First aiders should re-qualify every three years, otherwise: the Health and Safety Executive (HSE) no longer considers them competent to act as a first aider they will not be counted towards the required number of first aiders in your workplace. First aiders can re-qualify by completing a two-day first aid at work requalification course, but if some time has passed since the certificate expired, the HSE recommends completing the three-day first aid at work course. We support the HSE recommendation that first aiders have annual refresher training to keep their skills up-to-date.

Employers have an obligation under the Health and Safety (First Aid) Regulations 1981 and guidance documents L74 and GEIS to make adequate and appropriate first aid provision for their workforce. It is recommended that someone is able to undertake first aid duties at all times when people are at work.

Employers should provide at least one first aid kit per work site. Your needs assessment will help you identify what equipment you should provide but guidance is also available from the HSE. A first aid container should be green with a white cross (not a red cross, which is a protected symbol).

First aid at work training does not include giving tablets or medication except using aspirin to treat a casualty with a suspected heart attack, which is covered in our three-day first aid at work course. If a colleague has prescription medicine, you may help them to take this but should not administer it for them. There is no legal problem in any person administering adrenaline that is either prescribed for a specific person or administering adrenaline to an unknown person in such a life saving situation (through specific exemptions in the medicines act). However the first aider involved must be competent in being able to recognise the anaphylactic reaction and administer adrenaline using an auto-injector. First aiders must ensure that they work within the guidelines of the first aid training organisation that issued their qualification and their employer. The Health & Safety Executive also provides guidance. As at 25 January 2008 this stated: "Medicines legislation restricts the administration of injectable medicines. Unless self administered, they may only be administered by or in accordance with the instructions of a doctor (e.g., by a nurse). However, in the case of adrenaline there is an exemption to this restriction which means in an emergency, a suitably trained lay person is permitted to administer it by injection for the purpose of saving life. The use of an Epipen to treat anaphylactic shock falls into this category. Therefore, first aiders may administer an Epipen if they are dealing with a life threatening emergency in a casualty who has been prescribed and is in possession of an Epipen and where the first aider is trained to use it."

There is no legal problem in any person administering adrenaline that is either prescribed for a specific person or administering adrenaline to an unknown person in such a life saving situation (through specific exemptions in the medicines act). However the first aider involved must be competent in being able to recognise the anaphylactic reaction and administer adrenaline using an auto-injector First aiders must ensure that they work within the guidelines of the first aid training organisation that issued their qualification and their employer. The Health & Safety Executive also provides guidance. As at 25 January 2008 this stated: "Medicines legislation restricts the administration of injectable medicines. Unless self administered, they may only be administered by or in accordance with the instructions of a doctor (e.g., by a nurse). However, in the case of adrenaline there is an exemption to this restriction which means in an emergency, a suitably trained lay person is permitted to administer it by injection for the purpose of saving life. The use of an Epipen to treat anaphylactic shock falls into this category. Therefore, first aiders may administer an Epipen if they are dealing with a life threatening emergency in a casualty who has been prescribed and is in possession of an Epipen and where the first aider is trained to use it."

The decision whether to use Emerade adrenaline auto-injector, another brand of auto-injector, or an ampoule, needle and syringe is a local decision. The decision should factor in the ease of implementation and the likelihood of anaphylaxis. However the UK guidelines advise that healthcare professionals should use ampoule, needle and 1ml syringe and give the appropriate dose. Be rescue real and have a draw up kit ready. Check out our first aid shop.

Auto-injectors are primarily for self use by patients who are at risk of an anaphylactic reaction. They should be prescribed on an individual basis by a specialist in allergy. These guidelines are aimed at healthcare professionals in a variety of settings. We have not specifically recommended auto-injectors for use by this group for several reasons: Auto-injectors are relatively expensive with a limited shelf life compared with the cost of an ampoule of adrenaline and syringe and needle. Anaphylactic reactions are uncommon. Most auto-injectors purchased for the healthcare setting will not be used. Auto-injectors come with standard length needle which may not be long enough to give intramuscular adrenaline for some patients. Most healthcare staff likely to deal with an anaphylactic reaction in the healthcare setting should have the skills to draw up adrenaline and give an intramuscular injection of adrenaline. Ultimately it is a local decision whether a healthcare setting opts to use auto-injectors instead of adrenaline ampoules. If there is no other form of adrenaline available it would be appropriate for a healthcare professional to use an adrenaline auto-injector for the treatment of an anaphylactic reaction.

This qualification is valid for a period of 3 years. The Learner needs to retake the qualification before the certificate expiry date to remain qualified. It is possible to reduce GLH when requalifying and attend a 12 hour FAW requalifying course. In order to attend a 12 hour requalifying course, Learners must produce their current or previous recently expired FAW certificate. The certificate should be in a format as accepted by HSE. Requalification training should be delivered in no less than 12 hours (2 days) excluding breaks. Expired FAW certificates: If the Learner’s previous FAW certificate will have expired by more than one month at the start of FAW requalification course, the Centre must, in advance, provide the Learner/their Employer with the following information. FAW requalification courses are only 12 hours in duration, compared to 18 hours for the initial course. This means that the syllabus is covered at a significantly faster pace in the understanding that learners are familiar with the topics. Health and Safety Executive (HSE) guidance is clear that if an employee’s FAW certificate expires, they are “no longer considered competent to act as a first-aider in the workplace”. For this reason, you should make every effort to requalify a first aider before the certificate expires. Employers and Learners should be aware that there is an increased risk of failing to achieve the required standard if previous certification has expired by a considerable period (HSE defines this as in excess of 1 month). If this is the case, HSE recommends “it may be prudent to complete a 3 day course”.