First Aid for a Safer Future Updated Global Edition Advocacy Report 2010 (2)

7/29/2019 First Aid for a Safer Future Updated Global Edition Advocacy Report 2010 (2)

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Advocacy report 2010

F fo f fUpdated global edition


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IFRC /First aid for a safer future: updated global edition /September 2010//

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This updated edition o our advocacy report isreleased on the occasion o World First Aid Day2010. It ollows the frst edition which ocusedmainly on frst aid in Europe. This year, webroaden our approach beyond the Europeancontinent and emphasize the necessity to better

prepare communities or the unexpected bymaking frst aid available to all.

The frst edition o this report was welcomed bymany public health experts and was widely dis-

tributed to European decision-makers. Eventhough there was a consensus on many o therecommendations, more eorts are needed toconvert support into policy.

We believe legislation will make a real impact toraise the level o frst-aid education and prepar-edness or individuals and communities. We callon all governments and partners to take actionand make frst aid or all a reality. Let us con-tinue to build on the real progress made to date

as together we strive to build saer, more resil-ient communities.

> More than 7 million: number of people trained

worldwide by Red Cross and Red Crescent

Societies in the 52 countries covered by the

IFRC 2010 survey. This is a 20 per cent increase

compared to 2006.

> 17 million: total number of people who receivedcourses less than 6 hours by the 52 Red Cross

and Red Crescent Societies throughout the

world which were covered by the IFRC 2010 sur-

vey. An additional 46 million were reached by

rst-aid and preventive messages.

> Indian Red Cross and Red Cross Society of China

together have provided rst-aid certied training

course to around 4 million people in 2009.

> More than 90 per cent: percentage of increase

in rst-aid courses provision by Red Cross and

Red Crescent Societies in Europe between2006 and 2009.

First aidi Fiures


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> More than 1 million: the number of people

trained in rst-aid by French Red Cross alone in

2009.

> 75 per cent: percentage of increase in provision

of rst aid certied courses in 15 countries in

Asia Pacic covered by the IFRC 2010 survey.> Almost 3,500,000 people were trained in rst

aid by the Red Cross Society of China in 2009.

This number has doubled since 2006.

> 350,945: number of active rst aid volunteers in

the Asia Pacic region. This is an increase by

more than 50 per cent since 2006.

> 80 per cent compared to 0.5 per cent: 80

per cent is the average number of people trained

in rst aid in Austria compared to 0.5 per cent in

Turkey. This clearly shows that there is still a sig-

nicant preparedness divide between coun-tries when it comes to rst aid education.

> 51,000: total number of active rst aid volun-

teers in the Middle East and North Africa in 2009.

This is a 62 per cent increase since 2006.

The total number of people trained in certied

rst-aid courses in 2009 was 586,400.

> Worldwide, there are more than 36,000 activerst-aid trainers and 770,000 active volun-

teers serving their communities in rst-aid edu-

cation and services, making rst aid for all. The

total number of voluntary hours in rst aid given

globally is at least 3,224,880 per year.


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1.This advocacy report is based on two sources:> A more technical and comprehensive report First Aid in Europe: Overview and Perspectives, currently being drated by

Jrmie Car r, Dr Pascal Cassan and Diane Issard rom the European Reerence Centre o r First Aid Education. The Centre

is based at French Red Cross in Paris.> The IFRC 2010 First Aid Global Survey.

MainFindings1

First aid is by no means a replacement foremergency services; it is a vital initial stepfor providing effective and swift action thathelps to reduce serious injuries and improvethe chances of survival. Taking immediate ac-tion and applying the appropriate techniquesmakes a difference when saving lives. For theRed Cross Red Crescent, rst aid is a key pil-lar for building safer, more resilient communi-ties which in turn are best placed to increasethe impact of disaster preparedness and reducerisks to health.

For this to be achieved, the InternationalFederation of Red Cross and Red CrescentSocieties (IFRC) believes rst aid should beaccessible to all, including the most vulner-able, and be an integral part of a wider devel-opmental approach that values and prioritizesprevention.

svng lv ccn cn

Todays world is increasingly exposed to factorswhich put individuals in potentially danger-ous situations. These factors are called hazardsthat can be either natural (e.g. earthquakes) ormanmade (e.g. a chemical production plant ac-cident). Both can threaten or cause injury tothe population as well as have considerable eco-nomic and environmental impact.

Accidents, however, can happen equally at home

or on the road. Road accidents are certainly therst example people think of when highlightingthe benets of rst aid, and the needs for thosebenets are increasing all over the world.

Some 1.3 million people are killed in road ac-cidents worldwide each year and as many as50 million are injured. For every death, 20 to


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30 people are disabled, many per-manently. Road trafc injuries arethe leading cause of death amongyoung people aged 15 to 29, andthe second most common cause ofdeath for those aged 5 to 14. Be-tween 20 and 50 million sustainnon-fatal injuries.

Road accident injuries impose sub-stantial economic costs on nations,estimated between 1 and 3 per centof the gross national product, andreaching a total of more than 500billion US dollars. Road trafcinjuries can be prevented and costeffective measures do exist.

In addition to preventive measuresfocused on the majors risk andcontributory factors (not wear-ing seatbelts and helmets, speed-ing, drinking and driving, using amobile phone while driving, etc.),it is crucial to improve emergencyresponse and pre-hospital care sys-tem. First aid is, of course, at thecore of these measures.

