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American Red Cross

Guide for Training First Aid/CPR/AED Program Instructors

Copyright © 2001 by The American National Red Cross The care steps for CPR outlined within this product are consistent with the Guidelines 2000 for Emergency Cardiopulmonary Resuscitation and Emergency Cardiovascular Care. All rights reserved. No part of this publication may be reproduced, stored in a retrieval system, or transmitted, in any form or by any means, electronic, mechanical, photocopying, recording, or otherwise, without prior written permission from the American National Red Cross.

Acknowledgments

This program and manual were developed through the dedication of both volunteer and paid staff. Their commitment to excellence made this program possible. The following American Red Cross national headquarters staff contributed to the development, design, and review of this program and manual. The project team included Soraya Assaf, manager, Products & Services Marketing, Corporate Marketing; C.P. Dail Jr., senior associate, Business Planning & Development; Jennifer Deibert, senior associate, Educational Program Evaluation; Mike Espino, Don Vardell, senior associates, New Products & Services Development; Ted T. Crites, CHES, senior associate; Jacques de Broekert, Greg Stockton, Ann Dioda, John Thompson, associates, Products & Services Support; Sharron Silva, senior manager, Product Research, Market Research and Assessment; and Shannon Bates, senior project manager, StayWell. The project development team included Mary Ann Polacek, RN, MSN, MBA, senior associate; Stephen Bartos, MBS, Tab Bates, Jill K. Gross, MPH, CHES, Connie Harvey, Alexander R. Kuhn, NREMT-P, Marty Perreault, NREMT-B, Marc Madden, associates, New Products & Services Development; Betty J. WilliamsButler and Beatrice Clayton, administrative assistants, New Products & Services Development; and Eric Buhi, Christine Carr, associates, Educational Program Evaluation. The Workplace Training project coordination team included Sharon Fay, director, New Products & Services Development; Elizabeth Stewart, director, Market Research & Assessment; and Jean Wagaman, director, Products & Services Support. The following American Red Cross national headquarters Chapter Operations staff provided guidance and review: Jane Moore, associate, New Products & Services Development; and Elizabeth Critchley, associate, Business Planning & Development. The StayWell editorial and production team included Deborah Gale, vice president, Education & Safety Products; P.J. Bell, senior project manager; John Heffernan, senior manager; Barbara Miller, senior production coordinator; and Chris Cornell, production coordinator. Guidance and review were provided by-- Linda Burnette Associate, Wellness Unit American Red Cross National Headquarters Falls Church, VA Colm Griffin Manager, Education Programs American Red Cross of the St. Paul Area St. Paul, MN Tom Lochhaas Newburyport, MA Joan Pankey Director, Health and Safety Services Central Maryland Chapter American Red Cross Baltimore, MD Michele Restino Director, Workplace Education American Red Cross of Massachusetts Bay Boston, MA Kristy Vandenberg Director of Health and Safety American Red Cross Greater Houston Area Chapter Houston, TX

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American Red Cross First Aid/CPR/AED Program Guide for Training Instructors

CONTENTS

Section 1: PREPARATION Introduction ..........................................................................................................................1-1 Purpose of the Instructor Course .........................................................................................1-1 Streamlining of Instructor Authorizations ............................................................................1-2 Prerequisites for Instructor Candidates ................................................................................1-2 Course Code .........................................................................................................................1-2 Course Length ......................................................................................................................1-2 Class Size .............................................................................................................................1-3 Facilities ...............................................................................................................................1-3 Materials, Equipment, and Supplies ....................................................................................1-3 Preparation for the Precourse Session .................................................................................1-4 Precourse Session .................................................................................................................1-4 Certification Requirements ..................................................................................................1-4 Practice-Teaching Assignments ...........................................................................................1-4 Instructor Course Objectives ................................................................................................1-5 Course Evaluation ................................................................................................................1-6 Responsibilities of the Instructor Trainer ............................................................................1-6 Administrative Terms and Procedures for the Instructor Trainer ........................................1-6 Section 2: INSTRUCTOR COURSE OUTLINE AND LESSON PLANS Precourse Session Outline and Lesson Plan ....................................................................... 2-3 Session 1: Outline and Lesson Plan .................................................................................... 2-4 Session 2: Outline and Lesson Plan ................................................................................... 2-24 Session 3: Outline and Lesson Plan ................................................................................... 2-25 Section 3: APPENDICES A. B. C. D. E. F. G. H. I. J. K. L. Sample Letter and Course Information for Instructor Candidates ................................ 3-1 Practice-Teaching Assignments ..................................................................................... 3-3 Practice-Teaching Feedback and Evaluation Form ........................................................3-10 Instructor Candidate Participant Progress Log ..............................................................3-12 Precourse Examinations, Answer Sheet, and Answer Keys ...........................................3-14 First Aid/CPR/AED Program Instructor Examination, Answer Sheet and Answer Key ..............................................................................................................3-44 Recommendations for Manikin Decontamination .........................................................3-50 Course Evaluation Form for Instructor Candidates .......................................................3-51 Instructor Bridging Processes and Training Options .....................................................3-54 Automated External Defibrillation ..................................................................................3-56 Overview of Guidelines 2000 for ECC and CPR ...........................................................3-66 First Aid/CPR/AED Program Instructor Course Fact Sheet ..........................................3-70

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Section 1 PREPARATION

Introduction

This guide for training instructors is used by authorized American Red Cross First Aid/CPR/AED instructor trainers, Emergency Response instructor trainers, or other eligible instructor trainers who have completed a bridging process to the First Aid/CPR/AED Program, to conduct the First Aid/CPR/AED Program instructor course and the related instructor bridging and crossover training processes. Instructor trainers should possess and be familiar with the following American Red Cross First Aid/CPR/AED Program materials: I American Red Cross Guide for Training First Aid/CPR/AED Program Instructors (This guide has no stock number and is only available through download from CrossNet.) I American Red Cross First Aid/CPR/AED Program Instructor's Manual (Stock No. 656617) I American Red Cross First Aid/CPR/AED Program Participant's Booklet (Stock No. 656629) I American Red Cross Workplace Training: Standard First Aid Video (Stock No. 656616) I American Red Cross Infant & Child CPR Video (Stock No, 656632) I American Red Cross First Aid Skills Card (Stock No. 656628) I American Red Cross Adult CPR/AED Skills Card (Stock No. 656559) I American Red Cross Infant & Child CPR Skills Card (Stock No. 656631) I American Red Cross Workplace Training: Ergonomics Booklet (Stock No. 656603) I American Red Cross Workplace Training: Slips, Trips, & Falls Booklet (Stock No. 656604) I American Red Cross Workplace Training: Back Injury Prevention Booklet (Stock No. 656608) American Red Cross Workplace Training: Workplace Violence Awareness Booklet (Stock No. 656609) I American Red Cross Workplace Training: Managing Stress Booklet (Stock No. 656612) I American Red Cross Workplace Training: Your Heart Matters Booklet (Stock No. 656614) The instructor course is taught in approximately 17 hours, based on a ratio of six instructor candidates per instructor trainer. A precourse session is included that evaluates candidates' current knowledge and skills and gives the instructor trainer the opportunity to screen candidates, ensure that skills are demonstrated at an acceptable level of performance, and suggest remedial training, if appropriate.

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Purpose of the Instructor Course

The purpose of the First Aid/CPR/AED Program instructor course is to train instructor candidates to teach First Aid/CPR/AED Program courses and modules. This guide is used to teach the instructor course. The courses and modules of the American Red Cross First Aid/CPR/AED Program include: I Workplace Training: Standard First Aid I Workplace Training: Standard First Aid with AED I Adult CPR I First Aid I Adult CPR/AED I Child CPR I Infant CPR I Infant & Child CPR I AED Essentials I Workplace Training: Injury-control Modules

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The American Red Cross First Aid/CPR/AED Program includes the following instructor authorizations for teaching the above courses and programs to lay responders and individuals whose jobs require them to be trained and certified in first aid and CPR but are not professional rescuers: Workplace Training: Standard First Aid Instructor--This instructor is authorized to teach Standard First Aid, Standard First Aid with AED, First Aid, Adult CPR, Adult CPR/AED and the injury­control modules. First Aid/CPR/AED Instructor--This instructor is authorized to teach Standard First Aid, First Aid, Standard First Aid with AED, Infant and Child CPR, Infant CPR, Child CPR, and the injury-control modules.

Prerequisites for Instructor Candidates

To take the First Aid/CPR/AED Program Instructor course, instructor candidates must-- I Be at least 17 years of age by the last scheduled session of the instructor course; I Possess a Fundamentals of Instructor Training (FIT) certificate issued in the last 12 months or Instructor Candidate Training (ICT) (for training completed on or before 6/30/01 and valid until 6/30/02) certificate (C3007) or possess a current national Health and Safety Services Instructor Authorization (F5736); and I Pass the applicable precourse written examination(s) with a score of at least 80 percent or higher and demonstrate competency in the precourse skills evaluation.

Streamlining of Instructor Authorizations Course Code

As a result of recent restructuring and streamlining of instructor and instructor trainer authorizations in the first aid, CPR, and AED program line, it is now possible for instructors to teach similar program content without having to maintain numerous instructor authorizations. Therefore, the First Aid/CPR/ AED instructor and the Workplace Training: Standard First Aid instructor may also teach any other equivalent American Red Cross first aid, CPR or AED course or component as applicable to their specialty in other program areas upon orientation to the appropriate, specific instructional materials. Instructors must always use the materials specified for a particular course, module, or component. Emergency Response and Lifeguarding Instructors. Currently authorized Emergency Response instructors and Lifeguarding (r.01) instructors may teach any First Aid/CPR/AED Program course or component after orienting themselves to the instructional materials. In either case above, there is no requirement to maintain a separate instructor authorization. 3249I

Course Length

The First Aid/CPR/AED Instructor course is taught in approximately 17 hours. This includes a precourse session of up to about 31/2 hours. The instructor course may be divided into two or more sessions depending on instructor trainer and candidate needs. Course length may be affected by-- I The number of instructor candidates (the estimate of 17 hours is based on a ratio of six instructor candidates per instructor trainer). I The experience and abilities of the instructor candidates. I The experience and abilities of the instructor trainer. I The availability of additional instructor trainers to co-teach. I The availability of equipment and supplies, including the number of manikins and AED train-

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ing devices (the estimate of 17 hours is based on a recommended ratio of one manikin and one AED training device or rhythm simulator per two instructor candidates; using less than recommended equipment and supplies may increase course length). When you schedule the course, allow enough time to ensure that instructor candidates can meet the course objectives.

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Instructor examination, answer sheet, and answer key (Appendix F, page 3-44) Adult manikins (one for every two candidates) Child manikins (one for every two candidates) Infant manikins (one for every two candidates)

Note: Child skills may also be taught or demonstrated on adult manikins. Demonstration of child and infant skills are only required of the First Aid/CPR/AED instructor candidates.

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Class Size

It is recommended that there be no more than six instructor candidates per instructor trainer. If the course has more than six candidates, another instructor trainer should co-teach or the course should be extended by 30 minutes per additional instructor candidate.

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Facilities

The classroom must be suitable for discussion, practice teaching, viewing video segments, practicing skills, and completing the precourse session, final examination, and skills evaluation. The classroom should be conveniently located and equipped with the materials, equipment, and supplies needed for First Aid/CPR/AED Program courses and modules. Also, designate an area of the classroom to display appropriate American Red Cross identification and signage, such as posters.

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Materials, Equipment, and Supplies

The following materials, equipment, and supplies are needed for this instructor course: I American Red Cross identification and signage I Name tags or name tents for each candidate I Precourse examinations, answer sheet, and answer keys (Appendix E, page 3-14)

Extra manikin lungs Decontamination supplies AED training devices (one for every two candidates) Blankets or mats Breathing barriers (face shields or resuscitation masks) (at least one for each candidate, depending on style and/or manufacturer's recommendations) Disposable gloves (multiple sizes of latex gloves and at least one other alternative, such as nitrile or vinyl gloves; at least one pair for each candidate) Triangular bandages, 4 4 inch gauze pads, and roller bandages. The American Red Cross Bandage Training Packet (Stock No. 656319) may also be used. The contents of the bandage training packet are for training purposes only and are not intended for reuse. Permanent markers, pens, and pencils Newsprint A VCR and monitor Instructor Certificates (Form 5736) Course Record (F6418R) and Course Record Addendum (F6418AR) Practice-Teaching Feedback and Evaluation Form (Appendix C, page 3-10) Instructor Candidate Progress Log (Appendix D, page 3-12) Goggles (one pair per candidate for manikin decontamination)

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Preparation for the Precourse Session

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Before the course begins, notify instructor candidates in writing that they will be tested on their current knowledge and skills. See Appendix A, page 3-1, for a sample letter to instructor candidates. Strongly recommend to instructor candidates that they review the First Aid/CPR/AED Program Participant's Booklet, the First Aid Skills Card, the Adult CPR/AED Skills Card, and/or the Infant & Child CPR Skills Card prior to the precourse session written examination and skills evaluation. Remind candidates to bring copies of their Fundamentals of Instructor Training (FIT) certificate issued in the last 12 months, or Instructor Candidate Training (for training completed on or before 6/30/01 and valid until 6/30/02) Certificate (C3007) or a current national Health and Safety Services Instructor Authorization.

the infant and child CPR precourse testing requirements for the First Aid/CPR/AED instructor, but do pass the requirements of the Workplace Training: Standard First Aid instructor, have the option of entering the instructor's course as a Workplace Training: Standard First Aid instructor candidate.

Certification Requirements

To be certified as an instructor in either of the two specialties in the First Aid/CPR/AED Program, candidates must-- I Successfully complete the precourse session. I Attend all course sessions. I Successfully complete three practice-teaching assignments. I Score at least 80 percent (20 out of 25 questions) on the instructor examination. Upon successful completion of the instructor course, candidates will receive an American Red Cross Health & Safety Services Instructor Certificate (F5736) indicating the level to which they have trained, e.g., Workplace Training: Standard First Aid, or First Aid/CPR/AED.

Precourse Session

In the precourse session, candidates are tested on their current knowledge and skills to determine if they have the qualifications to enter the instructor course. This allows you the opportunity to teach instructional skills rather than focusing on teaching basic knowledge and skills during the instructor course. The precourse session includes the basiclevel written examination(s) and skills evaluation for the applicable specialty that the instructor candidate is striving for. Only those candidates who pass each section of the precourse written examinations with a score of 80 percent or higher and successfully demonstrate competency in the skills evaluation will be permitted to continue in the instructor course. If a candidate repeatedly experiences difficulty performing a skill, encourage him or her to enroll in a basiclevel or review course. See the Instructor Candidate Progress Log (Appendix D, page 3-12) for information on knowledge and skill requirements for the precourse session. Those candidates who do not pass all

Practice-Teaching Assignments

Practice teaching is an integral part of any instructor course. There are three practice-teaching assignments that may vary somewhat depending on the specialty in the First Aid/CPR/AED Instructor course. Candidates must successfully complete all assignments to pass the course. The purpose of practice teaching is to allow candidates to gain experience in-- I Preparing and delivering teaching sessions. I Providing direction. I Completing course lesson activities within suggested time frames. I Managing First Aid/CPR/AED Program skill sessions. I Evaluating performance and providing corrective feedback to help candidates improve their skills.

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Ensuring participants' health and safety during training. When conducting practice-teaching assignments, use the following guidelines-- I Each candidate conducts his or her assignment. The time required may vary depending on the specific activity or skill. I Follow each teaching session with evaluation and feedback. When conducting evaluations-- I First, have the instructor candidate evaluate his or her own performance (what was done particularly well and what could be improved upon). I Second, have two or three of the candidate's peers evaluate the performance (what was done particularly well and what could be improved upon). I Third, conduct your own evaluation. Briefly summarize any notable points from the peer evaluations. Provide additional feedback beginning and ending on a positive note. During practice-teaching sessions, instructor candidates and instructor trainers should use the Practice-Teaching Feedback and Evaluation Form (Appendix C, page 3-10). If a candidate's practice-teaching performance is not acceptable, consult with the candidate privately, explaining why and how to improve. Allow the candidate another opportunity to practice teach a similar assignment. If the candidate's performance remains unacceptable, counsel the candidate privately about remediation options or discontinuing the course. For more details on how to conduct practice sessions and skill checks, refer candidates to the appropriate sections of the instructor's manual.

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identify any deficiencies on which candidates should focus when preparing for their next practice-teaching assignment. Refer to Appendix B, page 3-3 for the teaching assignments.

Practice Teaching II

In this assignment, candidates conduct a first aid or CPR skill practice/evaluation session using the instructor's manual based on the candidate's particular specialty and the needs of the candidate as assessed by the instructor trainer. Refer to Appendix B, page 3-3 for specific activities or skills to assign.

Practice Teaching III

In this assignment, candidates conduct a CPR/AED skill scenario/evaluation session using the instructor's manual. Refer to the Practice-Teaching Assignments (Appendix B, page 3-3) for specific activities or skills to assign to the instructor candidates.

Instructor Course Objectives

At the conclusion of the First Aid/CPR/AED Program instructor course, instructor candidates should be thoroughly familiar with the applicable content (based on their specialty) of the First Aid/CPR/AED Program courses and modules material and should be able to-- I Expand on information from the American Red Cross Fundamentals of Instructor Training (FIT) course to teach First Aid/CPR/AED Program courses and modules. I Demonstrate the characteristics required of an American Red Cross representative and role model. I Plan, organize, and conduct First Aid/CPR/AED Program courses and modules. I Monitor participants' practice and provide corrective feedback and encouragement. I Teach courses and modules in a manner that keeps participants engaged in the learning process.

Practice Teaching I

In this assignment, instructor candidates have their first opportunity to teach and facilitate a portion of the course content using the instructor's manual. This gives you a chance to see how comfortable the candidates appear in front of a class and to

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Ensure participants' health and safety during training. Customize courses and modules to meet the specific training needs of the employer and employees. Demonstrate applicable first aid, CPR, and AED skills at an appropriate level of performance. Maintain complete and accurate records and reports.

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Course Evaluation

Ask the candidates to complete the Course Evaluation Form for Instructor Candidates (Appendix H, page 3-51) so that they can provide feedback for this course. Review and return these forms to your local Red Cross chapter. Do not send these forms to national headquarters. The information you gain from candidates will help you improve your skills as an instructor trainer.

Ensuring that you are familiar with state and local laws and regulations regarding who may teach and perform AED skills. Knowing how to safely use AED training devices/rhythm simulators and other training equipment. Advising the local Red Cross chapter of instructor candidates with leadership potential. Evaluating candidates and issuing a Health and Safety Services Instructor Certificate (F5736) to those who successfully meet the instructor course objectives.

Administrative Terms and Procedures for the Instructor Trainer

The following information has been condensed from the Health and Safety Services Manual of Administrative Policy and Procedures (MAPP) (ARC A3530) and is intended to define some American Red Cross terminology and provide some background in course administration. Contact your local Red Cross chapter for further clarification. Audit -- "Audit" should be entered as the final grade for a participant who has chosen the selfevaluation option for testing. This participant is allowed to choose his or her own level of participation and does not receive a course completion certificate. This should not be substituted for a "Fail" for a participant who attempts certification but is unable to pass the completion requirements. Authorized -- To be accepted by a local American Red Cross chapter to teach an American Red Cross course in that chapter's jurisdiction. To become authorized, the Health and Safety Services Instructor Certificate (F5736) and the Instructor Agreement (F6574) must be signed by the instructor and an official from the chapter of authorization. Authorized Provider -- An outside company, organization, or individual that provides Red Cross

Responsibilities of the Instructor Trainer

As a First Aid/CPR/AED instructor trainer, your responsibilities include-- I Conducting the precourse session to determine if candidates have the required applicable prerequisite knowledge and skills to take the instructor course. I Providing instruction in the preparation, management, and skills needed to teach the available courses and modules. I Providing for the health and safety of all instructor candidates. I Demonstrating required course skills at an appropriate level of performance. I Helping candidates become effective instructors by enhancing their ability to use various teaching methods to deliver course content. I Ensuring that you are familiar with your local chapter's policy on remediation in the event that an instructor candidate's basic knowledge and skills are unsatisfactory.

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instructional programs as outlined in the signed Authorized Provider Agreement (F6575). (See also Third-Party Instructor.) Authorized Provider Agreement -- (F6575) An agreement between the Red Cross and a thirdparty provider of Red Cross instructional courses outlining the responsibilities of each party. Certificate -- Formal recognition that an individual has passed an American Red Cross course of record. Certified -- Term used to describe the circumstance when a course participant passes an American Red Cross course and is issued a completion certificate. Certified Lay Responder -- A certified lay responder is an individual whose job requires him or her to be trained and certified in first aid and CPR but who is not a professional rescuer. Red Cross courses designed for this category include courses such as Workplace Training: Standard First Aid and Adult CPR/AED. Code of Conduct -- A code that all volunteer and paid staff of the American Red Cross, in delivering Red Cross services, shall meet. It is signed, as part of the Instructor Agreement, by every authorized American Red Cross instructor, and it serves as a general agreement between the instructor and the local Red Cross chapter. Co-teach -- Sharing full participation in course leadership and instruction with one or more co-instructors; also known as team teaching. Course of Record -- A course taught, properly reported, and accepted by the American Red Cross chapter in the jurisdiction where the course was conducted. Course Record (F6418R) -- A form that lists demographic information and is completed by an instructor and turned in within 10 days after course completion to the local American Red Cross chapter in whose jurisdiction the course was taught. This record is used to document certificate issuance, instructor teaching activity, and service activity for statistical reports.

