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First Aid Reference Centre INTERNATIONAL FIRST AID, RESUSCITATION, AND EDUCATION GUIDELINES 2020 Audience: First aid programme designers, programme managers, education and scientific committees, trainers Red Cross Red Crescent Networks Coordinated by IFRC Global First Aid Reference Centre © International Federation of Red Cross and Red Crescent Societies, Geneva, 2020 Copies of all or part of this study may be made for non-commercial use, providing the source is acknowledged. The IFRC would appreciate receiving details of its use. Requests for commercial reproduction should be directed to the IFRC at [email protected]. The opinions and recommendations expressed in this study do not necessarily represent the official policy of the IFRC or of individual National Red Cross or Red Crescent Societies. All photos used in this study are copyright of the IFRC unless otherwise indicated. Cover photo: IFRC, South Sudan Red Cross, Red Cross Society of the Democratic People’s Republic of Korea, Argentine Red Cross Address: Chemin des Crêts 17, Petit-Saconnex, 1209 Geneva, Switzerland Postal address: P.O. Box 303, 1211 Geneva 19, Switzerland T +41 (0)22 730 42 22 | F +41 (0)22 730 42 00 | E [email protected] | W ifrc.org International first aid, resuscitation, and education guidelines 2020 1303500 05/2016 E globalfirstaidcentre.org To know that the first aid programme of the National Societies is in accordance not only to the state or local standards but also to international guidelines makes the Georgia Red Cross Society first aid training more attractive and trustful. Having the guidelines and other resources online, on one platform, will make our team’s work easier and more effective. Tea Chikviladze, MD, First aid coordinator, Georgia Red Cross Society Table of contents ACKNOWLEDGEMENTS 7 FOREWORD 12 INTRODUCTION 15 About the Global First Aid Reference Centre 15 About the 2020 Guidelines 16 Definitions 18 Global First Aid Reference Centre online platform 20 Future development 20 Process to develop the 2020 Guidelines 21 Structure of the guidelines 22 Scientificfoundation 23 Guidelines 24 Key action 25 Chain of survival behaviours 25 Education considerations 26 Evidence to action 28 Adaptation 29 Contextualisation 30 Implementation 32 EDUCATION 35 Education strategy essentials 35 Chainofsurvivalbehaviours 35 Principlesoffirstaideducation 36 Theoriesrelatingtoemergencyresponsebehaviour 36 Contexts 38 Conflictcontext 38 Disaster context 42 Water context 46 Remote context 50 Pandemiccontext 53 Workplace context 56 Education modalities 60 Motivationtolearnfirstaid 61 Firstaideducationforchildren 63 Online learning for adults 67 Online learning for children 70 Blendedlearning 73 Media learning 77 Gamification 80 Peerlearning 83 Videolearning 88 Feedback devices 92 Refresh and retrain 94 FIRST AID 99 General approach 100 General approach 100 Hand hygiene 109 Psychologicalfirstaid 113 De-escalation techniques for violent behaviour 120 Medication administration 122 Oxygen administration 124 Unresponsiveness 128 Unresponsiveandbreathingnormally 128 Unresponsiveandabnormalbreathing(adolescentandadult) 134 Unresponsive and abnormal breathing (baby and child) 147 Unresponsiveandabnormalbreathingwhenadefibrillatorisavailable 154 Unresponsive and abnormal breathing with suspected opioid overdose 164 Breathing problems 170 Choking 170 Breathingdifficulties 175 Asthmaattack 180 Croup 184 Trauma 187 Severebleeding 187 Chest and abdomen injuries 195 Amputation 199 Cuts and grazes 202 Dental avulsion 206 Blister 209 Burns 213 Flash eye 221 Fractures,sprainsandstrains 223 Spinalinjury 228 Headinjury 233 Acutelowerbackpain 238 Mammal bites 242 Insect bites or stings 244 Aquatic animal injuries 250 Snakebites 254 Poisoning 258 Medical conditions 264 Chest pain 264 Stroke 271 Allergic reaction and anaphylaxis 279 Shock 288 Diabetic emergency 291 Seizure 295 Feeling faint 299 Fever 304 Abdominalpain 308 Emergencychildbirth 313 Sorethroat 321 Earache 324 Headache 326 Hiccups 330 Environmental 332 Hyperthermia 332 Dehydration 337 Hypothermia 343 Frostbite 349 Altitudesickness 352 Motionsickness 356 Decompressionillness 360 Radiationinjuries 363 Mental distress 366 Traumaticevent 366 Suicidalideation 371 Acutegrief 376 GLOSSARY 382 APPENDICES 389 RedCrossRedCrescentglobalsurveyonfirstaid2018 389 Resources 396 Safeclassroomchecklist 396 CPRskills(foradolescentsandadults) 397 CPRskills(forbabyorchild) 398 Choking skills 400 Assess the scene 402 Assess the person 404 Access help 405 Sexual and gender-based violence 406 REFERENCES 408 Education 408 Educationstrategyessentials 408 Contexts 409 Education modalities 416 First aid 425 General approach 425 Unresponsiveness 430 Breathingproblems 438 Trauma 440 Medical conditions 454 Environmental 465 Mental