First Aid/CPR AED Instructor Transition Course ECO
Course #21799
Statement of Purpose:
This course is a re-certification course that First Aid/CPR/AED instructors are required to complete once every two years to maintain certification as an instructor. This course provides instructors with any applicable updates to the First Aid curriculum and Title 22 policy changes. Students completing this course will be provided with the necessary curriculum updates to pass on to their respective work units.
Review of First Aid/CPR/AED Course content
Title 22
April 2015 changes
Department policy
8-hour First Aid/CPR update class every two years
Required topics
Role of the public safety-first aid provider
CPR and AED for adults, children, and infants
AED troubleshooting
Recognition and identification of adult and pediatric patients for both medical and traumatic emergencies
Medical emergencies
Facial injuries
Environmental emergencies
Bites and stings
Poisoning
Identify signs and symptoms of psychological emergencies
Patient movement
Tactical and rescue first aid principles applied to violent circumstances
Orientation to the EMS system
Trauma emergencies
Legal issues
Safety protocols
Integration with EMS to include Criminal Mass Casualty Incident
Components of EMS
Dispatcher, 911
First Responder
Emergency Medical Technician (EMT-B)
Paramedic (EMT-P)
Receiving Facility (Hospital)
EMT-B and Paramedics may be part of response team
Law enforcement will provide security for fire department response team
Law enforcement may assist with triage
Self-care and partner care while awaiting EMS
Use your equipment on yourself and your partners' equipment on them
Minimum equipment for first aid kits
Personal protective equipment
Gloves
CPR mask or barrier device
Trauma equipment
Tourniquets
Trauma dressings
Identify signs and symptoms of psychological emergencies
Pre-existing conditions
Mental illness
May mirror shock symptoms
Developmental disabilities
Certain conditions like Down syndrome are more susceptible to positional asphyxiation
Tactical casualty care principles
Active Shooter
Tactical rescue and First aid considerations
Movement to threat vs casualty care
Life safety and neutralizing the threat is a priority
Rescue teams and triage
Integration with EMS
Rescue teams may include fire and ambulance personnel
Tactical Emergency Care Concepts
Threat suppression
Hemorrhage control
Rapid extraction
Assessment by medical
Transport
Self-aid and buddy aid
Hemostatic dressings, wound packing, and chest seals
Hemostatic dressing
Types of Hemostatic Dressings
Granular type (Not used)
Sponge (Granular in mesh pouch)
Impregnated Gauze
Rolled
“Z-Fold”
4x4 pads
Trauma pads
State-Approved Hemostatic Dressings (check for current changes)
Quick Clot®, Z-medica®
Quick Clot Combat gauze®
Quick Clot EMS rolled gauze, 4x4 dressing, trauma pad®
Celox®
Celox® Gauze, Z fold Hemostatic Gauze
Celox® Rapid, Hemostatic Z-fold Gauze
Indications (When to use it)
Severe Hemorrhage
Area not allowing proper use of a tourniquet (i.e.: Shoulder, upper femoral
Major open wound
Contraindications (When not to use it)
Thoracic cavity
Abdominal cavity
Pelvic region closest to reproductive organs
Cranial cavity/skull
If seal had been previously broken
Eyes
Wound Packing
Filling the void of the wound to create surface area to apply direct pressure
Start on the side of the bleed
Preferably using hemostatic-impregnated gauze
Regular gauze will work as well
Once filled or packed, place pressure over the packing to slow or stop the bleeding
Do not pack wounds when associated with the following areas
Thoracic cavity
Abdominal cavity
Pelvic cavity area near reproductive and urinary systems
Four P’s of wound packing
Peel gauze off the roll
Push gauze into the wound against the bleeding vessel
Pile gauze above the level of the skin
Pressure dressing over the top of the wound
Making a simple wound-packing practice arm
Why a practice tool is necessary
How it helps students
Lifts and carries
Fireman’s carry
Two man carry
Fore and aft
Side by side
Shoulder or belt
Shoulder drag
Use of soft litters
CPR/BLS for Healthcare Providers
CPR based on the 2015 American Heart Association BLS for Health Care workers
Chain of survival
Recognize cardiac emergency
Activation of EMS
Early use of CPR
Rapid Defibrillation
Effective Advanced Life support
Post Cardiac arrest care
No reassessment
Continue until advanced medical aid arrives and relieves you
Until true signs of life
Watch for agonal gasps and spasms
“Recoil” of the heart during compressions
Allow full fill of heart chambers for maximum efficiency
Airway protective barriers
Mouth to mouth
Mouth to mask (one-way valve)
Bag valve mask
Recommended for two or more rescuers
Two-hand technique
Slow squeeze vs speed and volume
One rescuer and two-rescuer CPR
One rescuer
30-2
Two rescuer
Airway is held open during compressions
Infant and Child Changes
15-2
Increases respiratory input to match higher respiratory rates
Second rescuer should always begin chest compressions
Stronger and most effective
Adult
Child
Infant
Differences in Child and Infant
Witness vs unwitnessed
Two rescuer considerations
Infant check for response and Pulse check at the brachial artery
Airway obstructions
Adult
Conscious
Unconscious
Child
Considerations in size
Infant
5 back slaps to 5 chest compressions
Gravity to rescuer advantage
Breathing difficulties including asthma and COPD
Assisting with Albuterol inhalers
Cannot administer an inhaler
COPD have the patient sit up to ease breathing
Assisted Naloxone
Narcotic antagonist in case of overdose
Nasal spray
Auto-injector
Officer may assist per Title 22
Officer may administer if approved by the local EMSA director
May result in an immediate violent reaction
Dental emergencies
Maintain airway
If the airway obstructed consider the nasal airway
Must be approved by local EMSA director
Transport tooth in moist dressing for possible reinsertion
Prevent contamination
Drowning
Environmental hazards
Rescue could be dangerous in open water
Assess to determine need for CPR or rescue breathing
May have to drain fluid from airway first
Assisted administration of Epinephrine auto-injector and accessing EMS
Must be approved by local EMSA director to administer
Agency head must request permission from EMSA director to conduct training and administer
Must be prescribed to the patient and not expired
If not approved by medical director can only assist
Must still be prescribed to the patient and not expired
Exposure to CBRN
Chemical
Remove from contaminated area
If dry chemical brush chemical off first before decon
Remove clothing
Flush the area with water
Biological
Symptoms will be delayed
Send patients to one hospital to avoid contaminating multiple locations
Radiological
Remove from contaminated area
Utilize time, distance, and shielding
Treat as thermal burn for skin burns
Nuclear
Remove from contaminated area
Treat as a radiological burn
Large contaminated area
Written and/or oral assessment of cognitive skills
First aid scenarios
Students will be assigned one of the following scenarios
Stab wound
Skin exposure to toxic industrial chemical
Allergic reaction with anaphylaxis
Child in the pool for an unknown period of time
Students will have 10 minutes in groups to explain how they would handle the situation
Demonstration of Technical Skills Competency
CPR skills demonstration
Adult CPR and rescue breathing
One-person adult CPR
Two-person adult CPR
Adult rescue breathing
Two-person adult CPR with AED
Child CPR
One-person child CPR
Two-person child CPR
Child rescue breathing
Two-person child CPR with AED
Infant CPR
One-person infant CPR
Two-person infant CPR
Infant rescue breathing
Two-person infant CPR with AED
First aid skills demonstration
Apply a tourniquet
Apply a tourniquet to partner
Apply a tourniquet to self
Wound packing Demonstration
Use gauze to pack wound on dummy
PPE
Glove removal