1. VER: 1.1 04022011 Saving Lives Skills for Life Advanced Resuscitation Techniques Certificate HLTFA404A Apply advanced resuscitation techniques PUAEME003C Administer oxygen in an emergency situation PUAOPE010C Operate an automated external defibrillator in an emergency

2. Version: 1.1 04022011 Housekeeping 2 Phones Course timings and breaks Facilities Emergency Evacuation Exits Assembly point Language, literacy and numeracy Incident/injury notification Prerequisites Appeals process Enrolment form

3. Version: 1.1 04022011 Course Content HLTFA404A Apply advanced resuscitation techniques PUAEME003C Administer oxygen in an emergency situation PUAEME010C Operate an Automated External Defibrillator in an emergency situation. Course Duration: 9.5 hours The First Aid Training Manual or Public Safety and Aquatic Rescue manual may also be used as a reference 3

4. Version: 1.1 04022011 Learner Guide icons Remember this Case study Assessment activity 4 Reading material Individual activity Group activity Course objectives

5. Version: 1.1 04022011 Course outcomes By the end of the course you should be able to: 5 assess the casualty and develop a management plan check and use resuscitation equipment maintain an airway by:  using suction  using OP airways resuscitate a casualty using oxygen resuscitation equipment use oxygen to provide therapy recover and restore oxygen equipment check defibrillation equipment attach and operate a defibrillator recover and restore defibrillation equipment

6. Version: 1.1 04022011 Assessment Assessment purpose: to demonstrate your competence after the learning to meet organisational requirements for your role Assessment process: written assessment practical assessment including scenarios RPL 6

7. Version: 1.1 04022011 Topic 1 – First Aid and Resuscitation Review Learning outcomes On completion of this topic candidates will be familiar with: the legal implications associated with first aid infection controls for communicable diseases the chain of survival Emergency Action Plan (EAP) review of CPR 7

8. Version: 1.1 04022011 Legal implications of first aid Duty of care Documentation Confidentiality 8

9. Version: 1.1 04022011 Duty of care No requirement to provide assistance unless you already owe a duty of care to the sick or injured person. Examples include: a first aider at a worksite someone caring for children taking on a duty of care once you begin giving first aid Once you begin giving first aid, you have a duty to do everything reasonable and you cannot abandon the casualty 9

10. Version: 1.1 04022011 Recording 10 Make a record at the time of the incident to: assist with management and handover create a legal record The following information may be required: date and time what happened what assistance you provided.

11. Version: 1.1 04022011 Confidentiality Information about a casualty should not be shared with others not involved in their treatment (ie it is acceptable to share information with parents, other first aiders assisting with treatment or ambulance personnel) 11

12. Version: 1.1 04022011 First aid safety Wash hands after treating a casualty Use appropriate PPE (gloves, resuscitation masks, protective eyewear) Place sharps in sharps containers Dispose of contaminated wastes into appropriate labelled containers Be aware of the signs in yourself or colleagues and seek support 12

13. Version: 1.1 04022011 Airway obstructions 13

14. Version: 1.1 04022011 Chain of survival 14

15. Version: 1.1 04022011 Activity Activity (Individual) 1.1: Advanced Resuscitation and the Chain of Survival During this course you will be learning how to use a defibrillation unit, oxygen resuscitation equipment and airway management devices (suction and oropharyngeal airways). The value of defibrillation is clearly defined in stage three of the Chain of Survival, using your current knowledge of CPR, identify where use of oxygen resuscitation and airway management equipment will contribute to the chain of survival. 15

16. Version: 1.1 04022011 Emergency action plan (EAP) 16 Pause and plan Call for emergency assistance Primary assessment Secondary assessment  management of injuries  vital signs  history  body check  treatment Ongoing management

17. Version: 1.1 04022011 Pause and plan 17 This reminds the first aider to remain calm, stop and think. When pausing and planning consider? safety equipment length of time you may be out in the elements communications further assistance Is 000 required