Course Record Addendum (F6418AR) -- A form that lists demographic information on participants and grades received for a course. Should be used in addition to the Course Record (F6418R). Extended Authorization -- Permission granted by a local American Red Cross chapter to an American Red Cross instructor from another jurisdiction to teach within that chapter's jurisdiction. Instructors must request and receive extended authorization from that new chapter prior to teaching. Fail -- A course grade signifying that a participant has not passed ALL the required skills and/or written tests and prefers not to be re-tested or does not pass a retest. Incomplete -- A course grade signifying that a participant is unable to complete the course because of certain circumstances, such as illness or death in the family. An incomplete is given only when arrangements to complete the training have been made. Instructor -- A member of a select group of individuals authorized by the American Red Cross to teach American Red Cross basic-level courses and impart knowledge and skills consistent with American Red Cross policies, procedures, standards, and guidelines. Instructor Agreement (F6574) -- A form to be signed by American Red Cross instructors before being authorized to teach an American Red Cross course. It explains the rights and responsibilities of both the instructor and the American Red Cross chapter of authorization. Instructor Aide -- An individual who successfully completes instructor-aide training to help an instructor with a basic-level course. Instructor Course Record -- On successful completion of an American Red Cross instructor course, the original copy of an Instructor Certificate (F5736) is signed by the instructor trainer and issued to the instructor candidate. This must be endorsed by the local American Red Cross chapter

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before teaching. Endorsement by the local Red Cross chapter authorizes you to teach and issue the appropriate American Red Cross certificates within the jurisdiction of that administrative chapter. Instructor Trainer (IT) -- A member of a select group of individuals who exemplify the qualities of the American Red Cross and serve as role models for instructors and other instructor trainers. ITs are authorized by the local American Red Cross chapter to teach American Red Cross instructor courses and the Fundamentals of Instructor Training (FIT) course (or Instructor Candidate Training course until 6/30/01) within that chapter's jurisdiction. An IT may assist the local Red Cross chapter with training updates, recruitment, or other leadership responsibilities. Minimum Enrollment for Courses -- Each course must have enough participants to provide course participants with sufficient skills practice to accomplish the course objectives. Pass -- A course grade signifying that a participant has successfully completed all required skills and written tests according to national standards. Reauthorization -- To become authorized again by teaching or co-teaching at least one course during an authorization period. A new Health and Safety Services Instructor Authorization Certificate (C3005) is issued upon reauthorization. Record Card -- A card maintained by a local Red Cross chapter (also called an Instructor Record) that contains general demographic information, American Red Cross teaching history, and current authorizations of an instructor or instruc-

tor trainer. It may be maintained on hard copy or on a computer. Suspension -- The temporary withholding of an instructor's authorization by a local Red Cross chapter while formal steps are undertaken to determine whether to continue or withdraw the instructor's authorization. Third-Party Instructor -- An authorized instructor who teaches American Red Cross courses under the supervision of an authorized provider. (See also Authorized Provider.) Transfer of Authorization -- When a local American Red Cross chapter accepts a current instructor from another local American Red Cross chapter to teach within the accepting chapter's jurisdiction on a permanent basis. Contact the new American Red Cross chapter for further information on how the American Red Cross can transfer teaching records to the new location. Volunteer -- An individual who, beyond the confines of paid employment and normal responsibilities, contributes time and service to the American Red Cross to assist in the accomplishment of its mission. Withdrawal of Authorization -- The removal of an instructor's authorization to teach within the American Red Cross chapter's jurisdiction for due cause. Due cause generally means that the instructor does not or will not abide by the standards, policies, or procedures of the American Red Cross organization and its programs or in some way abuses the position of an authorized American Red Cross instructor.

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Section 2 INSTRUCTOR COURSE OUTLINE AND LESSON PLANS

Precourse Session

Topic Welcome and Introduction Precourse Examination Precourse Skills Evaluation Precourse Session Closing Total Suggested Time 5 minutes 55 minutes 140 minutes 10 minutes Approximately 31/2 hours

Session 1

Topic Course Introduction Purpose of the Instructor Course Instructor Course Objectives Certification Requirements Orientation to the First Aid/CPR/AED Program Program Design and Length (30 minutes) Course and Module Materials (110 minutes) Suggested Time 5 minutes

140 minutes

Note: The injury-control modules are optional. In order to teach a module, an instructor must complete the applicable self-study or group orientation. The detailed optional group orientation outlines are also valid for other H&SS instructors who wish to teach any of the injury-control modules. Participant Health and Safety Manikin Care and Decontamination Course Customization Automated External Defibrillation Teaching Strategies Teaching to the Standard and Testing to the Objective Facilitation Activity Skills Activity: Two-rescuer CPR Technique Conducting Skill Sessions Practice-teaching Overview and Assignments Preparation for Session 2 Total 15 minutes 15 minutes 5 minutes 20 minutes 15 minutes 10 minutes 45 minutes 15 minutes 15 minutes 15 minutes 10 minutes Approximately 51/2 hours

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Session 2

Topic Practice Teaching I (20 minutes per candidate) Evaluating Candidates' Skills Break/Preparation for Practice Teaching II Practice Teaching II (20 minutes per candidate) Break/Preparation for Practice Teaching III Total Suggested Time 120 minutes 10 minutes 15 minutes 120 minutes 5 minutes Approximately 41/2 hours

Session 3

Topic Practice Teaching III (20 minutes per candidate) Evaluating Candidates' Skills American Red Cross Policies and Procedures Final Written Examination Closing Total Suggested Time 120 minutes 10 minutes 40 minutes 30 minutes 10 minutes Approximately 31/2 hours

Total Time (including Precourse Session): Approximately 17 hours

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PRECOURSE SESSION OUTLINE AND LESSON PLAN Welcome and Introduction (5 minutes)

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Welcome instructor candidates. Introduce yourself and any co-instructor trainers. Ask candidates to introduce themselves and tell why they are taking this course and what courses they desire to teach. Identify the location of emergency exits, bathrooms, and telephones, and explain any building rules and regulations. Clarify how to call the local emergency number. Review "Health Precautions for Course Participants" to be followed during the precourse session (see First Aid/CPR/AED Program Instructor's Manual, page 2). Inform instructor candidates that to take the First Aid/CPR/AED Program Instructor course, they must-- I Be at least 17 years of age by the last scheduled session of the instructor course. I Possess a Fundamentals of Instructor Training (FIT) or Instructor Candidate Training (ICT) certificate issued within the last 12 months, or possess a current Health and Safety Services Instructor Authorization. I Be prepared to demonstrate basic-level knowledge and skills by passing each section of the precourse written examination with a score of at least 80 percent, and by demonstrating competency in the skills evaluation. Note: ICT training may be offered through 6/30/01; and ICT certificates are valid until 6/30/02, at which time only Fundamentals of Instructor Training (FIT) certificates will be accepted as a prerequisite for entry into Health and Safety Services instructor courses.

Precourse Written Examination (45-55 minutes)

Administer the precourse written examinations to instructor candidates (Appendix E, page 3-14). Candidates must score at least 80 percent on each section of the examinations (8 correct answers out of 10 questions and 4 correct answers out of 5 questions, as applicable) to continue in the instructor course. Record candidates' progress on the Instructor Candidate Participant Progress Log (Appendix D, page 3-12). Desired Instructor Authorization: First Aid/CPR/AED Instructor Required Precourse Examinations: Workplace Training: Standard First Aid with AED (sections 1 through 4); and Infant and Child CPR (sections 1 through 3) Workplace Training: Standard First Aid with AED (sections 1 through 4)

Workplace Training: Standard First Aid

Precourse Skills Evaluation (140 minutes)

Use the Instructor Candidate Participant Progress Log (Appendix D, page 3-12) for recording precourse skills evaluation results. When evaluating prerequisite skills, refer to the skill chart located in Sections 2 (adult, first aid, and AED skills) and 15 (Infant

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and Child CPR skills) of the First Aid/CPR/AED Program Instructor's Manual for the required skills for each instructor authorization. First Aid/CPR/AED Program instructor candidates are evaluated on: I Adult, child, and infant cardiac and breathing emergency skills; I AED skills; and I First aid skills. Workplace Training: Standard First Aid instructor candidates are evaluated on: I Adult cardiac and breathing emergency skills; I AED skills; and I First aid skills.

Precourse Session Closing (10 minutes)

Candidates who do not pass the precourse written examination and demonstrate competency in the precourse skills evaluation cannot continue in the instructor course. If a candidate is unable to complete the precourse requirements, suggest that the candidate enroll in a basic-level or review course. Give the candidate the name of the appropriate contact at the local Red Cross chapter for available remediation opportunities.

SESSION 1: OUTLINE AND LESSON PLAN Course Introduction (5 minutes)

Purpose of the Instructor Course

Key Points

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The purpose of the First Aid/CPR/AED Program instructor course is to train candidates to teach the First Aid/CPR/AED Program courses and modules. These courses include Workplace Training: Standard First Aid, Workplace Training: Standard First Aid with AED, Adult CPR/AED, AED Essentials, Adult CPR, Child CPR, Infant CPR, Infant and Child CPR, and First Aid. The injury-control modules cover ergonomics, slips, trips, and falls, back injury prevention, workplace violence awareness, managing stress, and coronary heart disease prevention. Any currently authorized Health and Safety Services instructor may be permitted to teach injury control modules once he or she has completed the applicable orientation to the materials. First Aid/CPR/AED Program instructors are oriented to the modules as part of their training.

Instructor Course Objectives

Key Points At the conclusion of the First Aid/CPR/AED Program Instructor course, candidates should be thoroughly familiar with the First Aid/CPR/AED Program course and module materials and should be able to-- I Expand on information from the Fundamentals of Instructor Training (FIT) (or Instructor Candidate Training) course to teach First Aid/CPR/AED Program courses and modules.

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Demonstrate the characteristics required of an American Red Cross representative and role model. Plan, organize, and conduct First Aid/CPR/AED Program courses and modules. Monitor participants' practice and provide corrective feedback and encouragement. Teach courses and modules in a manner that helps participants stay engaged in the learning process. Ensure participants' health and safety during training. Customize courses and modules to meet the specific training needs of employers and employees. Demonstrate applicable first aid, CPR, and AED skills at an appropriate level of performance. Maintain complete and accurate records and reports.

Certification Requirements

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To be certified as an American Red Cross First Aid/CPR/AED Program instructor, candidates must-- I Successfully complete the precourse session. I Attend all course sessions. I Successfully complete all applicable practice-teaching assignments. I Score at least 80 percent (20 correct answers out of 25 questions) on the instructor examination. Upon successful completion of the instructor course, candidates will receive an American Red Cross Health & Safety Services Instructor Certificate (F5736) indicating the level to which the instructor has achieved.

Orientation to the First Aid/CPR/AED Program (140 minutes)

Program Design and Length (20 minutes)

Instructor Trainer Note: Refer candidates to the course fact sheets in the First Aid/CPR/AED Program Instructor's Manual (Appendices 2-1 through 15-1). Key Point

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The American Red Cross First Aid/CPR/AED Program consists of the following courses and modules:

Standard First Aid

This 51/2-hour course gives individuals in the workplace the knowledge and skills necessary to recognize and provide basic care for injuries and sudden illnesses until advanced medical personnel arrive and take over. Topics include instruction in recognizing and handling emergency situations, using basic precautions to prevent disease transmission when providing care, breathing and cardiac emergencies, caring

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for sudden illnesses and wounds, controlling bleeding, and immobilizing muscle, bone, and joint injuries. Certificates for Standard First Aid are valid for 3 years; certificates for Adult CPR are valid for 1 year.

Standard First Aid with AED

This 61/2-hour course gives individuals in the workplace the knowledge and skills necessary to recognize and provide basic care for injuries and sudden illnesses, including using an automated external defibrillator (AED) for victims of sudden cardiac arrest, until advanced medical personnel arrive and take over. Topics include instruction in recognizing and handling emergency situations, using basic precautions to prevent disease transmission when providing care, breathing and cardiac emergencies (including how to use an AED for victims of sudden cardiac arrest), caring for sudden illnesses and wounds, controlling bleeding, and immobilizing muscle, bone, and joint injuries. Certificates for Standard First Aid are valid for 3 years; certificates for Adult CPR/AED are valid for 1 year.

Adult CPR

This approximately 4-hour course gives individuals in the workplace the knowledge and skills necessary to recognize and provide basic care for breathing and cardiac emergencies until advanced medical personnel arrive and take over. Topics include instruction in recognizing and handling emergency situations and using basic precautions to prevent disease transmission when providing care. Certificates for Adult CPR are valid for 1 year.

Child CPR

This approximately 4-hour course gives individuals the knowledge and skills necessary to prevent, recognize, and provide basic care for breathing and cardiac emergencies in children between the ages of 1 and 8 years until advanced medical personnel arrive and take over. Certificates for Child CPR are valid for 1 year.

Infant CPR

This approximately 31/2-hour course gives individuals the knowledge and skills necessary to prevent, recognize, and provide basic care for breathing and cardiac emergencies in infants under age 1 until advanced medical personnel arrive and take over. Certificates for Infant CPR are valid for 1 year.

Infant and Child CPR

This approximately 51/2-hour course gives individuals the knowledge and skills necessary to prevent, recognize, and provide basic care for breathing and cardiac emergencies in infants and children under the age of 8 until advanced medical personnel arrive and take over. Certificates for Infant and Child CPR are valid for 1 year.

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Adult CPR/AED

This 41/2-hour course gives individuals in the workplace the knowledge and skills necessary to provide care for breathing emergencies, perform cardiopulmonary resuscitation (CPR), and use an AED for victims of sudden cardiac arrest until advanced medical personnel arrive and take over. Topics include instruction in recognizing and handling emergency situations, using basic precautions to prevent disease transmission when providing care, breathing and cardiac emergencies including how to use an AED for victims of sudden cardiac arrest. Certificates for Adult CPR/AED are valid for 1 year. Adult CPR/AED certificates are to be issued only when conducting the Adult CPR/AED training course from Section 12 of the First Aid/CPR/AED Program Instructor's Manual.

AED Essentials

This approximately 2-hour course gives individuals the skills necessary to safely operate an automated external defibrillator for victims of sudden cardiac arrest (SCA) in conjunction with providing care for breathing emergencies and performing cardiopulmonary resuscitation (CPR). Participants who desire to take this training must hold a current (within one year), American Red Cross Adult CPR certificate, or its equivalent. This course may be taught from either the First Aid/CPR/AED Program materials or the Lifeguarding program materials. Participants may opt to challenge Adult CPR skills if they have successfully completed the skill requirements of AED Essentials and receive an Adult CPR/AED certificate instead of an AED Essentials certificate, upon successful completion of the remaining skills requirements and passing the Adult CPR/AED written examination. Guidelines for conducting this option are contained in the AED Essentials instructor's outline. As with all other American Red Cross AED certificates, the validity period of the AED Essentials certificate is one year. AED Essentials may be taught from either the Lifeguarding (r.01) materials and video or the Standard First Aid video, AED Essentials instructor's outline, (which is currently a downloadable resource on CrossNet) and the Adult CPR/AED Skills Card. The instructional outline also contains the information in Appendix J of this guide for training instructors which can serve as an information resource for instructors. There is no separate instructor's authorization for AED Essentials.

First Aid

This approximately 4-hour course gives individuals in the workplace the knowledge and skills necessary to recognize and provide basic care for injuries and sudden illnesses until advanced medical personnel arrive and take over. Topics include instruction in recognizing and handling emergency situations, using basic precautions to prevent disease transmission when providing care, caring for sudden illnesses and wounds, controlling bleeding, and immobilizing muscle, bone, and joint injuries. Certificates for First Aid are valid for 3 years.

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Ergonomics Module

This 1-hour injury-control module provides individuals in the workplace with the knowledge necessary to identify and reduce risks for musculoskeletal disorders (MSDs). Information in the module includes what ergonomics is, what musculoskeletal injuries are, how to identify and reduce the risks for MSDs at work and at home, and how to perform at least one exercise to help reduce the risk of MSDs. Upon successful completion of the module, the participant will receive a Universal Certificate indicating Ergonomics. The certificate has no expiration date.

Slips, Trips, & Falls Module

This 1-hour injury-control module provides individuals in the workplace with the knowledge necessary to identify and reduce the risk of slips, trips, and falls. Information in the module includes increasing safety awareness, identifying and correcting unsafe conditions and behaviors, providing tips for good balance, and developing a prevention plan. Upon successful completion of the module, the participant will receive a Universal Certificate indicating Slips, Trips, & Falls. The certificate has no expiration date.

Back Injury Prevention Module

This 1-hour injury-control module provides individuals in the workplace an introduction to the anatomy of the back and causes of back pain, how to identify and reduce risk factors for back injury, simple exercises for stretching and strengthening neck and back muscles and back injury prevention tips. The certificate has no expiration date.

Workplace Violence Awareness Module

This 1-hour module gives individuals in the workplace the knowledge necessary to identify and reduce the risk of workplace violence. It provides participants with information on how to recognize the categories of workplace violence, how to identify warning signals of potential workplace violence, and how to reduce the risk of becoming a victim of workplace violence. The certificate has no expiration date.

Managing Stress Module

This 1-hour module introduces individuals in the workplace to the knowledge necessary to recognize and manage stress. It includes information on how to recognize the causes and signals of stress, how to identify ways to mange stressful situations, and how to develop personal strategies for managing stress. The certificate has no expiration date.

Your Heart Matters Module

The purpose of this 1-hour module is to give individuals in the workplace an introduction to the knowledge necessary to identify and reduce their risk of coronary heart disease,

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how to recognize the signals of a heart attack and how to develop a plan to reduce the risk of coronary heart disease. Your Heart Matters module information can also serve as an additional resource to CPR instructors when teaching cardiac emergencies lesson plans of the First Aid/CPR/AED Program. The certificate has no expiration date.

Course and Module Materials (110 minutes)

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Explain that it is important for instructor candidates to be familiar with course and module materials. Briefly review and discuss the features of each product.

First Aid/CPR/AED Program Participant's Booklet (10 minutes)

Explain that the American Red Cross First Aid/CPR/AED Program Participant's Booklet is designed for use during class activities and discussions. The booklet includes information and activities to support the lessons of First Aid/CPR/AED Program courses, and it includes the written examinations for each course. It also incorporates the information from the transparency masters of the Adult CPR/AED course in the form of "Lecture Points" and contains injury prevention information for children and infants as a take home resource for course participants.

Adult CPR/AED Skills Card (10 minutes)

Explain that the American Red Cross Adult CPR/AED Skills Card is designed for participants to use during adult breathing and cardiac emergencies skill sessions and, if appropriate, using an AED. It can also be used as a reference for review and refresher after the course. The skills card includes information on breathing emergencies, cardiac emergencies, checking an unconscious victim, and safely and effectively using an AED. Review with the candidates the form and function of the skills card. Use examples of various skills to show the relationship of the color of the borders to the skill/icon and how to go from the unconscious victim check to the next care steps of a particular skill. Emphasize that this tool is the key element in the skills practice sessions. Instructors should instill this in their students and should ensure that they are using the skills card as it is intended during the practice sessions.

Infant & Child CPR Skills Card (7 minutes)

Explain that the American Red Cross Infant & Child CPR Skills Card is designed for participants to use during skills sessions for breathing and cardiac emergencies in infants and children 8 years of age and under. Child skills are listed on one side and infant skills are listed on the other. It can also be used as a reference for review after the course. The skills card includes information on checking an unconscious infant or child, breathing and cardiac emergencies. Review with the candidates the form and function of the skills card. Use examples of various skills to show the relationship of the color of the borders to the color of the skill in the next care step and how to go from the unconscious victim

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check to the next care steps of a particular skill. Emphasize that this tool is the key element in the skills practice sessions. Instructors should instill this in their students and should ensure that they are using the skills card as it is intended during the practice sessions.

First Aid Skills Card (5 minutes)

Explain that the American Red Cross First Aid Skills Card is designed for participants to use during appropriate skill sessions, and it can also be used as a reference after the course. The skills card includes information on controlling external bleeding, applying a sling and binder, and caring for head, neck, and back injuries.

First Aid/CPR/AED Program Instructor's Manual (30 minutes)

Tell candidates that the American Red Cross First Aid/CPR/AED Program Instructor's Manual is the main source of information for instructor candidates in this course. Explain that the instructor's manual is used for planning, preparing, and conducting the First Aid/CPR/AED Program. The instructor's manual is also helpful in preparing for the instructor course examination and conducting practice-teaching assignments. Review and discuss the instructor's manual, explaining how instructors can use each section when conducting the courses and modules. Emphasize to the instructor candidates the importance of following the outlines and lesson plans. The instructor's manual is divided into the following sections: Section 1: Preparation I The First Aid/CPR/AED Program I Conducting the Program I Acknowledging Course Participation I Appendices Section 2: Standard First Aid I Course Notes I Course Outline I Lesson Plans 1-12 I Appendices Section 3: Standard First Aid with AED I Course Notes I Course Outline I Lesson Plans 1-12 I Appendices

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Section 4: Adult CPR I Course Notes I Course Outline I Lesson Plans 1-8 I Appendices Section 5: First Aid I Course Notes I Course Outline I Lesson Plans 1-10 I Appendices Section 6: Ergonomics I Module Notes I Module Outline I Lesson Plan I Appendices Section 7: Slips, Trips, & Falls I Module Notes I Module Outline I Lesson Plan I Appendices Section 8: Back Injury Prevention I Module Notes I Module Outline I Lesson Plan I Appendices Section 9: Workplace Violence Awareness I Module Notes I Module Outline I Lesson Plan I Appendices Section 10: Managing Stress I Module Notes I Module Outline I Lesson Plan I Appendices

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Section 11: Your Heart Matters I Module Notes I Module Outline I Lesson Plan I Appendices Section 12: Adult CPR/AED I Course Notes I Course Outline I Lesson Plans 1-11 I Appendices Section 13: Child CPR I Course Notes I Course Outline I Lesson Plans 1-10 I Appendices Section 14: Infant CPR I Course Notes I Course Outline I Lesson Plans 1-9 I Appendices Section 15: Infant and Child CPR I Course Notes I Course Outline I Lesson Plans 1-14 I Appendices Additional Sections I Information on new courses or modules will be added if and/or when they are released.

Adult CPR/AED Instructor's Manual (1 minute)

Tell candidates that the content of the American Red Cross Workplace Training: Adult CPR/AED Instructor's Manual has been integrated within the First Aid/CPR/AED Program Instructor's Manual. Existing copies of this instructor's manual do not meet ECC 2000 guidelines and may not be used after 07/01/01.

