Courses & Info

Choosing an Outdoor First Aid course

There are a plethora of First Aid Aid training providers – and nearly as many different types of course – so I thought I’d write a little about what I think goes into making not just a good Outdoor First Aid (OFA) course – but also some things to look for in a provider.

 

I think I’ve attended in the region of a twenty different first aid courses in the last twenty years, as a well as monthly training events for various roles – and the standard and content has been very very different – in the end that was one of the key reasons I decided to become a trainer – I simply realised that there was a demand for good courses as well the prolific number of cheap simple courses. In a work setting employers might choose an Emergency First Aid at Work (EFAW) course which is typically one day or an full First Aid at Work (FAW) course which is typically three days. The OFA is often thought to sit in the middle as it’s two – but the differences are much greater than that (more of this to come). In addition if you work in a ‘specialist’ area then first aid has an abundance of additional courses that you can attend – from condition specific (e.g. Airway Management) to individual specific (e.g. Pediatric) to role specific (e.g. Forestry) – hopefully you’re starting to build up a picture. Then there are Regulated, Certified and Individual courses – you can quickly see how making a choice becomes a minefield.

 

So let’s start with which course is right for you?

EFAW & FAW are primarily aimed (as the name would suggest) to the ‘standard’ workplace – the difference between the two being based on  risk assessment requirements and based on an employers’ duties. I teach both – and whilst the content develops between the two, so FAW offers a logical progression and additional content, there is one key factor that stands out for me – the assumption of help arriving in a timely manner. Obviously its nonsense to lump all workplaces into the same category – but for courses that are largely standardised  this assumption holds true. The vast majority of workplaces will also hold a few things in common;

Relatively safe

Good access

Good communications

Other people around

 

This is where Outdoor First Aid starts to veer away from that path.  The outdoors (& for this blog I’m going to operate in the parameters of a day out on the high fells – but a riverbank, a remote beach, the back country – even just out of sight in a large country park – they all hold the same difficulties) is seldom safe, access is often difficult at best, you can be hours or even days from a phone signal or help arriving and you could well be in a small group – you might be the casualty’s only hope. Suddenly it doesn’t seem so simple.

If you work in the outdoors it should be a simple choice – I can’t think of a NGB or representative body that doesn’t require you to hold at least at 16hour First Aid qualification – I’ve certainly never been able to get commercial insurance as an instructor and leader without it – and even the volunteer organisations I work with will require it.  But, and its a big but, I think its also beholden on you if the outdoors is where you choose to play. If you look at your life and do a simple risk assessment, ask yourself the question “who’ll rescue my loved one, my mate, me…if we’re out playing”…suddenly 16hrs doesn’t seems a lot of time to give up.

 

I’ll often get asked “do I really need to, I did First Aid at Work?” – and yes, that is a great start – you’ll come to this with some basic skills. But again I have a simple test for this too – the Recovery Position, that staple of the First Aid course, well its easy to do it on a training room floor – its easy in the canteen – but can you do it on a rock strewn hillside? Can you apply those skills in a different environment? If the proverbial hits the fan are you really going to be able to cope? When no-one is coming – then its down to you.

A quick word on Regulated or Certified

In 2013 First Aid training ceased to regulated by the Health & Safety Executive (HSE) effectively opening the door for anyone to teach first aid. A simple fact is that no First Aid trainer can legitamatley now say “Approved by HSE” as that approval no longer exists.

Certified simply means that a certificate is issued and that may well be enough – there are some great trainers out there who certify their own courses. But in my experience these can be difficult to get accepted by NGB’s (eg, Moutain Training, British Canoeing, AMI etc), insurance companies and organisations such as the Scout Association, Girl Guides or Duke of Edinburgh Awards.

Regulated means that the qualification is, well, regulated by an external body – in my case OfQual.  Obviously I’m biased – but the fact that my courses are audited and assessed, that they meet a national standard – well I like that. I and my clients (& obviously the same is true for any regulated course) don’t need to worry about the qualification being accepted – they also can be assured that I’ll meet a uniform standard and I stay on top of current best practice guidelines. In addition to this – the process of qualification for me to provide regulated courses means that I also had to gain a teaching qualification – so its not just my knowledge that’s audited, its how I’m able to pass that on to the client – and in the end that’s what you’re really paying for isn’t it?  Which leads us nicely to…

What to look for in a Training Provider

I’m going to start with a contentious statement; Any First Aid Trainer should be able to teach EFAW & FAW – but not Outdoor First Aid. I’m starting on the assumption that they know their stuff – they’ll be solid on the ABC’s, choking, anaphylaxis, heart conditions – they’ll probably even have some neat tricks for applying slings. But (yes, another one of those buts…) they may well not have the bit that makes OFA special – can they do this outdoors? have they done this outdoors? can they teach you outdoors? In training terms this is known as vocational competence. And we all want to know our instructor is competent don’t we…..

