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{{short description|Emergency first response medical treatment}}
{{About|general first aid for humans|other uses}}
[[File:ISO 7010 E003 - First aid sign.svg|The universal first aid symbol|thumb]]
[[File:US Navy 030322-M-6270B-010 A U.S. Navy Corpsman assigned to the 15th Marine Expeditionary Unit (Special Operations Capable) gives first aid to an injured Iraqi citizen.jpg|thumb|A [[US Navy]] corpsman gives first aid to an injured Iraqi citizen.]]
{{Portal|Medical}}

'''First aid''' is the first and immediate assistance given to any person with a [[medical emergency]],<ref>{{Cite book |title=First aid manual: 9th edition |publisher=Dorling Kindersley |year=2009 |isbn=978-1-4053-3537-9}}</ref> with care provided to preserve life, prevent the condition from worsening, or to promote recovery until medical services arrive. First aid is generally performed by someone with basic medical or first response training. [[Mental health first aid]] is an extension of the concept of first aid to cover mental health,<ref>{{Cite web |url=https://www.mentalhealthfirstaid.org/ |title=Mental Health First Aid USA |date=2013-10-10 |website=Mental Health First Aid |access-date=2019-11-20}}</ref> while [[psychological first aid]] is used as early treatment of people who are at risk for developing [[Post-traumatic stress disorder|PTSD]].<ref>{{Cite web |url=https://www.nctsn.org/treatments-and-practices/psychological-first-aid-and-skills-for-psychological-recovery/about-pfa |title=About PFA |last=Peterson |first=Sarah |date=2018-01-30 |website=The National Child Traumatic Stress Network |access-date=2019-11-20}}</ref> Conflict first aid, focused on preservation and recovery of an individual's social or relationship well-being, is being piloted in [[Canada]].

There are many situations that may require first aid, and many countries have legislation, regulation, or guidance, which specifies a minimum level of first aid provision in certain circumstances. This can include specific training or equipment to be available in the workplace (such as an [[Automated External Defibrillator|automated external defibrillator]]), the provision of specialist first aid cover at public gatherings, or mandatory first aid training within schools. Generally, five steps are associated with first aid:

# Assess the surrounding areas.
# Move to a safe surrounding (if not already; for example, road accidents are unsafe to be dealt with on roads).
# Call for help: both professional medical help and people nearby who might help in first aid such as the compressions of cardiopulmonary resuscitation (CPR).
# Perform suitable first aid depending on the injury suffered by the casualty.
# Evaluate the casualty for any fatal signs of danger, or possibility of performing the first aid again.

==Early history and warfare==

Skills of what is now known as first aid have been recorded throughout history, especially in relation to [[warfare]], where the care of both [[injury|traumatic]] and medical cases is required in particularly large numbers. The [[bandage|bandaging]] of battle wounds is shown on [[Classical Greece|Classical Greek]] pottery from {{circa|500 BC}}, whilst the [[parable of the Good Samaritan]] includes references to binding or dressing wounds.<ref name="early">{{Cite journal |last=[[John Hemsley Pearn|Pearn]] |first=John |year=1994 |title=The earliest days of first aid |journal=The British Medical Journal |volume=309 |issue=6970 |pages=1718–1720 |doi=10.1136/bmj.309.6970.1718 |pmc=2542683 |pmid=7820000 }}</ref>  There are numerous references to first aid performed within the [[Roman army]], with a system of first aid supported by surgeons, field ambulances, and hospitals.<ref>{{Cite journal |last=Eastman |first=A Brent |year=1992 |title=Blood in Our Streets: The Status and Evolution of Trauma Care Systems |journal=JAMA Surgery |volume=127 |issue=6 |pages=677–681 |doi=10.1001/archsurg.1992.01420060043008 |pmid=1596168}}</ref>  Roman legions had the specific role of capsarii, who were responsible for first aid such as bandaging, and are the forerunners of the modern [[combat me]].<ref>{{Cite journal |last=Efstathis |first=Vlas |date=November 1999 |title=A history of first aid and its role in armed forces |url=http://www.defence.gov.au/Health/infocentre/journals/ADFHJ_nov99/ADFHealthNov99_1_1_42-44.pdf |url-status=live |journal=ADF Health |archive-url=https://web.archive.org/web/20141130145638/http://www.defence.gov.au/health/infocentre/journals/ADFHJ_nov99/ADFHealthNov99_1_1_42-44.pdf |archive-date=2014-11-30}}</ref>

Further examples occur through history, still mostly related to battle, with examples such as the [[Knights Hospitaller]] in the 11th century AD, providing care to pilgrims and knights in the [[Holy Land]].<ref name="medicinenet">{{Cite web |url=http://www.medicinenet.com/script/main/art.asp?articlekey=52749 |title=First Aid: From Witchdoctors & Religious Knights to Modern Doctors |url-status=live |archive-url=https://web.archive.org/web/20120118055846/http://www.medicinenet.com/script/main/art.asp?articlekey=52749 |archive-date=January 18, 2012 |access-date=March 23, 2011}}</ref>

===Formalization of life saving treatments===
During the late 18th century, [[drowning]] as a cause of death was a major concern amongst the population. In 1767, a society for the preservation of life from accidents in water was started in [[Amsterdam]], and in 1773, physician [[William Hawes (physician)|William Hawes]] began publicizing the power of [[artificial respiration]] as means of resuscitation of those who appeared drowned. This led to the formation, in 1774, of the [[Society for the Recovery of Persons Apparently Drowned]], later the [[Royal Humane Society]], who did much to promote resuscitation.<ref>New Scientist, Vol. 193 No. 2586 (13–19 Jan 2007), p. 50</ref><ref>{{Cite book |last=Price |first=John |title=Everyday Heroism: Victorian Constructions of the Heroic Civilian |publisher=Bloomsbury: London |year=2014 |isbn=978-1-4411066-5-0 |page=203}}</ref>

