The history of First Aid Training and the road ahead

The emergency first aid responder (EFAR) system was conceptualized in 2010 after a study was conducted in a township in Cape Town's Cape Flats region of the Western Cape, known for high crime and violence rates. This system trained local residents to help secure a scene, guide bystanders and patients, communicate with EMS and perform basic medical interventions to assist with emergencies in their communities. (Slinger et al, 2022)

Fourteen years later, there is still a desperate need for an initial emergency response at the scene of an incident, however, as more is learnt about health and the human body, the previously trusted “facts” have now been disproved, and therefore treatments have changed. For example, in days gone by it was believed that putting ice or butter on a burn helped to reduce inflammation. It has now been determined that butter slows the healing process and ice can damage the skin, so instead modern-day practice is to run the burned area under cool water.

It is for this reason that first aiders need to renew their first aid certificates every 3 years, to ensure that they keep up to date with modern health practices.

The Department of Employment and Labour (DEL) governs the implementation of the OSH Act in the workplace. Where more than 10 employees are employed at a workplace, the employer needs to appoint a first-aider. This is a compulsory legal appointment, and the first aider should be readily available during normal working hours. The first aider should be in possession of a valid first aid certificate, issued by an accredited provider who is also approved by the Chief Inspector’s Office for this purpose.

Prior to April 2021 first aid training standards were issued and approved by the DEL, however, in terms of the DEL’s Notice 682 of 2020, the standards ceased to exist after 31 March 2021, and First Aid training was then dealt with by the QCTO or their QAPs. This shift required Skills Development Providers to be accredited by QCTO/SETA and approved by DEL in order to offer First Aid Training. More significantly, these courses were then required to be based on a unit standard. This change meant that each service provider or person that was providing first aid courses, did so according to specific unit standards ensuring that each learner studies the same curriculum.

As of June 2024, all first aid providers will need to be accredited with the QCTO to offer the following Regulatory Skills Programmes in order to legally provide first aid training:

•Occupational Skills Programme SP-230801 Basic Emergency First Aid Responder

•Occupational Skills Programme SP-230802 Intermediate Emergency First Aid Responder

•Occupational Skills Programme SP-230803 Advanced Emergency First Aid Responder

Changes

There is now a defined requirement for a practical component where previously service providers may have gotten away with doing this section as a theory component:

• Level 1 has been reduced from 50 notional hours to 20 notional hours but increased from NQF level 1 to NQF level 2. This means that the content/knowledge base has increased.

• Level 2 has changed from being focused on workplace emergency care to more generic intermediate emergency first aid. It has remained with 5 credits and 50 notional hours; however, it has changed from NQF level 2 to NQF level 3.

• Level 3 will now focus on the functions and leadership of a first aid responder and has changed from NQF level 3 to NQF level 4. However, the credits have been reduced from 8 credits to credits 6.

The First Aid curriculum has very specific content that needs to be covered in terms of the theory and practical components and also incorporates tasks and assignments which make up the formative assessment component. At the end of the training modules, learners must have completed the summative assessment and must be found competent. Thereafter, they write the Final Integrated Supervised Assessment (FISA) for the relevant Skills Programmes. The Skills Development Provider administers the FISA and submits learner results for QCTO approval for certification. This ensures that skills development providers provide consistent training.

For First Aid, the FISA is a practical assessment that integrates the relevant Exit Level outcomes, with a simultaneous verbal assessment of embedded knowledge.

The Master Builders KwaZulu-Natal Training Academy has submitted an application for all three First Aid Skills programmes, and once accredited will offer the Basic First Aid 2-day course, the Intermediate First Aid 4-day course and the Advanced First Aid 5-day course.

Heidi Kilian

Head: Training Academy

Reference

Slingers, M et al. 2022. Ten years of the community-based emergency first aid responder (EFAR) system in the Western Cape of South Africa: What has happened, what has changed, and what has been learned. Afr J Emerg Med. 2022 Dec; 12(4): 299–306. Published online 2022 Jul 19. Accessed online: [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9307512/] 3 February 2024.