International First Aid And Resuscitation Guidelines 2016

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International first aid andresuscitation guidelines 2016For National Society first aid programme managers,scientific advisory groups, first aid instructorsand first responderswww.ifrc.orgSaving lives, changing minds.

International Federation of Red Crossand Red Crescent Societies, Geneva, 2016Copies of all or part of this study may be made for noncommercialuse, providing the source is acknowledged The IFRC would appreciate receiving details of its use. Requests for commercial reproductionshould be directed to the IFRC at secretariat@ifrc.org.The opinions and recommendations expressed in this study do notnecessarily represent the official policy of the IFRC or of individualNational Red Cross or Red Crescent Societies. The designations andmaps used do not imply the expression of any opinion on the part ofthe International Federation or National Societies concerning the legalstatus of a territory or of its authorities. All photos used in this studyare copyright of the IFRC unless otherwise indicated. Cover photo:American Red Cross.P.O. Box 303CH-1211 Geneva 19SwitzerlandTelephone: 41 22 730 4222Telefax: 41 22 733 0395E-mail: secretariat@ifrc.orgWeb site: www.ifrc.orgInternational first aid and resuscitation guidelines 20161303500 05/2016 EFollow us on:

International Federation of Red Cross and Red Crescent SocietiesInternational first aid and resuscitation guidelines 2016International first aid andresuscitation guidelines 2016for National Society first aid programmemanagers, scientific advisory groups,first aid instructors and first respondersThe International Federation of Red Cross andRed Crescent Societies (IFRC) is the world’slargest volunteer-based humanitarian network.With our 190 member National Red Cross andRed Crescent Societies worldwide, we are inevery community reaching 160.7 million peopleannually through long-term services anddevelopment programmes, as well as 110 millionpeople through disaster response and earlyrecovery programmes. We act before, during andafter disasters and health emergencies to meetthe needs and improve the lives of vulnerablepeople. We do so with impartiality as tonationality, race, gender, religious beliefs, classand political opinions.Guided by Strategy 2020 – our collective plan ofaction to tackle the major humanitarian anddevelopment challenges of this decade – we arecommitted to saving lives and changing minds.Our strength lies in our volunteer network,our community-based expertise and ourindependence and neutrality. We work toimprove humanitarian standards, as partners indevelopment, and in response to disasters. Wepersuade decision-makers to act at all times inthe interests of vulnerable people. The result:we enable healthy and safe communities, reducevulnerabilities, strengthen resilience and fostera culture of peace around the world.1

International Federation of Red Cross and Red Crescent SocietiesInternational first aid and resuscitation guidelines 20162

International Federation of Red Cross and Red Crescent SocietiesInternational first aid and resuscitation guidelines 2016Table of troduction11About this document12Link to Strategy 2020Where do the guidelines fit in IFRC policy?Definition, trends and facts and figuresDefinition of first aidProgress and trends in first aid: community-based health and first aid in actionNumber of people reached121315151516Process to develop these guidelines17Summary of scientific foundation and guidelinesLocal adaptationFuture development182020General principlesCitizen preparedness for disasters and daily emergenciesPreventionPersonal safetyLinkages to other healthcareUpdate and retrainingTarget populations and their supportersEthicsEducationIntroductionWhat is effective first aid education?Foundation for first aid educationThe effectiveness of first aid education on casualty outcomesMotivation of the learnerThe effectiveness of using different learning modalitiesScenario-based and simulation learningFirst aid education for childrenMeasuring outcomesConclusionsGeneral approachIntroductionAssessmentCasualty positioningCall for help, EMS or further helpMedication 404242434445463

International Federation of Red Cross and Red Crescent SocietiesInternational first aid and resuscitation guidelines 2016First aid for medical conditionsAllergic reaction and second dose of epinephrine for anaphylaxisPoisoningBreathing difficultiesChest painStrokeDehydration and gastrointestinal distressSeizuresFeverDiabetes and hypoglycaemia treatmentUse of oxygenShock and optimal position for shockUnresponsive and altered mental statusFaintingCroupFirst aid for injuriesForeign body airway al spinal motion restrictionChest and abdomen injuriesExtremity injuriesWounds and abrasionsDental avulsionInjuries due to chemical 878990919394Environmental health problems97Health problems caused by coldHealth problems caused by high altitudeRadiation emergencies97100101First aid for animal-related impairmentsAnimal bitesSnakebitesJellyfish stingsInsect bites or stingsDrowning and scuba diving decompression illnessDrowning processCervical spine injury among drowning casualtiesScuba diving decompression illnessResuscitationIntroductionCardiac arrestEarly defibrillationResuscitation in childrenWithholding of resuscitation in cases of traumatic pre-hospital cardiopulmonary arrestMethods of providing 5125130131