18. Version: 1.1 04022011 Call for emergency assistance 18 Four Ps P osition P roblem P eople P rogress

19. Version: 1.1 04022011 Primary assessment 19 Danger Response Send for help Airway Breathing Compression Defibrillation

20. Version: 1.1 04022011 Primary assessment - CPR 20 Jaw thrust is essential when performing airbag resuscitation Leadership during CPR You will be looked to for leadership by other first aiders You may need to instruct a bystander in CPR Activity (Group) 1.2: Jaw thrust Complete activity on page 17 of the Learner Guide to refresh your skills in obtaining effective head tilt and chin lift using jaw thrust Activity (Group) 1.3: CPR review Refresh your CPR skills and practise providing leadership during CPR by completing activity 1.3 on page 19 of the Learner Guide

21. Version: 1.1 04022011 Secondary assessment 21 Management of injuries Vital signs History Body check Treatment

22. Version: 1.1 04022011 Ongoing management 22 Reassess the casualty’s vital signs at regular intervals Continue to identify actual or potential problems and plan appropriate care Notify the ambulance service of any change to the casualty’s status as appropriate Hand over casualty to ambulance personnel Who should be sent to hospital? How long will an ambulance take to respond to your area?

23. Version: 1.1 04022011 Assessment Assessment Task 1: Written Questions Complete questions 1 - 10 in your assessment portfolio now. 23

24. Version: 1.1 04022011 Topic 2 – Advanced Resuscitation and Oxygen Administration Learning outcomes Oxygen equipment components Oxygen equipment safety precautions Equipment checks Oropharyngeal (OP) airways 24

25. Version: 1.1 04022011 Why use oxygen? Increases oxygen uptake Promotes recovery in most first aid situations Minimises risk of cross-infection Oxygen is useful in most situations where the casualty does not appear adequately perfused (oxygenated) 25

26. Version: 1.1 04022011 Why use oxygen? 26 Unconciousness Shock Blood loss Chest pain Shortness of breath Asthma Severe pain Circulatory distress Injuries After resuscitation Not breathing Anaphylaxis

27. Version: 1.1 04022011 The respiratory system 27

28. Version: 1.1 04022011 The breathing process 28

29. Version: 1.1 04022011 Respiratory noises Cough Wheeze Stridor Gurgling No sound 29

30. Version: 1.1 04022011 Respiratory conditions Hypoventilation Chronic Obstructive Airways Disease (COAD) Asthma Hyperventilation 30

31. Version: 1.1 04022011 Oxygen resuscitation equipment 31

32. Version: 1.1 04022011 Oxygen equipment components 32

33. Version: 1.1 04022011 Activity Activity (Group) 2.1: Oxygen Equipment In pairs or small groups, take turns in naming all the pieces of equipment in your kit. Once you and your partner are confident you can remember all of the items, remove an item or two without your partner watching, and then have them review the kit and identify the missing item(s). A checklist is supplied on page 32 of the Learner Guide. 33

34. Version: 1.1 04022011 Oxygen equipment 34

35. Version: 1.1 04022011 Safety precautions Oxygen must be used with care and respect at all times  Never use oxygen near an open flame  Never use oxygen near cigarettes  Never use grease or oil with oxygen equipment  Never use oxygen when delivering a shock via a defibrillator 35

36. Version: 1.1 04022011 Oxygen cylinders C size Pin indexed. 440-490L capacity. White/blue sleeve over outlet of full bottle. 36 White cylinder labeled Medical Oxygen (changed from black with white shoulder to all white between September 2009 and June 2011) Operational times:50 Min, Therapy (8L per min). 30 Min, Resus (14-15L per min). Replace cylinders when less than half full (can be used for training).

