David Patrick

Professor Sheffield
Technical Writing
9/21/19
Module 2 Project: Contrasting Instructions

Audience Needs Assessment

Scenario 1: I am head of the Health and Wellness Center at the University of New Haven. I was
asked to create an easy to understand set of instructions that can be easily accessible for how to
recognize a patient in cardiac arrest and how to begin cardiopulmonary resuscitation (CPR). The
primary reason for this set of instructions is to be placed throughout residence halls in common
rooms in the event someone goes unresponsive. I want to teach them how to recognize a patient
in cardiac arrest. If they are determined to be in cardiac arrest, I would like for them to know
what to do next. I would like there to be an introduction indicating when this is appropriate and
the potential results of their actions to ensure the instructions are completed fully. Many college
kids will be hesitant to follow proper protocol because they do not want to get in trouble. These
instructions will need to be concise, quick, and clear, as this is likely an urgent issue at hand. At
the same time, the instructions must be well detailed to ensure that proper CPR is done to
potentially save a life. Photos will be very helpful to the students throughout the instructions.
Medical terminology will be confusing and not useful for the user. A safety warning should also
be issued if there is an automated defibrillator nearby, as there is potential for injury if not used
properly. The user will likely skim the document, so it will be beneficial to have the most crucial
sections and steps outlined or bolded.
Scenario 2: I am the head nurse at a hospital. I was instructed to create a set of instructions to be
placed in each room for healthcare professionals to use when a patient is found to be
unresponsive in their bed. For this, my audience will be a group of registered nurses who are all
qualified health care professionals. They are proficient in medicine and are understanding of
most medical terminology, though potentially not very advanced terminology that physicians
may use. I want the instructions to be easy to read in high-stress situations and I would like them
to be completed quickly to ensure the highest patient care. I would like there to be a brief
introduction to include when to follow this procedure and how long our goal is to have the
procedure completed. These instructions will be sent out to all staff members within the hospital,
so they can be reviewed prior to the high-stress event. I would like for these instructions to be
easily memorized in the event of an unresponsive patient. Obviously, the personnel using this list
of instructions will be healthcare professionals (nurses, doctors, etc.) so some may already know
the procedure for this. A safety warning should be issued to warn the healthcare professionals of
the potential injuries that can occur if medical equipment is used wrong. However, in an ever-
changing medical field, there are always changing procedures. It is crucial for me to make note
of important techniques in these instructions that may have changed from what was originally
taught to the respective professional. In this scenario, medical terminology will be acceptable.
Additionally, different devices may be available in a hospital that are not found in other
locations, so we can take advantage of such devices.
Scenario 1 Instructions

How to Respond to an Unresponsive Student

These instructions can be used if you find a friend or another

student to be unresponsive. Proper use of these instructions can
result in the saving of a life. If this scenario arises, please follow
these instructions to ensure the safety of your peer and/or friend. In
these instructions, you will learn how to determine if someone is in
cardiac arrest and if so, how to perform cardiopulmonary
resuscitation (CPR) until Emergency Medical Services (EMS)
arrive. You will not get in trouble for doing the right thing. If an
Automated External Defibrillator (AED) is available, instruct a
peer to retrieve it. In the event an AED is available, please use
caution and follow all instructions for this device, as there is a risk
for harm and potentially death. These instructions should take
roughly twenty minutes to complete or until EMS arrives.

Assessing the Patient

1. Call 911 and alert them of the issue.

2. If the student is not lying flat on the floor or a hard surface, move

them to one.

3. Attempt to arouse the student.

a. Make a closed fist and press your knuckles into the middle of

the chest of the unresponsive student.

 b. At the same time, make noise to awaken the student. If the

student makes a noise, moves, or opens their eyes, they are

not in cardiac arrest. Wait for EMS arrival.

4. Tilt their head back to ensure their airway is open.

5. Determine if the student is breathing.

a. Observe the student and see if their chest is rising and falling.

If it is, they are not in cardiac arrest. Wait for EMS arrival.

b. At the same time, place your ear close to their mouth to listen

for a breath. If you hear a voice, they are not in cardiac

arrest.