[[Napoleon]]'s surgeon, [[Baron Dominique-Jean Larrey]], is credited with creating an ambulance corps, the ''[[ambulance volantes]]'', which included medical assistants, tasked to administer first aid in battle.<ref>{{Cite journal |last1=Baker |first1=David |last2=Cazalaà |first2=Jean-Bernard |last3=Carli |first3=Pierre |date=September 2005 |title=Resuscitation great. Larrey and Percy--a tale of two barons |journal=Resuscitation |volume=66 |issue=3 |pages=259–262 |doi=10.1016/j.resuscitation.2005.03.009 |issn=0300-9572 |pmid=15990216}}</ref>

In 1859, [[Switzerland|Swiss]] businessman [[Jean-Henri Dunant]] witnessed the aftermath of the [[Battle of Solferino]], and his work led to the formation of the [[International Red Cross and Red Crescent Movement|Red Cross]], with a key stated aim of "aid to sick and wounded soldiers in the field".<ref name=medicinenet/> The [[Red Cross]] and [[Red crescent|Red Crescent]] are still the largest provider of first aid worldwide.<ref>{{Cite web |url=http://www.redcross.org.uk/en/What-we-do/First-aid/Event-first-aid-and-ambulance-support |title=Event first aid and ambulance support |publisher=British Red Cross |url-status=live |archive-url=https://web.archive.org/web/20140908033750/http://www.redcross.org.uk/en/What-we-do/First-aid/Event-first-aid-and-ambulance-support |archive-date=2014-09-08}}</ref>

[[File:Esmarch original.jpg|[[Esmarch bandage]] showing soldiers how to perform first aid|thumb]]

In 1870, [[Kingdom of Prussia|Prussian]] military surgeon [[Friedrich von Esmarch]] introduced formalized first aid to the military, and first coined the term "erste hilfe" (translating to 'first aid'), including training for soldiers in the [[Franco-Prussian War]] on care for wounded comrades using pre-learnt bandaging and splinting skills, and making use of the [[Esmarch bandage]] which he designed.<ref name=early/> The bandage was issued as standard to the Prussian combatants, and also included aide-memoire pictures showing common uses.

In 1872, the [[Venerable Order of Saint John|Order of Saint John of Jerusalem in England]] changed its focus from hospice care, and set out to start a system of practical medical help, starting with making a grant towards the establishment of the UK's first [[ambulance]] service. This was followed by creating its own wheeled transport litter in 1875 (the St John Ambulance), and in 1877 established the St John Ambulance Association (the forerunner of modern-day [[St John Ambulance]]) "to train men and women for the benefit of the sick and wounded".<ref>Fletcher NC, The St John Ambulance Association: its history and its past in the ambulance movement. London: St John Ambulance Association, 1929:12–3.</ref>

Also in the UK, [[Peter Shepherd (British Army officer)|Surgeon-Major Peter Shepherd]] had seen the advantages of von Esmarch's new teaching of first aid, and introduced an equivalent programme for the British Army, and so being the first user of "first aid for the injured" in English, disseminating information through a series of lectures. Following this, in 1878, Shepherd and [[Francis Duncan|Colonel Francis Duncan]] took advantage of the newly charitable focus of St John,<ref name=early/> and established the concept of teaching first aid skills to civilians. The first classes were conducted in the hall of the Presbyterian school in Woolwich (near Woolwich barracks where Shepherd was based) using a comprehensive first aid curriculum.

First aid training began to spread through the [[British Empire]] through organisations such as St John, often starting, as in the UK, with high risk activities such as ports and railways.<ref>[http://www.sja.org.uk/history/victorian_britain.asp Industrial Revolution: St. John Ambulance] {{webarchive|url=https://web.archive.org/web/20070220111208/http://www.sja.org.uk/history/victorian_britain.asp |date=2007-02-20 }}, retrieved December 10, 2006.</ref>

The first recorded first aid training in the United States took place in [[Jermyn, Pennsylvania]] in 1899.<ref>{{cite web |url=https://jermynpa.com/community/history.php |title=Jermyn Pennsylvania - History |website=jermynpa.com |access-date=2024-09-10}}</ref>

== Common emergences that require first aid in humans ==
List of common situations that require first aid, and information about them (in alphabetical order):

=== Bleeding ===
[[File:"Get First Aid at Once" (15868018799).jpg|thumb|"Get first aid at once" prevention poster (New Zealand, 1950s).]]
{{Main|Emergency bleeding control#Wound management}}

'''Bleeding''' or '''hemorrhage''' is the escape of blood from veins or arteries.

=== Cardiac arrest (total stop of heartbeat) ===
{{For|the proper sequence of first aid reactions to a cardiac arrest|Cardiopulmonary resuscitation#Order of CPR in a first aid sequence}}{{For|the cardiopulmonary resuscitation (CPR) practice itself|Cardiopulmonary resuscitation#Compressions with rescue breaths}}

'''Cardiac arrest''' is the complete stop of heart function.

=== Choking ===
{{Main|Choking#Basic treatment (first aid)}}

'''Choking''' is the obstruction of breathing caused by a blockage in the respiratory tract.

=== Diabetes, hyperglycemia ===
{{Main|Hyperglycemia#Treatment}}

'''Hyperglycemia''' or '''hyperglycaemia''' is a condition in which an excessive level of glucose is present in the blood.

=== Diabetes, hypoglycemia ===
{{Main|Diabetic hypoglycemia#Treatment}}

'''Hypoglycemia''' or '''hypoglycaemia''' is a condition in which an excessively low level of glucose is present in the blood.

