relatively large head compared with their body.”

Ask:

“What happens when you put a baby flat on their back?”

“Because of the size of their head, it can naturally push their neck forward and potentially affect the airway.”

This is why neutral airway positioning is particularly important in infants.

⚠ Head Position — Important Difference

Adult

“With an adult, we generally use a head tilt–chin lift to open the airway.”

Infant

“With an infant, we aim for a neutral head position rather than aggressively extending the head.”

Demonstrate:

“Think about looking straight ahead—the baby’s face should be roughly facing upwards without excessive extension of the neck, as doing so will block their narrow airway”

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🅱 B — Breathing

CONSIDERING THAT WHEN ASSESSING BREATHING = WE LOOK LOOK, LISTEN AND FEEL, THERE ARE A FEW DIFFERENCES FROM ADULTS TO PAEDIATRICS

👶 3. Nose breathing

“Babies are predominantly nasal breathers, particularly in their early months.”, meaning that potentially we try to feel for breath from not just their mouth, but also their nose as well

👶 Diaphragmatic breathing

Ask:

“Have you ever noticed that babies’ tummies move quite a lot when they breathe?”

“That’s because infants rely heavily on diaphragmatic breathing.”

Their chest wall is:

• More compliant

• Less rigid than an adult’s

• Their respiratory muscles are less developed

Therefore:

“When you’re assessing an infant, don’t just look at the chest. Look at the chest and abdomen for movement.”

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👀 Assessing an Infant’s Breathing

“Just like adults, we are also listening for an infants’s breathing

Listen for:

• Grunting

• Stridor

• Wheezing

• Gurgling

• Abnormal breathing sounds

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CPR TECHNIQUE

“So CPR stands for Cardiopulmonary Resuscitation.

Essentially, we’re acting as the heart’s pump.

Our key principles are:

• Rate: 100–120 compressions per minute

• Depth: Around one-third of the chest depth (or about 5 cm for most adults)

• Ratio: 30 compressions to 2 breaths

One thing I commonly notice in the community is people don’t allow full chest recoil.

That recoil is incredibly important because it allows blood to refill the heart before the next compression.

No refill means less blood being pumped around the body.”

(Demonstrate technique.)

“I also recommend swapping compressors every two minutes.

Even as paramedics we become fatigued.

The longest CPR I’ve personally done lasted around an hour, and by the end of it I could barely lift my arms.”

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INFANT CPR

“For infants, the principles remain the same.

100–120 compressions per minute.

30 compressions to 2 breaths.

The difference is the technique.

We now use the two-thumb encircling hands technique, as recommended by the Australian Resuscitation Council, because it provides better compression depth and causes less rescuer fatigue.

Maintain the head in a neutral position.

When giving breaths, cover both the mouth and nose and give two gentle puffs—just enough to make the chest rise.”

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PRACTICAL

“Now we’ll split into groups.

Everyone needs to demonstrate two minutes of high-quality CPR.

I’ll come around and help with hand position, recoil, compression depth and technique.”

AED

“Once everyone’s comfortable with CPR, we’ll introduce the AED.

AED stands for Automated External Defibrillator, but a quick question, when should we apply an AED to a casualty?

“As soon as it’s available for someone who is unresponsive and not breathing normally. The earlier it’s applied, the better the chance of restoring a normal heart rhythm if a shockable rhythm is present.”

Unlike the movies, it doesn’t restart a heart that has no electrical activity or has “flatlined”

Instead, it analyses the heart whether it has an abnormal electrical rhythm and determines whether a shock is required

What’s inside an AED kit?

(Open the AED case if available.)

Ask:

“Apart from the AED itself, what else do you think you’ll usually find inside the case?”

Show the contents as you discuss them.

Typically, you’ll find:

• Adult adhesive electrode pads

• Trauma shears (to cut clothing)

• Disposable gloves

• Face shield or CPR mask

• Gauze or towel (to dry the chest)

• Disposable razor (for excessive chest hair)

• Sometimes paediatric pads (depending on the AED)

• Sometimes spare battery or spare electrode pads

“Different brands include slightly different accessories, but these are the most common.”

AED STEPS

(Demonstrate pad placement.)

“Pad one goes on the upper right chest.

Pad two goes below the left armpit.

This is called the anterior-lateral position.

