A Ministry of Health guide telling people how to help elderly residents if they fall in the street has stirred controversy with people arguing that it is a lack of trust that prevents them helping, not a lack of medical knowledge.

The 41-page guide, available to download from the ministry's website, advises people who see old people fall "not to help them up in a hurry, but to observe and inquire about their health conditions first and then act accordingly."

The guide says that in many cases their help could lead to more serious problems from elderly people suffering bone fractures, strokes or heart disease.

Accidental falls have become the main cause of deaths of people over the age of 65 in China, with more than 40 million elderly people falling down at least once a year, the guide says.

It advises dialing 120 for medical help if people see someone on the ground unconscious. And if the person is conscious, it says they should ask why and how they had fallen before taking any action.

But there was derision online with posts saying the guide could only be effective if people were willing to lend a helping hand in the first place.

They said the government should focus on re-establishing social trust as the top priority after a series of cases across the country where people trying to help were instead wrongly accused of causing the accident. Some old people even tried to sue people who rushed to their aid.

发现老年人跌倒时应该怎么办？卫生部6日公布的《老年人跌倒干预技术指南》提出：不要急于扶起，要分情况进行处理。

指南提出，如老人意识不清，在场者应立即拨打急救电话。有外伤、出血，应立即止血、包扎；有呕吐，应将其头部偏向一侧，并清理口、鼻腔呕吐物，保证呼吸通畅；有抽搐，应移至平整软地面或身体下垫软物，防止碰、擦伤，必要时牙间垫较硬物，防止舌咬伤，不要硬掰抽搐肢体，防止肌肉、骨骼损伤；如呼吸、心跳停止，应立即进行胸外心脏按压、口对口人工呼吸等急救措施；如需搬动，应保证平稳，尽量平卧。

事件背景：

8月26日，江苏南通，一位骑三轮车的老人被撞受伤，客车司机殷红彬下车搀扶老人，却被其一口咬定是被他的客车撞倒，警方通过调取监控录像才还了殷红彬一个清白。

8月28日，湖北武汉，骑电动车的胡师傅途经汉口合作路与鄱阳街交叉路口时好心扶起一名摔倒的八旬婆婆，却反被赖称是被其电动车撞倒，目击路人纷纷为胡师傅作证，民警多方调查，胡师傅方才惊险脱身。

9月2日晨，同样是在湖北武汉，李大爷跌倒在汉阳区的知音西村菜场，菜场人来人往，却没人敢去扶他一把，一小时后李大爷离开了人世。