Efr PSC Ig 100

Dear Instructor Candidate,
The package you have in hand contains the information you need to teach effective and
fun first aid and CPR courses through Emergency First Response (EFR). We’re glad you
picked EFR as your First Aid/CPR organization, and we are looking forward to building a
successful partnership with you.
You can begin your instructor course today by starting the independent learning segment
of your program. In the Appendix of this guide, go to page A-36 - Independent Learning,
Self-Study Instructor Knowledge Reviews. This material and knowledge reviews will help you
become familiar with the enclosed guides and the material you need to begin teaching EFR
courses. Complete the reviews in any order you like:
¨ Simply look through the two enclosed instructor guides (Emergency First Response –
Primary and Secondary Care; and EFR Care for Children) and answer the questions in
the corresponding self-study knowledge reviews.
¨ Read the Human Body Systems section found in the Appendix of the EFR Instructor
Guide, and complete the corresponding self-study knowledge review.
¨ Read the Medical Emergencies section found in the Emergency First Response Primary
Care and Secondary Care Participant Manual and complete the corresponding self-study
knowledge review.
If you haven’t already, contact an Emergency First Response Instructor Trainer to begin
your practical training at your convenience. For assistance in locating a trainer near you,
contact your Emergency First Response Regional Headquarters.
We are your emergency care organization. EFR is here to help you, the instructor, inspire
confidence in others to offer help to those in need. Through the powerful combination of
your skills and our materials and support, we are “Creating Confidence to Care” in those
we teach.
Welcome! And don’t hesitate to call on us if we can assist you in any way.
Sincerely,
Drew Richardson
President
Emergency First Response, Corp.
Section One – Course Overview and Standards
EMERGENCY
FIRST
RESPONSE ®
Creating Confidence to Care®
Instructor Guide
Primary and
Secondary
Care
emergencyfirstresponse.com
Product No. 67040 (07/11) Version 1.0 © Emergency First Response Corp. 2011
i
Primary and Secondary Care Instructor Guide
www.emergencyfirstresponse.com
Emergency First Response Corp.
30151 Tomas, Rancho Santa Margarita, CA 92688
Toll Free US and Canada: 800 337 1864
Tel: +1 949 766 4261, Fax: +1 949 858 8211
info@emergencyfirstresponse.com
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info@emergencyfirstresponse.co.uk
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Tel: +41 52 316 35 35 Fax: +41 52 304 14 98
info@emergencyfirstresponse.ch
Emergency First Response (Asia Pacific) Pty Ltd.
Unit 3, 4 Skyline Place, Frenchs Forest NSW 2086, Australia
Tel: +61 2 9454 2980, Fax: +61 2 9454 2999
info@emergencyfirstresponse.com.au
Emergency First Response® (EFR®) Primary and Secondary Care Instructor Guide
© Emergency First Response Corp. 2011.
Produced by Emergency First Response Corp.
Items in the Appendix may be reproduced by EFR Instructors for use in EFR-sanctioned training, but not for resale
or personal gain. No other part of this product may be reproduced, sold or distributed in any form without the written
permission of the publisher.
® indicates a trademark is registered in the U.S. and certain other countries.
Published by Emergency First Response Corp.
30151 Tomas, Rancho Santa Margarita, CA 92688 USA
Printed in U.S.A.
Product No. 67040 (07/11) Version 1.0
ii
Acknowledgements
Patient Care Standards
Emergency First Response Primary Care (CPR) and Secondary Care (First Aid) courses follow the
emergency considerations and protocols as developed by the members of the International Liaison
Committee on Resuscitation (ILCOR). Members include American Heart Association (AHA), European
Resuscitation Council (ERC), Australian Resuscitation Council (ARC), New Zealand Resuscitation
Council (NZRC), Heart and Stroke Foundation of Canada (HSFC), Resuscitation Council of Southern
Africa (RCSA), Inter American Heart Foundation (IAHF), Resuscitation Council of Asia (RCA – current
members include Japan, Korea, Singapore, Taiwan).
Source authority for the development of content material in Emergency First Response programs is based on
the following:
• Circulation, Journal of the American Heart Association. Volume 122, Number 18, Supplement 3.
November 2010. http://circ.ahajournals.org/content/vol122/18_suppl_3/
• Resuscitation, Journal of the European Resuscitation Council. Volume 81, Number 1. October 2010.
http://www.resuscitationjournal.com/
• Australian Resuscitation Council Guidelines. December 2010.
http://www.resus.org.au/policy/guidelines/index.asp.
• New Zealand Resuscitation Council Policies and Guidelines. December 2010.
http://www.nzrc.org.nz/policies-and-guidelines/.
When regional primary or secondary care guidelines differ significantly, the Emergency First Response
curriculum clearly lists those differences. When in doubt about a particular treatment protocol or procedure,
always refer to the actual guidelines produced by the council or organization having authority in your region.
International Medical Review