In Europe, studies show that morethan 50 per cent of all road accident fatalitiesoccur within a few minutes of the crash evenbefore the emergency services arrive at the hos-pital. Moreover, 15 per cent of road deaths oc-cur at the hospital within 4 hours while 35 percent occur 4 hours after the crash.

All injuries must be treated as fast as possible,otherwise the outcome can be fatal.

First-aid training should be provided to all in-dividuals, since they are the ones most likely

to be rst at a crash scene and they may needto take action. First aid is therefore essentialfor drivers, motorcyclists, professional drivers,police ofcers, ambulance teams and staff ofroadside rst-aid centres and others.2

The assistance provided during the rst few min-utes of an accident is essential for the injured,especially for their future health and quality oflife. A considerable amount of time may passbefore an ambulance arrives but professionalhelp can still be provided. As an example, after a

serious road accident if nobody applies pressureto the wound of a person with severe bleeding

to stop it, even the quickest, most sophisticatedemergency service in the world will arrive on thescene only to certify a death. In the EuropeanUnion, thousands of lives can be saved thanks toa speedier intervention or diagnosis. In contrast,insufcient post-accident care can induce, even

where casualties survive the crash, disability andinjuries which could have been prevented.

A British study estimates that 12 per cent ofroad trafc casualties who have a serious frac-ture continue to have serious disabilities after-

wards.

Emergency services response time is clearlycrucial. Their speedy response to a crash toavoid complications from injuries is critical.In a 2010 Red Cross Red Crescent survey (re-ferred to as the 2010 survey), the average timebefore the arrival of the ambulance service in12 countries in the Middle East and North Af-rica region, varied widely between the capitalcities and the rural areas. In capital cities, theaverage emergency response time can be 14.5

minutes, but in the rural areas and in crisissituations, the arrival time of emergency serv-

0.0

0.5

1.0

1.5

2.0

HIC: High-income countries LMIC: Low- and

middle-income countries

Millions of people per year

2010 2020

2010

2020

Road crash mortalityprojection 2020

2.http://www.irc.org/what/health/

roadsaety/call-or-action.asp

Road SafetyCall for actionOctober2009


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ices is very difcult to estimate. In Singapore,the response time is ten minutes while in someregions of Nepal, it can take up to three hours.

High-income countries regular emergencyservices have response times ranging from sixto eight minutes in urban areas.3 In France, 90per cent of cases of rescuers arrive on the scenein less than 13 minutes and 51 seconds.4 Theresponse time is longer, however, in rural areas.

The rst minutes after a serious injury are acrucial window of time during which poten-tially life-saving measures can be initiated. Manydeaths from blocked airways or external bleedingcan be avoided with quick action such as openinga blocked airway, assisting breathing and apply-

ing direct pressure to a wound to stop bleeding.

The likelihood of an injured person living ordying depends on the timeliness of these life-saving actions.5 The odds of survival are greatlyincreased if bystanders quickly begin applyingrst aid. Acting quickly means a reduction intime and in severity of injuries upon arrival atthe hospital.

Although rst aid is not a replacement foremergency services, it is a vital initial step inintervention that provides an effective andrapid contribution. This reduces the severity ofinjuries and improves the chances of survival.

Hom cn

ngo lcTrafc accidents are not the only scenes whererst aid can reduce injuries and prevent death.The other principle scene is at home. Everyonecan recall children or friends cutting a nger,breaking an arm or people scalding themselves

with boiling water.

Most accidents requiring rst-aid occur in

places where people feel secure at home inparticular. Such accidents include incidents orfalls, leisure accidents, cuts, burns and suffo-cation. The chart on page 7 shows that 41.4per cent of accidents in the United Kingdomhappen at home, whilst 19.5 per cent are onroads. Statistics show that hospitals in the Eu-ropean Union treat some 20.2 million homeand leisure accidents every year.

0

7 8 9 10 11 12 13 14 15 16 17 18 19

10

20

30

40

50

60

70

80

90

100

Medical and road emergencies FiresAll emergencies

min

%

Source: Les

statistiques des

services dincendies

et de secours,

Direction de la

Dfense et de la

scurit civi le, 2008

Waiting time for the arrivalof French emergency services

3.PrehospitalTrauma LieSupport, Elsevier,2004

4. Les statistiques

des servicesdincendie et desecours , directionde la Dense et dela Scurit Civile,2008

5. Prehospitaltrauma caresystems, WorldHealth Organiza-tion, 2005


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Disturbing social drinking and eating habits are also a cause for concern.Non-communicable diseases are affecting developing as well as developedcountries. Obesity is constantly growing in some countries whose govern-ments know that consequences will impact on their health systems in the nextdecades from an increase in heart problems, diabetes and blood cholesterol.First-aid training not only helps in accidents, but also promotes a healthierlifestyle.

Whether they happen in the street or at home, sudden heart attacks have tobe treated as quickly as possible. The following data published by the Ameri-can Heart Association is explicit:

i no frst aid is provided immediately ater a sudden cardiac ar-rest, the persons chances o survival all 7 per cent or every minute odelay until defbrillation. Few attempts o resuscitation are successuli frst aid and defbrillation are not provided within minutes o col-

lapse. Effective bystander cardiopulmonary resuscitation (CPR)provided immediately after cardiac arrest can double a personschance of survivalas it helps maintain vital blood ow to the heartand brain and increases the amount o time that an electric shock roma defbrillator can be eective. Since brain death starts to occur 4 to 6minutes ater someone experiences cardiac arrest i no CPR and defbril-lation occurs during that time, since a human heart will stop beatingwithin 4 minutes ater breathing stops, the beneft o providing frst aidcan be clearly demonstrated.

