1. Welcome to the Canadian Red Cross First Aid & CPR Course

2. What is the ACT Foundation?
Fundraises for mannequins and AED for schools.
Brings CPR to all schools.
Is partnered nationally with health partners who support ACT’s Canada-wide goal for CPR in schools:
AstraZeneca Canada
Pfizer Canada
Sanofi
Visit ACT!

3. Day 1
Preparing to Respond
EMS
Check, Call, Care

4. Why Do I Need To Learn CPR? See page 3, ACT Student Manual
The first link in the
Chain of Survival*
begins with YOU!
* © Reproduced with the permission of the Heart and Stroke Foundation of Canada, The Chain of Survival™ is a trade-mark of the Heart and Stroke Foundation of Canada.
See page 3, ACT Student Manual

5. Chain of Survival
The key to surviving emergencies is a CHAIN REACTION:
Early Healthy Choices – making lifestyle decisions
Early Recognition – recognizing a serious developing emergency
Early Access – calling 911 for help
Early CPR – maintaining a person’s breathing and circulation until help arrives
Early Defibrillation – a machine that delivers a shock to the heart
Early Advanced Care – paramedics racing to the side of a sick person
Early Rehabilitation – returning to a normal lifestyle after a cardiac problem

6. The 4 R’s of CPR
RISK – factors in your life that predispose you to developing heart problems or a stroke
RECOGNIZE – how to recognize a serious developing emergency
REACT – what to do when you see a developing emergency
RESUSCITATE – how to do CPR and how to help someone who is choking

7. Laws that Protect First Aiders
Ontario
The Good Samaritan Act, 2001
a legal principle that prevents a rescuer who has voluntarily helped a victim in distress from being successfully sued for 'wrongdoing.'
Its purpose is to keep people from being so reluctant to help a stranger in need for fear of legal repercussions if they made some mistake in treatment.
***It is KEY to get the person’s consent before you help, or parent/guardian consent for an injured child. For an UNCONSCIOUS person, consent is IMPLIED.

8. Definition of First Aid
First aid is the immediate care that you give to a sick or injured person until more advanced care can be obtained.
The First Aider’s Role:
Recognize the emergency
Call EMS/9-1-1
Act according to your skills, knowledge, and comfort level

9. Common Concerns About Providing First Aid
Other people at the scene
The ill or injured person
Unpleasant injuries or illnesses
Catching a disease
Doing something wrong

10. Infection
An infection is a condition caused by the invasion of the body by germs.
Germs in the environment
The germs enter body
Enough germs to cause infection
The individual’s natural defences must be weak

11. How is an Infection Spread Between People?
Direct contact >
Airborne transmission >
Indirect contact >
Vector transmission >

12. Preventing Diseases From Spreading
Take personal precautions
Wear protective equipment
Take environmental precautions

13. Preparing to Respond – Summary Questions
List three examples of a medical emergency.
How can a disease be transmitted in first aid?
How can disease transmission be prevented in first aid?
Can you be sued for doing first aid?
Name three elements of a home safety plan.

14. Hazards, Holler and a Little PLT
ESM = Emergency Scene Management
Check for Hazards – “no fire, no wire, no gas, no glass…”
Holler for help, if you are alone; call 911
While waiting for an ambulance, make the person more comfortable by:
Position the person so they are most comfortable.
Loosen tight clothing at the neck or waist.
Talk to the person – let them know that help is on the way. Stay with them; if they become unconscious they may need your help even more!

15. Check, Call, Care – Be Systematic

16. Check – Begin a Primary Survey
Before helping at an emergency, check the scene:
1. Is it safe?
2. What happened?
How did it happen?
3. How many ill or injured people are there?
4. Is there someone to help me?
5. Is there someone who looks unconscious?

17. If the scene is safe, check the person:
Do they respond?
Ask the person, “Are you okay?”
If it is safe, get closer
Gently tap the person on the shoulder
Do they want your help?
Tell them:
Who you are
You are trained in first aid
You are here to help

18. Call Call EMS/9-1-1 Be ready to tell the dispatcher the following:
Where exactly the emergency is
What telephone number you are calling from
What your name is
What has happened
How many people are involved and what their condition is

19. Care Determine care required: check CABs
Treat life-threatening emergencies immediately

20. Check ABCs for Life-Threatening Emergencies
Circulation
Airway
Breathing

21. Treat everybody for shock.
Shock is a potentially life-threatening condition in which vital organs do not receive enough oxygen-rich blood.
Shock can be caused by:
injury, illness, infection, or emotion.
Treat everybody for shock.
S & S: anxiety, cold or clammy skin, skin that is paler than usual, weakness, confusion, unconsciousness, weak/rapid pulse, rapid breathing, excessive thirst, nausea and vomiting, drowsiness

22. First Aid – Shock While you are waiting for EMS personnel to arrive:
Care for the cause of the shock.
Keep the person warm.
Monitor CABs.
Have the person rest.
Give comfort and reassurance.
**FLASH the paramedics!
(…wave and or flash lights when you see them, that is…!)