Always make sure nobody is touching the patient when the AED says:

‘Analyzing.’

or

‘Shock advised.’

After approximately every two minutes, the AED will stop and reassess the heart rhythm.

That’s also the perfect opportunity to swap compressors.”

RECOVERY POSITION

Introduction

“Now we’re going to look at the recovery position, also known as the lateral position.”

“Before we start, can anyone tell me when we would place someone into the recovery position?”

(Student answers.)

“Exactly. We use the recovery position when a casualty is unconscious but breathing normally.”

“If they’re not breathing normally, we don’t put them into the recovery position—we start CPR.”

⸻

Why do we use the recovery position?

Ask:

“Why do we turn them onto their side?”

(Student answers.)

Expand:

“The recovery position helps us achieve three main things:

1. Maintain a clear airway.

2. Allow vomit, blood or secretions to drain from the mouth, reducing the risk of aspiration.

3. Keep the casualty in a stable position while waiting for the ambulance.”

“As paramedics, we often say, ‘If you don’t have an airway, you don’t have a patient.’ So protecting the airway is our priority.”

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Step-by-Step Demonstration

Step 1 – Kneel beside the casualty

“First, kneel beside the casualty and make sure they’re breathing normally.”

⸻

Step 2 – Remove hazards

Ask:

“Before we roll them, what should we quickly check?”

(Student answers.)

“Exactly.”

Quickly check:

• Pockets

• Belt area

• Large objects

Examples:

• Mobile phone

• Wallet

• Keys

• Pens

• Scissors

• Syringes (especially in healthcare settings)

Explain:

“We don’t want them lying on hard objects for an extended period. These can cause discomfort, pressure injuries, or even injury while they’re unconscious.”

⸻

Step 3 – Position the arm closest to you

“Take the arm that’s closest to you and place it at a right angle to their body.”

Palm facing upwards.

Explain:

“This helps support the casualty once they’re rolled.”

⸻

Step 4 – Position the far arm

“Take the arm furthest away and bring the back of their hand against the cheek closest to you.”

Hold it there.

Explain:

“This helps support the head once they’re on their side and helps maintain the airway.”

⸻

Step 5 – Bend the far knee

“Bend the knee that’s furthest away.”

Foot flat on the ground.

Explain:

“This gives us leverage to safely roll the casualty.”

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Step 6 – Roll the casualty

Ask:

“Why do we roll them away from ourselves instead of towards us?”

(Student answers.)

Explain:

“Rolling the casualty away from you gives you much better control.”

Benefits:

• Uses the bent knee as a lever.

• The casualty rolls in one smooth movement.

• Less strain on your back.

• Easier to support the head and neck.

• Reduces the chance of the casualty rolling back onto their back.

Demonstrate:

“Keeping their hand against their cheek, gently pull on the bent knee and roll them away from you.”

⸻

Step 7 – Adjust the position

Once on their side:

• Tilt the head back slightly.

• Open the mouth towards the ground.

• Upper leg bent approximately 90°.

Explain:

“The bent knee prevents them from rolling onto their stomach or back.”

⸻

Step 8 – Reassess

Ask:

“Once we’ve put them into the recovery position, are we finished?”

(Student: “No.”)

Correct.

Continue monitoring:

• Airway

• Breathing

• Responsiveness

“Continue checking their breathing until the ambulance arrives.”

⸻

Common Student Questions

“What if they start vomiting?”

“That’s exactly why they’re on their side. Gravity allows the vomit to drain from the mouth instead of pooling in the airway.”

⸻

“What if they’re breathing but snoring?”

“Snoring in an unconscious person can indicate a partially obstructed airway. Reposition the head to maintain an open airway and continue to monitor their breathing.”

⸻

“Should we leave them flat because of a possible spinal injury?”

“If the casualty is unconscious and breathing normally, maintaining a clear airway takes priority. If possible, use a log roll with assistance to minimise spinal movement.”

⸻

Teaching Pearl

“Remember, the recovery position isn’t just about turning someone onto their side. It’s about protecting their airway.”

⸻

Easy Memory Flow

I teach my students to remember:

✅ Check breathing

✅ Empty pockets

✅ Near arm out

✅ Far hand to cheek

✅ Far knee bent

✅ Roll away from you

✅ Head tilted back

✅ Mouth facing down

✅ Continue monitoring breathing

WHEN DO WE STOP CPR?