Why is knowingrst aid so important?

A human heart ceases

beating within fourminutes after breathing

stops.

Permanent brain dam-

age can occur within

four to six minutes after

breathing stops.

Over 50 per cent of deaths

from trafc accidents oc-

cur in the rst few minutes

of the crash.

These statistics make it

clear that having someone

trained in rst aid on the

scene makes a real differ-

ence and saves lives.

Roads19.5%

Leisure/Sport17.1%

School/Childcare4.8% Other

2%

Home41.4%

Work15.2%

Source: Home

accident prevention:

Strategy & Action

Plan 2004 2009,

Department of

Health, Social

Services, and Public

Safety, UK, 2004

Injury location in the United Kingdom


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Oh hBesides the rise in cardiovascular diseases,there are other growing threats in Europeancountries that require a scaling up in rst-aidtraining and education.

Population ageing is one. The number of theelderly has more than doubled during the last50 years from 46 to 112 million people. Theirrelative weight in the total population increasedfrom 8 per cent in 1950 to 14 per cent in 2000.6Europe is projected to remain the worlds demo-graphically oldest region until the rst half ofthe 21st century. During the next 50 years, theproportion of elderly people in the total popula-tion will double from the current 14 per centto almost 28 per cent. This trend is worrying

because the elderly are together with children the most vulnerable categories of the popu-lation. Home and leisure accidents affect themmore often than other age categories. Seniorcitizens represent more than 50 per cent of acci-dents at home and its surroundings, 20 per centon public roads and 10 per cent in shops.7

Other threats such as the growing use of drugsand alcoholism can also bring devastating con-sequences and require more and more rst-aidassistance.

This is especially true of the binge drink-ing phenomenon. This extremely dangerouspractice is popular with teenagers and youngadults. It consists of getting drunk as fast aspossible, which often leads to a coma causedby an alcohol overdose. Again, having peopleamong those groups who are aware of the dan-gers and know how to help will make a differ-ence in reducing the number of serious medicalconsequences and deaths.

imonc ofc knowlgWe have already highlighted the necessityto advocate for providing systematic rst-aidtraining and education at school and before get-ting a driving licence. Todays children know somuch; they know how to use modern technolo-gies which provide them with hundreds of newopportunities. But do they know how to reactquickly to a life-threatening situation? Canthey take decisive steps when they face bleed-ing, a broken arm or when one of their friends

is suffocating? Does it not also make sense toteach them basic life-saving skills?

However, in the 2010 survey, only 7 out of 52respondent National Societies worldwide re-ported that their countries have passed legisla-tion to make rst aid compulsory in schoolsand 12 out of 52 for teachers.

A lack of rst-aid knowledge can increasethe risks associated with domestic accidents.Many emergency services report that parentsbring their child suffering from burns withouthaving cooled the burnt parts of his body orthat parents believe poisoning can be curedby making their child vomit. We can simplyno longer tolerate such a situation. All parentsshould know basic rst aid. By increasing thelevel of rst-aid training and education in thepopulation, everyone will be able to face the

most common of accidents without panickingbut by doing the right thing before health pro-fessionals can take care of the casualty.

Besides this life-saving function, rst-aid train-ing and education can also be a tool for pre-vention. Respecting basic safety measures suchas keeping toxic products, hot irons and clean-ing products, (especially in bottles that attractchildren) can considerably reduce these risks.

Qly nng n

con nThe issue is not just about making rst-aidtraining and education compulsory. There isalso a need to improve the existing trainingpractices and quality. This is why we call forpeople to attend rst-aid refresher classes. Allskills must be practised and upgraded. Re-fresher classes will bring the performance ofmost interveners to a higher level than that re-corded after the initial training.

Continuing rst aid education is essential to

maintain providers knowledge and skills par-ticularly when they do not use their skills fre-quently.8

One easy way to improve the situation is forcountries to issue rst-aid certicates thathave a time limit. Giving a diploma thatmakes clear there will be a need to take a re-fresher course from time to time. This willremind everyone about the need to updatetheir skill s. According to the 2010 survey, 65per cent of the 52 countries have no limit of

validity for the basic rst-aid certicate. Thisneeds to be changed.

6.Active age ing inEurope, Volume1, Populationstudies, No. 41,Dragana Avramov

and MiroslavaMaskova, Councilo EuropePublishing

7.The DG Sancoinjury database(Euro-IDB),Rupert Kisser,Robert Bauer,Institute SicherLeben, Vienna,April 2004

8.Prehospitaltrauma caresystems, WorldHealth

Organization,2005


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Another area where training can be improvedis by improving the methodology to transferrst-aid knowledge and skills from learning inthe classroom to providing rst aid in a realsituation. First aid is not just about providinglife-saving skills to a manikin. In real-life situ-ations, the person has to deal with aspects thatcan prevent the provision of efcient rst aid,

such as coping with the terrifying presence ofblood or a persons pale and sweaty appear-ance when having a cardiac arrest. The per-son providing rst aid can also be inuencedby a crowd gathering around an accident. Allthese are important reasons for preparing allrst-aid providers to cope with the stress they

will face. Improving this aspect of training willavoid people trained in rst aid running awayfrom an accident scene simply because they areafraid of blood or of the level of exposure.

