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Industry Standards – What Works and What Does Not

In 2013 Canadian Red Cross approached the CSA group in an attempt to create a national standard for first aid competencies and training. In April 2014, the advisory Council received strong support from regulatory members to create a national standard. There were 15 invited experts to the October 22, 2014 workshop. Some key themes that arose during the meeting were.   

·       The status quo is not an option. There needs to be a better policy in place for each jurisdiction.  

·       If there was a national standard, it could be updated more frequently and reflect scientific evidence-based practice recommendations.  

·       A national standard would also ensure consistency at a national level with high-quality and measurable training.  

·       As such, a national standard would not address all gaps; however, it would help consistency. 

·       Having a standard base framework would require significant resources in communication to have this project advance.  

At this current time, each jurisdiction, province, or territory can make its own first aid program regulations. So, if somebody wants to take a first aid class in Ontario and then go to work in Alberta, they would require a new first-aid certificate as it is not recognized interprovincially.   


There are currently no requirements or guidelines that specifically say, here’s what you have to have for equipment, or here are the relevant areas that instructors need to be proficient in. There’s no outline for the content that explicitly states what you should be doing or the best practices for each component of the course you are teaching. Each national first aid provider basically follows the same standards, which are limited requirements as follows: one instructor for 18 participants, equipment ratio standards 1 to 2 or 1 to 3; however, there is no mention of the quality of the equipment that should be used, for example, the archaic blue foam actors versus the Preston or Braden mannikins. There are some significant differences between these.   


Out-of-hospital cardiac arrest survival rates have been pretty much stagnated since 2012. We have almost a decade that we are not improving, so we need to ask ourselves why? Could it be that even though technology has advanced by leaps and bounds over the last decade, first aid is still being taught pretty well in the exact same manner?   


Because there is a lack of cohesion for industry standards at a national level, along with very limited auditing for programs, there seems to be a very large gap between what is acceptable and what is being taught. In my almost five years in the first aid industry, I have found many gaps in how first aid is being taught. Frequent comments that I get from participants are: Hey, are we breathing into people this year? I heard it was taken out. Are we doing 15 compressions? Were we doing 10 compressions? Are we doing 5 compressions and then 2 breaths? It appears that some instructors typically teach what they think the national standard could be as opposed to what the scientific evidence-based recommendations are. Now, this doesn’t necessarily fall entirely back on the instructor, but it could be the corporation, or it could be a lack of communication within that corporation without clear expectations and guidelines of why there are changes in what is being taught. There doesn’t seem to be any direct line of communication that could contribute to why there were so many issues within the industry.  

We need to find a way to shorten the gap to provide quality program training coast to coast with very little variation. Allowing more virtual programs in the industry would enable proper cohesion with minimal ability to distort the information, as the core information would be delivered via virtual content.   


Furthermore, when discussing industry standards, the 2020 American Heart Association guidelines heart and stroke foundation of Canada edition mentioned virtual gamified learning as a viable option to help retention rates.  


Currently, any revisions like the October 2020 American Heart Association guidelines typically take 12 to 18 months for the recommendations and guidelines to be implemented in day-to-day first aid programs. This is a huge issue because participants are receiving information that is over a year old.   


There are no actual industry standards, just best practices for equipment ratios or instructor certification or instructor programs etc. We need to work as an industry to elevate the standards industry-wide.