# Emergency first aid: the knowledge, not the certificate

*What to do in the first three minutes, and an honest statement that this cannot make you a first aider.*

## Production summary

- Modules to record: 2
- Total script: 1071 words, about 7 minutes of finished audio
- Voices: Amara (host) and Nadia (practice educator)
- Level: Awareness level, all staff

## Accreditation wording that must appear in the description

- **The CPD Certification Service** (planned): Application scheduled.
- **Resuscitation Council UK guidelines** (aligned): Written against current published guidelines. Alignment is our own mapping and confers no qualification.

> Do not upgrade any of these words in a description or a thumbnail. Aligned is not accredited, and planned is not approved.


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## The first three minutes

**Runtime** about 4 minutes. **Words** 551. **Starts at** 00:00 in the full course recording.

### Learning outcomes to state on camera

- Carry out a primary survey in order
- Recognise time critical conditions and act
- Use the recovery position correctly
- State what awareness level training does not cover

### Script


`[CUE 1]` *Warning card at the top: this is not a first aid qualification.*

**AMARA**  [00:00]
Before anything else. Does this make me a first aider?

**NADIA**  [00:04]
No. And I want that at the top rather than in a footnote, because burying it is how people end up believing they are qualified.

**AMARA**  [00:14]
What is missing?

**NADIA**  [00:15]
Everything requiring hands. Compression depth and rate. Opening an airway. Managing a real collapsed person while frightened. Those have to be practised on a manikin and assessed by an instructor.

**AMARA**  [00:27]
Then what is this for?


`[CUE 2]` *DRSAB sequence with danger held longest.*

**NADIA**  [00:29]
The sequence. Because the commonest reason people do nothing in an emergency is not cowardice. It is not knowing what order to do things in, so they stand there.

**AMARA**  [00:40]
Give me the order.

**NADIA**  [00:42]
Danger. Response. Shout for help. Airway. Breathing. Danger first, always, because a second casualty helps nobody and that is the step adrenaline removes.

**AMARA**  [00:51]
Shout for help. Just shout?

**NADIA**  [00:53]
No, and this is the detail that changes outcomes. Point at a specific person and name the task. You, in the blue coat, ring 999 and come back and tell me you have done it.


`[CUE 3]` *Pointing at one named person to ring 999, versus a general shout in a crowd.*

**AMARA**  [01:07]
Why so specific?

**NADIA**  [01:08]
Because a general shout in a crowd produces nothing at all. Everybody assumes somebody else is already doing it. Naming one person and one task breaks that instantly.

**AMARA**  [01:20]
Then airway and breathing.

**NADIA**  [01:21]
Head tilt, chin lift. Then look, listen and feel for no more than ten seconds. And here is the thing I most want you to remember from this whole course.

**AMARA**  [01:33]
Go on.


`[CUE 4]` *Agonal gasping labelled as cardiac arrest.*

**NADIA**  [01:34]
Agonal gasping is not breathing. In the first minutes of a cardiac arrest people often make irregular, noisy gasps. It looks like breathing to a frightened bystander, and it is the single commonest reason nobody starts CPR on somebody who could have survived.

**AMARA**  [01:51]
So gasping means?

**NADIA**  [01:52]
Treat it as cardiac arrest. 999, get an AED, start compressions.

**AMARA**  [01:57]
Let us do the time critical ones. Stroke.

**NADIA**  [02:00]
FAST. Face drooping, Arms cannot stay up, Speech slurred, Time to ring 999. And note the time symptoms started.


`[CUE 5]` *FAST with the onset time being written down and handed over.*

**AMARA**  [02:08]
Why does that matter?

**NADIA**  [02:09]
Because treatment options depend on it, and nobody at hospital will know it unless somebody who was there tells them. That one piece of information from a bystander can change what treatment is possible.

**AMARA**  [02:23]
Sepsis?

**NADIA**  [02:23]
Suspected infection plus deterioration. Slurred speech or confusion, extreme shivering or muscle pain, no urine in a day, severe breathlessness, a feeling of impending death, mottled or discoloured skin.

**AMARA**  [02:35]
And I should say the word?


`[CUE 6]` *Direct pressure on a wound, with an embedded object packed around rather than removed.*

**NADIA**  [02:37]
Say the word sepsis out loud when you call. It starts a different pathway. A described patient with an unnamed suspicion does not get the clock started.

**AMARA**  [02:48]
Severe bleeding?

**NADIA**  [02:49]
Firm direct pressure on the wound, with something clean if you have it and your hand if you do not. Do not pull out anything embedded, pack around it. Lie them down and ring 999.

**AMARA**  [03:03]
Last question, and it is the one that stops people. Can I be sued for helping?

**NADIA**  [03:09]
That fear prevents far more help than it should. The Social Action, Responsibility and Heroism Act 2015 requires a court to consider whether somebody was acting for the benefit of society and intervening in an emergency.

**AMARA**  [03:24]
So what is the sensible position?

**NADIA**  [03:26]
Act reasonably, within your competence, and do not attempt things you have not been trained in. Somebody in cardiac arrest is not going to be made worse by a bystander trying. They are dying already.