First aid is not only about responding to physi-cal injury or illness, but also about initial care

which includes psychosocial support for peoplesuffering emotional distress caused by experi-encing or witnessing a traumatic event. Thisis especially true when responding to earth-quakes. First-aid volunteers can be injuredthemselves, or have lost loved ones. They canbe traumatized, like casualties, by the loss oftheir homes or belongings. Dealing with these

aspects should also be an integral part of rst-aid training.

There are other kinds of fear that can makerst-aid providers refuse to act. In a surveycarried out by the United Arab Emirates RedCrescent, fear and concern about liability aretwo factors identied as barriers for a lay per-son to give rst aid. It can be the fear of beinginvolved in a police investigation, of being ex-posed to unsafe blood or even the risk of legalaction if the rst aid given is seen as ineffective

or even harmful. On this last point, it shouldbe clear that holding rst-aid providers re-


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sponsible for poor outcomes in these chal-lenging settings is not only unfair but alsohighly unwise: this will deter rst-aid pro-

viders from attempting to help those in needof care. Unless there is compelling evidence ofgross negligence, wilful disregard for a patients

welfare or clear evidence of abuse, trained vol-unteers or emergency personnel should not bepunished for poor outcomes.

A study revealed that 30 per cent of those with

rst-aid skills had already used them.9 But morestudies must be conducted for a clearer pictureof why trained people provide rst aid or not.

Finally, the harmonization of the rst-aidtraining curriculum should be improved. AEuropean First Aid Certicate already existsand is delivered across Europe by National RedCross and Red Crescent Societies. Commonstandards provide a working model for harmo-nization and quality across Europe.

First-aid education should also be tailored topeople with special needs and in specic cir-

cumstances. Philippines Red Cross offers morethan 19 different rst-aid courses to its public.

Ov-nncy on

mgncy vcOne of the main reasons people do not feel thenecessity for rst-aid training is that they arefully condent with their emergency services.However, they should not over rely on them.

We have already shown how essential action

can be taken while waiting for professionalemergency staff to arrive. In some developingcountries, it can take more than three hoursbefore an emergency response can reach ruralcommunities. Providing rst aid can, there-fore, really make a difference. In the case ofmajor disasters, there are often not enoughemergency vehicles and personnel available torespond quickly enough, leaving communitiesto rely on their own skills to save lives.

Governments should motivate people to get

trained and integrate non-governmental ac-tors into their health systems instead of merely

9. First-aid Trainingand BystanderActions at TrafcCrashes APopulation Study,Eva M. Larsson,MD; Niklas L.Mrtensson;Kristina A.E.Alexanderson,PhD, Prehospital

and disastermedicine, 2002


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acknowledging their contribution. Similarly,doctors should promote rst-aid training andeducation among relatives of people sufferingfrom heart diseases because their action duringa heart attack can be vital for the patient. This

would reinforce the progress that many coun-tries in Europe and in some other parts of the

world have made in facilitating access to de-brillators, which can save the lives of at least30 per cent of those who suffer a heart attack.

When debrillation is delayed, survival ratesdecrease by approximately 50 per cent everyve minutes. It should also be noted that those

who have been trained in rst aid are betterprepared in the use of debrillators.10

imovng h gn

of vvlWho are todays rst-aid providers? Some aremembers of emergency organizations, how-ever, most of them are just ordinary individu-als. The rst rescuer is often a neighbour, afriend, a family member, or just a bystander ora member of the community. Their role is keyto give casualties better chances of survival. Inless than ve minutes, rst-aid volunteers canmake very decisive steps.

The chain of help as dened by the WorldHealth Organization begins by contactingthe emergency services, securing the scene (e.g.preventing more accidents, controlling thecrowd) and providing rst aid.

A strong chain of survival can improve chancesof survival and recovery for people after heart

attacks, strokes and other emergencies, as thisdrawing from the American Heart Associationshows.

Lnkng vnono First-aid training is crucial in providing a moreefcient response to emergencies. It should alsogo further than that. First-aid training shouldinclude both information and awareness aboutdisaster preparedness so that people living indisaster-prone areas are aware of the risks andknow what to do in case of a disaster.

But prevention also starts with the risks thatwe face in everyday life, including trafc acci-

dents. Road safety messages about how to pre-vent accidents and deal with the consequencesof irresponsible behaviour should be includedin rst-aid training and education.

10.Les Franais etlarrt cardiaque,TNS, 2007

Chain of survival

Citizen Emergency services

10

rad safeycommitments

I commIt to:

Use a seatbelt

Wear a helmet on a motorcycle

Drive at a safe speed and distance

suitable for the conditions

Not drive under the influence of alcohol or drugs

Not use a mobile phone when driving

Be visible as a pedestrian or cyclist

Know and respect the highway code

Maintain my vehicle in a good condition

Be licensed and trained for the vehicle I drive

Know how to react in case of a crash

For that purpose, the IFRC has produced a road

safety commitment card that organizations can

use to strengthen a road safety culture among

their members, staff and volunteers.


