Blood, Breaks and Not Panicking: First Aid That Actually Works

Most first aid you'll ever give happens nowhere near a hospital. It happens on a track, in a car park, at a campsite, in your own kitchen — in that gap between something going wrong and help arriving. In the backcountry, that gap can stretch out for hours. Knowing what to do in it is the whole point.

This guide draws on the same framework taught by Hato Hone St John, New Zealand's peak first aid and ambulance body, and the New Zealand Resuscitation Council. It is not a substitute for a proper first aid course — it's the starting point that tells you why you need one.

DRSABCD — Your Action Plan

Every St John first aid course in New Zealand is built around the same simple sequence. It works whether the emergency is a heart attack in a supermarket or a fall on a remote track — it just tells you what order to check things in.

• D Danger — check the scene is safe for you, the patient, and any bystanders before you go near.
• R Response — talk to them, squeeze their shoulder. Are they conscious and responding?
• S Send for help — call 111, or activate a distress beacon if you're out of range.
• A Airway — is it clear? Tilt the head back gently to open it if needed.
• B Breathing — look, listen, and feel for breath for up to 10 seconds.
• C CPR — if they're not breathing normally, start chest compressions immediately.
• D Defibrillation — use an AED as soon as one is available. It will talk you through it.

You don't need to memorise all of this perfectly to be useful. Even getting the first three steps right — checking danger, checking response, and getting help on the way — puts you ahead of almost everyone.

Severe Bleeding

Small cuts and grazes are rarely a problem. What matters is recognising when bleeding has moved from "annoying" to "life-threatening" — and acting fast when it has.

What to look for

Bleeding that won't stop when you press on it, blood that's spurting or pooling quickly, or a wound involving a major vein or artery (like the neck, groin, or inner thigh) all count as severe.

What to do

• Call 111 if the bleeding is severe or won't stop.
• Press a clean cloth or dressing firmly on the wound. If you don't have one, use your hand — gloved if possible.
• Don't waste time hunting for the "perfect" dressing. Direct pressure, applied immediately, matters more than what you're pressing with.
• If the wound is on an arm or leg, raise it above the level of the heart to help slow blood flow.
• If blood soaks through, don't remove the original dressing — add more on top and keep pressing.
• If there's an object embedded in the wound, leave it in place. Pack around it and press either side, not on top of it.

Burns

Burns are common on camps and tracks alike — cookers, fires, and hot water are everywhere once you're living outdoors for a weekend.

What to do

• Cool it: pour cool (not icy) water over the burn for at least 20 minutes. Any clean, cool liquid works if water isn't available.
• Cover it: use a non-stick dressing or loosely wrapped cling film once it's cooled. Never wrap cling film around a limb tightly, and never use it on the face.
• Remove any tight clothing or jewellery near the burn before swelling sets in.

What not to do

• Don't burst blisters or pick at peeling skin.
• Don't apply butter, oil, creams, or toothpaste — old advice that actually increases infection risk.
• Don't use ice. It can damage already-injured tissue.

If clothing catches fire, remember Stop, Drop and Roll: stop the person moving or panicking, get them on the ground, and roll them to smother the flames. Call 111 for anything larger than half an arm's length, anything affecting the face or eyes, or any chemical burn.

Shock

Shock is what happens when the body can't get enough blood circulating to its vital organs — often following serious bleeding, a bad burn, or a major injury. It's genuinely life-threatening and easy to miss until it's advanced.

What to look for

Pale, cold, and sweaty skin. Fast, shallow breathing. A weak or rapid pulse. Confusion, dizziness, or a growing sense that something's "off" with them.

What to do

• Call 111.
• Help them lie down and raise their legs slightly, unless a leg injury makes this impossible.
• Loosen tight clothing around the neck, chest, and waist.
• Keep them warm with a blanket or jacket — but don't overheat them.
• Don't give them anything to eat or drink, even if they ask.
• Keep talking to them and monitor their breathing and responsiveness until help arrives.

Fractures, Sprains and Dislocations

Out on a track, it's often genuinely hard to tell a bad sprain from a break. Treat anything you're unsure about as a fracture until proven otherwise.

• Don't try to straighten or realign an obviously deformed limb.
• Support the injured area in the position it's in, using padding, a sling, or splinting materials to stop it moving.
• Check circulation beyond the injury regularly — colour, warmth, and feeling in fingers or toes.
• For a suspected dislocation, don't try to "pop it back in" yourself. Support and immobilise, and get them to help.
• For sprains and strains, the classic advice still holds: rest, ice, compression, elevation — but if you can't bear weight on it at all, treat it as a possible fracture.

Build the Kit Before You Need It

A basic kit doesn't need to be elaborate. Plasters in a range of sizes, sterile gauze dressings, a couple of bandages, tape, disposable gloves, tweezers, and any personal medications you or your group might need cover most situations. St John and Hato Hone St John both sell ready-made kits if you'd rather not build your own from scratch — the important thing is that you actually know what's in it and where it lives.

This Is Practised, Not Just Read

Reading this article makes you informed. It doesn't make you capable. First aid is a physical skill — the kind that only really sticks once your hands have done it, under a bit of pressure, with someone watching and correcting you.

Sourced from Hato Hone St John New Zealand's first aid guidelines and the New Zealand Resuscitation Council (ANZCOR). This article is general information only and is not a substitute for a qualified first aid course.