About this module
First aid is what you do in the first minutes, before the ambulance or the nurse arrives. Those minutes can decide whether a person lives. You do not cure. You keep the person alive, stop things getting worse and get them to help.
Who it is for. Beginners with no formal certificate: school leavers, market women and men, drivers, teachers, church and mosque volunteers, farm and fishing families, and persons with disabilities. National Proficiency I is the first level of Ghana's TVET framework.
Why first aid and community health
- Fewer than 1% of Ghanaians are trained in first aid or CPR, according to research led by WHO and the Ghana Health Service.
- St John Ambulance Ghana says most road deaths it sees could have been avoided if the first people on the scene had proper first-aid skills.
- In July 2025 the Youth Employment Agency and the National Ambulance Service agreed to train 6,000 young people as community medical first responders, so that no community is more than ten minutes from immediate help. In July 2026 the Ambulance Service chief said 6,000 responders had been trained.
- The Ghana Red Cross trains volunteers in basic first aid; in 2024 it ran a week-long camp for 100 young volunteers from the Central and Western regions.
- Ghana's community health system, CHPS (Community-based Health Planning and Services), relies on community health officers and volunteers. In 2020 there were 5,062 functional CHPS zones and 19,411 volunteers supporting them.
CTVET status. No CTVET first-aid or community health helper programme was found; CTVET's Safety Technology programme is about workplace safety, not first aid. This module is not a CTVET curriculum. It follows CTVET's format.
The hard gate: you are a helper, not a health worker. In this course you never:
- give any medicine, tablet, herb, injection or drip (you may hand a person their own prescribed inhaler at Level 2, not at this level);
- cut, suck, stitch, burn or put anything into a wound;
- tell a person what illness they have, or say "it is nothing";
- test for malaria or treat it, unless the Ghana Health Service has selected and trained you for that task under its own rules;
- keep a sick person away from the health service.
First aid is "the immediate assistance provided to an ill or injured person until professional help arrives". A first aider "recognises limitations and seeks additional care when needed". The rule of this book is simple: make safe, help, call 112 or refer, and write it down.
This manual is not a certificate. Reading it and passing its tests does not make you a certified first aider. Take a practical course with a recognised provider: the Ghana Red Cross Society, St John Ambulance Ghana or the National Ambulance Service, which all train the public. Course fees were not verified: phone them. The Ghana National Fire Service may also run first-aid sessions; this was not verified.
How the module works
Each unit has learning outcomes, performance criteria, the range and the evidence your assessor needs. You are judged Competent or Not Yet Competent. About 70% of the time is practical, following CTVET's Oil Palm programme split of about 30% school and 70% workplace.
Where the guidance comes from. The main guide is the International First Aid, Resuscitation and Education Guidelines 2020 of the International Federation of Red Cross and Red Crescent Societies (IFRC), written for Red Cross and Red Crescent trainers worldwide. Step-by-step methods come from St John Ambulance (UK), the UK National Health Service (NHS) and the US Centers for Disease Control and Prevention (CDC). Health facts come from the World Health Organization (WHO) and the Ghana Health Service. These are international guides: their advice about the body applies in Ghana, but their phone numbers do not. In Ghana, call 112.
Honesty rule. Numbers marked example were invented to teach the method. Where a Ghana fact could not be found, the book says not verified.
Unit 1 · Your role, your limits and keeping safe
The first rule of first aid is: do not become the second casualty. A dead helper helps nobody.
Competency standard
| Learning outcome | Performance criteria — the trainee… |
|---|---|
| 1.1 Explain the role | explains what first aid and a community health helper are, and what they are not |
| 1.2 Keep within limits | names the hard-gate acts a helper never does and always refers |
| 1.3 Make the scene safe | checks for danger before approaching and names common dangers |
| 1.4 Protect yourself | washes hands correctly and puts on and removes gloves safely |
| 1.5 Get consent and respect | asks permission, explains what they will do, and keeps privacy |
Range. Classroom, a mock roadside, a mock farm and a mock home. Evidence. Scene-safety role-plays; glove removal observed; oral questions.
What a first aider does
First aid tries to keep a person alive, ease their suffering, stop the illness or injury getting worse and help them recover. It includes psychological support for people who are frightened or upset by what happened. It does not include diagnosing or treating disease.
What a community health helper does
A community health helper is a trusted neighbour who:
- teaches simple ways to stay healthy (handwashing, sleeping under a mosquito net, safe water);
- notices when someone is sick and helps them get to the health service early;
- gives first aid when needed;
- keeps simple records and passes them to the health worker.
In Ghana, community health volunteers are chosen by their community and work with the CHPS community health officer. Volunteers in one Ghana programme had five days of training from district health staff and were not paid by the government. This course prepares you to be useful in that role, but only the Ghana Health Service can appoint you as its volunteer.
Scene safety: look before you go
Before you go near anyone, stop, look and think. Ask: what happened, is it still happening, and could it hurt me?
| Place | Dangers to look for | What to do |
|---|---|---|
| Road crash | Moving cars, motorbikes and okadas; leaking fuel; fire; broken glass | Warn traffic with a person or a branch far back; no smoking; switch off the engine if safe |
| Farm | Snakes; machines (corn mill, chainsaw); pesticide spills; falling branches | Stop the machine at the switch; move away from the snake; do not touch chemicals bare-handed |
| Beach or river | Waves and currents; deep water | Do not swim out: call for help and reach or throw something that floats (see Level 2) |
| Home | Electric wire; gas leak; fire; smoke | Switch off power at the mains if you can do it safely; no flames near gas; get out of smoke |
| Fight or crowd | Weapons; angry people | Wait for the police; call 112 |
The National Ambulance Service advises bystanders not to rush to move victims at a crash, because moving them wrongly can make injuries worse or kill. Move a person only if they are in immediate danger, such as fire or traffic.
Clean hands and gloves
Wash with soap and water; an alcohol hand gel with at least 70% ethanol (or 60% of another alcohol) also works when water is not available. Protect yourself from blood: wear gloves, or cover your hands with clean plastic bags if you have no gloves.