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Based on their experience as leading pro-viders of rst-aid training and education,National Red Cross Red Crescent Societies

worldwide suggest the following topics bepart of the rst-aid training curriculum fordrivers:

> spreading preventive road safety mes-sages

> protecting and stabilizing the accidentscene

> summoning the emergency removal ofan injured person from the scene if nec-essary and at all possible

> assessing a casualtys physical state bychecking vital functions such as con-sciousness, circulation, breathing andthe psychosocial needs

> responding to unconsciousness, breath-ing problems, visible bleeding, shock andoffering psychological support to enablethe casualty to survive while waiting forthe emergency services.

a co-ffcv

ng ochImproving prevention and community in-formation in disaster-prone areas a lso limits

the cost of emergency operations. For everyUS dollar invested in disaster preparedness,four US dollars are saved in emergency re-sponse. Prevention starts in rst-aid trainingby helping people to be more aware of risks.For this reason, the IFRC has developed anintegrated approach to its disaster responseby including long-term programmes thataim at prevention, development and emer-gency response. The IFRC has developed itscommunity-based health and rst aid in ac-tion (CBHFA) toolkit. This is a dynamic andexible new approach to developing rst-aidskills. It focuses on development, rst-aid,basic disease prevention, health promotionmessaging and capacity-building for healthi-er and safer communities.

CBHFA is being implemented by many Na-tional Red Cross and Red Crescent Socie-ties worldwide. It includes the promotionof first-aid training for vulnerable groupssuch as disabled people, the homeless, pris-oners, drug users, young people in urbanareas, the elderly, people facing a particularhealth risk, minorities, ethnic groups, iso-lated people in rural areas and people living

with HIV.


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rcng h hmn

n nncl co

Training citizens in rst aid has a cost. However,the numerous benets counterbalance and evenexceed the costs. It is especially true if you lookat the economic consequences of injuries. Thenancial and social benets of reducing pre-mature death and minimizing disability frominjury are potentially enormous. The socio-eco-nomic cost of fatal, serious and minor injuriesis estimated to be about 2 per cent of EU coun-tries GDP (around 180 billion euros).11 Provid-ing faster and more efcient rst aid is a way toreduce the human and nancial bill.

A similar conclusion can be drawn about the

work place. According to the European Statis-tics on Accidents at Work (ESAW), every year,about 5 million workers in the European Un-ion are casualties of accidents at work leadingto more than three days of absence from work.

About 5,000 workers are killed every year inaccidents at the workplace. In addition to thehuman suffering, these accidents have a strongeconomic impact on businesses.

Based on these statistics, it is easy to see whycompanies can benet from training their

workers in rst aid: it helps reduce injuries inthe workplace. First aid can always be madeavailable by having someone trained on eachshift. In the 2010 survey, legislation in 52 coun-tries to make rst-aid compulsory at workplaceis 58 per cent. For drivers, the percentage is 42per cent.

Another interesting nding is that there seemsto be a clear tendency for workers who have re-ceived rst-aid training to adopt safer workingpractices and inuence the behaviour of col-leagues who have not been trained.12

What people learn at work can also be useful

at home. First-aid training can therefore alsobe a useful tool for building a true cultureof prevention that benets the whole com-munity.

invng n chInvesting more in research should also be a pri-ority to make rst-aid training more relevantand efcient.

Self-protection is about the behaviour that

each citizen, family or community chooses to

adopt in order to prepare for, prevent and re-

spond effectively to emergency situations. For

this reason, rst aid is included in many Na-

tional Red Cross and Red Crescent disaster

preparedness and response programmes. In

the 2010 survey, more than 770,000 active

volunteers in 2009 were trained in responding

to crisis.

The French Red Cross has been implementing

what was originally a European project on citi-zen disaster preparedness. The objective is to

give individuals an active role in disaster pre-

vention and preparedness by teaching them

skills to respond to all types of disasters, in-

cluding everyday accidents.

Among the tools provided, there is a practical

guide with information on the nature of the

risks that surround us and how to prepare our-

selves in order to reduce the consequences of

Disaster self-protection:an obvious priority

12. HSE survey ofrst aid trainingorganisations, DrGareth EvansHealth & SaetyLaboratory,Harpur HillBuxton SK179JN, Health andsaety executive

11.Post ImpactCare, EuropeanRoad SaetyObservatory,2007 rom

www.erso.eu


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disasters and accidents. Self-protection train-

ing also includes information about returning

to normal life after a disaster.

The nal repor t highlights why making com-

munities aware of dangers and hazards as

well as preparing them to react quickly and ef-

ciently should be a priority. It cites as an ex-

ample the 1999 Marmara earthquake in Turkey

where at least 50,000 people were found alive

under collapsed buildings. Neighbours and

other local inhabitants rescued 98 per cent of

these. Outside professionals rescued just 350.

Another example of the impor tance of citizen

self-protection is provided by the rate of res-

cue following the large earthquake of Hanshin-

Awaji (Kobe, Japan) on 17 January 1995.

Some 65 per cent of those rescued were

found within the rst 24 hours by the primary

responders. Similarly, during the 1988 Arme-

nia earthquake, 65 per cent of those rescued

were found within the rst 18 hours.

This is why it is crucial to promote the concept

of self-protection. It is dened as the behav-

iour that each citizen, family or community

chooses to adopt to prevent, be prepared for,

respond to and recover effectively from emer-

gency.

