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3 min Introduction and welcome Thank you for coming today and welcome to Canadian Red Cross First Aid White board
Training.

We are going to tell you a little about ourselves and then go

through the agenda.

Introduce John (if appropriate)

Introduce myself

My name is Haifeng Yu. Sounds alien? Okay I will write it here - looks more alien?
Okay don’t worry, forget it. You can call me Frank, it is easy now. Right? Good.
Hello everyone, my name is Frank and I have been in Canada for one year and a
half. Today I am doing my co-teach for my first aid instructor training and I am
pleased to have the opportunity to study first aid with the class together. I wish we
can learn the experience as well as have fun in the following two days.

[Before I came to Canada I have been a medical professional in China for ten
years and I have been training CPR and first aid for China Red Cross and
American Heart Association for more than 5 years. ]

(Introduce the course

This is a two day training. The first day is focused on CPR and the second day is
focused on first aid. Those who come here for CPR only will have a test by the end
of today, and all others will have a test by the end of tomorrow. Those who meets
the skill assessment and successfully passed the exam will get a certificate from
Red Cross and it is good for 3 years.)

2 min Introduce Red Cross Before we start the first aid training, we’d like to introduce the Red Cross. Who are
we? What do we do? Now I am going to play a video. After the video we’ll ask
some questions and those who can’t answer within 3 seconds will fail this course
immediately. No, this is not true. But we do have a short quiz after the video. Now
let’s watch.

12 min Play Red Cross DVD Rec Cross DVD, TV

3 min Alright. Now it is the quiz time. Emblem Quiz Sheets

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Hand out the quiz

Please circle out the emblems that International Red Cross and Red Crescent
Movement uses.

Check answers.

Red Heart and Red Diamond are suits of playing cards, they are definitely not
emblems of us.

The star of David has been proposed by Israel, but it was not approved.

Now I will have another question: What are the fundamental principles of the
international red cross and red crescent movement? The Canadian Red Cross
started in which year?

- wait for answers.

First Aid Manual Page 3
Good. Now let’s open your manual and turn to page 3. There are 7 fundamental
principles of the red cross. You can read and learn more about the red cross Canadian Red Cross - May
organization when you have time. Now let’s move to first aid contents. We’ll 1909
discuss the first aid and the law. Let’s welcome John.

Check, Call Care Hello again everyone. Now we are going to access the emergency and help the Scenario: Electrocution
5 min - Action: Check Safety person. Emergency scene can be chaotic, stressful and you may feel that there are
so many things to do. Then what should you do first? Before we start, I would like
to make a scenario and ask everyone to response to the scene according to your
experience. I would like to know who are here to refresh their first aid training and
who are new to first aid. May I ask those come to learn first aid the first time to
stand at this side and those who are refreshing their skills at this side please?
Thanks.

I need a volunteer and John would you like to be my volunteer? Thanks.

Now I will need all of you to get out the class room and come back one by one.
Just come to the scene and response according to your knowledge and
experience. Don’t worry, you will be fine.

Observe everyone who come to the scene, first time students first.
Ask all first time students to lay down before the refreshing students come in.

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Okay how do you feel?

The most important person in the emergency is yourself. Do not compromise your
own safety to help.

This is the most important message I am trying to send you guys. The first thing is
to ensure the safety.

3 min Now follow me and shout out: No fire, no wire, no glass, no gas, nothing hurts them Write on white board
, nothing hurts me. Check
- the scene
The following exercises will need you to cooperate with a buddy. We have __ boys - the person
and ___ girls can you please pair up please? And now please practice how to (1) responsive ?
enter a scene. Check - environment. (2) get consent
(3) Check ABC
What if the environment is not safe?

Secure - move the patient - standby and seek help - leave the scene

5 min Now the scene is safe. The next step is to check the person.

First, ask the person “are you okay?” use the person’s name if you know it.
If the person do not response to your voice, tap the person on the shoulder.

GET CONSENT BEFORE HELPING

Tell the person:

- who you are
- that you are trained in first aid
- that you are here to help

Ask “can I help”?

