Occupational safety

First aid training in small and medium-sized enterprises (SMEs)

Summary: In small and medium-sized enterprises (SMEs), regular first aid training is required by law. All employees must be trained at least once a year. In addition, a sufficient number of first responders must be ensured: For 2 to 20 employees at least one person, in addition in administrative and commercial enterprises 5 %, in other establishments 10 %. The training sensitizes the workforce to emergency situations and conveys key practical content: Accessibility and tasks of first responders, locations of first aid kits and defibrillators, correct behavior in emergencies including emergency calls and basic first aid measures such as stable lateral position or hemorrhage.

Occupational health and safety are among the most important issues in every company. No employer wants their employees to be harmed during work or on their way to work. Nevertheless, there are hundreds of thousands of operational accidents every year. Some of them, unfortunately, have very serious or fatal consequences. Like the DGUV reports in 2024, there were 752,125 reportable accidents at work.

In large companies and international corporations, there are often more comprehensive resources to organize occupational safety, first aid and safety in the workplace. Effective measures for first aid and occupational safety are also crucial and mandatory for small and medium-sized enterprises. They can be successfully implemented with the right planning and support. An important basis for this is first aid training, which prepares the workforce for possible emergency situations, transports information and promotes safety in the company.

What are the legal requirements for this first aid training? What content is mandatory and how can requirements be effectively implemented? This article explains the most important guidelines for first aid training in small and medium-sized enterprises in a practical way.

How often does a company need to carry out first aid training?

First aid training must be provided in accordance with § 4 the DGUV Rule 1 shall be applied at least once a year. In the DGUV Rule 1 reads literally:

The employer shall instruct the insured persons on safety and health at work, in particular on the risks associated with their work and on the measures to prevent them. The instruction must be given and documented at least once a year.

§4 DGUV Rule 1

First aid training is designed to raise awareness among all employees. It is mandatory for all employees and not limited to specific groups such as first responders. The repetition of the first aid instruction is necessary to take into account changes in the company, for example through new machines, work equipment or processes. At the same time, regular repetition helps to refresh the knowledge of all employees on the subject of first aid.

How is teaching regulated by law?

The legal obligation to provide regular first aid training results from two guidelines. Essential is § 12 of the Occupational Safety and Health Act. The law states:

The employer shall provide sufficient and adequate information to workers on health and safety at work during their working hours.

§12 ArbSchG

Also essential for the implementation of first aid training is the DGUV Rule 1 ‘Principles of prevention’, which is available on the internet via the following link and can be downloaded free of charge. Both sets of rules define that entrepreneurs must take targeted measures to ensure the safety and health of all employees. One of the central measures is regular instruction in occupational safety and first aid.

In addition, Section 26 of the DGUV Rule 1 and Section 10 ArbSchGobligate, that a sufficient number of trained first responders must be provided for the operation:

The entrepreneur has due to DGUV-Requirement 1 to ensure that first responders are available for first aid in at least the following number:

For 2 to 20 insured persons present a person as a first responder,
With more than 20 insured persons present in administrative and commercial establishments 5%,
In other establishments 10%.

As defined by the European Commission (2003/361), which is also used by the Federal Statistical Office, the following company sizes are distinguished:

micro	Less than 10 employees and a maximum turnover of EUR 2 million
Small business	Less than 50 employees and a maximum of 10 million turnover
Medium-sized enterprise	Less than 250 employees. Less than EUR 50 million in annual turnover

Practical example: A handicraft company with 26 employees is obliged to train 10 % as first responders. This means that 3 first responders must be available in the company who are trained in first aid measures. A small insurance office with 5 employees only needs a first responder for first aid.

In addition to the annual training, first responders are required to refresh their training at least every two years. Companies must also ensure that these first responders are trained according to the specific hazards of their operations.

In what form must the instruction be carried out?

First aid training can be done in different ways. It is crucial that all content is conveyed in a complete and comprehensible manner. Possible formats include:

On-site training by safety officers, company doctors or external experts.
Digital formats such as e-learningplatforms or hybrid training.
Workshops and practical exercises for a better understanding, especially on topics such as emergency call execution, detection of emergencies or application of the stable lateral position.

Establishments are required to adapt the type of training and the information to the operational risk situation. For a craft business, other accident scenarios and first aid training are relevant than for employees who are exclusively in an office environment.

What basic information needs to be treated?

The mandatory annual first aid training should enable all employees to act quickly and proactively in an emergency. Four key elements of the training are:

Accessibility of first responders in the company and its tasks.
Locations of first aid material, such as first aid kits and defibrillators (AED).
Behavior in an emergency, including the making of an emergency call.
Asking essential W-questions: Where did the accident happen? What happened? How many people are affected? What injuries are there? Waiting for questions from the rescue control center and response.

Basics of first aid, such as the stable lateral position or the behavior and immediate measures for obvious injuries such as bleeding or burns in the workplace should also be discussed in a practical way, so that every employee understands the basics and can apply them.

One of the DGUV recommended visual support, such as posters and safety posters to the locations of the first aid kits or to the emergency call at the workplace are important. They can promote the long-term memory of employees.

What other information can be important in the training?

In addition to the basic topics of first aid training, the training should be extended sector-specific. Examples are:

Hazardous substances treatment, emergency call and first aid measures in the event of chemical accidents.
Handling of operational rescue equipment, such as emergency showers or eyewash stations as well as contents of the first aid kit.
Dealing with psychological stress situations after accidents (debriefing) for those affected and colleagues.
Legal consequences of failure to provide assistance. The Criminal Code explains in Section 323c StGB: ‘Any person who fails to provide assistance in the event of an accident or common danger or distress, even though it is necessary and reasonable for him to do so, in particular without significant risk of his own and without breach of other important obligations, shall be liable to a term of imprisonment not exceeding one year or to a fine.’

In addition, practical exercises such as the use of an automated external defibrillator (AED) or the induction of rescue workers can create a high added value. There is no legal obligation to purchase a defibrillator.

How is the instruction logged?

First aid instructions are provided in accordance with § 24 of the DGUV Documentation of Rule 1. The evidence shall include the following information:

Date of training.
Topics of instruction.
Names and signatures of participants.
Signature of the trainer.

The document should be kept as evidence for at least two years. In doing so, it must be ensured that personal data is processed exclusively in accordance with DSGVO processed. Digitization solutions such as keeping a digital association book are allowed. You can simplify the management of first aid training.