It typically occurs due to complications with medication used to reduce blood sugar levels in diabetic patients.

=== Drowning ===
{{For|first aid in a victim of drowning|Drowning#First aid}}{{For|the possible reactions when a victim is drowning|Drowning#Rescue}}

'''Drowning''' in humans is a type of suffocation caused by both the nose and mouth being submerged in liquid.

The first aid for drowning is very similar to that of cardiorespiratory arrest.

=== Infarction of the heart ===
{{Main|Management of acute coronary syndrome#Patient-dependent initial measures}}

A '''myocardial infarction''', commonly known as a '''heart attack''', is the sudden reduction in or lack of blood flow in one of the coronary arteries in the heart, causing [[infarction]] (tissue death due to inadequate blood supply). Risk factors for myocardial infarctions include living a [[Sedentary lifestyle|sedentary]] lifestyle, age (being over 45 for men and 55 for women), tobacco and alcohol use, stress, obesity, high cholesterol, family history, and diabetes.<ref>{{Cite web |title=Heart attack-Heart attack - Symptoms & causes |url=https://www.mayoclinic.org/diseases-conditions/heart-attack/symptoms-causes/syc-20373106 |access-date=2025-05-07 |website=Mayo Clinic |language=en}}</ref>

=== Stroke ===
{{Main|FAST (stroke)}}

A '''stroke''' is a sudden lack of blood supply to the brain caused by a burst or blocked artery.<ref>{{Cite web |title=What is a stroke? |url=https://strokefoundation.org.au/about-stroke/learn/what-is-a-stroke |access-date=2025-05-07 |website=Stroke Foundation - Australia |language=en}}</ref>

==Aims of first aid==
The primary goal of first aid is to prevent death or serious injury from worsening. The key aims of first aid can be summarized with the acronym of 'the three Ps':<ref>{{Cite web |title=Accidents and first aid |url=https://www.gulfphysio.com/moments-from-catastrophe-the-importance-of-first-aid-during-emergencies/ |url-status=live |archive-url=https://web.archive.org/web/20080503201513/http://www.nhsdirect.nhs.uk/articles/article.aspx?articleId=450 |archive-date=2008-05-03 |access-date=2008-10-04}}</ref>

* '''Preserve life:'''  The overriding aim of all medical care which includes first aid, is to save lives and minimize the threat of death.  First aid done correctly should help reduce the patient's level of [[Pain management|pain]] and calm them down during the evaluation and treatment process.
* '''Prevent further harm:'''  Prevention of further harm includes addressing both external factors, such as moving a patient away from any cause of harm, and applying first aid techniques to prevent worsening of the condition, such as applying pressure to stop a bleed from becoming dangerous.
* '''Promote recovery:'''  First aid also involves trying to start the recovery process from the illness or injury, and in some cases might involve completing a treatment, such as in the case of applying a plaster to a small wound.

First aid is not medical treatment, and cannot be compared with what a trained medical professional provides. First aid involves making common sense decisions in the best interest of an injured person.

==Setting the priorities==
A first aid intervention would follow an order, which would try to attend in the best manner the main threats for the life and mobility of the victim.

There are some first aid protocols (such as ATLS, BATLS and SAFE-POINT) that define which are the priorities and the correct execution of the steps for saving human life. A major benefit of the use of official protocols is that they require minimum resources, time and skills, and have a great degree of success.

=== ABCDE and csABCDE general protocol ===
The '''[[ABC (medicine)|ABCDE]]''' method is the general protocol of first aid and implies a quite general view.<ref>{{Cite journal |last1=Thim |first1=Troels |last2=Krarup |first2=Niels Henrik Vinther |last3=Grove |first3=Erik Lerkevang |last4=Rohde |first4=Claus Valter |last5=Løfgren |first5=Bo |date=2012-01-31 |title=Initial assessment and treatment with the Airway, Breathing, Circulation, Disability, Exposure (ABCDE) approach |journal=International Journal of General Medicine |language=English |volume=5 |pages=117–121 |doi=10.2147/IJGM.S28478 |pmc=3273374 |pmid=22319249 |doi-access=free}}</ref>

It was initially developed by Dr Peter Safar in the 1950s. But it has received some modifications, improvements and variations that were intended for more specific contexts. For example: it has been completed with improvements from the ATLS (Advanced Trauma Life Support) version of the American College of Surgeons<ref name=":0">{{Cite journal |last1=Schmidt |first1=Oliver I. |last2=Gahr |first2=Ralf H. |last3=Gosse |first3=Andreas |last4=Heyde |first4=Christoph E. |date=2009-03-03 |title=ATLS(R) and damage control in spine trauma |journal=World Journal of Emergency Surgery |volume=4 |pages=9 |doi=10.1186/1749-7922-4-9 |issn=1749-7922 |pmc=2660300 |pmid=19257904 |doi-access=free}}</ref> and the BATLS (Battlefield Advanced Trauma Life Support) version of the British Army.<ref name=":1">{{Cite journal |last1=Hodgetts |first1=T. J. |last2=Mahoney |first2=P. F. |last3=Russell |first3=M. Q. |last4=Byers |first4=M. |date=October 2006 |title=ABC to ABC: redefining the military trauma paradigm |journal=Emergency Medicine Journal |volume=23 |issue=10 |pages=745–746 |doi=10.1136/emj.2006.039610 |issn=1472-0213 |pmc=2579588 |pmid=16988297}}</ref>

