A trauma-skilled approach is embedded within the practice of everyone who provides care or support to people who may have experienced trauma, whether or not the trauma is known about. This applies to most organisations and services in Wales, and many working in and with the community.
First Aid training covers topics that can be emotionally activating, even when training is delivered sensitively. Trainers should also be sensitive to the different ways that learners may have experienced trauma, for example, cultural trauma, sexual trauma, Adverse Childhood Experiences (ACEs). Trauma-aware training seeks to ‘challenge perceptions that maintain oppression and inequality’, for example, challenging gender and cultural based perceptions about modesty and removal of bras to use an AED.
What does it mean to be trauma-aware?
Being trauma-aware does not require specialist clinical skills. Instead, it means prioritising kindness, safety and choice in how training is designed and delivered.
In First Aid courses, potentially activating elements may include:
- graphic images or videos
- real-life emergency footage
- role-play or simulated scenarios
- practising physical techniques such as CPR
- sharing lived experience in group discussions
For some learners, these activities can trigger distress or memories of past emergencies. Sharing personal experiences should always be optional.
Universal trauma-aware practices in First Aid training
Trauma-aware trainers can support learner wellbeing by:
- providing joining instructions with clear information on potentially challenging topics, self-care strategies and wellbeing locations (e.g. a nearby parks, quiet spaces) prior to the course.
- ensure that ground rules are established and maintained to ensure everyone feels safe in the learning environment.
- providing clear session structures, topic introductions and content warnings
- considering the audience and adapting content appropriately (e.g. age-appropriate CPR guidance)
- normalising a wide range of emotional and physical trauma responses that might impact our ability to respond in an emergency, including fight, flight, freeze and fawn
- correcting skills in a non-judgmental, supportive way
- actively challenging assumptions and inequalities, such as gender bias in CPR delivery or inappropriate humour
- provide opportunities for learners to share their first aid experiences only if they choose to do so.
Responding to learner distress
If a learner becomes distressed or discloses a traumatic experience, trauma-aware responses may include:
- a quiet check-in away from the group
- offering grounding or regulation strategies
- modifying participation or assessment methods
- signposting to appropriate support services
These responses help learners feel respected and safe, without requiring disclosure or explanation.
Why trauma-aware First Aid matters
Embedding universal trauma-aware practice:
- supports learner wellbeing
- improves engagement and skill retention
- builds confidence to act in future emergencies
- contributes to more compassionate and equitable emergency response systems
Pre-course trauma informed practice
A trauma-aware approach invites reflection on who may be missing from First Aid training spaces. There is limited understanding of how trauma deters people from attending training or how confidence can be rebuilt after a distressing emergency. Recognising these gaps highlights the need for more flexible, inclusive and trauma-enhanced training pathways.
Here is an example of good practice trauma-aware joining instructions for a sensitive training topic, with thanks to Cardiff University Student Health and Wellbeing team:
Referral to Specialist Interventions
Specialist interventions may be formal personalised and co-produced interventions that are offered within a range of settings, or specialist input to support organisations and systems to be trauma-informed.
Trauma-specific support sits outside the trainer’s role, however, trainers should be informed about:
- referral routes to mental health services; encouraging follow-up with NHS and third sector organisations, including employee wellbeing services or specialist occupational services (e.g. Cardiac Arrest Remedial Support)
- signposting to bystander-focused support lines such as the BHF Heart Helpline (for co-survivors of cardiac arrest), bereavement support lines (e.g. Cruise Bereavement)
- signposting to peer support organisations for co-survivors of cardiac arrest or other traumatic events (e.g. Sudden Cardiac Arrest Support Group, First Hand)
- how to deal with emotionally-loaded technical questions raised by learners (“did I do the right thing?”)
This acknowledges the limit of First Aid trainers’ responsibilities while ensuring signposting pathways exist.
For more information, see: Post-Incident Follow-up: Specialist Interventions for First Aiders