So when do we stop CPR?”

(Student answers.)

“Exactly.

We stop when:

• The patient shows signs of life.

• A paramedic or another appropriately trained clinician tells you to stop.

• The scene becomes unsafe.

• You’re physically unable to continue.”

GOOD SAMARITAN LAW

“I’ve got one final question.

If somebody has ‘Do Not Resuscitate’ tattooed across their chest, would you start CPR?”

(Discussion.)

“Yes.

A tattoo is not a legally recognised Advance Health Directive.

Unless there’s valid legal documentation, you should commence CPR.

Here in Western Australia, you’re protected under the Good Samaritan provisions when you provide assistance in good faith, within the limits of your training.

The law exists to encourage people to help rather than hesitate.”

Transition from CPR to First Aid

Alright everyone, we’ve now covered the basics of CPR and how to respond to someone who’s unconscious and not breathing normally.”

“The next part of today’s session is going to focus on some common first aid emergencies that you might come across, whether that’s at work, at home, or even out in the community.”

“The good thing is that most first aid follows the same principle—we recognise the emergency early, provide the appropriate first aid, and get further help if it’s needed.”

“For each scenario, we’re going to look at three things:

• How do we recognise it?

• What equipment or medication do we use?

• How do we use it correctly?”

“I’ll ask you a few questions along the way because I don’t want this to feel like a lecture. I want you to feel comfortable using this equipment if you ever need it in a real emergency.”

ANAPHYLAXIS AND EPIPEN

Now we’re going to move on to anaphylaxis, which is a severe, life-threatening allergic reaction. The key with anaphylaxis is recognising it early because the sooner we treat it, the better the patient’s outcome.”

(Hold up the EpiPen.)

“Does anyone know what this medication is called?”

(Student: “EpiPen.”)

“Perfect. Does anyone know what’s inside an EpiPen?”

(Student: “Adrenaline.”)

“Exactly. It contains adrenaline, which is the first-line treatment for anaphylaxis. Adrenaline helps open the airways, reduces swelling, and supports blood pressure.”

⸻

Signs and Symptoms

“Now here’s something that’s really important to remember.”

“Not every person experiencing anaphylaxis will present the same way.”

““Not everyone with anaphylaxis will have skin symptoms such as hives or itching. That’s why we assess the whole patient, not just the rash.”

“Someone can still be having anaphylaxis even if they don’t have a rash.”

“Some of the signs we look for include:

• Difficulty breathing or wheezing

• Swelling of the tongue or throat

• Difficulty speaking or a hoarse voice

• Persistent cough

• Feeling dizzy or faint

• Collapse or loss of consciousness due to a drop in blood pressure.”

“It can also affect the gastrointestinal system.”

“So don’t forget about symptoms like:

• Severe abdominal or tummy pain

• Persistent nausea

• Vomiting

• Diarrhoea

These symptoms, particularly when they occur after exposure to a likely allergen and alongside breathing or circulation problems, can be features of anaphylaxis.”

EPIPEN DEMONSTRATION

Demonstration

“Alright, let’s have a look at the EpiPen.”

“Before we use it, what’s one thing we should think about?”

(Student: “Needle-stick injury.”)

“Exactly.”

“Remember:

Blue to the sky.

Orange to the thigh.”

“The needle comes out of the orange end, so keep your fingers away from it.”

“Place it against the mid-outer thigh, push firmly until you hear a click, and hold it in place for 3 seconds before removing it.”

“Then call Triple Zero immediately.”

ASTHMA AND VENTOLIN

Now we’re going to move on to one of the most common medical emergencies you’ll encounter both at work and out in the community—asthma.”

“Can anyone tell me what asthma actually is?”

(Student answers.)

“Exactly. Asthma is a condition where the airways become inflamed and tighten. The muscles around the airways constrict, the lining swells, and extra mucus can be produced, making it difficult for air to move in and out of the lungs.”

⸻

Recognising Asthma

“What are some signs that someone might be having an asthma attack?”

(Student answers.)

