What are the issues in first aid and emergency health training

The current content problems of first aid and emergency health training are mainly concentrated in the following dimensions: separation from practical scenarios, poor adaptability to the population, lagging knowledge iteration, and blurred boundaries of value guidance. Many people who have participated in the training still have a blank mind when encountering an emergency situation, and they cannot use what they have learned.

I was doing a review of first aid effects in the community a while ago, and I met an aunt who said that she had just learned the Heimlich maneuver at a free training organized by the street last week. When her granddaughter was choked by toffee, she stood beside the child in a daze for a long time. She couldn't remember whether to stand in front of or behind her. She flipped through the printed training manual for a long time before she realized what happened, which took a long time. Later, I asked the training teacher at that time and found out that the adult model was only used to demonstrate the operation of adult obstruction once in the whole class. The difference in posture of foreign body obstruction in children and infants was not even mentioned, let alone letting the students get started one by one to feel the strength of the operation. Nowadays, many trainings are just a formality, reading PPT for half an hour, and just pressing twice on the CPR model is enough. They don’t even pay attention to the core requirements of a compression depth of 5 centimeters and sufficient rebound every time, let alone simulating real scenes such as crowded subways and outdoor rainy days that will interfere with first aid. They only learn the operations under ideal conditions, and they are naturally confused in practice.

Rather than the unpractical content, a more hidden problem is that many training contents do not consider the actual needs of the audience at all. A public welfare organization asked me to provide emergency training for factories. When I looked at the courseware they prepared, two-thirds of the content was about escape and avoidance from earthquakes and mudslides. However, the factory was located in the urban area of ​​the Yangtze River Delta plains and had not experienced even minor earthquakes in the decades since its establishment. On the contrary, emergency treatment of mechanical cuts, chemical splashes, and high-temperature heatstroke, which are most common on the assembly line, only took up less than ten pages. We also teach trauma bandaging to children in the first and second grade of primary school. The angles of gauze winding and professional techniques for tying knots are explained at the beginning. The children cannot understand at all. Instead, they feel scared when looking at the bandage and scissors. We also provide training for elderly people living alone. The operation steps are all densely packed with small print. The elderly people can’t see clearly even with two pairs of reading glasses. After the training, they can’t even distinguish the applicable scenarios of disinfectant and iodine.

There is still a very controversial point in the industry, which is whether a disclaimer for non-professionals to perform rescue operations should be included in the first aid training content. A group of trainers with a medical background believe that first aid training should be purely technical, and that legal issues do not fall within the scope of health training, and adding them would be nondescript. However, most of us trainers who have been working on the front line all year round feel that if the provisions of the Civil Code that exempt good-faith rescues are not clearly stated, many people, no matter how proficient they are, will not dare to step forward when a stranger faints, for fear of taking responsibility, and learning will be in vain. There are currently no unified regulations in this area, and many organizations simply don't mention it for fear of causing trouble, which in turn weakens everyone's willingness to rescue.

Another problem that is easily overlooked is the lag in knowledge iteration. The last time I encountered an enterprise’s internal training, it still used the 2015 version of the cardiopulmonary resuscitation guidelines. Now the 2020 version of the guidelines has long adjusted the operating requirements for non-professionals, giving priority to chest compressions, and does not even require people without professional training to perform artificial respiration. To avoid cross-infection, it will discourage everyone from rescuing. There are also many family emergency health trainings that still teach old knowledge from ten years ago and allow patients with diarrhea and fever to take antibiotics on their own, which is completely inconsistent with current diagnosis and treatment standards and can easily mislead people.

I have been doing frontline first aid training for almost 8 years. My deepest feeling is that there are problems with many training contents. Essentially, the organizers regard the training as a task to complete KPIs, and have never thought about whether the content can be used, whether they dare to use it, and whether it is easy to use from the perspective of the learner. If the content is always floating in the sky, no matter how high the training coverage is, when there is an emergency, no one will be able to stand up.