HLTAID011 Student Guide V3.6

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18
HLTAID011
Provide first aid
Student Guide V3.6
Item No: 5209

St John WA HLTAID011 Provide First Aid Student Guide
Disclaimer: This document is protected by copyright and may not be reproduced or

copied in part or in whole nor used for financial gain without the express approval in writing
by the owner, St John Ambulance Western Australia Ltd.
Entity Name: St John Ambulance Western Australia Ltd
Business Name: St John WA
ABN: 55 028 468 715
Address: 209 Great Eastern Highway
Belmont WA 6104
Telephone: (08) 9334 1222
Web: www.stjohnwa.com.au
St John operates as a Registered Training Organisation (RTO)
National RTO ID 0392
Web: St Johnwa RTO 0392
Page 1 of 130 V3.6

Contents
Contents ....................................................................................................................... 2
Welcome ....................................................................................................................... 3
Part 1 - Unit of Competency ..................................................................................... 5
Part 2 - Principles of First Aid .................................................................................. 8
Part 3: Legal, Workplace & Community Considerations...................................... 11
Part 4: Hazards and Risk Minimisation.................................................................. 21
Part 5 - DRSABCD Action Plan ............................................................................... 24
Part 6 - Basic Life Support...................................................................................... 27
Chain of Survival ..................................................................................................... 27
Part 7 – First Aid Management ............................................................................... 37
Part 8 – Post Incident Requirements ................................................................... 100
Part 9 – Basic Anatomy and Physiology Relating to the Chest ........................ 107
Quick Guides.................................................................................................................. 113
1. DRSABCD Action Plan ................................................................................. 114
DRSABCD Action Plan continued ........................................................................ 116
2. Perform Cardiopulmonary Resuscitation (CPR) – Child and Adult .............. 118
Perform Cardiopulmonary Resuscitation (CPR) – Child and Adult Continued 120
3. Perform Cardiopulmonary Resuscitation (CPR) - Infant ........................... 121
4. Perform CPR with an AED - Adult and Child Over 1 Year ......................... 122
Relevant Forms and Documents .................................................................................. 126
1. Incident, Injury, Trauma and Illness Record Form ................................................. 127
2. Reference Guide to Envenomation........................................................................ 129
Page 2 of 130 V3.6

Welcome
Welcome to HLTAID011 Provide first aid Student Guide!
The Guide is designed in a way to provide simple, relevant and useful first aid information.
It will not only meet the requirements of this Unit of Competency, but also assist you
beyond this course as your own quick reference guide to first aid.
The Guide has 5 main sections:
Unit of Competency
This part of the Guide presents a Unit of Competency in terms of performance criteria in a
simple and easy to understand way. It is a quick overview before you go into detail.
Principles of First Aid

This section introduces you to the general principles of first aid, the role of the first aider,
and legal issues to consider when providing care to a casualty.
First aid topics are presented in an easy to follow and user-friendly format, so you
understand, remember and find first aid information quickly.
Each topic is presented in traffic light colours:
RED: section explains what you need to

remember/know
AMBER: section explains what you need to

do/manage
GREEN: section explains your Plan “B” /

contingency
Post Incident Requirements

This section introduces you the post-incidents requirements when you have been involved
in a first aid incident. This includes, reporting the incident, review of the incident and
psychological wellbeing.
Page 3 of 130 V3.6

Quick Guides
Quick Guides are useful step by step pictorial instructions of the first aid management
process.
Quick Guides:
 Explain what you need to do
 Explain how you need to do it
 Explain why you need to do it
 Provide pictures of each step for greater
understanding
Relevant Forms and Documents

This section presents useful information about first aid documentation that you come
across when providing first aid.
 Incident, Injury, Trauma and Illness Record Form

 Reference guide to envenomation
References
 HLTAID011 Provide first aid Unit of Competency
 Australian Resuscitation Council (ARC) and ANZCOR is the Australian and New
Zealand Committee on Resuscitation (ANZCOR) Guidelines
 Australian peak clinical bodies
 Australian First Aid manual
 Code of Practice: First Aid in the Workplace
 St John WA clinical guidelines for Primary Care
Assessments
This icon indicates knowledge assessment content.
Page 4 of 130 V3.6

Part 1 - Unit of Competency

Learning Outcomes:
At the completion of this unit, students will demonstrate the ability to:
1. Respond to an emergency situation, assess and manage the situation

2. Correctly assess casualties with life threatening conditions
3. Safely perform first aid and CPR in a range of situations, apply and operate
an AED
4. Identify medical conditions and injuries and manage in line with best practice
guidelines
5. Communicate details of the incident with clarity and accuracy to emergency
personnel, and within the workplace
6. Evaluate the psychological impacts of being involved in a traumatic event to inform
well-being of self and others
7. Develop strategies to effectively manage stressors following an incident
To meet the requirements of the unit of competency, the student will need to successfully
demonstrate knowledge and skills to perform the following:
• Respond to an emergency situation

1
• Apply appropriate first aid procedures

2
• Communicate details of the incident

3
• Review the incident

4
Requirements of the unit of competency can be found at:

 https://training.gov.au/Training/Details/HLTAID011
Page 5 of 130 V3.6

1.1 Responding to an Emergency
DRSABCD Action Plan
DANGER
D Ensure area is safe to you, others and the casualty
RESPONSE
R NO RESPONSE
Send for help

RESPONSE
Check for injuries, make

comfortable, monitor
SEND
S Send for help: Call or ask someone to call Triple Zero
(000) for an ambulance.
If on your own place casualty in Recovery Position
before making a call.
AIRWAY
A NO FOREIGN MATERIAL
Open mouth:
Leave in the position found

FOREIGN MATERIAL
Place in Recovery
Position and clear airway
BREATHING
B Check for breathing: look, listen and feel
NOT BREATHING NORMALLY
Place on back, start CPR

BREATHING NORMALLY
Place in Recovery
Position and monitor
CPR
C 30 compressions 2 breaths
DEFIBRILLATION
D Apply defibrillator and follow the prompts
Page 6 of 130 V3.6

1.2 Cardiopulmonary Resuscitation (CPR) Chart

CPR Adult Child (1 - 8) Infant (up to 1)
Full Slight
Neutral alignment
Opening the
Airway - Chin
Lift, Head Tilt
One hand on the

One hand on the forehead and forehead and two First Aider’s hands
Hand Position
two fingers under the chin, fingers under the supporting either
to Open the
keeping away from soft part of chin, keeping away side of infant’s
Airway
throat from soft part of head
throat
Ratio 30:2 30:2
Compressions 30:2
30 compressions 30 compressions
30 compressions and 2 breaths
to Breaths and 2 breaths and 2 breaths
1/3 chest depth/
1/3 chest depth/ 1/3 chest depth/
approximately 4
more than 5 cm approximately 5 cm
cm
Compressions
Should be smooth, controlled - the same time to compress and release the
chest.
The First Aider should minimise interruptions of chest compressions, CPR
should not be interrupted to check for response or breathing. Interruptions to
chest compressions are associated with lower survival rates.
Compressions 100 – 120 100 – 120

100 – 120 compressions/min
Rate compressions/min compressions/min
Adult Child (1-8) Infant (up to 1)

Heel of 2 hands Heel of 1 or 2 hands 2 fingers
Pressure
Hand Lower half of Lower half of

Lower half of breastbone in the
breastbone in the breastbone in the
Positioning centre of the chest
centre of the chest centre of the chest
1. Cardiopulmonary Resuscitation (CPR) Chart
Page 7 of 130 V3.6

Part 2 - Principles of First Aid

First aid is the initial treatment
WHAT given to the ill or injured until
is first aid? medical assistance arrives or is
available.
2. What is First Aid

First aid is usually provided by First Aiders, people who are trained to
provide the very first lifesaving treatment to someone who is ill or
REMEMBER
injured.
The aims of first aid are to:
Know
 Promote a safe environment

 Preserve life
 Prevent injury or illness from becoming worse
 Help promote recovery
 Provide comfort to the ill or injured
A First Aider should:

1. Assess the situation quickly
2. Identify the nature of the injury or illness as far as possible.
Manage
DO
3. Arrange for emergency services to attend

4. Manage the casualty promptly and appropriately
5. Stay with the casualty until handing over to emergency services
6. Give further help if necessary
PLAN  Call Triple Zero (000) for an ambulance

“B”  Ask bystanders to assist if they are trained First Aiders
 Learn first aid
Contingency
Page 8 of 130 V3.6

2.1 First Aid Principles

Principles of first aid rely on the fact
WHAT that any attempt to provide first aid is
is it? better than no attempt on first aid at
all.
3. Principles of First Aid
First Aid knowledge and skills will prepare you to manage a casualty
who becomes ill or has been injured.
The benefits of first aid:

 Saves lives, by knowing what to do.
 Reduces pain, disability and discomfort by giving correct first aid
management.
 Increases safety awareness at home, work and on the road.
 Reduces accidents by increasing your awareness of safety
procedures and equipment.
 Reduces compensation.
REMEMBER
The four (4) aims of first aid are to:

1. Preserve life
Know
 Ensure self, casualty and others are not in any further danger
 Determine when the scene is no longer safe and calls emergency
services
2. Prevent further injury
 Clear the area of additional dangers
 Keep the casualty still to avoid aggravating their injury
 Do not move the casualty unless they are in immediate danger, for
example fire
3. Promote recovery
 Re-check airway and breathing
 Apply appropriate first aid procedures
 Provide reassurance
4. Protect the unconscious
 Maintain a clear and open airway
 Monitor the casualty until medical aid arrives
When faced with a first aid situation the formula to follow is:
Manage
1. Assess the situation quickly

DO
2. Decide on first aid management

3. Arrange medical aid if required
PLAN “B”  Call Triple Zero (000) for an ambulance.

Contingency
Page 9 of 130 V3.6

2.2 Role of the First Aider

The First Aider who arrives first at the scene of an incident takes
WHAT charge of the situation until handing over to a health professional such
is it? as a Paramedic.
The First Aider needs the knowledge and skills to enable them to
provide effective emergency treatment within the bounds of their
training.
 Do not provide treatment, or use equipment that you are not trained
to perform
You also need to be able to work effectively with the casualty and
REMEMBER
others.
Challenges:
Know
Proving first aid can sometimes be personally challenging and the

nature of the illness or injury, unpleasant smells, sight of blood, or
open wounds may be distressing.
You may also feel nervous about using your skills and question your
ability to do the right thing.
Acting calmly, confidently, and respectfully can help reassure the
casualty and allow you to provide the help they need. This will help
you to carry out first aid effectively.
Always tell the casualty what you are going to do, and ask the casualty
to assist you in their treatment
1. Recognise, assess, and prioritise the need for first aid.

2. Observe – look for signs of the nature of injury / illness.
3. Listen – to what symptoms the casualty tells you.
Manage
4. Always tell the casualty what you are doing and your plan of
DO
action.
5. Ask for permission (consent) before entering their personal space.
6. Enlist their assistance and tell them how they can help.
7. Treat the casualty how you would wish to be treated yourself.
In an emergency situation, if you feel overwhelmed and panicky:

PLAN “B”  Pause and take a few long, slow deep breaths.
 Remain calm, confident and respectful.
Contingency
 Recognise own limitations and seek additional when needed
Page 10 of 130 V3.6

Part 3: Legal, Workplace & Community

Considerations
First Aid Legislation is a set of laws and
WHAT rules that will apply to you when providing
is it? first aid.
4. First Aid Legislation
Legislation is put in place to set a

standard for safe work practices
and compliance. Legislation can be
national, or relevant to individual
states and territories.
REMEMBER
First aid practices in WA are governed by the following:

Source Description Relevant Documents
Act Rules Work Health and Safety Act 2020
Know
Regulations Describes how Work Health and Safety

to follow the Regulations 2022
rules
Code of Practical Code of Practice: First Aid in the
Practice guidance on how Workplace
to comply with
regulations
Standards Benchmark, AS/NZS 2161 Occupational
level of quality Protective Gloves (example)
Policies Organisational Company Emergency Evacuation
Procedures rules Plan
You need to know where to access these documents, to find

information on work health and safety.
Links:
www.worksafe.wa.gov.au
www.legislation.wa.gov.au
Manage
DO
www.safeworkaustralia.gov.au
Always:
1. Follow the relevant legislation and codes of practice.
2. Follow your workplace policies and procedures.
3. Adhere to your level of training.
4. Gain consent prior to helping casualty.
5. Document the incident and first aid management.
Organisations can make policies and procedures that

PLAN “B” exceed the Australian Standards and Codes of Practice;
Contingency however they must meet these minimum requirements.
Page 11 of 130 V3.6

3.1 Australian Resuscitation Council (ARC)

Recommendations & Guidelines
The Australian Resuscitation Council (ARC) is
a voluntary co-ordinating body which
WHAT represents all major groups involved in the
is it? teaching and practice of resuscitation across
Australia and New Zealand.
5. Australian Resuscitation Council (ARC) Recommendations
The Australian Resuscitation Council produces Guidelines that

provide a standard approach to resuscitation and first aid best
practice.
“The Australian Resuscitation Council produces Guidelines to meet its
REMEMBER
objectives in fostering uniformity and simplicity in resuscitation

techniques and terminology. Guidelines are produced after
consideration of all available scientific and published material and are
Know
only issued after acceptance by all member organisations. This does

not imply, however, that methods other than those recommended are
ineffective.”
The First Aider should always provide first aid within the ARC
recommendations and guidelines.
10.1 Basic Life Support - ARC Guideline recommends for CPR
training to be refreshed every 12 months for those who do not
perform CPR on a regular basis.
Access ARC website: http://resus.org.au/guidelines/ and familiarise

yourself with Australian Resuscitation Council Guidelines:
1. ANZCOR Guideline 2 – Managing an Emergency
2. ANZCOR Guideline 3 – Recognition and First Aid Management of
the Unconscious Victim
Manage
DO
3. ANZCOR Guideline 4 – Airway

4. ANZCOR Guideline 5 – Breathing
5. ANZCOR Guideline 6 – Compressions
6. ANZCOR Guideline 7 – External Automated Defibrillation in Basic
Life Support
7. ANZCOR Guideline 8 – Cardiopulmonary Resuscitation
PLAN “B”  There is no plan “B” in this case - always follow recommended
guidelines and best practice.
Contingency
Page 12 of 130 V3.6

3.1 Australian Resuscitation Council (ARC)

Recommendations & Guidelines - Continued
The Australian Resuscitation Council (ARC) is
a voluntary co-ordinating body which
WHAT represents all major groups involved in the
is it? teaching and practice of resuscitation across
Australia and New Zealand.
REMEMBER
Access ARC website: http://resus.org.au/guidelines/ and familiarise

Know
yourself with the Australian Resuscitation Council First Aid Guidelines:

 Trauma, Medical, Environment, Envenomation, Poisoning
Refer to ANZCOR Section 9 – First Aid Guidelines:

 Guideline 9.1.1 – First Aid for Management of Bleeding
 Guideline 9.1.3 – Burns
 Guideline 9.1.4 – Head Injury
 Guideline 9.1.6 – Management of Suspected Spinal Injury
 Guideline 9.2.1 – Recognition and First Aid Management of Heart
Attack
 Guideline 9.2.2 – Stroke
 Guideline 9.2.3 – Shock
 Guideline 9.2.4 – First Aid Management of a Seizure
 Guideline 9.2.5 – First Aid for Asthma
 Guideline 9.2.7 – First Aid Management of Anaphylaxis
Manage
DO
 Guideline 9.2.9 – First Aid Management of a Diabetic Emergency

 Guideline 9.3.2 – Resuscitation of the Drowning Casualty
 Guideline 9.3.3 – Hypothermia: First Aid Management
 Guideline 9.3.4 – Heat Induced Illness (Hyperthermia)
 Guideline 9.4.1 – Australian Snakebite
 Guideline 9.4.2 – Spider Bite
 Guideline 9.4.3 – Tick Bites and Bee, Wasp and Ant Stings
 Guideline 9.4 5 – Jellyfish Stings
 Guideline 9.4.6 – Blue-Ringed Octopus and Cone Shell
 Guideline 9.4.7 – Envenomation - Fish Stings
 Guideline 9.4.8 – Pressure Immobilisation Technique
 Guideline 9.5.1 – Emergency Management of a Casualty who has
been Poisoned
PLAN “B”  Always follow recommended guidelines and best practice.

Contingency
Page 13 of 130 V3.6

3.2 Australian National Peak Clinical Bodies

Peak bodies are not-for-profit non-government
organisations, whose activities are funded
WHAT from a range of sources, including states and
is it? territories, the Australian Government,
bequests, donations and fundraising activities.
Peak Bodies aim to:
 Provide high standards of training, practice, and care
 Produce clinical guidelines, action plans and management plans
 Provide expertise, information, and advice
 Raise community awareness and understanding
 Advocate for patients and carers
 Provide psychological, social, and emotional support
 Promote and fund research to improve health and outcomes
Examples of national peak bodies:

REMEMBER
Aboriginal Health Council of Western Australia
Asthma Australia
Know
Australian Society of Clinical Immunology and Allergy

(ASCIA)
Diabetes Australia
Epilepsy Action Australia
Heart Foundation
Mental Health Australia
Stroke Foundation
Western Australian Association for Mental Health
 Peak bodies exist in many different industries to represent

Manage
consumers, clinical service providers, special needs groups.

DO
 Research clinical peak bodies to learn about the work carried out to
promote health and well-being for Australians.
PLAN “B”  There is no plan “B” in this case - always follow recommended
Contingency guidelines and best practice.
Page 14 of 130 V3.6

3.3 Consent
Consent is permission or agreement by
your casualty to be treated by you.
WHAT
is it? This can be given verbally, non-verbally
or in writing.
8. Consent
In first aid, consent should always be obtained from a casualty where

possible prior to applying first aid. Treatment given without the person’s
consent may constitute as an assault.
There are two (2) different types of consent:
Implied (taken as given) consent – when the casualty is
unconscious, appears badly injured and confused (or not mentally
competent), and is unable to provide consent to the first aid treatment,
REMEMBER
therefore consent is assumed to be given or implied.

Expressed consent – the casualty is conscious and alert (compos
mentis) and is able to give oral or written permission to the First Aider
Know
to provide assistance.
NOTE:
 If the casualty is under 18 years, it is considered to be implied
consent, but where possible obtain the consent from a parent or legal
guardian.
 In the case of a child-care or education centre, parental/caregiver
consent is usually given in a written form when the child is enrolled.
 When a casualty cannot verbally communicate, body language and
other nonverbal cues are used instead.
 A person has the right to REFUSE treatment.
 If the casualty doesn't let you help, that means "NO".
1. Obtain consent from a casualty where possible before applying

first aid.
Manage
DO
2. Obtain consent of a parent or legal guardian if the casualty is

under 18 years of age.
3. Implied consent applies to the unconscious casualty.
PLAN “B”  There is no plan “B” in this case – obtain consent where possible.
Contingency
Page 15 of 130 V3.6

3.4 Duty of Care
Duty of care is a legal obligation for you

WHAT as a First Aider to protect yourself and
is it? your casualty when providing first aid.
9. Duty of Care
When you have made the decision to provide first aid to a casualty and
they have commenced the treatment, this means that you have
committed yourself to providing care to the casualty.
Duty of Care in first aid means that you stay with the casualty and
provide reasonable treatment to the best of your ability and to your
level of training.
As a First Aider, you are required you to continue providing first aid to
the best of your ability until:
REMEMBER
 The casualty no longer requires your assistance

 You hand over care to another or more experienced First Aider
 Medical aid arrives and you hand over to a medical professional
Know
 You are physically unable to continue to provide care

 The situation becomes unsafe to continue to provide care
NOTE:
 Once you commence giving first aid, you automatically take on a
Duty of Care.
 A duty of care can be breached by either action or inaction (for
example, if you do nothing and the person in your care gets worse).
 Duty of Care does not end after you call Emergency Services, or
you decide that you do not wish to continue first aid.
 In the workplace the employer has a Duty of Care to ensure that
appropriate numbers of First Aider(s) have been appointed and
trained
1. When giving first aid, stay within the scope of your training.
Manage
2. Complete required documentation and keep it confidential.

DO
3. Maintain your skills and knowledge.