International Federation of Red Cross and Red Crescent SocietiesInternational first aid and resuscitation guidelines 2016Psychological first aidIntroductionPsychological first aid principlesDe-escalating techniques for violent behaviourPanic attackExtreme stress and post-traumatic stress disorderSuicidal 181Appendix 1: Global survey data on first aidAppendix 2: Summary table of topics revision181184Note: Medical information changes constantly and therefore, should not be considered current, completeor exhaustive. You should not rely on the information in these guidelines to recommend a course of treatment for yourself or any other individual; doing so is solely at your own risk.These guidelines provide general information for educational purposes only. They are not designed to anddo not provide medical advice, professional diagnosis, opinion, treatment or services. They are not a substitute for medical or professional care, and the information should not be used as an alternative to a visit,call, consultation or advice of a physician or other healthcare provider. The International Federation of RedCross and Red Crescent Societies is not liable or responsible for any advice, course of treatment, diagnosisor any other information, services or product you obtain through these guidelines.5

International Federation of Red Cross and Red Crescent SocietiesInternational first aid and resuscitation guidelines 2016AcknowledgmentsThe Steering Committee of the International Federation of Red Cross andRed Crescent Societies (IFRC) Evidence-Based Network: David Markenson, MD . . . . . . . . . . . . . . . . . . . . . . . . . . . . American Red Cross Philippe Vandekerckhove, MD . . . . . . . . . . . . . . . . . . . . PhD, Belgian Red Cross Pascal Cassan, MD . . . . . . . . . . . . . . . . IFRC Global First Aid Reference CentreThe following team, in addition to the Steering Committee, has coordinated theEvidence-Based Network: Jeffrey L. Pellegrino, PhD, MPH . . . . . . . . . . . . . . . . . . . . . American Red Cross Susanne Schunder-Tatzber, MD . . . . . . . . . . . . . . . . . . . . . . Austrian Red Cross Emmy De Buck, PhD, Centre for Evidence-Based Practice . . Belgian Red Cross Viv Armstrong, MD . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . British Red Cross Emily Oliver . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . British Red Cross Andrew MacPherson, MD . . . . . . . . . . . . . . . . . . . . . . . . . . Canadian Red Cross Daniel Meyran, MD . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . French Red Cross Gabor Göbl, MD . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Hungarian Red CrossThe following IFRC team participated in the International Liaison Committeeon Resuscitation (ILCOR) process, which developed the first aid Consensuson Science: Richard Bradley, MD . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . American Red Cross David Markenson, MD . . . . . . . . . . . . . . . . . . . . . . . . . . . . American Red Cross Jeffrey L. Pellegrino, PhD, MPH . . . . . . . . . . . . . . . . . . . . . American Red Cross Linda Quan, MD . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . American Red Cross Richard Rusk, MD, MPH . . . . . . . . . . . . . . . . . . . . . . . . . . . American Red Cross S. Robert Seitz . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . American Red Cross Nici Singletary, MD . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . American Red Cross Christina Hafner, MD . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Austrian Red Cross Susanne Schunder-Tatzber, MD . . . . . . . . . . . . . . . . . . . . . . Austrian Red Cross Emmy De Buck, PhD, Centre for Evidence-Based Practice . . Belgian Red Cross Philippe Vandekerckhove, MD, PhD . . . . . . . . . . . . . . . . . . . . Belgian Red Cross Andrew MacPherson, MD . . . . . . . . . . . . . . . . . . . . . . . . . . Canadian Red Cross Gabor Göbl, MD . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Hungarian Red Cross Pascal Cassan, MD . . . . . . . . . . . . . . . . IFRC Global First Aid Reference CentreThe following representatives from across the Red Cross Red CrescentMovement have participated in the work of the Evidence-Based Network eitheras members or contributors and/or in attending some of the meetings held toprepare the writing of these guidelines: Fitzmorris T. Martin . . . . . . . . . . . . . Antigua and Barbuda Red Cross Society Melisa Pasquali . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Argentine Red Cross Cornel Binder-Kriegelstein, PhD . . . . . . . . . . . . . . . . . . . . . Austrian Red Cross Christina Hafner, MD . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Austrian Red Cross Supriya Saha . . . . . . . . . . . . . . . . . . . . . . . . . Bangladesh Red Crescent Society Denis Larger, MD . . . . . . . . . . . . . . . . . . Bataillon de Marins Pompiers de Marseille Vere Borra, PhD . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Belgian Red Cross Matthieu Clarysse . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Belgian Red Cross Sylvie Libotte . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Belgian Red Cross Axel Vande Veegaete . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Belgian Red Cross Hans Van Remoortel, PhD . . . . . . . . . . . . . . . . . . . . . . . . . . . . Belgian Red Cross Maggi Aslet . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . British Red Cross Andrew Farrar . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . British Red Cross Piers Flavin . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . British Red Cross Jane Hasler . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . British Red Cross6