Dr.PhilBryson, MBChB, DCH, DRCOG, MRCGP
Medical Director of Diving Services
Abermed Ltd, Aberdeen
DesGorman, BSc, MBChB, FAFOM, PhD
Head - Occupational Medicine
School of Medicine, University of Auckland
Auckland, New Zealand
HeidiKapanka, MD, MPH
Emergency Medicine
Alabama, USA
JanRisberg, MD, PhD
Begen, Norway
BrianSmith, MD
Mountain West Anesthesia
Utah, USA
Disclaimer: The first aid and CPR procedures presented in Emergency First Response programs are based on the most current
recommendations of responsible medical sources. Emergency First Response, Corp., however, can make no guarantee as to, and assume
no responsibility for, the correctness, sufficiency, or completeness of such information or recommendations. Other or additional safety
measures may be required under particular circumstances.
iii
Contents
Introduction
How to Use This Instructor Guide . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
Section One - Course Overview and Standards

Patient Care Standards. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1-1
Course Philosophy . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1-2
Course Goals . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1-4
Core Performance Requirements . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1-4
Course Structure. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1-5
Instructor Role . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1-6
Who May Take the Courses?. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1-7
Supervision and Ratios . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1-8
Required and Recommended Materials . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1-9
Course Completion Requirements . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1-11
EFR Refresher Courses . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1-11
Membership Commitment . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1-12
Code of Practice . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1-12
Youth Leader’s Commitment. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1-13
EFR Instructor Renewal Requirements . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1-13
Emergency Responders in Action . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1-14
Course Sequence . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1-14
Section Two - Knowledge Development

Independent Study . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2-1
Motivating Independent Study . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2-2
Participant Knowledge Evaluation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2-3
Instructor Led Approach Knowledge Development Outlines . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2-4
Primary Care (CPR)
• Course Introduction. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2-4
• Helping Others in Need . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2-7
• The Emotional Aspects of Being an Emergency Responder . . . . . . . . . . . . . . . . . . . . . . . . . . . 2-12
• Keeping Your Skills Fresh . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2-13
• Leading a Healthy Lifestyle . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2-14
• Protecting Yourself Against Bloodborne Pathogens . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2-15
• Recognizing Life-Threatening Problems. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2-16
• Primary Care Definitions and Background Information . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2-18
• Using AB-CABS and the Cycle of Care to Prioritize Primary Care . . . . . . . . . . . . . . . . . . . . . . 2-21
Instructor Led Knowledge Development Outlines – Secondary Care (First Aid)
• Course Introduction. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2-30
• Secondary Care (First Aid) Definitions and Background Information . . . . . . . . . . . . . . . . . . . 2-31
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Section Three - Skill Development
Skill Development . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3-1
Practice Groups – Why And How . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3-2
The Ability to Replicate Skills Without Hesitation. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3-2
Positive Coaching – Encouraging Good Technique. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3-3
Teaching the Skills . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3-4
Skill Development – Primary Care (CPR) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3-6
Skill 1 – Scene Assessment. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3-6
Skill 2 – Barrier Use . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3-10
Skill 3 – Primary Assessment . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3-12
Skill 4 – CPR: Chest Compressions. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3-17
Skill 5 – CPR: Chest Compressions With Rescue Breathing . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3-20
Optional Primary Skill – Automated External Defibrillator (AED) Use. . . . . . . . . . . . . . . . . . . 3-25
Skill 6 – Serious Bleeding Management. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3-28
Skill 7 – Shock Management . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3-30
Skill 8 – Spinal Injury Management. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3-32
Skill 9 – Conscious And Unconscious Choking Adult. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3-34
Optional Primary Skill – Emergency Oxygen Use Orientation . . . . . . . . . . . . . . . . . . . . . . . . . . 3-39
Skill Development – Secondary Care (First Aid) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3-41
Skill 1 – Injury Assessment . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3-42
Skill 2 – Illness Assessment . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3-45
Skill 3 – Bandaging . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3-49
Skill 4 – Splinting for Dislocations and Fractures . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3-52
Section Four – Scenario Practice

Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4-1
Overview . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4-1
Primary Care Emergency Scenario One - Collapsed Family Member. . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4-3
Primary Care Emergency Scenario Two - Down in Public . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4-5
Primary Care Emergency Scenario Three - Recreational Accident . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4-7
Primary Care Emergency Scenario Four - Major Multi-Person Accident. . . . . . . . . . . . . . . . . . . . . . . . . . 4-9
Secondary Care Emergency Scenario One - Fallen Friend . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4-11
Appendix . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . A-1
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Introduction
The Emergency First Response® Primary Care (CPR), Secondary Care (First Aid), CPR &
AED and Care for Children courses teach people how to provide emergency care for someone
in need. These four courses make learning easy by providing a non stressful environment in
which participants practice and apply emergency care skills. The courses are designed to: 1) help
participants remember appropriate emergency care procedures during times of need, and 2)
encourage them to apply those procedures by assisting those needing emergency care.
Emergency First Response courses are based on
internationally recognized medical guidelines for emergency
care – guidelines produced through a consensus process
of practicing professionals in the emergency medical
field. Educationally, the courses reflect a well-researched
instructional design for this type of training.
How to Use This Instructor Guide

This guide covers both the Emergency First Response Primary
Care (CPR) and Emergency First Response Secondary
Care (First Aid) courses. It consists of these sections: Course
Standards and Overview, Knowledge Development, Skill
Development, Scenario Practice and the Appendix.
Course requirements are covered in this guide. Text appearing in boldface denotes required standards
that may not be deviated from while teaching an Emergency First Response course. Emergency First
Response Standards do not, however, supersede local laws or regulations. Keep informed of these
wherever you teach. Though all Emergency First Response Members use this manual, it is written from
the instructor’s perspective, except for course performance requirements. These are written from the
program participant’s perspective, stating specifically what must be demonstrated or performed.
1
Section One
Course Overview and Standards
This section covers general background and information on how to
conduct both of the Emergency First Response courses. Topics include:
• Course Overview and Standards
• Patient Care Standards
• Course Philosophy
• Course Goals
• Core Performance Requirements
• Course Structure
• Instructor Role
• Course Standards
Section Two
Knowledge Development
This section details how to teach the foundational material for both courses. It explains the basis
for effective use of independent study materials, the philosophy behind guiding self-directed
learning and how to determine when participants need knowledge development assistance. Use
the Knowledge Development Outlines in this section if independent study isn’t possible because
participants don’t have access to an Emergency First Response Participant Manual , or Video in a
language they understand.
Section Three
Skill Development
This section outlines the nine required and two optional skills for Primary Care. It also includes
the four required skills for Secondary Care. Instructor notes and skill descriptions provide detailed
guidelines for leading participants through each skill and reinforcing correct techniques.
You’ll find specific directions and suggestions for effective skill development based on how much,
if any, interaction participants have with the Emergency First Response Participant Manual, or Video.
During skill development, you introduce and demonstrate skills, then have participants practice
while you provide encouragement and suggestions.
Typically, skill development encompasses the majority of instructor-participant contact time.
2
Section Four
Scenario Practice
This section covers emergency scenarios that allow participants to apply their Emergency Responder
knowledge and skills to realistic situations. There are four primary care scenarios and one secondary
