It has been part of every car for half a century: the first aid kit. Its content has been updated several times since then and must also be renewed every five years. But the problem lies elsewhere.
It is usually wedged in the trunk between the warning triangle and the jack: the first aid kit. For 50 years, the life-saving box or bag has been a must in the car to provide first aid after an accident.
This was very common in the early 1970s. Driving without a seat belt and speed limit on country roads, without ABS, ESP and without blood alcohol limits was very dangerous: in 1970, 19,193 people died on the road in Germany, with 13.94 million cars. For comparison: in 2021, 2569 people died in traffic accidents in Germany, with around 59 million registered vehicles.
At that time, ambulances needed a long time to reach the scene of an accident. Therefore, on January 1, 1972, the legislature introduced the obligation to carry a vehicle first aid kit to enable rapid first aid. Since then, every car must have first-aid material on board according to Section 35h of the Road Traffic Licensing Regulations (StVZO), defined according to DIN 13164.
"There were first-aid kits for cars before, but there was no obligation to carry one. That's why only a few cars had first-aid material on board," says Andreas Holthaus.
For more than 20 years he has headed the First Aid department (FBEH) at the German Medical Technology Association (BVMed). He is also the managing partner of Holthaus Medical. The family company from Remscheid has been producing bandages for almost 100 years, and first aid kits for over 50 years. These have been modernized several times over the past decades, and the standards have been adapted to ensure that they are always state-of-the-art in emergency medicine.
Checking the first aid kit is one of the checkpoints at the inspection intervals of some car manufacturers. If the box is expired, they usually offer a new one. There are also new first-aid boxes in car accessories stores or as promotional items at discounters. The content of the first aid kit does not differ due to the DIN standard. Their shape can vary, so they come in the form of a bag or a storage box.
The set consists of 42 items, including plasters, compresses, sterile products and fixation bandages. Disposable gloves have been mandatory since 1987, and a rescue blanket since 1998. First aid kits have had to contain skin cleansing wipes since 2014 and two face masks since February 2022.
"The supplements are intended to increase hygiene and protect first responders, because many are concerned about becoming infected from an accident victim," says Andreas Holthaus. This should increase the willingness to step in as a first aider.
"It is important that drivers note the expiry date and replace the first aid kit after five years," says Andreas Holthaus. Because various products have an expiry date due to the temperature fluctuations in the car. The old first aid kit does not have to be disposed of. Many drivers use it at home, even for minor injuries.
If the expiry date has passed or is missing altogether, a vehicle inspection could result in a fine of five to ten euros. If it is missing from a general inspection, if it is defective or incomplete, this will be reported as a "minor defect". According to Dekra, if the date has expired, this only appears as a note in the test report. The plaque is still there.
Even if the number of road deaths is falling, the number of traffic accidents remains high. According to the Federal Statistical Office, the police register 2.3 million accidents every year - with around 258,000 injuries. A total of around 321,000 people are injured on the road. "Many accident victims can be treated directly at the scene of the accident with a first aid kit. This help should not be underestimated," says Andreas Holthaus.
Siegfried Brockmann, on the other hand, considers the first-aid kit to be of only limited use. "Correct use depends on knowledge of first aid. If you don't have that, then the first aid kit is of little help," says the head of accident research for insurers (UDV) in the General Association of the German Insurance Industry (GDV).
For most drivers, the first aid course was many years ago. Since very few drivers refresh their knowledge after a few years, there is a lack of practice and skill. "Many drivers feel overwhelmed as first aiders and therefore cannot help," says Brockmann. However, there are no precise studies on the use of first aid kits.
In addition, the accident researcher considers the first aid kit to be overloaded. "First aid refers to serious injuries such as open wounds, heavy bleeding, cardiac arrest or shock. Small plasters and bandages are inappropriate," he says.
Rather, first responders should know how to treat life-threatening wounds, how a pressure bandage works, and find the appropriate material in the first-aid kit. Minor injuries are usually not treated at the scene of the accident, but later.
"Of course it doesn't hurt to have a first-aid kit in the car. But in its current form it's of little use," he says.
In order to use a first aid kit sensibly, knowledge needs to be refreshed. Among other things, the participants learn how to stop heavy bleeding and how to use a heart rhythm massage to the rhythm of the Bee Gees classic "Staying Alive". This also includes performing the stable lateral position and treating shock patients.
For Marcel Mühlich from the Auto Club Europa (ACE), knowing how to use first aid correctly is more important than having a first aid kit. "Anyone who doesn't feel safe should take a refresher course in first aid every three to five years. The course integrates the immediate measures at the scene of the accident and lasts only one day. But afterwards the participants know how they can save lives," says Mühlich.
There is no golden rule for using the first aid kit, but there is a precise procedure for first aid: get an overview, secure the scene of the accident, rescue handle, dial an emergency call, initiate life-saving immediate measures, stop bleeding and use a stable side position. "Every driver is legally obliged to provide first aid. It's better to help poorly than not to help at all. But practice makes perfect," he says.
When buying a first aid kit, Marcel Mühlich advises looking at the expiry date of the contents. "It's not always necessary to renew all of the content, it's often enough to replace the materials that have expired," he says. There are also refill packages for some first-aid kits that are cheaper than a new box.
Important: The expiry date should only be reached in five years and the content should meet the current status of DIN 13164 - with two medical masks. "They have to be sealed in the first-aid kit and not somewhere open and loose in the car," says Mühlich.
The first aid kits on the market according to the previously valid standard may still be used until January 31, 2023 and do not have to be exchanged or retrofitted. Storage location is also important. "It's best to keep the first-aid kit within easy reach in the interior. That's where drivers can get it right after an accident," says Mühlich. After a rear-end collision, however, the life-saving box in the trunk remains wedged between the warning triangle and the jack.
