1. Hands-Only CPR & AED Training Created for the San Francisco Unified School District Ninth Grade Health Curriculum By the San Francisco Fire Department & American Heart Association 2015-2016

2. What is Sudden Cardiac Arrest? SUDDEN CARDIAC ARREST What happens? The heart stops beating or stops beating effectively. (Electrical problem) The person loses consciousness and stops breathing. What to do? Call 9-1-1. Start CPR compressions. Get an AED. HEART ATTACK What happens? Blood flow to the heart is blocked. (Plumbing problem) What to do? Call 9-1-1.

3. Chain of Survival – Sudden Cardiac Arrest Immediate recognition of cardiac arrest and activation of 9-1-1 system Prompt Hands-Only CPR Prompt use of AED (Automated External Defibrillator), if available Transport to hospital that is equipped to provide specialized care

4. Overview: Check, Call, CPR If a teen or adult suddenly collapses, CHECK to see if he/she is responsive by tapping the shoulder and shouting: “Hey, are you OK?” If there is no response, CALL 9-1-1 If possible, send someone else to call 9-1-1 If there’s an AED nearby, send someone to get it Place patient on a flat, hard surface Start CPR compressions Push hard and fast in the center of the chest Continue CPR compressions until help arrives, trading off with someone else every 2 minutes if possible If an AED is available, turn it on and follow the prompts

5. Check If a teen or adult suddenly collapses or is found lying unconscious, CHECK to see if he or she is responsive by shaking the shoulder and shouting: “Hey, are you OK?” IMPORTANT: Your safety comes first! If the person is in a dangerous spot – such as in a busy road or at the scene of a fire or another hazardous situation – call 9-1-1 and wait for assistance before approaching

6. Call 9-1-1 Don’t wait to call 9-1-1! When you call, be ready to give your location and stay on the line If possible, have someone else call 9-1-1 while you stay with the patient and begin CPR Call from a land line, if possible

7. Call 9-1-1 What happens when you call 9-1-1 for a medical emergency? An ambulance and Fire Department will come to your home (not the police) What are some barriers to seeking help? Discomfort with having an ambulance in front of one’s house Worry about language barrier Feeling that you “don’t have permission” to call 9-1-1 or might get into trouble for calling Fear that emergency responders will ask for payment Fear based on immigration status

8. Call: Typical 9-1-1 Medical Call Questions What is the address and phone number you are calling from? What’s the problem? Can you meet the ambulance or fire engine to escort medical personnel to the patient? Is the person unconscious? Is he/she breathing? Instructions on how to give CPR or other relevant information.

9. CPR: Start CPR Compressions Place the heel of one hand in the center of the person’s chest Place the other hand on top of the first one Lock your elbows Push hard and fast: 2 inches deep or deeper 100 times a minute or faster You will get tired. Trade off with another CPR provider every 2 minutes if possible Continue until help arrives or until an AED is at the scene and ready to use Don’t stop until Emergency Responders arrive and tell you they are ready to take over.

11. AED Use AED stands for Automated External Defibrillator AEDs are made by different manufacturers but they are all very easy to use In the case of a Sudden Cardiac Arrest, turn on the AED and follow the prompts Some AEDs turn on automatically when you open the case. Others have a large “on” button. Make sure the patient is not laying in or next to a puddle of water You will be directed to place the sticky pads on the patient’s bare chest, according to the diagram Make sure no one touches the patient while the AED is analyzing the heart rhythm If directed to deliver shock, make sure no one is touching the patient when you press the button The AED will direct you to resume CPR

12. CPR Frequently Asked Questions Why aren’t we learning rescue breathing? If I know rescue breathing, should I provide breaths as well as compressions? Can I hurt the patient? What if I get tired? Can I get sued? Am I required to perform CPR if I know it? How do I learn “full” CPR – including rescue breathing?

13. Review: Cardiac Arrest and Heart Attack Cardiac Arrest: Sudden collapse, unresponsive, no normal breathing Call 9-1-1, start CPR, send someone for an AED Heart Attack: Most common symptom is discomfort in the center of the chest that lasts more than a few minutes or goes away and comes back Other symptoms may include discomfort in other areas of the upper body, shortness of breath, breaking out in a cold sweat, nausea or lightheadedness Call 9-1-1

14. Choking First Aid / Abdominal Thrusts (Formerly called the Heimlich Maneuver) Ask the person if they are choking. Can the person speak? If so, stand by and let them try to dislodge the object by coughing. Look for the universal choking sign (hands held to throat). If the person can’t speak, tell them you are going to try to help. Stand behind the person and reach your arms around their waist, just above their belly button. Make a fist and wrap your other hand around the fist. Make sharp motions, pushing up as well as in. If you’re alone, use the back of a chair or the edge of a table to try dislodge the stuck object.

15. Heart-Healthy / Brain-Healthy Lifestyle Most heart disease and most strokes can be prevented. Healthy diet Physical activity Stay away from tobacco in all forms, including “vaping”, hookah, and e-cigarettes If you have a risk factor such as high blood pressure, high cholesterol or diabetes, seek treatment and follow the doctor’s orders.

16. Public Service Careers To prepare for a career with the San Francisco Fire Department: Graduate from high school, no felonies Age 19 or older Become an E.M.T. (Emergency Medical Technician – 1 semester, offered at City College) Pass the CPAT – Candidate Physical Ability Test Visit www.sf-fire.org to see schedule for career information sessionswww.sf-fire.org What is the difference between an E.M.T., Paramedic and Firefighter? City College of San Francisco: E.M.T. and Paramedic Program and Fire Academy 19 or older and a San Francisco resident? You may join the San Francisco Fire Department Fire Reserve