care scenario. Each scenario outlines situations that require participants to make decisions based
on their training, recall steps for performing emergency care skills and take appropriate action.
Although each scenario focuses on a specific emergency or accident, you may change the location
and other factors to accommodate regional needs and procedures.
Step-by-step procedures for conducting scenarios help you guide practice. Evaluation questions
allow you to discuss participant performance and concerns. By helping participants apply skills and
knowledge through scenarios, you build confidence and reinforce the need to act.
Appendix
The first part of the Appendix includes forms and information you’ll use when preparing for and
teaching Emergency First Response Primary and Secondary Care courses. You can make copies of
these forms for use in your classes.
The second part of the Appendix covers foundational knowledge needed for the Emergency First
Response Instructor Course. The Human Body Systems segment covers how the various systems
in the human body work and how they relate to the Emergency Responder. As an Emergency First
Response instructor candidate, you’ll read this segment and answer the included Knowledge Review
questions. This segment also serves as background reference for you when teaching Emergency First
Response courses.
Regional Resuscitation Councils and Organizations

Resuscitation councils and organizations use agreed upon the International Liaison Committee on
Resuscitation (ILCOR) emergency considerations and protocols to develop primary and secondary
care guidelines for their specific regions. The following entities distribute guidelines for the listed
regions:
• American Heart Association (AHA) guidelines are used in North, South and Central America, Asia
and the Pacific Island countries
• European Resuscitation Council (ERC) guidelines are used in Europe, Africa, Middle East
and Russia
• Australia and New Zealand Resuscitation Councils (ARC/NZRC) guidelines are used in Australia
and New Zealand
When regional primary or secondary care guidelines differ significantly, the Emergency First Response
curriculum clearly lists those differences. When in doubt about a particular treatment protocol or
procedure, always refer to the actual guidelines produced by the council or organization having
authority in your region.
3
4
One
Course Overview and Standards
The two courses, Emergency First Response Primary Care (CPR) and Emergency First Response
Secondary Care (First Aid), make up foundational offerings in emergency care for the lay provider.
Within the two courses, CPR and first aid skills are integrated into an easy-to-remember emergency
care sequence. This sequence allows participants to provide
effective emergency care to injured or ill persons.
Because of the sequence of skills and information,
participants must complete the Emergency First Response
Primary Care (CPR) course (or other qualifying course)
before beginning the Emergency First Response Secondary
Care (First Aid) course. Participant material is the same for
both courses.
Patient Care Standards

Emergency First Response Primary Care (CPR) and
Secondary Care (First Aid) are medically based, following
the same priorities of care used by professional emergency
care providers. Both courses assume a local Emergency
Medical Service (EMS) is in place to support Emergency
Responder care.
1-1
Emergency First Response Primary Care (CPR) and Secondary Care (First Aid) courses follow the
emergency considerations and protocols as developed by the members of the International Liaison
Committee on Resuscitation (ILCOR).
Source authority for the development of content material in Emergency First Response programs is
based on the following:
• Circulation, Journal of the American Heart Association. Volume 122, Number 18,
Supplement 3. November 2010. http://circ.ahajournals.org/content/vol122/18_suppl_3/
• Resuscitation, Journal of the European Resuscitation Council. Volume 81, Number 1.
October 2010. http://www.resuscitationjournal.com/
• Australian Resuscitation Council Guidelines. December 2010.
http://www.resus.org.au/policy/guidelines/index.asp.
• New Zealand Resuscitation Council Policies and Guidelines. December 2010.
http://www.nzrc.org.nz/policies-and-guidelines/.
Course Philosophy
The Emergency First Response Primary Care (CPR) course covers emergency care for most life-
threatening situations. Students are taught the Cycle of Care to guide them.
Cycle of Care: AB-CABS™
Help or AED Arrives