Wash your hands (about 40 seconds)
You need: a Veronica bucket with a tap, or any running clean water; liquid or bar soap; a clean towel or paper towel.
- Wet your hands with clean running water. Turn off the tap.
- Put on soap.
- Rub to make a lather: backs of hands, between fingers, under nails.
- Scrub for at least 20 seconds (sing "Happy Birthday" twice).
- Rinse well under clean running water.
- Dry with a clean towel or let them air-dry.
Check. A partner watches: did you clean between the fingers and under the nails? Did you scrub for 20 seconds? Common mistake: wiping wet hands on your clothes. Fix: carry a small clean towel.
Put on and take off gloves safely
You need: disposable examination gloves (sold at pharmacies, licensed chemical shops and medical supply shops); a bin bag.
- Wash or gel your hands. Check the gloves have no holes.
- Pull on each glove so it covers your wrist.
- To take off: pinch the outside of one glove at the wrist and peel it off inside-out. Hold it in your gloved hand.
- Slide two fingers of your bare hand inside the cuff of the other glove. Peel it off over the first glove.
- Drop both into the bin bag. Wash your hands.
Check. Your bare skin never touched the outside of either glove. Practice tip: put a little paint or flour on the gloves first; any mark on your skin shows a mistake.
Consent, respect and privacy
- Say who you are: "My name is Esi. I am a first aider. Can I help you?"
- Ask before you touch. If the person says no, do not force them; stay near, call 112 if needed, and keep watching.
- A person who does not respond cannot answer: you may help them.
- For a child, ask the parent if they are there.
- Cover the person. Keep the crowd back. Never take photos or videos of a casualty to post on social media.
- What you see is private. Tell only the health worker who takes over.
The helper's limits: always refer
| You CAN | You must NOT |
|---|---|
| Make the scene safe, call 112, check breathing | Diagnose ("it is malaria", "it is only gas") |
| Give CPR and clear choking | Give tablets, herbs, injections, drips or "concoctions" |
| Press on a bleeding wound; cool a burn with water | Put toothpaste, oil, egg or herbs on burns or wounds |
| Keep a broken limb still | Pull or "set" a broken bone |
| Keep a snakebite victim still and get them to hospital | Cut, suck, tie a tight band, use a black stone or herbs |
| Teach handwashing and net use; refer sick people | Test or treat malaria unless the Ghana Health Service trained and assigned you |
Look after yourself too. If you get blood or body fluid on broken skin, in your eyes or in your mouth, wash it at once with plenty of water and go to a health facility the same day. Seeing an emergency can upset you; talk to someone you trust afterwards.
Your safety map
Walk around your house, your street and one workplace (shop, farm, beach or lorry station). List five dangers you see and what a first aider should do about each.
Check yourself
- Give the IFRC meaning of first aid in your own words.
- Name three things a helper must never do.
- Why should bystanders not rush to move a crash victim?
Unit 2 · Check the person: the primary survey, calling 112 and the recovery position
Check in the same order every time. The order puts the things that kill fastest first.
Competency standard
| Learning outcome | Performance criteria — the trainee… |
|---|---|
| 2.1 Do the primary survey | checks Danger, Response, Airway, Breathing and Circulation in order |
| 2.2 Call 112 | gives the call-taker clear facts and stays on the line |
| 2.3 Use the recovery position | rolls an unresponsive, breathing person onto their side and keeps checking |
| 2.4 Help a person who feels faint | sits or lies them down safely and watches them |
Range. Partners and manikins; mock indoor and outdoor scenes. Evidence. Observed primary surveys; recorded 112 role-plays; recovery position checklist.
The primary survey: DR ABC
| Letter | Means | What you do |
|---|---|---|
| D | Danger | Make sure the place is safe for you and the person |
| R | Response | Kneel by the chest, gently shake the shoulders, ask loudly "Are you OK?" |
| A | Airway | Hand on the forehead, tilt the head back; two fingers lift the chin |
| B | Breathing | Look, listen and feel for normal breathing for no more than 10 seconds |
| C | Circulation | Look for severe bleeding; press on it at once |
Gasping is not normal breathing. In the first minutes after the heart stops, a person may give occasional gasps. Treat this as not breathing.
Severe bleeding comes first. If you see blood pouring out, press on it straight away, even before you check the airway, and call 112.
Primary survey, step by step
You need: a partner lying on a mat (for response, airway and breathing) and a manikin.
- Danger. Stop. Look around. Say aloud what dangers you see and what you will do.
- Response. Kneel beside the chest. Tap the shoulders. Say: "Hello, can you hear me? Open your eyes."
- If there is no response, shout "Help!" so others come.
- Airway. One hand on the forehead, tilt the head back gently. Two fingers of the other hand under the bony part of the chin; lift.
- Breathing. Put your cheek near their mouth and look at the chest. Count aloud to 10 at most.
- Decide.
- Not breathing normally → call 112 and start CPR (Unit 3).
- Breathing, but unresponsive → recovery position, call 112.
- Responsive → check for bleeding and injuries; ask what happened.
- Circulation. Look quickly from head to toe for heavy bleeding.
Check. Did you do it in order? Did you stop at 10 seconds?
Calling 112
Ghana's single emergency number 112 reaches the police, fire service and ambulance service on all mobile networks; it was launched in January 2020. The police later said their older numbers also still worked, but 112 is the one to remember.
The National Ambulance Service asks callers to describe the situation and stay on the line so the dispatch centre can guide them until help arrives. The service has no advanced tracking of callers and relies on maps and landmarks to find people. So landmarks matter.
- Where: town, area, street, and a big landmark ("Akwidaa junction, opposite the blue church")
- What happened: "A man fell from a coconut tree"
- How many people are hurt
- How they are: awake or not; breathing or not; bleeding
- Your phone number
- Stay on the line and follow the instructions; put the phone on speaker if you are giving CPR
If you are alone with an adult who is not breathing, put your phone on speaker so you can keep pressing on the chest while you talk.