4. Maintain first aid kits and equipment in the workplace.
PLAN “B” There is no plan “B” in this case – always provide a Duty of
Contingency Care to your casualty.
Page 16 of 130 V3.6

3.5 Respectful Behaviour
As a First Aider, you need to treat each

WHAT casualty with respect, regardless of their
is it? injury or illness
1. Respectful Behaviour
As a First Aider you will need to always act in a professional and

respectful way. Being respectful means:
 Introducing yourself
 Asking for the casualty’s name and using it
 Asking the casualty for consent
 Informing the casualty of what you are doing and why
 Focus on providing care and ask the casualty to assist if they can
 Being aware of cultural differences and showing sensitivity
REMEMBER
 Comfort and reassure the casualty at all times

 Using a calm voice
 Protecting their privacy and confidentiality
Know
Respectful behaviour also includes culturally appropriate behaviour. A

person who is culturally aware can communicate sensitively and
effectively with people who have different languages, cultures, religions,
genders, ethnicities, disabilities, ages and sexualities.
Cultural awareness includes:
 Appropriate communication
 Awareness of own body language and tone
 Appropriate use of eye contact
 Awareness of differences in age, gender or ethnicity
Respectful and culturally aware First Aiders build trust which leads to
improved outcomes in establishing good rapport with their casualty.
Manage
1. Always treat your casualty with dignity and respect.

DO
2. Always treat your casualty in a culturally appropriate way.
PLAN “B” There is no plan “B” in this case – respect your casualty at all
Contingency times.
Page 17 of 130 V3.6

3.6 Own Skills and Limitations
Limitation is a form of restriction

WHAT where you provide first aid within the
is it? scope of your first aid training.
Own Skills and Limitations

The first aid you provide as a First Aider will be restricted by:
 Scope of your training – this means that when giving first aid, always
stay within what you know and treat a casualty to a standard of
care at your level of training. For example, if you have not learnt
how to use oxygen equipment you would not be able to administer
REMEMBER
oxygen to a casualty.
 Your level of confidence – this means the more confident you are in
Know
providing first aid the more proficient you will be.

 Your company’s policies and procedures – this means you always
need to know and apply your company’s policies and procedures
when providing first aid in the workplace.
 Legal considerations – you should not allow the thought of liability
stop you from providing lifesaving first aid! First aiders are only liable
if negligence can be shown.
 Ensure that you fully understand the law.
1. Code of Practice: First Aid in the Workplace recommends

workplaces ensure first aiders receive appropriate training
2. Maintain your skills and knowledge – First aid in the workplace
Manage
refresher training in CPR should be carried every 12 months

DO
and first aid qualifications should be renewed every 3 years.

3. Always stay within the skills, knowledge and limitations of
your training and manage a casualty to a standard of care that
is appropriate to your level of training.
PLAN “B”  Seek assistance from health professionals

 Expand your skills and knowledge
Contingency
 Enroll into a St John First Aid course
Page 18 of 130 V3.6

3.7 Privacy and Confidentiality

Privacy and confidentiality are legal terms
that relate to your casualty being free from
WHAT intrusion; as well as your restriction from
is it? releasing any information about your casualty
to a third party.
10. Privacy and Confidentiality
Your casualty, as any other person, has a right to privacy and
confidentiality. It is your duty and legal responsibility to always protect
your casualty’s privacy.
When providing first aid, your casualty may be in a position when they
are most vulnerable due to the nature of the injuries as well as their
circumstances.
Most people use mobile phones to take pictures, videos, access
REMEMBER
email, social media, and the internet. Be mindful of others using their
devices to record the incident.
Know
It is important to maintain the privacy of yourself and the

casualty.
Do not:
 Talk about the incident and the casualty to any third party, including
work colleagues, family, or friends
 Take personal pictures of the casualty, post to social media sites
such as Facebook, Instagram etc.
 Leave your casualty exposed and vulnerable
Any information and documentation you have obtained about a

casualty whilst rendering first aid should remain confidential.
1. At the scene – protect your casualty’s privacy and dignity.

2. Maintain the casualty’s privacy – do not release information to a
third party.
Manage
3. Follow your company’s policy and procedures.

DO
4. Familiarise yourself with the legislative requirements governing

privacy and confidentiality.
5. Access Freedom of Information Act 1982 (Amended 2020).
6. Access The Privacy Act 1988 (Amended 2020).
PLAN “B”  There is no plan “B” in this case – always maintain

Contingency privacy and confidentiality of your casualty.
Page 19 of 130 V3.6

3.8 Confidentiality of First Aid Records
Legislation varies with respect to who can have

WHAT access to first aid records, the extent of access
is it? and what incidents have to be reported.
11. Confidentiality of First Aid Records

The following people have the right to access casualty and
incident information:
 Ambulance paramedics/officers or a treating doctor.
 People investigating workplace illness or injury such as the police,
coroner, workplace inspection authority, the courts and
employer.
 An employer to make sure the injury was work related, or to help
identify the cause of the incident.
REMEMBER
With the casualty’s agreement, access can also be given to:

 Insurance company handling the claim
Know
 Union representatives
 Work health and safety committees.
The person controlling the records has a responsibility to:

 Ensure records are only released to people with appropriate
authority
 Ensure records are stored in a secure location: for example, in a
locked filing cabinet or if electronically stored protected by
password and a range of IT security measures.
 Inform the casualty if access has been given to a third party.
 Keep a record of anyone who has had access to particular
documents, when and why.
1. Securely store first aid documentation specified by relevant

legislation.
Manage
DO
2. Follow your company’s policy and procedures.

3. Familiarise yourself with the legislative requirements governing
privacy.
There is no plan “B” in this case – always maintain

PLAN “B” 
privacy of your casualty and first aid documentation.
Contingency
Page 20 of 130 V3.6

Part 4: Hazards and Risk Minimisation

Safety is the condition of being protected from harm, freedom from the
occurrence or risk of danger, injury or loss.
WHAT Hazard is anything in the workplace or environment that has the potential
is it? to harm people, property or the environment.
Safe Work Practises to Minimise Risk and Potential Hazards

Risk assessment
A risk Assessment is a process to identify existing and possible hazards that may
cause harm / damage in the working environment.
Eliminating / minimising risk
The results of a risk assessment should enable employers to make decisions
about establishing appropriate controls to eliminate or minimise risk. Risk
assessments should also inform the Employer of required first aid provision in the
workplace, including:
 First aid equipment
REMEMBER
 First aid facilities

 Number of trained first aiders
As a First Aider, minimising risks may involve:

Know
 Using correct manual handling techniques to avoid back and shoulder

injuries.
 Ensuring safety for self, casualty, and bystanders e.g., watching out for
incoming traffic, avoiding debris.
 Using PPE, e.g., gloves, masks.
First aid requirements will vary from one workplace to the next, depending on the
nature of the work, the types of hazards, the workplace size and location
(remoteness), as well as the number of people at the workplace.
For example, low risk workplaces require:
 One first aider for every 50 workers
 Basic first aid kits
 A first aid room for more than 200 employees
 Code of Practice: First Aid in the Workplace

 Developed to provide practical guidance for persons who have duties to manage
Manage
risks to health and safety in the workplace.

DO
Section 3.5 recommended first aid requirements for high-risk workplaces: One
first aider for every 25 workers, basic first aid kits plus additional equipment
identified for specific risks.
PLAN  Safety is your priority - Call Triple Zero (000) in case of an emergency
“B” in the workplace.
Contingency
Page 21 of 130 V3.6

4.1 Infection Control and Standard Precautions

Infection is an invasion of body tissues by disease causing agents (for
WHAT example, bacteria); their multiplication and the reaction of body tissue to
them. Infection prevention and control involves preventing a health-
is it?
related spread of infection when managing a casualty.
Infection Control and Standard Precautions
Infection may be transmitted via breathing, coughing, touching, eating or body
REMEMBER
penetration. Infection-control is achieved by protecting both the casualty and the

First Aider from the transmission of:
Know
 Blood and bodily fluids such as saliva, vomit, pus, urine, and faeces.
 Direct contact such as scabies and fungal infections
 Infected hypodermic needles and other sharps
 Droplets from nasal, throat or airway secretions
Standard precautions are the best practices to achieve infection control. They
include:
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DO
Reference: Australian Commission on Safety and Quality in Health Care

To minimise the risk of infection during resuscitation, the Personal Protective
DO Continued
Equipment (PPE) may include:

Gloves
Manage

 Resuscitation barrier devices, for example face
shield
 Face masks
 Goggles
If water is not available, use alcohol-based gels or wipes.

PLAN 
 If your gloves tear while giving first aid, take them off straight away, wash and dry
“B” your hands, or use alcohol gel, and put on a new pair of gloves.
Contingency
Page 22 of 130 V3.6

4.2 Safe Manual Handling

The term 'manual handling' is
used to describe a range of
WHAT activities including lifting,
is it? lowering, pushing, pulling,
carrying, moving or holding an
object or person.
12. Safe Manual Handling
In an incident where you are required to provide Cardiopulmonary
Resuscitation (CPR) or provide first aid, you may have to lift or move the
casualty to a suitable position or location. A casualty should only be moved
if there is an immediate danger; for example: an explosion, collapsing
structure, traffic hazards, lying on railway tracks, fire or poisonous
fumes.
REMEMBER
Refer to ANZCOR Guideline: ANZCOR Guideline 2 – Managing an

Emergency
If you are required to move the casualty, an awareness of safe manual
Know
handling techniques can prevent injury to yourself.

Some general principles for reducing risks associated with manual handling
when providing first aid are to:
 Minimise lifting and lowering forces exerted
 Avoid the need for bending, twisting, and reaching movements
 Reduce pushing, pulling, carrying, and holding
 Consider the size, surface characteristics, stability, and weight
 Reduce the vertical and horizontal movements involved
 Consider postures and space requirements from the WorkSafe WA
1. Always follow your organisational policies and procedures

2. Follow DRSABCD
Manage
3. Bend at the knees, keep your back straight and head up

DO
4. Stay balanced: keep your centre of gravity low

5. Hold the weight close to your body for stability
6. Take small steps
 Do not move a casualty unless absolutely necessary (it can lead to further
PLAN “B” injury).
Contingency  Use help for lifting, by working in a team.
Page 23 of 130 V3.6

Part 5 - DRSABCD Action Plan

The DRSABCD Action Plan is an acronym of seven (7) letters that
WHAT represents an action plan for the First Aider to follow to manage a
is it? casualty in an emergency.
1. The DRSABCD St Action Plan
D – Danger
REMEMBER
R – Response
S – Send for help
Know
A – Airway
B – Breathing
C – Cardiopulmonary Resuscitation (CPR)
D – Defibrillation
D – Check for danger to you, bystanders, and the casualty: by looking,

listening and using your sense of smell.
R – Check for response: ask their name and squeeze their shoulders.
S – Send for help: call Triple Zero (000) for an ambulance or ask a
bystander to make the call.
A – Open mouth. Check for foreign materials.
o If YES – place in recovery position and clear the airway with fingers.
Manage
o If NO – leave in the position found.

DO
Open airway with a head tilt and chin lift – adult and children only.
(Neutral alignment for an infant).
B – Check for breathing - look, listen and feel for 10 seconds.

If breathing place into the recovery position.
C – If not breathing. Start CPR: 30 chest compressions: 2 breaths.
Continue until help arrives.
D – Defibrillation: apply defibrillator as soon as available and follow
voice prompts.
PLAN “B”
Contingency  Call Triple Zero (000) for an ambulance.
Page 24 of 130 V3.6

5.1 Managing an Emergency
Early recognition is a key step in initiating

WHAT early management of an emergency
situation.
is it?
13. Visual and Verbal Assessment

In all emergencies, the first aider / rescuer should follow DRSABCD
Action Plan to:
 Quickly assess the situation
REMEMBER
 Ensure safety of self, bystanders, and the casualty
Assess the casualty’s response to verbal and tactile stimuli (talk and
Know
touch) ensuring not to cause or aggravate any injury.

 Give simple commands such as “open your eyes, squeeze my hand,
let it go” then squeeze the shoulders to get a response.
A person who fails to respond or only shows a minor response such as
groaning without eye opening, should be managed as unconscious
(see next section – Part 6).
If the casualty is unresponsive and breathing normally:

 Assist the casualty to the ground and position into a lateral side-lying
recovery position
 Ensure the airway is open – care of the airway takes precedence
over any injury, including spinal injuries
 Do not leave the person sitting in a chair, or place their head
between their knees
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DO
 Call for an ambulance

 Manage and stop any bleeding
 Constantly re-check for any change in condition
 Stay with the casualty
Refer to:
 ANZCOR Guideline 2 – Managing an Emergency
 ANZCOR Guideline 3 – Recognition and First Aid Management of the
Unconscious Person.
 There is no plan “B”

PLAN “B”  Call Triple Zero (000) in case of an emergency.
Contingency
Page 25 of 130 V3.6

5.2 Visual and Verbal Assessment

A visual assessment is your initial
assessment of what you observed about
WHAT the casualty when you approached them.
is it? A verbal assessment is assessment of the
casualty’s condition by asking the casualty
verbal questions.
14. Visual and Verbal Assessment
Visual Assessment
When you first approach the casualty after checking for danger at the
REMEMBER
scene you will need to complete a visual assessment to observe the

casualty carefully and pay attention to the visual signs of their injuries
and cues about their condition without touching them.
Know
Verbal Assessment
A verbal assessment is achieved by asking questions and noting the
answers. You will need to ask the right questions to determine the
extent of the injuries. It accompanies your visual assessment of the
casualty.
Visual Assessment
 Is the person conscious or have they just lost consciousness?
 Check the casualty for a medical alert bracelet or necklace
 Check if the casualty has any medication, drugs, or poisons in their
possession or in close proximity.
 Observe for obvious injuries, such as bleeding.
 Observe for obvious medical conditions such as respiratory distress
Verbal Assessment
Manage
DO
 Introduce yourself and ask the casualty their name, the year and if
they know where they are and ask consent to perform first aid.
 If they are experiencing any pain, quantify it on a scale from 1 to 10,
with 10 being the worst pain that the casualty has ever felt.
 Do they know what happened?
 If they are experiencing any numbness or tingling in the hands, arms,
or legs or anywhere in the body: this could indicate a heart condition
or a stroke.
 Are they taking any medication, do they have any allergies?
 There is no plan “B”

PLAN “B”  Call Triple Zero (000) in case of an emergency.
Contingency
Page 26 of 130 V3.6

Part 6 - Basic Life Support

Chain of Survival
1 4 The aid provided to
2 3 maintain airway, breathing
WHAT and circulation, in the hope
is it? that the natural function of
the lungs and heart will be
restored.
15. Basic Life Support – Chain of Survival
In an emergency, immediate action needs to be taken to maximise a
casualty’s chances of survival, particularly when there are no signs of
life: no breathing, movement or response. Time is of the essence!
The Chain of Survival consists of four (4) links:
1. Early Recognition and Call for Help - The ambulance must be
called immediately to ensure that early defibrillation and advanced
life support can commence without delay.
REMEMBER
St John First Responder App sends your GPS

coordinates to the operator when you call Triple Zero
(000) for an ambulance, reducing the time it takes to
Know
confirm your location and dispatch and ambulance.
2. Early CPR - If CPR is started within four (4) minutes of the heart
stopping, oxygenation of the vital organs (such as the brain) is
maintained.
3. Early Defibrillation - If CPR is given within four (4) minutes and
defibrillation within eight to twelve (8-12) minutes, there is a
significantly improved chance of survival.
4. Post Resuscitation Care - Definitive treatment by the ambulance
service, such as giving medication and stabilising the airway may
increase chances of survival even further.
1. Follow DRSABCD Action Plan.

Manage
DO
2. Full step-by-step instructions in the Quick Guide at the end of this

booklet.
PLAN “B”  Thereis no plan “B” – Call triple zero (000) for an
Contingency ambulance.
Page 27 of 130 V3.6

6.1 Cardiopulmonary Resuscitation (CPR) - Adult

Cardiopulmonary Resuscitation (CPR) is
an emergency procedure performed in
WHAT an effort to manually preserve brain
is it? functions until further measures are
taken to restore spontaneous blood
circulation and breathing in a person.
16. Cardiopulmonary Resuscitation (CPR)
Cardiopulmonary Resuscitation (CPR) includes chest compressions
and inflation of lungs by breathing into the casualty’s mouth. It is
designed to pump the heart to get blood circulating and deliver
oxygen to the brain until the treatment can stimulate the heart to start
working again. When the heart is starved of oxygen and stops
pumping – it is known as a cardiac arrest.
CPR is the second link in the Chain of Survival and is most effective
REMEMBER
when administered as quickly as possible.

IMPORTANT: CPR is given to a casualty who is:
Know
 Not breathing normally

 Not responding
 Not moving
NOTE: Compressions on an adult casualty should be performed on

the floor / ground.
CPR is ceased (stopped) when:
 The casualty responds and starts breathing normally
 A health care professional arrives and takes over CPR
 It is impossible to continue due to exhaustion
 A healthcare professional directs that CPR be ceased
1. 30:2 - Give thirty (30) compressions and two (2) breaths aiming
to achieve five (5) sets of compressions in two (2) minutes (at a
Manage
rate of approximately 100 – 120 compressions per minute).

DO
2. Full step-by-step instructions are available in the Quick Guide at

the end of this booklet.
3. Access ANZCOR Guideline 6 – Compressions.
Call Triple Zero (000) for an ambulance.

PLAN “B” 
 Ask bystanders to assist if they are trained First Aiders.
Contingency
Page 28 of 130 V3.6

6.2 Cardiopulmonary Resuscitation (CPR) - Infants

Cardiopulmonary resuscitation or
commonly known as CPR is an
emergency procedure performed in an
WHAT effort to manually preserve brain
is it? functions until further measures are
taken to restore spontaneous blood
circulation and breathing in an infant
under one (1) year.
17. Cardiopulmonary Resuscitation (
Providing Cardiopulmonary Resuscitation (CPR) to infants will be
slightly different to CPR provided to an adult person due to the
delicate nature of an infant’s body.
An infant’s airway is smaller and more prone to blockage
because the trachea is shorter and softer, so over extension of the
head and neck will compress the airway.
REMEMBER
When opening an infant’s airway:

 Place the infant flat on their back on a firm surface. The head
should be kept in a neutral position and maximum head tilt should
Know
not be used.
 The lower jaw should be supported at the point of the chin while
keeping the mouth open.
 There must be no pressure on the soft tissues of the neck. If these
manoeuvres do not provide a clear airway, the head may be tilted
backwards very slightly with a gentle movement. Avoid pressure on
the soft tissue under the infant’s chin.
Chest compressions on infants are lighter than on adults and/or
children and are performed with two (2) fingers only.
1. 30:2 - Give thirty (30) compressions and two (2) breaths aiming
Manage
to achieve five (5) sets of compressions in two (2) minutes.

DO

 Call Triple Zero (000) for an ambulance.

PLAN “B”  Ask bystanders to assist if they are trained First Aiders.
Contingency
Page 29 of 130 V3.6

6.3 Automated External Defibrillator (AED)

Automated External Defibrillator
or AED is a device used in the
treatment of cardiac arrest to
WHAT deliver a therapeutic dose of
is it? electrical energy to the heart for
the purpose of re-starting and
Examples of AEDs
stabilising heartbeat rhythm.
18. Automated External Defibrillator (AED)
The use of a defibrillator is the third link in the Chain of Survival

The time to defibrillation is a key factor that influences survival. For
every minute defibrillation is delayed, there is approximately 10%
reduction in survival if the casualty is in cardiac arrest.
The greatest casualty survival results are when the interval between
the start of the cardiac arrest and the delivery of defibrillation is as
brief as possible.
The appropriate use of an AED is on a casualty who is assessed as
REMEMBER
being:
 Unresponsive
 Not breathing normally
Know
Access an AED in a timely manner - ensure you are

familiar with its location in the workplace or, use the
AED locator on the St John First Responder App to
identify AED locations near you.
An AED is a battery-operated device and is available in
the community, workplace and public facilities.
NOTE: When conducting Work Health and Safety Act 2020 audits in
the workplace always check if the battery is fully charged and the
pads/electrodes are in date.
For instructions on the correct use, safety and maintenance
procedures of the AED always follow manufacturer’s
instructions!
1. Refer to the Quick Guide at the end of this booklet.

Manage
DO
2. Familiarise yourself with ANZCOR Guideline 7: Automated

External Defibrillation in Basic Life Support.

Contingency
Page 30 of 130 V3.6

6.4 Defibrillation - Adults and Children

Over 8 Years
Defibrillation is a treatment of delivering a
therapeutic dose of electrical energy to
the heart by using a device called a
WHAT defibrillator (or Automated External
is it? Defibrillator – AED) for the purpose of re-
starting and stabilising heartbeat rhythm
in adults and children over 8 years of age.
19. Defibrillation – Adults and Children (Over 8 Years)
An AED is used to assist your casualty’s heart to regain its normal
rhythm by providing electric shocks in a sudden cardiac arrest
situation which may help re-establish normality in a heart’s rhythm.
REMEMBER
It is crucial CPR continues except when a shock is being delivered or

when instructed by the AED machine.
NOTE: Do not remove defibrillator pads even if the casualty is
Know
conscious.
If two First Aiders are present, one should go for help and collect a
defibrillator (if available), while the other should begin CPR on the
casualty. If alone, ask a bystander to fetch the AED.
Defibrillation for children aged eight (8) years or older and adults are
the same.
 Follow DRSABCD Action Plan.