You can reinforce:

• Wheezing

• Persistent cough

• Shortness of breath

• Chest tightness

• Difficulty speaking in full sentences

• Increased work of breathing (using neck or chest muscles)

• Anxiety or distress

“If someone is unable to speak more than a few words, looks exhausted, or their symptoms are getting worse despite using their reliever, treat it as a severe attack and call Triple Zero.”

VENTOLIN PUFFER

Holding the puffer.)

“Does anyone know what medication this is?”

(Student: “Ventolin.”)

“Perfect.”

“What does Ventolin actually do?”

(Student answers.)

“Ventolin is a reliever medication. It relaxes the muscles around the airways, allowing them to open up so the person can breathe more easily. It starts working within a few minutes.”

(Hold up the spacer.)

“And what is this called?”

(Student: “Spacer.”)

“Excellent.”

“Why do we use a spacer?”

(Student answers.)

“A spacer helps deliver more of the medication into the lungs instead of it ending up in the mouth or throat. It also makes it much easier for someone who’s short of breath to inhale the medication effectively.”

Step 1

“Sit the casualty upright.”

“We don’t want them lying down because sitting upright allows the lungs to expand more effectively.”

⸻

Step 2

“Keep them calm and reassure them.”

“Feeling anxious can actually make an asthma attack worse.”

⸻

Step 3

“Give 4 separate puffs of their blue reliever medication.”

(Demonstrate.)

“Shake the puffer first.”

“Insert it into the spacer.”

“Press one puff only into the spacer.”

“Ask the casualty to take four slow breaths through the spacer.”

“Then repeat.”

“One puff.”

“Four breaths.”

“Until they’ve received 4 puffs.”

⸻

Step 4

“Wait 4 minutes.”

“Allow the medication time to work.”

⸻

Step 5

“If they’re improving, continue monitoring them.”

“If there’s little or no improvement after four minutes, repeat another 4 puffs.”

⸻

Step 6

“If symptoms remain severe, worsen, or the person becomes exhausted, call Triple Zero immediately.”

“While waiting for the ambulance, continue giving 4 puffs every 4 minutes if needed.”

Choking (Foreign Body Airway Obstruction)

Introduction

“Now we’re going to look at another very common emergency, especially in workplaces, restaurants, and homes—choking.”

“Can anyone tell me what is actually happening when someone is choking?”

(Student answers.)

“Exactly. Choking occurs when a foreign object, commonly food, becomes stuck in the airway and prevents normal airflow.”

“The most important thing to remember is that choking can progress very quickly. Someone who is talking and coughing may deteriorate into someone who cannot breathe or respond.”

⸻

Recognising Choking

Ask the class:

“What are some signs that someone might be choking?”

Expected answers:

• Coughing

• Difficulty breathing

• Unable to speak

• Unable to make sounds

• Clutching their throat (universal choking sign)

• Blue lips/skin

• Distress or panic

Explain:

“The first thing we need to determine is whether this is a mild obstruction or a severe obstruction.”

⸻

🟢 Mild Airway Obstruction (Effective Cough)

Signs:

• Person can:

• Speak

• Cough forcefully

• Breathe

Script:

“If someone is coughing effectively, what do we do?”

(Student answers.)

“Exactly. We encourage them to keep coughing.”

Treatment:

✅ Encourage coughing

✅ Monitor them closely

✅ Do not interfere unnecessarily

“The cough is actually the body’s most effective way of removing the object.”

Avoid:

❌ Do not slap their back while they are coughing effectively

❌ Do not put your fingers into their mouth searching for the object

⸻

🔴 Severe Airway Obstruction (Ineffective Cough)

Signs:

• Cannot speak

• Cannot breathe

• Weak or silent cough

• Turning blue

• Becoming distressed

• May become unconscious

Script:

“Now if they cannot cough effectively, cannot talk, and cannot breathe, this becomes a life-threatening emergency.”

⸻

Adult and Child Choking Treatment

Step 1: Encourage Response

“First, we ask the person: ‘Are you choking?’”

If they cannot respond properly:

“We immediately move into treatment.”

⸻

Step 2: Give Back Blows

“We start with 5 back blows.”

Technique:

• Stand slightly to the side and behind them.

• Support their chest with one hand.

• Lean them forward.

• Deliver 5 firm blows between the shoulder blades using the heel of your hand.

Explain:

“The reason we lean them forward is because we want gravity to help remove the object rather than pushing it further down.”

