First Aid Certification in South Africa: Complete Guide 2026

First Aid knowledge is practically the most important thing most people never prepare for — until they need it. When we built the Dragonfly First Aid practice set, we focused on the scenarios that are most likely to occur in real life and are most commonly assessed in South African workplace first aid courses: CPR, choking, bleeding control, shock, and recognition of cardiac and neurological emergencies. This guide covers the knowledge component of First Aid certification and how to retain it under real-world pressure.

First Aid levels in South Africa

South African workplace first aid training is regulated by the Department of Employment and Labour under the Occupational Health and Safety Act (OHSA). Training is divided into three levels. Level 1 (approximately 2 days): Basic life support — CPR, AED use, choking response, bleeding control, burns, basic wound care, and recognition of medical emergencies. This level is sufficient for most non-hazardous workplaces. Level 2 (approximately 3 days): Extends Level 1 with more advanced wound care, fracture management, spinal injuries, eye injuries, and more detailed emergency management. Level 3 (approximately 4 days): Advanced first aid including oxygen therapy, advanced airway management, and extended emergency care. Required for high-risk workplaces and mining operations.

Under the OHSA General Safety Regulations, employers are required to have at least one trained first aider for every 50 employees in a low-risk workplace, and one for every 10 employees in a high-risk workplace. First Aid certificates are valid for 3 years before requiring renewal. Check your employer's specific requirements as some industries (mining, construction, manufacturing) have stricter ratios.

CPR: the most important skill

Cardiopulmonary resuscitation (CPR) is the intervention most likely to save a life in a cardiac emergency. The Chain of Survival — early recognition, early call for help, early CPR, early defibrillation — is the framework for cardiac arrest response. In South Africa, call emergency services (10177 for ambulance, 112 from mobile) immediately while beginning CPR.

Adult CPR sequence: confirm the scene is safe, check for response (tap shoulders, call loudly), call for help and send someone to find an AED, open the airway (head-tilt chin-lift), check for normal breathing for no more than 10 seconds, begin chest compressions at the centre of the chest — hard (at least 5cm depth), fast (100-120 compressions per minute), with full chest recoil between compressions. The ratio is 30 compressions to 2 rescue breaths for trained first aiders. Compression-only CPR (no breaths) is acceptable and effective for untrained bystanders.

AED use: demystified

Automated External Defibrillators (AEDs) are designed to be used by non-medical personnel. The device analyses the heart rhythm and delivers a shock only if it detects a shockable rhythm — you cannot accidentally shock someone who does not need it. The sequence: turn on the AED (open the lid or press the power button — it will guide you verbally), attach the pads as shown in the diagrams on the pads, allow the AED to analyse (ensure no one is touching the patient), deliver the shock if prompted (call 'clear' and ensure no contact before pressing the shock button), immediately resume CPR starting with chest compressions.

AED pad placement: one pad on the upper right chest (below the collarbone, to the right of the breastbone) and one pad on the lower left side of the chest (below the left armpit). Do not place pads over a pacemaker (visible lump under the skin) or a medication patch — move the patch or adjust pad placement. For children under 8 years, use paediatric pads if available; if not, adult pads can be used with front-back placement (one on the chest, one on the back).

Choking: adult vs infant response

For a conscious adult or child over 1 year who is choking: encourage coughing if they can cough effectively. If ineffective or cannot cough: stand behind them, give 5 firm back blows between the shoulder blades with the heel of your hand, then 5 abdominal thrusts (Heimlich manoeuvre — hands above the navel, firm inward-and-upward thrusts). Alternate 5 back blows and 5 abdominal thrusts until the object is dislodged or the person becomes unconscious. If unconscious, call for help immediately and begin CPR.

For an infant under 1 year: do not use abdominal thrusts. Instead, use 5 back blows (face-down on your forearm, firm blows between the shoulder blades) followed by 5 chest thrusts (face-up on your forearm, two fingers on the lower half of the breastbone, firm downward thrusts). This modified technique prevents abdominal injury in infants.

Medical emergencies: recognition and response

Cardiac arrest vs heart attack: A cardiac arrest is the sudden cessation of the heart's pumping function — the person collapses, is unresponsive, and not breathing normally. Begin CPR immediately. A heart attack (myocardial infarction) is a blockage of a coronary artery — the person may be conscious, experiencing chest pain, shortness of breath, nausea, and sweating. Call emergency services immediately, help them sit or lie in a comfortable position, and give aspirin (300mg chewed, not swallowed) if available and not contraindicated.

Stroke recognition — use FAST: Face drooping (one side of the face droops or is numb), Arms weak (one arm drifts down when both are raised), Speech slurred or strange, Time to call emergency services immediately. Stroke is a time-critical emergency — every minute without treatment results in the loss of approximately 1.9 million neurons. Do not give anything by mouth to a suspected stroke patient.

Diabetic emergencies: Hypoglycaemia (low blood sugar) — the patient is conscious, pale, sweating, shaky, confused. Give sugar: a glass of fruit juice, sugary cool drink, or glucose tablets. Hyperglycaemia (high blood sugar) — develops more slowly, patient may be drowsy, thirsty, passing urine frequently. Requires medical management — call emergency services if severe.