As a result, the mnemonic of the steps of this protocol is '''ABCDE''', or its improved version '''(cs)ABCDE''' (sometimes called '''xABCDE''', the words in the mnemonic may vary), which represent:<ref>{{Cite web |last=NotSan |title=xABCDE untersuchung Rettungsdienst |url=https://notsan.info/index.php?content_id=8 |website=notsan.info |archive-url=https://web.archive.org/web/20241120112312/https://notsan.info/index.php?content_id=8 |archive-date=November 20, 2024 |language=de}}</ref><ref>{{Cite journal |last1=Certain |first1=Lucas |last2=Rostirola |first2=João Vitor Cerávolo |last3=Pereira |first3=Juliana Silva |last4=Rostirola |first4=Gabriela Cerávolo |last5=Estevam |first5=Barbara Canto |last6=Vieira |first6=Carla Caroline Aguiar |last7=da Silva |first7=Israel |last8=da Silva |first8=Jussara Aparecida Rodrigues |last9=Schevenin |first9=Juliana de Cássia |last10=de Oliveira |first10=Ana Barbara Regiani |last11=Franceli |first11=Amanda Bonamichi |last12=Lisboa |first12=Camila Emanuele Camargo |last13=Benites |first13=Bruno Deltreggia |date=2023-07-01 |title=First immediate transfusion at a prehospital environment in Latin America: A case report |journal=Hematology, Transfusion and Cell Therapy |series=Diversity in Classical Hematology Research |volume=45 |issue=Suppl 2 |pages=S153–S156 |doi=10.1016/j.htct.2021.08.007 |issn=2531-1379 |pmc=10433293 |pmid=34862155}}</ref><br/>
—An attached first part (named as "cs" or "x", or in any other way) that will always mention stopping the critical losses of blood and managing with a special and careful treatment to patients with serious damages at the spine that threaten their future mobility:

* '''catastrophic-bleeding''' (stopping urgently the massive external bleedings, as it is marked in the BATLS version).
* '''spine-protection''' (previous examination of the spine, and careful preventive treatment for its damages, as it is marked in the ATLS version).
—The ABCDE protocol itself:
*'''Airway''' (clearing airways).
*'''Breathing''' (ensuring respiration).
* '''Circulation''' (ensuring effective cardiac output).<br />Any '''Defibrillation''' process for a [[Cardiopulmonary resuscitation#Compressions with rescue breaths|cardiac arrest]] (total stop of heartbeat) would be included here, or in 'Disability' (as a double mnemonic 'D').
* '''Disability''' (neurological condition, level of glucose can also be examined).
* '''Exposure''' (or 'Evaluate': other questions in an overall examination of the patient, environment).

=== ABC and CABD cardiopulmonary resuscitation protocol ===
This protocol (originally named as '''ABC''') is a simplified version or concrete application of the previous csABCDE (or ABCDE) protocol, that focuses in the use of [[Cardiopulmonary resuscitation#Compressions with rescue breaths|cardio-pulmonary resuscitation]]. The American Heart Association and the International Liaison Committee on Resuscitation teach it as a reference.<ref>{{Cite web |last=American Heart Association (AHA) |date=2015 |title=Highlights of the Guidelines for CPR and ECC |url=http://eccguidelines.heart.org/wp-content/uploads/2015/10/2015-AHA-Guidelines-Highlights-English.pdf.heart.org/wp-content/uploads/2015/10/2015-AHA-Guidelines-Highlights-English.pdf |archive-url= https://web.archive.org/web/20190203102957/http://eccguidelines.heart.org/wp-content/uploads/2015/10/2015-AHA-Guidelines-Highlights-English.pdf.heart.org/wp-content/uploads/2015/10/2015-AHA-Guidelines-Highlights-English.pdf|access-date=2024-12-01|archive-date=February 3, 2019 }}</ref><ref>{{Cite journal |last1=Field |first1=John M. |last2=Hazinski |first2=Mary Fran |last3=Sayre |first3=Michael R. |last4=Chameides |first4=Leon |last5=Schexnayder |first5=Stephen M. |last6=Hemphill |first6=Robin |last7=Samson |first7=Ricardo A. |last8=Kattwinkel |first8=John |last9=Berg |first9=Robert A. |last10=Bhanji |first10=Farhan |last11=Cave |first11=Diana M. |last12=Jauch |first12=Edward C. |last13=Kudenchuk |first13=Peter J. |last14=Neumar |first14=Robert W. |last15=Peberdy |first15=Mary Ann |date=2010-11-02 |title=Part 1: Executive Summary: 2010 American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care |url=https://ahajournals.org/doi/10.1161/CIRCULATIONAHA.110.970889 |journal=Circulation |language=en |volume=122 |issue=18 Suppl 3 |pages=S640-56 |doi=10.1161/CIRCULATIONAHA.110.970889 |pmid=20956217 |issn=0009-7322|url-access=subscription }}</ref>

Its current mnemonic is '''CABD''' (an improvement in the sequence for most of the cases):

* '''Circulation''' or Chest '''Compressions.'''
* '''Airway''': attempt to open the airway (using a head-tilt and chin-lift technique; not in the case of babies, which require avoid tilting the head).
* '''Breathing''' or Rescue '''Breaths'''.
* '''Defibrillation''': use of an automated external defibrillator to recover heart function.

=== Wider protocols ===
These are the protocols that do not only deal with direct care to the victim but they also mention other complementary tasks (before and later).

==== European protocol ====
This method has been studied and employed for a long time in many European countries, as France.<ref>{{cite web |last=Croix-Rouge francaise |title=Les 4 étapes pour porter secours |url=http://croix-rouge.fr/Je-me-forme/Particuliers/Les-6-gestes-de-base/Les-4-etapes-pour-porter-secours |archive-url=https://web.archive.org/web/20230522153855/http://croix-rouge.fr/Je-me-forme/Particuliers/Les-6-gestes-de-base/Les-4-etapes-pour-porter-secours |access-date=2024-10-30 |archive-date=May 22, 2023 |language=fr-FR}}<!-- auto-translated from French by Module:CS1 translator --></ref> It is a reference, of a certain reputation, that could be applied solely or to a certain degree, usually combining it with the common csABCDE (ABCDE) method or its simplified CABD (ABC) variant about [[Cardiopulmonary resuscitation#Compressions with rescue breaths|cardio-pulmonary resuscitation]]. The European method has a wider range than them, and their steps include tasks that are previous to the first aid techniques themselves.