⸻

Step 3: Chest Thrusts

If back blows are unsuccessful:

“We move on to 5 chest thrusts.”

Technique:

• Stand behind the casualty.

• Place your arms around their chest.

• Make a fist.

• Place it in the middle of the chest.

• Deliver upward thrusts.

“For a choking pregnant person or someone who is significantly overweight, chest thrusts are preferred instead of abdominal thrusts.”

⸻

Continue Cycle

“We continue alternating:

5 back blows

5 chest thrusts

Until:

• the object comes out,

• they start breathing normally,

• or they become unconscious.”

⸻

If They Become Unconscious

Ask:

“What happens if they suddenly collapse?”

(Student answers.)

“This is where we transition into CPR.”

Treatment:

1. Carefully lower them to the ground.

2. Call Triple Zero / send someone for help.

3. Start CPR.

4. Each time you open the airway for breaths:

• Look for the object.

• Remove it only if it is visible.

• Do not perform blind finger sweeps.

Teaching point:

“We don’t blindly sweep inside someone’s mouth because we can push the object further down.”

⸻

Infant Choking

Introduction

“Infants are slightly different because their anatomy is different and we need to support their smaller bodies.”

Signs:

• Difficulty crying

• Weak cough

• Difficulty breathing

• Becoming quiet or floppy

⸻

Treatment

5 Back Blows

• Place infant face down along your forearm.

• Support their head and jaw.

• Head lower than the body.

• Give 5 back blows between shoulder blades.

5 Chest Thrusts

• Turn infant face up.

• Support head.

• Give 5 chest thrusts using two fingers in the centre of the chest.

Continue:

“Five back blows, five chest thrusts, until the object is removed or they become unconscious.”

⸻

Common Student Questions

“Should I do a finger sweep?”

Answer:

“Only remove an object if you can clearly see and grasp it. Blind finger sweeps can push the obstruction further down.”

⸻

“Should I hit someone on the back if they are coughing?”

Answer:

“No. If they are coughing effectively, encourage them to keep coughing. Their cough is doing the work.”

⸻

“What if they stop breathing?”

Answer:

“If they become unconscious, treat it as a cardiac arrest situation and start CPR.”

• Hold up a dummy → “What do we do first?”

• Show back blows → “Where do my strikes go?”

• Ask scenarios → “What changes if they collapse?”

Workplace First Aid

Workplace ܪrst aid reVuirements in Australia are governed by the Model Work Health and Safety WHS laws, which have been implemented in most states and territories. These laws reVuire employers to ensure that their workplace has adeVuate ܪrst aid eVuipment and facilities, and that there are suitable arrangements in place for providing ܪrst aid.

Each workplace requirements can vary, but might include having first aid kit, appointing a trainer first aid officer or dedicating a first aid rooms

First Aid and Duty of Care Australia

The definition of duty of care in Australia is the legal obligation of an individual requiring that they adhere to the standard of reasonable care whilst performing any acts that could foreseeably harm others. In a first aid setting, anyone who provides first aid care now also undertakes a duty of care towards the injured person. This means that once assistance has commenced, you have a legal duty to continue providing care until it is no longer required or until someone with equal or greater training takes over.

Duty of Care Key Considerations

• Consent

• Do No Harm

• Confidentiality

• Negligence

• Good Samaritan Legislation

• Consent: Consent must be given from the casualty before first aid could be applied unless the individual is unable to provide consent due to their condition, consent is then “implied” in this situation.

• Do No Harm: First Aid Trained individuals should only provide care to the level of their training or capabilities. Attempting procedures or treatment beyond your scope may potentially cause more harm and therefore lead to legal issues.

• Confidentiality: First Aiders must be aware that personal and medical information of the casualty must be kept confidential and shared only with medical professionals during the transfer of care.

• Negligence: As first aiders, when providing first aid it must be done in a non negligent manner. Meaning that the provision of care provided must be to the standard of the level of training that has been completed by the first aid individual

• Good Samaritan legislation: A legislation that protects individuals who provide assistance in an emergency situation in good fait and without expectation of payment from legal liability

Implied Consent:

An implied consent in a first aid context may fall under specific circumstances when a casualty is unable to provide explicit consent. These situations may include:

• unconsciousness: unresponsive to any forms of stimuli or incapacitated

• altered mental state: due to illness, injury or substance abuse

• minors in life threatening emergencies: paediatrics / kids in a life threatening situation and their parent / legal guardian are not present / unavailable to give consent.