23. Secondary Survey: Are there any other injuries?
Only do a secondary survey if the CABs are present.
Do the three-steps of a secondary survey:
Ask SAMPLE questions
Check vital signs
Do a head-to-toe check
Always complete the secondary survey before treating any non-life-threatening injuries.

24. Secondary Survey – SAMPLE Questions
S Signs and symptoms
A Allergies
M Medications
P Past medical history
L Last meal
E Events leading up to the emergency

25. Secondary Survey – Vital Signs
Level of consciousness
Breathing
Skin

26. Secondary Survey – Head-to-Toe Check
Hands-Off Check

27. Secondary Survey – Head-to-Toe Check
Hands-On Check

28. Continual Care Keep the person comfortable
Put an unconscious person in the RECOVERY POSITION if:
The airway is open
The person is breathing
There is no deadly bleeding
You don’t suspect a neck or back injury
Monitor the person

29. Summary Check Call Care Secondary Survey Continual Care
Check the scene
Check the person
Call
Call EMS/9-1-1
Care
Deal with life-threatening conditions (CABs)
Secondary Survey
Perform a secondary survey and treat any non-life-threatening injuries
Continual Care
Keep the person comfortable and monitor vital signs

30. Check, Call, Care – Summary Questions
What should you do during the check?
What actions must you take in call?
What actions must you take in care?
What can you do to prevent shock?
What do you do during the secondary survey?
What does the acronym SAMPLE stand for?
What should you look for in a head-to-toe check?
***PRACTICE THE RECOVERY POSITION!

31. Cool Idea! ICE your phone!
ICE stands for In Case of Emergency Putting ICE before your designated next of kin in your list of contact numbers lets emergency personnel know who to contact in case of emergency!

32. Day 2
Choking
&
Airway Emergencies

33. Airway System – Anatomy and Physiology
We breathe in 21% oxygen and breathe out 16% oxygen…This is more than enough to sustain life.
Nose
Mouth
Epiglottis
Trachea
Lungs
Bronchioles
Alveoli

34. Airway Blockages
A mild airway obstruction occurs when the airway is partly blocked, reducing the flow of air to the lungs
A severe airway obstruction occurs when the airway is totally blocked, stopping air from reaching the lungs
Blockage
S&S:
If the person can speak, cough, or breathe, it is mild choking.

35. See page 14, ACT Student Manual
RESUSCITATE
Choking – Adult Conscious
Step 1. Assess the airway blockage
Step 2. Holler for help
See page 14, ACT Student Manual

36. See page 14, ACT Student Manual
RESUSCITATE
Choking – Adult Conscious
Step 3. Give abdominal thrusts
Step 4. Repeat abdominal thrusts
See page 14, ACT Student Manual

37. See page 15, ACT Student Manual
RESUSCITATE
Choking – If the Choking Person Becomes Unconscious
Step 1. Call 9-1-1
Step 2. Open the mouth and look for the obstruction
See page 15, ACT Student Manual

38. See page 15, ACT Student Manual
RESUSCITATE
Choking – If the Choking Person Becomes Unconscious
Step 3. Open the airway
Step 4. Try to give a breath
See page 15, ACT Student Manual

39. See page 15, ACT Student Manual
RESUSCITATE
Choking – If the Choking Person Becomes Unconscious
Step 5. If the chest does not rise, landmark and give 30 chest compressions
See page 15, ACT Student Manual

40. See page 15, ACT Student Manual
RESUSCITATE
Choking – If the Choking Person Becomes Unconscious
Step 6. Open the mouth and look for the obstruction
Step 7. Repeat sequence of chest compressions
See page 15, ACT Student Manual

41. See page 15-16 ACT Student Manual
RESUSCITATE
Choking – Adult Found Unconscious
Step 1. Check for hazards
Step 2. Assess responsiveness
Step 3. Call 9-1-1
See page ACT Student Manual

42. See page 16, ACT Student Manual
RESUSCITATE
Choking – Adult Found Unconscious
Step 4. Landmark and give 30 chest compressions
Step 5. Open the airway
See page 16, ACT Student Manual

43. See page 16, ACT Student Manual
RESUSCITATE
Choking – Adult Found Unconscious
Step 6. Try to give a breath
Step 7. Open the mouth and look for the obstruction
See page 16, ACT Student Manual

