Nationwide Survey on Public Knowledge and Attitudes Regarding First Aid for Common Emergencies in Pakistan with Multivariable Regression Analysis

Background: First aid provided by lay responders can lower preventable illness and death; however, community-level skills and training access are still uneven in low- and middle-income countries. Pakistan does not have nationally representative data on first-aid knowledge and attitudes. Objective: To measure adult first-aid knowledge and attitudes in Pakistan and identify sociodemographic and geographic differences to guide public health training strategies. Methodology: We conducted a nationwide cross-sectional survey (September–November 2025) using a structured, bilingual (Urdu/English) questionnaire adapted from validated instruments. Multi-stage cluster sampling with equal quotas recruited adults (≥ 18 years) from all seven provinces and territories through community sites and online dissemination; healthcare workers and ALS-trained individuals were excluded. Knowledge (6-item score; higher = better) and attitude (3-item Likert score, 3–15; higher = more positive) were predefined outcomes. Descriptive statistics summarized distributions. χ² tests assessed associations between categorical levels of knowledge and attitude and demographics; one-way ANOVA compared provincial mean knowledge scores. Listwise deletion addressed missing data; analyses used SPSS v22. Results: Of 490 respondents (52.4% female; 89.2% aged 18–30 years), equal representation (n = 70 each) was obtained from Azad Jammu & Kashmir, Sindh, Punjab, Khyber Pakhtunkhwa, Balochistan, Islamabad, and Gilgit-Baltistan. The average knowledge score was 3.71 ± 1.45 out of 6; 43.1% had poor, 45.1% moderate, and 11.8% good knowledge. Provincial means differed (ANOVA F (6,483) = 11.478, p < 0.001), with the highest in Khyber Pakhtunkhwa and the lowest in Sindh. Knowledge level was associated with gender, marital status, age, education, occupation, and province (all p ≤ 0.001). The mean attitude score was 11.07 ± 2.23 out of 15; 41.0% displayed a positive attitude, 49.2% neutral, and 9.8% negative. Attitude was linked to education and province (p ≤ 0.001), but not with gender, marital status, age, or occupation. Only 38.2% had attended a first-aid course, with reported barriers including “course not offered” (31.4%), lack of time (12%), and fees (6.9%). Conclusions: First-aid knowledge in Pakistan is moderate with noticeable regional and educational differences, although attitudes toward training are mostly positive. Expanding accessible, standardized first-aid education, focusing on underserved provinces and utilizing blended or community-based delivery, should become a national public health priority to bridge the gap between intent and capability.