“implied consent assumes that a reasonable person would wish to receive first aid in a critical or life threatening situation. An individual that demonstrates capacity has the right to refuse further treatment and their wishes must be respected.

First Aid Management (Both Sprains and Fractures)

Introduction

“The main principle with fractures and suspected fractures is immobilisation.”

“Our goal is not to straighten the limb or put the bone back into place. Our goal is to prevent further movement and reduce pain.”

⸻

Key principles:

✅ Support the injury in the position found

✅ Avoid unnecessary movement

✅ Immobilise above and below the injury

✅ Check circulation and sensation before and after immobilisation

⸻

🩹 Sling Application

(Hold up triangular bandage)

Ask:

“Does anyone know what this piece of equipment is?”

(Student: “Triangular bandage.”)

“Exactly. This is one of our most versatile pieces of first aid equipment.”

⸻

Arm Sling (St John Style)

Used for:

• Forearm injuries

• Wrist injuries

• Hand injuries

• Suspected fractures of the arm

Technique:

1. Support the injured arm.

2. Place triangular bandage under the arm.

3. Point of triangle towards elbow.

4. Bring the upper corner around the neck.

5. Tie securely.

6. Adjust so the hand is slightly higher than the elbow.

7. Secure the elbow if required.

Teaching point:

“The sling should support the injury, but it shouldn’t be so tight that it affects circulation.”

HAEMORRHAGE

Introduction

“Now we’re going to move on to one of the most important first aid emergencies — severe bleeding, or haemorrhage.”

“Can anyone tell me why severe bleeding is considered life-threatening?”

(Student answers.)

“Exactly. The body relies on having enough circulating blood volume to deliver oxygen to vital organs, especially the brain and heart. If someone loses a significant amount of blood, they can deteriorate very quickly.”

“The good news is that bleeding is one of the emergencies where early first aid intervention can make a huge difference.”

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Recognising Severe Bleeding

Ask:

“How would you know that someone is experiencing significant blood loss?”

Expected answers:

• Large amount of blood loss

• Bleeding that won’t stop

• Blood pooling on the ground

• Blood soaking through clothing or dressings

• Spurting or continuous bleeding

• Signs of shock

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Signs of Shock

Ask:

“What happens to the body when someone loses a lot of blood?”

Explain:

“The body tries to compensate by increasing the heart rate and redirecting blood to vital organs.”

Signs include:

• Pale, cool, clammy skin

• Fast breathing

• Rapid pulse

• Dizziness

• Weakness

• Confusion

• Collapse

• Reduced level of consciousness

Teaching point:

“Someone can look okay initially but deteriorate later, so we treat significant bleeding seriously.”

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First Aid Approach

1. Danger

“As always, we start with danger.”

Consider:

• Broken glass

• Machinery

• Needles

• Bodily fluids

• Unsafe environment

Teaching point:

“Remember, we don’t want to create a second casualty.”

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2. Send for Help

Ask:

“If someone has severe bleeding, what is one of the first things we need to do?”

(Student answers.)

“Correct — call Triple Zero early.”

Especially if:

• Bleeding is severe

• It won’t stop

• Person shows signs of shock

• Major trauma involved

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3. Control the Bleeding

Direct Pressure

(Hold up dressing)

Ask:

“What is our first method of controlling bleeding?”

(Student: “Direct pressure.”)

“Exactly.”

Procedure:

1. Apply firm, direct pressure over the wound.

2. Use a sterile dressing if available.

3. Maintain pressure.

4. Do not keep lifting the dressing to check.

Teaching point:

“The clot that’s forming is fragile. Every time we lift the dressing, we risk disturbing that clot.”

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Pressure Bandage

(Hold up roller bandage)

Ask:

“If direct pressure is working and we need our hands free, what can we apply?”

(Student: “Pressure bandage.”)

Procedure:

1. Apply dressing over wound.

2. Wrap firmly with a bandage.

3. Ensure adequate pressure.

4. Check circulation beyond the bandage.

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If Blood Soaks Through

Common student question:

“What happens if the bandage becomes soaked with blood? Do we remove it?”