Workplace Training: Standard First Aid Video (15 minutes)

Tell candidates that the American Red Cross Workplace Training: Standard First Aid Video is designed specifically for the adult CPR, first aid and AED program courses and components. Explain that the video demonstrates skills including choking, rescue

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breathing, adult CPR, and first aid. It also covers the use of AEDs and contains scenarios to facilitate the discussion of appropriate care in first aid emergencies. Emphasize that the Standard First Aid video is an integral part of the First Aid/CPR/AED Program, and its use is required when conducting program courses. If the video cannot be shown, the courses cannot be conducted. Show a couple of sample segments especially ECCrevised skills, such as Unconscious Choking, and a first aid scenario or skill segment.

Adult CPR/AED Video (1 minute)

Tell candidates that the content of the American Red Cross Workplace Training: Adult CPR/AED Video has been incorporated into the updated Workplace Training: Standard First Aid video. This now allows Adult CPR/AED to be conducted using the Standard First Aid video.

Infant & Child CPR Video (10 minutes)

Tell candidates that the American Red Cross Infant & Child CPR Video is designed specifically for the Infant and Child CPR courses from the First Aid/CPR/AED Program instructional materials. Other videos may not be substituted or used in its place. Show the beginning introduction segment and one child and one infant segment. Explain that this video is used for teaching lifesaving skills for victims under the age of about 8 years. Tell the candidates that both the child and infant sections of the video begin with a dramatic scene. The dramatic scene in the child section also serves as the instructional segment for teaching the conscious choking skill. The dramatic scene in the infant section immediately leads into the instructional segment on checking an unconscious infant. Instructor Trainer Note: Strongly encourage instructor candidates to view the videos in their entirety before teaching any course. Questions about the videos should be directed to an instructor trainer for clarification.

Injury-control Modules

Point out to candidates the following common features: Each injury control module is 1 hour in length. The associated booklet is required to conduct the module. Module information focuses on awareness and knowledge necessary to reduce risks and is not intended to substitute for worksite health and safety training, policies, or procedures. Each module booklet includes a self-assessment so that participants may measure their understanding of the module material. Participants are not required to turn in the self-assessment, nor does the instructor grade it.

Ergonomics Booklet (5 minutes)

Explain that the American Red Cross Workplace Training: Ergonomics Booklet includes information to prepare individuals in the workplace with the knowledge necessary to identify and reduce risks for musculoskeletal disorders (MSDs). A self-assessment for the module is included in the booklet.

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Slips, Trips, & Falls Booklet (5 minutes)

Explain that the American Red Cross Workplace Training: Slips, Trips, & Falls Booklet includes information on increasing workplace safety awareness, identifying and correcting unsafe conditions and behaviors, using good balance, and developing a prevention plan. A self-assessment for the module is included in the booklet.

Back Injury Prevention Booklet (5 minutes)

Explain that the American Red Cross Workplace Training: Back Injury Prevention Booklet includes information on reducing the risk of back injury such as simple exercises to stretch and tighten muscles in the neck, shoulders, and upper, middle, and lower back, the causes of back pain, maintaining good posture and back injury prevention tips.

Workplace Violence Awareness Booklet (5 minutes)

Tell candidates that the American Red Cross Workplace Training: Workplace Violence Awareness Booklet focuses on giving individuals in the workplace the knowledge necessary to identify and reduce the risk of workplace violence and includes information on how to recognize the categories of workplace violence, how to identify warning signals of potential workplace violence and how to reduce the risk of becoming a victim of workplace violence.

Managing Stress Booklet (5 minutes)

Explain that the American Red Cross Workplace Training: Managing Stress Booklet must be used when conducting this module. The purpose of the Managing Stress module is to introduce individuals in the workplace to the knowledge necessary to recognize and manage stress. It includes information on how to recognize the causes and signals of stress, how to identify ways to manage stressful situations, and how to develop personal strategies for managing stress.

Your Heart Matters Booklet (5 minutes)

Advise candidates that the American Red Cross Workplace Training: Your Heart Matters Booklet is required for use when conducting this 1-hour module. Tell candidates that it includes information on the risk factors for coronary heart disease, how to recognize the signals of a heart attack and how to develop a plan to reduce the risk for coronary heart disease. Point out to candidates that information in this module can serve as an additional resource for instructors when teaching cardiac emergencies lesson plans of the First Aid/CPR/AED Program.

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Participant Health and Safety (15 minutes)

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The American Red Cross has a responsibility to safeguard the health and safety of the participants enrolled in its courses and modules.

Instructor Trainer Note: Refer to, and review with candidates the following information in the First Aid/CPR/AED Program Instructor's Manual:

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"Health Precautions for Course Participants" (page 2) "Program Materials, Equipment, and Supplies" (page 3) "Instructor Responsibilities" (page 6) "Recommendations for Manikin Decontamination" (page 16A) "Breathing Barriers" (page 19) "Disposable Gloves" (page 20) "Instructor Note" under "Skill Session" regarding signs of latex allergy (page 26) "Manikins" (first four bullet points) (page 20) Notify participants of possible health risks. Carefully supervise skill sessions. Caution participants about inappropriate actions while practicing skills (such as engaging in horseplay, performing abdominal thrusts on a partner, or during practice sessions involving using an AED). Use guidelines for manikin decontamination during and after class. Make manikins available for individual use as needed, or consider rescheduling participants into other classes.

Manikin Care and Decontamination (15 minutes)

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Assign a manikin to every two candidates to practice manikin care and decontamination. Give candidates a copy of "Recommendations for Manikin Decontamination" (Appendix G, page 3-50) or refer them to Appendix 1-6 of the instructor's manual as they practice. Tell candidates to wear disposable gloves and goggles. Explain to candidates that these guidelines are based on the Centers for Disease Control and Prevention (CDC) recommendations. Demonstrate to the candidates how to-- I Make minor repairs to the manikins (such as reconnecting the air passage, replacing the lungs, and clearing airway obstructions). I Disassemble and apply decontamination solution to the manikin. I Decontaminate the manikin during class between skill sessions. I Differentiate procedures for using specific types of manikins. I Properly remove and discard gloves. Explain to candidates that using breathing barriers does not forego the requirement to disinfect the manikin face between use when the same face is shared by more than one participant. Instructors should be familiar with the manufacturer's operating, maintenance and cleaning/disinfection procedures for the manikins they will be using.

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Course Customization (5 minutes)

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First Aid/CPR/AED Program courses and modules are flexible and can be customized to meet an employer's specific needs. The courses can be offered as a certification program to meet a regulatory requirement or as an employee benefit. When you are offering courses to meet certification requirements, customizing does not mean that you can add to, delete, or change the content. It gives you the opportunity to address the specific needs of your audience by placing special emphasis on relevant topics. When preparing to customize courses, it is important to ask the client such questions as-- I Why are you offering first aid, CPR, and AED training? I What background and relevant experience do the program participants have? I What site-specific information is known?

Teaching Strategies (15 minutes)

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It is important to create a positive learning environment. Appendix 1-4, page 12 of the First Aid/CPR/AED Program Instructor's Manual describes different teaching strategies used throughout the lessons, along with suggestions on how to make them effective. Instructors can promote learning by-- I Building on participants' existing knowledge. I Maintaining enthusiasm for the learning process. I Customizing course content to the abilities and needs of the participants. I Setting ground rules and requirements for participation. I Emphasizing key points within each lesson. I Asking open-ended questions and waiting for responses. I Listening and managing silence. I Looking for group consensus when answering participants' questions.

Teaching to the Standard and Testing to the Objective (5 minutes)

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The Americans With Disabilities Act (PL 101-336) has led to an increased awareness that people with disabilities and other conditions can perform first aid and CPR skills. The skills needed to prevent injury or to save a life may need modification, but the result is the same. This awareness challenges instructors to focus on the critical components of a skill that are needed to successfully complete an objective, rather than focusing on perfecting every facet of a skill. For example, a person with one arm cannot perform a head-tilt/chin-lift using two hands. However, he or she may be able to perform a modified head-tilt/chin-lift using one hand. If the objective for the rescuer is to open the victim's airway, the

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person with one arm may fully satisfy that objective without using a traditional technique. Always teach to the standard, but be aware that participants may modify how a skill is accomplished and still meet the objective. You may refer to the Fundamentals of Instructor Training Participant's Manual, Lesson 6 and Appendix D and/or Appendix 1-8 of the First Aid/CPR/AED Program Instructor's Manual.

Facilitation Activity (45 minutes)

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The lesson plans are designed so that the instructor can maximize learning by facilitating class discussion and interaction. The instructor or facilitator must remember that education generally has two major components--content and process. I Content is the information being taught. I Process is how the content is taught. I Content and process are equally important in promoting learning. The instructor must know the content thoroughly and be skilled in using processes that promote learning. Effective instructors balance content and process. Facilitation is based on the concept of push, pull, and balance. I Push skills are used when information flows mostly from facilitator to participants. I Pull skills are used when the facilitator engages participants in discussion through interactive exercises, asking and answering questions, or other processes that actively involve participants in learning. I Balance skills involve encouraging appropriate levels of participation, providing appropriate depth of content, and maintaining a nonjudgmental approach. Lead a discussion on the principles of facilitation. Begin by asking instructor candidates to describe the benefits of facilitation: Why do participants learn more efficiently and retain information when they are actively engaged in the learning process than when they are passively receiving information, as in a lecture? Note candidates' responses on a blank piece of newsprint, chalkboard, or dry-erase board. Responses should include the following: I An instructor has the opportunity to evaluate a group's needs and to focus learning activities on those needs. I An instructor can build on participants' previous knowledge and skills. I Participants can associate their previous knowledge and skills with new information. I Participants can learn from one another. I Participants remain engaged and interested. Ask instructor candidates to think of ways to encourage class interaction. Note the responses on a blank piece of newsprint, chalkboard, or dry-erase board. Responses may include-- I Do not just lecture to participants. I Use open-ended questions (e.g. questions that begin with "what," "who," "when," "where," or "how") and wait for responses.

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Listen and manage silence. Refer participant questions back to the group for discussion and resolution instead of immediately answering them. I Give and receive feedback. I Maintain a nonjudgmental perspective. I Stay on the topic. I Manage time effectively. Divide the class into two groups. One group will act as instructors and conduct a learning session, while the other group acts as participants. They will then switch roles. Assign each group one of the following topics. (The information on the topics can be copied and distributed to each group to help facilitate this activity.) Groups will have 15 minutes to prepare their learning session and 5 minutes to conduct it. Tell the group who presents first that they can use as few or as many presenters as they want. When the first group is finished, repeat the same process with the second group.

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Group 1

Topic: Signals of a Heart Attack

The most common cause of sudden cardiac arrest is a heart attack. Based on what you already know, what signals do you think the victim of a heart attack exhibits? I Facilitate a discussion about the common signals of a heart attack. Ask the participants to describe what a victim of a heart attack looks like. List their answers or, based on their answers, draw a simple picture, such as a stick figure, on a blank piece of newsprint, chalkboard, or dry-erase board. I Use the pull technique to ensure that all signals of a heart attack are covered in the discussion. Give positive reinforcement as the signals are mentioned. Do not discourage a participant when an incorrect answer is given. Use eye contact and voice prompts to engage every participant in the exercise. (For example, when a correct answer is given, look directly at the participant and say, "That's right!" and turn to another participant, asking, "What do you think another common signal is?")

Group 2

Topic: Signals of a Heart Attack

The most common cause of sudden cardiac arrest is a heart attack. Recognizing the signals of a heart attack is important in saving lives. I Prepare a brief presentation in which you present and describe the signals of a heart attack, using newsprint, chalkboard, or dry-erase board. At the end of the presentation, ask simple questions, such as, "Is the information clear to everyone?" I Take down the newsprint or erase the information you wrote down and ask, "Who can name four signals of a heart attack?"

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Instructor Trainer Note: After the discussion, you may want to use Lecture Point 6: "Signals of a Heart Attack" (located in Section 12 of the instructor's manual, Adult CPR/AED Lecture Point 6, or participant's booklet) to reinforce the information on the signals of a heart attack. After both groups have conducted their activities, discuss their reactions to the two different teaching approaches. Model effective facilitation techniques by using positive reinforcement as differences are mentioned. Use eye contact and voice prompts and try to engage every candidate (e.g., when one candidate answers, say "That's right!" and turn to the next saying, "What do you think?") as you lead an open discussion of which approach was more effective and why. Conclude the discussion by suggesting that the candidates focus on creating active learning environments.

Skills Activity: Two-rescuer CPR Technique (15 minutes)

Activity Responders should be familiar with both 1- and 2-rescuer CPR. When a responder gets fatigued, another trained responder can either take over compressions and rescue breaths or assist by taking over either compressions or rescue breaths to maintain oxygenation and circulation of the victim. Explain to candidates that while participants who take certified lay responder courses of the First Aid/CPR/AED Program are not required to perform two-rescuer CPR for certification, instructors need to know that I They need to be able to explain the benefits of the technique and allow practice if time permits. I Set-up and introduction of the technique are contained in the instructor's manual. I They should be able to provide adequate guidance and feedback to participants if or when they practice this skill. I Two-rescuer CPR can be practiced if there is sufficient time and interest. Candidates will participate in the following activity to demonstrate how to conduct an orientation of their students to two-rescuer CPR. Instructor Trainer Note: Use the following scenario to familiarize instructor candidates with the procedures for two-rescuer CPR. Have manikins, breathing barriers, disposable gloves and decontamination supplies set up in advance. Assign or ask candidates to team up two responders per manikin. Instruct candidates that they are not to make mouth contact on their partner's face shield. The candidate who will begin with giving chest compressions will be "Responder 1" and the candidate who will begin by checking for signs of circulation and giving rescue breaths will be "Responder 2." Remind candidates that in this training situation, when changing positions, the responder who was compressing should simulate his or her breaths on the manikin when taking over rescue breaths since the manikin would not have been decontaminated during the change of positions. Before the scenario begins, be sure responders know whether their victim is an adult or a child between the ages of 1 and 8 years so they are able to establish the appropriate CPR technique and ratios.

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Two-rescuer CPR:

Setup: Imagine that you are in an emergency situation involving an adult or child victim who needs CPR. Demonstrate how two responders who know CPR can work together to provide effective compressions and rescue breaths. EMS has been activated and CPR by one responder has been in progress, when a second responder who is trained, arrives and offers his or her assistance. Instructor trainer: Responder 1 will give chest compressions, Responder 2 will give rescue breaths. The responders should be positioned on opposite sides of the manikin. Responders will peform the same technique (depth, speed, hand position, etc.) and compression/breath ratios as with single-rescuer CPR (Adult: 15:2; Child: 5:1). Responders 1 and 2 get in position to begin CPR. Responder 2, check for signs of circulation. Responder 2 checks for signs of circulation for 10 seconds while Responder 1 is ready to begin chest compressions if needed. The victim shows no signs of circulation. Responder 2 says "No signs of circulation, begin CPR." Responder 1 begins CPR by giving a cycle of chest compressions (15 for adult; 5 for child), then pauses while Responder 2 gives the rescue breath(s) (2 for adult; 1 for child). Continue for several more cycles to improve coordination of chest compressions and rescue breaths. Continue CPRrecheck for signs of circulation as appropriate.

Candidates' Action: Instructor trainer: Candidates' Action:

Instructor trainer: Candidates' Action:

Instructor trainer:

Advise candidates that: I If one responder gets tired, (often the one giving compressions), he or she may call for a change to take place at the end of the next cycle, such as: I "Change and two, and three, and four, and five...." for child CPR, I Or "... twelve and, thirteen, and fourteen, and change..." for adult CPR. I The person giving rescue breaths should simply call for a change when tired. I The cycle is then ended with rescue breaths (or a breath as appropriate) before the change takes place. I While remaining at the same side of the victim, Responder 1 (who was giving compressions) moves toward the victim's head to take over rescue breaths but first checks for signs of circulation.

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Responder 2 (who was giving rescue breaths) moves toward the victim's chest and gets into position to give compressions. If Responder 1 does not see or feel signs of circulation, he or she should state "No pulse, continue CPR." CPR is resumed with compressions, then breaths. Signs of circulation should be checked after about the first minute, every few minutes thereafter and when changing positions. Each time signs of circulation are checked, chest compressions must be stopped for no more than 10 seconds. If a second responder takes over both chest compressions and rescue breaths for a fatigued responder, he or she should check for signs of circulation for no more than 10 seconds before beginning.

Conducting Skill Sessions (15 minutes)

Key Points Tell candidates that conducting skill sessions involves responsibility for-- I Showing video segments or demonstrating skills where appropriate. I Guiding participants through the skill sessions. I Keeping the skill sessions running smoothly. I Providing sufficient time for all participants to practice a skill. I Identifying errors promptly and providing corrective or positive feedback to help participants improve their skills. I Ensuring that participants practice skills correctly. I Encouraging participants to continue practicing to improve their skills while you minimize interruptions. I Evaluating participants for proper skill performance. I Maintaining a safe environment during skill sessions. I Monitoring the proper use and supervision of instructor aides.

Automated External Defibrillation (20 minutes)

Video

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Show the Workplace Training: Standard First Aid video segment: "Different Types of AEDs" (1:30). Explain to candidates that instructors must be familiar with the type of AED that the participants or workplace will be using. Briefly review Lecture Points 7-9, 11 and 12 in the participant's booklet (pages 41-43, 45, 46). To give an overview of the role of AEDs in emergency care, show the video segment: "The Cardiac Chain of Survival" (4:29).

Key Points

Emphasize especially for candidates that: I Some states have laws or regulations that govern who may use or teach the use of automated external defibrillators (AEDs).

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Although Emergency Response instructors, First Aid/CPR/AED instructors, Workplace Training: Standard First Aid instructors, AED training instructors, Adult CPR/AED instructors and eventually all instructors who teach adult CPR will be trained by the Red Cross to provide AED instruction, instructors will be able to teach this material only if they are permitted to do so by their state and local laws and regulations.

Instructor Trainer Note: If possible, provide participants with copies of their relevant state and local laws and regulations. If clarification is needed on laws and regulations, suggest that participants call their local EMS offices or consult legal counsel.

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When teaching an AED training course, American Red Cross instructors have responsibilities that include the following: I AED training devices or AED rhythm simulators should never be connected to humans--only to manikins. I Live AEDs (those that can deliver a shock) should never be attached to a human for purposes of training. I Since a live AED has the capacity to deliver a potentially lethal shock if not properly deactivated by applying the rhythm simulation mode before being used as a training device, follow the manufacturers' instructions for deactivation of all AEDs used in training. I Caution participants not to tamper with the deactivation mode (such as removal of the PC data card). I Throughout the course, visually check and verify that the deactivation mode (rhythm simulation) is in use. I Ensure that participants treat the AED training devices and rhythm simulators with respect, and do not allow horseplay involving any AED training device or rhythm simulator. Throughout AED training courses, participants and instructors are to treat the manikins as actual victims. This includes ensuring that all AED precautions are followed during the course, which includes but is not limited to the following: I Do not use alcohol to wipe the victim's chest dry. Alcohol is flammable. I Do not use an AED on a victim who is in contact with water. I Do not use an AED on a victim lying on a conductive surface. I Do not touch the victim while the AED is analyzing or delivering a shock. I Do not defibrillate someone around flammable materials, such as gasoline or free flowing oxygen. I Do not use a cellular phone or radio within 6 feet of the AED. It may interrupt analysis. It is recommended that instructors have at least one AED training device (an AED device designed not to deliver an electrical shock) or AED rhythm simulator (an AED with a PC training card) per every two participants. If the local Red Cross chapter or training agency does not have one AED training device for every two participants, the course length will need to be extended. Instructors should work with their local Red Cross chapter to obtain training devices for classroom use.

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AEDs and Oxygen The following guidance is provided regarding the use of AEDs in conjunction with administration of emergency supplemental oxygen: I Avoid the use of supplemental, free flowing oxygen and use of an AED in a confined space. I Prior to shocking a victim with an AED, ensure that no one is touching or is in contact with the victim, or the resuscitation equipment. I Keep breathing devices with free flowing oxygen away from the victim during defibrillation. I Follow local protocols. Free flowing oxygen--is any oxygen that is released into the environment either intentionally or unintentionally, that could reach potentially dangerous levels. Confined space--is a space that is large enough and configured so that an employee can enter and perform assigned work. Instructor Trainer Note: When training is conducted or sponsored by the American Red Cross, only AED training devices incapable of delivering a shock or AED rhythm simulators (AEDs with PC training cards) should be used. The training devices and rhythm simulators allow simulation of shockable versus nonshockable scenarios that can enhance decision-making skills and diversify training activities. An AED rhythm simulator is a live AED whose shock delivery feature has been overridden for training purposes through the insertion of a PC training card or other feature. As with any manufactured device, there is a risk that the device or the override feature may fail to perform as designed. AED training devices and AED rhythm simulators should never be connected to humans--only to manikins. Live AEDs (those that can deliver a shock) should never be attached to a human for the purposes of training.

Practice-Teaching Overview and Assignments (15 minutes)

Key Points

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The purpose of practice-teaching sessions is to give the instructor candidate experience in-- I Preparing and delivering teaching sessions. I Giving directions. I Completing course activities within suggested timeframes. I Managing First Aid/CPR/AED Program skill sessions. I Evaluating performance and providing corrective feedback to help course participants improve their skills. I Ensuring participants' health and safety during training. The steps for the practice-teaching process are as follows: I Each candidate's practice-teaching session is 20 minutes in length. I Each candidate prepares a teaching session and, if necessary, arranges group members depending on the activity. I Each candidate conducts the session until the instructor trainer indicates that time is up.

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Candidates evaluate themselves on organizational ability, knowledge of the subject matter, and presentation and communication skills. Candidate evaluations are followed by peer and instructor trainer evaluations. Each candidate will be expected to successfully complete three practice-teaching assignments.

Instructor Trainer Note: Assign each instructor candidate one topic from practiceteaching assignments I and II (see Appendix B, page 3-3, for a listing of teaching session opportunities). Inform instructor candidates that each of them will conduct two practice-teaching assignments during Session 2 of this instructor course.

Preparation for Session 2 (10 minutes)

Give instructor candidates the opportunity to ask questions or seek clarification on their practice-teaching assignments.