Continue Until
AB C
Chest
Airway Breathing
Open? Normally?
Compressions
AA irway Open
BB reathing
for Patient
S SS erious Bleeding
hock
Spinal Injury
The Emergency First Response Secondary Care (First Aid) course covers secondary patient
assessment and first aid. Secondary patient assessment teaches participants how to conduct patient
head-to-toe evaluations, allowing them to determine the extent of an injury or illness when
Emergency Medical Service personnel are unavailable or delayed. Participants learn both injury and
illness assessment sequences, which helps them prepare information for EMS personnel. The first aid
portion of the course teaches participants how to support and care for specific disabilities, injuries
and illnesses discovered during a secondary patient assessment and prior to EMS arrival.
1-2
Emergency First Response Primary Care (CPR) and Secondary Care (First Aid) courses adhere to
the following instructional design philosophy and core concepts:
• Course Simplification. Widespread consensus within the medical community and
instructional design research indicate that community-based, layperson CPR training is to
be simple in both course content and scope. Research studies indicate that simpler, objective-
based, media centric courses do a better job at teaching patient care skills for retention than
do longer, more traditional lecture-style courses.
• Performance-Based Instruction. Performance-based instruction means participants
progress through a course at their own speed by meeting measurable learning objectives and
performance requirements. The course instructional design sequences objectives from simple
to complex so participants use and build upon previous learning as they progress. In CPR
and first aid training, instructors encourage participants to master the skills in the course
while at the same time avoiding any hint of the need for perfect performance (emphasizing
that “adequate care provided is better than perfect care withheld”). For participants, the major
benefit of performance-based instruction is reduced stress. Performance-based instruction
provides a positive and nurturing learning environment that helps reduce participant anxiety,
guilt and fear of imperfect performance. Also, performance-based as opposed to time-based
instruction reduces participant stress to master skills within a certain time period. Another
benefit of performance-based instruction is that it automatically adjusts for class size. The
more participants an instructor has, the more time is required to complete all the course
objectives. In a like manner, less participants can mean less required course time.
• Increased Skill Practice and Repetition. CPR and first aid skill retention requires ample
opportunities for participant practice to meet all psychomotor objectives. When key skills
and knowledge content are repeated throughout the instructional materials, along with
purposeful practice, the student builds toward skill mastery.
• Domain Inclusive Instruction. Effective CPR and first aid instruction includes all three
domains of learning – cognitive (mental skills, knowledge), affective (feelings, emotional and
attitude) and psychomotor (manual or physical skills).
• Context Based Instruction. When relevant, real-world training scenarios are part of the
course, participants are better able to apply what they’ve learned once the course is completed.
• Independent Study. Educational studies show that use of participant independent study
consistently produces well-prepared participants. Independent study also reduces the need
to establish base concepts in the classroom, allowing more time for skill development,
scenario practice, individual participant needs and regional variations. Through participant
independent study, knowledge development elaboration is minimized in the classroom. This
maximizes time for practice and reinforcing both critical information and important skills.
• Instructional Consistency. When course content and skill demonstrations are presented in
a consistent manner, using participant self-study materials (video, participant manual and
prompt cards such as the EFR Emergency Care at a Glance card), instructor variability and
classroom distractions are minimized.
• Relevant Participant Assessment. Participant assessment comes directly from the measurable
cognitive, affective and psychomotor objectives and performance requirements. Objective
and performance-based assessments serve not only as proof of participant competence and
mastery of objectives, but also as learning tools – correcting gaps in student understanding
and skill performance.
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Course Goals
The goals for both Emergency First Response Primary Care (CPR) and Secondary Care (First Aid)
courses are:
¨ Increase access to CPR education, increase effectiveness and efficiency of instruction,
improve skills retention, and reduce barriers to action for basic life support providers.
¨ Provide a positive and nurturing learning environment that reduces participant anxiety, guilt
and fear of imperfect performance.
¨ Teach a course that increases the percentage of CPR and first aid-trained laypersons who use
their skills without hesitation to assist those in need.
¨ Combine CPR and first aid into one Emergency Responder protocol.
¨ Teach a simple CPR and first aid protocol that promotes long-term memory retention by
participants.
¨ Maximize participant skill development and practice time, while minimizing instructor led
knowledge development (lectures).
¨ Teach a course following the latest ILCOR (International Liaison Committee on
Resuscitation) Basic Life Support guidelines, thus providing an internationally consistent
course flexible enough to accommodate regional CPR and first aid protocols and cultural
differences.
¨ Integrate participant independent study whenever possible for course efficiency and respect
for valuable participant time.
Core Performance Requirements