If someone is unconscious, or can’t answer (i.e. Choke), you can assume you have
consent to give first aid.
Now if the person is unconscious, check the person’s ABC

A: airway
Anyone can speak or cry has an open airway and has breathing
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If unconscious, we need to open the airway because the tongue will be relaxed and
block the airway, exactly as people snores in sleep.

We will use head tilt chin lift to open the airway. Then we check breathing when ear
close to the person’s mouth, use cheek to feel the breath and watch the check
movement.
[If you are learning CPR for HCP please pay attention, you will learn another
technique at the end of today to open the airway]

Check for 5-10 seconds. If the person has normal breathing, you should be able to
observe at least one breath in 5-10 seconds. You can count “ one one thousand”
that is about the length of one second.

The person can have breath or don’t have breath. Write on white board a
flowchart
Then we need to check circulation. In general we only need to have a very quick
look for deadly bleeding. If there is deadly bleeding it must be controlled as soon as
possible. We’ll learn how later.

Now we have basic information and we need to call for help. Please follow me to
2 min give instructions to bystanders and request a 911 call. Action

You and you!

Call 911!
Get an ambulance,
Report back to me when you are done.
If you see an AED, bring it to me.
Do you understand?
Go!

Why I said “ you and you?” and why I ask “do you understand?”

And when they go to get help, we will go to the next step and start care.

AED is automatic Electric Defibrillator. When this equipment is available the

survival rate is much increased than before. We’ll talk and learn how to use it in the
5 min afternoon.
- no check environment
Now I need a volunteer [GET CONSENT to touch volunteer] - did not ask consent
- slap the face
3 min I will do the check and call part, please say “STOP” if I did anything wrong. - left the scene trying to
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find security, and ask
Now pair up, one is the injured person and the other arrives the scene and start bystanders to wait at scene
from “no fire....”
3 min
Okay now let’s discuss some special situation.
What if you are alone? For adult? For Child? Fir Baby?

Care for all life threatening conditions.

If the patient has no breath we need to start CPR. We’ll learn it after the break.
If the patient has breath but is not responsive, we will need to protect his airway
and wait for ambulance to come.

We can do head tilt chin lift till the EMS person come. That is acceptable.
Or we can put the person to HAINES position.

10 min [Example: how to put an unresponsive person to sitting position]

Request a volunteer
Explain use body to control
Demo and do not push the
person away.
Pair up and practice

5 min Another condition we need to recognize is shock. It can be life threatening.

Now let’s do an exercise before break; squeeze hands with one fist hold up - for 1
min
Compare the two hands - the hand held up is in shock.

Let’s open the manual and turn to page 34. Any one can please read the common Book page 34
causes?

Can you please read the “what to look for section?”

Can you read the “what to do?”

Okay, now let’s look at the white board to review what we just learned. Check, Call
and Care. Any questions? Now let’s have a 10 minutes break.

15min Unconscious Obstructed Airway If the person gets unconscious, we will not have many options and the treatment
will be basically the CPR. Please practice on your mannequin.

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First check environment.

Then check the person’s responsiveness, ABC

Call 911 - remember if you are alone? Practise - adult, child, baby

If you have done all these before - when he was still conscious, then just do the White board
below things

- start chest compressions 30’

- Give one rescue breath just enough to rise the chest. If the air go in, give second
one and go back to compressions.
- if the air did not go in, which is likely in a choking person, and you did not see
chest rise, probably you did not do head tilt and chin lift well. Redo and blow again.
- If this time the air still do not go in, that means maybe something is blocking the
airway. Start 30 chest compressions
- the air went in, give a second breath and if no response, start compression
- After 30 compressions, look in the person’s mouth. Grasp tongue and lower jaw
to lift. If you see object, try remove it
- Give a rescue breath again and loop

This is described on page 51.

When to stop? Discussion White board

- AED arrives 4 situations to stop
- EMS personnel take over
- the scene becomes unsafe
- you are physically exhausted

Any questions?
Okay let’a break for lunch now. After lunch we will come back and continue.

5 min Use of AED This is the AED. There are many different types and manufacturers but they all Page 81
serve the same purpose: they STOP the heart.