These are its steps (with no official mnemonic that helps to remember them):

* '''Protection''' for patients and rescuers. If dangers are present, the patient would be moved to a safer place with a careful management of any detected spinal injury.
* '''Evaluation''' of the patient (looking for priorities as critical bleeding and cardiac arrest).
* '''Alerting''' to medical services and bystanders.
* '''Performing''' the first aid practices. The '''CABD (or ABC)''' method for [[Cardiopulmonary resuscitation#Compressions with rescue breaths|cardio-pulmonary resuscitation]] and many details of the wider '''csABCDE (or ABCDE)''' method would be included in this step.

=== Other mentionable protocols ===
Some other known protocols that could be mentioned in many contexts (in alphabetical order):

'''AMEGA protocol'''

{{anchor|AMEGA}}It is similar to the European protocol, because it also has a wider range<ref>Furst, J., [https://web.archive.org/web/20231022015347/http://firstaidforfree.com/what-does-amega-stand-for-in-first-aid/ What does AMEGA stand for in first aid?], updated 12 July 2019, accessed 24 January 2022</ref> than the common csABCDE (or ABCDE) protocol, and includes other tasks that are previous to the first aid techniques themselves. The order of the steps is changed, and the experience with it is lesser, but it adds the idea of a posterior 'aftermath' phase.

The mnemonic AMEGA refers to:

* ''Assess'' the situation, looking for risks.
* ''Make safe'' the situation, after having identified the risks.
* ''Emergency aid''. Performing the first aid practices.
* ''Get help''. Asking for emergency help to medical services and bystanders.
* ''Aftermath''. The aftermath tasks include recording and reporting, continued care of patients and the welfare of responders and the replacement of used first aid kit elements.
'''ATLS and BATLS protocols'''{{See also|Advanced trauma life support|BATLS}}
{{anchor|ATLS and BATLS}}They are basically the common [[First aid#ABCDE and cAsBCDE protocol|ABCDE and csABCDE protocol]], but focusing in particular aspects.

The ATLS (Advanced Trauma Life Support) version<ref name=":0" /> was developed by the American College of Surgeons, focusing in the particular needs of trauma and specifically in the spinal injuries. And the BATLS (Battlefield Advanced Trauma Life Support) version<ref name=":1" /> is an improvement for the British Army that added the concept of 'catastrophic bleeding'.

The preference for one or another among all these protocols can depend on the context and the audience.

==== Check, Call and Care protocol ====
{{anchor|Check, Call and Care}}It comes from Red Cross<ref>{{Cite web |last=American Red Cross |title=Check, Call, Care: 3 Emergency Actions Steps to Take to Save Lives |url=http://redcross.org/take-a-class/resources/articles/the-three-cs-of-first-aid-check-call-care|archive-url=https://web.archive.org/web/20241111144154/http://redcross.org/take-a-class/resources/articles/the-three-cs-of-first-aid-check-call-care |archive-date=November 11, 2024 }}</ref> and, as the European protocol, has a wider range than the common csABCDE (ABCDE) method. So it could be seen as a simplification of the European protocol, and, especially, easier to remember as a guide for most of cases.

It mentions the following steps:

* ''Check'' the scene for safety of the rescuer and others, and check the patient's condition.
* ''Call'' to emergency medical services.
* ''Care'' the patient.

==== SAFE-POINT protocol ====
{{anchor|SAFE-POINT}}Another European protocol, which appeared in the field of construction of Czech Republic to react to any emergence .<ref>{{Cite web |last=safe-point.cz |title=SAFE-Point: 6 steps to save life |url=http://safe-point.cz/index.php/6-kroku-k-zachrane-zivota-2/ |language=Czech}}</ref>

Their steps (which have not any mnemonic) are:

* ''Safety of the rescuers.''
* ''Calling'' to emergency telephone number.
* ''Bleeding'': treating the massive bleedings.
* ''Freeing the airways''.
* ''Resuscitation'': applying cardiopulmonary resuscitation.
* ''Keeping warm'' to the patient.

== Key basic skills ==
Certain skills are considered essential to the provision of first aid and are taught ubiquitously.

=== Displacement skills ===
If there are dangers around (such as fire, electric dangers or others) the patient has to be moved to a safe place,<ref name=":2" /><ref>{{Cite web |last=Community Emergency Response Team of L.A. |date=2024-10-31 |title=Lifts and carries |url=https://cert-la.com/cert-training-education/lifts-carries/ |website=CERTLA}}</ref> (if it is safe for the first aid provider to do so), where providing the required first aid procedures is possible.

—'''In case of a possible severe spinal injury:''' when a patient seems to have a possible serious injury in the spinal cord (in the backbone, either at the neck part or the back part), that patient must not be moved except if that is necessary, and, when necessary, it must be done as little as possible and very carefully (see mentions about this type of injury in the gallery of drawings below). These precautions avoid many risks of causing further damages for the patient's mobility in the future.