Upon completion of both courses, Emergency Responders will be able to:
¨ Perform a scene assessment.
¨ Use barriers appropriately.
¨ Perform a patient responsiveness check by giving the
Responder Statement and then tapping the collarbone,
grasping or squeezing the shoulder or arm to gain
patient attention.
¨ Phone an Emergency Medical Service number at the
appropriate time within the CPR and first aid sequence.
¨ Quickly recognize unresponsiveness and absence of
normal breathing to determine when CPR – chest
compressions – is appropriate.
¨ Perform one rescuer, adult CPR – chest compressions – at a rate of at least 100 compressions
per minute, to a depth approximately one third the depth of the chest – at least 5
centimeters/2 inches.
¨ Minimize the frequency and duration of interruptions to chest compressions to maximize the
number of compressions delivered per minute.
¨ Perform effective chest compressions by allowing the chest to completely recoil after each
compression.
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¨ Open and maintain an airway using the head tilt-chin lift or pistol grip technique.
¨ Provide effective rescue breaths (normal breaths of 1-second duration) that make the patient’s
chest rise. The rescue breaths may be given using the mouth-to-mouth, mouth-to-barrier, or
mouth-to-mask techniques.
¨ Perform complete CPR with chest compressions and rescue breathing at a rate of 30
compressions to 2 rescue breaths.
¨ Explain the importance and timeliness of defibrillation within the CPR and first aid protocol
and list the two ways it can be obtained (EMS and AED provided).
¨ Perform an emergency move and place a person in the recovery position.
¨ Demonstrate how to assist a conscious choking patient and/or an unconscious choking
patient consistent with local protocol.
¨ Manage serious external bleeding using direct pressure.
¨ Perform appropriate shock management.
¨ Stabilize and manage suspected spinal injury.
¨ Provide manual stabilization of suspected skeletal injuries when Emergency Medical Service
personnel will be delayed.
¨ Perform initial and ongoing assessments of an injured or ill person when Emergency Medical
Service personnel are either delayed or unavailable.
¨ Perform all skills in a manner that minimizes risk to the Emergency Responder, patient and
bystanders.
Course Structure
Both the Emergency First Response Primary Care (CPR)
and Secondary Care (First Aid) courses are divided into three
segments: 1) Knowledge Development, 2) Skill Development
and 3) Scenario Practice. Using the Emergency First Response
Participant Manual, participants may independently study
all required Knowledge Development material. With the
use of the Emergency First Response Video participants may
independently preview all required skills and skill applications.
There are three ways to organize and structure both courses:
1. Independent Study Approach – Use this approach
whenever possible as it is the most time efficient. This
course structure assumes participant independent study
of the Emergency First Response Participant Manual,
or Video prior to Instructor Led Skill Development and Scenario Practice. It also assumes
participants come prepared to review their completed Knowledge Review worksheet(s).
When using this approach you need not use the Knowledge Development Outlines in
Section Two. Avoid lecturing to participants when using the independent study approach.
The video contains basically the same background material as presented in the Emergency
First Response Participant Manual. Therefore, if a participant has not read the manual, having
watched the video would adequately prepare a participant to join in during skill development.
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2. Video Guided Approach – In some instances it is impossible to provide participants with