 Open the case and turn ON the AED.
 The automatic prompts will tell you what you need to do.
 Expose the casualty’s chest.
o If the casualty is wearing a bra, remove it before applying the
defibrillator pads.
o Wipe chest to remove any moisture.
o Remove any medication patches.
 Apply the pads to a casualty’s bare chest:
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DO
o 1st pad to right chest wall, below the collarbone.

o 2nd pad to left chest wall, below the left nipple.
o Ensure both pads adhere to the skin.
 The AED analyses the heart rhythm.
 Follow voice prompts
o If no shock advised, continue with CPR when prompted.
o If shock advised, deliver shock by pressing the shock button.
Note: Full step-by-step instructions are available in the Quick Guide at

Page 31 of 130 V3.6

Safety Precautions:
 Do not place pads over a pacemaker or
implanted device. Pads should be placed
at least 8cm from these devices.
DO Continued
 Take care not to touch the casualty
during shock delivery.
Manage
 Ensure medication patches are removed

before applying the pads.
 Ensure that no one is touching the casualty.
 Do not use the device in direct presence of possible ignition
sources, for example flammable vapours, and/or explosive
materials.
Note: Using mobile phones or radios when attempting defibrillation is no
longer a safety concern.

Contingency
Page 32 of 130 V3.6

6.5 Defibrillation - Children under 8 Years
Defibrillation is a treatment of delivering

a therapeutic dose of electrical energy
to the heart by using a device called a
WHAT defibrillator (or Automated External
is it? Defibrillator – AED) for the purpose of
re-starting and stabilising heartbeat
rhythm.
20. Defibrillation – Children 1 - 8 Years

Defibrillation for children under eight (8) years of age is slightly
different to defibrillation for adults.
Defibrillation for children under eight (8) years is ideally performed
using a defibrillator with a paediatric mode or paediatric pads.
Paediatric pads are positioned one pad in the centre of the chest
REMEMBER
between the nipples and the second pad on the back between the
shoulder blades (as shown above).
If the AED does not have a paediatric mode or paediatric pads, then
Know
the standard AED and adult AED pads can be used.

If the child is large enough the pads can be placed as per the adult
pads. Ensure the pads do not touch each other on the child’s chest. If
the pads are too large place them on the child as per the paediatrics
pads (One on the chest between the nipples and one on the back
between the shoulder blades).
It is recommended that both adult and paediatric pads are stored with
the defibrillator.

Manage
DO
2. Familiarise yourself with ANZCOR Guideline 7: Automated

External Defibrillation in Basic Life Support
http://resus.org.au/guidelines/

Contingency
Page 33 of 130 V3.6

6.6 Defibrillation - Infants

Because infants have such small and
delicate systems, it is even more critical to
WHAT get their heart restarted quickly. Applying
is it? an AED is an important part of treating
cardiac arrest.
21. Defibrillation - Infants
It is important to know that AEDs are safe to use on young children
under 8 years old and infants (<12 months of age).
A cardiac arrest in an infant under one year, is very rare.
REMEMBER
Some AED models may have smaller paediatric (child) specific pads,
with or without a 'key' for the device to recognise use on a child or
infant. The device will then be able to deliver a shock at an
Know
appropriately lower energy setting automatically. These pads are

generally packaged in a different colour.
The Australian Resuscitation Council recommends that if the AED
does not immediately appear to have a paediatric mode or paediatric
pads, then it is reasonable to proceed with standard adult AED pads in
order to provide the best chance of recovery. It is better to use an
AED on a non-breathing infant than not.
Ideally, for infants < 1-year paediatric pads and an AED with a
paediatric capability should be used.
 Locate the paediatric electrode pads and attach to the infant.
 Use the front-back position (antero-posterior) for pad placement.
 One pad placed on the upper back (between the shoulder blades)
and the other pad on the front of the chest.
Manage
DO
 Plug in the connector to analyse for a rhythm and follow the

prompts.
 Follow the prompts from the AED instructing you when to
commence CPR and deliver shocks.
 Continue until emergency services arrive and relieve you.
 Call Triple Zero (000) for an ambulance and stay on the line for
and follow the guidance from emergency services.
PLAN “B”  Ambulance crews carry different defibrillators that may have
Contingency adjustable energy settings for the delivery of a shock by trained
clinicians.
Page 34 of 130 V3.6

6.7 Positional Asphyxia

Positional asphyxia is also a form of respiratory
distress and occurs when the body position
prevents someone from breathing adequately from
WHAT an upper airway obstruction (blockage) or a
is it? limitation in chest wall expansion, for example due
to steering wheel compression or an unconscious
casualty facing down.
22. First Aid Managment of Asphyxia
When providing first aid for an unconscious casualty or casualty with
an altered consciousness it is important to ensure their body position
does not compromise their airway. This usually occurs when the
casualty has their head slumped forward blocking the airway.
Positional asphyxia is caused by:
 Airway obstructions - tongue, vomit, and position of the body
REMEMBER
 Head injuries - no nerve messages from brain about breathing

 Heart conditions - no blood supply to carry oxygen from lungs to
Know
vital organs
 Chest conditions - bronchospasm, for example ineffective
exchange of gases
 Lack of oxygen - poisonous gases, smoke, drowning, suffocation,
and strangulation
Signs and Symptoms:
 Breathlessness, air hunger
 Blue tinge to lips and skin
Complications:
 If the casualty is unconscious and is not breathing normally – start CPR.
Follow DRSABCD Action Plan

Conscious Casualty:
 Seek medical aid if required
Unconscious Casualty:
 Remove cause and position casualty to maintain airway
Manage
DO
 Place the casualty into the recovery position to maintain the

airway and prevent positional asphyxia
 Avoid any pressure to the casualty's chest, for example when they
are in a prone (face down) position, kneeling or forward position
 Resuscitate if necessary
 Urgent medical aid
 If you cannot physically move the casualty, for example:

PLAN “B” unconscious in a car with their head slumped forward; manually
Contingency hold the casualty’s head so that the airway is open only if safe to
do so.
Page 35 of 130 V3.6

6.8 First Aid Management in Case of Regurgitation and

Vomiting
Regurgitation is the passive flow of
WHAT stomach contents into the mouth and nose.
is it? Vomiting is the forceful ejection of the
stomach content through the mouth.
23. First Aid Management in Case of Regurgitation and Vomiting
Causes:
 Head injury
 Stomach flu
 Dehydration
 Overeating
REMEMBER
 Flu
 Acid Reflux
Know
 Intestinal, kidney, liver, and other diseases

 Signs and Symptoms:
 Nausea
 Complications:
o Choking (airway obstruction)
Note: Although this can occur in any person, regurgitation and
inhalation of stomach contents is a major threat to an unconscious
person.
In resuscitation, regurgitation and vomiting are managed by:

 Prompt positioning the casualty on their side in the recovery
position
 Manual clearance of the airway prior to continuing rescue
breathing
Manage
DO
 If the person begins to breathe normally, they can be left on their

side with appropriate head tilt
 If not breathing normally, the person must be rolled on their back
and resuscitation commenced
Note: Always clear the airway before opening it.
PLAN “B”  No plan “B” – you must clear the airway to allow the casualty to
breathe or to perform CPR.
Contingency
Page 36 of 130 V3.6

Part 7 – First Aid Management
With St John training you will have the

WHAT skills and knowledge to manage
is it? potentially life-threatening illness and
injuries.

This section will provide you with ‘what to do’ action plans to assist
you with the identification and treatment of potentially life-threatening
illness and injuries that you may witness in the home, community, or
workplace, including:
REMEMBER
 Respiratory conditions
 Cardiovascular emergencies
Know
 Bleeding
 Trauma injuries
 Medical conditions
 Envenomation
 Environmental conditions
 Poisoning
You will have the skills, knowledge, and confidence to provide first aid
to your family, friends, community members and colleagues
 Always follow the DRSABCD Action Plan when initiating first aid
and assisting a casualty.
Manage
 Maintain your safety, and the safety of others.

DO
 Provide care to the best of your ability and within the bounds of
your skill set.
 Maintain your skills and knowledge to keep up to date.
PLAN “B”  Learn First Aid Skills.

Contingency
Page 37 of 130 V3.6

7.1 Choking Adult or Child (over 1 year)

Choking is severe difficulty in breathing
WHAT due to obstruction of the airway or lack of
air. Follow ANZCOR Guideline 4 - Airway
is it?

Caused by:
 Airway partially or completely blocked by food
 Airway partially or completely blocked by small objects or foreign
REMEMBER
material
 Eating too quickly
 Not chewing food sufficiently
Know
Signs and Symptoms:

 Clutching the throat
 Coughing, wheezing, or gagging
 Difficulty breathing, speaking, or swallowing
 Making a whistling or “crowing” sounds or no sound at all
 Face, neck, lips, ears, fingernails turning blue
 Collapsing and becoming unconscious
Mild Choking
 Encourage the casualty to relax. Ask the casualty to cough to
remove the object
Severe Choking
 If coughing does not remove the blockage call Triple Zero (000) for
an ambulance.
 Bend the casualty forwards, give up to 5 sharp back blows, on the
back between the shoulder blades using the heel of one hand.
o Visually check if the obstruction has been removed after each
Manage
back blow.
DO
 If the blockage is not removed after back blows, give up to 5 chest

thrusts:
o Place one hand in the middle of the back for support and the
other on the lower half of the sternum.
o Chests thrusts are sharper than CPR compressions and
delivered at a slower rate
o Visually check if the obstruction has been removed after each
chest thrust.
 If the blockage does not clear after 5 chest thrusts, keep alternating
5 back blows with 5 chest thrusts until medical aid arrives.
 If the casualty becomes unconscious and is not breathing normally,

PLAN “B” then commence CPR and defibrillation. Ensure that Triple Zero
Contingency (000) for an ambulance has been called.
Page 38 of 130 V3.6

7.2 Choking infant (under 1 year)
WHAT Choking is severe difficulty in breathing due

is it? to obstruction of the airway or lack of air.

An infant is defined as younger than one year, a child as one to
REMEMBER

eight years of age
 In an infant, the upper airway is easily obstructed because of the
Know
narrow nasal passages, the entrance to the windpipe (vocal cords)

and the trachea (windpipe)
 Follow DRSABCD Action Plan
 Follow ANZCOR Guideline 4 - Airway
Severe Choking
1. Immediately call Triple Zero (000) for an ambulance
2. Position infant with their head pointing downwards on your forearm
while supporting the head and shoulders. Hold the infant’s mouth
open with your fingers.
3. Give up to 5 sharp back blows with heel of one hand to the back
between the shoulders. Visually check if the obstruction has been
removed after each back blow.
o If the blockage has come loose, turn the infant into the
recovery position and remove (finger sweep) with your little
Manage
finger.
DO
4. If unsuccessful, place the infant on their back on a firm surface.

5. Place 2 fingers on the lower half of the sternum and give up to 5
chest thrusts – slower but sharper than CPR compressions.
Visually check if the obstruction has been removed after each
chest thrust.
6. If the blockage has come loose, turn the infant into the recovery
position and remove (finger sweep) with your little finger.
7. Continue alternating with five back blows and five chest thrusts until
medical aid arrives.
8. If the infant becomes unconscious and is not breathing normally,
then commence CPR.
PLAN “B”  If the casualty becomes blue, limp, or unconscious - call Triple Zero
(000) for an ambulance has been called.
Contingency
Page 39 of 130 V3.6

7.3 Asthma Emergency

Asthma is a disorder of the smaller
airways of the lungs. People with asthma
WHAT have sensitive airways which can narrow
is it? when exposed to certain ‘triggers’, leading
to difficulty in breathing.
Signs and Symptoms – Mild to Moderate Asthma Attack
 Chest tightness
 Shortness of breath
 Dry, irritating, persistent cough
 Wheeze (high pitched whistling sound during breathing)
Signs and Symptoms – Severe Asthma Attack

 Symptoms get worse very quickly
 Little or no relief from inhaler
 Severe shortness of breath
 Inability to speak more than one or two words per breath
 Blue lips, face, earlobes, fingernails
REMEMBER
An asthma emergency is potentially life-threatening.

 Most people are aware of their asthma and should have an
Action Plan and medication, usually in the form of an inhaler.
Know
They may wear a medical alert device, for example a bracelet.

 If the casualty’s inhaler is not available, or has not previously had
an asthma attack, use another person’s inhaler or one from a first
aid kit if possible.
 Follow ARC (ANZCOR) Guideline 9.2.5 – First Aid for Asthma.
National Asthma Council Australia is a national peak clinical body that

provides relevant guidelines and procedures on asthma and allergy
management.
Asthma Australia works with people with asthma, their family and
friends, health professionals, researchers, and government to find the
best treatments and practices to make sure life with asthma is the
best it can be.
 See National Asthma Council Australia and Asthma Australia
Page 40 of 130 V3.6

Help the casualty to sit down in an upright position, reassure and stay
with them.
How to give medication:
1. Give separate 4 puffs of reliever medication:
o Shake the inhaler
o Give 1 puff with spacer
Manage
o Take 4 breaths
DO
o Repeat until 4 puffs have been given

2. Wait 4 minutes.
o If no improvement, give 4 more separate puffs
3. If the casualty still cannot breathe normally, call Triple Zero (000)
for an ambulance.
4. Keep giving 4 puffs every 4 minutes until casualty recovers or
medical aid arrives.

Contingency
Page 41 of 130 V3.6

7.4 Allergic Reaction

An allergic reaction is the body’s reaction
to a foreign substance by triggering the
WHAT immune system to react to substances in
is it? the environment that are harmless for
most people.
Caused by:
 Dust mites
 Pollen, hay fever
 Foods such as peanuts, cow's milk, soy, seafood, and eggs
 Cats and other furry or hairy animals
 Insect stings: bees, wasps
 Moulds
 Medicines
Signs and Symptoms:

REMEMBER
 Swelling of the lips, tongue (Breathing difficulty)

 Hives or welts (rash on skin)
 Tingling of mouth
Know
 Watery eyes
 Runny nose
 Abdominal pain, vomiting, diarrhoea
Depending on the allergen and where it enters the body, different

symptoms may appear.
 Pollen, when breathed in through the nose, usually causes
symptoms in the nose, eyes, sinuses, and throat (allergic rhinitis).
 Allergy to foods usually causes stomach or bowel problems and
may cause hives (urticaria).
 In some cases, anaphylaxis is preceded by signs of a mild to
moderate allergic reaction - Australasian Society of Clinical
Immunology and Allergy (ASCIA).
Page 42 of 130 V3.6


2. For insect allergy:
 Bee Sting:
o Remove sting by scraping it out sideways with a fingernail. If
possible, try not to squeeze the venom sac, as this may
increase the amount of venom injected.
o Apply an ice pack.
o Monitor for signs of anaphylaxis.
 Tick:
o If the casualty has a history of tick allergy, the tick must be

killed where it is rather than removed, if you have the
Manage
DO
appropriate equipment to do so, this should be performed in a

safe place with medical aid. If in a remote location,
consultation with a healthcare professional is recommended.
3. Place in a position of comfort.
4. Stay with the casualty and call for help.
5. Locate adrenaline Autoinjector and Action Plan, if available, in the
event of anaphylaxis.
6. Watch for any signs of anaphylaxis.
7. Give medications if prescribed. Whilst antihistamines may be
used to treat mild to moderate allergic reactions, if these progress
to anaphylaxis, then adrenaline is the only suitable medication
8. Mild to moderate allergic reaction may or may not precede
anaphylaxis.
PLAN “B”  Call Triple zero (services) for an ambulance.

Contingency
Page 43 of 130 V3.6

7.5 Anaphylaxis
Anaphylaxis is the most severe form of
allergic reaction and is potentially life
WHAT threatening. It is a generalised allergic
is it? reaction, which often involves more than
one body system.
An anaphylactic reaction is likely to occur within twenty (20) minutes
of exposure to the trigger and can rapidly become life threatening.
Severe allergic reactions may occur without prior exposure to a
trigger.
Triggers:
 Food: peanuts, tree nuts, cow’s milk, eggs, wheat, seafood, fish,
soy, sesame
 Medications: Penicillin, Aspirin, Ibuprofen, Pethidine, Codeine or
Morphine
 Venom: bites from ticks or stings from bees, wasps, or ants
REMEMBER
It is characterised by rapidly developing airway and/or breathing

and/or circulation problems usually associated with swelling, redness
Know
or itching of the skin, eyes, nose, throat, or mouth

Signs and Symptoms:
 Difficult and/or noisy breathing
 Wheeze or persistent cough
 Swelling of face and tongue
 Swelling / tightness in throat
 Difficulty talking and / or hoarse voice
 Dizziness / loss of consciousness
 Pale and floppy (young children)
 Abdominal pain and vomiting
 Hives, welts, and body redness
Page 44 of 130 V3.6

Anaphylaxis Management
2. Prevent further exposure to the triggering agent if possible.
3. Lay the casualty flat. Do not allow them to stand or walk. If
breathing is difficult allow them to sit (if available).
4. Administer adrenaline (epinephrine) autoinjector - EpiPen®
and follow Anaphylaxis Action Plan if available:
o Child less than 5 years - 0.15 mg
o Older than 5 years - 0.3mg
5. Call Triple Zero (000) for an ambulance.
In a childcare situation: ensure the parent, guardian or
emergency contact are informed.
6. Give asthma medication for respiratory symptoms.
7. A second dose of adrenaline (epinephrine) autoinjector should be
administered if symptoms are not relieved by the initial dose five
Manage
DO
(5) minutes after the initial dose.
If in any doubt, give an adrenaline (epinephrine) autoinjector as

recommended by the Australian Society of Clinical Immunology and
Allergy (ASCIA). Adrenaline is life saving and must be used promptly.
Withholding or delaying the giving of adrenaline can result in
deterioration and death.
Anaphylaxis Action Plans
Action Plans are developed for individuals with their doctor when it
has been confirmed that they have a food, insect or medication
allergy and are at risk of developing anaphylaxis.
The Australasian Society of Clinical Immunology and Allergy (ASCIA)
is a national peak clinical body that provides relevant guidelines and
procedures on treatment of allergies and anaphylaxis.
Access ASCIA website to learn more: http://www.allergy.org.au.
PLAN “B”  Signs and symptoms become more severe.