37. Version: 1.1 04022011 Preparing cylinders for use 1.Check heat warning tag. 2.Remove protective plastic wrap. 3.Open or ‘crack’ valve safely. 4.Ensure yoke is clean and dry, sealing washer in place. 5.Attach the yoke – do not over tighten. 6.Slowly open valve fully, then back half a turn. 7.Check contents (Under half full replace), 8.Ensure system is free of leaks. 9.When finished using, turn valve off, then release pressure from regulator. 10.Mark cylinder with contents and date checked 37 Protective plastic wrap Heat warning tag

38. Version: 1.1 04022011 Oxygen equipment Check tubing Check flow Check that there is no odour Close cylinder valve and drain unit of oxygen 38

39. Version: 1.1 04022011 Ancillary equipment Therapy masks (adult and child) Resuscitation masks (adult and child) OP airways Chalk Pencil, sharpener and paper Gloves Spare sealing washers 39

40. Version: 1.1 04022011 Activity Activity (Group) 2.3: Airbag checks In pairs or small groups, take turns checking that the oxygen equipment and ancillary items are available and serviceable. Have your partner test you by following along using the processes outlined in your learner guide. 40

41. Version: 1.1 04022011 Administering oxygen therapy Check oxygen equipment Place equipment so the operator can reach and see the contents gauge Attach tubing to mask and turn on Secure mask to casualty’s face 41 NOTE: If the casualty does not want to use the mask, remove the mask and direct oxygen flow around the mouth and nose

42. Version: 1.1 04022011 Opening the airway Use Pistol Grip Jaw Support Jaw Thrust Maximum Head Tilt (Except Infants) 42

43. Version: 1.1 04022011 Mouth-to-mask with oxygen Used when rescuer is not ARC/ARTC qualified or airbag is not working correctly 43

44. Version: 1.1 04022011 Air bag resuscitator Patient valve Oxygen Inlet valve Self refilling Recoil bag Extension tube (optional) Reservoir bag Resus mask 44

45. Version: 1.1 04022011 Pre Use Airbag Checks (Assembled components) 45 Check the airbag for leaks Seal patient valve Squeeze recoil bag 1 Check patient valve for non-breathing 2 Fill reservoir bag, place over patient valve Squeeze lifts yellow membrane Check reservoir valve “blow off” 3 Fill reservoir bag, connect to inlet valve Squeeze lifts yellow membrane Check intake valve 4 Fill reservoir bag, connect to inlet valve Squeeze Reservoir bag deflates

46. Version: 1.1 04022011 Airbag operation Gentle squeezing motion 1.5-2 seconds  Adult: 2 hands  Child:1 hand Squeeze airbag before use to fill with oxygen Watch rise and fall of casualty’s chest If unhappy with equipment, discard Airbag may still be used when cylinder is empty 46

47. Version: 1.1 04022011 Activity Activity (Group) 2.4: CPR with Oxygen In teams of three practice performing CPR using the airbag resuscitator 47

48. Version: 1.1 04022011 Assessment Assessment Task 1: Written Questions Complete questions 11 - 29 in your assessment portfolio now. 48 Assessment Task 2: Peer Assessment – Oxygen equipment checks Ask peer to assess you as you complete the pre- operational checks to ensure your oxygen equipment is ready for use (Details page 62)

49. Version: 1.1 04022011 Oropharyngeal (OP) airways curved plastic device assists in the maintenance of an adequate airway in the unconscious casualty keeps the airway clear and the tongue in place 49 Flange Bite block

50. Version: 1.1 04022011 OP airways An airway blocked by the tongue Using an OP airway to assist with a clear airway 50

51. Version: 1.1 04022011 OP airway sizing Leave airway in the packaging for sizing process The airway must extend from the centre of patient’s lips, to the angle of the jaw X X Too small Too big Correct sizing

52. Version: 1.1 04022011 OP airway precautions Only insert into deeply unconscious or non- breathing ADULT casualties - not children Lateral position for unconscious breathing casualties When casualty is non-breathing, insertion can be made on back or side (lateral position) Airway should NOT be inserted while chest compressions are being performed on the casualty 52

