Background: Injuries and acute medical emergencies account for approximately 4.4 million deaths annually worldwide. Timely first aid during the critical “golden hour” can reduce mortality and disability, yet evidence on first aid preparedness among undergraduate medical students in India remains limited.

Objectives: To assess knowledge, attitudes, and practices (KAP) regarding first aid and emergency response among undergraduate MBBS students, and to examine associations between KAP domains and academic year, gender, and prior first aid training.

Methods: An analytical cross-sectional study was conducted among 406 undergraduate MBBS students (first to fourth year) at a tertiary care teaching institution in Chennai, India, selected by stratified random sampling with 104 students drawn from each academic year. Data were collected using a pre-tested, structured, self-administered multiple-choice questionnaire covering knowledge, attitude, and practice domains. Associations between KAP domains and sociodemographic variables were examined using Chi-square tests and odds ratios with 95% confidence intervals.

Results: The mean age was 21 ± 1.5 years; 49.8% were male and 50.2% female; 67% had received prior first aid training. Good knowledge was demonstrated by 40.4% of participants and poor knowledge by 35.2%. Attitude was predominantly positive (mean score: 20.38 ± 2.95), with 85.2% agreeing that first aid improves patient survival. Practice scores were lowest across domains (mean: 3.46 ± 1.76), with the weakest performance in airway obstruction (62.3% correct) and fracture management (66.5% correct). First-year students showed significantly higher odds of poor knowledge. Prior training was significantly associated with practice and attitude scores, though not in the expected direction. Female students demonstrated significantly better knowledge and practice than male students.

Conclusion: Medical students demonstrated varying levels of knowledge and generally positive attitudes towards first aid, although practical competency remained limited in selected emergency scenarios. Longitudinally integrated, competency-based first aid training with periodic reinforcement should be incorporated across all years of undergraduate medical education.

KEYWORDS: First Aid, Knowledge, Attitudes, Practices, Emergency Response, Undergraduate Medical Students, Medical Education, Cross-sectional Study, Basic Life Support, India.