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

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

3. Preparing to Respond
What would you do?

4. 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

5. 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

6. 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

7. 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

8. 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.

9. 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

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

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

12. Preparing to Respond – Summary Questions
List three examples of a medical emergency.
Good job!
How can a disease be transmitted in first aid?
Direct, indirect, airborne, or vector transmission
How can disease transmission be prevented in first aid?
Personal precautions, protective equipment, environmental precautions
Can you be sued for doing first aid?
Nope! (Good Samaritan Act, 2001)

13. Preparing to Respond – Scenario Review
So, what would you do?

14. Check, Call, Care – Be Systematic

15. 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?

16. 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

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

18. Care Determine care required: check ABCs (on next slide)
Treat life-threatening emergencies immediately

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

20. Secondary Survey: Are there any other injuries?
Only do a secondary survey if the ABCs are okay.
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.

21. 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

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

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

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

25. 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.
Signs & Symptoms: 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
Treat everybody for shock.

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

27. 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

28. 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 (ABCs)
Secondary Survey
Perform a secondary survey and treat any non-life-threatening injuries
Continual Care
Keep the person comfortable and monitor vital signs

29. Check, Call, Care – Summary Questions
What should you do during the “Check”?
Check the scene, check the person
What actions must you take in “Call”?
Call 9-1-1
What actions must you take in “Care”?
Check ABCs, treat life-threatening emergencies immediately, follow with secondary survey
What do you do during the secondary survey?
Ask SAMPLE questions, check vital signs, head-to-toe check
What should you look for in a head-to-toe check?
Bumps, bruises, blood, etc.
***PRACTICE THE RECOVERY POSITION!

30. Check, Call, Care – Scenario Review
So, what would you do?

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 Emergencies
What would you do?

34. 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

35. 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
Signs & Symptoms:
If the person can speak, cough, or breathe, it is mild choking.

36. Recognizing and Treating Choking
Complete the following:
Demonstrate the universal sign for choking.
hands to the throat
Name the 2 types of choking.
mild and severe
Describe signs and symptoms of each type of choking.
Mild: Person can still speak, cough, or breathe.
Treatment: Encourage the person to keep coughing!
Severe: No air getting in (can’t speak, cough, or breathe).
Treatment: Act quickly with first aid for conscious or unconscious choking…
DVD#3 & DVD#6

37. 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!

38. Airway Emergencies – Summary Questions
How would you recognize that someone is choking?
Universal sign, coughing, wheezing, turning blue
What are the first aid steps for mild choking?
Encourage the person to cough it up
What are the first aid steps for conscious severe choking?
Perform 5 firm back blows followed by 5 abdominal thrusts (fist just above belly button, other hand over fist, pull sharply in and up). Repeat this process…
What are the first aid steps for someone who is choking and becomes unconscious? ...you will need to be able to show this skill!
Go through Check, Call, Care for unconscious choking adult

39. Breathing Emergencies
What would you do?

40. 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.

41. Day 3
Circulation
Emergencies

42. 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.

43. 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

44. 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

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

46. 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.

47. 5P’s (Symptoms of Heart Attack/Angina)
Pain
Pale
Puking
Puffing
Pooped

48. 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.

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

50. 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.

51. DVD
DVD #9
-CPR technique

52. 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

53. Signs and Symptoms of Transient Ischemic Attacks and Stroke
F – Face (numb/weak, especially on one side)
A – Arm (numb/weak, especially on one side)
S – Speech (slurred, or difficulty speaking)
T – Time (is important; call immediately!)
First Aid:
Call 9-1-1
Have the person rest
Place the person in the recovery position with the affected side up
Monitor ABCs and provide reassurance

54. Circulation Emergencies – Summary Questions
List the risk factors for developing cardiovascular disease.
Smoking, diet, high blood pressure, diabetes, obesity, stress, lack of exercise, gender, heredity, age
What is the first aid for someone complaining of chest pain?
Rest, ask about erectile dysfunction drugs, help them take nitroglycerin and/or ASA
When do you do CPR?
When the ABC’s are not present

55. Circulation Emergencies – Summary Questions
What are the signs and symptoms of a stroke?
F.A.S.T. – Face, Arm, Speech (and Time is important!)
What is the first aid for a suspected stroke?
9-1-1, rest, recovery position, monitor ABCs and provide reassurance

56. Circulation Emergencies – Scenario Review
So, what would you do?

57. Automated External Defibrillator
Day 4
Cardiac Arrest
&
Automated External Defibrillator
(AED)

58. Small Change…ABCD! Airway Breathing Circulation DEFIBRILLATION!
What’s a defibrillator?

59. 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.

60. Chase McEachern Act

61. Chase McEachern Act

62. 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 cardiac arrest victims:
2 minutes of CPR can increase chances of the AED detecting a shockable rhythm

63. 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.”

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

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

66. 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)

67. Day 5
Practical
&
Written Testing