TIP: Be sure to listen for at least thirty seconds, as the

student may not be breathing fast and it may be difficult

to hear.
6. Stick out your pointer and middle finger and place them on the

neck of the student, directly under the curve of their jaw bone.

a. Press in to feel for a pulse. Be sure to not press too hard,

stopping blood flow. If a pulse is felt, the student is not in

cardiac arrest.
 7. If the student is not arousable, not breathing, and without a pulse,

begin cardiopulmonary resuscitation (CPR)

Performing CPR

8. To begin CPR, get on your knees beside the student.

a. Place the heel (bottom) of one hand onto the middle of the

student’s chest.

b. Place your other hand over the first and interlock your

fingers. Position yourself over the student.

c. Push down hard and fast 2 inches into the chest.

TIP: Keep your elbows locked and use your whole body.
 9. After each compression, lift your hands slightly off the chest to

ensure that the chest completely recoils.

10. Continue CPR at a pace of 100 beats per minute until EMS

re arrives.

a. If an AED is available, have a peer go and retrieve it.

b. Begin having your peer set the AED up on the student while

CPR is continued. Be sure to follow all AED instructions

explicitly to avoid additional injury.

c. Have another bystander begin CPR when you get tired or

after two minutes.

TIP: Use the song “Stayin’ Alive” by the Bee Gees to ensure you

are doing CPR at an adequate pace.

WARNING: An AED is a device that has the potential to deliver a
high-powered shock, potentially causing injury or death to those who are
not intended to receive the shock.

Once EMS has arrived on scene, your job is done. You have
successfully performed CPR and done all that you can to help the
student. It is best now to take a deep breath and relax, as performing
CPR can be traumatizing.

Scenario 2 Instructions

Protocol for Unresponsive Patients

This set of instructions outlines the protocol to be followed in the

event that a patient is found unresponsive. Please ensure that
completion of this protocol is performed by medical staff only and
not family or bystanders who may be in the room. It is best for
family to leave the room during a medical emergency. These
instructions will ensure that no steps are missed and that medical
professionals are following up to date protocol. It is assumed for
these instructions that multiple healthcare professionals will be
 available in the room immediately. If not, the #1 priority is CPR.
Medical devices utilized throughout these instructions can cause
harm to the user if used improperly. Please follow the safety
warning issued by each individual device. As a hospital, we would
like this protocol to be completed within five minutes of the patient
being found unresponsive, or until the physician has entered the
room to determine further treatment.

1. Determine the status of the patient.

a. Check to see if the patient is in cardiac arrest. If so, call a

code blue.

b. If the patient is found to be unresponsive but is breathing

with a pulse, call the rapid response team to evaluate the

patient.

2. Tilt the patient’s head back to ensure the airway is open.

3. Lay the patient down flat and place a backboard under the patient

to ensure adequate CPR.

4. Begin CPR at a rate of 100 beats per minute.

5. Place the patient on oxygen.

a. Give the patient ventilation via bag valve mask every five

seconds, or twelve per minute.

 Note: Ensure that a proper seal is created around the patient’s

mouth. Proper ventilation should result in chest rise and fall from

the patient.

6. After two minutes of CPR, pause CPR to do a pulse check. If the

patient remains pulseless, continue CPR.

Note: Every two minutes, switch who is doing CPR to ensure

proper technique and reduce fatigue.

7. Attach the defibrillator to the patient for use if indicated.

8. If not already placed, insert an IV into the patient to administer the

necessary medications ordered by the physician in the room.

9. Continue CPR until the physician has arrived at the room.

10. Upon arrival of the physician, give them a brief report on the to

patient.

a. This report should include the patient’s medical diagnosis,

are known down time, and any medications given.