44. See page 16, ACT Student Manual
RESUSCITATE
Choking – Adult Found Unconscious
Step 8. Repeat sequence of chest compressions
Recovery Position:
See page 16, ACT Student Manual

45. ACT Manual Using the ACT Manual: Describe 2 types of choking. (p. 14)
Describe signs and symptoms of mild choking. (p. 14)
Describe signs and symptoms of severe choking (p. 14)
Know the universal sign for choking. (p. 14)
Refer to pp for the first aid for conscious severe choking adult and for unconscious severe choking adult.
Demo and/or DVD#3 & DVD#6

46. Airway Emergencies – Summary Questions
How would you recognize that someone is choking?
What are the first aid steps for mild choking?
What are the first aid steps for conscious severe choking?
What are the first aid steps for someone who is choking and becomes unconscious? ...you will need to be able to show this skill!

47. DVD’s & Practice: DVD 3 – Conscious Choking Adult
DVD 6 – Unconscious Choking Adult
Practice Time!
Pair up and practice conscious and unconscious choking first aid!

48. Reminder Tips! Ask the person if he/she is choking.
Be prepared for the person to become unconscious.
With an adult, when the first breath does not go in, tilt the head back further.
Check in the mouth for objects after using chest compressions to unblock the airway and BEFORE trying to give rescue breaths again.
Keep the jaw open with one hand while removing the object with the other hand. (tongue-jaw grab)
Go back to the ABC’s every time the situation changes.

49. Day 3
Circulation
Emergencies

50. No Oxygen: Brain Cells Die
Without oxygen, brain cells begin to die in 4 to 6 minutes.
0 minute: Breathing stops. Heart will soon stop beating. Clinical death.
4-6 minutes: Brain damage possible.
6-10 minutes: Brain damage likely.
10+ minutes: Irreversible brain damage certain. Biological death.
Doing CPR “resets” the clock.

51. Anatomy and Physiology
To upper body
Aorta
To lung
To lung
From lung
From lung
Right atrium
Left atrium
Right ventricle
Left ventricle
From lower body
To lower body

52. Chest Pain
Angina
A blockage that opens up after a little bit and the pain goes away (temporarily).
Heart attack
An artery that STAYS blocked, the pain remains, and the area of affected heart muscle starts to die.
(aka – myocardial infarction)
Partial blockage

53. Risk Factors for Developing Cardiovascular Disease
Controllable factors:
Major:
Smoking
Poor diet (cholesterol: HDL/LDL)
High blood pressure
Diabetes (*)
Minor
Obesity
Lack of regular exercise
Stress
Other factors:
Gender
Heredity
Age
(Can’t do anything to change these ones!)

54. See page 6, ACT Student Manual
RISK FACTORS
Smoking
Leading cause of heart disease in Canada
Causes lung cancer
Second-hand air pollution
Stinky breath
Copyright © Province of British Columbia. All rights reserved. Reprinted with permission of the Province of British Columbia.
See page 6, ACT Student Manual

55. RISK FACTORS Anatomy of a Cigarette
Image courtesy of Thompson Educational Publishing, Inc.

56. High Blood Cholesterol See page 6, ACT Student Manual
RISK FACTORS
High Blood Cholesterol
Too much cholesterol can cause
heart disease or stroke
Means lots of fat in the blood
Some fat is produced by the body;
other fat comes from food
What you can do: Eat vegetables, fruits & grain products; reduce fat in diet; exercise
See page 6, ACT Student Manual

57. See page 6, ACT Student Manual
RISK FACTORS
High Blood Pressure
Can damage your heart and blood vessels
Increases chances of a heart attack or stroke
Heart has to work harder
Some causes: hereditary, diet, stress
Blood pressure cuff
Get it checked regularly
See page 6, ACT Student Manual

58. See page 6, ACT Student Manual
RISK FACTORS
Diabetes
Affects the level of sugar and fat in your blood
Eat properly, follow doctor’s instructions
See page 6, ACT Student Manual

59. Obesity and Lack of Exercise See page 6-7, ACT Student Manual
RISK FACTORS
Obesity and Lack of Exercise
Obesity: Heart has to pump harder all the time to move blood around
Exercise: Your heart is a muscle - it works better if you keep fit & active
See page 6-7, ACT Student Manual

60. See page 7, ACT Student Manual
RISK FACTORS
Stress
Affects the body in very physical ways
Stress over a long period of time can cause body to break down
Heart problems may result
See page 7, ACT Student Manual

61. Signs and Symptoms of Heart Attack and Angina
Squeezing chest pain
Problems breathing
Abdominal or back pain (most commonly in women)
Cold, sweaty skin
Skin that is bluish or paler than normal
Nausea and vomiting
Denial
Signs and symptoms vary from person to person.