Usually, the patient needs to end up lying down, in a face-up position, on a sufficiently firm surface (for example, on the floor, which allows to perform the chest compressions of cardiopulmonary resuscitation).
{{Gallery|File:Recovery_position_maneuver.jpg|—A victim with a serious injury in the spine (in the back or the neck), which indicates a risk to the future mobility, can be carefully transferred by several rescuers that work coordinately.<br />The victim’s head and back would be held in the same position they were.|File:Rautek-maneuver.png|—When there is a victim with a serious injury in the spine (in the back or the neck) and a rescuer without instruments, the rescuer can try to carry the victim carefully through the Rautek maneuver (as in the picture), trying to keep victim’s head and back in the same position they were.<br />The victim's head can be supported on the rescuer to try to soften the movements.<br />A second rescuer can hold the legs.|File:Blanket-Pull.png|—A victim without a serious injury in the spine (in the back or the neck) can be pulled through the floor, which is easier on a blanket, carpet or another tissue located under most of the body.<br />—Carrying on a base to victims with a suspected spinal injury would require to place them carefully, while keeping their head and back in the same position they were, on a higher or much thicker base (as a litter or mattress), for a better displacement.|width=225|height=225|align=center|title=Displacement of victims to a safe place}}

=== Checking skills ===
They evaluate the condition of the victim,<ref name=":2">{{Cite book |last=American Red Cross |title=CPR/AED for Professional Rescuers |year=2016 |edition=2nd}}</ref> first attending to the main threats for life.

The preferred initial way of checking consist of asking, commonly by touching the patient in one of his shoulders and shouting something, such as: "can you hear me?"

In some cases, the victim has a wound that bleeds abundantly, which requires its own additional treatment to stop the blood loss (usually, it would begin by keeping the wound pressed).

If the patient does not react, the heartbeats can be checked in the carotid pulse: placing two fingers on any side of the neck (on the left or the right side), near his head. In cases where checking the carotid pulse is impossible, heartbeats can be perceived in the radial pulse: placing two fingers on a wrist, under the part of the thumb, and applying moderate pressure. Breathing can also be checked additionally, placing an ear on the mouth and, at the same time, watching the chest rising by the effect of the air. It is recommended not to waste too much time of first aid in checking (professional rescuers are taught to take 10 seconds in it).

{{Gallery|File:Carotidian_pulse_(clear).jpg|Checking of heartbeats in the carotid pulse.<br/>This is usually the fastest method of checking the patient's condition.|File:Pulse2.jpg|Verification of heartbeats in the radial pulse, pressing moderately on a wrist, under the part of the thumb.|File:Checking_respiration3.jpg|Check of patient's breathing, listening the air inside of the mouth and watching the chest swelling.|width=200|height=200|align=center|title=Check of patient's condition}}

=== Cardiopulmonary resuscitation (CPR) ===
{{For|the proper sequence of first aid reactions to a cardiac arrest|Cardiopulmonary resuscitation#Order of CPR in a first aid sequence}}{{For|cardiopulmonary resuscitation (CPR) practice|Cardiopulmonary resuscitation#Compressions with rescue breaths}}
Cardiopulmonary resuscitation (CPR) is the method of first aid for treating victims of cardiac arrest (complete stop of heartbeat).

{{Multiple images
| direction         = horizontal
| image1            = Ratownik medyczny, defibrylacja.jpg
| caption1          = Traditional maneuvers of cardiopulmonary resuscitation (CPR) have included in the present the use of automatic defibrillators.
| align             = center
| width1            = 230
| header            = Cardiopulmonary resuscitation (CPR)
}}

=== Airway, Breathing, and Circulation skills ===
[[File:Tongue blocking airway.svg|thumb|In case of tongue fallen backwards, blocking the airway, it is necessary to hyperextend the head and pull up the chin, so that the tongue lifts and clears the airway.]]<!-- Before editing this section to change circulation to Compressions, please read the article at ABC (medicine) -->
ABC method stands for ''Airway'', ''Breathing'', and ''Circulation''.<ref>{{Cite journal |last1=Eisenburger |first1=Philip |last2=Safar |first2=Peter |year=1999 |title=Life supporting first aid training of the public—review and recommendations |journal=Resuscitation |volume=41 |issue=1 |pages=3–18 |doi=10.1016/S0300-9572(99)00034-9 |pmid=10459587}}</ref><!-- Before editing this section to change Circulation to Compressions, please read the article at ABC (medicine) --> The same [[mnemonic]] is used by [[emergency medicine|emergency health professionals]].

It is focused on critical life-saving intervention, and it must be rendered before treatment of less serious injuries.

Attention must first be brought to the [[airway]] to [[basic airway management|ensure it is clear]]. An [[airway obstructions|obstruction]] (choking) is a life-threatening emergency. If an object blocks the airway, it requires [[Choking#General strategy: "five and five"|anti-choking procedures]]. Following any evaluation of the airway, a first aid attendant would determine adequacy of [[breath]]ing and provide [[rescue breathing]] if safe to do so.

Assessment of [[Circulatory system|circulation]] is now not usually carried out for patients who are not breathing, with first aiders now trained to go straight to chest compressions (and thus providing artificial circulation) but [[pulse]] checks may be done on less serious patients.

Some organizations add a fourth step of "D" for ''[[Bleeding|Deadly bleeding]]'' or ''[[Defibrillation]]'', while others consider this as part of the ''Circulation'' step simply referred as Disability. Variations on techniques to evaluate and maintain the ABCs depend on the skill level of the first aider. Once the ABCs are secured, first aiders can begin additional treatments or examination, as required if they possess the proper training (such as measuring pupil dilation).<ref>{{Cite web |url=https://www.resus.org.uk/resuscitation-guidelines/abcde-approach/ |title=Guidelines and Guidance: The ABCDE approach |website=Resuscitation Council (UK) |url-status=live |archive-url=https://web.archive.org/web/20050812085403/http://www.resus.org.uk/pages/alsABCDE.htm |archive-date=12 August 2005 |access-date=2 May 2019}}</ref>

Some organizations teach the same order of priority using the "3Bs": ''Breathing'', ''Bleeding'', and ''Bones'' (or "4Bs": ''Breathing'', ''Bleeding'', ''Burns'', and ''Bones''). While the ABCs and 3Bs are taught to be performed sequentially, certain conditions may require the consideration of two steps simultaneously. This includes the provision of both [[artificial respiration]] and [[cardiopulmonary resuscitation|chest compressions]] to someone who is not breathing and has no pulse, and the consideration of [[cervical spine]] injuries when ensuring an open airway.