SESSION 2: OUTLINE AND LESSON PLAN Practice Teaching I (120 minutes)

Instructor Trainer Note: In this assignment, instructor candidates have their first opportunity to teach a portion of the course content using the instructor's manual. Their performance on this assignment gives you a chance to see how comfortable they appear to be in front of a class and to identify any deficiencies on which they can focus when preparing for their next practice-teaching assignment. Activity

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Begin by having an instructor candidate conduct a practice-teaching assignment. Each candidate has 10 minutes to conduct the assignment, followed by 10 minutes of peer and instructor trainer evaluation. You should facilitate the feedback and evaluation process by making comments focusing on correct performance and specific suggestions for improvement. The feedback and evaluation process includes a self-critique by the candidate, peer feedback, and additional feedback and comments from you.

Evaluating Candidates' Skills (10 minutes)

Key Points

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Tell instructor candidates that they can improve their teaching performance by-- I Observing the teaching styles of others. I Sharing ideas and experiences. I Planning instruction to meet learning objectives. I Understanding participants' learning differences. I Reviewing peer and instructor trainer evaluations.

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Break/Preparation for Practice Teaching II (15 minutes)

Have instructor candidates prepare for Practice Teaching II.

Practice Teaching II (120 minutes)

Instructor Trainer Note: In this assignment, candidates conduct a first aid or CPR skill practice/evaluation session using the instructor's manual. Ask each candidate to introduce the assigned skill practice and lead an appropriate skill progression. Workplace Training: Standard First Aid instructor candidates are not given Infant and Child skills for this assignment. Activity

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Begin by having an instructor candidate conduct a practice-teaching assignment. Each candidate has 15 minutes to conduct the skill session followed by 5 minutes of peer and instructor trainer evaluation. After each candidate completes the assignment, you should facilitate the feedback and evaluation process with comments focusing on correct performance and specific suggestions for improvement. The feedback and evaluation process includes a selfcritique by the candidate, peer feedback, and additional feedback and comments from you.

Break/Preparation for Practice Teaching III (5 minutes)

Instructor Trainer Note: Assign each instructor candidate one topic from Practice Teaching III (see Appendix B, page 3-3, for a listing of teaching session opportunities). Inform candidates that they will each conduct an AED skill/evaluation session using the instructor's manual. Give instructor candidates the opportunity to ask questions or seek clarification on their practice-teaching assignment.

SESSION 3: OUTLINE AND LESSON PLAN Practice Teaching III (120 minutes)

Instructor Trainer Note: In this assignment, candidates will conduct an AED skill/evaluation session using the instructor's manual. Ask each candidate to introduce the assigned skill practice and lead an appropriate skill progression. Activity

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Begin by having an instructor candidate conduct a practice-teaching assignment. Each candidate has 15 minutes to conduct the session, followed by 5 minutes of peer and instructor trainer evaluation. You should facilitate the feedback and evaluation process with comments focusing on correct performance and specific suggestions for improvement. The feedback and evaluation process includes a self-critique by the candidate, peer feedback, and additional feedback and comments from you.

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Evaluating Candidates' Skills (10 minutes)

Activity Facilitate a short discussion on noted improvements of the instructor candidates from their previous teaching assignments. Ask each candidate which of the following has most helped them improve their teaching skills: I Observing the teaching styles of others I Sharing ideas and experiences I Planning instruction to meet learning objectives I Understanding participants' learning differences I Reviewing peer and instructor trainer evaluations

American Red Cross Policies and Procedures (40 minutes)

Key Points Explain the administrative terms and procedures relative to Red Cross courses. Refer candidates to Appendix 1-1, page 8 in the First Aid/CPR/AED Program Instructor's Manual.

Instructor Certification, Authorization, and Reauthorization

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Review the difference between certification and authorization. Discuss the instructor's "chapter of authorization." Review policies for reauthorization, extension of authorization, and withdrawal of authorization. Review requirements for teaching under the authorized provider agreement. Discuss the different roles of the instructor, assisting instructor, and instructor aide. Have instructor candidates complete their section of the Health & Safety Services Instructor Certificate (F5736).

Course Records

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Review with instructor candidates the information required on the Course Record and Course Record Addendum and how to complete them. Distribute sample forms to instructor candidates. Review the criteria for assigning grades. "Pass" (P) should be entered as the final grade for a participant who has attended all sessions, successfully completed written examinations, and demonstrated competency in all skills sessions. "Fail" (F) should be entered as the final grade for a participant who has not attended all sessions or successfully completed written examinations and demonstrated competency in all skills sessions. "Incomplete" (Inc) should be entered as the final grade if the participant is unable to complete the course because of certain circumstances, such as the illness or death of a family member. An "incomplete" is given only when arrangements to complete the course have been made.

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"Audit" (A) should be entered as the final grade for a participant who only chooses to participate in some of the activities and skill sessions. "Audit" can also be entered as a grade for those participants who do not meet course completion age requirements. It should not be substituted for a "Fail" when a participant attempts certification but is unable to meet course completion requirements.

Issuing Course Completion Certificates

Explain local Red Cross chapter procedure for issuing course completion certificates. I Explain that course completion certificates cannot be issued if the specific course curriculum was not followed as designed. I Explain how long certificates are valid and which sections of the certificate instructors are responsible for completing. I Explain that course participants should contact their local Red Cross chapter for more information on additional training opportunities. Review local Red Cross chapter procedures relating to-- I Instructor agreements. I Authorized Provider agreements and related fees (if applicable). I Administrative and reporting requirements. I Reservation of equipment and supplies. I Reporting faulty equipment. I The chapter's point of contact.

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Final Written Examination (30 minutes)

Key Points

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Distribute copies of the First Aid/CPR/AED Program Instructor written examination and answer sheet (Appendix F, page 3-44). Briefly review the instructions. Tell the candidates to mark all answers on the answer sheet, not on the examination, and to put away all notebooks and course materials. When candidates have completed the examination, have them return both their examinations and answer sheets to you for grading. Refer to Appendix F, page 3-44, for the answer key. Candidates must score at least 80 percent (20 correct answers out of 25 questions) to pass the examination.

Instructor Trainer Note: If a candidate does not successfully complete the instructor written examination, he or she should be counseled to study further before retaking the instructor's course. The instructor candidate must leave his or her copy of the First Aid/CPR/AED Program Instructor's Manual with the instructor trainer to be returned to the local Red Cross chapter.

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Closing (10 minutes)

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Congratulate successful candidates and issue each of them a signed, original Health and Safety Services instructor certificate. Ask each candidate to complete a Course Evaluation Form for Instructor Candidates (Appendix H, page 3-51) and return it to you before leaving. Identify candidates with leadership potential to the local Red Cross chapter. Complete the Course Record and Course Record Addendum, and return the additional copies of instructor certificates with the completed Course Record and Course Record Addendum, to your local Red Cross chapter.

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Section 3 APPENDICES

APPENDIX A Sample Letter and Course Information for Instructor Candidates

Date Dear First Aid/CPR/AED Program Instructor Candidate: Thank you for enrolling in the American Red Cross First Aid/CPR/AED Program instructor course. The instructor course is approximately 17 hours in length which includes a 31/2-hour precourse session. The schedule is as follows: Date(s) _____________________________________ Time(s) Place Directions Please bring the following documents to the first session: I Proof that you will be at least 17 years old by the last scheduled session of the instructor course I A Fundamentals of Instructor Training (FIT) (or Instructor Candidate Training, for training completed on or before 6/30/01 and valid until 06/30/02) certificate issued in the last 12 months, or current American Red Cross Health and Safety Services instructor authorization During the instructor course, you will be participating in potentially strenuous activities, such as performing cardiopulmonary resuscitation (CPR) and automated external defibrillation (AED) skills on the floor. Wear comfortable clothing. If you have a medical condition or disability that may prevent you from taking part in the skill sessions, or if you have any questions regarding your ability to participate fully in the instructor course, you should discuss this with your health-care provider or the appropriate person at the local Red Cross chapter before you start. To teach courses and modules of the American Red Cross First Aid/CPR/AED Program, you must be thoroughly familiar with the content and skills taught in the course. Upon entry to the First Aid/CPR/AED Program Instructor course, you will be tested on your current knowledge and skills. Prior to the instructor course, thoroughly review and obtain personal copies of the following materials: I American Red Cross: Adult CPR/AED Skills Card I American Red Cross: First Aid Skills Card I American Red Cross: Infant & Child CPR Skills Card* I American Red Cross: First Aid/CPR/AED Program Participant's Booklet I American Red Cross: Workplace Training: Injury-control Module Booklets *Workplace Training: Standard First Aid instructor candidates are not required to possess the Infant & Child CPR Skills Card.

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During the instructor course, you will be responsible for preparing and conducting practice-teaching assignments. The assignments will give you experience in presenting information, conducting skill sessions, and evaluating skills. An authorized instructor trainer will evaluate you during your practice-teaching assignments. To receive certification as a First Aid/CPR/AED or Workplace Training: Standard First Aid instructor, you must attend all sessions, successfully complete the precourse session and required practice-teaching assignments, demonstrate competency in required skills, and score at least 80 percent on the instructor examination. I look forward to having you as a candidate in this course. Sincerely,

(Name) Instructor Trainer or Chapter Representative

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APPENDIX B Practice-Teaching Assignments

The following is a list of practice-teaching assignments. Assign candidates one practice-teaching assignment for each of the three practice-teaching sessions. Instructor candidates should use the relevant parts of the First Aid/CPR/AED Program instructor's manual, skills cards, participant's booklets, and videos to prepare and conduct practice-teaching assignments. Directions for conducting the practice-teaching portions of this course are found in the lesson plans of this guide (page 2-23). Directions for the candidates are in Appendix C, Practice-Teaching Feedback and Evaluation Form, page 3-10. Give candidates copies of Appendix C so that they will know their roles when carrying out the practice-teaching assignments.

Practice-Teaching Session I: Course Content

1. Protecting Yourself (IM, page 24) Name _________________________________ 2. Prioritizing Care (IM, page 33) Name _________________________________ 3. Calling EMS (IM, page 31) Name _________________________________ 4. Sudden Illnesses (IM, page 53) Name _________________________________ 5. Signals of a Heart Attack (IM, pages 45 or 347) Name _________________________________ 6. Heat- and Cold-related Emergencies (IM, page 66) Name _________________________________

Workplace Training: Injury-control Modules (Optional)

7. Module Topic______________________________________(IM, page ___) Name _________________________________ 8. Module Topic______________________________________(IM, page ___) Name _________________________________ 9. Module Topic______________________________________(IM, page ___) Name _________________________________ 10. Module Topic______________________________________(IM, page ___) Name _________________________________

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Practice-Teaching Session II: First Aid and CPR Skills

1. Protecting Yourself--Glove Removal (IM, page 25) Name _________________________________ 2. Conscious ChokingAdult (IM, page 36) Name _________________________________ 3. Checking an Unconscious Victim--Adult (IM, page 37) Name _________________________________ 4. Rescue BreathingAdult (IM, page 42) Name _________________________________ 5. Adult CPR (IM, page 47) Name _________________________________ 6. Unconscious ChokingAdult (IM, page 49) Name _________________________________ 7. Wounds--Bleeding (IM, page 56) Name _________________________________ 8. Injuries to Muscles, Bones, and Joints (IM, page 62) Name _________________________________ 9. Conscious ChokingChild (IM, page 392) Name _________________________________ 10. Checking an Unconscious Child (IM, page 396) Name _________________________________ 11. Rescue BreathingChild (IM, page 401) Name _________________________________ 12. CPRChild (IM, page 404) Name _________________________________ 13. Unconscious ChokingChild (IM, page 407) Name _________________________________ 14. Checking an Unconscious Infant (IM, page 439) Name _________________________________

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15. Conscious ChokingInfant (IM, page 443) Name _________________________________ 16. Rescue BreathingInfant (IM, page 445) Name _________________________________ 17. CPRInfant (IM, page 449) Name _________________________________ 18. Unconscious ChokingInfant (IM, page 451) Name _________________________________

Practice-Teaching Session III: CPR/AED Scenarios

Refer to page 116 in the First Aid/CPR/AED Program Instructor's Manual for more information on conducting these skill scenarios. Candidate Name _____________________________________ CPR/AED Scenario 1 Setup: You are at work taking a break when you find a co-worker who appears to be unconscious. No one else standing around knows CPR or how to use an AED, but an AED is nearby. Follows emergency action steps starting with Check. The victim is unconscious. Calls or instructs someone else to call 9-1-1 or the workplace/local emergency number and get the AED; checks victim's breathing. The victim is not breathing. Provides care by giving 2 rescue breaths, then checks for signs of circulation/pulse. There is no pulse. Gives CPR. After about 3 cycles of CPR, AED arrives. Gives 3 shocks, checks pulse, gives 1 minute of CPR, 1 shock. Check pulse. Checks pulse and breathing. The victim's pulse and breathing are restored.

Participant Action: Instructor: Participant Action: Instructor: Participant Action: Instructor: Participant Action: Instructor: Participant Action: Instructor: Participant Action: Instructor:

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Candidate Name _____________________________________ CPR/AED Scenario 2

Setup: You walk into the restroom at work and find someone lying on the floor next to the wash basin. No one else is in the restroom.

Follows emergency action steps, starting with Check. The victim is unconscious. Calls or instructs someone else to call 9-1-1 or the workplace/local emergency number; checks victim's breathing. The victim is not breathing. Provides care by giving 2 rescue breaths, then checks for signs of circulation/pulse. The victim has no pulse. Gives CPR. After about 2 or 3 cycles of CPR, AED arrives. Gives 1 shock. Pulse and breathing are restored, but then pulse and breathing are lost. Gives 1 shock. The victim's pulse and breathing are restored.

Participant Action: Instructor: Participant Action: Instructor: Participant Action: Instructor: Participant Action: Instructor: Participant Action: Instructor: Participant Action: Instructor:

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Candidate Name _____________________________________

CPR/AED Scenario 3

Setup: A co-worker has been complaining of indigestion. He now states that he has severe chest pain and is nauseous. You notice that his skin is pale or ashen and that he is having trouble breathing. Suddenly he collapses and becomes unconscious.

Responder 1 follows the emergency action steps: Check-Call-Care. The victim is not breathing and has no signs of circulation/pulse. Responder 1 gives CPR. After 1 or 2 cycles, Responder 2 arrives with an AED. Responder 2 uses the AED and gives 3 shocks; Responder 1 gives CPR for about 1 minute, Responder 2 gives 1 shock. Pulse is restored, but the victim is not breathing. Responder 1 gives rescue breathing for 1 minute, rechecks pulse and breathing. The victim's pulse and breathing are restored.

Participant Action: Instructor: Participant Action: Instructor: Participant Action: Instructor: Participant Action: Instructor:

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Candidate Name _____________________________________

CPR/AED Scenario 4

Setup: You are at the cafeteria when you hear a commotion. People are standing around a woman who has collapsed on the floor.

Responder 1 follows the emergency action steps: Check-Call-Care. The victim is unconscious and breaths do not go in after two attempts to give rescue breaths. Responder 1 gives care for an unconscious choking adult. After about 3 cycles of 15 chest compressions, look for a foreign object, and 2 rescue breaths, you see an object. The responder removes the object from the victim's mouth, gives 2 rescue breaths and checks for signs of circulation and breathing. The victim has a pulse but is not breathing. Responder 1 gives 1 minute of rescue breathing and rechecks pulse. There is no pulse. Responder 2 gives 1 shock. Pulse and breathing are restored, but then pulse and breathing are absent. Responder 2 gives 1 shock. The victim's pulse and breathing are restored.

Participant Action: Instructor: Participant Action: Instructor: Participant Action: Instructor: Participant Action: Instructor: Participant Action: Instructor: Participant Action: Instructor:

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APPENDIX C Practice-Teaching Feedback and Evaluation Form

The following guidelines and form (see following page) provide a framework for giving and receiving feedback on practice-teaching assignments and are to be distributed to instructor candidates. How to effectively give and receive appropriate feedback can be learned, with practice. The feedback you receive from other instructor candidates can help you develop new and improved teaching skills and become a better instructor. Practicing giving feedback makes you more aware of your own and others' teaching styles. You will be giving and receiving feedback and will have an opportunity to critique your own teaching skills. When receiving feedback, listen carefully. If you do not understand the point being made, ask the person to explain more specifically. When giving feedback on your own or another instructor candidate's teaching session-- I First, provide positive feedback. I Next, discuss an aspect that could be improved, with a specific example of how to make it better. (This is called corrective feedback.) Remember that useful feedback-- I Is evaluative rather than negative or judgmental. I Reinforces positive aspects of the teaching session. I Focuses on improving teaching skills. I Is specific and concise. I Takes into account the needs of both receiver and giver. I Is well-timed. Feedback will follow this order: 1. Presenters critique their own teaching session. 2. Other candidates give feedback. 3. The instructor trainer gives feedback and summarizes.

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APPENDIX C Practice-Teaching Feedback and Evaluation Form

Session No._____________ Assignment Topic ____________________________________________ Instructor candidate_______________________________________ Date _______________________ Overview Circle the appropriate responses for the following statements. The instructor candidate-- 1. Spoke loudly and clearly. Yes No N/A

Comments: ________________________________________________________________________ 2. Was interesting and self-motivated. Yes No N/A

Comments: ________________________________________________________________________ 3. Made eye contact when speaking. Yes No N/A

Comments: ________________________________________________________________________ 4. Organized the activity logically and followed the lesson plan. Yes No N/A

Comments: ________________________________________________________________________ 5. Provided accurate information. Yes No N/A

Comments: ________________________________________________________________________ 6. Was able to answer questions asked by the group. Yes No N/A

Comments: ________________________________________________________________________ 7. Kept participants involved and motivated. Yes No N/A

Comments: ________________________________________________________________________ 8. Related course content to participants' needs and experiences. Yes No N/A

Comments: ________________________________________________________________________ 9. Gave clear instructions on safety precautions before having participants perform the activity. Yes No N/A

Comments: ________________________________________________________________________

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10. Used supporting materials (e.g., manikins, AEDs) appropriately.

Yes

No

N/A

Comments: ________________________________________________________________________ 11. Efficiently conducted the skill session. Yes No N/A

Comments: ________________________________________________________________________ 12. Noticed and corrected participants' errors. Yes No N/A

Comments: ________________________________________________________________________ 13. Provided positive corrective feedback. Yes No N/A

Comments: ________________________________________________________________________ 14. Gave specific directions for correcting errors. Yes No N/A

Comments: ________________________________________________________________________ 15. Provided accurate demonstrations when needed. Yes No N/A

Comments: ________________________________________________________________________

Other Comments

_____________________________________________________________________________________ _____________________________________________________________________________________ _____________________________________________________________________________________ _____________________________________________________________________________________ _____________________________________________________________________________________ _____________________________________________________________________________________ _____________________________________________________________________________________ _____________________________________________________________________________________ _____________________________________________________________________________________ _____________________________________________________________________________________ _____________________________________________________________________________________ _____________________________________________________________________________________ _____________________________________________________________________________________

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Instructor Candidate Participant Progress Log APPENDIX D

Precourse Written Exam Removing Gloves

Checking an Unconscious Adult or Child Victim* Conscious ChokingAdult or Child

Unconscious Choking Adult* Rescue Breathing-Adult* Adult CPR*

Using an AED*

Controlling External Bleeding* Sling and Binder*

Head, Neck, and Back Immobilization

Rescue Breathing-Child*

CPR-Child*

Unconscious Choking-Child*

Name of Instructor Candidate

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Checking an Unconscious Infant*

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All instructor candidates must pass the written examinations, skill evaluations and practice-teaching assignments to be certified as a First Aid/CPR/AED Program instructor. Use a "P" to record that the instructor candidate passed each written examination or skill evaluation. Use an "F" to record that the instructor candidate failed a written examination or skill evaluation. For each of the practice-teaching sessions, rate each instructor candidate "C" (competent) or "NI" (needs improvement). If "NI," state on the back of this form what needed improvements have been discussed with the instructor candidate. NOTE: Precourse requirements with an (*) include using appropriate basic precautions to reduce the risk of disease transmission (breathing barriers and/or disposable gloves).

Precourse Requirements

Course Requirements

Instructor Candidate Participant Progress Log

Precourse Requirements Conscious Choking-Infant Rescue Breathing-Infant*

APPENDIX D (continued)

CPR-Infant*

Unconscious Choking-Infant*

Practice-Teaching Session I Practice-Teaching Session II Practice-Teaching Session III

Name of Instructor Candidate

1.

2.

3.

4.

5.

6.

7.

8.

9.

10.

*Includes using appropriate basic precautions to reduce the risk of disease transmission (breathing barriers and/or disposable gloves)

Instructor Written Exam

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Course Requirements

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APPENDIX E Precourse Examinations, Answer Sheet, and Answer Keys

AMERICAN RED CROSS FIRST AID/CPR/AED PROGRAM Precourse Examination A--Adult

Instructions: Read each question slowly and carefully. Then choose the best answer. Fill in that circle on the answer sheet. When you are done with the examination, hand in the completed answer sheet to your instructor. Section 1--Before Providing Care 1. The steps to follow in an emergency are a) Check-Call-Care. b) Call-Check-Secure. c) Check-Care-Defibrillate. d) Early access-Early CPR-Early recognition. 2. How can you protect yourself from disease transmission when giving care? a) Avoid contacting the victim's blood or other body fluids. b) Ask the victim first if he or she has any communicable diseases. c) Use protective equipment, such as disposable gloves and breathing barriers, when giving care. d) A and C. 3. You come upon a scene where someone seems to be hurt. Why should you check the scene before approaching the victim? a) To find out what happened and how many victims there are. b) To see if there are any bystanders who can help. c) To ensure your own safety. d) All of the above. 4. You see someone on the ground in the parking lot who appears to be unconscious. After checking the scene for safety, what should you do next? a) Move the victim. b) Check the victim by gently tapping him and shouting; "Are you O.K.?" c) Give CPR. d) Check for a pulse. 5. You see a co-worker collapse. You check the scene and then check the victim for consciousness, but she does not respond. What should you do next? a) Call, or have a co-worker call, 9-1-1 or the workplace emergency number. b) Give 2 rescue breaths. c) Check for a pulse. d) Move the victim.

