First aid update

A revised and updated edition of the First Aid manual has been
released.  The changes affect the way
first aid is carried out in the workplace and are not without controversy, by Dave

The First Aid manual, which is produced by the three voluntary aid societies
– St. Andrew’s Ambulance Association, the British Red Cross and St John
Ambulance, is used both inside and outside the workplace. However, the manual
holds particular importance for the former as it defines the course content of
the HSE First Aid at Work certificate.

The eighth edition of the First Aid manual has just been released. It has
several changes – some minor, some major and some controversial. These changes
are important, however, as they affect the way first aid is carried out at

The main changes

– The jaw thrust procedure has been added. This is a procedure for opening
the casualty’s airway in situations where a neck injury is suspected. It may be
used when a casualty has fallen from a height or has an impact injury to the
head or face, for example

– The mechanism for assessing the injured casualty is now divided into
‘primary survey’ and ‘secondary survey’ to assist in giving more appropriate
treatment and care to the casualty

– The control of bleeding has changed. Where blood seeps through a second
dressing over a wound, both dressings are now removed and a new dressing is
applied and positioned to place pressure to the point of bleeding. The
rationale for this is that continued bleeding is an indication that the initial
dressing is incorrectly positioned

– Although no specific spinal recovery position has been introduced, the
recovery position for suspected spinal injuries now includes procedures where
multiple helpers are available

– The depth of chest compression for an adult casualty is 4-5cms

– ‘Normal colour’ as a sign of circulation has been removed, as it is
difficult to define

– When seeking a response from a child, you should now tap the child’s shoulder
rather than shake him or her. This follows the passing of a law in Scotland
that makes it illegal to shake a child

– The management of burns has altered. The ‘rule of nines’ used for the
assessing the extent of a burn has been removed and replaced with new
guidelines relating to sending a casualty to hospital

– Stings are no longer removed with tweezers, as this squeezes further
poison into the casualty. Instead, the sting should be brushed off using a
fingernail or a blunt instrument such as a credit card

– The time to release a crush injury has been increased from 10 to 15

Controversial changes

Some of the changes are controversial. For example, in the section on the
control of bleeding, it has been argued that by removing the dressings
completely, bleeding could increase and infection be introduced.

Many first aid personnel and first aid trainers are concerned about such
issues. This may lead to further amendments to the manual’s recent changes.

In any event, first aid is not an ‘exact science’, but is continually
reviewed and revised dependent on studies, practice and the environment in
which it is being used.

The certification for first aid at work remains valid for the many thousands
of existing first aider work personnel, despite the recent changes.

Further information, including an online video of the changes can be found
at, which also features a discussion of the views of
first aid trainers and personnel in the forum section of the website.

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