112 role-play (never dial for real)
- Your trainer gives you a card: "Woman collapsed at the lorry station."
- A partner plays the call-taker. Give the six facts above in under one minute.
- Swap. The call-taker scores you out of 6.
- Write your own home landmark sentence in your logbook.
The recovery position
Use it for a person who is unresponsive but breathing normally, and has no injury that stops you moving them.
- Kneel beside them. Straighten their legs. Take out glasses and bulky things from pockets.
- Put the arm nearest you out at a right angle, elbow bent, palm up.
- Bring the far arm across the chest. Hold the back of their hand against the cheek nearest you.
- With your other hand, lift the far knee so the foot is flat on the ground.
- Keep the hand on the cheek. Pull the far knee towards you to roll them onto their side.
- Bend the top leg at a right angle so they do not roll forward.
- Tilt the head back and lift the chin to keep the airway open.
- Call 112 if nobody has. Keep checking their breathing. If they stay like this for 30 minutes, roll them onto the other side.
A pregnant woman who is unresponsive may be placed on her left side.
Recovery position
You need: a mat; a partner.
- Your partner lies flat, eyes closed, breathing.
- Do the 8 steps aloud.
- Your trainer checks: is the airway open? Is the person stable? Did you keep checking breathing?
- Swap.
Common mistake: forgetting to tilt the head back at the end. Fix: say "head back, chin up" as your last step every time.
Feeling faint and fainting
Fainting is a short loss of response because less blood reaches the brain; heat, standing still for a long time, stress, pain and hunger can cause it.
- Help the person sit or lie on the floor so they cannot fall.
- If they feel faint, ask them to cross their legs and squeeze, or squat; this can stop the faint.
- If they cannot, let them lie down and raise their legs.
- A faint should be brief. If they do not wake quickly, check breathing and act.
- Once they are fully awake and can swallow, you may offer water.
- Advise them to see a health worker, especially if it happens again.
Landmarks card
Make a card for your house: the 112 number, your area and three landmarks. Stick it near the door and teach your family to read it out.
Check yourself
- What do the letters DR ABC stand for?
- For how long do you check breathing?
- Why must you give landmarks when you call 112?
Unit 3 · CPR and choking: adults, children and babies
When the heart stops, the brain starts to die within minutes. Your hands pressing on the chest keep blood moving until help arrives.
Competency standard
| Learning outcome | Performance criteria — the trainee… |
|---|---|
| 3.1 Give adult CPR | gives compressions at the right place, depth and rate, with or without breaths |
| 3.2 Give child and baby CPR | starts with five breaths and uses the right hand position and depth |
| 3.3 Clear choking | gives back blows and thrusts correctly for adult, child and baby |
| 3.4 Keep going and hand over | swaps helpers, uses a defibrillator if one arrives, hands over to the ambulance |
Range. Adult, child and baby manikins only. Evidence. Observed CPR for two minutes on each manikin; choking drills; oral questions.
Manikins only. Never press on the chest of, or give back blows or thrusts to, a person who is breathing normally. Real CPR can crack ribs; that is acceptable to save a life, never in practice.
Who counts as adult, child or baby
- Baby: under one year old.
- Child: from one year old to puberty.
- Adult: after puberty.
Adult CPR
You need: a firm floor; your hands; a phone on speaker. A face shield if you have one.
- Safe? Check danger. Tap and shout. No response: shout for help.
- Airway and breathing. Tilt the head, lift the chin, look, listen and feel for up to 10 seconds. Gasps are not normal breathing.
- Call 112 (or ask a helper to call and bring a defibrillator if there is one). Speaker on.
- Hands. Kneel beside the chest. Heel of one hand in the middle of the chest, other hand on top, fingers locked.
- Push. Arms straight, shoulders over your hands. Press down 5–6 cm, then let the chest come right back up.
- Speed. 100 to 120 presses a minute.
- Breaths, if trained. After 30 presses, give 2 breaths: tilt the head, lift the chin, pinch the nose, seal your mouth over theirs, blow for up to one second until the chest rises. If the breaths do not go in, go straight back to pressing.
- If you cannot or will not give breaths, just keep pressing without stopping.
- Keep going until help takes over, the person shows signs of life and breathes normally, you are too exhausted to continue, or a defibrillator is ready. If there are two of you, swap every 1–2 minutes.
Defibrillators (AEDs). An AED is a machine that can shock the heart back into rhythm. Few public places in Ghana have one (not verified). If one arrives, switch it on and follow its spoken instructions; the 112 call-taker can help. AED use is taught on recognised practical courses.
How long are 30 presses?
At 100 presses a minute, how many seconds do 30 presses take? At 120 a minute? If you give 30 presses and 2 breaths five times, about how many presses is that?
Child CPR (one year to puberty)
- Check danger, response, airway and breathing as for an adult.
- If not breathing normally: give 5 rescue breaths first. Pinch the nose, seal your mouth over theirs, blow gently and steadily for up to one second until the chest rises.
- Calling for help if you are alone: after the 5 breaths, call 112 on speaker and start compressions. Without a speaker phone, give one minute of CPR first, then call.
- Compressions: one hand in the centre of the chest. Press down one third of the depth of the chest. Let it come back up.
- Speed: 100 to 120 a minute.
- Ratio: 30 presses to 2 breaths (30:2). People trained in children's life support may use 15:2.
- Keep going until help takes over, the child breathes normally, or a defibrillator is ready.
Baby CPR (under one year)
- Check danger and response (talk and tap the foot gently; never shake a baby).
- Open the airway: tilt the baby's head only slightly, into a neutral (level) position, and lift the chin. Check breathing for up to 10 seconds.
- Always start with 5 rescue breaths.
- Compressions: two fingers in the centre of the chest. Press down about one third of the chest depth, about 4 cm.
- Speed: 100 to 120 a minute. Ratio: 30:2 (15:2 if trained in children's life support).
- Calling: with a speaker phone, give the 5 breaths then call 112. Without one, give the 5 breaths and one minute of CPR, then call. Never leave the baby to make the call: carry the baby with you if you must go for help.