Answer:

“No. We leave the original dressing in place.”

“Removing it can remove the clot that has started forming.”

Treatment:

✅ Add another dressing on top

✅ Apply more pressure

✅ Secure with another bandage if needed

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Embedded Objects

Ask:

“What if someone has a knife or object stuck in their wound?”

(Student answers.)

“Do we remove it?”

Answer:

“No.”

Explain:

“The object may actually be helping control bleeding by blocking the blood vessel. Removing it could make the bleeding worse.”

Treatment:

• Do not remove object.

• Apply pressure around the object.

• Stabilise it.

• Call Triple Zero.

Pressure Immobilisation Technique (PIT)

Introduction

“Now we’re going to look at a very important first aid skill, particularly here in Australia — the Pressure Immobilisation Technique, or PIT.”

“Before we start, does anyone know what situations we would use PIT for?”

(Student answers.)

“Perfect. We primarily use it for suspected snake bites and some other venomous bites where venom can travel through the lymphatic system.”

“The purpose of PIT is not to remove venom from the body. Once venom enters the body, we can’t suck it out or wash it away. The purpose is to slow the movement of venom through the lymphatic system until medical help arrives.”

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Recognising a Snake Bite

Ask:

“What signs might make us suspect a snake bite?”

Possible answers:

• Bite marks

• Pain or swelling

• Nausea or vomiting

• Tingling or numbness

• Weakness

• Collapse

• Difficulty breathing

• Altered consciousness

Teaching point:

“Sometimes the person may not know they have been bitten, and symptoms can be delayed, which is why we treat any suspected snake bite seriously.”

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First Aid Steps

1. Danger

“As always, we start with danger.”

Consider:

• Is the snake still nearby?

• Is the environment safe?

• Do not attempt to catch or kill the snake.

Teaching point:

“We don’t need the snake for identification. Your safety comes first.”

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2. Keep the Patient Still

Ask:

“Why do we want the person to remain still?”

(Student answers.)

“Exactly. Movement causes muscles to contract, which can increase lymphatic flow and potentially spread venom faster.”

Actions:

✅ Keep them calm

✅ Keep them still

✅ Avoid walking them around

✅ Call Triple Zero

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3. Apply Pressure Bandage

(Hold up pressure bandage)

Ask:

“What equipment would we use for PIT?”

(Student answers.)

“Correct — a broad pressure bandage.”

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Bandaging Technique

Step 1: Start at the Bite Site

“We start by applying pressure directly over the bite area.”

Step 2: Bandage Towards the Heart

“We then continue wrapping from the bite site upwards towards the body.”

For example:

• Foot → up the entire leg

• Hand → up the entire arm

Step 3: Immobilise

“Once the limb is bandaged, we want to keep it still.”

Use:

• Splint if available

• Sling for upper limb injuries

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How Tight Should the Bandage Be?

Ask:

“How tight should this bandage be?”

(Student answers.)

“It should be firm and provide pressure, but we still need to make sure we are not cutting off circulation.”

Check:

• Fingers/toes remain normal colour

• No severe numbness

• No signs of compromised circulation

Teaching point:

“The goal is to restrict lymphatic movement, not stop blood flow.”

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After Applying PIT

Continue:

“Once the bandage is on, the patient should remain still until ambulance arrives.”

Monitor:

• Airway

• Breathing

• Consciousness

Be prepared for deterioration.

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Things NOT to Do

Ask:

“What are some things we should avoid with a suspected snake bite?”

Expected answers:

❌ Do not wash the bite site

❌ Do not cut the wound

❌ Do not suck out venom

❌ Do not use a tourniquet

❌ Do not allow the person to walk around

❌ Do not try to catch the snake

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Scenario Practice

“Scenario: Someone has been bitten while walking in bushland. They tell you they felt something bite their ankle but they haven’t seen the snake. They are currently feeling okay. What do you do?”

Expected response:

1. Ensure danger is clear

2. Keep patient still

3. Call Triple Zero

4. Apply PIT

5. Immobilise limb

6. Monitor until help arrives

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Teaching Pearl

“With snake bites, the biggest treatment is not chasing the snake or trying to remove venom — it is keeping the patient still and stopping venom from travelling while waiting for help.”