PHECC FAR cheat sheet

PHECC First Aid Response (FAR) is a 3-day (18-hour) course delivered by a PHECC-approved training institution; certification is valid for 2 years, after which a refresher is required to remain on the PHECC First Aid Responder register.

Scene safety sequence before any contact: danger to self, bystanders and casualty; then mechanism of injury; then number of casualties and available help. A responder must not enter an unsafe scene - the first priority is personal safety.

Primary survey mnemonic: Catastrophic bleeding, Airway, Breathing, Circulation, Disability (AVPU), Exposure/Environment. Life-threatening problems are treated as they are found, before moving to the next step.

Adult CPR: compressions at 100–120 per minute, depth 5–6 cm, ratio 30:2, with full recoil and minimal interruption. For a child or infant, give 5 initial rescue breaths, then 30:2 (single responder) or 15:2 (two responders).

Adult out-of-hospital cardiac arrest: attach an AED as soon as available and follow its voice prompts; do not delay compressions to apply pads. Minimise hands-off time and resume compressions immediately after each shock or 'no shock advised' message.

Recovery position is indicated for an unresponsive casualty who is breathing normally and has no suspected spinal injury; it maintains a clear airway and allows vomit to drain. Monitor breathing continuously until handover.

Choking adult or child: up to 5 back blows between the shoulder blades, then up to 5 abdominal thrusts, alternating and reassessing between cycles; if the casualty becomes unresponsive, start CPR and call emergency services. For an infant, use 5 back blows and 5 chest thrusts - never abdominal thrusts.

Stroke recognition uses FAST: Face drooping, Arm weakness, Speech difficulty, Time to call 112/999. Note the time of symptom onset, as it determines eligibility for thrombolysis and thrombectomy.

Medical emergency numbers in Ireland and Northern Ireland are 112 and 999; both are free from any phone. Give location, casualty condition, number of casualties and a callback number, and do not hang up until told to.

Secondary survey (after life threats are managed): history using SAMPLE (Signs/symptoms, Allergies, Medications, Past medical history, Last oral intake, Events leading up to the incident), plus a head-to-toe check and vital signs.

Normal adult resting values used as a baseline: respiratory rate 12–20 per minute, pulse 60–100 per minute, and SpO2 of 94–100% on room air. A decreasing level of consciousness is the most important single indicator of deterioration.

AVPU scale: Alert, responds to Voice, responds to Pain, Unresponsive. Record and trend it; a fall from Alert to Voice or below warrants urgent escalation.

Anaphylaxis is a medical emergency: airway swelling, wheeze, urticaria, hypotension and a rapid onset after exposure. Adrenaline auto-injectors are given into the outer thigh, and the casualty must be brought to hospital even if symptoms resolve.

Suspected fracture management: immobilise in the position found, support above and below the injury, check circulation, sensation and movement distally before and after splinting, and never attempt to straighten a deformed limb.

Severe external bleeding is controlled with direct pressure and, where available, a tourniquet applied high and tight on the limb, with the time of application recorded. Packing plus pressure is used for junctional or deep wounds.

Burns: cool with running water for at least 20 minutes, remove jewellery and loose clothing before swelling, and cover with cling film laid lengthwise (not wrapped circumferentially). Do not apply ice, butter or creams; do not burst blisters.

Hypoglycaemia in a conscious casualty: give fast-acting oral glucose (15–20 g), reassess after 10–15 minutes and repeat if needed, then give a longer-acting carbohydrate. If the casualty is unresponsive, do not give anything by mouth - place in the recovery position and call emergency services.

Handover uses the ISBAR structure: Identify, Situation, Background, Assessment, Recommendation. Include the casualty's condition, treatment given, times, and any changes observed while in your care.