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6. You and a co-worker enter the lunchroom and find a person lying on the floor. You check the scene and then you check the victim. Your co-worker is getting ready to move the victim onto a nearby sofa "to be more comfortable," and asks for your help. What should you do? a) Help your co-worker move the victim. b) Start rescue breathing. c) Tell your co-worker not to move the victim since there is no immediate danger and moving the victim could cause further injury. d) Give the victim lots of water. 7. You respond to an emergency and find four victims. Which victim should you care for first? a) A victim who is bleeding lightly from his thigh. b) A victim who is complaining of abdominal cramps. c) A victim who has a burn on his forearm. d) A victim who is unconscious. 8. A person was injured when a heavy object fell on him in the warehouse. You think he may be in shock. Which of the following signals indicates the victim may be in shock? a) Restlessness and irritability. b) Pale or ashen, cool, moist skin. c) Nausea and vomiting. d) All of the above. 9. You determine that a victim is in shock. Which of the following should you NOT do for someone in shock? a) Keep the victim comfortable. b) Give the victim water. c) Monitor the victim's ABCs. d) Raise the victim's legs 12 inches. 10. A co-worker has been injured and is conscious. You should a) Talk to her to find out what happened. b) Ask her to walk with you to the first aid station. c) Check her for life-threatening conditions and for conditions that may become life threatening. d) A and C. Section 2--Adult CPR 1. You are in the cafeteria when a co-worker at the next table suddenly clutches his throat with both hands. You ask him if he is choking and he frantically nods yes. You tell him you are trained in first aid and that you can help. As you send someone to call 9-1-1, what should you do? a) Try to give 2 slow breaths to the victim. b) Check his carotid pulse, and then give back blows. c) Give 15 chest compressions. d) Stand behind the victim, and give abdominal thrusts.

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2. You and a co-worker find someone on the floor unconscious. You send your co-worker to call 91-1. When you check the victim's breathing and pulse, you find that he is not breathing but has a pulse. You should a) Give quick breaths at the rate of 60 to 80 per minute. b) Give CPR. c) Give back blows and chest thrusts. d) Breathe slowly into the victim about once every 5 seconds. 3. If your first 2 breaths do not go in during your care for an unconscious victim, what should you do next? a) Reposition the victim's airway and reattempt 2 rescue breaths. b) Give up to 5 abdominal thrusts. c) Sweep out the mouth. d) None of the above. 4. Where should you position your hands to give abdominal thrusts for a conscious choking victim? a) On the rib cage. b) On the belly button. c) In the middle of the abdomen just above the belly button. d) Any of the above. 5. To check if a victim is breathing a) Check for a pulse in the neck. b) Look, listen, and feel for breathing. c) Look in the victim's mouth for at least 10 seconds. d) Hold your hands over the ribs to feel for chest expansion. 6. You notice that a co-worker looks uncomfortable. He is sweating and seems to be having trouble breathing. You ask him if he feels okay, and he says no, that he feels a heavy pressure in his chest. What life-threatening condition could he be experiencing? a) Indigestion b) Heart attack c) Upset stomach d) All of the above 7. You are called to help a co-worker who is not breathing and has no pulse. Why is it crucial for you to start CPR as quickly as possible? a) CPR helps prevent a heart attack. b) With early CPR, the victim will not need advanced medical care. c) CPR helps circulate blood that contains oxygen to the vital organs until more advanced medical personnel arrive. d) CPR helps restart a heart. 8. How long should you check a victim's pulse? a) No more than 10 seconds. b) 1 to 3 seconds. c) About 60 seconds. d) About 15 to 20 seconds.

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American Red Cross First Aid/CPR/AED Program Guide for Training Instructors

9. Where should you place your hands to give chest compressions during CPR? a) One hand on the notch and one hand on the ribs. b) On the center of the breastbone, just above the notch where the ribs meet the breastbone. c) On the left side of the rib cage, 31/2 inches from the breastbone. d) Over the abdomen, about 2 inches below where the ribs meet the breastbone. 10. When giving CPR a) Compress the chest straight down about 2 inches. b) Give cycles of 15 compressions and 2 slow breaths. c) Compress the chest about 1/2 inch. d) A and B. Section 3--First Aid 1. A co-worker has fallen to the ground and has been shaking uncontrollably for at least 5 minutes. Which of the following is most appropriate to care for this victim? a) Clear the area of objects that may injure the co-worker and have someone call 9-1-1 or the workplace emergency number. b) Try to prevent the victim from swallowing his tongue by placing your fingers in his mouth. c) Try to give the victim some sugar. d) Hold the victim down. 2. On the way to a meeting, a co-worker collapses in front of you. When she regains consciousness, she has difficulty speaking and one side of her face and body appears to be paralyzed. These signals lead you to believe your co-worker has a) Had a stroke. b) Had a diabetic emergency. c) Had a seizure. d) Been poisoned. 3. You have bandaged a co-worker's cut forearm in a way that applies pressure on the wound and a co-worker has called 9-1-1. Blood is still soaking through the dressing and bandage. You help the man elevate his arm in an attempt to stop the bleeding, but the bleeding continues. What should you do now? a) Remove the dressing and bandage and start over again with a tighter bandage. b) Apply a tourniquet around the arm above the wound. c) Apply additional dressings and bandages, and apply pressure on the inside of the arm midway between the shoulder and elbow. d) Go to the doctor because there is nothing else you can do. 4. A co-worker burned her hand in the office lunchroom when she touched a stove burner she did not realize was hot. There are burns with blisters across the palm and several fingers. You are present in the room when this happens. What care should you give first? a) Cool the burn with large amounts of cool water. b) Cover the burn with a dry, sterile dressing. c) Blow on the burn to cool it off, or have her wave her hand around in the air. d) Apply some ointment or grease to the burn.

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5. Your co-worker is bleeding severely. After putting on disposable gloves, what is the first step in your care? a) Press firmly against the wound with a sterile dressing. b) Apply pressure at a pressure point. c) Elevate the wound if there are no broken bones and you can do so without causing further pain. d) Let the wound bleed until it stops on its own. 6. A co-worker has injured his ankle in the warehouse. It seems to be a sprain, and another coworker wants to drive him to a nearby clinic to have it examined by a doctor. You should immobilize the ankle a) Because movement during transport could cause more injury. b) After it is examined by the doctor. c) Only if you can do so without causing more pain and discomfort to the victim. d) A and C. 7. The sling that you apply to an injured co-worker's arm should be a) Loose, so that the victim can move the arm around. b) Snug, but not so tight that it slows circulation. c) Tied off directly over the injured area. d) None of the above. 8. It is a hot summer day, and you have been working outside. You think a co-worker may be suffering from heat exhaustion because he is sweating profusely and looks pale. Your care should include a) Having the victim take a salt tablet. b) Rapidly transporting the victim to a medical facility. c) Removing him from the heat and giving him cool water to drink if he is conscious. d) Vigorously massaging the victim. 9. What care should you give to a co-worker with frostbitten hands? a) Immerse his hands in hot water. b) Massage his hands vigorously. c) Have the victim shake his hands vigorously until feeling is restored. d) Rewarm the hands in warm water. 10. You begin to care for a victim of a heat-related emergency, but she becomes unconscious. What should you do first? a) Be sure 9-1-1 or the workplace emergency number has been called. b) Monitor the victim's airway. c) Give the victim ice to eat. d) Pour water on her face to try to revive her.

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American Red Cross First Aid/CPR/AED Program Guide for Training Instructors

Section 4--Automated External Defibrillation 1. Early defibrillation is an important link in the cardiac chain of survival because a) Each minute that defibrillation is delayed reduces the chance of survival. b) Defibrillation can help prevent stroke. c) A cardiac arrest victim may have an unshockable rhythm. d) All of the above. 2. Where should you attach the AED pads to the victim? a) Place one pad on the center of the chest and the other pad on the victim's lower abdomen. b) Place one pad on the victim's lower left side and the other pad on the victim's lower right side. c) Place one pad on the victim's upper right chest and the other pad on the victim's lower left side. d) Place both pads on the victim's upper chest. 3. Which of the following precautions apply when operating an AED? a) Do not touch the victim while the AED is analyzing. b) Do not touch the victim when defibrillating. c) Do not use an AED on a victim lying on a conductive surface, such as sheet metal or bleachers. d) All of the above. 4. Before delivering a shock with an AED, you should a) Do a finger sweep. b) Place the victim on his or her side. c) Have another responder hold the victim. d) Instruct others to stand clear. 5. You are giving care to a victim with no pulse. After you give 2 shocks, the AED prompts, "No shock advised." What action should you take next? a) Check for a pulse. b) Push the shock button anyway. c) Start CPR. d) Give 2 slow breaths.

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Precourse Examination Answer Sheet Standard First Aid with AED

Name _______________________________________________ Date _____________________ Examination A B

Section 2 Adult CPR d d d d d d d d d d 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. a a a a a a a a a a b b b b b b b b b b c c c c c c c c c c d d d d d d d d d d 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. a a a a a a a a a a Section 3 First Aid b b b b b b b b b b c c c c c c c c c c d d d d d d d d d d

Section 1 Before Providing Care 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. a a a a a a a a a a b b b b b b b b b b c c c c c c c c c c

Section 4 Automated External Defibrillation 1. 2. 3. 4. 5. a a a a a b b b b b c c c c c d d d d d

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American Red Cross First Aid/CPR/AED Program Guide for Training Instructors

Precourse Examination A Answer Key Standard First Aid with AED

Section 1 Before Providing Care 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. a a a a a a a a a a b b b b b b b b b b c c c c c c c c c c d d d d d d d d d d 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. a a a a a a a a a a Section 2 Adult CPR b b b b b b b b b b c c c c c c c c c c d d d d d d d d d d 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. a a a a a a a a a a Section 3 First Aid b b b b b b b b b b c c c c c c c c c c d d d d d d d d d d

Section 4 Automated External Defibrillation 1. 2. 3. 4. 5. a a a a a b b b b b c c c c c d d d d d

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AMERICAN RED CROSS FIRST AID/CPR/AED PROGRAM Precourse Examination B--Adult

Instructions: Read each question slowly and carefully. Then choose the best answer. Fill in that circle on the answer sheet. When you are done with the examination, hand in the completed answer sheet to your instructor. Section 1--Before Providing Care 1. How can you protect yourself from disease transmission when giving care? a) Avoid contacting the victim's blood or other body fluids. b) Ask the victim first if he or she has any communicable diseases. c) Use protective equipment, such as disposable gloves and breathing barriers, when giving care. d) A and C. 2. The steps to follow in an emergency are a) Check-Call-Care. b) Call-Check-Secure. c) Check-Care-Defibrillate. d) Early access-Early CPR-Early recognition. 3. There is a commotion in your work area. One of your co-workers has fallen from a ladder. Your other co-workers are getting ready to move the injured victim and ask for your help. What should you do? a) Help your co-workers move the victim. b) Start rescue breathing. c) Tell your co-workers not to move the victim since there is no immediate danger and moving the victim could cause further injury. d) Give the victim lots of water. 4. A co-worker has been injured and is conscious. You should a) Talk to her to find out what happened. b) Ask her to walk with you to the first aid station. c) Check her for life-threatening conditions and for conditions that may become life threatening. d) A and C. 5. You are at work when you see what looks like a serious accident between two vehicles. Why should you check the scene before giving care? a) To find out what happened and how many victims there are. b) To ensure your own safety. c) To see if there are any bystanders who can help. d) All of the above. 6. You respond to an emergency and find four victims. Which victim should you care for first? a) A victim who is bleeding slightly from his thigh. b) A victim who is complaining of pain in his knee. c) A victim who has a burn on his forearm. d) A victim who is unconscious.

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American Red Cross First Aid/CPR/AED Program Guide for Training Instructors

7. You are on your lunch break when you notice a co-worker who appears to be unconscious. After checking the scene, you check the victim for consciousness by a) Rolling him onto his side and sweeping his mouth. b) Calling, or having a co-worker call, 9-1-1 or the workplace emergency number. c) Gently tapping him and shouting "Are you O.K.?" d) Checking for a pulse. 8. You see a co-worker collapse. You check the scene and then check the victim for consciousness, but she does not respond. What should you do next? a) Call, or have a co-worker call, 9-1-1 or the workplace emergency number. b) Give 2 rescue breaths. c) Check for a pulse. d) Move the victim. 9. You are helping a co-worker who is cut and bleeding severely. You control the bleeding, but you think the victim may be in shock. What should you do? a) Make sure 9-1-1 or the workplace emergency number has been called. b) Keep the victim from getting chilled or overheated. c) Monitor and reassure the victim until advanced medical help arrives. d) All of the above. 10. You determine that this victim is in shock. Which of the following should you NOT do for someone in shock? a) Keep the victim comfortable. b) Give the victim water. c) Monitor the victim's ABCs. d) Raise the victim's legs 12 inches. Section 2--Adult CPR 1. What is the purpose of CPR? a) CPR restarts the heart. b) With CPR, the victim will not need advanced medical care. c) CPR helps circulate blood that contains oxygen to the vital organs until more advanced medical personnel arrive. d) CPR helps prevent a heart attack. 2. You notice that a co-worker looks uncomfortable. He is sweating and seems to be having trouble breathing. You ask him if he feels okay, and he says no, that he feels a heavy pressure in his chest. What life-threatening condition could he be experiencing? a) Indigestion b) Heart attack c) Upset stomach d) All of the above

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3. You are in the cafeteria when a co-worker at the next table suddenly clutches his throat with both hands. You ask him if he is choking and he frantically nods yes. You tell him you are trained in first aid and that you can help. As you send someone to call 9-1-1, what should you do? a) Try to give 2 slow breaths to the victim. b) Check his carotid pulse, and then give back blows. c) Give 15 chest compressions. d) Stand behind the victim and give abdominal thrusts. 4. How long should you check a victim's pulse? a) No more than 10 seconds. b) 1 to 3 seconds. c) About 60 seconds. d) About 15 to 20 seconds. 5. When giving rescue breaths to an adult a) Give quick breaths at the rate of 60 to 80 per minute. b) Give about 15 compressions. c) Give back blows and chest thrusts. d) Breathe slowly into the victim, about once every 5 seconds. 6. When giving care to a victim who is conscious and has an obstructed airway, where should you position your hands to give abdominal thrusts? a) On the rib cage. b) On the belly button. c) In the middle of the abdomen just above the belly button. d) Any of the above. 7. If your first 2 breaths do not go in during your care for an unconscious victim, what should you do next? a) Reposition the victim's airway and reattempt 2 slow breaths. b) Give up to 5 abdominal thrusts. c) Sweep out the mouth. d) None of the above. 8. To check if a victim is breathing a) Check for a pulse in the neck. b) Look, listen, and feel for breathing. c) Look in the victim's mouth for at least 10 seconds. d) Hold your hands over the ribs to feel for chest expansion. 9. When giving CPR a) Compress the chest straight down about 2 inches. b) Give cycles of 15 compressions and 2 slow breaths. c) Compress the chest at an angle about 1/2 inch. d) A and B. 10. Where should you place your hands to give chest compressions during CPR? a) One hand on the notch and one hand on the ribs. b) On the center of the breastbone, just above the notch where the ribs meet the breastbone. c) On the left side of the rib cage 31/2 inches from the center. d) Over the abdomen, about 2 inches below where the ribs meet the breastbone.

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American Red Cross First Aid/CPR/AED Program Guide for Training Instructors

Section 3--First Aid 1. A co-worker collapses. As she regains consciousness she has difficulty speaking and one side of her face and body appear to be paralyzed. These signals lead you to believe your co-worker has a) Had a stroke. b) Had a diabetic emergency. c) Had a seizure. d) Been poisoned. 2. A co-worker has fallen to the ground and has been shaking uncontrollably for at least 5 minutes. Which of the following is most appropriate to care for this victim? a) Clear the area of objects that may injure the co-worker and have someone call 9-1-1 or the workplace emergency number. b) Try to prevent the victim from swallowing his tongue by placing your fingers in his mouth. c) Try to give the victim some sugar. d) Hold the victim down. 3. If someone has injured a muscle, bone, or joint and is unable to move or use the injured part a) Call, or have someone else call, 9-1-1 or the workplace emergency number. b) Have the person try to walk it off. c) Try to apply a splint before advanced medical personnel arrive and take over. d) Slowly move the injured part around until it feels better. 4. A co-worker seems to have sprained his ankle in the warehouse. He can move the injured ankle, but he has decided to go to a nearby clinic to have it examined. Another co-worker wants to drive him to the clinic. You should immobilize the ankle a) Because movement during transport could cause more injury. b) After it is examined by the doctor. c) Only if you can do so without causing more pain and discomfort to the victim. d) A and C. 5. What care should you give to a co-worker with frostbitten hands? a) Immerse his hands in hot water. b) Massage his hands vigorously. c) Have the victim shake his hands vigorously until feeling is restored. d) Rewarm the hands in warm water. 6. You begin to care for a victim of a heat-related emergency, and she becomes unconscious. What should you do first? a) Be sure 9-1-1 or the workplace emergency number has been called. b) Monitor the victim's airway. c) Give the victim ice to eat. d) Pour water on her face to try to revive her.

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7. It is a hot summer day, and you have been working outside. You think a co-worker may be suffering from heat exhaustion because he is sweating profusely and looks pale. Your care for this victim should include a) Having the victim take a salt tablet. b) Rapidly transporting the victim to a medical facility. c) Removing him from the heat and giving him cool water to drink if he is conscious. d) Vigorously massaging the victim. 8. A co-worker has burned his hand on some hot metal. There are burns with blisters across the palm and several fingers. How should you care for this burn injury? a) Blow on the burn to cool it off, or have him wave his hand around in the air. b) Raise the victim's feet 12 inches. c) Cool the burn with large amounts of cool water, and then cover the burn with a dry, sterile dressing. d) Apply some ointment or lotion on the burn. 9. You have bandaged a co-worker's cut forearm in a way that applies pressure on the wound and a co-worker has called 9-1-1. Blood is still soaking through the dressing and bandage. You help the man elevate his arm in an attempt to stop the bleeding, but the bleeding continues. What should you do? a) Remove the dressing and bandage and start over again with a tighter bandage. b) Apply a tourniquet around the arm above the wound. c) Apply additional dressings and bandages, and apply pressure on the inside of the arm midway between the shoulder and elbow. d) Go to the doctor because there is nothing else you can do. 10. Your co-worker is bleeding severely. After putting on disposable gloves, what is the first step in your care? a) Press firmly against the wound with a clean or sterile dressing. b) Apply pressure at a pressure point. c) Elevate the wound if no broken bones and you can do so without causing further pain. d) Let the wound bleed until it stops on its own. Section 4--Automated External Defibrillation 1. Early defibrillation is an important link in the cardiac chain of survival because a) Each minute that defibrillation is delayed reduces the victim's chance of survival. b) Defibrillation can help prevent stroke. c) A cardiac arrest victim may have an unshockable rhythm. d) All of the above. 2. Where should you attach the AED pads to the victim? a) Place one pad on the center of the chest and the other pad on the victim's lower abdomen. b) Place one pad on the victim's lower left side and the other pad on the victim's lower right side. c) Place one pad on the victim's upper right chest and other pad on the victim's lower left side. d) Place both pads on the victim's upper chest.

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American Red Cross First Aid/CPR/AED Program Guide for Training Instructors

3. Which of the following precautions apply when using an AED? a) Do not touch the victim while the AED is analyzing. b) Do not touch the victim when defibrillating. c) Do not use an AED on a victim lying on a conductive surface such as sheet metal or bleachers. d) All of the above. 4. Before delivering a shock with an AED you should a) Do a finger sweep. b) Place the victim on his or her side. c) Have another responder hold the victim. d) Instruct others to stand clear. 5. You are giving care to a victim with no pulse. After you give 2 shocks the AED prompts, "No shock advised." What action should you take next? a) Check for a pulse. b) Push the shock button anyway. c) Start CPR. d) Give 2 slow breaths.

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Precourse Examination Answer Sheet Standard First Aid with AED

Name _______________________________________________ Date _____________________ Examination A B

Section 2 Adult CPR d d d d d d d d d d 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. a a a a a a a a a a b b b b b b b b b b c c c c c c c c c c d d d d d d d d d d 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. a a a a a a a a a a Section 3 First Aid b b b b b b b b b b c c c c c c c c c c d d d d d d d d d d

Section 1 Before Providing Care 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. a a a a a a a a a a b b b b b b b b b b c c c c c c c c c c

Section 4 Automated External Defibrillation 1. 2. 3. 4. 5. a a a a a b b b b b c c c c c d d d d d

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American Red Cross First Aid/CPR/AED Program Guide for Training Instructors

Precourse Examination B Answer Key Standard First Aid with AED

Section 1 Before Providing Care 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. a a a a a a a a a a b b b b b b b b b b c c c c c c c c c c d d d d d d d d d d 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. a a a a a a a a a a Section 2 Adult CPR b b b b b b b b b b c c c c c c c c c c d d d d d d d d d d 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. a a a a a a a a a a Section 3 First Aid b b b b b b b b b b c c c c c c c c c c d d d d d d d d d d

Section 4 Automated External Defibrillation 1. 2. 3. 4. 5. a a a a a b b b b b c c c c c d d d d d

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AMERICAN RED CROSS FIRST AID/CPR/AED PROGRAM Precourse Examination A--Infant and Child CPR

Instructions: Read each question slowly and carefully. Then choose the best answer. Fill in that circle on the answer sheet. When you are done with the examination, hand in the completed answer sheet to your instructor. Section 1--Before Providing Care 1. How can you protect yourself from disease transmission when giving care? a) Providing 2 rescue breaths with every 15 compressions. b) Wipe off the victim's hands and mouth. c) Use protective equipment, such as disposable gloves and breathing barriers when giving care. d) Getting annual physical exams after age 40. 2. The emergency action steps to follow are a) Check-Call-Care. b) Check-Call-Secure. c) Check-Call-Defibrillate. d) Early access-Early CPR-Early recognition. 3. You are at the mall when you see what looks like a serious accident involving a bicycle and a vehicle. Why should you check the scene before giving care? a) To find out what happened and how many victims there are. b) To ensure your own safety. c) To see if there are any bystanders who can help. d) All of the above. 4. You respond to an emergency and find four victims. Which victim should you care for first? a) A victim who is bleeding slightly from his thigh. b) A victim who is complaining of pain in his knee. c) A victim who has a small burn on his fingertip. d) A victim who is unconscious. 5. You are on your lunch break when you notice a child who appears to be unconscious. After checking the scene, you check the child for consciousness by a) Rolling him onto his side and sweeping his mouth. b) Checking his blood pressure. c) Gently tapping him and shouting, "Are you O.K?" d) Checking for signs of circulation. 6. At a youth soccer game, you see a player collapse. You check the scene and then check the child for consciousness, but he does not respond. What should you do next? a) Have a bystander call 9-1-1 or the local emergency number. b) Give 5 rescue breaths. c) Give 2 back blows. d) Move the child.