the manual and video prior to the Skill Development session. Using this approach, you
provide each participant with an Emergency First Response Participant Manual, or Video at the
start of the course. During class, you conduct a short overview of important background
and foundational information by leading participants through their Emergency First Response
Participant Manual. As you cover the material, have participants complete their Knowledge
Review.
During your skill development session, use the video to preview each skill. Show a skill,
stop the video, conduct your demonstration and allow participants to practice. Sections
Three and Four of this guide contain guidelines for conducting skill development and then
scenario practice.
3. Instructor Led Approach – Use this method when
training materials are unavailable in a language
participants understand and you don’t have access
to a method of showing the video in class or when
extended participant to instructor contact time is
required. To use this method, you will need to:
¨ Teach material directly from the Knowledge
Development Outlines in Section Two.
¨ Conduct role-model demonstrations of all skills
in Section Three.
¨ Organize Scenario Practice for participants as outlined in Section Four.
Instructor Role
The role of the Emergency First Response Instructor is to:
¨ Help participants feel at ease during the courses by providing them with a positive, relaxed
and low-stress learning environment.
¨ Demonstrate role-model quality skills and emphasize application during scenario discussions.
¨ Provide participants with positive and constructive instruction.
¨ Never rush participants through skill development. Individualize skill development time
based on each participant’s ability to meet performance requirements. Allow participants
plenty of time to practice.
¨ Emphasize the need for personal safety through scene assessments and barrier use.
¨ Encourage participants to use their knowledge and skills to assist those in need of emergency
care once they complete the course.
¨ Appropriately modify the course curriculum to meet regional guidelines, requirements or laws.
¨ Feel the reward and satisfaction of teaching others emergency care.
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Course Standards
Who May Take the Courses?
Anyone interested in learning emergency care may take these
courses. There are no certification or licensure prerequisites for
the Emergency First Response Primary Care (CPR) course.
Also, there is no minimum age.
To participate in the Emergency First Response Secondary
Care (First Aid) course, individuals must complete the
Emergency First Response Primary Care (CPR) course or
another qualifying prerequisite course. Courses that qualify
are those teaching primary care (CPR) from any training
organization. Examples of a few organizations that teach
CPR-related courses are American Heart Association,
American Red Cross, American Safety and Health Institute, Cruz Roja de Mexico, Deutsches Rotes
Kreuz, MEDIC FIRST AID®, Inc., Queensland Ambulance Service, South African Red Cross
Society, Canadian Heart and Stroke Foundation and St. John’s Ambulance.
The Emergency First Response Secondary Care (First Aid) course builds upon the emergency care
skills learned in the Emergency First Response Primary Care (CPR) course. Therefore, give people
attending the Emergency First Response Secondary Care (First Aid) course who have taken
CPR training through another organization an orientation to these three Primary Care course
subject areas:
¨ Serious Bleeding Management
Standards in this section
¨ Shock Management may need modification based
¨ Spinal Injury Management on regional guidelines, laws or
requirements. For example, it may
Courses from other organizations may not include these be necessary to reduce participant-
critical skills needed for total patient care. To offset to-instructor-to-mannequin ratios,
this, participants may read those three segments in the etc. To meet regional guidelines,
participant manual and watch those three segments laws or requirements for Emergency
of the video prior to coming to the skill practice Responder/basic life support
session. Also, cover these primary care skills in your courses, you are encouraged to
demonstration and participant skill practice before communicate directly with your
moving into the Emergency First Response Secondary Emergency First Response Regional
Care (First Aid) course skills. Headquarters or the appropriate
organization, governmental body
or health and safety service in your
community or country.
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Supervision and Ratios