This is a training machine and it will not give real electric shock. But the procedure Show AED models
is the same. I will show you how to use this tool. Let’s start from the beginning.
Shout “I am clear, you are
5 min Now let’s pair up, and start practice from entering the scene. One person practice clear, everyone is clear”
and the other brings the AED at the third CPR cycle.

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5 min And switch when you finish 5 cycles

Any questions?
If not I will discuss with you some special conditions:
Person lying in a pool of blood
Hairy chest - razor to shave
Sweaty chest
Nipple rings

Introduce children and baby pads. If there is no children and baby pads, use adult
pads.

10 min Infant mannequin Setup Now let’s clean up the adult mannequins we do not need them for now. Please Baby mannequin
take a baby mannequin and I will tell you how to put the parts together.

15 min Infant CPR and AED

Please notice: (1) don’t blow too much, just see chest rise is enough. (2) use your
mouth to cover both baby nose and mouth. (3) use two fingers to push and push at
least 4 cm, 1.5 inch or 1/3 to 1/2 of chest depth

One hand to head tilt the baby and the other hand use two fingers to press

Let’s practice from the beginning. Please remember to finish 5 rounds of CPR
before take the baby to call 911.
15 min

Check call care

If the baby is coughing or gagging, the choking is mild, do not interfere and
observe. It is likely that the baby can remove the object himself or herself.

If the baby is making high pitch noises, wheezing or can no longer make a sound,
or become too weak to cough, have someone call 911 and get and AED, then care
for baby. Page 49

Sandwich the baby between your forearms, supporting the head

Turn the baby face down with the head lower than the body
Lower your forearm onto your thigh. With the heel of your hand, deliver five firm
back blows between the shoulder blades.

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If the object has not been dislodged, while still supporting the head, turn the baby
face up with your arm supported on your thigh.
Place 2 fingers in the middle of the chest just below nipple line. Push hard push
fast for 5 times using CPR standard. What is the CPR standard? - at least 4 cm or
1.5 inches or 1/3 to 1/2 of the chest depth.

Repeat five back blows and five chest thrusts until the object is coughed up, the
baby starts to cry, breathe, or cough, or unfortunately, the baby becomes
unconscious.

If the object comes out, perform a secondary survey and treat life threatening
conditions, then continue care until EMS personnel come. Can we dismiss the
EMS and get the baby home? No.
15min Page 51

If the baby become unconscious, follow the unconscious choke protocol. Do you
still remember the protocol for unconscious adult or child we studied together
before lunch? It is the same. Let’s do it together:

First check environment.

Then check the person’s responsiveness, ABC

Call 911 - remember if you are alone? Practise baby. 5 cycles of CPR first then
take the baby to 911.

- start chest compressions 30’

- Give one rescue breath just enough to rise the chest. If the air go in, give second
one and go back to compressions.
- if the air did not go in, which is likely in a choking person, and you did not see
chest rise, probably you did not do head tilt and chin lift well. Redo and blow again.
- If this time the air still do not go in, that means maybe something is blocking the
airway. Start 30 chest compressions
- the air went in, give a second breath and if no response, start compression
- After 30 compressions, look in the person’s mouth. Grasp tongue and lower jaw
to lift. If you see object, try remove it
- Give a rescue breath again and loop

Additional Skills for HCP Now because we are health care professionals we will need to learn a little bit more Chapter 14 page 178
2 min than others. We will learn another technique to open the airway, how to check
pulse, how to use a BAG-VALVE-MASK for ventilation and how to perform 2

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3 min rescuer CPR.

All the additional information are in the chapter 14.

15 min BVM
Now we are going to explain another technique to open the airway called Jaw
thrust. It needs one person to knee at the person’s head and use both hands to lift
20 min the jaw forward gently with thumbs pressing cheeks. Be sure to keep the head on
the ground.

Pulse check - carotid artery or branchial artery

Check own - Pair up to check others

Now we need to learn two rescuer CPR for adult, child and baby. Again child is
defined as ? ( 1 yo to onset of puberty )

BVM 2 rescuer for breath only 5-6s / 3-5s / 3-5s

Practice each category

CPR 2 rescuer with BVM - 30:2 / 15:2 / 15:2

Practice each category

Any questions?
Alright that is all for today then. See you tomorrow and good bye.

