The Australian and New Zealand Committee on Resuscitation (ANZCOR) has released a significant update to their first aid guidelines for recognizing and managing seriously ill persons. This update consolidates and expands previous guidance, making it more practical and comprehensive for first aiders in the community.
What’s New?
ANZCOR has merged two separate guidelines into one comprehensive resource. The updated Guideline 9.2.3 now covers both shock AND sepsis recognition under the broader umbrella of “Recognition and First Aid Management of the Seriously ILL person, including Shock and Sepsis.”
The Big Picture Change
The key shift in this guideline is a move away from trying to diagnose specific conditions toward recognising that someone is critically unwell and needs urgent help. ANZCOR emphasises that first aiders shouldn’t worry about naming the exact condition – instead, they should focus on identifying the warning signs that someone needs emergency medical care.
Key Changes Every First Aider Should Know
1. Person-Centered Language
The guidelines now use “person” instead of “victim” throughout, reflecting a more respectful and modern approach to first aid care.
2. Enhanced Recognition Criteria
The new guidelines provide much clearer “red flags” for serious illness, organised by body system:
Breathing Red Flags:
- Rapid breathing (22+ breaths per minute in adults)
- Breathlessness or difficulty breathing
- Noisy breathing, gasping, or struggling to speak
Circulation & Skin Red Flags:
- Rapid heart rate (over 100 beats per minute when not exercising)
- Cool, sweaty, pale, or mottled skin
- New widespread rash
Neurological Red Flags:
- Confusion, disorientation, or decreased consciousness
- Restlessness, agitation, or anxiety
- Sudden weakness or seizures
Temperature & Systemic Red Flags:
- Fever (38°C or higher) or feeling very cold
- Shivering or chills
- Little or no urine output
- Nausea and vomiting
3. Trust Your Instincts
One of the most important additions is the explicit emphasis on subjective concerns. The guidelines now state that when someone says “I don’t feel right” or “I think I am going to die,” this should NEVER be dismissed. This is considered a red flag for serious illness.
Similarly, if family members notice concerning behavior changes, or if parents worry their child is more unwell than usual, these concerns must be taken seriously.
4. Special Focus on Children and Infants
The updated guideline includes a dedicated section on recognising serious illness in children and infants, with age-appropriate warning signs:
- Rapid, weak, or labored breathing
- Hard to wake or unusually sleepy
- Rash that doesn’t fade when pressed
- Poor feeding or persistent vomiting
- Inconsolable crying or severe irritability
- No wet nappies for several hours
Crucially: A parent’s instinct that “something is not right” should always be treated as a red flag.
5. Simplified Positioning Approach
The new guidelines take a more flexible, person-centered approach to positioning:
- If conscious, assist the person to lie on the floor
- BUT if they’re not comfortable, unable, or don’t want to lie down, offer them a chair
- Bring the chair to them rather than making them move
This represents a shift from rigid positioning rules to prioritising comfort and individual needs.
6. Explicit Sepsis Recognition
While sepsis diagnosis is beyond the scope of first aid, the guideline now explicitly addresses that sepsis is difficult to identify even for trained clinicians. The emphasis is on recognising the general signs of serious illness, which may indicate sepsis, and acting quickly because early treatment dramatically improves outcomes.
7. Comprehensive Management Steps
The management section now provides a clear, numbered sequence:
- Ensure scene safety
- Call for an ambulance (000 in Australia, 111 in New Zealand)
- Commence CPR if unresponsive and not breathing normally
- Position conscious persons appropriately
- Recovery position for unconscious but breathing persons
- Manage seizures if present
- Control any bleeding
- Consider specific conditions (diabetes, anaphylaxis)
- Administer oxygen if trained and available
- Maintain body temperature appropriately
- Reassure and monitor continuously
What This Means for Your First Aid Training
These changes reflect evidence-based best practice and align with international guidelines. Key takeaways for first aiders:
✓ Don’t diagnose – recognise that someone is seriously unwell
✓ Trust subjective concerns – yours and the person’s
✓ Count warning signs – the more present, the higher the concern
✓ Act quickly – delay in treatment can lead to serious complications
✓ Call early – if you think something is wrong, call for help
✓ Be flexible – prioritise person comfort and safety
Get Up To Date
Our nationally recognised First Aid and CPR courses now incorporate these updated ANZCOR guidelines on the Recognition and First Aid Management of the Seriously Ill Person, including Shock and Sepsis, ensuring you’re trained to recognise critical warning signs and respond confidently when someone’s life is on the line.
Check out our upcoming in Port Macquarie First Aid Courses and Taree First Aid courses and enrol in a first aid course today to refresh your skills, stay compliant with current standards, and be ready to identify serious illness and provide lifesaving care when it matters most.