==== Preserving life ====
The patient must have an open airway—that is, an unobstructed passage that allows air to travel from the open [[mouth]] or uncongested [[human nose|nose]], down through the [[human pharynx|pharynx]] and into the lungs. [[Conscious]] people maintain their own airway automatically, but those who are unconscious (with a [[Glasgow coma scale|GCS]] of less than 8) may be unable to do so, as the part of the brain that manages spontaneous breathing may not be functioning.

Whether conscious or not, the patient may be placed in the [[recovery position]], laying on their side. In addition to relaxing the patient, this can have the effect of clearing the tongue from the [[pharynx]]. It also avoids a common cause of death in unconscious patients, which is choking on regurgitated stomach contents.

The airway can also become blocked by a foreign object. To dislodge the object and solve the choking case, the first aider may use [[Choking#General strategy: "five and five"|anti-choking methods]] (such as 'back slaps, 'chest thrusts' or 'abdominal thrusts').

Once the airway has been opened, the first aider would reassess the patient's breathing. If there is no breathing, or the patient is not breathing normally (e.g., [[agonal breathing]]), the first aider would initiate [[Cardiopulmonary resuscitation|CPR]], which attempts to restart the patient's breathing by forcing air into the lungs. They may also manually massage the heart to promote blood flow around the body.

If the choking person is an infant, the first aider may use [[Choking#Infants|anti-choking methods for babies.]] During that procedure, series of five strong blows are delivered on the infant's upper back after placing the infant's face in the aider's forearm. If the infant is able to cough or cry, no breathing assistance should be given. Chest thrusts can also be applied with two fingers on the lower half of the middle of the chest. Coughing and crying indicate the airway is open and the foreign object will likely to come out from the force the coughing or crying produces.<ref>{{Cite web|url=https://medlineplus.gov/ency/article/000048.htm|title=Choking - infant under 1 year: MedlinePlus Medical Encyclopedia|website=medlineplus.gov}}</ref>

A first responder should know how to use an [[Automated external defibrillator|Automatic External Defibrillator]] (AED) in the case of a person having a sudden cardiac arrest. The survival rate of those who have a cardiac arrest outside of the hospital is low. Permanent brain damage sets in after five minutes of no oxygen delivery, so rapid action on the part of the rescuer is necessary. An AED is a device that can examine a heartbeat and produce electric shocks to restart the heart.<ref>{{Cite journal |last=Nessel |first=Edward H. |date=2012 |title=Treating Sudden Cardiac Arrest and the Use of Automated External Defibrillators in the Community Setting |url=https://www.thefreelibrary.com/Treating+sudden+cardiac+arrest+and+the+use+of+automated+external...-a0285436339 |journal=AAMA Journal |volume=25 |page=9}}</ref>

A first aider should be prepared to quickly deal with less severe problems such as [[wounds|cuts]], [[Abrasion (medical)|grazes]] or [[bone fracture]]. They may be able to completely resolve a situation if they have the proper training and equipment. For situations that are more severe, complex or dangerous, a first aider might need to do the best they can with the equipment they have, and wait for an ambulance to arrive at the scene.

== First aid kits ==
[[File:A first aid box.jpg|thumb|A first aid box]]
A [[first aid kit]] consists of a strong, durable bag or transparent plastic box. They are commonly identified with a white cross on a green background. A first aid kit does not have to be bought ready-made. The advantage of ready-made first aid kits are that they have well organized compartments and familiar layouts.

===Contents===
There is no universal agreement upon the list for the contents of a first aid kit. The UK Health and Safety Executive stress that the contents of workplace first aid kits will vary according to the nature of the work activities.<ref>First aid at work: The Health and Safety (First-Aid) Regulations 1981. Guidance on Regulations L74</ref> As an example of possible contents of a kit, [[British Standards|British Standard]] BS 8599 ''First Aid Kits for the Workplace''<ref>BS 8599-1:2011 BSI 2011</ref> lists the following items:

{{div col | colwidth=25em}}
*Information leaflet
*Medium [[Asepsis|sterile dressing]]s
*Large sterile dressings
*Bandages
*Triangular dressings
*Safety pins
*Adhesive dressings
*Sterile wet wipes
*Microporous tape
*[[Nitrile]] gloves
*Face shield
*Foil blanket
*Burn dressings
*Clothing shears
*Conforming bandages
*Finger dressing
*Antiseptic cream
*Scissors
*[[Tweezers]]
*Cotton
{{div col end}}

== Training principles ==
[[File:Suicide-prague.jpg|thumb|First aid scenario training in progress]]

Basic principles, such as knowing the use of adhesive bandage or applying direct pressure on a bleed, are often acquired passively through life experiences. However, to provide effective, life-saving first aid interventions requires instruction and practical training. This is especially true where it relates to potentially fatal illnesses and injuries, such as those that require CPR; these procedures may be invasive, and carry a risk of further injury to the patient and the provider. As with any training, it is more useful if it occurs ''before'' an actual [[emergency]]. And, in many countries, calling emergency medical services allows listening basic first aid instructions over the phone while the ambulance is on the way.