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American Red Cross First Aid/CPR/AED Program Guide for Training Instructors

7. What does the "C" in "A-B-C" stand for? a) Continue b) Circulation c) Compressions d) Choking 8. When checking for breathing in an unconscious child a) Place the victim in the recovery position. b) Lift the head and tilt the chin. c) Pinch the victim's nose shut. d) Look, listen, and feel for breathing. 9. A child has a life-threatening condition. There is no parent or guardian present. Consent is implied, so you should provide care. True False 10. A child may have suffered a neck injury. There is no immediate danger to you or the child. You should move the victim to a comfortable position. True False Section 2--Child CPR 1. What is the purpose of CPR? a) CPR restarts the heart. b) With CPR, the child will not need advanced medical care. c) CPR helps circulate blood containing oxygen to the vital organs until more advanced medical personnel arrive and take over. d) CPR prevents a cardiac emergency. 2. You notice that a child looks panicked. (She cannot cough, speak, or breathe.) What life-threatening condition could the child be experiencing? a) Indigestion b) Cardiac arrest c) Upset stomach d) Choking 3. When giving rescue breaths to a child a) Give quick breaths at the rate of about 40 to 80 per minute. b) Give about 5 compressions. c) Give back blows and chest thrusts. d) Take a breath and breathe slowly into the child, just enough to make chest clearly rise. 4. When giving care to a child who is conscious and has an obstructed airway, where do you position your hands to give abdominal thrusts? a) On the rib cage b) Just above the belly button c) In the center of the breastbone d) Any of the above

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5. When giving CPR a) Compress the chest straight down about 1-11/2 inches with one hand. b) Give cycles of 5 chest compressions and 1 rescue breath. c) Compress the chest at a 45-degree angle. d) A and B. 6. Where do you place your hands to give chest compressions during child CPR? a) One hand on the notch of the breastbone and the other hand on the nose to hold it open. b) One hand on the notch and one on the ribcage. c) One hand on the center of the breastbone, just above the notch where the ribs meet the breastbone and the other on the forehead. d) Over the stomach, just above the belly button and below the notch. 7. Your child is choking on a french fry. When you reach the child, you ask if he is choking and he frantically nods his head yes. As you send someone to call 9-1-1, what should you do? a) Try to give 2 rescue breaths. b) Check his brachial pulse. c) Give 15 chest compressions. d) Stand behind the child and give abdominal thrusts. 8. When should you initially check a child for signs of circulation? a) After giving 2 effective rescue breaths b) After 15 chest compressions and 2 rescue breaths c) About 4-5 minutes after you began CPR d) After checking the scene for safety 9. When giving care to a child who is unconscious and has an obstructed airway, where do you position your hand to give compressions? a) On the back sides of the rib cage. b) Below the belly button in the center of the abdomen. c) Above the belly button and below the notch where the ribs meet the breastbone. d) One hand on the center of the breastbone, just above the notch where the ribs meet the breastbone. 10. To check if an unconscious child is breathing a) Check for the brachial pulse in the arm. b) Look, listen, and feel for breathing. c) Look in the victim's mouth for at least 10 seconds. d) Place your hands on the rib cage to feel for chest expansion. Section 3--Infant CPR 1. Some signs that an infant is choking are a) Rapid breathing and crying. b) Looking panicked and not able to cough, cry, or breathe. c) Breathing noisily and deeply. d) Crying and spitting up food.

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2. When giving rescue breaths to an infant a) Give quick breaths at a rate of 40 to 80 per minute. b) Give about 5 compressions. c) Give back blows and chest thrusts. d) Take a breath and breathe slowly into the infant, just enough to make the chest clearly rise. 3. When giving care to an infant who is unconscious and has an obstructed airway, where do you position your fingers to give chest compressions? a) On the rib cage b) On the breastbone near the neck c) In the center of the breastbone, one finger width below the nipple line d) Any of the above 4. When giving an infant CPR a) Compress the chest straight down about 1/2-1 inch with two fingers. b) Give cycles of 5 chest compressions and 1 rescue breath. c) Compress the chest at a 45-degree angle. d) A and B. 5. An infant in need of CPR will have a) Rapid and shallow breathing. b) No breathing and no signs of circulation. c) Signs of circulation and will be conscious. d) Breathing and no signs of circulation. 6. Where do you place your fingers to give chest compressions during infant CPR? a) Two fingers on the notch of the breastbone and on the nose to hold it open. b) Two fingers on the notch and one on the ribcage. c) The heel of one hand on the center of the breastbone, just below the nipple line. d) Two fingers on the center of the breastbone, one finger width below the nipple line. 7. You are in a fast food restaurant when your conscious 11-month-old infant chokes on a french fry and is unable to breathe. As you send someone to call 9-1-1, what should you do? a) Try to give 2 rescue breaths. b) Check for signs of circulation. c) Give 5 back blows and 5 chest thrusts. d) Stand behind the infant and give abdominal thrusts. 8. When should you initially check an infant for signs of circulation? a) After giving 2 effective rescue breaths b) After 15 chest compressions and 2 rescue breaths c) 4-5 minutes after you began CPR d) After checking the scene for safety 9. When giving care to an infant who is conscious and choking, where do you position your hand for back blows? a) On the back sides of the rib cage b) Below the below button c) In the middle of the back, between the shoulder blades d) Any of the above

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10. To check if an unconscious infant is breathing a) Check for the carotid pulse in the neck. b) Look, listen, and feel for breathing. c) Look in the infant's mouth for at least 10 seconds. d) Hold your hands over the rib cage to feel for chest expansion.

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Precourse Examination Answer Sheet Infant and Child CPR

Name _______________________________________________ Date _____________________ Course: Child CPR (Complete Sections 1 and 2) Infant CPR (Complete Sections 1 and 3) Infant and Child CPR (Complete Sections 1, 2, and 3) A B

Section 2 Child CPR d d d d d d d d 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. a a a a a a a a a a b b b b b b b b b b c c c c c c c c c c d d d d d d d d d d 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. Section 3 Infant CPR a a a a a a a a a a b b b b b b b b b b c c c c c c c c c c d d d d d d d d d d

Examination

Section 1 Before Providing Care 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. a a a a a a a a b b b b b b b b c c c c c c c c

True/False True/False

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Precourse Examination Answer Key Infant and Child CPR

Examination A

Section 1 Before Providing Care 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. a a a a a a a a True False b b b b b b b b c c c c c c c c d d d d d d d d 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. a a a a a a a a a a Section 2 Child CPR b b b b b b b b b b c c c c c c c c c c d d d d d d d d d d 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. Section 3 Infant CPR a a a a a a a a a a b b b b b b b b b b c c c c c c c c c c d d d d d d d d d d

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AMERICAN RED CROSS FIRST AID/CPR/AED PROGRAM Precourse Examination B--Infant and Child CPR

Instructions: Read each question slowly and carefully. Then choose the best answer. Fill in that circle on the answer sheet. When you are done with the examination, hand in the completed answer sheet to your instructor. Section 1--Before Providing Care 1. When checking for breathing in an unconscious child a) Place the victim in the recovery position. b) Lift the head and tilt the chin. c) Pinch the victim's nose shut. d) Look, listen, and feel for breathing. 2. You are at the mall when you see what looks like a serious accident involving a bicycle and a vehicle. Why should you check the scene before giving care? a) To find out what happened and how many victims there are. b) To ensure your own safety. c) To see if there are any bystanders who can help. d) All of the above. 3. You respond to an emergency and find four victims. Which victim should you care for first? a) A victim who is bleeding slightly from his thigh b) A victim who is complaining of pain in his knee c) A victim who has a small burn on his fingertip d) A victim who is unconscious 4. The emergency action steps to follow are a) Check-Call-Care. b) Check-Call-Secure. c) Check-Call-Defibrillate. d) Early access-Early CPR-Early recognition. 5. How can you protect yourself from disease transmission when giving care? a) Providing 2 rescue breaths with every 15 compressions. b) Wipe off the victim's mouth and hands. c) Use protective equipment, such as disposable gloves and breathing barriers when giving care. d) Getting annual physical exams after age 40. 6. What does the "C" in "A-B-C" stand for? a) Continue b) Circulation c) Compressions d) Choking

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7. At a youth soccer game, you see a player collapse. You check the scene and then check the child for consciousness, but he does not respond. What should you do next? a) Have a bystander call 9-1-1 or the local emergency number. b) Give abdominal thrusts. c) Check for signs of circulation. d) Move the child. 8. You are on your lunch break when you notice a child who appears to be unconscious. After checking the scene, you check the child for consciousness by a) Rolling him onto his side and sweeping his mouth. b) Checking his blood pressure. c) Gently tapping him and shouting, "Are you O.K?" d) Checking for signs of circulation. 9. A child may have suffered a neck injury. There is no immediate danger to you or the child. You should move the victim to a comfortable position. True False 10. A child has a life-threatening condition. There is no parent or guardian present. Consent is implied, so you should provide care. True False Section 2--Child CPR 1. You are in a fast food restaurant when you see a child, who was playing with french fries in his mouth and running, suddenly clutch his throat with both hands. When you reach the child, you ask if he is choking and he frantically nods his head yes. You inform the parents that you are trained in first aid and can help; they give you permission. As you send someone to call 9-1-1, what should you do? a) Try to give 2 rescue breaths. b) Check his brachial pulse. c) Give 15 chest compressions. d) Stand behind the child and give abdominal thrusts. 2. When giving care to a child who is unconscious and has an obstructed airway, where do you position your hand to give compressions? a) On the rib cage. b) On the belly button. c) In the center of the breastbone. d) Any of the above. 3. When giving care to a child who is conscious and has an obstructed airway, where do you position your hands to give abdominal thrusts? a) On the backsides of the rib cage. b) Below the belly button in the center of the abdomen. c) One hand on the center of the breastbone, and the other on the forehead. d) Above the belly button and below the notch where the ribs meet the breastbone.

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4. What is the purpose of CPR? a) CPR restarts the heart. b) With CPR, the child will not need advanced medical care. c) CPR helps circulate blood containing oxygen to the vital organs until more advanced medical personnel arrive and take over. d) CPR prevents a cardiac emergency. 5. Where do you place your hand to give chest compressions during child CPR? a) One hand on the notch of the breastbone and the other hand on the nose to hold it open. b) One hand on the notch and one on the ribcage. c) One hand on the center of the breastbone, just above the notch where the ribs meet the breastbone, and the other on the forehead. d) Over the stomach, just above the belly button and below the notch. 6. To check if an unconscious child is breathing a) Check for the brachial pulse in the arm. b) Look, listen, and feel for breathing. c) Look in the victim's mouth for at least 10 seconds. d) Place your hands on the rib cage to feel for chest expansion. 7. When giving rescue breaths to a child a) Give quick breaths at the rate of about 40 to 80 per minute. b) Give about 5 compressions. c) Give back blows and chest thrusts. d) Take a breath and breathe slowly into the child, just enough to make the chest clearly rise. 8. When giving a child CPR a) Compress the chest straight down about 1-11/2 inches with one hand. b) Give cycles of 5 chest compressions and 1 rescue breath. c) Compress the chest at a 45-degree angle. d) A and B. 9. When should you initially check a child for signs of circulation? a) After giving 2 effective rescue breaths. b) After 15 chest compressions and 2 rescue breaths. c) About 4-5 minutes after you began CPR. d) After checking the scene for safety. 10. You notice that a child looks panicked. (She cannot cough, speak, or breathe.) What life-threatening condition could the child be experiencing? a) Indigestion. b) Cardiac arrest. c) Upset stomach. d) Choking.

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Section 3--Infant CPR 1. An infant in need of CPR will have a) Rapid and shallow breathing. b) No breathing and no signs of circulation. c) Signs of circulation and will be conscious. d) Breathing and no signs of circulation. 2. Some signs that an infant is choking are a) Looking panicked and not able to cough, cry, or breathe. b) Rapid, shallow breathing and crying. c) Breathing noisily and deeply. d) Crying and spitting up food. 3. Where do you place your fingers to give chest compressions during infant CPR? a) Two fingers on the notch of the breastbone and on the nose to hold it open. b) Two fingers on the notch and one on the ribcage. c) The heel of one hand on the center of the breastbone, just below the nipple line. d) Two fingers on the center of the breastbone one-finger width below the nipple line. 4. When giving care to an infant who is unconscious and has an obstructed airway, where do you position your fingers to give chest compressions? a) On the belly button b) At the top of the breastbone near the neck c) In the center of the breastbone, one finger width below the nipple line d) Any of the above 5. Your conscious 11-month-old infant chokes on a french fry. As you send someone to call 9-1-1, what should you do? a) Try to give 2 rescue breaths. b) Check for signs of circulation. c) Give 5 back blows and 5 chest thrusts. d) Stand behind the infant and give abdominal thrusts. 6. When should you initially check an infant for signs of circulation? a) After giving 2 effective rescue breaths. b) After 15 chest compressions and 2 rescue breaths. c) After 4-5 minutes after you began CPR. d) After checking the scene for safety. 7. When giving care to an infant who is conscious and has an obstructed airway, where do you position your hand for back blows? a) On the backsides of the rib cage. b) Below the belly button. c) In the middle of the back, between the shoulder blades. d) Any of the above.

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8. To check if an unconscious infant is breathing a) Check for the carotid pulse in the neck. b) Look, listen, and feel for breathing. c) Look in the infant's mouth for at least 10 seconds. d) Hold your hands over the rib cage to feel for chest expansion. 9. When giving rescue breaths to an infant a) Give quick breaths at a rate of 40 to 80 per minute. b) Give about 5 compressions. c) Give back blows and chest thrusts. d) Take a breath and breathe slowly into the infant, just enough to make the chest clearly rise. 10. When giving an infant CPR a) Compress the chest straight down about 1/2 to 1 inch with two fingers. b) Give cycles of 5 chest compressions and 1 rescue breath. c) Compress the chest at a 45-degree angle. d) A and B.

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Precourse Examination Answer Sheet Infant and Child CPR

Name _______________________________________________ Date _____________________ Course: Child CPR (Complete Sections 1 and 2) Infant CPR (Complete Sections 1 and 3) Infant and Child CPR (Complete Sections 1, 2, and 3) A B

Section 2 Child CPR d d d d d d d d 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. a a a a a a a a a a b b b b b b b b b b c c c c c c c c c c d d d d d d d d d d 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. Section 3 Infant CPR a a a a a a a a a a b b b b b b b b b b c c c c c c c c c c d d d d d d d d d d

Examination

Section 1 Before Providing Care 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. a a a a a a a a b b b b b b b b c c c c c c c c

True/False True/False

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Precourse Examination Answer Key Infant and Child CPR

Examination B

Section 1 Before Providing Care 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. a a a a a a a a False True b b b b b b b b c c c c c c c c d d d d d d d d 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. a a a a a a a a a a Section 2 Child CPR b b b b b b b b b b c c c c c c c c c c d d d d d d d d d d 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. Section 3 Infant CPR a a a a a a a a a a b b b b b b b b b b c c c c c c c c c c d d d d d d d d d d

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APPENDIX F American Red Cross First Aid/CPR/AED Program Instructor Examination, Answer Sheet, and Answer Key

First Aid/CPR/AED Program Instructor Examination

INSTRUCTIONS: Mark all answers in pencil on the answer sheet. Do not write on this examination. Read each question slowly and carefully. Then choose the best answer and fill in that space on the answer sheet. If you wish to change an answer, erase your first answer completely. Return this examination to your instructor trainer when you are finished. EXAMPLE 75. Why does the American Red Cross teach first aid, CPR and AED courses? a. To help people stay calm in emergencies. b. To help people make appropriate decisions when they confront an emergency. c. To help people in an emergency keep a victim's injuries from getting worse until EMS personnel arrive and take over. d. All of the above ANSWER SHEET a b c

75.

d

1. The purpose of the Workplace Training: Standard First Aid course is to-- a. Provide individuals in the workplace with knowledge and skills necessary to prevent, recognize, and provide basic care for injuries and sudden illnesses until advanced medical personnel arrive and take over. b. Reduce the time needed for CPR. c. Provide individuals in the workplace the information needed to avoid lawsuits brought about by a victim's death. d. Care for infant and child breathing and cardiac emergencies. 2. Why are skill demonstrations included on the video? a. They provide a review of skills that participants have practiced. b. They provide model demonstrations of the skills taught in the course. c. They give participants an alternative to actually completing the skills. d. All of the above. 3. To receive a Workplace Training: Standard First Aid and Adult CPR certificate, a participant must-- a. Demonstrate competency in all Adult CPR and first aid skills. b. Correctly answer at least 80 percent of the questions on the Adult CPR and first aid written examinations. c. Attend and participate in all class activities. d. All of the above

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4. What are the prerequisites for enrolling in the American Red Cross Workplace Training: Standard First Aid basic-level course? a. Possess a current American Red Cross Adult CPR certificate. b. There are no prerequisites. c. Possess a current American Red Cross Community CPR certificate. d. Possess a current American Red Cross AED certificate. 5. First Aid/CPR/AED Program course times are partially based on a ratio of how many manikins per participant? a. One for every six participants b. One for every two participants c. One for every four participants d. One for every participant 6. Which of the following courses can an American Red Cross First Aid/CPR/AED instructor teach? a. Standard First Aid b. Standard First Aid with AED c. Infant and Child CPR d. All of the above 7. Which of the following is NOT a guideline for the use of AED training devices/rhythm simulators for training purposes? a. AED training devices or rhythm simulators should never be connected to humans--only to manikins. b. Live AEDs (those that can deliver a shock) should never be attached to a human for training purposes. c. Students may adjust the AED deactivation mode. d. Always follow manufacturer instructions for the deactivation of all AEDs used in training. 8. As a Workplace Training: Standard First Aid instructor, which of the following First Aid/CPR/ AED Program courses, review or challenge can you teach or co-teach to become reauthorized? a. Standard First Aid b. Standard First Aid with AED c. Adult CPR d. Any of the above 9. The American Red Cross policy statement on the use of AED training devices states that when training is conducted or sponsored by the American Red Cross, only AED training devices incapable of delivering a shock or AED rhythm simulators should be used. a. True b. False 10. Which of the following is NOT a correct procedure for evaluating skills? a. Ask each participant to demonstrate the skill without help. b. If there is not much time to evaluate skills, coach each participant through the skill until he or she does most of it correctly once. c. During a practice session, watch for participants who can comfortably and correctly complete the skill without assistance; these participants need not be evaluated further. d. Have participants perform the skill until they demonstrate competency.

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11. Facilitated discussions-- a. Allow you to evaluate participants' knowledge and understanding throughout the course. b. Allow you to build on participants' previous knowledge and skills. c. Keep participants engaged and interested throughout the course. d. All of the above. 12. Which of the following is an example of combining positive feedback and corrective feedback when evaluating CPR skills? a. "Good job, keep going." b. "Didn't you pay attention to the video? Give compressions straight up and down!" c. "Good pace: But you need to compress the chest a little deeper--about two inches." d. "Tilt the head further back, and don't give breaths so hard!" 13. The Workplace Training: Standard First Aid course is designed to be taught in approximately 51/2 hours based on a class size of-- a. 4 participants. b. 10 participants. c. 11 participants. d. 12 participants. 14. Which of the following program materials, equipment, and supplies are optional for teaching First Aid/CPR/AED Program courses? a. Video b. Participant's booklet c. Skills cards d. None of the above 15. Before using disposable gloves for the skill sessions, instructors should-- a. Ask participants if anyone is sensitive to latex and provide nonlatex gloves to those who want them. b. Provide nonlatex gloves only if a participant has a note from a physician. c. Wait until participants show the signals of an allergic reaction to latex, then let them know that nonlatex gloves are available. d. None of the above. 16. Which of the following teaching strategies should be kept as brief as possible in order to prevent boredom among participants? a. Video instruction b. Presentation c. Skill sessions d. Facilitating discussion 17. Which of the following is the responsibility of an American Red Cross First Aid/CPR/AED instructor or Workplace Training: Standard First Aid instructor? a. To provide for the health and safety of participants b. To be familiar with the instructor's manual, participant's booklets, videos, skills cards, and training equipment c. To abide by the obligations in the Instructor Agreement and, if applicable, the Authorized Provider Agreement d. All of the above

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18. For any injury-control module-- a. Participants are required to pass the self-assessment. b. Participants are required to participate in the activities. c. The instructor should issue a completion certificate for those who attend the session. d. The instructor to participant ratio is 1 to 10. 19. When you are giving feedback to participants who are practicing skills-- a. Only give feedback to those who make mistakes. b. Make sure the feedback is timely and specific. c. Cite an aspect of the skill that was done correctly. d. B and C. 20. "Teaching to the standard and testing to the objective" means-- a. Altering course requirements so everyone can pass. b. Certifying participants who have a job requirement, but can't complete all the required skills. c. Lowering national course completion standards. d. Allowing a course participant to meet the objective of a skill without using a traditional technique. 21. If you notice that a participant is having difficulty performing a skill and you cannot easily correct the problem with alternative methods before the end of the course-- a. Counsel the participant and encourage him or her to enroll in another class at a later date. b. Check the participant off on the skill sheet if most of the skill was completed correctly. c. Give the participant a certificate, but note the poor skill performance on the course record. d. Ask the participant to leave. 22. Which of the following skills should not be practiced on a course participant? a. Locating and feeling the carotid pulse b. Performing rescue breathing c. Opening the airway d. Positioning the victim for rescue breathing 23. A participant is having trouble opening a manikin's airway because the participant is not tilting the head properly. Which is the best statement you can make to help the participant? a. "Your hand position is good, but you should tilt the head back farther. That will open the airway." b. "Don't open the airway like that. Do it like this." c. "Don't worry about opening the airway. Go on to the next step." d. "Put your hand under the neck and push up to open the airway." 24. Learning can be enhanced by-- a. Giving participants lots of information beyond what is needed to meet the learning objectives. b. Maintaining a rigid learning environment. c. Actively involving the participants. d. Giving lengthy technical lectures. 25. Evaluation forms filled out at the end of a course-- a. Provide the instructor with feedback on the course and its instruction. b. Are not required to be completed. c. Should be mailed to American Red Cross national headquarters. d. None of the above.