CPR drills on manikins
You need: adult, child and baby manikins; a stopwatch; a metronome app at 110 beats a minute; a partner to count.
- Adult: full sequence from "Danger" to two minutes of 30:2. Your partner counts presses and checks depth (if the manikin has a clicker or light).
- Hands-only adult: two minutes of compressions without stopping.
- Child: 5 breaths, then 30:2 with one hand for one minute.
- Baby: 5 breaths, then 30:2 with two fingers for one minute.
- Swap drill: with a partner, swap every 2 minutes without a long pause.
- Clean the manikin face with an alcohol wipe or as the maker says before the next person.
Check. Rate 100–120? Full recoil? Hands in the middle of the chest? Pauses for breaths under 10 seconds? Common mistakes: bent elbows (too shallow); leaning on the chest (no recoil); pressing too fast. Fix: lock elbows, shoulders over hands, follow the metronome.
Choking: adult
Mild choking (can cough, speak or breathe): encourage them to keep coughing. Severe choking (cannot breathe, cough or make a sound):
- Ask: "Are you choking?" Remove any object you can see in the mouth.
- Back blows: lean them forward, support the chest, give up to 5 sharp blows between the shoulder blades with the heel of your hand. Check the mouth after each.
- Abdominal thrusts: if still choking, stand behind them, put a fist just below the breastbone, hold it with the other hand, pull sharply inwards and upwards up to 5 times. Check the mouth after each.
- If it has not cleared, call 112 and repeat 5 back blows and 5 thrusts until help arrives.
- If they become unresponsive, start CPR.
Choking: child
Same as the adult: encourage coughing; up to 5 back blows with the child leaning forward; then up to 5 abdominal thrusts; check the mouth after each; do not sweep the mouth with your finger; call 112 if it does not clear; CPR if they become unresponsive. Every child who has had abdominal thrusts must be seen in hospital, even if the object came out.
Choking: baby
- If the baby cannot cough, cry or breathe: lay the baby face down along your thigh, supporting the head, and give up to 5 firm back blows between the shoulder blades.
- Turn the baby over and look in the mouth after each blow. Remove only an object you can see. Never sweep the mouth with your finger: you can push the object further down.
- If still choking: lay the baby on their back on your knees and give up to 5 chest thrusts using two thumbs on the breastbone (sharper than CPR compressions). Check the mouth after each.
- If it has not cleared, call 112, taking the baby with you.
- Repeat 5 back blows and 5 chest thrusts until help arrives.
- If the baby becomes unresponsive, start baby CPR.
- Any baby who has had chest thrusts must be seen in hospital.
Never hold a baby upside down by the legs and shake it, and never give abdominal thrusts to a baby.
Choking drills
You need: an adult or child choking vest or manikin if available; a baby manikin.
- Adult: on a partner, show positions only, with no force: lean forward, hand position for back blows, fist position for thrusts. Then full force on a choking manikin or vest if available.
- Baby: on the baby manikin, full sequence of 5 back blows and 5 chest thrusts, turning and checking the mouth each time.
- Say aloud when you would call 112.
Teach one person
Teach a family member the adult choking steps using a pillow or doll. Write who you taught and what they found hard.
Check yourself
- How deep and how fast are adult chest compressions?
- What is different at the start of child and baby CPR?
- Why must a baby who had chest thrusts go to hospital?
Unit 4 · Bleeding, shock, burns, broken bones and sprains
Press, cool, keep still. Most injuries need only these three ideas, done quickly and well.
Competency standard
| Learning outcome | Performance criteria — the trainee… |
|---|---|
| 4.1 Control severe bleeding | uses gloves, direct pressure and a dressing; leaves embedded objects in place |
| 4.2 Recognise and treat shock | names the signs and positions and warms the casualty |
| 4.3 Cool and cover a burn | cools for at least 20 minutes and covers with cling film |
| 4.4 Support a broken bone | keeps the limb still with padding and a sling or bandage |
| 4.5 Care for a sprain | uses protection, rest, ice, compression and raising, and knows when to refer |
Range. Partners (no real wounds), moulage (make-up wounds) if available. Evidence. Observed bandaging, sling and burn-cooling drills; oral questions.
Severe bleeding
You need: gloves (or clean plastic bags); a sterile dressing or clean cloth; a roller or triangular bandage.
- Put on gloves.
- Press hard on the wound with a dressing or clean cloth. If you have nothing, the person can press with their own hand. Cut or pull away clothing over the wound.
- Something stuck in the wound? Do not pull it out. Press on both sides of it.
- Get someone to call 112 (or use speaker phone yourself).
- Tie a bandage over the dressing firmly, but not so tight that it stops blood flow.
- Check circulation beyond the bandage: press a fingernail until it goes pale, then let go. If colour does not come back within 2 seconds, loosen the bandage.
- If blood soaks through, take off the dressing, put a new one on with pressure and bandage again.
- Support the limb in a sling or bandage. Recheck circulation every 10 minutes.
- Watch for shock. If they become unresponsive, prepare to give CPR.
First aiders should not use "pressure points" to stop bleeding. Tourniquets (a tight band around a limb) are only for life-threatening limb bleeding that direct pressure cannot control; they can cost the person the limb if left too long. Use one only if you are trained, or the 112 call-taker tells you to.
Shock
Shock means the body is not getting enough blood to the organs, for example after heavy bleeding.
Signs: pale, cold, clammy skin; sweating; a fast pulse that gets weaker; fast, shallow breathing; grey-blue lips; feeling sick; restlessness; becoming unresponsive.
- Treat the cause (for example, press on the bleeding).
- Lay them down and raise and support their legs (do not raise a broken leg).
- Call 112 and say you think it is shock.
- Loosen tight clothing at the neck, chest and waist.
- Keep them warm with a cloth or blanket, and calm.
- Watch them. If they become unresponsive, follow the primary survey.
Burns and scalds
Burns from hot water, cooking oil, kerosene lamps, gas and fires are common at home and in chop bars.
