Every couple of years my TV bosses send me and others on a residential course to cope with working in a war zone. It was noteworthy that this month’s refresher contained a module looking at how to survive a terror attack in Britain.

It was presented by a former Royal Marine. He had no time for the current, official Metropolitan Police guidance on what to do when confronted by an armed extremist. “Don’t run, don’t hide,” he said, “your best chance is to do this.” At which point he demonstrated what looked like the front crawl, a series of haymakers designed to make a knife-wielding assailant flinch.

You might expect opinion to be divided on what, ultimately, amounts to a deeply personal contingency. There are arguments for flight and for fight. More surprising was what our trainers told us about first aid. How do we do CPR? Should we use a tourniquet? These are some of the fundamental questions faced by first responders and they were not settled, as you might imagine, by Florence Nightingale.

For when it comes to keeping people alive in the moments after a traumatic event, the canon is far from closed. On previous courses I accepted the explanation of evolving practice on how to stop “big bleeds”. The wars in Iraq and Afghanistan, where soldiers survived the loss of multiple limbs thanks to the early application of tourniquets and the rapid intervention of cutting-edge medicine, made sense of the idea that some treatments could still be modernised or contradicted. But the number and speed of chest compressions? The importance of mouth-to-mouth resuscitation? The received wisdom seems to alter every few years.

It’s the kind of thing that has cynics at the back of the class gurning. Does first aid have a producer interest, which induces contractors to keep coming up with new material? Surely not.

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