A specic multilingual website has been creat-

ed to inform people about risks and how to pre-

vent them: www.citizenselfprotection.eu

In 2008, the IFRC participated in a stra-tegic collaboration with the InternationalFirst Aid Science Advisory Board (referredto as the Advisory Board) co chaired by the

American Heart Association (AHA) and theAmerican Red Cross for the development ofthe Consensus of Science in First Aid. Theteam conducted a thorough review of exist-ing literature, evaluated and graded the levelof scientic evidence in specic rst aid top-ics. The nal Consensus of Science and itsrecommendations will be launched in Octo-ber 2010. Based on this Consensus of Sci-ence, the IFRC will develop its rst set ofInternational First Aid Guidelines in orderto advance our evidence base rst aid prac-tice and education.

Red Cross Red Crescent societies will alsocontinue their work with academic institutes,researchers, practitioners and other researchpartners to nd out more about the most ef-fective way people learn rst-aid and themethodologies to create behavioural changeto better prevent injuries and promote injuryprevention and healthy living.

The research is not just about rst-aid skills,but also on factors inuencing a lay persons

wil lingness to provide rst aid. The Brit-ish Red Cross and Belgian Red Cross areundertaking research in this area. The Bel-gian Red Cross Flanders is undertaking arandomized-controlled trial to compare theeffectiveness of training with a rst-aid andhelping behavioural curriculum versus a rstaid curriculum only on the enhancement ofhelping behaviour in lay person. The Brit-ish Red Cross is carry ing out research to ndout if particular activities within courses cansignicantly increase peoples wil lingness touse rst aid.

The IFRC believes that sharing good practice

among National Societies in rst-aid educationand provision will further improve the qual-ity and standards of rst aid provided by RedCross and Red Crescent Societies.


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1. First-aid education should be accessible

to all and not just for those who can afford

it, whether they live in a rich or poor coun-

try.

2. Compulsory rst-aid training should be set

up at different stages of peoples lives

(school, driving licence, etc.). Every driving

licence candidate should be trained in rstaid.

3. More laws and legislation should be made

to make rst-aid training and education

compulsory at the workplace and in schools.

4. Time limits must be set for rst aid certi-

cates to establish refresher courses that

should be taken at least every ve years.

5. The harmonization of rst-aid education in

Europe should also be extended. A Euro-

pean rst-aid certicate delivered acrossEurope by National Red Cross Red Cres-

cent Societies already exists. A similar har-

monization process will be promoted glo-

bally. Based on its experience as a leading

provider of rst-aid training, the IFRC sug-

gests several key areas that should be part

of the curriculum worldwide.

a. take safety measures, including giv-

ing an alert

b. observe vital life signs (from initial

assessment to situation monitoring)

c. manage the unconscious casualty

d. manage the casualty who has

breathing difculties

e. manage the casualty who has cir-

culation difculties

f. control severe bleeding and

g. manage burns and wounds.

6. All citizens and communities should be

given an active role in disaster prevention

and preparedness by acquiring skills, in-

cluding rst aid, to respond to all kinds of

disasters and accidents.

7. More information campaigns should

be funded and developed to encourage

rst-aid education and training, using allmodern communications techniques (in-

cluding social media).

8. More groups should be targeted for rst-

aid training and education, such as family

members of people living with heart dis-

ease, elderly persons, people living with

disabilities, minority groups often faced

with stigma and discrimination.

9. Access to debrillators should be further

increased by making them more widely

available in all public places.

10. There should be some clear regulation

and legislation against holding rst-aid

providers responsible for poor outcomes

in the challenging settings of an accident

which will deter rst-aid providers from at-

tempting to help those in need of care.

As the major global provider of rst-aid

training and education, and with rst-aid

being one of the core missions of the In-

ternational Red Cross and Red CrescentMovement since its foundation after the

battle of Solferino 150 years ago, IFRC as

well as its member National Societies are

committed to advocate for the implemen-

tation of these measures. We strongly

believe that they are an essential contri-

bution to build safer and more resilient

communities.

Ten recommendations

to promote rst aid worldwide


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First aid:a LObaL iMpat


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19

The IFRC is the worlds leading pro-

vider of rst-aid training, since 186 Red

Cross and Red Crescent Societies

have rst aid as their core activity

Every year, the IFRC organizes a World

First Aid Day on the second Saturday

of September. On 12 September 2009,

more than 40 million people were

eached by rst-aid messages deliv-

ered by Red Cross Red Crescent so-

cieties globally.

Red Cross and Red Crescent Nation-

al societies are committed to doing

more, doing better and reaching

urther in rst-aid education and ac-

ion. First aid is provided to save lives

especting diversity fully and with-

out discrimination. First-aid training isadapted to local needs. It includes the

prevention of common diseases, health

promotion, disaster preparedness and

esponse.

The IFRC believes that rst-aid

raining and education should be

available to all and not just to those

who can pay for it. It is all the more

essential that remote communities with

mited access to professional health

services should have trained rst-aidvolunteers within the community who

can make a real difference by building

safer and more resilient communities.

As a result, the IFRC has developed its

community-based health and rst aid

in action (CBHFA) approach to long-

term capacity building for improved

health programmes and community

development. It includes an implemen-

tation guide, a facilitators guide, a vol-

unteer manual and community tools.

