Same stigma as bystander CPR, same cost. The bra comes off, or gets cut. Pads must go on bare skin. A wire or padding under a pad is a burn risk and a poor contact. Pad placement doesn't change: below the right collarbone, and the left side below the armpit. Under breast tissue, not on it. Remove piercings and jewellery from the pad area. Wipe the chest dry. Nobody has ever been prosecuted for exposing a chest to save a life. People have died while bystanders debated it. Cover this in every session you teach. It changes what people do.

Danger is the first step of the primary survey and the one most people treat as a single check at the door. It isn't. It's continuous. Conditions change — a crowd builds, a vehicle moves, someone who was calm isn't any more, weather turns, a second casualty appears. The scene you assessed ninety seconds ago is not the scene you're standing in now. Four priorities, on repeat: identify hazards · reduce risks · protect yourself with PPE · decide whether it's still safe to be there. And the uncomfortable one — if it isn't safe, you don't go in. Waiting for police or fire isn't hesitation. You cannot help anyone if you become the second casualty.

If you learned AVPU, you're one letter behind. A — Alert C— Confusion, new or worsening V— responds to Voice P— responds to Pain U— Unresponsive The C was added because new confusion is an early, sensitive marker of deterioration — often the first thing to change and the easiest to dismiss as "they're just a bit muddled". It's also in NEWS2, so if you're scoring obs you're already using it whether you realised or not. P or U means the airway is at risk. Act, don't observe.

It isn't a typo, and it isn't decoration. c — catastrophic haemorrhage. Lowercase because it isn't a step in sequence like the others. It's an interrupt. If you find life-threatening bleeding, everything else stops until it's controlled. Direct pressure → wound packing → tourniquet. Reassess continuously, because controlled doesn't mean permanently controlled. The reason it sits before Airway at all is simple: someone can bleed out faster than they can obstruct. Order matters, and this one earns its place. Full lesson in the Primary Survey classroom.