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First Aid Guidelines Revised

03 February, 2023

The American Red Cross and American Heart Association's first aid guidelines have been updated for the first time since 2010.

The American Red Cross and American Heart Association's first aid guidelines have been updated for the first time since 2010, providing revised treatment for stroke recognition, bleeding, anaphylaxis, and hypoglycemia. The organization released the guidelines with aid from 14 national and international organizations.

"First aid can be initiated by anyone in any situation, and our responsibility as experts is to designate assessments and interventions that are medically sound and based on scientific evidence or expert consensus," said Dr. Eunice Singletary, Chair of the First Aid Guidelines Writing Group. "Knowing the correct steps to take in those critical first moments of an emergency can mean the difference between life and death."

Key Issues & Major Changes to the Guidelines Include:

  • The use of stroke assessment systems can assist first aid providers with identifying signs and symptoms of stroke.
  • When glucose tablets are not available, other forms of sugar found in common dietary products are acceptable alternatives for diabetics with mild symptomatic hypoglycemia who are conscious and are able to swallow and to follow commands.
  • It is acceptable for a first aid provider to leave a chest wound open and uncovered. If a dressing and direct pressure are needed to control bleeding, care should be taken to ensure the dressing does not inadvertently convert to an occlusive dressing.
  • There are no single-stage concussion assessment systems to aid first aid providers in the recognition of concussion.
  • When reimplantation of an avulsed tooth will be delayed, temporary storage of the tooth in an appropriate solution may help prolong viability of the tooth.
  • First aid education delivered through public health campaigns, focused topics, or courses resulting in certification can increase survival rates, decrease severity of injury and time in the hospital, and resolve symptoms of injured and ill persons.
  • When caring for an unresponsive person who is breathing normally, and in the absence of major trauma such as to the spine or pelvis, placing the person into a lateral, side-lying position may improve airway mechanics. The modified High Arm in Endangered Spine (HAINES) recovery position is no longer recommended.
  • Routine administration of supplementary oxygen by first aid providers is often unnecessary.
  • While awaiting the arrival of EMS providers, the first aid provider may encourage a person with chest pain to chew aspirin if the signs and symptoms suggest that the person is having a heart attack. However, if a person has chest pain that does not suggest that the cause is cardiac in origin, or if the first aid provider is uncertain about the cause of the chest pain, a first aid provider should not encourage the person to take the aspirin.
  • Epinephrine is recommended for the life-threatening condition of anaphylaxis, and those at risk typically carry epinephrine auto-injectors, often as a two-dose package.
  • The primary method to control bleeding is through the application of firm, direct pressure. When direct pressure is not effective for severe or life-threatening bleeding, the use of a hemostatic dressing combined with direct pressure may be considered but requires training in proper application and indications for use.
  • Use of cervical collars by first aid providers is not recommended. For injured persons who meet high risk criteria for spinal injury, the ideal method for a first aid provider is to help prevent movement of the spine.