- Cool the burn under cool running water for at least 20 minutes, or until the pain eases. Start fast. If you have no water, cold milk or cold canned drinks can be used.
- Take off rings, watches and clothing near the burn before it swells, unless they are stuck to the burn.
- Cover loosely with cling film laid lengthways (do not wrap it round tightly), or put a burnt hand or foot in a clean plastic bag.
- Get medical advice. Keep watching the person.
Never use ice, creams or gels; never burst blisters. Do not use toothpaste, palm oil, raw egg or herbs either: they trap heat and bring infection (teaching advice). For large, deep, face, hand, genital or electrical burns, and for any burn on a baby or child, call 112 or go straight to a health facility (teaching advice; confirm on your practical course).
Electrical burns. Do not touch the person until the power is off at the switch or mains. Then call 112.
Broken bones (fractures)
Signs: pain, swelling, a limb at an odd angle, a crack heard, a bone through the skin.
Open fracture (bone or wound at the break):
- Call 112.
- Take off rings, watches and tight things on the limb.
- Cover the wound with a sterile dressing or clean, non-fluffy cloth.
- Press around the wound to control bleeding, not on the bone.
- Bandage the dressing in place.
- Ask them to keep still. Support the joints above and below the break. Pad around it.
- Do not move them unless they are in danger.
- Use a sling for an arm; broad-fold bandages for a leg.
- Watch for shock. Do not raise the legs if a leg, hip or pelvis may be broken.
Closed fracture: if the back, neck or pelvis may be broken, call 112 at once and do not move them. For smaller bones, the person still needs a hospital, but it is less urgent.
Never pull or "set" a broken bone, and never send a person to a bone-setter instead of a hospital. Keep the limb still and get them to a health facility. For a suspected neck or back injury, keep the person still; first aiders should not put on a neck collar.
Sprains and strains
A sprain is a stretched or torn ligament (for example a twisted ankle); a strain is a stretched muscle. For the first 2–3 days use PRICE:
| Letter | Means | How |
|---|---|---|
| P | Protect | Support or firm shoes |
| R | Rest | Stop the activity; no weight on it |
| I | Ice | Ice pack or cold pack wrapped in a cloth, up to 20 minutes every 2–3 hours |
| C | Compression | A bandage for support during the day |
| E | Elevate | Keep it raised on a pillow |
Avoid heat, alcohol and massage for the first couple of days.
Go to hospital if a crack was heard, the limb has changed shape, it is numb or tingling, the skin is blue, grey or cold, or the person cannot put weight on it.
Ice times
A trader twisted her ankle at 6 a.m. She ices it for 20 minutes every 3 hours until 9 p.m., starting at 6 a.m. (a) How many times does she ice it? (b) How many minutes of ice in total?
Bleeding, burns and bones
You need: gloves; dressings; roller and triangular bandages; cling film; a basin and running water or a Veronica bucket; rolled newspaper for padding; a stopwatch.
- Bleeding: on a partner's arm (pretend wound), put on gloves, press, dress and bandage. Do the 2-second nail check.
- Embedded object: a pencil taped to a partner's sleeve stands for a nail. Pad on both sides and bandage around it.
- Burn: cool a partner's forearm under running water while your stopwatch runs (do 2 minutes in class; say "20 minutes" aloud). Remove the "ring". Cover with cling film lengthways.
- Arm fracture: support the arm and tie an arm sling with a triangular bandage. Check fingers for colour and feeling.
- Leg fracture: pad between the legs and tie broad-fold bandages (not over the break).
- Shock: lay a partner down, raise the legs on a chair, cover and reassure.
Myth check
Ask three people what they put on a burn. Write down each answer, and next to it what the first-aid guide says.
Check yourself
- What do you do with a knife stuck in a wound?
- How long do you cool a burn, and with what?
- When must you not raise the legs of a person in shock?
Unit 5 · Seizures, heat illness, poisoning, snakebite and animal bites
Some emergencies look frightening. Your job is calm: protect the person, keep them still or cool, and get them to help without wasting time on myths.
Competency standard
| Learning outcome | Performance criteria — the trainee… |
|---|---|
| 5.1 Help during a seizure | protects the person, times the seizure and knows when to call 112 |
| 5.2 Treat heat illness | cools a person with heat exhaustion or heatstroke and calls 112 for heatstroke |
| 5.3 Help after poisoning | does not cause vomiting, keeps the container and calls 112 |
| 5.4 Give snakebite first aid | keeps the person still, removes rings, gets them to hospital, and refuses harmful myths |
| 5.5 Help after an animal bite | washes the wound for 15 minutes and refers for rabies care |
Range. Role-plays and partners. Evidence. Observed role-plays; myth-busting quiz; oral questions.
Seizures (fits)
Calm, cushion, call.
- Protect. Ask people to step back. Move hot drinks, sharp things and furniture away. Note the time it started.
- Do not hold them down or move them unless they are in danger. Put nothing in their mouth (no spoon, no finger, no stick).
- Cushion the head with something soft (a folded cloth, bag or jacket). Loosen clothing at the neck.
- After the jerking stops, open the airway and check breathing. If they are breathing, put them in the recovery position.
- Watch. Recovery can take 15–30 minutes. Note how long the seizure lasted.
Call 112 if: it is their first seizure; seizures repeat; the cause is unknown; it lasts more than 5 minutes; they stay unresponsive more than 10 minutes after it stops; they are injured or not breathing normally.
For a small child having a fit with fever, pad around them, take off one layer of clothes and bedding to cool them, but do not let them get cold. Every child with a fit and fever must be seen at a health facility: in Ghana, fever may be malaria (teaching advice; see Unit 6).
Myths. Epilepsy is not caught by touching a person or their saliva (teaching advice). Never pour water on the face, put a key or onion in the hand, or force anything into the mouth.
Heat illness
Working on farms, at sea, in markets and at funerals in the sun can cause heat illness.
Heat exhaustion signs: headache, dizziness or confusion; feeling sick; heavy sweating with pale, clammy skin; cramps; a fast, weakening pulse.
