Emergency First Aid at Work common mistakes
Emergency First Aid at Work · Understand the traps and how to avoid them.
When asked what to do first on finding a collapsed casualty, the candidate starts chest compressions or checks the pulse before checking for a response and opening the airway to confirm normal breathing.
Candidates conflate the CPR sequence with the primary assessment and skip the 'unresponsive and not breathing normally' decision point, often because they have rehearsed compressions most and treat them as the default action.
What to do instead
Drill the fixed order aloud every time: danger, response (shout and shake shoulders), open airway (head tilt, chin lift), look/listen/feel for up to 10 seconds, then call for help and start CPR only if not breathing normally. Practise saying the decision out loud before touching the manikin.
The candidate performs compressions on the lower tip of the sternum or too high on the chest, or lets the heel of the hand lift and reposition between compressions.
Hand placement is taught quickly and then assumed; candidates lose the landmark under pressure and do not re-check it, and on a manikin there is no pain feedback to correct them.
What to do instead
Use the landmark routine: heel of one hand in the centre of the chest, on the lower half of the sternum, second hand on top with interlocked fingers, arms straight, shoulders over the hands. Have an assessor physically check and mark the spot before every practice set until it is automatic.
During CPR the candidate stops compressions for long pauses to talk, reposition, check for a pulse, or wait for the AED to be fully set up, and compressions are too shallow or too slow.
Candidates prioritise completing each step neatly over uninterrupted circulation, and they have not internalised the rate and depth targets as measurable numbers.
What to do instead
Memorise the targets as numbers: 100 to 120 compressions per minute, 5 to 6 cm deep, full recoil, no more than 10 seconds off the chest at any point. Practise with a metronome and count aloud, and rehearse handing over to a second rescuer with a planned swap on the AED's rhythm analysis.
The candidate puts a breathing but unresponsive casualty into the recovery position without first checking that breathing is normal, or places them on their back with the head tilted back and walks away.
The recovery position is remembered as 'the thing you do to unconscious people', and the breathing check that must precede it gets skipped; the purpose of protecting the airway from vomit and the tongue is not understood.
What to do instead
State the rule explicitly: recovery position only for an unresponsive casualty who is breathing normally. Rehearse the sequence with a spoken check of breathing for up to 10 seconds, then the position, then a repeat breathing check and continuous monitoring until help arrives.
The candidate sends a bystander for help with a vague instruction such as 'get an ambulance' or 'call someone', or leaves the casualty alone to fetch help themselves when they are the only rescuer.
Under stress candidates speak in generalities, and they have not been taught to assign a specific person, confirm the message, and specify what to report.
What to do instead
Practise the script: point at one person, say 'You in the blue shirt, call 999, ask for the ambulance service, tell them we have an adult who is not breathing, and come back and tell me what they said.' If alone with an unresponsive non-breathing adult, call on speakerphone while starting CPR.
The candidate declares the scene safe without actually scanning for hazards, or moves a casualty with a suspected spinal injury to 'get them comfortable' before assessing them.
Scene safety is treated as a box to tick rather than an active assessment, and candidates want to appear helpful, so they act before thinking about traffic, electricity, fire, or the mechanism of injury.
What to do instead
Use a spoken hazard sweep: traffic, electricity, fire, water, chemicals, other people, and the mechanism of injury. State the rule that you do not move a casualty unless there is immediate danger to them or you, and that your own safety comes first because an injured rescuer helps no one.
When controlling external bleeding, the candidate presses on the wound loosely or repeatedly lifts the dressing to look, and does not recognise or treat the early signs of shock such as pale clammy skin, fast shallow breathing and thirst.
Candidates want to check whether bleeding has stopped and are not taught that disturbing a clot restarts bleeding; shock is often learned as a separate topic and not linked to blood loss.
What to do instead
Rehearse firm direct pressure with a sterile dressing or clean cloth, pressing hard enough to stop the flow, adding a second dressing on top rather than removing the first, and not using a tourniquet unless trained and bleeding is life-threatening. Then list the shock signs and the response: lay the casualty down, keep them warm, do not give food or drink, and monitor breathing until help arrives.
The candidate treats a burn with butter, oil, toothpaste or ice, or bursts a blister, or applies a dressing that sticks to the burn.
Old household remedies persist in popular belief, and candidates overestimate the value of 'cooling' with ice without knowing it damages tissue.
What to do instead
Fix the rule: cool the burn under cool running water for at least 20 minutes, remove jewellery and loose clothing near the area before it swells, cover with cling film or a clean non-fluffy dressing, and never apply creams, ice, or burst blisters. Practise the 20-minute figure and the 'cool, cover, do not pop' sequence.
The candidate fails to recognise anaphylaxis and gives an asthma reliever inhaler, or delays using the casualty's adrenaline auto-injector, or uses it in the wrong site and does not call an ambulance afterwards.
Asthma and anaphylaxis present similarly in the candidate's mind, and the auto-injector is unfamiliar, so the candidate hesitates or substitutes the wrong device.
What to do instead
Learn the distinguishing features: anaphylaxis involves swelling of the face, lips or throat, difficulty swallowing, a hoarse voice, widespread rash, and rapid deterioration, often after a known trigger. Rehearse the response: call 999, help the casualty use their own auto-injector into the outer thigh, note the time, and repeat after 5 minutes if there is no improvement and a second device is available.
The candidate gives a diabetic casualty who is drowsy or unable to swallow a sugary drink, or gives food or drink to a casualty with a suspected stroke or heart attack, or tries to restrain a casualty who is having a seizure.
Candidates apply a generic 'give sugar for diabetes' rule without checking the casualty's ability to swallow, and they misread seizure movements as something that must be physically controlled.
What to do instead
Set the decision rule: only give oral glucose to a conscious casualty who can swallow and follow instructions; if they are drowsy or unresponsive, place them in the recovery position and call 999. For a seizure, protect the head, clear the area, time the seizure, do not restrain or put anything in the mouth, and call 999 if it lasts over 5 minutes or is a first seizure.