53. Version: 1.1 04022011 Preparation for insertion Tilt casualty’s head backwards, open casualty’s mouth using jaw support (or thrust) Check casualty’s airway and manually clear if required Size oropharyngeal airway Remove airway from packet (squeeze plastic bag) and lubricate airway using water or casualty’s saliva 53

54. Version: 1.1 04022011 OP airway insertion method Hold airway by the flange and with the flange’s tip pointing towards roof of mouth, insert airway until roof of the mouth resistance is felt, (approx 1/3 length).

55. Version: 1.1 04022011 OP airway insertion method (continued) Gently push airway further in, rotate 180 degrees until airway tip points downwards and then slide over patient’s tongue into the back of the pharynx until the flange is touching the patient’s lips.

56. Version: 1.1 04022011 OP airway insertion A correctly inserted Oropharyngeal airway.

57. Version: 1.1 04022011 OP airway insertion precautions Ensure lower lip is NOT pinched between teeth and airway Ensure OP airway does NOT push tongue backwards and block the casualty’s airway Ensure adequate head tilt before inserting airway Do NOT force the airway into the mouth 57

58. Version: 1.1 04022011 OP airway insertion & the mask Insertion of the airway will not interfere with the use of oxygen resuscitation equipment.

59. Version: 1.1 04022011 Activity Activity (Group) 2.5: Sizing and Inserting OP Airways In pairs practice choosing the correct size OP airway for your partner. If an airway manikin is available, practise inserting the OP airway, otherwise describe the process to your partner in your own words. 59

60. Version: 1.1 04022011 Assessment Assessment Task 3: Peer Assessment – OP Airway Ask peer to assess you as you size and insert an OP airway (Details page 62) Assessment Task 1: Written Questions Complete questions 30 - 33 in your assessment portfolio now. 60

61. Version: 1.1 04022011 Topic 3 - Suction Learning outcomes On completion of this topic candidates will be familiar with: Pre-operation checks of suction devices Administering suction Post-operation maintenance of suction devices 61

62. Version: 1.1 04022011 Use of suction 62

63. Version: 1.1 04022011 Manual suction units 63

64. Version: 1.1 04022011 Failure of suction apparatus Oxygen supply exhausted (for oxygen powered units) Suction tubing blocked Bottle full or cracked Seal missing or perished Not turned on 64

65. Version: 1.1 04022011 Activity Activity (Individual) 3.1: Suction equipment Look at the suction equipment your club/service has available for use or the equipment you have been provided to train with. Identify the following components:  Suction catheter  Collection jar  Jar cap and connection port  Suction device  Vacuum port If you cannot identify all of the components check with your trainer. Your device may not have these exact components but will have something that performs the same function Test the function of your suction device by performing the checks described in your learner guide 65

66. Version: 1.1 04022011 Suction Techniques Roll casualty on their side. Measure length of insertion on catheter Turn suction unit on (if battery or oxygen). Insert suction catheter inside bottom cheek. Use suction for 15 seconds only (five seconds for electric or oxygen powered) as extended use will deprive casualty of oxygen. Repeat procedure as necessary. Measuring for lips to corner of the jaw Suctioning – inserting no further than measured (top picture) 66

67. Version: 1.1 04022011 Activity Activity (Group) 3.2: Administering suction In pairs or groups of three, practice assembling your suction equipment and sizing the insertion distance on your partner. If an appropriate manikin is available practice performing suction. NOTE: To ensure infection free training, do not place the suction catheter in your own mouth or that of your partner. 67

68. Version: 1.1 04022011 Assessment Assessment Task 1: Written Questions Complete questions 34 - 36 in your assessment portfolio now. 68 Assessment Task 4: Peer Assessment – Suction Ask peer to assess you as you test and use the suction device to provide a clear airway (Details page 62)