- Help them lie down in a cool, shaded place and raise their legs.
- Give plenty of water to drink.
- Check breathing, pulse and response.
- Encourage them to get medical advice; call 112 if you are worried.
Heatstroke is an emergency. Signs: hot, flushed, dry skin; confusion or strange behaviour; quickly getting less responsive; body temperature above 40 °C.
- Move them to a cool, shaded place; remove outer clothing.
- Call 112.
- Cool them fast: wrap in a cool wet sheet, or fan and sponge them with cold water. Cold packs in the armpits and around the neck.
- When they feel cooler, replace the wet sheet with a dry one.
- Keep checking. Be ready for the recovery position and for seizures. Cool again if they heat up.
Poisoning
Poisons at home and on farms include kerosene, bleach, caustic soda (for soap making), pesticides and other people's medicines.
- Ask what they swallowed, when and how much.
- Do not make them vomit.
- Do not give food or drink.
- Call 112 and give as much information as you can.
- Keep the container or label to show the health workers. If they vomit, keep some in a bag.
- If they become unresponsive, open the airway, check breathing and prepare for CPR.
Do not give palm oil, milk, salt water or "antidotes" to make someone vomit or to "neutralise" a poison (teaching advice; the St John guide says give nothing to eat or drink). Pesticide on the skin or in the eyes: wear gloves, remove soaked clothing, and wash with plenty of clean water (teaching advice; follow the product label).
Snakebite
Ghana records an estimated 9,600 snakebites a year. Worldwide, about 5.4 million people are bitten each year and between 81,410 and 137,880 die; good antivenom is the most effective treatment.
Do this:
- Move away from the snake. Do not try to catch or kill it. A photo from a safe distance helps, if it is safe.
- Reassure the person. Many bites are from harmless snakes, and even venomous bites rarely kill straight away.
- Remove rings, watches, bracelets and tight clothing near the bite before it swells.
- Keep them completely still. Splint the limb. Do not let them walk on a bitten leg; carry them on a makeshift stretcher.
- Get them to a health facility fast, ideally a hospital with antivenom.
- If they vomit, lay them on their left side in the recovery position. Do not transport them flat on their back.
- Watch their breathing; be ready to give CPR.
Never:
- cut the bite, suck it, or use a suction pump;
- tie a tight band or tourniquet;
- put on a black stone, herbs or any traditional remedy;
- use ice or a cold compress, or rub the bite.
No pressure bandage. WHO recommends the pressure-bandage method only for bites by snakes whose venom paralyses and that do not cause local swelling. In a Ghana study, carpet vipers, which cause swelling and bleeding, caused most snakebite poisoning. So in this course: no pressure bandage, no tight band; splint loosely and keep still. This is the same rule as the Hub's Workplace Safety Level 2.
Medicines: do not give any. WHO says paracetamol may be given for local pain, but at this level leave all medicines to the health worker. Never give aspirin or ibuprofen, which can make bleeding worse (teaching advice, as in Workplace Safety Level 2).
Dog and other animal bites
Dogs cause up to 99% of human rabies cases, and rabies kills tens of thousands of people a year.
- Wash the wound with soap and water for at least 15 minutes, straight away.
- Cover it with a clean dressing.
- Send the person to a health facility the same day for post-exposure care, which may include rabies vaccine.
- Note the animal and where it lives, so its owner and the veterinary office can be told.
Role-plays
You need: cards with scenarios; a stopwatch; a blanket; a stick and bandage for a splint.
- Seizure at a church service: protect, cushion, time it; at 6 minutes, call 112.
- Heatstroke on a farm: cool and call.
- Child drank kerosene from a mineral bottle: what you do and do not do.
- Snakebite on a cocoa farm: keep still, remove a ring, splint, carry to the road, call 112, give landmarks.
- Dog bite: wash for 15 minutes (time 2 minutes in class) and refer.
Your trainer will add a "myth" to each role-play (a neighbour shouting "suck it!" or "give him palm oil!"). Politely refuse and explain why.
Snakebite plan
Write a one-page snakebite plan for your farm or family: who to call, how to carry the person to the road, which health facility to go to and its phone number.
Check yourself
- Name three things you must never do after a snakebite.
- When do you call 112 for a seizure?
- Why should you not make a poisoned person vomit?
Unit 6 · Community health helper: handwashing, malaria, diarrhoea, referral, records and the first-aid kit
Most sickness is cheaper to prevent than to treat. A helper who teaches one street to wash hands and sleep under nets saves lives that no ambulance ever sees.
Competency standard
| Learning outcome | Performance criteria — the trainee… |
|---|---|
| 6.1 Teach handwashing | demonstrates the steps and the key times to a group |
| 6.2 Teach malaria prevention | explains how malaria spreads and how to use a net, and refers fever early |
| 6.3 Respond to diarrhoea safely | teaches prevention, knows the danger signs and refers |
| 6.4 Refer and record | fills a referral note and a simple record without breaking privacy |
| 6.5 Check a first-aid kit | checks contents and dates and lists what is missing |
Range. A group health talk; a mock home visit; a first-aid box. Evidence. Health-talk observation; referral note and record; kit checklist.
Handwashing: when
Teach people to wash with soap and water:
- Before, during and after preparing food, and before eating
- Before and after caring for someone who is vomiting or has diarrhoea
- Before and after treating a cut or wound
- After using the toilet, changing a baby or helping a child use the toilet
- After blowing the nose, coughing or sneezing
- After touching animals, animal feed or waste, and rubbish
Handwashing with soap, safe water, good toilets and breastfeeding all help prevent diarrhoea.
Malaria
- Malaria is spread by the bite of infected female Anopheles mosquitoes. It does not spread from person to person.
- Early signs are fever, headache and chills, usually 10–15 days after the bite.
- The WHO African Region has about 95% of the world's malaria cases and deaths, and children under five account for about 75% of malaria deaths there.
- WHO recommends that every suspected case is tested before treatment. Ghana's National Malaria Elimination Programme aims to test 100% of suspected cases by 2028.