62. 5P’s
Pain
Pale
Puking
Puffing
Pooped

63. First Aid – Heart Attack and Angina
Have the person rest.
Ask if they have taken any erectile dysfunction drugs. If they have, do not allow them to take nitroglycerin.
Help the person take their nitroglycerin and ASA.
Take one dose every 5 minutes (3 doses maximum).
If they don’t carry nitroglycerin, or if the first dose doesn’t make the pain go away, suggest they chew two 80 mg ASA tablets or one 325 mg ASA tablet.

64. Cardiac Arrest Cardiac arrest occurs when the heart stops beating.
Causes:
Cardiovascular disease
Drowning
Suffocation
Certain drugs
Severe chest injuries
Severe blood loss
Electrocution

65. Cardiopulmonary Resuscitation (CPR) and Automated External Defibrillation (AED)
Clinical death occurs when the heart stops. It is reversible.
CPR keeps oxygen-rich blood circulating throughout the body.
AED can deliver a shock to re-establish an effective rhythm. Quick defibrillation greatly increases chances of survival.

66. See page 10, ACT Student Manual
RESUSCITATE
As simple as CAB-D!
Compressions
Airway
Breathing
Defibrillation
See page 10, ACT Student Manual

67. See page 11, ACT Student Manual
RESUSCITATE
One Rescuer CPR – Adult
Step 1. Check for hazards
Step 2. Assess responsiveness
Step 3. Call & retrieve defibrillator ASAP
See page 11, ACT Student Manual

68. See page 11, ACT Student Manual
RESUSCITATE
One Rescuer CPR – Adult
Step 4. Landmark for chest compressions
Step 5. Give 30 compressions
See page 11, ACT Student Manual

69. See page 12, ACT Student Manual
RESUSCITATE
One Rescuer CPR – Adult
Step 6. Open the airway
See page 12, ACT Student Manual

70. See page 12, ACT Student Manual
RESUSCITATE
One Rescuer CPR – Adult
Step 7. Give 2 breaths if the person is not breathing normally
See page 12, ACT Student Manual

71. Rock ‘em till someone can See page 12, ACT Student Manual
RESUSCITATE
Remember:
30 and 2
is what you do.
Rock ‘em till someone can
SHOCK ‘EM…!
See page 12, ACT Student Manual

72. DVD
DVD #9
-CPR technique

73. Early AED
Survival rate decreases 7% to 10% with each minute there is a delay
Defibrillation combined with CPR, is the key treatment in more than 80% of all sudden cardiac arrest victims
For unwitnessed arrest:
2 minutes of CPR can increase chances of the AED detecting a shockable rhythm
…more on AEDs later!

74. Stroke
A stroke happens when the blood flow to the brain gets interrupted
Causes:
A clot in an artery to the brain
An artery that ruptures in the brain
A tumour

75. See page 8, ACT Student Manual
Suspect a STRoke? Try asking: Can you …
Talk in a simple sentence?
Smile?
Raise both arms?
RECOGNIZE
Signals of a Stroke
Sudden paralysis of the face, arm or leg
Sudden speech problems
Weakness, numbness,
or tingling in the face, arm or leg
Sudden headache or dizziness
See page 8, ACT Student Manual

76. Signs and Symptoms of Transient Ischemic Attacks and Stroke
F - Face
A - Arm
S - Speech
T - Time
First Aid:
Call EMS/9-1-1
Have the person rest
Place the person in the recovery position with the affected side up
Monitor CABs and provide reassurance

77. Circulation Emergencies – Summary Questions
List the risk factors for developing cardiovascular disease.
What is the first aid for someone complaining of chest pain?
When do you do CPR?
What are the signs and symptoms of a stroke?
What is the first aid for a suspected stroke?
(REVIEW - refer to pp. 4-7 in the ACT Manual)

78. Automated External Defibrillator
Day 4
Cardiac Arrest
&
Automated External Defibrillator
(AED)…or (PAD)

79. Small Change…CABD! Circulation Airway Breathing DEFIBRILLATION!
What’s a defibrillator?

80. Chase McEachern Act
In addition to Ontario’s Good Samaritan Act, there is also now liability protection for people using public automated external defibrillators (AEDs). The Chase McEachern Act came into force on July 3, 2007 and is named after 11 year old Barrie resident Chase McEachern.
After being diagnosed with an irregular heartbeat, and hearing that two professional hockey players also have irregular heart beats like his, Chase decided to start a campaign to make defibrillators mandatory in hockey arenas and schools everywhere.
In February 2006, Chase passed out in gym class and was rushed to the hospital. Efforts to resuscitate him failed. The McEachern family created a tribute fund in honour of their son. A donor made a $100,000 gift to the fund with the condition it be used to put defibrillators in arenas in Grey and Bruce counties.
The Chase McEachern Act protects individuals and health care professionals from liability for damages that may occur in relation to their use of an AED to save someone’s life at the immediate scene of an emergency. It also protects the owners and occupiers of the buildings where AEDs are installed from liability that may occur in relation to the use of the AED provided that the owner or occupier of the building made the AED available for use in good faith.