 Monitor the casualty closely for signs of deterioration / anaphylaxis.
Contingency
Page 45 of 130 V3.6

7.6 Using Adrenaline (Epinephrine) Autoinjectors

The adrenaline (epinephrine)
autoinjector is a disposable drug
WHAT delivery system that is designed for
is it? self-administration of a single dose
of adrenaline for severe allergic
emergencies (anaphylaxis).
The adrenaline (epinephrine) contained within the autoinjector rapidly
constricts the blood vessels, relaxes the muscles in the airway and
lungs, reverses swelling, and stimulates heartbeat, thereby reversing
the most dangerous effects of an anaphylactic reaction.
EpiPen® available In Australia and New Zealand, there are currently

two doses of adrenaline autoinjectors for the brand
EpiPen®Jr (0.15mg) is usually prescribed for children

7.5-20kg / younger than 5 years of age
REMEMBER
(green label)
Know
EpiPen® (0.3mg) is usually prescribed for adults and

children over 20kg / 5 years of age and older
(yellow label)
Anapen® available in three different doses. Your healthcare

professional will decide which dose is right for you.
Page 46 of 130 V3.6

 Lay the casualty flat. Do not allow them to stand or walk. If

breathing is difficult allow them to sit (if available).
 Before use, check the expiry date, and ensure that the liquid in the
pen is clear.
 How to administer and use an EpiPen® the adrenaline
autoinjector:
1. Form a fist around and pull off blue safety release
2. Hold leg still and place orange end against mid outer thigh (with
or without clothing)
3. Push down hard until a click is heard or felt and hold for 3
seconds
4. Remove and dispose of it safely
5. Monitor the casualty, if no improvement, administer a second
dose after 5 minutes
 How to administer and use AnaPen® the adrenaline autoinjector:

Manage
1. Pull off the black needle shield by pulling hard in the direction of
DO
the arrow
2. Remove the grey safety cap from the red firing button.
3. Position the needle end of the device against the outer part of
the thigh. Anapen® can be used through light clothing, such as
denim, cotton, or polyester.
NB: Anapen® is intended only for intramuscular use. Administer to the
outer part of the thigh only, nowhere else.
WHITE END ON LEG | PRESS THUMB ON RED
4. Press the red firing button so that it clicks.
Hold the device against the outer thigh for 3 seconds before
removing.
5. Check the injection indicator is red. Red shows the injection was
completed successfully. If the injection indicator is not red,
repeat the process with a new Anapen®.
6. After using Anapen® the needle is exposed. Cover it with the
wide end of the black needle shield.
If no adrenaline (epinephrine) autoinjector is available:

 Lay the casualty flat. Do not allow them to stand or walk. If
PLAN “B” breathing is difficult, allow them to sit.
 Follow DRSABCD Action Plan and monitor airway and breathing
Contingency
until arrival of medical aid.
 If the casualty becomes unconscious start CPR.
Page 47 of 130 V3.6

7.7 Management of Bleeding
Bleeding is defined as loss of blood. The

WHAT loss can range from minor bleeding
is it? through to severe external and internal
bleeding

Types of bleeding / wounds:
 Abrasion - a superficial wound where the skin is scraped, and tiny
blood vessels exposed
 Laceration - open wound where the layers of skin and underlying
tissue are damaged
 Incision - open wound from knife or glass. The wound is cut
cleanly with regular edges
 Cut - Open wound where the skin, soft tissue or muscles are
severed by a sharp object
 Tear or avulsion - superficial wound where the skin and other
soft tissues are partially or completely torn away
 Puncture - wounds from blunt, pointed instrument or gunshot
wound, results in damage
REMEMBER
Caused by:
 Anything that cuts or damages a blood vessel
Know
 Injury to blood vessel

 Amputation
Signs and Symptoms:

 Pain
 Tenderness
 Pallor
 Sweating
 Faintness or dizziness
 Thirst
 Visible blood loss, oozing, flowing, or spurting
Complications:
 Severe blood loss
 Cardiac arrest
Management of wounds and bleeding are dependent on the type of

injury and severity.
Page 48 of 130 V3.6

7.8 Minor Wound

Wounds such as cuts, grazes (e.g., scrapes
or abrasions) and lacerations (e.g., a deep
cut or tear of the skin) are a split of the skin
WHAT caused by an impact of some sort. It is
is it? common to sustain these types of injuries
through play, sport, accident or during
ordinary day-to-day activities
Written Report – Incident Report Form
 Antiseptic creams are not recommended and do not help the wound
to heal.
 Minor wounds do not usually require any medical attention
For minor wounds, change the dressing or bandage whenever it
REMEMBER

becomes wet or dirty. Remove the bandage or dressing after a
couple of days - this will promote healing.
Know
 Watch for signs of infection as the wound heals.

o If the wound isn’t healing or your notice any redness, increasing
pain, oozing, warmth or swelling of the wound or the immediate
area visit your GP.
o If the wound is infected, it may also smell, and you may develop
a fever and feel generally unwell.
 Taking good care of wounds reduces scaring and promotes healing.
 Perform hand hygiene, put on gloves

 Identify minor wound
 Clean wound thoroughly with sterile gauze soaked in saline or
water to remove all dirt and debris
 Wipe wound from inner to outer edge, do not dab at the wound
 Use each piece of gauze only once and throw away after use
Manage
 Visually check the wound for infection

DO
 Once the bleeding has stopped and the wound is clean, you
should cover it with a sterile bandage or gauze or cleanest
dressing available
 Correctly dispose used materials, PPE
 Instruct casualty not to remove dressing, keep bandage clean and
dry
 Seek medical aid and monitor the wound
PLAN “B”  If there is dirt or debris you cannot remove, you should go to your
Contingency local GP. Very small amounts of dirt are OK in grazes.
Page 49 of 130 V3.6

7.9 Severe External Bleeding

Severe bleeding is an excessive amount
of blood loss that can be life threatening.
WHAT Even a small injury can result in severe
is it? external bleeding, depending on where it
is on the body.
Written Report – Incident Report Form
Signs and Symptoms:
 Visible blood loss, oozing, flowing or spurting
REMEMBER
 Weak, rapid pulse

 Pale, cool, moist skin
 Sweating
Know
 Loss of consciousness, confusion

Note:
 Any severe bleeding should be stopped as soon as possible
 Use PPE e.g., wear gloves to prevent infection
 Handle gently if you suspect a broken bone.
 Do not give the casualty anything to eat or drink
Direct Pressure
1. Help the casualty to lie down. Remove or cut their clothing to
expose the wound.
2. Squeeze the wound edges together if possible.
3. Apply firm direct pressure over the wound using a pad or your
hands or ask the casualty to do this if possible.
4. Apply a pad over the wound and secure by bandaging over it.
5. Raise and support the injured part above the level of the heart. If a
facial wound, keep casualty sitting.
6. Secure pad by bandaging over the pad wound
7. If bleeding is still not controlled, leave the initial pad in place and
Manage
DO
apply a second pad and secure with the bandage.

8. If bleeding continues through second pad, replace the second
pad, leaving the first pad in place and rebandage.
9. Check every fifteen (15) minutes that the bandages are not too
tight and that there is circulation below the wound.
10. Continue to monitor the casualty.
Embedded Objects
11. Do not remove the embedded object because it may be plugging
the wound and restricting bleeding.
12. Apply padding around or on each side of the protruding object,
with pressure over the padding.
Page 50 of 130 V3.6

External Bleeding – Severe Life-threatening Bleeding

If there is severe, life-threatening bleeding from a limb, not controlled
by applying standard control measures:
1. Apply an arterial tourniquet above the bleeding point, if trained in
its use and one is available
2. Apply a haemostatic dressing, if there is severe life-threatening
bleeding from a wound site not suitable for tourniquet, or from a
limb when a tourniquet is not available or has failed to stop the
bleeding, if trained in its use and one is available.
3. If the casualty is unconscious and not breathing normally, start
CPR and defibrillation.
Arterial Tourniquet
Arterial tourniquets should only be used for life-threatening bleeding
from a limb, where the bleeding cannot be controlled by direct
DO Continued
pressure.
Rules for Applying a Tourniquet:
Manage
1. Apply above a joint or wound in

accordance with the
manufacturer’s instructions (or
5cm above the bleeding point if
no instructions).
2. Do not cover up by any bandage
or clothing.
3. Note the time of tourniquet
application.
4. Do not remove the tourniquet until
the casualty receives specialist
care.
IMPORTANT: Once applied, the casualty requires urgent transfer to
hospital.
If a correctly applied tourniquet(s) has failed to control the bleeding,
consider using a haemostatic dressing in conjunction with the
tourniquet.
Page 51 of 130 V3.6

Haemostatic Dressings
Haemostatic dressings are impregnated with agents that help stop
bleeding in the following situations:
 Severe, life-threatening bleeding not controlled by wound pressure,
from a site not suitable for tourniquet use.
 Severe, life-threatening bleeding from a limb, not controlled by
wound pressure, when the use of a tourniquet(s) alone has not
stopped the bleeding, or a tourniquet is not available
DO Continued
1. Apply as close as possible

to the bleeding point, hold
Manage
against the wound using

local pressure (manually
initially).
2. Secure in place with a
bandage (if available).
3. Leave on the bleeding
point until medical care is available.
NOTE:
The use of Tourniquet and Haemostatic Dressings should only
be applied by First Aiders trained in the use of these specialised
applications.
 Seek urgent medical attention if you can’t stop any bleeding, if

something is sticking out of the wound, if blood is spurting, or is
PLAN “B” from a human or animal bite.
Contingency  Ask bystanders to assist if they are trained First Aiders.
 Follow ARC (ANZCOR) Guideline 9.1.1 - First Aid for
Management of Bleeding
Page 52 of 130 V3.6

7.10 Nosebleed (Epistaxis)

Nose bleeds can occur when the blood
vessels or the lining or the nose
become damaged.
WHAT
is it? Nosebleeds occur more commonly in
young children and adults over 65
years of age.
1. Written Report – Incident Report Form
Common causes of nosebleeds include:

 Foreign object stuck in the nose
 Chemical irritants
REMEMBER
 Allergic reaction
 Injury to the nose
 Repeated sneezing
Know
 Picking the nose

 Cold air
 Upper respiratory infection
 Large doses of aspirin
Injuries that might cause a nosebleed include a fall, a car accident, or

a punch in the face. Nosebleeds that occur after an injury may
indicate a broken nose, skull fracture, or internal bleeding.
1. Sit the casualty up, lean their head forward to avoid blood
flowing down the throat and make them comfortable.
2. Apply pressure equally to both sides of the nose, over the soft part
below the bony bridge (usually between the thumb and index
finger) for at least ten (10) minutes.
3. Instruct the casualty to breathe through their mouth and not to blow
Manage
DO
their nose (it will dislodge any clots that may have formed).
4. Instruct the casualty to spit out blood rather than swallow it as
swallowed blood irritates the stomach and causes vomiting which
can worsen the bleeding.
5. Seek medical aid if bleeding is not controlled within twenty (20)
minutes. On a hot day or after exercising it may take much longer
to stop the bleeding
PLAN “B”  If the bleeding is profuse and you are unable to stop it with first aid,
Contingency see your family GP or go to the emergency department.
Page 53 of 130 V3.6

7.11 Shock
Shock is a loss of effective circulation
resulting in impaired tissue oxygen and
WHAT nutrient delivery and causes life
is it? threatening organ failure. Any seriously
ill or seriously injured person is at risk
of developing shock.
32. First Aid Management of
Caused by:
Many conditions may cause shock such as severe bleeding, major
trauma, severe burns or scalds, spinal injuries, severe allergic
reactions, cardiac conditions
Signs Symptoms
 Collapse  Dizziness
 Rapid breathing  Thirst
REMEMBER
 Rapid pulse which may  Anxiety

become weak or slow  Nausea
 Fever or abnormally low  Breathlessness
Know
temperature  Feeling cold, shivering or

 Cool, sweaty skin that may chills
appear pale or discoloured  Extreme discomfort or pain
 Skin rash
 Confusion or agitation
 Decreased or deteriorating
level of consciousness
 Vomiting
 Decreased urine output
Follow ARC (ANZCOR) Guideline 9.2.3 – Shock: First Aid Management
of the Seriously Ill or Injured Person
1. Ensure Triple Zero (000) for an ambulance is called.

2. Lie the casualty down with head flat on floor and reassure and
DO NOT raise legs. (ANZCOR recommends the supine (lying)
position without leg raising for those in shock).
Manage
3. Manage severe bleeding then treat other injuries

DO
4. Loosen tight clothing.

5. Keep the casualty warm and cover with blanket, coat or similar but
DO NOT use any source of direct heat.
6. Reassure and constantly re-check the person’s condition for any
change.
PLAN “B”  Place casualty on their side into the Recovery Position if they have
Contingency difficulty breathing, become unconscious or are likely to vomit.
Page 54 of 130 V3.6

7.12 Cardiovascular Emergencies: Angina
WHAT Angina is pain caused by narrowed arteries in the heart

is it? due to low oxygen.
33. First Aid Management of Cardiovascular Emergencies:

Caused by:
 Atherosclerosis (narrowing of the arteries)
 Causes include a diet high in saturated fats, smoking, and high
blood pressure
REMEMBER
Signs and Symptoms:

 Pale and clammy
 Tight, gripping or squeezing pain or discomfort
Know
 Pain can vary from mild to severe; felt in the centre of the chest,
which may spread to either or both shoulders, the back, neck or
jaw or down the arm
 Feeling nauseous
Complications:
 Cardiac arrest.
1. Advise casualty to immediately stop any activity and rest.

2. Provide reassurance. Ask the casualty to describe their
symptoms.
3. Assist the casualty in taking their prescribed angina
medication.
4. Give three hundred (300) mg of Aspirin (one tablet) in water
unless the casualty is allergic to aspirin or advised by their doctor
Manage
not to take aspirin.

DO
5. If symptoms are not relieved within five (5) minutes, assist the
casualty to take another dose of angina medication.
6. Call Triple Zero (000) for an ambulance if: pain or discomfort is
not completely relieved by rest and medication within 5-10
minutes; any of the symptoms are severe or worsen quickly. Stay
on the phone. Wait for advice from the operator. It is not
recommended that you drive the casualty to the hospital yourself.
You may need to perform CPR.
PLAN “B”  Perform CPR if casualty unconscious and not breathing normally.
Page 55 of 130 V3.6

7.13 Cardiovascular Emergencies:

Chronic Heart Failure
Chronic heart failure is an ongoing condition
WHAT in which the heart muscle is weakened and
is it? can’t pump as well as it normally does.
34. First Aid Management of Cardiovascular Emergencies: Chronic

Caused by:
 Atherosclerosis (narrowing of the arteries):
o Narrowing of the arteries occurs when fatty deposits (called
cholesterol plaques) build up on the inner walls of arteries
As an artery gets narrower, less and less blood can get through
REMEMBER
 Causes include a diet high in saturated fats, smoking, and high

blood pressure
Know
Signs and Symptoms:

 A general feeling of tiredness
 Breathlessness when exercising, lying flat or even resting
 Swollen feet, ankles, legs and abdomen
 Coughing and wheezing
Complications:
 Sudden cardiac arrest.
Conscious casualty:
2. Help the casualty to a sitting position.
Manage
3. Reassure and loosen tight clothing.

DO
4. Stay with the casualty until medical aid arrives.
If the casualty becomes breathless and collapses:


Page 56 of 130 V3.6

7.14 Cardiovascular Emergencies:

Heart Attack
Heart Attack is pain caused by sudden complete
blockage of an artery that supplies blood to the
WHAT heart and causes damage or death of the heart
is it? muscle. Having one or more signs or symptoms
of a heart attack is a life-threatening emergency.
35. First Aid Management of Cardiovascular Emergencies: Heart Attack
Caused by:
Atherosclerosis (narrowing of the arteries):
 Narrowing of the arteries occurs when fatty deposits (called
cholesterol plaques) build up on the inner walls of arteries
 As an artery gets narrower, less and less blood can get through
Signs and Symptoms:

Casualties may have one or a combination of symptoms. The casualty
may feel discomfort in the middle of the chest.
For some casualties, sudden cardiac arrest may occur as the first sign
of heart attack, however most experience some warning signs.
IMPORTANT:
 A heart attack can occur in a casualty without chest pain or
REMEMBER
discomfort as one of their symptoms

 The most common symptom of heart attack in a casualty without
chest pain is shortness of breath
Know
 A casualty who experiences a heart attack may pass off their

symptoms as ‘just indigestion’
Warning signs:
If the warning signs are severe, get worse quickly, or last longer than
10 minutes, act immediately. The casualty may experience one or a
combination of these symptoms:
 Pain in one or more of the following:
o Chest, neck, and jaw, one or both arms, back, shoulders
 Pale skin
 Nausea or vomiting
 Sweating
 Feeling dizzy or light-headed
Follow ARC (ANZCOR) Guideline 9.2.1 – Recognition and First Aid
Management of Heart Attack.
Page 57 of 130 V3.6

Atypical chest pain is defined as pain that does not have a heaviness
REMEMBER or squeezing sensation (typical angina symptoms), precipitating factors
(e.g., exertion), or usual location. Some people are more likely to
Continued describe non-typical or minimal symptoms and include:
Know
 The elderly
 Women
 Persons with diabetes
 Australian indigenous population and Māori and pacific island people
Complications:
 Cardiac arrest.
Conscious Casualty:
1. Encourage the casualty to stop what they are doing and to rest in a
comfortable position.
2. If the casualty has been prescribed medication such as a tablet or
oral spray to treat episodes of chest pain or discomfort associated
with Angina, assist them to take this as they have been directed.
3. Call an ambulance if symptoms are severe, get worse quickly or last
longer than 5-10 minutes.
4. Give Aspirin (300 mg). Dissolvable Aspirin is preferred. Only
withhold if the casualty is known to be anaphylactic to Aspirin or if
their doctor advised them not to take Aspirin.
5. Stay with the casualty until the ambulance or on-site resuscitation
Manage
team arrives.
DO
6. If practical and resources allow, locate the closest AED, and bring it
to the casualty.
7. Continue to monitor the casualty. Be prepared to give CPR if
symptoms worsen.
Unconscious Casualty:
4. Place the casualty on their side in the Recovery Position.
5. Call Triple Zero (000) for an ambulance. Stay on the phone. It is not
recommended that you drive the casualty to the hospital yourself,
as you may need to perform CPR.
6. Stay with the casualty until medical aid arrives.
7. Continue to check the casualty’s breathing and pulse. Be prepared
to give CPR if symptoms worsen.

Contingency
Page 58 of 130 V3.6

7.15 Cardiovascular Emergencies: Sudden Cardiac Arrest
Cardiac arrest is an electrical malfunction of the heart

WHAT that causes the heart to beat irregularly or stop beating
is it? unexpectedly.
36. First Aid Management of Cardiovascular Emergencies: Sudden Cardiac Arrest

Caused by:
 Heart attack and causes of heart attack.
Signs and Symptoms:
 Unexpected collapse
 Abnormal or no heartbeat
REMEMBER
 Unconsciousness
 Signs of no circulation (pale or blue lips, face, earlobes, fingernails)
 Not breathing or abnormal breathing
Know
IMPORTANT: It can occur to anyone young or old, male, or female,

anywhere at any time. Many casualties have no warning signs or
symptoms.
The MOST EFFECTIVE treatment for cardiac arrest is good quality
CPR and using an automated external defibrillator (an AED) to deliver
a shock to the casualty’s heart quickly whilst awaiting medical aid.
Complications:
 Death.

Manage
2. Start CPR.
DO
3. Defibrillate as soon as possible.

4. Continue CPR while the AED is being collected.

Contingency
Page 59 of 130 V3.6

7.16 Stroke
A stroke occurs when an artery taking blood to
the brain becomes blocked with a blood clot or
WHAT plaque or the artery bursts or leaks.
is it? Approximately 80% of strokes are caused by a
blockage of a blood vessel supplying part of the
brain.
37. First Aid Management of Stroke
As a result of a stroke, brain cells are damaged, and functions
controlled by that part of the brain are paralysed. Partial paralysis of
the body and/or speech problems are common.
Caused by:
 Blocked arteries
 Blood clots
 Haemorrhaging
Signs and Symptoms:

 Numbness of the face, arm, or leg on either or both sides of the
body
 Difficulty swallowing
 Dizziness, loss of balance or an unexplained fall
 Loss of vision, sudden blurred or decreased vision in one or both
REMEMBER
eyes
 Headache, usually severe and of abrupt onset or unexplained
Know
change in the pattern of headaches

 Drowsiness
 Confusion
 Reduced level of consciousness
Complications:
 Unconsciousness
 Breathing difficulties
 Swallowing difficulties
A Transient Ischaemic Attack (TIA) happens when there is a

temporary interruption to the blood supply to the brain. It causes the
same symptoms as a stroke, but these go away completely within 24
hours.
Even though symptoms may go away it is also important to get the
casualty hospital treatment as quickly as possible.
Follow ARC (ANZCOR) Guideline 9.2.2 – Stroke.
Page 60 of 130 V3.6

Unconscious casualty:
1. Place on their side in recovery position.
2. Call Triple Zero (000) for ambulance.
Conscious casualty:
2. Call an ambulance for any casualty who has shown signs of
Manage
DO
stroke, no matter how brief or if symptoms have resolved.

3. Do not give anything to eat or drink.
4. Reassure the casualty.
5. Support head and shoulders on pillows. Loosen tight clothing.
Maintain body temperature. Wipe away secretions from mouth.
6. Ensure airway is clear and open.
7. If the casualty becomes unconscious and is not breathing
normally, then commence CPR and defibrillation.

 Recognise signs of a Stroke:
PLAN “B”
Contingency
Page 61 of 130 V3.6

7.17 Envenomation
Envenomation is the process by which venom
(poison) is injected into the body by sting, spine,
bite, or other venom apparatus usually by insects,
WHAT reptiles and fish.
is it? Pressure Immobilisation is a technique of
applying force to the affected part of the body to
stop the envenomation spread to the rest of the
body.
38. First Aid Management
Bee Sting
Single stings from a bee, while painful, seldom cause serious
problems except for persons who have an allergy to the venom.
It is important to remember that bee stings with the venom sac
attached continue to inject venom into the skin, whilst a single wasp
REMEMBER
or ant may sting multiple times.