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5 min Hand washing Hand washing is a very simple but effective and important precaution. IT helps
prevent from spreading germs that can cause many infectious diseases.

When should you wash your hands:

Before and after contact with ill or injured person
After removing gloves
After helping in an emergency
When your hand looks dirty
Before eating or drinking
After handling dirty articles, instruments, or dressings
Before or after treating wounds
Before going home from work

Now watch me wash my hands and tell me what is not right. Page 16

Now turn to page 16 and check.

Keep rubbing for 20-30 seconds. Remember how long ten seconds seem to be ?
This is twice to three times of that long

5 min Gloves Now everyone please have your gloves on.

Rub the ketch up on your gloves please. Okay. Imagine you just finished helping a
first aid involves massive bleeding, and your hands are stained with blood that
potentially carries germs which can harm your health. EMS personnel came to you
and said “ hey buddy thanks very much, nice job, we will take care of this person
from now on.”

Now you need to take off your dirty gloves, try to do it without getting the blood
touch your skin. Is it a piece of cake or a mission impossible?

Now look at me.

Pinch the glove at the wrist being careful to touch only the outside
Pull off one glove
Form the glove into a ball and hold it in the other hand
Then insert your thumb under inside rim of the other glove, on the palm side. (it is
easier). Push the glove inside-out and down onto fingers and over the balled glove.

Discard gloves appropriately.

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Where should the gloves go? Do they go to the normal waste? Or recyclable
waste?
No. It goes to the biohazard wastes. They have specific biohazard labels
Now if you work as a HCP probably you have biohazard waste at your work place
but if the event was on the street or in the subway, what should you do?
You can ask the EMS person to take it. They have biohazard waste on the
ambulance. Or you can take them to a hospital, a clinic or a drug store such as
drugmart and ask them to handle it.

Turn to page 17 and read the words in the square at the bottom of the page. This is
why we are using vinyl gloves rather than latex ones now.

15 min H.A.IN.E.S recovery position Again review when to put the person into this position:

- have to leave the person along for any reason

- airway is open
- person is breathing
- no deadly breathing

Helps to keep the airway open and allows any blood or vomit to drain from the
mouth.

15 min Spinal Injuries Some one falls from the height and now he is moaning and groaning. But his head
is not in Neutral position. You are the first aider. What should you do?

Check, call, care - he is okay. EMS is on the way.

We try to fix his head at the position it was found to avoid further damage to the
spinal cord.

Use both hands to support the head with arms on the ground.

Talk with the patient and try to calm him down.

He gets unconscious. What should you do? - check the breath.

Till when? Till the EMS arrives.

Now if the person throw up and vomits, what we need to do?

Put in to HAINES position but we are suspecting a spinal injury now and we want
to do a better protection.

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Log Roll. I need 3 volunteers

Keep the head supported and at the same position relative to the shoulders

Turn the person on his back again.

Questions?

Okay now practice.

20 min Shock Scenarios When a person is in shock, check call care

While waiting for EMS, (1) care for the cause, (2) have the person rest, (3) keep
the person warm and (4) ensure the person’s ABC is present. (5) Give comfort and
reassurance.

[Shock is a simple concept. The signs and symptoms are important and are usually
obvious. However, by the time they appear it is too late to prevent shock. Always
treat the ill or injured for shock right away.

First Aid for shock should not make other injuries worse.]

1. A person was hit by an car. He was knocked 5 meters away and landed on his
arm. When you arrive he was lying on the ground complaining about stomachache
to the left side, and he is groaning, pale, anxious, weak, his skin feels cool and
clammy, and he is breathing fast.

2. A colleague collapsed during a lengthy meeting. She was known to be diabetic

and when ask questions, she response with only one work. She feels clammy and
cold, and she looks pale and upset. She said that she is cold and hungry and
would like to go and buy a hot chocolate, but she is too weak to stand up.

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