These tools consist mainly of illustra-tions that can be easily used in the eld

by volunteers, regardless of the com-

munitys level of literacy. It provides

guidance for life-saving basic rst-aid

activities. These integrated approach

programmes are currently being imple-

mented all over the world.

http://www.ifrc.org/Docs/pubs/health/

firstaid/CBFA-implementation-guide-

en_LR.pdf

As an example, in 100 villages in Acehprovince, Red Cross community vol-

unteers are involved in rst aid, dis-

ease prevention and health promotion

by doing household visits, community

mobilization through growth monitoring

and vaccinations, education sessions

and broadcasting programmes on lo-

cal radio stations.

First-aid activities by the IFRC as well

as Red Cross and Red Crescent soci-

eties throughout the world are furtherextended in conict areas and situa-

tion of violence through the activities of

the International Committee of the Red

Cross (ICRC).


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IFRC / First aid for a safer future: updated global edition /September 2010 //

20

First aid FOr aLL

First aid reduces vulnerabilities and helps build

stronger counities. he FRC is actively pro-

oting suitable and accessible learning opportu-

nities throughout the world.

Here is a selection of exaples of projects initiated

by Red Cross and Red Crescent ational ocieties.13

bh r o identied disabled people

as a group which can benet fro access to

rst-aid training. However, the training offered

in the early 2000s was inaccessible to any

disabled people. British Red Cross therefore

has set up a project which ais to train 5,000

disabled people in practical rst aid over three

years thanks to ore than 40 disabled volun-

teers. hese were recruited and supported as

peer educators and trainers in rst aid. he

prograe was a ajor step in integrating

disabled people as volunteers.

hn r o and its partners are be-hind a proposal to convince the authorities to

ake rst aid andatory for drivers in a coun-

try where trafc accidents are estiated to kill

ore than 1,800 people annually. uch legis-

lation will require Red Cross rst aid training a

prerequisite for licence applicants before they

are aditted to take the driving test. Putting

this legislation into effect represents a cost-

effective investent for a developing country

such as Ghana. But it will also show that the

Red Cross is ready to deliver and contribute to

reduce the rate of fatalities in the country.

agnn r ohad done a lot to i-

prove and siplify rst-aid instruction eth-

ods. he idea is to insist ore training tie

spent on practice than on traditional school-

like teaching. Red Cross staff worked with an

adult education expert who suggested a case-

study approach that includes sall discussion

groups and lots of practice.

n 2009, ih r o introduced a co-

unity-based health and rst-aid prograe

in Dublins Wheateld prison, a ediu- to

high-security facility and hoe to 450 ale

prisoners any of who are long-ter in-

ates. welve prisoners were chosen to par-

ticipate as Red Cross volunteers and receive

rst-aid education with relevant health aware-

ness. hey took classes two hours a week,

then spread what they had learned to the

rest of the prisoners. he rst result sees

very encouraging. During the swine u crisis,

a neighbouring prison had several cases but

there was not a single one at Wheateld. When

a ass HV-testing project took place in June

2010, rst-aid courses highlighted HV aware-

ness as a key health issue. n the days lead-

ing up to the tests, the volunteers passed out

leaets, encouraged other prisoners to go and

talked openly about the disease. n the end,

the turnout exceeded all expectations. sur-

vey was held showing that without peer sup-

port, any would not have got tested.r o socy of hn has been work-

ing in recent years to standardize and iprove

quality of rst-aid courses throughout the

country. he ational ociety counicates

the iportance of rst aid to the public at large.

his was ade possible thanks to the support

of national lottery funds. his long ter work is

particularly iportant in a country where so far

there had been little public encourageent for

learning rst aid skills. n addition, there is no

andatory requireent for rst aid training to

be provided in high-risk industries.

Hllnc r o has developed a spe-

cial training session for blind people focusing

on how to deal with and prevent doestic ac-

cidents. he basic rst aid course has been

adapted and aterials put into Braille. n 2008,

at least 100 people had been trained. he pro-

grae will be extended throughout Greece.

talian Red Cross has also set up a siilar pro-

grae in this eld.

Fnnh r o has developed a special

prograe aied at young people who have


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21

to perfor rst aid on a friend engaged in risky

behaviour such as the use of drugs or alcohol.

raining is provided in schools with groups ofabout 30 students, focusing on both eergen-

cy rst aid and prevention around the use of

drugs and alcohol.

amnn r o has set up a pro-

grae designed for reote counities

that are ore vulnerable as a result of delayed

response by eergency services. raining

takes place in reote villages, providing spe-

cic rst-aid courses including what can be

done while waiting for an abulance (which

can take ore than an hour). bout 680 peo-ple were trained in 2006 and the prograe is

now ipleented by all branches.

Fnch r o has developed a spe-

cic rst aid education prograe for young

people living in inner cities. his tackles social

issues and ais at preventing violence and

providing an opportunity for young people to

express theselves. raining has been held in

schools, leisure centres and counity youth

centres. he prograe started soe years

ago with urban oderators.

r o soc n eon, Fnc,

og, c, owy, pogl n

slovn have established special training

that focuses especially on the prevention of

hoe accidents for senior citizens including

specic issues such as heat waves, poisoning

and choking and how to act in an eergency.

t least 1,600 people attended these sessions

in 2008. even Red Cross Red Crescent so-

cieties have also developed prograes for

carers for the elderly. more than 2,400 trainers

beneted fro this special training.rn r o has developed a specif-

ic prograe for industrial workers aged be-

tween 40 and 60, especially those at risk fro

respiratory disease and astha. t also targets

copanies throughout Russia where risks of

accidents are high. raining is very practical,

involving real-life situations. Participants can

ask questions related to their job and hobbies.