- The main protection is insecticide-treated nets and indoor spraying; repellents, long clothes after dark and window screens also help.
Your message: "Sleep under a treated net every night, all year. Fever? Go to the health facility today to be tested. Do not buy malaria drugs without a test."
Hang and care for a net
You need: an insecticide-treated net; string; four nails or hooks (or a frame).
- Hang the net over the sleeping place from four corners (or one ring).
- Tuck the edges under the mattress or mat all round.
- Check for holes; mend small holes with thread or a patch.
- Explain: air a new net in the shade, not the sun; wash it gently and not too often (teaching advice: follow the instructions printed on the net's bag).
- Teach a family member to hang it.
Diarrhoea
Diarrhoea kills about 443,832 children under five a year worldwide; dehydration (losing too much water) is the main danger.
- Prevention: safe drinking water, toilets, handwashing with soap, only breast milk for the first six months, food hygiene, and rotavirus vaccine.
- Oral rehydration solution (ORS), a mix of clean water, salt and sugar, replaces lost fluid. ORS sachets are sold at pharmacies and licensed chemical shops; mix exactly as the packet says with safe water.
- Children should keep eating and breastfeeding during diarrhoea.
- Refer to the health facility for: diarrhoea that goes on, blood in the stool, or signs of dehydration, and always for a baby or a very sick child (teaching advice).
Your limit. You teach prevention and how to mix ORS from the packet, and you refer. Zinc tablets and any other medicine are for the health worker to decide. In one Ghana programme, ORS and zinc were given only by volunteers the health service had trained for it.
Referral: sending people to help on time
Danger signs: refer at once (call 112 if severe)
- Not breathing normally, unresponsive, or a fit
- Fever in a baby or young child; fever with stiff neck, confusion or fits
- A child who cannot drink or breastfeed, or vomits everything
- Severe diarrhoea, blood in the stool, or signs of dehydration (very thirsty, sunken eyes, little urine)
- A pregnant woman with bleeding, severe headache, swollen face or fits
- Severe pain in the chest or belly
- Any snakebite, dog bite, deep burn or broken bone
The rest of the list is teaching advice; your CHPS officer may add local signs.
A referral note (on a page of your notebook):
| Field | Example |
|---|---|
| Date and time | 12 Oct 2026, 7:40 a.m. |
| Name, age, sex | Kofi A., 3 years, male |
| Where they live | Near the Methodist school, Akwidaa |
| What you saw | Hot body since yesterday, not eating, vomited twice |
| What you did | Advised mother; walked with them to the CHPS compound |
| Sent to | CHPS compound / health centre |
| Your name and phone |
Simple records and privacy
Community health volunteers in Ghana keep a logbook and a community register of births, deaths and pregnancies for the health service.
- Write only what you saw and did. No guesses about illness.
- Keep the book in a closed bag or locked box. Do not show it to neighbours.
- Do not send people's health details on WhatsApp groups.
- Ghana's Data Protection Act, 2012 (Act 843) governs how personal information is obtained, held and shared, and the Data Protection Commission says all data controllers and processors must register with it. As a volunteer under the health service, ask the CHPS officer how records are kept.
The first-aid kit
A basic workplace first-aid box holds (UK guide): a first-aid leaflet; assorted sterile plasters; sterile eye pads; triangular bandages; safety pins; large and medium sterile dressings; disposable gloves. It is recommended that no tablets or medicines are kept in it.
Ghana's First Aid Regulations, 1970 (L.I. 655) require a first-aid box or cupboard in every factory, office and shop, plus one more for each 150 workers above the first 150.
Add for community and farm use (teaching advice): cling film; clean plastic bags; a pocket face shield; scissors; a torch; a whistle; a small notebook and pen; a card with 112 and local numbers.
In October 2026, first-aid kits were advertised in Ghana from about GH¢90 for a small kit to GH¢360–399 for a 25-person workplace kit and GH¢600–650 for a 50-person kit.
Check a first-aid box
You need: a first-aid box; its contents list; a checklist.
- Tick each item against the list.
- Check expiry dates on sterile dressings and eye pads, and that packets are sealed and dry.
- Remove any tablets or medicines and give them to the owner.
- Write a "missing and expired" list with quantities.
- Write the check date and your name on the label inside the lid.
Give a five-minute health talk
- Choose handwashing, malaria nets or diarrhoea.
- Plan: one key message, one demonstration, two questions to ask the group.
- Give the talk to your class in English or Fante (or the local language), then take questions.
- Your trainer scores: clear message; correct facts; demonstration; respect for the audience.
Household survey (with permission)
With the head of household's permission, visit three homes near you. Ask: is there a handwashing place with soap? Do the children sleep under a net? Write only "yes/no" answers, no names. Bring the totals to class.
Check yourself
- How is malaria spread, and what must happen before anyone is treated for it?
- Name three danger signs that need referral at once.
- Why should there be no tablets in a first-aid box?
Unit 7 · Your location, small business ideas and marketing yourself
Your first-aid skill is a service. Build trust first: get certified, volunteer, show up on time and never claim more than you can do.
Competency standard
| Learning outcome | Performance criteria — the trainee… |
|---|---|
| 7.1 Find the right path | names the recognised providers and volunteer routes and a plan to get certified |
| 7.2 Cost and price | costs a first-aid kit and sets a price |
| 7.3 Choose a location | judges where first-aid kits and help are needed |
| 7.4 Market yourself honestly | writes a profile and a plan that claim only what they can do |
Range. The trainee's own plan. Evidence. Kit costing; one-page plan; profile.
Your first steps
- Get a certificate from a practical course with a recognised provider: the Ghana Red Cross Society, St John Ambulance Ghana or the National Ambulance Service. Fees were not verified: phone them and write the answer in your logbook.
- Volunteer. The Ghana Red Cross trains young volunteers in first aid and emergency response. The National Ambulance Service and the Youth Employment Agency run a community medical first responder programme with responders attached to Assembly members; ask your Assembly member how recruitment works (not verified).