Signs and Symptoms:
Know
Minor
 Immediate and intense local pain.
 Visible stinger, pain, redness and
swelling.
Major/Serious
 Allergic reaction/anaphylaxis - ARC(ANZCOR) Guideline 9.2.7.
 Abdominal pain and vomiting in the case of allergic reaction to
insect venom - ARC(ANZCOR) Guideline 9.2.7.
Page 62 of 130 V3.6

Redback Spider
The redback spider is approximately one (1)
cm in length and has a characteristic red
/orange stripe on its back. They are common
in dry places around buildings, outdoor
furniture, machinery, and stacked materials.
In the bush, they nest under logs and rocks. A redback spider bite can
be life threatening to a child or the elderly and infirm but apart from
the pain it is rarely serious for an adult. A rash can also develop
Continued
around the bite site. The bites usually occur due to disturbing the
spider.
Caused by:
 A bite
REMEMBER
Know
Signs and Symptoms:

 Immediate pain at the bite site which becomes hot, red and swollen
 Intense local pain which increases and spreads
 Nausea, vomiting and abdominal pain
 Profuse sweating especially at the bite site
 Swelling of glands in the groin or armpit of the limb that was bitten
Note:
Local pain develops rapidly at the bite site and may become
widespread, but venom acts slowly so a serious illness is unlikely in
less than 3 hours.
Complications:
 Altered conscious state
 Severe pain
 Allergic reaction
Page 63 of 130 V3.6

Snake
Many of the snakes found in Australia
are capable of lethal bites to humans.
These include Taipans, Brown
snakes, Tiger snakes, Death Adders,
Black snakes, Rough Scaled snakes
and many Sea snakes.
Snakes produce venom in modified salivary glands and force venom
out under pressure through paired fangs in the upper jaw. Snake
venom is a complex mixture of many toxic substances which can
cause a range of effects in human casualties. The life-threatening
early effect of an Australian snake bite is neurotoxic muscle paralysis,
which kills by causing respiratory failure.
The spread of snake venom depends on its absorption through the
lymphatic system.
Continued
Caused by:
 A bite
Signs and Symptoms:
 Paired fang marks, but often only a single mark or a scratch mark
REMEMBER
Know
may be present; localised redness and bruising are uncommon in

Australian snake bite
 Headache
 Nausea and vomiting
 Abdominal pain
 Blurred or double vision, or drooping eyelids
 Difficulty in speaking, swallowing, or breathing
 Swollen tender glands in the groin or armpit of the bitten limb
 Limb weakness or paralysis
 Respiratory weakness or respiratory arrest
Complications:
 The greatest threat to life and cause of over half of deaths is early
cardiovascular collapse
 Other significant effects include:
o Major bleeding due to inability to clot blood
o Nerve paralysis leading to respiratory muscle paralysis
o Muscle damage
o Kidney failure due to microscopic blood clots
Tropical Envenomation
Potentially fatal envenomation is caused by two jellyfish types in
tropical Australian waters; they are the Box Jellyfish and the Irukandji
Page 64 of 130 V3.6

Box Jellyfish
The Australian Box jellyfish, Chironex fleckeri, has a large (box-like)
bell up to 20 x 30 cm and multiple tentacles. It inhabits estuarine and
onshore coastal waters. Contact with tentacles causes severe
immediate pain and whip-like marks on the skin.
The multiple stings from a jellyfish are
caused by the simultaneous discharge of
many thousands of microscopic stinging
capsules called nematocysts. These are
located on the surface of the tentacles and in
some species on the body of a jellyfish.
Irukandji Jellyfish
The Irukandji are small and extremely venomous jellyfish and at times
too small to be seen, the sting can be minor but can cause single or
mass stinging. With an adult size of about a cubic centimetre (1 cm³),
they are both the smallest and one of the most venomous jellyfish in
Continued
the world.
Signs and Symptoms:
 Tentacles on the skin
 Skin markings
REMEMBER
 Severe immediate pain

Know
 Whip-like marks on the skin

 Restlessness and irrational behaviour
 Nausea and vomiting, headache
Non-Tropical Envenomation
Bluebottle (Pacific Man-O-War)
The bluebottles inhabit water throughout Australia and often found in
swarms. The large bluebottles have tentacles that can be 10 m in
length and is more dangerous and can produce a severe
envenomation syndrome.
Signs and Symptoms:
 Oval-shaped blanched wheals
 Redness of the skin
 Muscle pains
 Nausea, and vomiting
Complications:
 Respiratory and cardiac arrest in
minutes
 Life threatening outcome
Page 65 of 130 V3.6

Bee Sting
See Allergic Reaction Section 7.4, of this Student Guide.
Redback Spider:
2. Lay the casualty down, rest and reassure.
3. Monitor the casualty constantly.
4. Apply a cold compress/cold pack to lessen the pain (no
longer than twenty (20) minutes).
5. Seek medical aid promptly, urgent if:
A young child, or elderly and infirmed
The casualty collapses
Pain is severe
Snake:
2. Call Triple Zero (000) for an ambulance for any person with a
suspected snake bite.
3. Keep the casualty immobilised (still), reassured and under
constant observation.
4. Use pressure immobilisation technique
5. If the bite is on a limb, apply a broad pressure elasticised
Manage
bandage
DO
(10-15 cm) over the bite site as soon as possible.

6. To further restrict lymphatic flow and to assist in immobilisation of
the limb, apply a further elasticised (preferred) or firm heavy
crepe bandage - start at fingers or toes and move up the limb as
far as can be reached. Apply tightly but without stopping blood
flow. The bandage should be firm and tight, you should be unable
to easily slide a finger between the bandage and the skin.
7. Mark the site of the bite with a pen on the bandage, the time that
the casualty was bitten and when the bandage was applied.
8. Splint the limb including joints on either side of the bite, to restrict
limb movement.
9. Do not remove the bandages or splints before evaluation in an
appropriate hospital environment.
Note:
 DO NOT wash the venom off the skin (may aid in identification).
 DO NOT cut the bitten area and try to suck venom out of the
wound.
 DO NOT use an arterial tourniquet.
 DO NOT try and catch the snake.
Snake identification:
 As many of Australia’s snakes are protected species, it is illegal to
kill snakes. There is also the danger and risk of further bites.
Page 66 of 130 V3.6

 Antivenom is available for all venomous Australian snake bites in

Australia; it is not routinely available in New Zealand. For much of
Australia, polyvalent anti-venom that covers potential bites from
different snakes is used.
Tropical Jellyfish
 Remove the casualty from the water; be aware of danger from
tentacles to the rescuer.
 Urgent medical aid.
 Calm the casualty.
 Flood the stung area with vinegar for at least thirty (30) seconds
(neutralises stinging cells).
 If vinegar is unavailable, pick off remaining tentacles and rinse
well with seawater (NOT freshwater, this will cause further stinging
cell discharge).
 Apply a cold pack.
 Remain with the casualty.
DO Continued
 Provide CPR if necessary.

 Keep casualty at rest.
Manage
Non-Tropical Jellyfish
 Keep the casualty at rest, reassure and keep under constant
observation.
 Do not allow rubbing of the sting area.
 Pick off any tentacles (this is not dangerous to the rescuer) and
rinse sting area well with seawater to remove invisible
nematocysts.
 Place the casualty’s stung area in hot water (no hotter than the
rescuer can comfortably tolerate) for twenty (20) minutes.
 If local pain is unrelieved by heat, or if hot water is not available,
apply a cold pack or ice in a dry plastic bag.
 If pain persists or is generalised, if the sting area is large (half of a
limb or more), or involves sensitive areas, for example the eye,
call Triple Zero (000) an ambulance and seek assistance from a
lifesaver/lifeguard if available.
 Follow Australian and New Zealand Committee on Resuscitation:

o ARC (ANZCOR) Guideline 9.4.1 - Australian Snakebite
o ARC (ANZCOR) Guideline 9.4.2 - Spider Bite
o ARC (ANZCOR) Guideline 9.4.3 - Tick Bites and Bee, Wasp and Ant Stings
PLAN “B” o ARC (ANZCOR) Guideline 9.4 5 - Jellyfish Stings
Contingency o ARC (ANZCOR) Guideline 9.4.6 - Blue-Ringed Octopus and Cone Shell
o ARC (ANZCOR) Guideline 9.4.7 - Envenomation - Fish Stings
o ARC (ANZCOR) Guideline 9.4.8 - Pressure Immobilisation Technique
o ARC (ANZCOR) Guideline 9.5.1 - Emergency Management of a Casualty
who has been Poisoned
Page 67 of 130 V3.6

7.18 Fractures
A fracture, also referred to as a bone fracture, is a

WHAT medical condition when the continuity of the bone is
is it? broken due to a high force impact or stress, or because
of a medical condition which weakens the bones.
39. First Aid Management of Fractures Using Arm Slings and Roller Bandages
Types of Fractures:
 Closed - Bone is broken with skin intact
 Open - Broken bone is protruding (sticking out) through skin
or there is a wound leading up to the break
 Complicated - Both open and closed fractures may be complicated
when there is an associated injury to a major nerve, blood vessel,
or vital organ(s)
Caused by:
 Direct force at site of impact; for example, hit by falling
object/cricket ball
 Indirect forces, for example, fall landing on feet and as a result
REMEMBER
break a spinal bone

 Abnormal muscle contractions, which may result from a seizure or
sporting injury, such as a sudden change of direction
Know
Signs and Symptoms:

 Pain/tenderness at or near site of injury - especially if moved
 Swelling or bruising
 Loss of function
 Deformity - it looks wrong
 Shortening of a limb such as in the event of a fractured upper leg
 Crepitus - sound as bone ends “grate” against each other (do not
try to see if it happens)
 Broken bone penetrating skin
Complications:
 Open fracture – gently and loosely cover to help prevent
contamination
 Severe blood loss from large bone fracture
 Nerve, organ, and muscle damage
Page 68 of 130 V3.6

1. DO NOT pull on fractures.

2. DO NOT give anything to eat or drink.
3. DO NOT force or straighten fractures or joints.
4. Follow DRSABCD Action Plan – Remember care of the
unconscious casualty and control bleeding; then fracture
management.
5. Rest and reassure, ask casualty to remain still.
6. Handle gently, so as not to increase pain or further damage.
7. Immobilise the fracture in the most comfortable position with
broad bandages, padding, splints and/or slings.
Manage
DO
8. Splint, then bandage above and below the fracture site

leaving a five (5) cm gap either side of the break: do not
bandage over the fracture.
9. The casualty may be able to support the fracture themselves.
10. If you must move a broken bone, support both sides of the break.
11. Fracture to the lower leg: carefully remove the shoe and sock
from the injured leg if possible.
12. Check that the bandages are not too tight and watch for signs of
loss of circulation to the limb every fifteen (15) minutes.
13. Monitor the casualty.
14. Medical aid.

Contingency
Page 69 of 130 V3.6

7.19 Dislocations
A dislocation occurs when one or more bones
WHAT are displaced at a joint, this is most often at the
is it? shoulders, elbow, kneecap, and fingers.
40. First Aid Management of Dislocations
Dislocations usually occur following a blow, fall, or other trauma.

Caused by:
 Sudden impact on the joint
 Tearing of ligaments
REMEMBER
Signs and Symptoms:

 Pain at or near the site of injury
 Difficult or impossible to move the joint
Know
 Loss of power
 Deformity or abnormal mobility
 Tenderness
 Swelling
 Discoloration and bruising
Complications:
 Fracture
 Damage to nerves and blood vessels

2. Do not attempt to reduce (put back into position)
3. If injury is to a limb:
o Check blood flow – if absent move limb gently to try and restore
it.
o Call Triple Zero (000) for an ambulance.
Manage
DO
o Apply icepacks if possible, directly over the joint.

o Rest and support the limb with padding and bandages.
4. Shoulder:
o Support arm in position of least discomfort.
5. Wrist:
o Apply a sling in a position of comfort.
 If no bandages, padding, or splints are available improvise with

PLAN “B” clothing, rolled newspaper, or household items.
Contingency
Page 70 of 130 V3.6

7.20 Sprains and Strains

A sprain is a severe wrench or twist of the ligaments
(such as an ankle, wrist or other joint), causing pain
and swelling but not dislocation.
WHAT A strain is a force tending to pull or stretch muscles
is it? or tendons causing damage.
A soft tissue connects, supports, or surrounds other
body structures and organs in the body.
41. First Aid Management of Sprains, Soft Tissue Injuries
Sprains and Strains
A sprain occurs when a joint is forced beyond its normal range,
stretching, or tearing the supporting ligaments. A strain is the result of
over-stretching or tearing of the muscles or tendons.
Many things can cause a sprain - falling, twisting, or impact can force a
joint out of its normal position. This can cause ligaments around the
joint to stretch or tear. Sprains happen most often in the ankle.
Sometimes when people fall and land on their hand, they sprain their
wrist. A sprain to the thumb is common in sports.
Caused by:
 Falls, trips, and slips
REMEMBER
 Falls and landing on arm/hand

 Falls on the side of their foot
 Twisting of a knee
Know
Signs and Symptoms Strains:

 Sudden pain on any attempt to stretch the muscle
 Swelling
 Bruising
 Loss of power
 Tenderness
 Muscle spasm
Signs and Symptoms Sprains:

 Swelling and pain around the joint
 Bruising
 Tenderness
Complications:
 Severe bruising
 Dislocations
Page 71 of 130 V3.6


2. Follow RICE:
o Rest the person and injured part.
o Ice pack (cold compress) – 15 minutes.
o Compression bandage after ice pack – apply firmly and
extend well beyond the injury.
o Elevate the limb.
3. Medical aid if necessary.
Manage
DO
Rules when using Ice Packs:

1. Wrap ice in a damp cloth (a cloth placed in cold water and wrung
out).
2. Hold for 15 minutes on the injury site, then reapply every two (2)
hours for the first 24 hours.
3. For the next 24 hours – 15 minutes on every four (4) hours.
4. Never apply ice directly onto the skin, skin is too thin and may
freeze.
5. Never put ice onto an open wound, such as burns or cuts.
 If no ice is available, use a cloth wrung out in cold water – this will
PLAN “B” need replacing every ten (10) minutes.
Contingency
Page 72 of 130 V3.6

7.21 Burns
Burns are injuries to the skin and underlying

WHAT tissues caused by heat, chemicals, electricity,
is it? and friction.
42. First Aid Management of Burn Injuries

Burns are extremely painful and are a high risk for infection. Burns
result in fluid loss, loss of temperature control and damage to
underlying tissues and nerves. Burns can also affect the respiratory
system and the eyes.
Children: An infant or child’s skin is much thinner and has a smaller
surface area than an adult, therefore the skin will burn quicker and
deeper even at lower temperatures.
Elderly: Can be more at risk due to associated illnesses such as
diabetes, respiratory, or cardiac problems and age-related
degenerative problems.
Types of Burns
Superficial:
 Skin is red and painful, may blister and swell for example sunburn.
REMEMBER
Deep:
 Skin is white, dark red or charred
Know
 No pain where nerve endings have been destroyed

 Usually surrounded by superficial burns
Caused by:
 Heat (thermal)
 Fire
 Radiant heat such as an electric cooker
 Scalds such as hot liquid and steam
 Radiation from the sun
 Chemicals - corrosive substances
 Electricity
 Friction such as a rope burn
Complications:
 Respiratory distress from smoke inhalation
 Respiratory arrest
 Shock
 Cardiac arrest
Page 73 of 130 V3.6


2. Ensure that the scene is safe and no risk to the First Aider.
3. Extinguish burning clothing.
If clothing is on fire: STOP-DROP-ROLL-MANAGE
 Stop the casualty from running around.
 Drop the casualty to the ground and wrap a blanket, rug or coat
around them, wool is best, (do not use synthetic materials as they
could melt).
 Roll the casualty along the ground until flames are smothered.
 Manage burns, cooling for at least twenty (20) minutes.
 Seek urgent medical aid.
General Burn Management
1. Move away from the burn source to a safe environment.
2. Always assess the adequacy of airway and breathing.
3. Cool burn with copious amounts of cool water for up to twenty (20)
minutes on the burnt area only – observe the casualty and ensure
that they do not become too cold.
4. Cover burn after cooling for at least twenty (20) minutes with a
Manage
clean non-stick burns dressing or loosely applied cling wrap. This

DO
will help prevent infection. Note: Cling wrap must only be applied
after twenty (20) minutes of cooling and should be loose.
5. Scald - remove wet clothing from affected area.
6. Rest and reassure the casualty.
7. Urgent medical aid if:
o Burns involving airway, hands, feet, face or genitals.
o Deep burn.
o Superficial burn larger than twenty (20) cent piece on an adult or
ten (10) cent piece on a child.
Note:
o DO NOT Peel off clothing that is stuck to the skin.
o DO NOT Use ice or iced water to cool a burn as further tissue
damage may result.
o DO NOT Apply lotions, ointments, or creams.
o DO NOT Break blisters.
Thermal Burns:
1. Do not remove clothing that is stuck to the skin.
2. Remove jewellery if possible. Burns cause swelling, if a ring is left
on the casualty it can act as a tourniquet and restrict blood flow.
Page 74 of 130 V3.6

Sunburn:
1. Cool the sunburn with cool, running water.
2. Stay out of the sun.
3. Give cool fluids.
4. Medical aid for infants and casualties with blisters.
Chemical Burns:
1. Move casualty from burn source if safe to do, using appropriate
Personal Protective Equipment (PPE).
2. Assess the adequacy of airway and breathing.
3. Remove contaminated clothing and footwear to avoid
contaminating yourself. Do not pick off contaminants that stick to
the skin.
DO Continued
4. Cool burn with copious amounts of cool water for twenty (20)
minutes
Manage
5. Cover burn with a clean non-adherent burns dressing.

If Chemical in the Eye:
1. Tilt casualty’s head back and turn to the affected side.
2. Protect uninjured eye.
3. Gently flush with cool water for twenty (20) minutes.
4. Cover eye with dressing.
5. Urgent medical aid.
Electrical Burns:
1. Follow DRSABCD Action Plan – Complete a risk/hazard
assessment.
2. Check for danger and ensure the power is turned off wherever
possible.
3. Remove casualty from electrical supply. Do not directly touch the
casualty, use dry non-conductive materials such as a broom
handle.
 If running water is not available soak a dressing or cloth in saline or

PLAN “B” water and apply it to the burn, keep as wet and cool as possible.
Replace regularly so that the dressing can absorb the heat.
Contingency
Page 75 of 130 V3.6

7.22 Diabetic Emergencies
Diabetes is a chronic, lifelong medical condition

WHAT which occurs when the pancreas fails to produce
is it? sufficient insulin, or the body develops a
resistance to the action of its own insulin.
43. First Aid Management
Normally our body tightly controls its blood glucose level within a
‘normal’ range.
Having diabetes negatively interferes with this control system, and

people living with diabetes need to manage their own blood glucose
levels by monitoring what they eat, adjusting their insulin or medication
doses, and frequently testing their own blood glucose levels.
Untreated, the absolute or relative lack of insulin will lead to a high

blood glucose level.
When blood glucose levels become too high or too low, people with
Diabetes (and some other people without Diabetes) may become
unwell and need first aid, or even treatment at a medical facility.
REMEMBER
There are two diabetic emergencies:

 Low blood glucose - Hypoglycaemia (hypo)
Know
 High blood glucose - Hyperglycaemia (hyper)
When unsure if the casualty has a high or low blood glucose level,
the safest option is to treat as for hypoglycaemia (low blood
glucose level).
Treatment may lead to a marked improvement if the blood glucose
level is low and is unlikely to do more harm if the blood glucose level is
high.
NOTE:
 People suffering from diabetes often wear a
medic alert chain or bracelet.
 Remember to check for these when dealing
with an unconscious casualty.
Read: ANZCOR Guideline 9.2.9 – First aid Management of a Diabetic

Emergency
Page 76 of 130 V3.6

LOW Blood Glucose

In Diabetes, low blood glucose can be a result of:
 Too much insulin or other blood glucose lowering medication
 Inadequate or delayed carbohydrate intake after their usual insulin or
oral medication dose
 Exercise without adequate carbohydrate intake; possibly delayed for
up to 12 hours or more after exercise
 In the setting of illness
 Excessive alcohol intake
Signs and Symptoms:
The brain requires a continuous supply of glucose to function normally.
When blood glucose levels fall below normal levels symptoms and
signs may include:
 Sweating
 Pallor (pale skin), especially in young children
Continued
 A rapid pulse
 Shaking, trembling or weakness
 Hunger
 Light headedness or dizziness
 Headache
REMEMBER
Know
 Mood or behavioural changes, confusion, inability to concentrate

 Slurred speech
 Being unable to follow instructions
 Unconsciousness
 Seizures
HIGH Blood Glucose
Common causes of hyperglycaemia include:
 Inadequate levels of insulin
 Incorrect doses of Diabetes tablet medications
 Infections
 Excess carbohydrate intake
 Stressful situations
Signs and Symptoms:
 Excessive thirst
 Frequent urination
 Recent weight loss
 Rapid pulse
 Nausea and vomiting
 Abdominal pain
 Rapid breathing
 Blurred vision
Page 77 of 130 V3.6

 Fruity sweet smell of acetone on the breath (similar to paint thinner or

nail polish remover)
 Confusion, a deteriorating level of consciousness, or
unconsciousness
Low Blood Glucose: Conscious Casualty
If the casualty has a Diabetes management plan, then that plan should
be followed:
1. Stop any exercise, rest, and reassure
2. If the casualty can follow simple commands and swallow safely, we
recommend that first aid providers administer 4 - 5 x 4 grams
glucose tablets (15-20 grams).
3. If glucose tablets are not available, administer:
 Confectionary including:
o Jellybeans (5-20 beans depending on the brand)
o Skittles® (20-25 candies)
o Mentos® (5-10 mints)
 Sugary drinks or sugar-sweetened beverages (approx. 200 ml), but

DO NOT administer ‘diet’ or ‘low-cal’ or ‘zero’ or ‘sugar free’
beverages
 Fruit juices (approx. 200 ml)
 Honey or sugar (3 teaspoons)
Manage
DO
 Glucose gels (15 g of glucose gel)
4. Monitor the casualty for improvement – resolution of symptoms

would be expected within 15 minutes.
If symptoms or signs of hypoglycaemia persist after 10-15 minutes, and
the casualty is still able to follow simple commands and swallow safely,
administer a further 4 x 4 grams glucose tablets (16 grams) or
alternatives as listed above.
Once recovered, give a snack with longer acting carbohydrate, for
example:
 1 slice of bread OR 1 glass of milk OR 1 piece of fruit OR 2-3 pieces
of dried fruit OR 1 snack size tub of yoghurt (not diet or ‘sugar free’
yogurt). If it is a usual mealtime, then eat that meal.
 If the casualty deteriorates, does not improve with treatment, is
seizing or is unconscious, call Triple Zero (000) for an ambulance.
Low Blood Glucose: Unconscious Casualty
2. If the casualty is unconscious and not breathing normally,
commence cardiopulmonary resuscitation (CPR).
3. If the casualty is unconscious but breathing, place them on their
side in the Recovery Position and ensure their airway is clear.
Page 78 of 130 V3.6

High Blood Glucose: Conscious Casualty

If a person with Diabetes has a Diabetes management plan, then that
plan should be followed.
If the casualty has no management plan and has symptoms or signs of

DO Continued
hyperglycaemia, they should be assessed by a health care

professional.
Manage
High Blood Glucose: Unconscious Casualty

2. If the casualty is unconscious and not breathing normally,
commence cardiopulmonary resuscitation (CPR).
3. If the casualty is unconscious but breathing, place them on their
side in the Recovery Position and ensure their airway is clear.