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American Red Cross First Aid/CPR/AED Program Instructor Examination Answer Sheet

Name _______________________________________________ Date _____________________

1. 2. 3. 4. 5. 6. 7. 8. 9. 10.

a a a a a a a a a a

b b b b b b b b b b

c c c c c c c c

d d d d d d d d

11. 12. 13. 14. 15. 16. 17. 18. 19.

a a a a a a a a a a

b b b b b b b b b b

c c c c c c c c c c

d d d d d d d d d d

21. 22. 23. 24. 25.

a a a a a

b b b b b

c c c c c

d d d d d

c

d

20.

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American Red Cross First Aid/CPR/AED Program Instructor Examination Answer Key

1. 2. 3. 4. 5. 6. 7. 8. 9. 10. a a a a a a a a a a b b b b b b b b b b c d c c c c c c c c d d d d d d d d 11. 12. 13. 14. 15. 16. 17. 18. 19. 20. a a a a a a a a a a b b b b b b b b b b c c c c c c c c c c d d d d d d d d d d 21. 22. 23. 24. 25. a a a a a b b b b b c c c c c d d d d d

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APPENDIX G Recommendations for Manikin Decontamination

The use of CPR manikins for training has never been documented as being responsible for transmitting a bacterial, fungal, or viral disease. Because it is vitally important to prevent the spread of infectious disease through manikin use, manikins should be cleaned and disinfected carefully and consistently. Take the following health precautions: I Inspect manikins before each class: Inspect the manikins for cracks or tears in the face that make it difficult or impossible to clean properly. Do not use any manikin that has cracks or tears in the face. I Properly decontaminate manikins during class: Between uses by students and after demonstrations by the instructor, the manikin's face and the inside of its mouth should be wiped vigorously. Use a clean, absorbent material (e.g., 4 4 inch gauze pad), wet it with either a solution of liquid household chlorine bleach and water (1/4 cup of bleach to 1 gallon of water), or with 70 percent alcohol (isopropanol or ethanol). The surfaces should remain wet for at least 30 seconds before they are wiped dry with a second piece of clean, absorbent material. I Properly decontaminate manikins after each class: As soon as possible after each class session in which manikins are used, all manikins should be properly cleaned. Follow the manufacturer's recommendations for disassembly. Scrub the parts with warm, soapy water, rinse, and decontaminate with a solution of liquid household chlorine bleach and water (1/4 cup of bleach to 1 gallon of water). To decontaminate manikins after class, use the decontamination solution and gauze pads, a bottle brush, soap and water, basins or buckets, nonsterile disposable gloves, and any other supplies recommended by the manikin manufacturer. As soon as possible after each class session, replace or clean the manikin's head and airway passages as follows: I Wash with warm, soapy water. I Rinse with clean water. I Decontaminate by soaking in the bleach solution for 10 minutes. I Rinse with fresh water. I Dry all internal and external surfaces. Vigorously scrubbing manikin parts with soap and water is as important as soaking them in the bleach solution. Always wear safety goggles and protective gloves when cleaning manikins with bleach solution. Always clean manikins in a well-ventilated area.

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APPENDIX H Course Evaluation Form for Instructor Candidates

American Red Cross First Aid/CPR/AED Program Instructor Course

A course evaluation form for instructor candidates is on the following page. This form is designed to measure participant satisfaction with the First Aid/CPR/AED Program Instructor course and will provide useful feedback about instruction, course materials, and other course aspects from the perspective of the participant. You can use the feedback to evaluate and improve the way you teach this course. This form may also provide useful feedback to your local Red Cross chapter. Before using the form, check with your chapter to see if it has a particular system for the use of such forms. For example, there may be guidelines covering: I How often to use the forms. I How to handle logistics (such as making copies of the forms). I Whether to add chapter-specific questions to the forms (space for adding questions is available). I What to do with the forms after completing them. This form is not designed to measure course effectiveness or program outcomes. If you are interested in demonstrating the positive effects of this course to funders, such as United Way, please contact the Educational Program Administration and Evaluation Unit at Red Cross national headquarters at (703) 2067738. The unit can provide advice and written materials that will help you design and implement an evaluation of this type. The form is not designed for use by national headquarters. Do not forward the form to national headquarters. American Red Cross national headquarters periodically evaluates its programs and will request your participation as needed.

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Course Evaluation Form for Instructor Candidates

First Aid/CPR/AED Program Instructor Course

Thank you for participating in the American Red Cross First Aid/CPR/AED Program Instructor course. We would like to give you an opportunity to tell us what you thought about the course. Your honest responses will help us improve the training. This survey is completely voluntary and anonymous; please do not write your name on the survey. We greatly appreciate your feedback.

Date of Training __________________ Instructor Trainer's Name ________________________

(Circle only one response.) 1. The facility was adequate for the training. 2. The training time was convenient for me. 3. The instructor trainer was well prepared. 4. The instructor trainer presented information clearly. 5. The instructor trainer was able to answer my questions. 6. I believe the training on how to use the materials (skills cards, videos, participant's booklet) was helpful. 7. The instructor trainer provided clear directions for the facilitation activity. 8. The feedback I received during the facilitation activity was helpful. 9. The feedback I received from other instructor candidates during the practiceteaching sessions was helpful. 10. The feedback I received from the instructor trainer during practice-teaching sessions was helpful. 11. I believe the instructor's manual will be useful to me in teaching this course. 12. Based on the training, I feel prepared to assess participants' skills. Strongly Disagree Disagree 1 1 1 1 1 1 2 2 2 2 2 2 Agree 3 3 3 3 3 3 Strongly Agree 4 4 4 4 4 4 Not Sure NS NS NS NS NS NS

1 1 1

2 2 2

3 3 3

4 4 4

NS NS NS

1

2

3

4

NS

1 1

2 2

3 3

4 4

NS NS

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13. Based on the training, I feel prepared to teach the First Aid/CPR/AED Program. 14. I was satisfied with this course.

1 1

2 2

3 3

4 4

NS NS

15. Please elaborate on any items in the previous section where you circled "Strongly Disagree" or "Disagree."

16. What was the most useful part of this course for you? Why?

17. What was the least useful part of this course for you? Why?

The information in this section helps us to know more about the people we reach with our education. This section is completely voluntary and anonymous. Gender: Age: ______ Race: (Mark all that apply.) Ethnicity: American Indian or Alaska Native Asian Black or African American Hispanic or Latino Native Hawaiian or Other Pacific Islander White Not Hispanic or Latino Female Male

Please write additional comments or suggestions about this course below.

Thank you for completing this survey!

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APPENDIX I Instructor Bridging Processes and Training Options

Bridging is the process that allows an American Red Cross instructor in one program to become an instructor in another program with the same or related content without participating in a full instructor course. Currently authorized American Red Cross Health and Safety Services instructors in programs with similar content (e.g., first aid, CPR, or AED) may become Workplace Training: Standard First Aid or First Aid/CPR/AED instructors through bridging. Some instructors will need to "upgrade" their knowledge and skills prior to participating in the bridging process. For more information on the instructor bridging process, see Section II of the First Aid/CPR/AED Program Release Connection. A compressed instructor course for bridging current instructors who do not possess AED teaching skills is available in this document as well as being posted as a downloadable resource on CrossNet. Emergency Response and Lifeguarding Instructors. Currently Authorized Emergency Response and Lifeguarding (r.01) instructors may teach any First Aid/CPR/AED Program course or component after orienting to the instructional materials. In either case above, there is no requirement to maintain a separate instructor authorization.

Special Situations

Changes in Authorization An instructor currently authorized at a lower level (e.g., Community First Aid and Safety) who wishes to teach a higher level authorization (e.g., CPR for the Professional Rescuer) must complete the precourse session and pass the written tests for the course(s) he or she wishes to teach. The instructor must also pass the skills tests for skills that are not a part of the course(s) or program(s) he or she is currently authorized to teach. The instructor also must practice teach a skill (Practice Teach II or III) in the new content area (e.g., AED), at an appropriate point during the instructor course, i.e. the latter portion of Session 2 (Practice Teach II) or Session 3 (Practice Teach III) of the instructor course. Other bridging options are available. Consult the applicable Program Release Connection for more details. Upgrade to AED Training Instructor Currently authorized Adult CPR/AED instructors, Workplace Training: Standard First Aid instructors, or First Aid/CPR/AED instructors may upgrade their authorization to teach the professional rescuer Automated External Defibrillation (AED) Training course by completing the following process:

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Possess a current eligibility authorization as outlined in H&SS Connection #41, April 8, 1998, (i.e., CPR for the Professional Rescuer instructor or Lifeguarding instructor). I Review the AED Training course materials. I Pass the basic-level written examination. I Pass the instructor's written examination. I Receive certification and authorization as an AED Training instructor. Once an instructor acquires the AED Training instructor authorization, he or she must maintain teaching activity in the eligibility authorization program and the AED Training program in order to be reauthorized as an AED Training instructor. (See Health &Safety Services Connection #41, April 8, 1998 for more detailed information). Note: If the instructor fails either the basic-level or instructor-level examination, and desires to continue to become an AED Training instructor, he or she must enroll in the AED Training instructor's course including the precourse session.

Reentry for Instructors With Expired Authorizations

Qualified instructors from outside organizations and former instructors in the First Aid/CPR/AED Program whose authorizations have been expired less than two years may become reauthorized if they successfully complete the crossover/reentry training. Instructors from outside organizations whose Consult the specific Program Release Connection for details regarding crossover or reentry training for a particular program. The crossover/reentry process for the First Aid/CPR/AED Program includes the following basic steps: I Meet applicable prerequisites. I Be a currently authorized instructor from an accepted organization or show evidence of an expired American Red Cross instructor authorization (C-3005, F5736, or a letter of verification from the Red Cross unit of authorization) in either First Aid/CPR/AED or Workplace Training: Standard First Aid. I Complete the Fundamentals of Instructor Training Self-study Guide for Educators and Trainers. I Once the instructor has completed the above requirements, he or she may enter the compressed instructor's course.

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APPENDIX J

Automated External Defibrillation (AED)

The following information is provided as a resource for instructors and instructor trainers who teach automated external defibrillation (AED) training as part of their authorization. It is not intended for this information to be added to the current national American Red Cross courses on the subject. However, it can be used by instructors and instructor trainers to answer questions from their students and to enhance their subject knowledge.

Introduction

Each year, approximately 500,000 adult Americans die as a result of coronary heart disease. Almost half of these deaths, about 250,000, occur suddenly from cardiac arrest, a condition known as sudden cardiac arrest (SCA). Most of these arrests occur away from a hospital, where the care needed to immediately correct the cardiac arrest condition is not readily available. Cardiopulmonary resuscitation (CPR), started promptly, can help by keeping oxygenated blood flowing to the brain. However, in many cases CPR by itself is insufficient to correct the underlying heart problem. What is needed to correct the problem, in many sudden cardiac arrests, is an electric shock known as defibrillation. The sooner this shock is administered, the greater the likelihood of the victim's survival. In the out-of-hospital setting, defibrillation in the past has typically been administered only by paramedics. But paramedics are rarely the first to arrive on the emergency scene. Often, EMT-Basics and first responders such as fire fighters, law enforcement personnel and lifeguards, arrive first or are already on the scene. But without the capability to defibrillate victims of sudden cardiac arrest, they are limited to performing less effective emergency care such as CPR while awaiting the arrival of more advanced medical personnel. This delay in defibrillation is believed to be a major contributing factor to the low survival rates throughout the United States, some as low as 3 percent, associated with out-of-hospital cardiac arrests. As a result of these low survival rates, the medical community and other concerned organizations have refocused efforts on providing earlier defibrillation to sudden cardiac arrest victims. To make earlier defibrillation possible, both the defibrillator and the skills needed to properly operate it have been greatly simplified. Additionally, state and federal legislation that allows more non-traditional responders to utilize these lifesaving devices in an emergency has been enacted. Passage of the Cardiac Arrest Survival Act in 2000 is intended to encourage public access defibrillation (PAD) and therefore facilitate broader and quicker access to defibrillation. Simplification of operation of defibrillators in the form of automated external defibrillators (AEDs) has also resulted in more non-traditional responders being able to provide early defibrillation and thereby save more victims of sudden cardiac arrest. The American Red Cross believes strongly in the life-saving potential of AED technology and the critical role it plays in the cardiac chain-of-survival. As a result, it has incorporated training in the use of AEDs into the First Aid/CPR/AED Program and Lifeguarding program.

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The Heart's Electrical System

To better understand both the limitations of CPR and how defibrillation works, it is helpful to understand how the heart's electrical system functions. The electrical system determines the pumping action of the heart. Under normal conditions, specialized cells of the heart initiate and carry on electrical activity. These cells make up what is commonly called the conduction system. Think of the conduction system as the pathway or road that electrical impulses must travel. This pathway originates in the upper chambers of the heart, known as the atria. It ends in the lower chambers of the heart, known as the ventricles. The normal point of origin of the electrical impulse is the sinoatrial (SA) node above the atria. Approximately every second of an adult's life, a new electrical impulse is generated from the SA node. This impulse travels down the pathway of cells to a point midway between the atria and ventricles. This point is the atrioventricular (AV) node. Below the AV node the pathway divides, like a fork in a road, into two branches. The electrical impulse travels by way of these right and left bundle branches to its final destination, the right and left ventricles. These right and left bundle branches become a vast network of microscopic fibers called Purkinje fibers, which spread electrical impulses across the heart. Under normal conditions, this impulse reaches the muscular walls of the ventricles and causes the ventricles to contract. The strong contraction of the ventricles forces blood out of the heart to circulate through the body. The contraction of the left ventricle results in a pulse. The pauses between the pulse beats you feel are the periods between contractions. Through the timing of these electrical impulses, the chambers of the heart are able to contract and relax. When they contract, blood is forced out of the heart. When they relax, blood refills the chambers. The electrical activity of the heart can be evaluated by a cardiac monitor or electrocardiograph. A cardiac monitor has electrodes that usually are attached to the chest. The electrodes pick up the electrical impulse and transmit it to the monitor. The movement of the electrical impulse down the pathway appears as a graphic record on the monitor. This graphic record is referred to as an electrocardiogram (ECG). A regular rhythm that occurs within a normal rate, 60 to 100 beats per minute (bpm), and without unusual variations, is called a normal sinus rhythm. This rhythm appears on an ECG as a series of regularly spaced and sized peaks and valleys.

When the Heart Fails

Any damage to the heart, caused either by disease or injury, can disrupt the conduction system. This disruption can result in an abnormal heart rhythm that can stop circulation. The two most common abnormal rhythms that are present initially in sudden cardiac arrest (SCA) victims are ventricular fibrillation (V-fib) and ventricular tachycardia (V-tach). Ventricular fibrillation (V-fib) is a state of totally disorganized electrical activity in the heart. It results in the fibrillation, or quivering of the ventricles. This fibrillation is not adequate for the ventricles to pump blood. Consequently, there is no pulse. Ventricular tachycardia (V-tach) refers to a very rapid contraction of the ventricles. Though there is electrical activity resulting in a regular rhythm, the rate is often so fast that the heart is unable to pump blood properly. As with V-fib, when blood flow is severely impaired, there will not be a detectable pulse.

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Defibrillation In many cases, these two abnormal rhythms can be corrected by early defibrillation. During defibrillation, an electrical shock is delivered to the heart. This shock is intended to disrupt abnormal electrical activity, such as that of V-fib and V-tach, long enough to allow the heart to spontaneously develop an effective rhythm on its own. If not interrupted, these rhythms will deteriorate to the point where all electrical activity will cease, a condition known as asystole. Asystole is not corrected by defibrillation. However, CPR is still important for a heart in asystole. Remember that you will not be able to tell what, if any, rhythm the heart is in by feeling for signs of circulation and pulse. The Role of CPR CPR, begun immediately and continued until defibrillation is available, helps to maintain a low level of circulation of oxygenated blood in the body until the abnormal rhythms are corrected by defibrillation. In addition, CPR performed during this period can maintain vital organs and the brain. However, CPR cannot maintain this low-level circulation indefinitely and cannot convert V-fib or V-tach to a normal sinus rhythm. The major factor determining survival for a person in V-fib is the time from cardiac arrest until the first shock from defibrillation. For this reason, the American Red Cross encourages programs and courses that teach and promote early CPR and early defibrillation to more emergency care providers, both traditional such as first responders (police, fire, EMS, etc.) and non-traditional including workplace responders, flight attendants, and security personnel and others.

Automated External Defibrillators: Improving Survival of Cardiac Arrest

The use of the traditional manual defibrillator requires specialized training that includes learning how to recognize abnormal rhythms on a monitor and how to deliver a shock with hand-held paddles. The process demands extensive training, and manual defibrillators are expensive. It is impractical to train first responders in their use. Instead, the answer to the problem of how to get timely, life-saving defibrillation to sudden cardiac arrest victims as soon as possible lies with automated external defibrillators (AEDs). As the name implies, the AED is an automated device capable of automatically recognizing a heart rhythm that requires a shock. It can then charge itself and prompt the operator to deliver a life-saving shock to the victim by pressing a button. These devices are sometimes referred to as semi-automatic external defibrillators (SAEDs). AEDs are simple to operate and extremely reliable when used and maintained properly. AEDs analyze the victim's heart rhythm several times before identifying it as shockable rhythm. The technologies of AEDs currently available vary somewhat in the types of waveforms and the energy levels used. Generally, some AEDs use higher energy "monophasic" waveforms while others use lower energy "biphasic" waveforms. Monophasic waveforms deliver energy in one direction, while biphasic waveforms deliver the energy in a positive direction for a period of time and then reverse to a negative direction. Some AEDs are designed to deliver "stacked" shocks in increasing increments of power (expressed in "joules") from about 200j to 360j. Other "low energy" devices deliver shocks that can vary somewhat in strength depending on the impedance of the individual victim and therefore "customize" the shock to the victim. Energy levels, the increments and cycles of shocks delivered between analysis may vary from locality to locality and are set by the manufacturer for a particular area's established EMS protocols.

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Using an Automated External Defibrillator (AED) In a situation involving cardiac arrest, an AED should be put to use as soon as it is available and safe to do so. CPR in progress must be stopped once the AED is applied. All AEDs can be operated by the following five simple steps: 1. Confirm cardiac arrest: Check the victim for signs of circulation (breathing and pulse) for no more than 10 seconds. 2. Turn on the AED, apply the pads to the victim's bare, dry chest, and attach defibrillator pads and cables (if necessary) to the AED. 3. Let the AED analyze the heart rhythm (or push the button marked "analyze"). 4. Advise all rescuers and bystanders to "stand clear." 5. Deliver a shock by pushing the shock button if indicated and prompted by the AED. Deciding to Use an AED Whether you are the first person to arrive on the scene or arrive after CPR has been started, you should check the victim's signs of circulation (including a pulse) to determine that the victim is in cardiac arrest before attaching the AED. The absence of all signs of circulation confirms cardiac arrest. When you establish the absence of signs of circulation, you should turn on the AED. Once the AED is turned on, some AEDs are capable of recording the events surrounding the care of the victim. If the AED you are using has a voice recording mechanism, you should briefly give a verbal report for the recording. It should include I Your identity and location. I Assessment findings. I Any significant events that have occurred (such as a drowning incident or trauma). Next, prepare to attach the electrode pads to the victim's chest. To do this, the victim's chest must be bare and wiped dry. Pad Placement I Remove the pads from their packaging. I If needed, connect the two cables from the AED to the pads or the cables to the AED. I Wipe the victim's chest dry, if necessary. I Peel away the protective plastic backing from the pads. I Place the pads, adhesive-side down, on the victim's chest: I Place one pad on the upper-right side of the victim's chest, above the nipple and below the collarbone. I Place the other pad on the lower-left side of the victim's chest, below the nipple. Some AEDs have color-coded cables, in which case, you can remember the phrase "white on upperright" to help guide correct pad placement. (This means that the pad attached to the white cable is applied to the upper-right side of the victim's chest.) On models that do not have color-coded cables, either pad may go in either location on the chest. Reversing the pads may cause the data readout of some AEDs to display backwards (if the model is equipped with a display). Also, some models have clear pictures on the pads themselves indicating the correct pad placement. If the pads are not securely attached to the victim's chest or if the cables are not fastened properly, you will receive a "connect electrodes" or other error message from the AED. This message may appear in print on the small screen on the front of the machine and/or in voice prompt. If you receive such a

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message, check to see that the pads and cables are attached properly. In all cases, you must follow the manufacturer's instructions, since AEDs differ in the type of cables and adhesive electrode pads used. At this point, the AED is ready to analyze the heart rhythm. Some devices require the first responder to press a button marked "analyze" to have the machine examine the heart rhythm. Other models will automatically analyze the heart rhythm. Be sure no one is touching or moving the victim during this time. If the AED identifies a rhythm that should be defibrillated, it will prompt you with either an on-screen message or by voice prompt, or both. This message often states "shock advised," followed by "press to shock" or "press the shock button now" indicating that the responder needs to press a button to defibrillate the victim. You will also be instructed by a voice prompt from the AED to "stand clear" before administering a shock. This is an important measure that you and others present must follow. Anytime an AED is analyzing the rhythm, charging to a specific energy level, or delivering a shock, you and others must not be in contact with the victim. It is the responsibility of the AED operator to warn and move rescuers and bystanders away from contact with the victim before analyzing and before depressing the shock button. This can be done by shouting "stand clear!" Another common warning is "I'm clear, you're clear, everybody clear!" Be sure to visually check around the victim before pressing the shock button. The number of shocks the AED delivers and the energy level for each shock is often preset by the manufacturer according to the standard of care established by the state or local EMS authority. The medical director for the individual or local AED program can establish local operating protocols based on the area EMS or regulatory guidelines. The American Heart Association's Emergency Cardiovascular Committee has established guidelines to follow when using an AED. These guidelines include how CPR should be used as part of the protocol.