- Offer to help your CHPS compound. Community health volunteers are selected by their community and trained by district health staff.
Small business ideas (honest ones)
- First-aid kit assembly and refills for shops, taxis and trotros, farms, fishing canoes, schools and churches (no medicines in the box)
- Kit checking visits: a monthly check and refill list for small businesses
- Emergency number cards and posters: 112 and local landmarks for homes, shops and lorry stations
- Handwashing stations: setting up Veronica buckets with soap for shops and chop bars
- Mosquito-net hanging help for older people and new mothers (nets come from the health service or the market; you sell only your time)
- Event first-aid helper as a volunteer with a recognised provider, after you are certified
Do not sell "first-aid training" or "certificates" at this level. Only recognised providers issue first-aid certificates. You may give free awareness talks (handwashing, nets, calling 112) and say clearly that they are not a certificate.
Location settings that give good returns
- Lorry stations, markets and junctions, where accidents and crowds happen and drivers need kits
- Near farms, cocoa areas and fishing landing beaches (Akwidaa, Dixcove, Busua), where cuts, snakebite and heat are common
- Schools, churches and mosques, where groups meet and can learn
- Near the CHPS compound or health centre you will refer to
Cost a small kit (all figures are example)
You buy: a plastic box GH¢25; 20 plasters GH¢10; 4 sterile dressings at GH¢6 each; 2 triangular bandages at GH¢8 each; 2 roller bandages at GH¢5 each; 2 pairs of gloves at GH¢2 each; cling film GH¢12; safety pins GH¢3; a leaflet and 112 card you print for GH¢5. (a) What does one kit cost? (b) What price gives 40% profit on cost? (c) If you sell 15 kits in a month at that price, what is your profit?
Market yourself honestly
- WhatsApp Business: a business profile with your name, area and services, with greeting and away messages. Post photos of kits, not of injured people.
- Google Business Profile: a free listing so people searching nearby can find you.
- Signage: a small sign "First-aid kits and refills · Call 112 in emergencies".
- Referrals: drivers' unions, market queens, pastors and imams, school heads, farm groups.
- Your portfolio: your certificate (when you have it), volunteer letters, photos of talks (with permission), a list of kits supplied.
- Never say "nurse", "doctor" or "certified trainer" unless it is true.
Accessibility
Ghana's Persons with Disability Act, 2006 (Act 715) bans discrimination against persons with disabilities at work and requires public places and services to be accessible. The Assemblies' disability fund rose from 3% to 5% in 2026 and now favours skills, assistive devices and start-up capital.
Much of this work suits persons with disabilities: kit assembly and checking, health talks, record keeping, 112 cards and posters, and phone support. Adjustments that help: CPR practice on a table-height manikin for wheelchair users (on a real call, direct a helper to do compressions while you guide them and talk to 112); large-print or audio checklists for people with low vision; picture cards and sign-language interpreters for deaf trainees; and working in pairs at emergencies. Ask the person what works for them.
My plan
- Phone one recognised provider. Ask the next course date, fee and certificate validity. Record it.
- Cost one kit and set a price.
- Choose a location and explain why.
- Write a one-page plan with your name, service, customers, price and how you will be honest about your limits.
Talk to a customer
Ask a taxi driver, a shop owner and a farmer whether they have a first-aid kit, and what they would pay for one.
Check yourself
- Who may issue a first-aid certificate?
- Name two honest first-aid business ideas at Level 1.
- Name two adjustments for a trainee who uses a wheelchair.
Glossary
| Term | Meaning |
|---|---|
| 112 | Ghana's emergency number for police, fire and ambulance |
| Abdominal thrust | A sharp inward and upward pull below the breastbone to clear choking |
| AED | Automated external defibrillator: a machine that shocks the heart |
| CHPS | Community-based Health Planning and Services, Ghana's community health system |
| CPR | Cardiopulmonary resuscitation: chest presses (and breaths) when the heart stops |
| DR ABC | Danger, Response, Airway, Breathing, Circulation: the primary survey |
| Fracture | A broken or cracked bone |
| ORS | Oral rehydration solution: water, salt and sugar to replace lost fluid |
| PRICE | Protect, Rest, Ice, Compression, Elevate: care for sprains |
| Recovery position | Lying on the side to keep the airway open |
| Referral | Sending a person to the health service, with a note |
| Shock | Not enough blood reaching the organs |
| Tourniquet | A tight band on a limb for life-threatening bleeding; trained use only |
Logbook
- Unit 1: safety map; handwashing and glove checklist
- Unit 2: primary survey checklist; 112 role-play score; landmarks card
- Unit 3: CPR drill records (adult, child, baby); choking drill record; person you taught
- Unit 4: bandaging, sling and burn-cooling checklist; myth check
- Unit 5: role-play records; snakebite plan
- Unit 6: health talk score; net-hanging check; kit check; household survey totals
- Unit 7: provider phone call notes; kit costing; one-page plan
- Every homework, dated
Self-check quiz
- What is the first thing you check at any emergency?
- What number do you call in Ghana, and what six things do you tell them?
- For how long do you check breathing, and is gasping normal?
- Give the depth, rate and ratio for adult CPR.
- How do you start CPR on a child or baby?
- What do you do for a baby who is choking?
- What do you do with an object stuck in a wound?
- How do you treat a burn?
- Name four things you must never do after a snakebite.
- How long do you wash a dog bite, and why must the person go to a health facility?
- What must happen before anyone is treated for malaria?
- Name five items in a basic first-aid box.
Further reading and sources
Best next reads: a practical first-aid course with the Ghana Red Cross, St John Ambulance Ghana or the National Ambulance Service; the IFRC International First Aid Guidelines 2020 (free); the Hub's Workplace Safety Level 2 (Unit 5 First aid) and Caregiving manuals.
What this module does not cover: secondary survey, head and spinal injuries, chest pain, stroke, asthma, diabetes and allergy, drowning, psychological first aid, home visits and event first aid (see Level 2); running a first-aid training and community health service (see Level 3).
Every source used in this manual is listed, with links, in the Teacher Copy.