 Follow ARC (ANZCOR) Guideline 9.1.1 – First Aid for Management
Contingency
of a Diabetic Emergency.
Page 79 of 130 V3.6

7.23 Drowning
WHAT Drowning is respiratory impairment from

is it? submersion/immersion in liquid.
44. First Aid Management in Case of Drowning
When drowning, a person gasping for air while trying to stay afloat may
inhale only a small amount of water. The casualty usually has little
water in their lungs because the muscles of the larynx close the airway
to stop water entering.
The spasm which prevents water going in also stops air, a mucous
plug forms and as a result the casualty suffocates and becomes
unconscious. In minor incidents, removal from the water is often
followed by coughing and spontaneous resumption of breathing.
Caused by:
 Immersion of the face in water/liquid
 Inability to swim
 Panic in the water
REMEMBER
 Leaving children unattended near bodies of water

 Falling through thin ice
 Alcohol consumption while swimming or on a boat
Know
 Concussion or seizure while in water

 Suicide attempt
Signs and Symptoms:

 Blue tinge to face and lips
 Cold, pale skin
 Not breathing or breathing difficulties
 Shallow, rasping breathing (harsh vibrating noise when breathing)
 Vomiting, especially during recovery
 Confusion
 Unconscious
 Be aware of spinal injury, but airway takes priority
Complications:
 Unconscious
 Life threatening outcome
 Breathing and airway problems up to twenty-four (24) hours after
drowning
Page 80 of 130 V3.6


2. Remove the casualty from the water as soon as possible but
do not endanger your own safety.
3. Assess airway and breathing with the head and body at the
same level rather than head down position.
4. Place the casualty on their side into the recovery position if
the airway is obstructed, then clear and open the airway.
Manage
5. If unconscious and breathing normally place on their side into the

DO
Recovery Position.
6. If unconscious and not breathing normally commence CPR
(compression only CPR is not recommended).
7. Apply AED and follow prompts.
8. Monitor the casualty closely.
9. Ensure the casualty goes to hospital even if they recover, as
airway and breathing difficulties can develop or redevelop up to
twenty-four (24) post drowning.

 Remove their wet clothing lay them flat and warm them up
gradually
Contingency
 Learn how to swim and how to provide first aid.
 Follow ARC (ANZCOR) Guideline 9.3.2 – Resuscitation of the
Drowning Victim.
Page 81 of 130 V3.6

7.24 Environmental Impacts:

Hypothermia, Hyperthermia
Hypothermia is the condition of having an
abnormally low body temperature. Hyperthermia
(Heat Induced Illness) is the condition when the
WHAT body temperature is greatly elevated.
is it? Dehydration is a condition that occurs when the
loss of body fluids, mostly water, exceeds the
amount that is taken in.
The body works efficiently only as long as it remains at a constant

temperature. If the body’s temperature drops more than a few degrees
below the normal of approximately 37ºC, or rises significantly, it cannot
function properly.
Hypothermia (Cold Induced Illness)
Hypothermia is the body’s reaction to cold to try and conserve body
heat. It does this by shutting down blood vessels in the skin to prevent
the body’s core body heat escaping and this action affects the fingers
and toes first.
Hypothermia occurs when the body’s warming mechanisms fail or is
overwhelmed, and the body temperature drops below 35ºC.
REMEMBER
If not recognised in the early stages, it has the potential to develop into
a serious condition.
Know
Caused by:
 Body temperature drops below 35°C.
Signs and Symptoms:

 Feeling cold, shivering
 Clumsiness and slurred speech
 Apathy and irrational behaviour
When body temperature drops:

 Shivering usually ceases
 Pulse may be difficult to find
 Heart rate may slow
 Level of consciousness continues to decline
Around 30°C body temperature:

 Unconsciousness is likely
 Heart rhythm is likely to change
Page 82 of 130 V3.6

Hyperthermia (Heat Induced Illness)

Mild elevation in body temperature is normally controlled with
sweating, which allows cooling by evaporation. Once the individual
becomes too dehydrated to sweat, body temperature can rise rapidly
and dramatically. Factors which may contribute to heat induced illness
include:
 Excessive physical exertion
 Hot climatic conditions with high humidity
 Inadequate fluid intake
 Infection
 Persons who are overweight or obese
 Unsuitable environments, for example unventilated hot buildings,
parked motor vehicles
 Wearing unsuitably heavy, dark clothing on hot day
 Drugs which affect heat regulation
Continued
The very young and very old are more prone to heat induced illness.
For workers in outdoor or potentially hot environments, there are
occupational health guidelines relevant to the particular environment.
Work environments that may be particularly prone to precipitating
hyperthermia and heat induced illness include those in which there is a
REMEMBER
Know
high ambient temperature with reduced air movement, where the

worker is exposed to radiant heat and there is difficulty in maintaining
adequate hydration.
Caused by:
 Excessive heat absorption from a hot environment
 Excessive heat production from metabolic activity
 Failure of the body’s cooling mechanisms
 An alteration in the body’s set temperature
Signs and Symptoms:

Heat induced illness presents with a spectrum of severity. The person
may show the signs of exertion (feeling hot, sweaty and breathless) but
also have some of these indicators/red flags:
 Inability to continue the activity
 Feeling hot - high body temperature
 Dizziness and faintness
 Nausea and/or vomiting or diarrhoea
 Dry skin
 Pale skin and other signs of shock - Australian and New Zealand
Committee on Resuscitation ARC (ANZCOR Guideline 9.2.3)
 Poor muscle control or weakness
 Decreasing levels of consciousness, confusion or seizures
Page 83 of 130 V3.6

IMPORTANT: The lack of sweating is a sign of serious illness, but only

seen in a proportion of the more serious cases.
Prevention:
At no time should children, the disabled or the elderly be left
unattended in parked motor vehicles. On warm, humid, or hot days:
 Keep infants and the elderly in cool, ventilated areas and provide
ample oral fluids
Continued
 Wear light coloured, loose-fitting clothing during physical exertion

and hats during outside activities
 Take adequate fluids during exertion on hot days. For students in,
and organisers of sporting events:
o Allow six weeks for acclimatisation with progressive exercise
REMEMBER
Know
before competition
o Avoid vigorous exercise if suffering from an infection
o Plan to conduct events in the early morning or late evening or in
the cooler months of the year
o Provide regular drink stations
o Follow the support guidelines relevant to specific activities
First aiders may need to prepare for the potential for heat induced
illnesses for specific high-risk events, such as events held in high
temperatures. Preparation for such events should include the ability to
measure temperatures and provide first aid management.
Complications:
 Shock
 Cardiac arrest
Page 84 of 130 V3.6

Hypothermia (Cold Induced Condition):

2. Move the casualty to a warm, dry place.
3. Remove their wet clothing
4. Keep the casualty in a horizontal position.
5. Warm the casualty gradually by:
o Placing between blankets, in a sleeping bag, or wrap in a
thermal/emergency rescue blanket or similar and cover the
head to maintain body heat
o Use an emergency foil blanket, or plastic wrap if available
and place as close to the skin as possible, then apply
blankets or other clothing to provide better insulation and
minimise further heat.
o Encourage the casualty to hold the cup to promote warming,
and only take small sips; do not allow the casualty to consume
rapidly or drink large amounts even when at a drinkable
temperature.
o Hot water bottles, heat packs may be applied to the casualty’s
neck, armpits and groin
6. Aim to stabilise core temperature rather than attempt rapid
rewarming:
Manage
o Do not use radiant heat such as fire or electric heater

DO
o Do not rub affected areas

7. Give casualty warm drinks if conscious – NOT alcohol.
8. Seek urgent medical aid and monitor the casualty until medical aid
arrives
Hyperthermia (Heat Induced Illness)
2. The management of heat induced illness is aimed at cooling and
hydration.
Cooling Management
 Lie the person in a cool environment or in the
shade.
 Loosen and remove excessive clothing.
 Call Triple Zero (000) for an ambulance if
casualty is not improving quickly.
While waiting for the ambulance for casualties over 5 years of age:
 Immerse casualty in cold water (a bath, if possible, as cold as
possible) for 15 minutes (whole-body from the neck down). This
is the most effective method of cooling. If this is not available, a
combination of the following methods should be used:
Page 85 of 130 V3.6

o Wet the person with cold or cool water, under a shower if safe,
or with a hose or other water source.
o Apply ice packs (groin, armpits, facial cheeks, palms and feet
soles).
o Repeatedly moisten the skin with a moist cloth or water spray.
o Fan continuously.
While waiting for professional assistance for children 5 years of age

and under a combination of the following methods should be used:
 Cool in a tepid (lukewarm) bath sponging frequently if bath
Continued
available or:
o Repeatedly moisten the skin with a moist cloth or atomizer
spray
o Fan continuously
Hydration Management
REMEMBER
Know
Oral hydration should only be given if fully

conscious and able to swallow.
Give cool or cold water to drink if fully
conscious and able to swallow. For exertional
dehydration, Australian and New Zealand
Committee on Resuscitation (ANZCOR)
suggest a 3-8% carbohydrate electrolyte fluid, for example any
commercially available sports drink.
 When managing heat induced illness, cooling methods will vary

depending on availability and circumstance, for example using
frozen food packs.
A combination of cooling methods may be most effective if
immersion is not available.
PLAN “B”  When managing hypothermia, if no other form of warming the
Contingency casualty is available then use direct body-to-body contact.
 Follow ARC (ANZCOR) Guidelines 9.3.3 Cold Induced Illness
(Hypothermia) and 9.3.4 Heat Induced Illness (Hyperthermia).
Page 86 of 130 V3.6

7.25 Eye Injuries
An eye injury is trauma or damage to the

WHAT eye caused by a direct blow to the eye.
is it? An ear injury trauma or the outer ear, ear
canal or eardrum.
45. First Aid Management of Eye and Ear Injuries

The Eye
The eye is a round shaped organ approximately twenty-four (24)
millimetres in diameter that allows us to see. The eyes are paired
structures, and they move in the same direction at the same time. The
eyes allow us to see three-dimensional images due to its binocular
vision. The eyes are the most sensitive and delicate organs in the
body. They are easily injured and is the organ of vision.
An eye injury always results in pain and watering of the eye, as a result
the white part of the eye (sclera) becomes red, and the casualty may
not be able to open the eye. If the casualty is wearing contact lenses
as they can be removed easily, ask the casualty to remove them before
REMEMBER
you manage the eye injury. The First Aider must not remove the
casualty’s contact lenses themselves. Never remove a contact lens if
the eye is badly damaged.
Know
Injury Caused by:

 Impact with objects, such as fist, ball, stones, or tree branches
 Small foreign objects, such as dirt, slivers of wood/metal or sand
 Chemicals, such as acid, caustic soda, lime
 Flames, flash burns, smoke, or lasers
Signs and Symptoms:

 Pain
 Redness
 Photophobia - abnormal visual intolerance to light
 Watering
 Bleeding
 Pupil distortion, impaired vision
Complications:
 Loss of sight
 Shock
Page 87 of 130 V3.6

Eye - General
2. Wash hands thoroughly, put on gloves then wash the powder from
the gloves.
3. DO NOT touch the eye or any contact lens.
4. DO NOT allow the casualty to rub their eye.
5. DO NOT try to remove any object which is penetrating the eye; and
6. DO NOT apply pressure when bandaging the eye.
7. Wash out the eye gently with a generous stream of water or normal
saline from the corner closest to the nose outwards.
8. If unsuccessful, pad eye and seek medical aid.
Eye - Major
2. Lay casualty flat on their back.
3. DO NOT remove any embedded object.
4. Gently cover injured eye - fix gaze of uninjured eye on distant
point. Never apply direct pressure to the eyeball.
Manage
DO
Penetrating Eye Injury

1. Very carefully place pads around the object or place a paper cup
over the eye and bandage in place. DO NOT place pressure on the
eye.
2. Keep head still with blankets/towels.
3. Reassure casualty, they will be anxious.
Eye – Flash or Radiation Burn
2. Cover eye(s) with a pad.
3. Medical aid.
Eye – Chemical or Heat Burn

2. Open eyelids gently.
3. Flush eye with cool water for twenty (20) minutes, tilt head back
and turn to the affected side, protect the uninjured eye.
4. Pad eye with sterile or clean non-adherent dressing.

Contingency  Learn first aid.
Page 88 of 130 V3.6

7.26 Head, Neck and Spinal Injuries

Head Injuries are any injuries that result
in trauma to the skull, scalp, or brain.
WHAT Neck and Spinal Injuries is damage to
is it? the structures of the neck and spine
including soft tissues, bones, spinal
column, and nerves.
46. First Aid Management of and Spinal Injuries
As the brain is the controlling organ for the body, injuries to the head
are potentially dangerous and always require medical attention.
With a serious head injury, there is always the potential for neck and
spinal injuries. Take extreme care to maintain spinal alignment and
immobilise as soon as possible.
HEAD INJURIES
Caused by:
 Skull fracture from direct force such as a blow to the head or indirect
force such as a fall from a height
 Concussion: altered state of consciousness, from a blow to the
head
 Compression: excess pressure on part of the brain, such as a
REMEMBER
depressed skull fracture

Signs and Symptoms:
Know
 Change in conscious level

 Headache, nausea, vomiting
 Loss of memory
 Altered or abnormal responses to commands or touch, such as
irritability, confusion
 Twitching, noisy breathing
 Wounds to the scalp or face
 Blood or fluid from the ear
 Dizziness
 Blurred vision
Complications:
 Unconsciousness
 Traumatic brain injury
 Memory loss
 Sensory effects, such as loss of taste or smell
Page 89 of 130 V3.6

The spine is made up of thirty-three (33) separate bones, known as

vertebrae, extending from the base of the skull to the coccyx (tailbone).
Each vertebra surrounds and protects the spinal cord (nerve tissue).
Fractures or dislocations to the vertebral bones may result in injury to
the spinal cord.
The direct mechanical injury from the traumatic impact can compress
or sever the nerve tissue. This is followed by secondary injury caused
by ongoing bleeding into the spinal cord, as well as continued swelling
at the injured site and surrounding area.
Spinal injury is very traumatic as it may be permanent, resulting in loss
of function such as paralysis in the legs or arms and if the injury is very
high up the spine, breathing can be affected as no nerve messages are
received below the injury.
NECK AND SPINAL INJURIES
Spinal injuries can occur in the following regions of the spine:

Continued
 the neck (cervical spine)

 the back of the chest (thoracic spine)
 the lower back (lumbar spine)
Caused by:
REMEMBER
Know
 Traffic related accidents

 Workplace related accidents
 Sporting accidents
 Falls, hit by falling objects
 Significant blows to the head
 Severe penetrating wound, such as a gunshot
Signs and Symptoms:

 Head or neck in an abnormal position
 An associated head injury
 Altered conscious state
 Breathing difficulties, nausea, headache, or dizziness
 Change in muscle tone, either flaccid or stiff
 Loss of function in limbs
 Loss of bladder or bowel control
 Priapism (erection in males)
 Tingling, numbness in the limbs and area below the injury
 Weakness or inability to move the limbs (paralysis)
 Altered or absent skin sensation
Complications:
 Shock
 Unconsciousness
Page 90 of 130 V3.6

Head Injuries:
2. Urgent medical aid – even if only momentary loss of consciousness.
Seek medical aid for all head injuries.
If conscious and NO suspected neck or spinal injury:
1. Place casualty with head and shoulders slightly raised.
2. Support head to stop movement, improvise using rolled towels,
blankets, or clothing.
3. If any blood or fluid from the ear, place casualty with injured side
down to allow fluid to drain, place pad between ear and ground.
4. Ensure airway is kept clear and open and monitor the level of
consciousness
5. Manage the wounds on scalp and face but do not apply direct
pressure to the skull.
If unconscious and breathing normally:
DO Continued
1. Place on their side in the Recovery Position.

2. Support casualty’s head and neck in neutral alignment during
Manage
movement to avoid any twisting action.

3. If any blood or fluid from the ear, place injured side down to allow
fluid to drain, place pad between ear and ground.
4. Ensure airway is kept clear and open.
5. Control bleeding, but do not apply direct pressure to the skull.
6. Observe for any changes in signs, symptoms, and level of
consciousness.
Neck and Spinal Injuries – Conscious Casualty:
1. Follow DRSABCD Action Plan - DO NOT move unless in a
dangerous situation such as fire.
2. Rest and reassure and loosen tight clothing.
3. Support and hold head and neck in a neutral position, place
hands on either side of the casualty’s head until other support is
applied.
4. If medical aid only minutes away (urban area), place support such
as an article of clothing, padded rock) on either side of the
casualty’s head to prevent movement of the neck.
5. Keep warm or protect from elements by covering them with a
blanket.
6. Seek urgent medical aid and monitor casualty until medical aid
arrives.
Page 91 of 130 V3.6

Neck and Spinal Injuries – Unconscious Casualty:
DO Continued 1. Follow DRSABCD Action Plan.