13. Additional report ing by Amy Serafn, Red Cross Red Crescent Magazine


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IFRC / First aid for a safer future: updated global edition /September 2010 //

22

sai Lies...First aid i sOutH asia

First aid i tHe MiddLe eastad OrtH aFria

outh sia is one of the ost vulnerable region

in the world. he region is not only exposed

to different health and disaster-related risks,

but also to ared insurgencies, and interna-

tional and internal ared conicts. here is a

huge discrepancy between the lack of health

professionals and their ability to respond to

the populations needs proportionate to itssize. his is why all Red Cross Red Crescent

ational ocieties in the outh sia region are

coitted to scaling up their rst-aid educa-

tion. moreover, there is a lack of proper rst-

aid legislation and education in the countries of

the region which are key to iniize or protect

the liability of citizens adinistering rst aid.

Consequently, ational ocieties believe it is

crucial for people living in disaster-prone areas

to receive rst-aid training and for their volun-

teers to be failiar with life-saving techniques.

ational ocieties in the region focus their at-

tention on basic rst aid and cardiopulonary

resuscitation (CPR). In 2009 alone at least

562,000 people obtained certied rst aid

training in the region. here is however aneed to iprove the quality of existing train-

ing and regularly organize refresher courses.

n coing years, the focus will be on scaling

up rst-aid through counity-based health

activities and rolling out the global counity-

based health and rst aid (CBHF) in action

across the region.

n light of the continuing conicts in the middle

ast, rst aid reains a core and ainstrea ac-

tivity within the ational ocieties of the region

and it is considered as an excellent entry point toengage with local counities and the society

at large. n fact, between 2008 and 2009, there

was around a ten per cent increase in certi-

ed courses provided by National Societies.

A total of 586,423 people are trained in certi-

ed rst-aid courses. many ational ocieties

have well-established rst-aid training teas and

instructors. meanwhile, as a core coponent of

counity-based health, rst aid is used to e-

power local counities in the prevention and

treatent of injuries and trauas.

he key focus of rst-aid activities in the region

is to provide rst aid in schools which is gain-

ing oentu. many ational ocieties are

targeting school children and young people inorder to change their behaviour and as a result

to build healthy and safe failies. n addition,

coercial rst aid is also regarded as a good

incoe-generating activity by any ational

ocieties. First aid is an iportant Red Cross

and Red Crescent prograe reaching out

to the general population to proote safe and

healthy living. here is a need to have ore ev-

idence-based initiatives to ake rst aid avail-

able to every household and faily.


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The Fundamental Principles

of the International Red Cross

and Red Crescent Movement

Humanity

The International Red Cross and Red Crescent Movement,

born of a desire to bring assistance without discrimination

to the wounded on the battleeld, endeavours, in its

international and national capacity, to prevent and alleviate

human suffering wherever it may be found. Its purpose

is to protect life and health and to ensure respect for

the human being. It promotes mutual understanding,

friendship, cooperation and lasting peace amongst all

peoples.

Impartiality

It makes no discrimination as to nationality, race, religious

beliefs, class or political opinions. It endeavours to relieve

the suffering of individuals, being guided solely by their

needs, and to give priority to the most urgent cases of

distress.

Neutrality

In order to enjoy the condence of all, the Movement

may not take sides in hostilities or engage at any time in

controversies of a political, racial, religious or ideological

nature.

Independence

The Movement is independent. The National Societies,

while auxiliaries in the humanitarian services of their

governments and subject to the laws of their respective

countries, must always maintain their autonomy so that

they may be able at all times to act in accordance with the

principles of the Movement.

Voluntary service

It is a voluntary relief movement not prompted in anymanner by desire for gain.

Unity

There can be only one Red Cross or Red Crescent

Society in any one country. It must be open to all. It must

carry on its humanitarian work throughout its territory.

Universality

The International Red Cross and Red Crescent

Movement, in which all societies have equal status and

share equal responsibilities and duties in helping each

other, is worldwide.


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First aid for a safer future:updated global editionA joint publicat ion from IFRC and the European Reference Centre for First Aid Educat ion

For more information on the IFRC rst aid global programmes, please contact:

Grace LoIFRC manager, community health unit, GenevaE-mail: [email protected]

Media and public relations contacts:

IFRC media serviceEmail: [email protected]: www.ifrc.org

For more information on the European Reference Centre for First Aid Education, please contact:

Dr Pascal CassancoordinatorE-mail: [email protected]

Diane IssardmanagerE-mail: [email protected]: www.rstaidinaction.net

202000

09/2010

E

300

The International Federation ofRed Cross and Red Crescent

Societies promotes thehumanitarian activities of National

Societies among vulnerablepeople.

By coordinating internationaldisaster relief and encouraging

development support it seeksto prevent and alleviate human

suffering.

The International Federation,

the National Societies and theInternational Committee of

the Red Cross together constitutethe International Red Cross and

Red Crescent Movement.

First Aid for a Safer Future Updated Global Edition Advocacy Report 2010 (2)

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