Emergency First Aid: Authorized Actions for Trained Responders

Emergency First Aid responders (lay rescuers with certified training) are authorized to perform specific life-saving interventions within their scope. These actions follow the Chain of Survival and evidence-based guidelines (AHA, Red Cross, ILCOR).

Authorized Actions

1. Scene Safety & Assessment
   • Ensure safety for self, victim, bystanders (traffic, fire, electrical, violence).
   • Check responsiveness (tap/shout).
   • Activate EMS (911) – or direct someone to call.
2. CPR & AED (Adult/Child/Infant)
   • High-quality chest compressions: 100–120/min, 2–2.4" depth, full recoil, minimize interruptions.
   • AED use: Turn on, attach pads, follow prompts, clear for shock, resume CPR.
   • Rescue breaths (if trained/willing): 30:2 ratio; barrier device preferred.
3. Bleeding Control
   • Direct pressure with sterile/clean dressing.
   • Pack wound (junctional: neck, axilla, groin) with hemostatic gauze if trained.
   • Tourniquet (commercial, windlass) for life-threatening limb hemorrhage – 2–3" above wound, tighten until bleeding stops, note time.
4. Burn Management
   • Cool with cool (not cold) running water 10–20 min.
   • Remove jewelry/clothing (unless stuck).
   • Cover with clean, dry, non-adherent dressing.
   • Do not apply ice, butter, ointments, break blisters.
5. Musculoskeletal Injury
   • Splint in position found – immobilize joint above and below.
   • RICE: Rest, Ice, Compression, Elevation (for sprains/strains).
   • Check CMS (circulation, motor, sensory) before/after splinting.
6. Medical Emergencies
   • Choking: Abdominal/chest thrusts (conscious); CPR (unconscious).
   • Anaphylaxis: Assist with epinephrine auto-injector (if prescribed/authorized).
   • Opioid overdose: Naloxone (IN/IM) if available/authorized.
   • Seizure: Protect head, time seizure, roll to recovery position post-ictal.
   • Stroke: BE-FAST recognition; note time last known well; EMS transport.
7. Environmental
   • Heat illness: Cool rapidly (ice water immersion best).
   • Hypothermia: Gentle rewarming, dry layers.
   • Envenomation: Pressure immobilization (neurotoxic); suction/ice contraindicated.
8. Psychological First Aid
   • Calm presence, active listening, practical assistance, connect to support.

Scope Limits

• No medications (except assisting with patient's own prescribed epi/naloxone/inhaler per protocol).
• No invasive procedures (IV, intubation, decompression).
• No diagnosis – recognize, stabilize, hand off.
• Good Samaritan laws protect good-faith actions within training.

Training (AHA Heartsaver, Red Cross First Aid/CPR/AED) + regular refreshers = competent responder.