2. Place on their side into the Recovery Position, always support head
Manage and neck in the neutral position.
3. Maintain a clear and open airway.
4. Hold head and spine in neutral position to prevent twisting or
bending movement.
5. Seek urgent medical aid and monitor the casualty until medical aid
arrives

PLAN “B”  Follow ARC (ANZCOR) Guidelines 9.1.4 Head Injury and 9.1.6
Contingency Management of Suspected Spinal Injury.
Page 92 of 130 V3.6

7.27 Needle Stick Injuries and Exposure to Blood and

Bodily Fluids
Needle stick injuries are injuries to the body
caused by a sharp object such as a needle.
WHAT Exposure to blood and bodily fluids is direct
is it? contact of the casualty’s blood/bodily fluids to
the First Aiders open wound, eyes, mouth, and
genitals.
47. First Aid Management of Needle njuries and Exposure to Blood and Bodily Fluids
Correct management of exposure to blood, or body fluids contaminated
with blood and needle stick, or 'sharps' injuries will reduce any potential
for infection with:
 Human Immunodeficiency Virus (HIV),
 Hepatitis B Virus (HBV), Hepatitis C Virus (HCV) or
 Other blood-borne infectious agents.
Any item such as blood, body fluid, or 'sharps’ considered as being a

potential source of infection should be safely contained.
The contaminated item should be kept for testing, if required. Blood
contaminated clothing should be removed.
Seek medical attention as soon as possible (within hours) of such
REMEMBER
an exposure is important as some medications and vaccinations work

best if taken soon after exposure.
Caused by:
Know
 A needlestick
 Exposure to bodily fluids
Signs and Symptoms:

 Puncture wound from a used needle or sharps
 Blood or body fluids in contact with broken skin, mouth, eyes
Complications:
 Infection
 Disease
First aiders should be aware of what to do if they have accidental

contact with blood or body substance, a sharps injury or contact with a
person known to have a contagious illness.
Read: Appendix 6 – Precautions for Infection Control from the Code of
Practice: First Aid in the Workplace
and refer to your workplace policies and procedures.
Page 93 of 130 V3.6

Skin:
1. Wash the affected area with soap and water as soon as
possible.
2. Apply an antiseptic and dressing/Band-Aid.
3. Seek medical aid as soon as possible.
Note: Do not squeeze or rub the injured site to induce bleeding.
Eyes:
Manage
DO
1. If contaminated or splashed with blood or body fluids, the eyes

should be irrigated gently but thoroughly with copious amounts of
running water or normal saline. At least five (5) minutes washing is
advised. The eyes must be kept open during this process.
Mouth:
1. Contaminated fluid should be spat out and the mouth rinsed
thoroughly with water several times.

 A health practitioner should also give advice on the possible need
Contingency
and timing of HIV, Hepatitis B or Hepatitis C testing if required.
Page 94 of 130 V3.6

7.28 Poisoning and Toxic Substances

Poisoning is a process of inhalation, ingestion,
absorption, or administration of poisons either
deliberately or accidentally.
A poison is a substance that is harmful to your
WHAT health if ingested, inhaled, or absorbed through
is it? the skin.
A toxic substance is defined as a substance
that causes injury, illness, or death, especially
by a chemical.
48. First Aid Management of Poisoning and Toxic Substances
Poisoning can occur from many sources, such as fire fumes, alcohol,
drugs, common plants, and household items such as bleach and
fertilisers.
Poisoning can be:
 Accidental
 Intentional
Routes of Poisoning – poison can be:

 Inhaled
 Ingested / Swallowed
 Injected
 Absorbed
REMEMBER
Caused by:
 Toxic fumes
 Toxic substances
Know
Signs and Symptoms:

Dependent on the nature of the substance:
 Confusion, drowsiness, delirium, seizures, unconsciousness
 Burns to skin, lips, and throat
 Bite(s) or injection marks
 Irritation to eyes and skin
 Respiratory distress, such as difficulty in breathing
 Effected heart function
 Abdominal pain, nausea/vomiting, diarrhoea
 Blurred vision
 Headache
Complications:
 Burns
 Respiratory distress
 Cardiac arrest
Page 95 of 130 V3.6

St John Ambulance recommends management advice for all

poisonings be obtained from the Poisons Information Centre - call 13
11 26 and follow instructions on the container label.
General
1. Follow DRSABCD Action Plan - remove yourself and the casualty
from any danger if possible.
2. Seek urgent medical aid.
If conscious:
1. Listen to the casualty and give reassurance.
2. Determine the nature of the substance and record.
3. Call Poisons Information 13 11 26 and/or follow instructions on
container.
Ingested / Swallowed
1. DO NOT induce vomiting.
2. DO NOT give anything by mouth.
3. Wash any corrosive substance off the mouth and face with water or
wipe off.
4. Contact Poisons Information Centre by calling 13 11 26.
Manage
DO
Inhaled
1. Immediately get the casualty to fresh air, without placing yourself at
risk.
2. Avoid breathing fumes. Special breathing apparatus may be
required.
3. If it is safe to do so, open doors and windows wide.
Absorbed
1. Flush the affected skin with running water immediately.
2. Remove any contaminated clothing.
3. Take care to avoid contact with the poison.
4. Wash the affected area gently with soap and water.
Injected
1. Avoid needle stick injuries to yourself / casualty.
2. Treat any other signs and symptoms. Send any empty syringes,
bottles, vials and handle all materials carefully using tongs or
gloves with the casualty to hospital.
3. Seek medical aid and treat the signs and symptoms.
 Contact Poisons Information Centre by calling 13 11 26

PLAN “B”  Follow ARC (ANZCOR) Guideline 9.5.1 - Emergency Management of a
Contingency Casualty who has been Poisoned.
Page 96 of 130 V3.6

7.29 Seizures
Epilepsy is a disorder of the brain characterised
by a tendency to have recurrent seizures and is
defined by two or more unprovoked seizures.
WHAT Seizure is a sudden attack of illness such as a
stroke or an epileptic fit.
is it?
Febrile Convulsion is a fit or a seizure that
occurs in children aged six (6) months to six (6)
years when they have a high fever.
49. First Aid Management of Epilepsy, Seizures and Febrile Convulsions
Seizures may vary from the briefest lapses of attention to severe and
prolonged convulsions.
For people at risk of recurring seizures, approximately seventy percent
(70%) can expect seizure control with medication – from Epilepsy
Australia website: http://www.epilepsyaustralia.net/
Febrile convulsions in infants and children may be due to fever,
infection, epilepsy, or other conditions. A rapid rise in body
temperature, to even 1.5ºC above the norm (37ºC) can cause
convulsions.
REMEMBER
Seizure and Epilepsy Management Plans

The plans contain information that can assist the First Aider and
Know
medical aid. Information such as personal details, seizure information,

triggers and management, warning signs, recovery time, medication
being taken, first aid requirements and medical contact.
A seizure plan is extremely important for the person with epilepsy and
others around them, such as childcare workers, medical personal,
employers and colleagues.
Caused by:
 Not all seizures/convulsions are epilepsy. They can be caused by a
lack of oxygen, onset of cardiac arrest, a head injury, low blood
sugar, low blood pressure, high fever, brain tumour, poisoning, drug
overdose, withdrawal from alcohol and other substances of
dependence, stroke, or serious infection.
Page 97 of 130 V3.6

 In Western Australia, at least 20,000 people have active Epilepsy

with at least a further 1,400 new people presenting with a seizure
each year. One in 20 children will have a seizure at some time
during childhood and adolescence and Epilepsy is increasingly
common after the age of fifty (50) years.
Signs and Symptoms:
Continued
 Sudden spasm of muscles producing rigidity. If standing, the casualty

will fall which may result in injury
 Suddenly cry out
 Jerking movements of the head, arms, and legs
 Shallow breathing or breathing may temporarily stop, leading to
REMEMBER
Know
pale, blue tinged lips, and face

 Excessive saliva (frothing) from the mouth, and the tongue may be
bitten leading to excessive bleeding
 Temporary incontinence
 Changes in conscious state from being fully alert to confused,
drowsy, or loss of consciousness
 Changes in behaviour where the casualty may make repetitive
actions like fiddling with their clothes
 Person may be extremely tired, confused or agitated after
Complications:
 Unconsciousness
 Respiratory problems
During Seizure
 DO NOT restrain the casualty or restrict movement.
 DO NOT put anything in the casualty’s mouth.
 DO NOT move the casualty unless they are in danger.
 Protect casualty from environment, by moving furniture, cushion
head and shoulders.
 Ensure that the airway is maintained by turning the casualty on the
side when practical.
Manage
DO
 If in place, follow the casualty’s Seizure Management Plan.

 Record the duration of the seizure, noting the start and finish time
After seizure
1. Follow DRSABCD Action Plan - Recovery Position, ensure that the
airway is clear and open.
2. Rest and reassure.
3. Manage any injuries.
4. Seek medical aid.
5. Do not disturb if casualty falls asleep but continue to monitor
breathing and response.
Page 98 of 130 V3.6


 If medical aid is delayed, monitor the casualty and keep them warm
and give reassurance.
 Familiarise yourself with information on the Epilepsy Foundation
PLAN “B” website: http://www.epinet.org.au .
Contingency  Familiarise yourself with information on the Epilepsy Action Australia
websites: http://www.epilepsy.org.au and
http://www.epilepsyaustralia.net/.
 Follow ARC (ANZCOR) Guideline 9.2.4 - First Aid Management of a
Seizure.
Page 99 of 130 V3.6

Part 8 – Post Incident Requirements

All accidents and injuries sustained in the
workplace must be reported to comply with
WHAT OHS and regulatory requirements.
is it?
Serious injuries must be reported to
WorkSafe and undergo an investigation.
Reporting requirements include:
1. Verbal handover to Emergency Services
2. Verbal incident report to workplace supervisor / line manager
3. Written incident report for the workplace
REMEMBER
Verbal handover to Emergency Services

If you respond to a casualty, and you are first on scene, it will be
necessary to handover care of the casualty to the appropriate authority,
Know
usually, an ambulance crew, doctor, or other medical professional who

is better qualified and equipped to deal with the situation.
A handover enables continuing patient management to both maximise
care and communicate an accurate timeline of the incident.
NOTE: Remember to speak slowly and clearly to convey information
and ensure that the details you provide are factual, concise, and
relevant.
On the arrival of the ambulance:

 Continue first aid management and observation of the casualty until
the ambulance officer is ready to assume care
 Provide as much information as possible, this may include:
o Nature of the accident / injury
Manage
o Time you arrived on the scene

DO
o Casualty signs and symptoms

 First aid management provided
 Casualty name and age
 Provide any other information that is asked for, including your
contact details
 Stay and assist the ambulance officer if requested to do so.
PLAN “B”  If it has been your duty to respond, then, a verbal and/or incident
report form must be completed as soon as possible.
Contingency
Page 100 of 130 V3.6

8.1 Verbal Incident Report

All accidents and injuries that occur in the
workplace must be reported to comply with
WHAT OHS reporting requirements.
is it? This includes providing verbal and written
reports of all incidents.
51. Verbal Report
Verbal incident report
In the event of an emergency in the workplace, you will need to
escalate the incident to management.
In the first instance you should provide a verbal report to your supervisor
or line manager to inform them of the situation.
REMEMBER
Your supervisor will then escalate the incident to senior management

to manage the situation.
Know
Reporting may include using communication equipment such as two-

way radio, mobile phone, or face-to-face if your supervisor is close by.
NOTE: When providing a verbal report to your supervisor, ensure that
the information that you give is factual, concise, relevant, and clear.
Incidents also must be recorded in written form, this may include:
 Hand-written incident report form, or
 Digital report form
You should provide the following information:

1. What happened (events leading up to the incident)?
2. How long ago did it happen / at what time?
Manage
3. Signs and symptoms / nature of injury

DO
4. The first aid management given

5. The condition of the casualty now
6. Has the casualty improved or deteriorated in the First Aider’s care?
7. Casualty’s personal details (if known).
PLAN “B”  Always follow the workplace policies and procedures and comply
with the emergency management plan.
Contingency
Page 101 of 130 V3.6

8.2 Written Report - Incident Report Form

Incident reporting is the process of
documenting all worksite injuries, near
WHAT misses, and accidents. An incident report
is it? should be completed at the time an incident
occurs no matter how minor an injury is.
52. Written Report – Incident Report Form
Written Incident Report
It is important that the First Aider fully documents all

incidents when responding to an incident.
All documentation should adhere to the following:
 Be accurate and legible
 Be completed as soon as practicable
 Be written in ink and never erased
REMEMBER
 If a mistake has been made, cross it out with a single line so that the
original writing can still be read
Know
 Sign and date the correction and then add the correct record
 DO NOT use correction fluids
When completing documentation ensure that:
 Facts are recorded as stated by the casualty/employee
 Opinions or hearsay are not recorded and documented
 First aid provision and any medications administered are correctly
documented
NOTE:
An incident report form should contain all the information required to
satisfy statutory requirements. If possible, ensure that records
concerning accidents are validated and signed by the casualty involved.
1. Fully complete a written / digital report form report as per workplace

policies and procedures
Manage
2. Complete report within specified reporting times

DO
3. Adhere to OHS and legal requirements

4. Fatalities, serious injuries or health and safety incidents are
notifiable incidents and are to be reported to WorkSafe.
 You are only required to notify your regulator of the most serious
PLAN “B” safety incidents, and this will trigger requirements to preserve the
Contingency incident site pending further direction from your regulator.
Page 102 of 130 V3.6

8.3 Post Incident Debrief and Evaluation

Debrief is a process of obtaining
information from a person after an
WHAT incident.
is it? Evaluation is a process of making
judgement about the value of first aid
provided.
53. Post Incident Debrief and Evaluation
A major incident can be a very traumatic experience for the First
Aider, witnesses and those not directly involved.
Following an incident, it is important that a debriefing session is
held, followed up by an evaluation of the outcomes of that incident.
Everyone will react differently after an incident. Reactions will vary
according to the individual and the incident.
A post incident debrief is an important part of the incident
management process.
The purpose of the post incident debrief is:
 Primarily to look after the individuals involved in the incident
REMEMBER
and their welfare, giving them the opportunity to discuss the

emotions that they might have about the incident.
 Bring the incident to a close.
Know
 Allows the provision of support to the First Aider.

 To provide information to prevent a similar incident from
occurring in the future.
 Identification of any shortfalls in the emergency action plan.
The debrief may involve:

 Gathering and documenting all relevant details regarding the
incident and effectiveness of incident management process and
first aid given
 Document any information relayed by the individuals involved
 Providing advice on further assistance available; for example,
counselling.
NOTE: Remember not to lose sight of those who were involved in
the incident, including yourself; and bear in mind the need for
professional services.
Page 103 of 130 V3.6

Post Incident Debrief and Evaluation - Continued

All those involved in the incident should be present at the debriefing
session and be encouraged to discuss the process and outcomes. It is
equally important to ensure that following the debriefing session(s),
appropriate referrals are made to counsellors, mediators, or the
Continued
industry chaplain.
The role of the First Aider not only encompasses the employee’s
physical health requirements but should also include concerns for their
own psychological wellbeing.
REMEMBER
Evaluating an incident
Know
Evaluation can form part of the formal and informal debriefing process.
All ‘incidents’ need to be investigated to identify

what happened with a view to preventing them
from happening again.
Determining the facts of the incident will assist
in identifying control measures that can be put
in place to prevent further re-occurrences.
Workplaces will have procedures in place for example: First Aid Action
Plan, Emergency Action Plan and Risk Management Plan. These plans
should be evaluated for their effectiveness on an ongoing basis.
All plans should be compliant with:
 Established first aid principles
Manage
DO
 Australian Resuscitation Council (ARC) Guidelines

 Australian National Peak Bodies
 Industry standards and Guidelines
 State/Territory legislation and regulations
 Relevant Codes of Practice
 Organisational / workplace policies and procedures
PLAN “B” NOTE: At the time you did the best you could do.
Contingency
Page 104 of 130 V3.6

8.4 Stress Management

Stress is our way to respond to pressure, a
feeling we have when we think we are in a
WHAT situation we cannot manage. Stress
is it? management is a technique or numerous
techniques which control our level of stress for
the purpose of improving it.
54. Stress Management
Providing care in a high-pressure emergency, can be draining and
cause stress especially when children are involved. Even experienced
First Aiders or personnel attending an emergency can experience
unpleasant effects.
People react differently and may display a variety of responses to an
emergency situation, often not until after the event or sometime later.
Some people handle stresses by talking, some people withdraw, while
others prefer to physically work it off. Reactions of colleagues,
bystanders and so on; will vary according to the individual and the
nature of the incident. A post incident debrief is an important part of the
incident management process.
Signs and symptoms of stress:
 Feelings of guilt, fear, shame
REMEMBER
 Insomnia and sleep problems

 Headaches
 Ulcers
Know
 Anxiety / Depression
 Digestive problems
 Eating disorders
 Difficulty concentrating / making decisions
Stress Management may include:

 Debriefing post incident for the purposes of individual welfare
 Access to professional services such as: counsellors, doctor, a help
line, or the clergy
 Meditation / Exercise
 Changes to lifestyle
 Healthy diet
 Peer Support
 First Aid for Mental Health training
 Debriefing post incident for the purposes of individual welfare
 Evaluation post incident to identify shortfalls in the Emergency Action
Plan
Page 105 of 130 V3.6

Sources of Support
There are a number of sources of support that be accessed. These
include:
 Employee Assistance Program (EAP)
 Access to professional services such as: counsellors, Doctor (GP)
 Organisations such as Lifeline and Beyond Blue
 Family, friends, and colleagues
Self-Care
REMEMBER Continued
Know
 Self-care includes maintaining a healthy diet, eating regular meals,

getting enough sleep, and exercising. Avoid the use of alcohol and
other drugs to either relax or keep going.
 Any organisation you work for should have clear policies and
procedures in place that ensure a safe, risk-free environment. It is the
responsibility of both the employer and employees to ensure all
members of staff work together to create a workplace environment
that is pro-active and strives to recognise potential causes of stress so
immediate action can be taken to reduce or eliminate stress and harm.
How this is organised will depend on the individual organisation and the
strategies that they have in place. Not all cases will require an individual
to receive professional assistance and an initial debrief may be
sufficient.
1. Familiarise yourself with the stress related issues.

Manage
DO
2. Seek assistance.
3. Look after your health and wellbeing.
Additional Support:
PLAN “B”  Australian Psychological Society: https://www.psychology.org.au
 Beyond Blue: https://www.beyondblue.org.au/home
Contingency
Page 106 of 130 V3.6

Part 9 – Basic Anatomy and Physiology

Relating to the Chest
Anatomy is part of biology that study the
structure of organs and their parts. Physiology
WHAT is the scientific study of the normal functioning in
is it? a living system. The Chest (or thorax) is part of
anatomy of humans (and some animals) located
between the neck and abdomen.
55. Basic Anatomy and Physiology Relating to the Chest
The chest or thorax extends from the neck to the diaphragm. The chest
is made of the thoracic cavity and the thoracic wall (rib cage).
 The rib cage (twelve (12) pairs of ribs) protects major organs such as
heart, lungs, and liver. It consists of sternum, ribs, and thoracic
vertebrae. The chest contains the following main organs: the heart;
lungs; thymus gland and muscles.
 The body needs a constant supply of oxygen to function. The act of
breathing not only supplies this oxygen to the body but also expels
waste gases such as carbon dioxide from the body. Respiratory
REMEMBER
distress syndrome is a potentially life-threatening medical condition

where the lungs cannot provide enough oxygen for the rest of the
body.
Know
 A child’s airway is narrower than an adult and is more prone to

blockage by blood or secretions during Cardiopulmonary
Resuscitation (CPR). Children prefer to breathe through their nose so
a nasal obstruction can cause respiratory distress. A child’s primary
response to respiratory distress is to increase the rate and effort of
breathing.
 An infant’s airway is smaller than an adult’s is and more prone to
blockage. Their trachea is shorter, softer so over extension of the
head and neck when opening the airway will compress it. When
opening the airway, an infant’s head should be kept in neutral
alignment, with First Aider’s hands supporting either side of infant’s
head.
Manage
1. Research basic anatomy and physiology topics.

DO
2. Apply your knowledge when providing first aid.
PLAN “B”  Consult a medical practitioner.

Contingency
Page 107 of 130 V3.6

9.1 The Heart
The heart is a muscular organ in humans and

WHAT animals which pumps blood through the blood
is it? vessels and the circulatory system.
56. The Heart

The heart is in the chest cavity just behind and slightly to the left of the
REMEMBER
sternum (breastbone).
The heart is a muscular organ around the size of an adult’s clenched
fist. It is a two-sided pump that contracts and relaxes to pump blood into
Know
the circulatory system.