81. Using an AED When using an AED: Turn on the machine
Follow the diagrams to place the pads
Use the age appropriate pads
Follow the voice prompts!
No one touch the person.
When shocking, state, “I’m clear, you’re clear, everybody’s clear.”

82. Reference to Page #41-42 of FA/CPR/AED Manual
RESUSCITATE
Reference to Page # of FA/CPR/AED Manual
How the AED Works
Ventricular Fibrillation
Shock Delivered
Heart Recovery
Normal Sinus Rhythm
ZAP !!
References:
Ottawa Paramedic Service Online Manual: p 21
Ottawa Paramedic Service Field Guide: p -
How the AED Works: An AED is made up of a computerized microprocessor which interprets (analyzes) the victim's heart rhythm through adhesive electrodes. The computer analyzes the heart rhythm and advises the operator whether a shock is needed. AEDs advise a shock only when the patient’s heart is in ventricular fibrillation (VFib) and fast ventricular tachycardia (VTac). The electric current is delivered through the victim's chest wall through adhesive electrode pads. Extensive clinical experience has revealed that the AED’s are safe, reliable, easy to use and cost effective. Flight attendants, security personnel, police officers, fire fighters, lifeguards, family members and many other laypersons have used AED’s successfully.
Defibrillation: Defibrillation is a delivery of electrical current through the chest wall within 5 to 30 milliseconds for the purpose of terminating VFib and VTac. The shock depolarizes a large mass of myocardial cells at once. If 75% of these cells are in a resting state after the shock is delivered, it is hoped that the heart’s normal pacemaker may resume discharging and take over the heart beat.
Stored and Delivered Energy: Electrical energy is commonly measured in joules (watt seconds). One joule of electrical energy is the product of one volt (potential) multiplied by one ampere (current) multiplied by one second. Delivered energy is approximately 80% of stored energy because of losses within the circuitry of the defibrillator and the resistance to the flow of current across the chest wall. As a rule, 80% of stored energy approximates the amount of joules delivered to the patient. The Zoll AED Plus+ is configured to deliver 120 J per shock.
Check with the defibrillator that you will be using for more information. A manual of the AED used with this program is in the appendix.
In Ventricular Fibrillation heart muscles become all “squirmy”
... they don’t pump blood properly
The AED recognizes that and shocks the heart
... often that fixes the problem 82

83. RESUSCITATE When should I use an AED? If a person is … Unresponsive
Not breathing
Appears to be 8+ years or 55+ lbs (25+ kg)

84. See page 13, ACT Student Manual
RESUSCITATE
How to use an AED
Continue CPR until someone brings you the AED
Place the AED right beside you
Turn on AED
Make sure someone continues CPR while you follow AED prompts
Emphasize the pad placement (refer to the graphic at right).
See page 13, ACT Student Manual

85. See page 13, ACT Student Manual
RESUSCITATE
How to use an AED
Once pads are properly applied, AED will tell you to stop CPR and not touch the patient
It will start “analyzing heart rhythm” to see if it needs to shock the person
If it sees a shockable rhythm, the AED will tell you: “shock advised”
Emphasize the following teaching points:
Analyzes a person’s heart rhythm through special pads that you stick onto the chest.
If it finds a “shockable” rhythm, it will tell you to press the shock button.
If it does not find a “shockable” rhythm (e.g. the person’s heart is beating normally, or is in another rhythm), it will prompt you to do CPR.
Meant for public use - designed not to let you shock someone who doesn’t need it.
See page 13, ACT Student Manual

86. A Properly Prepared AED Should ALSO Have:
Razor
Scissors
Cloth

87. DVD
DVD #9
– Review Check, Call, Care, CPR & AED
Demonstrate AED

88. Practice Time! Work in groups of 3 to practice with the AED.
Be able to:
-describe special considerations with the AED, particularly safety considerations!
-describe adjuncts used with the AED
(pocket mask, scissors, towel, razor)

89. Day 5
Practical
&
Written Testing