11.1 First Aid, Casualty Assessment and PPE Limitations

Practise first aid; do not turn rescue into another exposure

ADR 8.2.2.3.8 requires individual practical exercises covering at least first aid, firefighting and incident/accident action. This section supports those exercises. Competence comes from approved practice and current instruction, including a suitable CPR manikin, not from reading a checklist alone.

At a dangerous goods incident, assess traffic, fire, leaking chemicals, electrical equipment and unstable packages before approaching. A casualty in a vapour cloud or oxygen-deficient compartment needs specialist rescue. Do not enter wearing ordinary gloves, goggles and an emergency escape mask. A filter mask does not supply oxygen, remove every gas or make contaminated rescue safe.

Call 112, or the applicable national emergency number such as 999 in Great Britain, promptly. State the location, casualties and dangerous goods, using the transport information if safely available. Do not delay the call to find every document or finish setting out signs. Follow the dispatcher’s instructions and keep others from entering danger from a safe position.

Initial decision aid

Responsiveness, breathing and CPR

The 2025 Resuscitation Council UK basic life-support guidance advises calling for an ambulance as soon as a person is found unresponsive, with breathing assessed while the call is being answered. Absent or abnormal breathing, including gasping, can mean cardiac arrest. Do not treat occasional gasps as normal breathing or delay action while searching for a pulse.

If the scene is safe and the unresponsive adult is not breathing normally, begin CPR and use an automated external defibrillator (AED) as soon as available. Adult compressions are 100–120 per minute, to a depth of 5–6 cm, with full recoil and minimal interruption. If trained and able to give rescue breaths safely, use 30 compressions to 2 breaths. If unable or unwilling to give breaths, provide continuous compressions and follow the dispatcher. Chemical contamination can create additional exposure risk; tell the dispatcher and do not use contaminated equipment or expose yourself to the chemical.

Switch on the AED and follow its prompts. Keep everyone clear when it analyses or delivers a shock. Follow site/dispatcher directions to use it in a safe location away from a hazardous atmosphere. Continue as instructed until professional help takes over, normal signs of life return, you are exhausted or the scene becomes unsafe.

Recovery position and trauma

For a person with reduced responsiveness who is breathing normally and does not need CPR, a side-lying recovery position can protect the airway where appropriate. Do not routinely roll a road-collision casualty with suspected trauma into that position. Current first-aid guidance distinguishes trauma and agonal breathing from ordinary recovery-position cases. Minimise movement, monitor breathing and follow emergency guidance; airway and immediate life safety take priority.

Never leave the casualty unmonitored because they briefly responded. Reassess responsiveness and breathing and report changes to the dispatcher. If breathing becomes abnormal or stops, follow the cardiac-arrest instructions. Do not give food, drink or medicines to an unconscious person.

Severe bleeding and shock

Where safe, use suitable protection and apply firm direct pressure to serious external bleeding with an appropriate dressing or clean material. Obtain urgent help. Trained first aiders may use additional bleeding-control measures under their current instruction and equipment; improvised invasive treatment is not part of basic dangerous goods driving.

Keep the person reassured and protect them from heat loss without worsening exposure or moving a trauma casualty unnecessarily. Do not give alcohol or attempt to “wake them” by making them stand. Tell responders about chemical contamination as well as the visible injury, so they can manage both safely.

Chemical burns, eyes and ingestion

Current NHS chemical-burn guidance advises urgent medical help, removing contaminated clothing where possible, carefully brushing dry chemical off skin and using plenty of cool/lukewarm running water for about one hour. Start prompt suitable irrigation; follow product-specific emergency advice. Do not apply creams or try to neutralise an acid with alkali or vice versa.

For eye exposure, obtain urgent medical help and begin appropriate gentle irrigation, avoiding contamination of the unaffected eye. The cab eyewash is an immediate resource while a continuing water supply and professional assistance are arranged. A small bottle does not define an adequate total treatment or mean the injury is minor.

Do not induce vomiting after swallowing a chemical. Keep the product information available from safety and follow poison/emergency medical instructions. Do not give anything by mouth to someone who cannot safely swallow. An ADR water-reactive cargo warning must not be copied mechanically into a prohibition on all casualty irrigation; get urgent specialist advice for the actual exposure.

Thermal and cryogenic injuries

Hot goods can burn without a flame, and a cryogenic liquid can injure through intense cold. Stop exposure safely and obtain medical help. For ordinary thermal burns, current NHS guidance recommends cool running water for 20 minutes; do not use ice or creams or pull away material stuck to the burn. Chemical burns have different guidance and may need longer irrigation.

For suspected frostbite, protect the area, avoid rubbing or direct intense heat and obtain medical care. Do not peel away clothing frozen to skin or return an injured person to contact with the cold source. Keep cryogenic relief vents clear; blocking a vent to stop “smoke” can create a pressure hazard.

PPE selection and removal

The ADR kit includes a warning vest, lighting, protective gloves and eye protection for each crew member, plus goods-dependent equipment. Carry requirements are not proof of suitability for every task. A glove suitable for abrasion can fail against a solvent; a face shield may need goggles beneath it; an escape filter has a specified scope and service life. The undertaking’s risk assessment and manufacturer instructions determine selection and use.

Know how to put on and remove the assigned PPE without transferring contamination to skin or the cab. Stop using damaged, contaminated or expired equipment and report replacement needs. The approved practical exercise should include inspection, safe removal and emergency reporting. After any exposure, seek the required medical assessment even if early symptoms seem mild.

Sources checked 17 October 2026: 2025 adult BLS, 2025 first aid, NHS chemical burns, thermal burns and frostbite treatment.