On too many forums to mention I’ve lost count of the FAW instructors that have commented on posts with an “oh you can’t do that” or a “you have to leave that to the ambulance crew” – when often, in the outdoors neither is an option. OFA means improvisation, it means risk assessment, it means making some pretty tough decisions – and all of that is going to take place in a potentially stressful situation. So when looking for an Outdoor First Aid Trainer I’d suggest that what you’re looking for is:

  • Someone who’s demonstrably active in the outdoors – preferably in the environment that meets your needs. Someone who understands and has experience of where you’ll be when these skills are needed.
  • Someone who’s active in using their First Aid – this isn’t a time or place for book knowledge. Mountain Rescue, First Responding, Event Cover, simply running a lot of courses – all help offer an assurance that skills will be up to date, slick and relevant. I think every trainer has a few ‘tricks’ but they’ve got to actually be useful – not simply clever or filling time. (example – for years I attended courses where I was told that rope stretchers were a simple gimmick and took too long to be useful etc etc – then I attended a workshop with a French Mountain Guide and learnt how to make a bombproof  stretcher in under 5 mins, I’ve since used it in winter for real)
  • Someone who’ll run a good percentage of the course in a suitable location. Now this can be a little tricky – you want to maximise contact time, i.e. the time you’re actually being taught – you don’t want to lose time traipsing into the wilderness – but you do want it to be applicable – a good provider will address all of that. Realistically I think that means you’re looking for a course that offers a bit more that the minimum 16hrs. Knowing you can put these skills into practice in the environment you’re going to need them is essential.
  • A course that mixes learning styles – its old science to say that people are visual, audible or kinesthetic – people learn best by a mixture – but it should be remembered that First Aid is a practical skill – there is no substitute  for a practical course that gives you real hands on experience. It’s not enough to send you away from a course having learnt some skills – a good course/instructor should seek to give you the confidence to use those skills, quickly, safely & correctly.

What should be covered?

Not as simple as it seems!

Regulated courses will have a syllabus – that gives you the benefit of knowing the elements of what they’ll cover, but there are some basic things every course should cover & some that will add an extra touch.

  • DR(s) ABC – is the foundation of every first aid course.
  • Danger – and this is often skipped over, yet is vital in Outdoor First Aid
  • Response – again often skipped over, and again, a lot of vital connotations for Outdoor First Aid
  • Shout – astoundingly this now doesn’t form part of many core first aid courses. Whether we shout for help, call for help or send for help its hugely important in the outdoors. A simple vagary of contours could make you invisible – equally to a search & rescue helicopter we’ll all hard to see if we don’t know how to signal.
  • Airway
  • Breathing
  • Circulation

So we have a basic; but for Outdoor First Aid we need more than a basic, we need to know that we’re also going to cover:

  • D –  again we can diverge here depending on the course. In many workplace courses this might be defibrillator – but in Outdoor First Aid we’re going to take it to be Disability.
  • E- Exposure – or increasingly I prefer Environmental Factors
  • F – Fractures
  • G – Group – all too often forgotten – have you got one casualty or four….
  • H – Hurry Up!

We could carry on right through the alphabet…

 

A good course should look to cover the basics in a way they are possibly going to occur, much like the Recovery Position example I gave earlier – simple tasks can be harder outdoor, moving someone, having enough bandages to stop bleeding, keeping a group warm and safe – these can all become matters of life or death where prompt confident action is needed. Candidates don’t learn well when they’re wet and cold – but on my courses (& the courses I choose to go on myself) we cover the basics in comfort – then we test our ability to do them in real locations.

Outdoor First Aid will also often require the ability to improvise – every first aid trainer has a range of fancy toys – but they won’t help you if you don’t have them when you need them. So I ask candidates to bring the kit they know they’ll have with them as they work or play. I also give them access to anything I might carry with me – but when we head onto the fell that’s what we have, much like a real day out. I’ve been running courses for a couple of years now & yet each course I run leads to us as a group reviewing what we consider our basic kit, for trek leaders we’ll discuss specific risks & measure to minimise them, I’ll let people see and practice with (training versions of) kit that they can expect a group to have, such as inhalers, auto injectors etc.

Additional Elements

Most instructors will also add additional elements that they feel are required for Outdoor First Aid. Often these may be location specific or at a clients request (high altitude sicknesses, poisoning, water treatment are all additions I’ve been asked for). It’s worth knowing what these are – and are they relevant to you. These can often be the deciding factor for candidates who have attended previous courses.

I tell clients that my course nominally runs to approximately 18hours as I include both AED training & catastrophic bleed management. And I have a simple rationale for both;

  • AED – not a syllabus requirement for Outdoor First Aid – and yet increasingly these devices are readily accessible, and they are so easy to operate that I think it would be remiss not to include them.
  • Catastrophic Bleed. So much nonsense has leaked into the training field concerning tourniquets and haemostatics – and yet both have a vital role to play in some scenarios. Some basic training can overcome this; catastrophic bleeding is also one of the few things that would override the basic DR ABC procedures – so an awareness of it is, to me, vital.

Cost

Like many courses First Aid has a w-i-d-e range of costs. And oddly enough I’m not going to say you get what you pay for – as it’s quite possible to get an OFA certificate on a cheap course, whilst paying a lot of money is not a guarantee of an excellent course. What I am going to say is that if cost is the first factor you consider when booking a course then you are almost certainly going to find that you’re on a course that is basic in it’s approach to your needs and leaves you certified but none the wiser.

As with any purchase of skills, time spent understanding what it is you really want to learn, what the skills you want to come away from the course with are and how the course meets those needs will be time well spent. In putting together my courses I’ve obviously looked at other providers – and there is seldom more than £20 or £30 a day difference between courses (though some providers can charge double for the same 16hrs) – but the content and the way it’s delivered can be hugely different.

If I had to sum up choosing a First Aid course in one sentence it would be?

“Is it relevant to what I actually need?”