distress 469 Acknowledgements The International first aid, resuscitation, and education guidelines (referred to as the Guidelines) is an international publication made in collaboration with Red Cross Red Crescent Societies, first aid specialists and task-forces. This collaboration of work by volunteers and staff is coordinated by the Global First Aid Reference Centre and a dedicated steering committee. The Global First Aid Reference Centre warmly thanks and values all these important contributions. Steering committee of the Guidelines Pascal Cassan, MD IFRC Global First Aid Reference Centre Emmy De Buck, PhD Centre for Evidence-Based Practice/Cochrane First Aid, Belgian Red Cross Andrew Macpherson, MD Canadian Red Cross Don Marentette Canadian Red Cross David Markenson, MD American Red Cross Emily Oliver British Red Cross Kristopher Tharris Canadian Red Cross Thomas Wilp, PhD International Committee of the Red Cross Global First Aid Reference Centre project team Salomé Boucif, First aid officer Maud Boutonné, International first aid attestation coordinator Diane Issard, Manager Bassinte Ossama, Project assistant Adele Perkins, Platform manager (British Red Cross) Editors Christine Boase British Red Cross Keely Siegle American Red Cross Proofreaders Grace Lo Global First Aid Reference Centre Léa Meunier Global First Aid Reference Centre Chris Pickin Global First Aid Reference Centre Acknowledgements | 7 Methodology Jorien Laermans, PhD Centre for Evidence-Based Practice/Cochrane First Aid, Belgian Red Cross Vere Borra, PhD Centre for Evidence-Based Practice/Cochrane First Aid, Belgian Red Cross IFRC Health and care department, Geneva Emanuele Capobianco, MD, MPH, Director Bhanu Pratap, MBBS, MPH, Senior officer, Care in the community Content contributors Education Christine Boase British Red Cross Nancy Claxton, EdD International Federation of the Red Cross and Red Crescent Societies Didier Dusabe International Committee of the Red Cross Kaysha Edwards Canadian Red Cross Andrew Farrar British Red Cross Piers Flavin Netherlands Red Cross Felicity Gapes New Zealand Red Cross Lamin Gassama Gambia Red Cross Adam Gesicki Canadian Red Cross Ellen Gordon British Red Cross Panagiotis Ioannidis, PhD International Committee of the Red Cross Lesley Jacobson New Zealand Red Cross Brian Kanaahe Mwebaze, PhD Uganda Red Cross Lyle Karasiuk, Canadian Red Cross Shelly King-Hunter (Longmore) Canadian Red Cross Katrina Kiss British Red Cross Alexander Kurucz Austrian Red Cross Ambrose Lee Singapore Red Cross Moeketsi Augustinus Lethoko Lesotho Red Cross Željko Malić Slovenian Red Cross George Mamabolo South African Red Cross Jodie Marshall Canadian Red Cross Christoph Meier Swiss Red Cross Fabienne Meier Swiss Red Cross Joanna Muise Canadian Red Cross Joe Mulligan British Red Cross Kristiina Myllyrinne Finnish Red Cross Malini Nair International Federation of the Red Cross and Red Crescent Societies Country Cluster Delegation for the Pacific Mabvuto Ng’ambi Zambia Red Cross Melisa Pasquali Argentine Red Cross Aaron Orkin, MD University of Toronto Jeffrey Pellegrino, PhD American Red Cross/University of Akron Tyrone Power Canadian Red Cross 8 | International first aid, resuscitation, and education guidelines 2020 Aaron Pritchard British Red Cross Cees van Romburgh Netherlands Red Cross Sandra Sabury Red Cross Society of Seychelles Christopher Shirley Betsi Cadwaladr University Health Board Maneesh Singhal, MD All Indian Institute of Medical Sciences Odd-Bjørn Sørnes Norwegian Red Cross Tracey Taylor British Red Cross Debbie Van’t Kruis Canadian Red Cross Conrad Wanyama Kenya Red Cross/Kenya Medical Research Institute Alexander Ward British Red Cross Clinical Kevin Hung, MBChB Red Cross Society of China - Hong Kong Branch Gabor Göbl, MD Hungarian Red Cross Daniel Meyran, MD French Red Cross Cees van Romburgh Netherlands Red Cross Axel Siu, MBChB Red Cross Society of China - Hong Kong Branch Susanne Schunder-Tatzber, MD Austrian Red Cross Owen Chauhan, MD University of Ottawa Jorien Laermans, PhD Centre for Evidence-Based Practice/Cochrane First Aid, Belgian Red Cross Communications Michael Nemeth Canadian Red Cross Mike Skinner Canadian Red Cross Tracey Taylor British Red Cross Lyle Karasiuk Canadian Red Cross Roger Mayo Canadian Red Cross Psychological first aid and mental distress Eliza Cheung, PhD IFRC Reference Centre for Psychosocial Support Cherry Lin Red Cross Society of China - Hong Kong Branch Katie Pavoni British Red Cross Stijn Stroobants, PhD Belgian Red Cross Conflict Mazen Al-Hebshi, MD, MPH International Committee of the Red Cross William Clucas International Committee of the Red Cross Matthew Earl International Committee of the Red Cross Thomas Wilp, PhD International Committee of the Red Cross Rony Timo International
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