### Sources for the on screen credit

- Adult basic life support guidelines, Resuscitation Council UK
- Health and Safety (First Aid) Regulations 1981 and first aid needs assessment, Health and Safety Executive
- Sepsis: recognition, diagnosis and early management, NG51, NICE
- Social Action, Responsibility and Heroism Act 2015, legislation.gov.uk

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## Bleeding, burns, seizures and choking

**Runtime** about 3 minutes. **Words** 520. **Starts at** 03:40 in the full course recording.

### Learning outcomes to state on camera

- Control severe bleeding, including a catastrophic bleed
- Treat a burn correctly, and know what makes it worse
- Support somebody through a seizure without restraining them
- Manage choking in an adult, and know when to call 999

### Script


`[CUE 1]` *Direct pressure applied, with an embedded object packed around rather than removed.*

**AMARA**  [03:40]
Heavy bleeding. What do I actually do?

**NADIA**  [03:43]
Firm direct pressure on the wound. Something clean if you have it, your bare hand if you do not. Pressure stops bleeding; a dressing is just a more comfortable way of applying pressure.

**AMARA**  [03:56]
There is glass in the wound.

**NADIA**  [03:58]
Then leave it. Do not pull it out, because it may be the only thing stopping much heavier bleeding. Pack around it and press either side.

**AMARA**  [04:09]
The dressing has soaked through.


`[CUE 2]` *A soaked dressing with a second added on top rather than replaced.*

**NADIA**  [04:11]
Add more on top. Never remove the first one, because you strip off the clot that was forming underneath it.

**AMARA**  [04:19]
Both of those feel like the wrong thing to do.

**NADIA**  [04:23]
They both feel like helping, and they both increase blood loss. That is why they are worth learning before you are standing over somebody.

**AMARA**  [04:32]
Burns. How long do I cool it for?

**NADIA**  [04:36]
Twenty minutes under cool running water. Twenty, not a couple, and it is still worth doing up to three hours afterwards.


`[CUE 3]` *Twenty minute cooling timer, with the burn still cooking at two minutes.*

**AMARA**  [04:44]
Twenty minutes is a long time.

**NADIA**  [04:46]
It is, and it is the single most effective thing anybody does for a burn. People stop at two minutes because the person says it feels better, and the burn carries on cooking underneath.

**AMARA**  [05:00]
Should I take a ring off?

**NADIA**  [05:02]
Yes, and quickly, unless it is stuck to the burn. Swelling comes fast and a ring becomes a tourniquet on a finger.

**AMARA**  [05:11]
Then cover it?


`[CUE 4]` *Ring removed before swelling, and cling film laid on rather than wrapped.*

**NADIA**  [05:12]
Cling film laid on, not wrapped around, because wrapping constricts as it swells. Or a clean non fluffy cloth. Cling film is ideal: it does not stick, and the wound stays visible.

**AMARA**  [05:25]
My grandmother swore by butter.

**NADIA**  [05:27]
Your grandmother was wrong, and so is toothpaste, cream and ice. Butter and creams trap heat and get scraped off in hospital, which is as unpleasant as it sounds. Ice causes additional tissue damage. And never burst a blister.

**AMARA**  [05:43]
Seizures frighten me. Do I hold them?

**NADIA**  [05:46]
No. Do not restrain them, and do not put anything in their mouth. Both are actively harmful.


`[CUE 5]` *Seizure: furniture moved, head protected, hands off, clock started.*

**AMARA**  [05:52]
What about swallowing their tongue?

**NADIA**  [05:54]
It does not happen. It is not anatomically possible, and people have broken teeth and fingers acting on that belief.

**AMARA**  [06:02]
So what do I do?

**NADIA**  [06:04]
Protect their head, move the furniture, note the time it started, and stay with them. When it stops, recovery position, and let them come round in their own time. Confusion and exhaustion afterwards are normal and they may not know where they are.

**AMARA**  [06:22]
When do I call 999?


`[CUE 6]` *Choking: five back blows, five abdominal thrusts, alternating.*

**NADIA**  [06:24]
More than five minutes. Another one before they have recovered. Their first ever. If they are injured. Or if they do not regain consciousness.

**AMARA**  [06:33]
Choking. Back blows first?

**NADIA**  [06:35]
If the cough is ineffective, yes. Five back blows between the shoulder blades, then five abdominal thrusts, alternating. Unresponsive, start CPR.

**AMARA**  [06:43]
And if they are coughing well?

**NADIA**  [06:46]
Leave them to it and encourage it. A person coughing forcefully is moving far more air than you will move for them, and interfering can turn a partial obstruction into a complete one.

**AMARA**  [06:59]
Afterwards?

**NADIA**  [06:59]
Anyone who has had abdominal thrusts gets medical assessment, even if they feel completely fine, because of the risk of internal injury.

### Sources for the on screen credit

- First aid guidelines, Resuscitation Council UK
- Burns and scalds first aid, NHS England
- Epilepsy seizure first aid, Epilepsy Action

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