First Aid: Guidelines From the American Heart Association and American Red Cross

Physicians are often asked to speak to groups about providing first aid and are sometimes bystanders during an acute emergency, in or out of the office. This guideline from the American Heart Association and American Red Cross provides guidance on administering first aid.

Approaching a Person Who May Be Ill or Injured

When providing first aid, the responder should calmly approach the person who may need help from the direction the person is facing. The responder should introduce themself, state their intentions, and ask for consent. Provision of verbal consent from the individual can demonstrate responsiveness, airway patency, and mental state. The person should be evaluated for responsiveness, breathing, and potential injuries. Consent is implied if the person or their legal guardian is not responsive. If possible, the responder should clean their hands with soap and water before and after contact with the person, bodily fluids, or nearby surfaces.

When to Activate EMS

Emergency medical services (EMS) should be activated if the individual has any signs of a potential life-threatening emergency (Table 1).

Equipment

Lack of equipment does not prevent provision of first aid. Although use of a pulse oximeter by trained clinicians can be beneficial, use by first aid providers can be limited by accuracy, which is affected by the patient, device, and environmental factors. Hypoxemia is often missed in Black patients on assessment with pulse oximetry. Because administration of oxygen has not been shown to be beneficial in provision of first aid, the practical benefit of pulse oximetry is limited.

Special Populations

Infants younger than 1 year should be handled gently due to their fragility. Children from age 1 year to adolescence may be challenging to communicate with after trauma; age-appropriate calming techniques should be used and help sought from their caregiver. With adolescents, privacy and emotional well-being should be prioritized. With older adults, preexisting conditions and medications should be considered.