The circulatory system enables blood to circulate throughout the body,
transporting oxygen and nutrients to cells and removing waste products
from the body.
Manage

DO

Contingency
Page 108 of 130 V3.6

9.2 The Lungs
WHAT The lungs are essential respiratory organs in

is it? humans and most breathing animals.
57. The Lungs
The lungs are located on either side of the heart. The lungs are part of
REMEMBER
the respiratory system which supplies a constant supply of oxygen to the

body.
When a person inhales oxygen is taken from the mouth or nose, down
Know
the trachea and into two tubes (bronchi) that then branches into smaller
tubes (bronchioles) which end in air sacs (alveoli) within the lungs.
From the lungs, oxygen crosses into the blood to be transported to all
parts of the body.
Manage

DO

Contingency
Page 109 of 130 V3.6

9.3 Breathing
Breathing is the process that moves air in and

out of the lungs or oxygen through other
WHAT respiratory organs. Breathing is also called
is it? ventilation which includes both inhalation and
exhalation.
58. Breathing
The body needs a constant supply of oxygen to function. The act of
breathing not only supplies this oxygen to the body but also expels
waste gases such as carbon dioxide from the body.
The diaphragm and intercostal muscles expand the chest to draw air
into the lungs. The air then crosses to the blood for transportation to the
body. As the diaphragm and intercostal muscles relax, air is forced out
of the lungs.
Normal breathing is essential to maintaining life. Persons who are
gasping or breathing abnormally and are unconscious require
resuscitation.
Breathing can be categorised as:
REMEMBER
1. Effective
2. Ineffective breathing
Breathing may be absent or ineffective as a result of:
Know
1. Direct depression of/or damage to the breathing control centre of the

brain
2. Upper airway obstruction
3. Paralysis or impairment of the nerves and/or muscles concerned with
breathing
4. Problems affecting the lungs
5. Drowning
6. Suffocation
There is a high incidence of abnormal gasping (agonal gasps) after
cardiac arrest.
The First Aider should:
1. Look for movement of the upper abdomen or lower chest
2. Listen for the escape of air from nose and mouth
3. Feel for movement of air at the mouth and nose
Page 110 of 130 V3.6

Movement of the lower chest and upper abdomen does not necessarily
mean the casualty has a clear airway and is breathing. Impairment or
complete absence of breathing may develop before consciousness is
lost by the casualty.
Absence of normal breathing
Respiratory distress syndrome is a potentially life-threatening medical
condition where the lungs cannot provide enough oxygen for the rest of
the body. There are many causes /conditions that come under the
umbrella of respiratory distress, for example, asthma, airway
REMEMBER Continued
obstruction, hyperventilation, croup, and epiglottitis. It manifests as a

difficulty in breathing and the psychological experience associated with
such difficulty.
Signs and symptoms may include, rapid shallow breathing, sharp pulling
in the chest below and between the ribs with each breath, grunting
Know
sounds, flaring of the nostrils, increased sweat on the forehead with skin
feeling cool and clammy and wheezing when breathing.
Anatomic and physiological differences between adults and
children (airway)
A child’s airway is narrower than an adult and is more prone to blockage
by blood or secretions. Children prefer to breathe through their nose so
a nasal obstruction can cause respiratory distress. A child’s primary
response to respiratory distress is to increase the rate and effort of
breathing.
In infants the trachea is shorter, softer and more pliable and may be
distorted by excessive backward head tilt (overextension); so when
opening the airway, an infant’s head should be kept in a neutral
alignment, with First Aider’s hands supporting either side of infant’s
head.
1. Look for movement of the upper abdomen or lower chest.

2. Listen for the escape of air from nose and mouth.
Manage
DO
3. Feel for movement of air at the mouth and nose.

4. Familiarise yourself with ARC (ANZCOR) Guideline No. 5 -
Breathing.

PLAN “B”  Provide CPR.
Page 111 of 130 V3.6

9.4 Response and Consciousness
Conscious is the state of awareness by being

WHAT aware of surroundings, also known as
is it? consciousness.
59. Consciousness and Response

Unconsciousness is a state of unarousable or unconsciousness, where
the casualty is unaware of their surroundings and no purposeful
response can be obtained.
The causes of unconsciousness can be classified into four broad
groups:
 Low brain oxygen levels
 Heart and circulation problems (for example fainting, abnormal heart
rhythms)
 Metabolic problems (for example overdose, intoxication, low blood
sugar)
REMEMER
 Brain problems (for example head injury, stroke, tumour, epilepsy)
Combinations of different causes may be present in an unconscious

Know
casualty: for example, a head injury casualty under the influence of

alcohol.
Before loss of consciousness, the casualty may experience yawning,
dizziness, sweating, change from normal skin colour, blurred or changed
vision, or nausea.
Assess the collapsed casualty’s response to verbal and tactile stimuli
(‘talk and touch’), ensuring that this does not cause or aggravate any
injury. This may include giving a simple command such as, “open your
eyes; squeeze my hand; let it go”. Then grasp and squeeze the
shoulders firmly to elicit a response.
A casualty who fails to respond or shows only a minor response such as
groaning without eye opening, should be managed as if unconscious.

Manage
2. Familiarise yourself with ARC (ANZCOR) Guideline No. 3 –

DO
Recognition and First Aid Management of the Unconscious

Casualty.

Contingency
Page 112 of 130 V3.6

Quick Guides
1. DRSABCD Action Plan

2. Perform Cardiopulmonary Resuscitation (CPR) – Child and Adult
3. Perform Cardiopulmonary Resuscitation (CPR) – Infant
4. Perform Cardiopulmonary Resuscitation (CPR) with an AED
5. Recovery Position
Page 113 of 130 V3.6

1. DRSABCD Action Plan

“WHAT?” “HOW?” “WHY?” SHOW ME
DANGER For safety to:

1. Check for  YOU (if not safe you can
danger by: get injured and become a
 Observing casualty).
 Listening  OTHERS (if not safe more
 Using your casualties).
sense of  CASUALTY (if not safe the
smell condition can worsen).
2. Danger
from:
D 

Hazards and
obstacles
Traffic
 Fuel
 Electrical
wires
 Poisonous
gas fumes
 Fire
IF SAFE
PROCEED
RESPONS
E
R
 Determining if the casualty
1. Ask for
is CONSCIOUS.
NAME.
2. SQUEEZE
shoulders.
SEND FOR  You may not know the
extent of the injuries
HELP medical help extends the
1. Call Triple
chances of survival.
Zero (000) for
an
S ambulance.
o If
available
, ask a
bystande
r, give
them
Page 114 of 130 V3.6

clear
instructio
ns and
tell them
to call
000 and
ask for
an
ambulan
ce
o If alone,
call 000
from your
mobile
phone on
speaker
so that
you have
your
hands
free to
provide
aid to the
casualty
2. If on your
own place
casualty on
their side in
RECOVERY
position
before
making a call.
3. Or ask
bystander to
make the call.
Page 115 of 130 V3.6

DRSABCD Action Plan continued

AIRWAY  To find obstructions to

1. Open mouth breathing.
by gently  In order to survive, casualty
pulling chin must breathe.
down.
2. Check mouth
for foreign
materials.
3. If YES -
place in
RECOVERY
position.
4. Clear foreign
material with
fingers.
A
5. If NO –
Leave
person in the
position in
which they
have been
found.
6. Open
cleared,
open airway
by tilting
head and
lifting chin
(Adults and
Children).
Infants’
neutral
alignment.
BREATHIN  Without breathing brain will
not get oxygen.
G
Look.
B

 Listen.
 Feel.
Do this for ten

(10) seconds
only!
Page 116 of 130 V3.6

 Place in
RECOVERY
position if
breathing
normally
CPR 30:2  To pump oxygen to brain

1. Start with  To increase chance of
thirty (30) survival
C
compression
s and two (2)
breaths
2. Continue
until help
arrives
DEFIBRILL  To re-start heart
 To establish normal heart
ATION rhythm
1. Open
defibrillator
case and
turn device
ON
D
2. Automatic
prompts will
instruct you
what to do
3. Place pads
in correct
position
4. You will be
instructed
when to give
shocks
Page 117 of 130 V3.6

2. Perform Cardiopulmonary Resuscitation

(CPR) – Child and Adult
1.  Follow
Action DRSA from
Plan  To preserve life.
DRSABCD
Action Plan.
2.  Thirty (30)  To provide oxygen to the

Breaths chest brain.
compression  So the chest rising is
s two (2) visible.
Mouth to breaths.
Mouth  Tilt the head
Breaths back; lift the
chin (adult),
child - slight,
infant –
neutral.
 Blow for one
(1) second
into
casualty’s
mouth until
you see the
chest rise.
 Take a clear
breath of
fresh air.
 Blow a 2nd
breath for
one (1)
second, the
First Aider is
to turn their
head and
watch for the
chest to
begin to fall.
Page 118 of 130 V3.6

It may be used  If casualty is severely

when: injured in head area.
 Jaw and/or  To provide oxygen to the
teeth are brain.
broken.  So the chest rising is
Mouth to  Jaw is tightly visible.
Nose clenched.
 Deep water
resuscitation
.
 Resuscitatin
g an infant
or child.
Mouth to Mask  Appropriate if the casualty
(Avoids mouth-to- has blood in their mouth, a
mouth contact):
facial injury, is inebriated or
 Note:
Mouth to has vomited.
Resuscitatio
 So the chest rising is
Mask n should not
visible.
be delayed
by attempts
to obtain a
mask.
Page 119 of 130 V3.6

Perform Cardiopulmonary Resuscitation (CPR) –

Child and Adult Continued
STEP 1
 Place the casualty on
their back and kneel
beside them.
STEP 2
 Place heel of one hand
on the lower half of the
sternum (breastbone) in
the centre of the chest.
STEP 3
 Position your other hand
on top of the first hand
Chest Compressions
and interlock your

fingers.  To pump
oxygen to the
STEP 4 brain.
3.
 Position yourself above  For the best

the casualty’s chest. outcome.
STEP 5
 Give thirty (30) chest
compressions at a rate
of about two (2)
compressions a second
(100 -120 per minute).
 Press straight down on
their chest using your
body weight.
 Adult: Heels of two (2)
hands.
 Child 1-8: Heels of one
(1) or two (2) hands.
 30:2  As per ARC
Ratio
(ANZCOR)
4.
Guidelines.
Page 120 of 130 V3.6

3. Perform Cardiopulmonary Resuscitation

(CPR) - Infant
1.  Follow
Action DRSA from
Plan  To preserve life.
DRSABCD
Action Plan.
2.  Place on the
Breaths back on firm
surface.
 Keep head
in neutral
alignment.
 Perform
breaths as
per child and
adult CPR.
3.  Due to delicate anatomy of
Compress  Two (2)
an infant.
ions fingers
 Soft bones.
(index and
middle).
4.  Two (2)  Due to delicate anatomy of

Hand fingers. an infant.
position  Lower half of  Soft bones.
breastbone
in the centre
of the chest.
5.  30:2 (100 -
Ratio 120 per  As per ARC Guidelines.
minute)
Page 121 of 130 V3.6

4. Perform CPR with an AED - Adult and Child

Over 1 Year
1.  To preserve life.
Action Plan  Follow DRSA from
DRSABCD Action Plan.
2.  Look for the rise and fall  Greater chances

Breathing of the upper abdomen of survival if
and chest - Normal? breathing.
 Listen for the escape of
air from nose and
mouth - Normal?
 Feel for movement of
air at the mouth and
nose - Normal?
3.  Casualty is  Not breathing –
CPR Unresponsive and Not the brain is not
Breathing Normally - receiving oxygen
Commence CPR. (without oxygen
 Give thirty (30) chest brain damage /
compressions at a rate death).
of about two (2)
compressions a second
(100 - 120 per minute)
given on the lower half
of the breastbone in the
centre of the chest,
followed by two (2)
breaths each lasting for
one (1) second.
4.  If the casualty is  Removal of
Defibrillation wearing a bra, remove clothing - to
it before applying the attach pads
defibrillator pads. properly so an
 Remove any AED can read the
medication patches. heart rate and
 Check for any rhythm.
pacemaker/defibrillation  Defibrillation to
implanted devices (scar restart normal
will be between the
Page 122 of 130 V3.6

collar bone and the top heart rate and

of the breast – either rhythm.
left or right). Pads
should be placed at
least 8cm from these
devices.
Apply pads to the
casualty’s bare chest:
Adults and children over

eight (8) years:
 1st pad to right chest

wall, below the
collarbone
 2nd pad to left chest
wall, below the left
nipple
Children under 8 years:
 Ideally a defibrillator
with paediatric mode or
paediatric pads should
be used
 Pads should be placed
one pad in the centre of
the chest between the
nipples and the second
pad on the back
between the shoulder
blades
 If only an AED without
paediatric mode or
pads is available, then it
may be used. Adult
pads are positioned as
per the adult
placement.
 Ensure the pads do not
touch each other on the
child’s chest. If the
pads are too large
place as per paediatric
(front and back)
 Ensure both pads
adhere to the skin
Page 123 of 130 V3.6

5.  Follow voice prompts o To commence

Stop CPR  If no shock advised, defibrillation using
continue with CPR an AED device.
when prompted.
If shock advised:
 Ensure that it is safe to
defibrillate.
 Ensure that no one is
touching the casualty
 When advised by the
defibrillator press the
“shock” button; and
follow prompts.
6.  Continue CPR until the  To re-establish
If no casualty regains the heart rhythm.
Response consciousness or it is  To monitor the
clear that there are heart rhythm.
signs of life, or medical
aid takes over.
 Do not remove
defibrillator pads even if
the casualty is
responsive.
 If the casualty starts
breathing, regains
responsiveness then
place on their side into
the Recovery Position
and closely monitor the
casualty’s airway and
breathing.
 Be prepared for the
casualty to rearrest.
Cardiopulmonary For unresponsive/unconscious and not breathing normally casualties with

Resuscitation in severe hypothermia, ANZCOR Guideline 9.3.3 suggests:
Hypothermia
 Where it is not possible to start CPR (for example if initially moving the
person to a safer location), rescuers may consider delaying the onset
of CPR for up to 10 minutes.
 Only where it is not possible to maintain the continuity of CPR (for
example during transport), performing periods of at least 5 minutes of
CPR with periods of no more than 5 minutes without CPR.
Uninterrupted CPR should be resumed as soon as feasible.
Page 124 of 130 V3.6

6.Recovery Position
“WHAT?
“HOW?” “WHY?” SHOW ME
”
1. o Kneel beside the casualty. o Ensuring unconscious
Position o Position the casualty’s casualty airway
Arms furthest arm out at a right remains clear and
angle to the body. open.
o Place the other arm across o Any vomit and fluid will
the chest with fingers not cause them to
pointing to the shoulder. choke.
o Support the arm with your o To stop the arm falling
knee/leg. back to the floor.
2. o Lift the nearest leg at the o For easier lifting.
Position knee; ensure that it is fully
Legs bent upwards.
3. o Place your hand on the o Ensuring unconscious

Prepare casualty’s knee. casualty airway
to Roll o Support the head and neck; remains clear and
place your palm along the open.
neck and support the back of o Any vomit and fluid will
the head with your fingers. not cause them to
o Position your forearm under choke.
the casualty’s shoulder
blade.
4. o Roll casualty away from you o Safe way to move
Roll minimising head and neck casualty.
movement, until their knee is
on the ground.
5. o Slide casualty’s hand, palm o Airway remains clear

Recovery down under the side of their and open.
Position face, without moving their
head.
o Ensure that the casualty’s
airway is clear and open.
Page 125 of 130 V3.6

Relevant Forms and Documents

Examples
1. Incident Report Form (Incident, Injury, Trauma and Illness Record Form)
2. Reference Guide to Envenomation
Page 126 of 130 V3.6

1. Incident, Injury, Trauma and Illness Record Form
Incident, Injury, Trauma and Illness Record Form

Incident Details
Location:
Date of
Casualty Name:
Birth:
Gender ☐ Male ☐ Female ☐ Other ☐ Prefer not to say
Address: Age:
Time of
Date of Incident:
Incident:
Witnesses:
Description of Incident (what happened, how it happened, factors leading up to the event)
General Observations:
Body Part: put an ‘X’ on injured area Injury Type: Illness Type:
☐ Minor Bleeding ☐ Anaphylaxis
FRONT BACK ☐ Severe Bleeding ☐ Asthma
☐ Dislocation ☐ Choking
☐ Fracture ☐ Cardiac Arrest
☐ Nosebleed ☐ Chest pain
☐ Shock ☐ Envenomation
☐ Sprain / Strain ☐ Poisoning
☐ Other (specify) ☐ Other (specify)
_______________ _______________
Cause of Injury:
☐ Slip / Trip / Fall
☐ Psychological
☐ Equipment Use
☐ Environmental
☐ Bites and Stings
☐ Collision with Object
☐ Physical exercise / activity
☐ Previous injury / illness
☐ Peer Interaction
☐ Unknown
☐ Other (specify)_______________________
Level of Consciousness: Ambulance Time Called:

☐ Alert / Conscious / Responsive Called:
☐ Unconscious / Non-Responsive ☐ Yes ☐ No
Page 127 of 130 V3.6

Incident, Injury, Trauma and Illness Record Form

Treatment Details
First Aid Treatment Provided Medication Given
☐ Ice Pack List all medications used in the management of
☐ Wound Cleaned the casualty and the dosage / amount given:
☐ Dressing Applied Medication:
☐ Bandage Applied
☐ Adrenaline Autoinjector
☐ Inhaler / Puffer / Spacer
☐ Immobilisation Splint
☐ Emergency Blanket
☐ CPR / AED Dose/Time
☐ Recovery Position
☐ Additional Care:
Persons Notified of Incident, Injury, Trauma or Illness
Person / Department Name of Person Notified Time Date

Emergency Services
☐ Written ☐ Verbal
Parent/Caregiver
Supervisor / Manager
WorkSafe Notified
Outcome of Incident
☐ Resulted in death Details (specify)
☐ Life-threatening
☐ Significant disability / incapacity
☐ Required hospitalisation
☐ Medical treatment required
☐ First aid required
☐ Injuries not requiring first aid
First Aid Providers:
First Aid Qualified: ☐ Yes ☐ No ☐ Yes ☐ No
Report Completed By: Date:
Signature: Date:
Page 128 of 130 V3.6

2. Reference Guide to Envenomation
REFERENCE GUIDE TO ENVENOMATION

Pressure
Immobilisation Cold Pack Hot Water Vinegar
(PIT)
Funnel-web spider Bees Blue-bottle jellyfish Box jellyfish
Mouse spider Wasps (European) Bullrout fish Irukandji jellyfish
Blue-ringed octopus Ants Catfish Jimble jellyfish
Crown-of-Thorns Tropical marine stings

Cone shells Scorpions
Starfish of unknown origins
All venomous snakes, Tropical jellyfish

Centipedes Stingray
including sea snakes stings
Redback Spider Stonefish
All other spiders Non-tropical jellyfish
FIRST AID MANAGEMENT

1. DRSABCD. 1. Apply a cold 1. DRSABCD. 1. DRSABCD.
2. Calm casualty. pack directly 2. Place casualty’s 2. Calm casualty.
3. Keep casualty over the bite site stung limb in hot 3. Flood stung
still. to relieve pain. water (as hot as area with
4. Apply pressure 2. Seek medical you can vinegar for at
immobilisation. aid if necessary. tolerate). least thirty (30)
5. Ensure Triple 3. Ensure Triple seconds.
Zero (000) for Zero (000) for 4. If vinegar not
an ambulance an ambulance available, flick
has been called. has been called. tentacles off
using a stick or
gloved fingers.
5. Ensure Triple
Zero (000) for
an ambulance
has been called.
Page 129 of 130 V3.6

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Page 1 of 130 V3.6

Page 2 of 130 V3.6

The Guide has 5 main sections:

Principles of First Aid

Each topic is presented in traffic light colours:

RED: section explains what you need to

AMBER: section explains what you need to

GREEN: section explains your Plan “B” /

Post Incident Requirements

Page 3 of 130 V3.6

Relevant Forms and Documents

 Incident, Injury, Trauma and Illness Record Form

This icon indicates knowledge assessment content.

Page 4 of 130 V3.6

Part 1 - Unit of Competency

1. Respond to an emergency situation, assess and manage the situation

• Respond to an emergency situation

• Apply appropriate first aid procedures

• Communicate details of the incident

• Review the incident

Requirements of the unit of competency can be found at:

Page 5 of 130 V3.6

1.1 Responding to an Emergency

DRSABCD Action Plan

Send for help

Check for injuries, make

Leave in the position found

Place on back, start CPR

Page 6 of 130 V3.6

1.2 Cardiopulmonary Resuscitation (CPR) Chart

One hand on the

Compressions 100 – 120 100 – 120

Adult Child (1-8) Infant (up to 1)

Hand Lower half of Lower half of

Page 7 of 130 V3.6

Part 2 - Principles of First Aid

2. What is First Aid

 Promote a safe environment

A First Aider should:

3. Arrange for emergency services to attend

PLAN  Call Triple Zero (000) for an ambulance

Page 8 of 130 V3.6

2.1 First Aid Principles

The benefits of first aid:

The four (4) aims of first aid are to:

1. Assess the situation quickly

2. Decide on first aid management

PLAN “B”  Call Triple Zero (000) for an ambulance.

Page 9 of 130 V3.6

2.2 Role of the First Aider

Proving first aid can sometimes be personally challenging and the

1. Recognise, assess, and prioritise the need for first aid.

In an emergency situation, if you feel overwhelmed and panicky:

Page 10 of 130 V3.6

Part 3: Legal, Workplace & Community

Legislation is put in place to set a