Recognising Serious Illness: ANZCOR Combines Shock and Sepsis First Aid Guidance
ANZCOR Guideline 9.2.3 has been updated to combine recognition and first aid management of the seriously ill person, including shock and sepsis. The exact diagnosis has been deliberately de-emphasised. The guideline replaces the earlier separate documents on shock and sepsis with one practical approach to recognising deterioration and calling for urgent help.
This is an important shift for first aiders. Serious illness can be difficult to diagnose even in hospital. In the community, the priority is to recognise that the person is dangerously unwell, not to decide whether the label is sepsis, shock or another medical emergency.
Red flags for serious illness
No single sign proves that a person has sepsis or shock. Concern increases when several changes occur together or the person is worsening quickly.
- Rapid, difficult or noisy breathing, gasping, or difficulty speaking because of breathlessness.
- A fast, weak, slow or newly irregular pulse.
- Cool, sweaty, pale, blotchy or discoloured skin, or a new widespread rash.
- Restlessness, confusion, unusual drowsiness, collapse, seizures or a falling level of consciousness.
- Fever, shivering or feeling unusually cold, especially in an older or vulnerable person.
- Very little or no urine, repeated vomiting, unexplained severe pain or rapidly worsening illness.
- The person says they do not feel right, feels they may die, or has a strong sense of impending doom.
- In a child, a parent or carer says the child is much more unwell than usual or that something is wrong.
What the first aider should do
If serious illness is suspected, call 000 in Australia or 111 in New Zealand. Do not wait for every sign to appear or for the diagnosis to become obvious. Delay can allow a reversible illness to progress to organ failure, cardiac arrest or death.
Ensure the scene is safe. If the person is unresponsive and not breathing normally, begin resuscitation using the DRSABCD approach. If the person is conscious, help them into a safe resting position, keep them comfortable, monitor for deterioration and follow the emergency call taker’s instructions. Do not give food or drink when consciousness is impaired or when urgent procedures may be required.
What this means for first aid education
The update supports scenario-based teaching rather than diagnosis-based memorisation. Learners should practise noticing a cluster of abnormal signs, listening to the concerns of family members, making an urgent call and communicating clearly with ambulance services.
Training should also reinforce that a normal-looking temperature or blood pressure does not exclude serious illness. Some people, particularly older adults, young children and those with weakened immune systems, may deteriorate without classic signs.
The practical takeaway
A first aider does not need to prove sepsis or classify shock. Recognise that the person is seriously unwell, call an ambulance early, manage immediate threats to airway and breathing, and keep monitoring until professional help arrives.
Continue your training
Modern first aid training should build confidence to recognise deterioration and escalate early. The goal is not to turn first aiders into diagnosticians; it is to help them act before a seriously ill person becomes critically unstable.
Primary clinical source: ANZCOR Guideline 9.2.3 – Recognition and First Aid Management of the Seriously Ill person, including Shock and Sepsis
Publication disclaimer: Educational summary only. It does not replace the full ANZCOR guideline, local policy, formal training or clinical judgement. Verify the current official guideline before publication or clinical use.
