8 Are prehospital deaths from trauma and accidental injury preventable? A summary report The Red Cross has a humanitarian vision: a world of that education, was articulated in scientific where everyone gets the help they need in a crisis. literature (Søreide et al. 2013). This highlighted the importance of the bystander being adequately As a strategic objective: ‘For those with an equipped to step forward and be willing to help, increased risk of experiencing a crisis, and to through skills and confidence, to step forward and develop individual and community resilience, our help. The realisation of the critical role of the first education offer will ensure all those reached are person on the scene also drew attention to the more confident and willing to act.’ lack of data and insight into what makes good first aid education – that is, education which empowers To help achieve this strategic objective, the Red the learner to act effectively and gives them the Cross strives for advancements in education confidence to do so. through a strengthened evidence base, by developing its first aid offer and underpinned A 2016 survey of 600 members of the general pedagogy, alongside influencing change through public (British Red Cross, unpublished) asked its advocacy priorities. These developments not a series of questions related to their confidence only reflect the wider external context of first aid and willingness to act in a number of first aid education but have also influenced this context. emergencies: The late 1970s saw a burgeoning interest in > confidence to act when someone was prehospital care – specifically, managing the unconscious but breathing, unconscious and patient in the first stage of the chain of survival, not breathing, or bleeding severely where actions and events in each stage of their journey contribute to their chance of survival > willingness to act when someone they knew (Hsieh 2016). was unconscious but breathing, unconscious and not breathing, or bleeding severely These events include: > willingness to act when someone they did > early access to the emergency cardiac care not know was unconscious but breathing, system by recognising sudden cardiac arrest unconscious and not breathing, or bleeding quickly and calling 911 severely. > early cardiopulmonary resuscitation (CPR) by The survey revealed that confidence was a greater those nearest to the sudden cardiac arrest i.e. issue than willingness in all three emergency bystanders scenarios. > early defibrillation of ventricular arrhythmias With an ambition to reach the general population – but with the public displaying little confidence – > early advanced-level care by trained and a need to position first aid as a public health professionals (Hsieh 2016). issue, a new strategy for first aid was required. What is Everyday First Aid and why is it Based on the experiential/facilitation approach important? which has gained currency in the last 10 years, the Everyday First Aid approach was developed in This interest in prehospital care led to the use line with current good educational practice which of the relevant learning from clinical research allows for flexibility in delivery and firmly roots its to create a first aid training offer and saw the teaching methodology in active learning. This development of the inaugural first aid manual. approach encompasses: Set against a backdrop of clinically focused > flexibility in its approach to delivery, allowing a research, the offer of first aid centred on decision- greater variety of people to learn first aid making pathways – arguably containing complex information and assessment criteria – which we > appreciation of the ways in which adults and now understand does not give the general public young people learn and the influences on their confidence to act in an emergency. learning It was not until 2010 that a new ‘formula for > a variety of teaching resources, including a survival’, which acknowledged the importance of mobile app both effective education and local implementation