At the time of physician arrival, allow them to take over. Be sure to

document the event properly. It is crucial that all medical equipment
used during this event is replaced for future events. After completion of
the event, revaluate your other patients.
Reflection:
I found the both the class readings and lessons to be very beneficial as a tool to help me
write effective instructions. I found that consulting the readings after each completed section of
the instructions gave me new ideas and new things to add to improve my instructions. When
drafting a title for each set of instructions, I wanted to keep it broad and simple. As a student,
they may not have knowledge on what cardiac arrest is. I made my first title “How to Respond
to an Unresponsive Patient” for scenario one. I felt that this title was simple and clear, but
effective. I wanted to avoid using gerund and difficult to read titles in this scenario. In scenario
two, I created the title “Protocol for Unresponsive Patients”. Though I still kept my overall
purpose somewhat broad, I made the title more formal for a hospital setting and I made it more
concise, eliminating unnecessary words.
I leaned very heavily on the book for the introduction to each set of instructions. The
book outlines multiple questions that you want to have answered in the introduction. Although
users in each scenario are likely going to skip over this introduction in an emergency, there will
be times that they are around the instructions and could potentially read it. I felt it was important
to have the important information outlined in this introduction so that the users could read it
when they are not in an emergency. When writing the introduction for both scenarios, I wanted
to mention the potential safety hazards of using an AED and other medical equipment. Because
these instructions were not being placed directly alongside one of these medical devices, I did
not feel the need to mention any additional safety issues, as they would have been outlines on
that specific medical device. I felt it was important to outline the purpose of these instructions in
scenario one, as sometimes students may not realize how much is at stake. Additionally, I wanted
to explicitly state in scenario one that they would not get in trouble if they were drinking or
doing drugs. Often times, students will not do anything to help a peer because they do not want
to get in trouble themselves, so this was important. I decided to bold this so that it stood out even
if the user was skimming the instructions.
When drafting the instructions, I tried my best to present the right amount of information
in each step. In scenario one, many actions needed additional information, so I took advantage of
using two level numbering. For example, in scenario one, I needed to outline the proper way to
initiate and perform CPR in multiple steps. In scenario two, I was able to simply state “Begin
CPR at 100 beats per minute”.
I tried my best to bold important things throughout the directions, and I highlighted even
more important things. I used this technique to help the user and to ensure that if anything was
read, these bolded points were known. I made a point to make the titles of each scenario red, as
red is often a symbol of both medicine and urgency. I chose to use a medium sized font that I
thought would be easy to read for the user in each scenario. I was tempted to increase the font of
steps that I found to be more substantial, but this created a poor appearance for the instructions
that I did not like. Throughout the scenarios, I tried to make use of notes. I often found that there
was information I wanted to include for the user, but it did not necessarily fit as a step. I placed
these as notes or tips, and bolded them for easy reading. Some of these notes were feedback
statements that I used. For example, I added a feedback statement in scenario two that was
“Proper ventilation should result in chest rise and fall from the patient”. In scenario one, there
were not many spots that feedback statements could be used. However, I offered feedback about
what a result meant, such as “If the student makes a noise, moves, or opens their eyes, they are
not in cardiac arrest”. I believe that these statements will be useful for a student during this
event.
As mentioned in the book, I found the graphics to be very helpful in allowing me to show
proper technique. In scenario one, I included images in steps that I thought would be difficult for
the average person, such as knowing where to place your hands for CPR or how to feel for a
pulse in the neck. I did not find any areas in scenario two that I thought would benefit from an
image, as most healthcare professionals are familiar with the medical devices used and know
how to perform basic life support. In each scenario, I chose to increase the spacing for the actual
instructions to create a more open design that would be easier to read.
I tried my best to ensure each set of instructions was tailored to the proper audience. In
scenario one, I often used the term “student” as opposed to the term “patient”. I felt that by
labelling the person who is unresponsive a student, this made the instructions more personal and
tailored to the user. In scenario one, I tried to use minimal medical terminology. Any difficult
terms that the user may not know was explained or accompanied by a graphic. In scenario two, I
used the term “patient” to maintain the formal construct of the instructions. I avoided using
medical terminology in scenario one. In scenario two, I was able to use more medical
terminology, such as “defibrillator” and “IV”, which the average student may not know of.
For the conclusions, I tried to keep them simple. I followed the book and instructed the
user on completion of the task and what the next steps were. Due to the type of instructions, there
was not much need for troubleshooting or maintenance.
 Throughout both sets of instructions, I tried my best to ensure I was using an active voice.
As mentioned in our book, it is crucial to use an active voice for instructions. I wanted to make
sure that I was emphasizing the task that the subject was performing.
Through completion of the instructions in scenario one, I am confident that an
unknowledgeable bystander could perform adequate CPR to save someone’s life. I believe that
the protocol outlined the instructions in scenario two will allow better patient care to be achieved
and will help healthcare professionals during this high-stress event.