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The following template is a generally accepted sample AED protocol, which may vary somewhat by state or local regulation:

Sample AED Protocol

Check for Signs of Circulation/pulse

If no pulse . . . Analyze Rhythm If shock advised . . . Analyze Rhythm If shock advised . . . Analyze Rhythm If shock advised . . . Defibrillate. Defibrillate. Defibrillate. Perform CPR until AED is attached

Recheck for Signs of Circulation/pulse If no pulse . . . If still no pulse . . . Perform 1 minute of CPR and recheck for signs of circulation/pulse. Repeat analysis and set of up to 3 shocks.

Recheck for Signs of Circulation/pulse If no pulse . . . If still no pulse . . . Perform 1 minute of CPR and recheck for signs of circulation/pulse. Repeat analysis and set of up to 3 shocks.

Recheck for Signs of Circulation/pulse If still no pulse . . . Continue CPR and prepare to transport if appropriate.

Note: As long as signs of circulation/pulse are absent and the AED still indicates a need to shock, continue repeating sets of 3 shocks to the maximum that local protocols allow, with 1 minute of CPR between each set of 3 shocks. Responders should be thoroughly familiar with local EMS protocols, which may vary slightly from this table. In some instances, the heart will not require defibrillation. In these cases, the AED device will inform you that no shock is needed and that you should recheck the victim's signs of circulation/pulse. The AED should be left attached to the victim. If signs of circulation/pulse are still absent, resume CPR. If signs of circulation are present but the victim is not breathing, provide rescue breathing for the victim and monitor the "A-B-C's.

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Precautions The following precautions must be taken when using an AED: I Do not use alcohol pads to clean the chest before attaching the pads. The alcohol is flammable. I Stand clear of the victim while analyzing and defibrillating. I Do not analyze the heart rhythm or defibrillate in a moving vehicle. I Do not defibrillate a victim who is in water. Move victims away from puddles of water (such as around a swimming pool) before defibrillating. I Do not defibrillate a victim lying on a surface, such as sheet metal, that is likely to transfer the electrical energy to others on or in contact with the same surface. I Do not defibrillate a victim who is less than 8 years old or weighs less than 55 pounds (follow local protocols). I Do not defibrillate a victim while he or she is wearing a medication patch on the chest. Remove any patch from the chest with a gloved hand, and wipe the area clean before attaching the device. I Do not defibrillate someone in the presence of flammable materials (such as gasoline). I Avoid radio transmissions while defibrillating, including cell phones, within 6 feet of the victim. I Keep breathing devices with free flowing oxygen away from the victim during defibrillation.

Special Resuscitation Situations

Some situations require rescuers to pay special attention when using an AED. It is important that rescuers be familiar with these situations and be able to respond appropriately. AEDs Around Water AEDs can be used in a variety of environments including rain and snow. Always use common sense when using an AED and follow the manufacturer's recommendations. Generally, the victim should not be in a puddle of water, nor should the rescuer be kneeling in a puddle of water when operating the AED. If it is raining, steps should be taken to ensure that the victim is as dry as possible and sheltered from the rain. Ensure the victim's chest is wiped dry. Minimize delaying defibrillation though when taking steps to provide for a dry environment. The electrical current of an AED is very directional between the electrode pads, and AEDs are very safe when all precautions and manufacturer's operating instructions are followed. When using an AED near the water, such as at a pool facility, attempt to put the victim on a dry surface such as a backboard. The victim's chest should be wiped dry. If possible, the victim should be placed on a backboard and moved away from the water. Proceed to use the defibrillator as in any situation. AEDs and Implantable Devices Some people whose hearts are weak and not able to generate an electrical impulse may have a pacemaker implanted. The pacemaker serves the function of the SA node. These small implantable devices may sometimes be located in the area below the right collar bone. There may be a small lump that can be felt under the skin. Sometimes the pacemaker is placed somewhere else. Other individuals may have an implantable cardioverter-defibrillator, (ICD), a miniature version of an AED, which acts to automatically recognize and restore abnormal heart rhythms.

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If visible, or you know that the victim has an implanted device, do not place the defibrillation pads directly over the implanted device. This may interfere with the delivery of the shock. Adjust pad placement if necessary, and continue to follow the established protocol. If you are not sure, use the AED, if needed. It will not harm the victim or rescuer. AEDs for Infants and Children Cardiac arrest in infants and children mainly results from respiratory failure, not cardiac failure. Therefore, establishing and maintaining a clear airway and provision of effective rescue breaths and circulation are the main priorities of any infant or child resuscitation. AEDs in use as of this print date are not designed for infants and children. Currently, these devices have not been shown to have the capability to deliver shocks at energy settings considered safe for infants and children under the age of 8 or about 55 pounds in weight. If you are dealing with an infant or child under the age of 8 or 55 pounds, initiate CPR and call for more advanced medical care. Nitroglycerin Patches and AEDs People that have a history of cardiac problems may use nitroglycerin patches (Nitropatch®). These patches are usually placed on the chest. If you encounter a victim with a patch on his or her chest, remove it with a gloved hand. Nitroglycerin patches pose a possible absorption risk for rescuers, not an explosion hazard. Nitroglycerin patches look very similar to nicotine patches that people use to stop smoking. Although these patches do not interfere with defibrillation, time may be wasted attempting to identify the type of patch. Therefore, any medication patches that are on the victim's chest should be removed. Hypothermia Victims of hypothermia have been resuscitated even after prolonged exposure. It will take longer to do your check, or assessment, of the victim since you may have to check for signs of circulation and pulse for up to 30 to 45 seconds. If you do not feel a pulse, begin CPR until an AED becomes readily available. Dry the victim's chest and attach the AED. If a shock is indicated, deliver up to 3 shocks. If there is still no pulse, continue CPR. Follow local protocol as to whether additional shocks should be delivered. CPR should be continued and the victim should be protected from further heat loss. Wet garments should be removed, if possible. The victim should not be defibrillated in water. CPR or defibrillation should not be withheld to rewarm the victim. Responders should take care not to shake a hypothermia victim unnecessarily as this could result in ventricular fibrillation (V-fib). Trauma and AEDs If a person is in cardiac arrest resulting from traumatic injuries, the AED may still be used. Defibrillation should be continued according to local protocol. Maintenance For defibrillators to perform optimally, they must be maintained like any other machine. The AEDs that are available today require minimal maintenance. These devices have various self-testing features. However, it is important that operators are familiar with any visual or audible warning prompts the AED

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may have to warn of malfunction or a low battery. It is important that you read the operator's manual thoroughly and check with the manufacturer to obtain all necessary information regarding maintenance. In most instances, if the machine detects any malfunction, you should contact the manufacturer. The device may need to be returned to the manufacturer for service. While AEDs require minimal maintenance, it is important to remember the following: I Follow the manufacturer's specific recommendations for periodic equipment checks. I Make sure that batteries have enough energy for one complete rescue. (A fully charged back-up battery should be readily available). I If the defibrillator is hooked up to a charger, make sure that it is charged properly. I Make sure that defibrillator pads are in the package and properly sealed. I Check any expiration dates on defibrillation pads and batteries and replace as necessary. I After use, make sure that all accessories are replaced and that the machine is in proper working order. I If at any time the machine fails to work properly or warning indicators are recognized, discontinue use and contact the manufacturer immediately.

Summary

Automated external defibrillators (AEDs) show great promise in saving the lives of victims of sudden cardiac arrest. To defibrillate a victim of cardiac arrest using an AED, take the following basic steps: 1. Confirm cardiac arrest. 2. Turn on the AED. 3. Attach the AED to defibrillator pads and cables, and apply the pads to the victim's bare, dry chest. 4. Let the AED analyze the heart rhythm (or push the button marked "analyze"). (Have rescuers and bystanders stay clear while the AED analyzes.) 5. Deliver a shock if one is indicated after ensuring that no one is touching the victim and that there are no hazards present. Local protocols must be followed that establish how many shocks are delivered, the energy setting of each shock, and how CPR and other life-saving measures are used. AEDs are relatively easy to operate and generally require minimal training and retraining. Strategically placed in a community where the first persons to arrive on the scene are trained in their use, AEDs are a highly valuable emergency resource of great promise in saving the lives of cardiac arrest victims.

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Glossary

Asystole: The absence of any electrical activity in the heart. Atria: The two upper chambers of heart. Automated external defibrillator (AED): a semiautomatic device that recognizes a heart rhythm that requires a shock and prompts the rescuer to deliver the shock. Sometimes referred to as a semiautomatic external defibrillator (SAED). Conduction system: Specialized cells that initiate and carry on electrical activity of the heart. Defibrillation: An electric shock delivered to the heart to correct certain life-threatening heart rhythms. Electrocardiogram (ECG): A graphic record produced by a device that records the electrical activity of the heart from the chest. Electrocardiograph: A device used to record the electrical activity of the heart; a cardiac monitor. Normal sinus rhythm: A regular heart rhythm that occurs within a normal rate, 60 to 100 beats per minute (bpm), and without unusual variations. Purkinje fibers: A vast network of microscopic fibers that carry an electrical impulse through the ventricles. Sinoatrial (SA) node: The normal origin of the heart's electrical impulse. Ventricles: The two lower chambers of the heart. Ventricular fibrillation (V-fib): A life-threatening heart rhythm; a state of totally disorganized electrical activity in the heart. Ventricular tachycardia (V-tach): A life-threatening heart rhythm in which there is very rapid contraction of the ventricles.

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APPENDIX K Overview of Guidelines 2000 for ECC and CPR

Summary of ECC Guidelines Changes

In keeping with our mission of providing life-saving training that reflects the latest in scientific research, the American Red Cross began updating CPR courses in Fall, 2000 in response to changes to the Emergency Cardiovascular Care (ECC) Guidelines. The ECC Guidelines were last updated in 1992. These revisions will be incorporated into all affected CPR courses. The First Aid/CPR/AED Program reflects these changes. The following summarizes and provides rationale for the ECC revisions that have been integrated into the First Aid/CPR/AED Program. Recovery Position--Whenever the victim is breathing and unconscious, or if you are alone and must leave the victim to get help, the victim should be placed in the recovery position. Once in the recovery position, the victim should be turned to the opposite side after 30 minutes or if there are signs of loss of circulation to the lower arm, such as pale, ashen or grayish skin that is cool to the touch. If there is a suspected head, neck or back injury and a clear, open airway can be maintained, do not move the victim unnecessarily. If a clear airway cannot be maintained, the victim should be moved to his or her side maintaining in-line stabilization. This position is not demonstrated nor specifically recommended for infant victims. Rationale--A victim that is lying face up and breathing may develop an obstructed airway by his or her tongue, mucus or vomit. This problem can be avoided by placing the victim on his or her side so that fluid may drain from the mouth. While maintaining an open, clear airway, it is also important to maintain adequate circulation. Since there is no single ideal position for all victims, the videos portray slightly different approaches. The position should allow unimpaired breathing and an open airway. Use of Breathing Barriers When Giving Rescue Breaths--Red Cross training incorporates the practice of using breathing barriers, such as face shields and resuscitation masks, when giving rescue breaths. It is recommended that a breathing barrier be used. However, a responder should not delay care if a breathing barrier is not immediately available or if he or she is unsure of how to use it. A resuscitation mask has advantages over a face shield. The primary advantage is that a resuscitation mask is equipped with a one-way valve that prevents the victim's exhaled breath from entering the responder's mouth. Rationale--Mouth-to-mouth rescue breathing has proven to be a safe and effective way of providing oxygen to a nonbreathing victim and has saved many lives. While using breathing barriers may reduce the risk of disease transmission when giving breaths, the incidence of disease transmission during direct mouth-to-mouth rescue breathing is very low. Rescue Breaths--Whenever a breath is given to an unconscious victim, it is considered a "rescue breath." Rescue breaths should be given to an unconscious adult, child or infant victim in such a way to ensure the delivery of effective breaths and to reduce the risk of gastric inflation (air in the stomach) during rescue breathing. An effective breath will cause the victim's chest to clearly rise.

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For an unconscious adult victim: I Each breath should be slow, gentle and last about 2 seconds. I The responder should pause and take a breath between breaths given to the victim. I Each rescue breath should cause the victim's chest to clearly rise. For an unconscious child or infant victim: Each breath should be slow, gentle and last about 11/2 seconds. I The responder should pause and take a breath between breaths given to the victim. I Each rescue breath should cause the victim's chest to clearly rise.

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Rationale--slower breaths reduce the amount of gastric inflation, which can cause serious complications such as vomiting, aspiration or pneumonia and restrict lung movement. When the responder pauses and takes a breath between rescue breaths, it ensures maximum oxygen and minimum carbon dioxide in each rescue breath. Pulse Check--Where previously instructed to check for a pulse, responders are now instructed to look, listen and feel for "signs of circulation." Signs of circulation include: I Normal breathing. I Coughing or movement in response to rescue breaths. I A pulse. This check should last no more than 10 seconds. Rationale--Most responders do not accurately determine the absence or presence of a pulse. It is more harmful to delay or choose not to give care to a victim who needs it than to perform chest compressions on or attach an AED to a victim who is not in cardiac arrest. Research shows that the time spent trying to locate a pulse far exceeded the limit of 10 seconds. Note that manufacturers of AEDs contacted by NHQ indicated that the voice prompt on both AED trainers and live devices will continue to instruct the responder to "check pulse." Certified lay responders are taught to identify other life signs in assessing a victim's circulation in addition to a pulse check. "Normal breathing" should not be mistaken for agonal breaths. Chest Compressions CPR for an adult victim will be taught at a ratio of 15 chest compressions to 2 rescue breaths for one or two responders at a rate of about 100 compressions per minute. I CPR for a child victim will be taught at a ratio of 5 chest compressions to 1 rescue breath at a rate of about 100 compressions per minute. I CPR for an infant victim will be taught at a ratio of 5 chest compressions to 1 rescue breath at a rate of at least 100 compressions per minute.

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Rationale--The rate of compressions has been increased to achieve the best possible blood flow during CPR. For an adult victim, the research shows that CPR is most effective when more uninterrupted chest compressions are delivered. As such, the ratio of 15 chest compressions to 2 rescue breaths will apply in both a one- or two-responder situation. For infants and children, breathing problems are the most common cause of arrest. Also, the breathing rate of infants and children is faster than in adults. Therefore, for this age group (age 8 and under), the emphasis remains on rescue breaths for maximum oxygenation, so the ratio will remain 5 chest compressions to 1 breath.

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Two-Rescuer CPR Technique--Certified lay responders should be shown two-rescuer CPR where time and interest permit. The information on two-rescuer CPR is provided in the instructor's manual and guide for training instructors. Practice time can be allotted but this skill is not required for certification for certified lay responders. Rationale--Two-rescuer CPR should be shown as an alternative to one-rescuer CPR when a rescuer becomes fatigued. This technique should only be used when there are two trained rescuers present. Full CPR Versus Compression-Only CPR--Responders will be taught full CPR that includes chest compressions and rescue breaths. The potential question of compression-only CPR is addressed through a frequently asked question (FAQ). If asked, the instructor's response should be: If the responder is unwilling or unable to perform rescue breaths and chest compressions, it is better to either provide rescue breaths or chest compression than nothing at all. Rationale--CPR that includes chest compressions and rescue breaths is more effective than either skill on its own for a victim of cardiac arrest. As stated, it is better to either provide rescue breaths or chest compressions than nothing at all. Because of difficulty in leading an untrained bystander (a person who has no previous knowledge of or training in CPR) on the telephone, an EMS dispatcher may simplify the steps to care for a victim of cardiac arrest to compression-only CPR. The simplicity of modified, compression-only CPR allows untrained bystanders to provide at least some care for the victim until advanced medical personnel arrive and take over. Unconscious Choking Victim--For an unresponsive (unconscious) choking victim, certified lay responders will be taught a modified CPR technique to clear the airway obstruction. Upon verification of the airway obstruction, the responder will begin CPR. Each time the airway is positioned to give rescue breaths, the responder will look for an object in the victim's mouth and remove an object only if one is seen. Then the breath(s) in the CPR cycle are given. This process applies regardless of whether the victim is an adult, child or infant. Rationale--Early scientific research indicates that chest thrusts are as effective as, and potentially more effective than, abdominal thrusts. This revision results in simplifying training for the certified lay responder by reducing the number and complexity of skills taught in class. The same basic skill of chest compressions and rescue breaths is used on victims who either have no pulse/signs of circulation or are unconscious and choking. Since this skill is a modified CPR technique, responders will be taught CPR before the airway obstruction skill so that the learning process is logically connected and builds on the skills previously learned. This technique is not new. The chest compression technique basically equates to the "chest thrust" that is currently taught in Red Cross courses for the unconscious choking victim who is noticeably pregnant. This modified CPR technique is virtually identical to CPR in that the compressions-tobreaths ratios are the same as is the rate of delivery and technique of compressions. There is no retilt nor reattempt of breaths performed during the modified CPR cycle except in the initial assessment or check of the unconscious victim. AED Use in Children--The use of an AED is not currently recommended for an infant or child less than 8 years old and who weighs less than 55 pounds. For an infant or child less than 8 years old weighing less than 55 pounds who is in cardiac arrest, the initial priorities continue to be support of the airway, breathing and circulation through rescue breaths and chest compressions.

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Rationale--The energy levels in current models of AEDs may be too high for use on children less than 8 years old weighing less than 55 pounds. Jaw-Thrust Maneuver to Open the Airway--For a suspected head, neck or back injury, the jawthrust maneuver will be shown as a technique to open the airway on an adult or child victim. This skill is not required for certification, but responders need to be aware of this alternative airway management technique. This technique is shown in detail in the Standard First Aid and the Infant & Child CPR videos. Rationale--The certified lay responder should be familiar with this skill to reduce the possibility of causing further injury to a victim with a suspected head, neck or back injury. Sequence for A Responder Who Is Alone--When the responder is alone, Call First, that is, call 9-1-1 or the local emergency number before providing care for: I An unconscious adult victim or child 8 years old or older, and I An unconscious infant or child known to be at a high risk for heart problems. When the responder is alone, provide 1 minute of care, then Call Fast for: An unconscious victim less than 8 years old; I Any victim of submersion or near drowning; I Any victim of arrest associated with trauma; and I Any victim of drug overdoses.

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Rationale--The situations in Call First should be assumed to be cardiac emergencies, such as sudden cardiac arrest, and the time factor is critical. The research shows that the shorter the time from collapse to first shock from an AED, the greater the chance of survival for an adult or child 8 years old or older. For an infant or child with a known risk for heart problems, early access to the EMS system and the advanced medical care that results increases that victim's chance of survival. In the Call Fast situations, the conditions are most often related to breathing emergencies rather than sudden cardiac arrest. In these situations, providing support for airway, breathing and circulation through rescue breaths and/or chest compressions as appropriate is the most important initial step a trained responder should take. Instructors need to be prepared to clarify these situations for course participants.

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APPENDIX L First Aid/CPR/AED Program Instructor Course Fact Sheet

Course Course Code Purpose American Red Cross First Aid/CPR/AED Program Instructor 3249I The purpose of the First Aid/CPR/AED Program Instructor course is to train instructor candidates to teach American Red Cross First Aid/CPR/AED Program courses and modules.

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Prerequisites

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Be at least 17 years of age by the last scheduled session of the instructor course. Possess a Fundamentals of Instructor Training (FIT) Certificate or Instructor Candidate Training Certificate (for training conducted through 6/30/01; valid through 6/30/02)(C3007) issued in the last 12 months, or have a current Health and Safety Services Instructor Authorization (F5736) and Pass each section of the precourse written examination with a score of at least 80 percent and demonstrate competency in the skills evaluation. Expand on information from the American Red Cross Fundamentals of Instructor Training (FIT) course to teach the First Aid/CPR/AED Program courses and modules. Demonstrate the characteristics required of an American Red Cross representative and role model. Plan, organize, and conduct applicable program courses and modules. Monitor participants' practice and provide corrective feedback and encouragement. Teach courses and modules in a manner that keeps participants engaged in the learning process. Ensure participants' health and safety during training. Be able to customize courses and modules to meet the specific training needs of employers and employees. Demonstrate first aid, CPR, and AED skills at an appropriate level of performance. Maintain complete and accurate records and reports.

Learning Objectives

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Length Instructor

Approximately 17 hours (based on 6 instructor candidates per instructor trainer) Currently authorized First Aid/CPR/AED instructor trainer, Lifeguard (r.01) instructor trainer, or Emergency Response instructor trainer.

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Certification Requirements

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Successfully complete the precourse session. Attend all course sessions. Successfully complete three practice-teaching assignments. Score at least 80 percent (20 correct answers out of 25 questions) on the instructor written examination.

Authorization Validity Participant Materials

Authorization is for 2 calendar years. All authorizations expire on December 31st. Initial authorizations may be slightly longer or shorter than 2 years depending on when the course is taken.

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American Red Cross First Aid/CPR/AED Program Instructor's Manual (Stock No. 656617) American Red Cross First Aid/CPR/AED Program Participant's Booklet (Stock No. 656629) American Red Cross First Aid Skills Card (Stock No. 656628) American Red Cross Adult CPR/AED Skills Card (Stock No. 656559) American Red Cross Infant & Child CPR Skills Card (Stock No. 656631) American Red Cross Workplace Training: Ergonomics Booklet (Stock No. 656603) American Red Cross Workplace Training: Slips, Trips, & Falls Booklet (Stock No. 656604) American Red Cross Workplace Training: Back Injury Prevention Booklet (Stock No. 656608) American Red Cross Workplace Training: Workplace Violence Awareness Booklet (Stock No. 656609) American Red Cross Workplace Training: Managing Stress Booklet (Stock No. 656612) American Red Cross Workplace Training: Your Heart Matters Booklet (Stock No. 656614)

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