International Federation of Red Cross and Red Crescent SocietiesInternational first aid and resuscitation guidelines 2016 David McKinney . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . British Red CrossJoe Mulligan . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . British Red CrossTracey Taylor . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . British Red CrossPencho Penchev . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Bulgarian Red CrossCharles Manirambona . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Burundi Red CrossDon Marentette . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Canadian Red CrossGrace Lo . . . . . . . . . . . . . . . . . Red Cross Society of China – Hong Kong BranchYuet Chung Axel Siu, MD . . . Red Cross Society of China – Hong Kong BranchThompson Leung . . . . . . . . . . Red Cross Society of China – Hong Kong BranchKristiina Myllyrinne . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Finnish Red CrossAugustin Baulig, PhD . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . French Red CrossHripsimé Torossian . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . French Red CrossChristoph Müller, Diploma Education Scientist . . . . . . . . . . German Red CrossEric Bernes, MD . . . . . . . . . . . . . . . . International Committee of the Red CrossNana Wiedemann . . . . . . . . . IFRC Reference Centre for Psychosocial SupportNiamh O’Leary . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Irish Red Cross SocietyEun Young Park . . . . . . . . . . . . . . . . The Republic of Korea National Red CrossRosabelle B. Chedid, MSc . . . . . . . . . . . . . . . . . . . . . . . . . . . Lebanese Red CrossAlick Msusa . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Malawi Red Cross SocietyKhin Khin Shein . . . . . . . . . . . . . . . . . . . . . . . . . . . Myanmar Red Cross SocietyNatasja Oving . . . . . . . . . . . . . . . . . . . . . . . . . . . . . The Netherlands Red CrossCees van Romburgh . . . . . . . . . . . . . . . . . . . . . . . . The Netherlands Red CrossPeter Paul Tenthof van Noorden . . . . . . . . . . . . . . The Netherlands Red CrossAmna Khan, MD . . . . . . . . . . . . . . . . . . . . . . . . . Pakistan Red Crescent SocietyJosé Manuel Almeida do Couto . . . . . . . . . . . . . . . . . . . . Portuguese Red CrossLjubica Aleksic, MD . . . . . . . . . . . . . . . . . . . . . . . . . . . . The Red Cross of SerbiaLars Adamsson . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Swedish Red CrossChristoph Bosshard . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Swiss Red CrossPaul Bitex Okot, MPH . . . . . . . . . . . . . . . . . . . . . . . . . Uganda Red Cross SocietyAyikanying Morris . . . . . . . . . . . . . . . . . . . . . . . . . . . Uganda Red Cross SocietyBarbara Juen, PhD . . . . . . . . . . . . . . . . . . . . . . . . . . . . . University of InnsbruckMohammed Al Fakeeh . . . . . . . . . . . . . . . . . . . . . Yemen Red Crescent SocietyThe participation and/or past and present evidence-based work of the following organizations and agencies were invaluable in the development of theseguidelines: Belgian Red Cross Centre for Evidence-Based Practice (CEBaP) European Resuscitation Council First Aid Education European Network IFRC Global First Aid Reference Centre (GFARC) IFRC Reference Centre for Psychosocial Support International First Aid Science Advisory Board International Liaison Committee on Resuscitation (ILCOR) Scientific Advisory Council of the American Red CrossWe would like to thank the following colleagues for their exemplary andtireless efforts in translating the scientific evaluations into implementationconsiderations for this document: Emmy De Buck, PhD . . . Centre for Evidence-Based Practice, Belgian Red Cross Emily Oliver . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . British Red Cross Salomé Boucif . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . French Red Cross Jean-Daniel Féraud . . . . . . . . . . . . . . . IFRC Global First Aid Reference CentreWe also wish to acknowledge the first aid managers, trainers and volunteers whowill implement this information in the programmes they design and deliver, andthe countless individuals who will use this information and skills to save lives.7

International Federation of Red Cross and Red Crescent SocietiesInternational first aid and resuscitation guidelines 20168

International Federation of Red Cross and Red Crescent SocietiesInternational first aid and resuscitation guidelines 2016ForewordA young volunteer treats an injured soldier as a battle rages around them. Avolunteer bandages a young girl’s head in the aftermath of an earthquake.A team of volunteers tend to the survivors of a building collapse.First aid is central to our identity around the world. For many people, whenthey think of the Red Cross and Red Crescent, they think of our volunteers onthe frontline of humanitarian crises, treating the wounded and sick, or of thetraining that we provide in schools, community centres, and places of work.The members of the International Federation of Red Cross and Red CrescentSocieties (IFRC) are some of the leading providers of first aid in the world. Formore than 150 years, first aid has been one of the principal services providedby Red Cross and Red Crescent volunteers to injured people.Each year, National Red Cross Red Crescent National Societies train more than15 million people in first aid. There are currently more than 180,000 active firstaid trainers serving their communities, making first aid available for all.Why is this so important? Because when a disaster strikes, no first respondercan respond as quickly as a neighbour or family member. And when that person knows first aid, crisis can be averted, and lives can be saved.For more than 100 years, the Red Cross and Red Crescent has been a worldleader in establishing training standards and in developing procedures andguidelines. Drawing on our extensive experience we have helped s

International first aid and resuscitation guidelines 2016 For National Society first aid programme managers, scientific advisory groups, first aid instructors . You should not rely on the information in these guidelines to recommend a course of treat-ment for yourself or any other individual; doing so is solely at your own risk.

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