Training is generally provided by attending a course, typically leading to certification. Due to regular changes in procedures and protocols, based on updated clinical knowledge, and to maintain skill, attendance at regular refresher courses or re-certification is often necessary. First aid training is often available through community organizations such as the [[Red Cross]] and [[St. John Ambulance]], or through commercial providers, who will train people for a fee. This commercial training is most common for training of employees to perform first aid in their workplace. Many community organizations also provide a commercial service, which complements their community programmes.

1.Junior level certificate [[Basic Life Support]]

2.Senior level certificate

3.Special certificate

=== Types of first aid which require training ===
[[File:Resusci Anne - CPR dummy.jpg|thumb|Shown here is an example of a way for people to practice CPR in a safe and reliable manner.]]There are several types of first aid (and first aider) that require specific additional training. These are usually undertaken to fulfill the demands of the work or activity undertaken.
* '''Aquatic/Marine first aid''' is usually practiced by professionals such as [[lifeguards]], professional [[sailor|mariner]]s or in [[diver rescue]], and covers the specific problems which may be faced after water-based rescue or delayed [[MedEvac]].
* '''[[Battlefield medicine|Battlefield first aid]]''' takes into account the specific needs of treating wounded [[combatants]] and [[non-combatants]] during [[armed conflict]].
* Conflict First Aid focuses on support for stability and recovery of personal, social, group or system well-being and to address circumstantial safety needs.
* '''[[Hyperbaric medicine|Hyperbaric]] first aid''' may be practiced by [[underwater diving]] professionals, who need to treat conditions such as [[decompression sickness]].
*'''[[Oxygen therapy|Oxygen]] first aid''' is the providing of oxygen to casualties with conditions resulting in [[hypoxia (medical)|hypoxia]]. It is also a standard first aid procedure for underwater diving incidents where gas bubble formation in the tissues is possible.
*'''[[Wilderness first aid]]''' is the provision of first aid under conditions where the arrival of [[emergency responders]] or the evacuation of an injured person may be delayed due to constraints of terrain, weather, and available persons or equipment. It may be necessary to care for an injured person for several hours or days.
*'''[[Mental health first aid]]''' is taught independently of physical first aid. How to support someone experiencing a mental health problem or in a crisis situation. Also how to identify the first signs of someone developing mental ill health and guide people towards appropriate help.
[[File:First aider in parade.jpg|First aider of the [[British Red Cross]] accompanies parade of morris dancers at the [[Knutsford]] Royal May Day, Knutsford, Cheshire, England, 2012|thumb]]

== First aid services ==
Some people undertake specific training in order to provide first aid at public or private events, during filming, or other places where people gather. They may be designated as a ''first aider'', or use some other title. This role may be undertaken on a voluntary basis, with organisations such as the [[Red Cross]] society and [[St John Ambulance|St. John Ambulance]],<ref>{{Cite web |url=http://www.sja.org.uk/sja/first-aid-advice/what-to-do-as-a-first-aider/the-role-of-a-first-aider.aspx |title=Role of a First Aider - First Aid - St John Ambulance |website=www.sja.org.uk |access-date=2019-11-20}}</ref> or as paid employment with a medical contractor.

People performing a first aid role, whether in a professional or voluntary capacity, are often expected to have a high level of first aid training and are often uniformed.

==Symbols==
{{further|Emblems of the Red Cross#Use of the emblems}}
Although commonly associated with first aid, the symbol of a red cross is an official protective symbol of the [[Red Cross]]. According to the [[Geneva Conventions]] and other international laws, the use of this and [[International Red Cross and Red Crescent Movement#Protection symbols vs. organizational emblems|similar symbols]] is reserved for official agencies of the '''[[International Red Cross and Red Crescent]]''', and as a protective emblem for medical personnel and facilities in combat situations. Use by any other person or organization is illegal, and may lead to prosecution.

The internationally accepted symbol for first aid is the white cross on a green background shown below.

Some organizations may make use of the [[Star of Life]], although this is usually reserved for use by ambulance services, or may use symbols such as the [[Maltese Cross]], like the [[Order of Malta Ambulance Corps]] and [[St John Ambulance]]. Other symbols may also be used.
<gallery>
File:Star of life2.svg|[[Star of Life]]
File:CivilDefence.svg|[[Civil defense]] 
File:Flag of the Red Crystal.svg|Emblem of the [[Emblems of the International Red Cross and Red Crescent Movement#Red Crystal|Red Crystal]]
File:Flag of the Red Crescent.svg|Emblem of the [[Emblems of the International Red Cross and Red Crescent Movement#Red Crescent|Red Crescent]]
File:Flag of the Red Cross.svg|Emblem of the [[Emblems of the International Red Cross and Red Crescent Movement#Red Cross|Red Cross]]
File:ISO 7010 E003 - Crescent Symbol.svg|ISO First Aid Symbol ([[ISO 7010#Crescent variant|Crescent variant]])
File:ISO 7010 E003 - First aid sign.svg|[[ISO 7010|ISO First Aid Symbol]]
File:Maltese-Cross-Heraldry.svg|[[Maltese cross|Maltese or Amalfi Cross]]
</gallery>

==References==
{{reflist|30em}}

==External links==
{{Wiktionary}}
{{wikibooks|First Aid}}
{{Wikivoyage|First aid kit for travellers}}
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* [http://www.mayoclinic.com/health/FirstAidIndex/FirstAidIndex First Aid Guide at the Mayo Clinic]
* [http://www.redcross.org.uk/first-aid/first-aid-apps/ First aid from the British Red Cross] – including first aid tips and first aid training information
* [http://www.sja.org.uk/get-advice/free-first-aid-app/ First aid from St John Ambulance] – first aid information and advice
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{{Emergency medicine}}
{{Lifesaving and Lifeguarding}}
{{Underwater diving|divsaf}}
{{Civil defence}}

{{Authority control}}

{{DEFAULTSORT:First Aid}}
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