Only current Teaching status Emergency First Response Instructors qualify to teach the
Emergency First Response Primary Care and Secondary Care courses.
The participant-to-instructor ratio is 12 participants per Emergency First Response Instructor.
You may increase ratios to a maximum of 24:1 when using one or more assistants qualified as
follows:
¨ A current Teaching status Emergency First Response Instructor.
¨ A current CPR/First Aid instructor with
another regionally recognized organization.
¨ A trained medical professional with an
emergency care background (such as a
paramedic, EMT, nurse practitioner, etc.).
The maximum participant-to-mannequin ratio
is 12:1. Use of more mannequins is recommended.
No specific model of CPR mannequin is required,
however, mannequins capable of simulating an airway
obstruction if the airway is not positioned properly
are recommended. Be sure to follow manufacturer
guidelines for disinfecting mannequins after each
session or course.
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Required and Recommended Materials

The following chart outlines the required and recommended materials for both Instructors and
participants.
Primary Care (CPR) Course Instructor and Participant Materials
Instructor Materials Participant Materials

REQUIRED: REQUIRED:
• Emergency First Response Primary and Secondary • Emergency First Response Participant Manual
Care Instructor Guide (unless the manual is unavailable in a language
• Emergency First Response Participant Manual the participant understands)
(manual includes the Knowledge Review) • Gloves
• Emergency First Response Video • Ventilation barrier
• CPR Mannequin(s) • Gauze pads and dressings for bandaging
• Gloves
• Ventilation barrier
• Gauze pads and dressings for bandaging
• Emergency Care at a Glance
RECOMMENDED: RECOMMENDED:
• Blankets or towels for shock management • Emergency First Response Video
• Rugs or floor coverings for participant comfort • Emergency Care at a Glance
and protection during skill development
• Bag marked Biohazard for disposal of barriers to
show as example
• Different types of ventilation barriers to show as
examples
• Automated External Defibrillator (AED) unit or
AED trainer (optional skill)
• Extra adhesive pads to simulate AED pad
placement (optional skill)
• Oxygen unit (optional skill)
• Phone to simulate EMS call during scenarios
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Secondary Care (First Aid) Course Instructor and Participant Materials
Instructor Materials Participant Materials

REQUIRED: REQUIRED:
1. Emergency First Response Primary and • Emergency First Response Participant
Secondary Care Instructor Guide Manual (unless the manual is unavailable in
2. Emergency First Response Participant Manual a language the participant understands)
(manual includes the Knowledge Review) • Gloves
3. Emergency First Response Video • Ventilation barrier
4. Gloves • Gauze pads and dressings for bandaging
5. Roller bandages
6. Triangle bandages
7. Splints (commercial, padded wood, heavy
cardboard, rolled newspaper, etc.)
8. Emergency Care at a Glance
RECOMMENDED: RECOMMENDED:
• Phone to simulate EMS call during scenarios • Emergency First Response Video
• Emergency Care at a Glance
Barrier Use During the Course

Current guidelines reduce emphasis of barrier use when providing CPR. Although they are
recommended, treatment should not be delayed if barriers are not available. Research has shown that
the chance of disease transmission is very rare when providing CPR.
Nevertheless, during EFR courses, participants must use barriers for practice. You must provide
participants with an adequate supply of barriers to complete all barrier-related performance
requirements during the course.
In certain circumstances, and at appropriate times within the training,
participants may simulate using barriers (i.e., putting on gloves,
appropriately placing ventilation masks and shields, etc.) during skill
development sessions. These circumstances and times are noted in
Section Three and in the participant manual. Also, some participants
may be sensitive to latex. Consider having non-latex type gloves on
hand for these individuals.
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Course Completion Requirements

Participants are required to take the final Primary and Secondary Care written examinations
(found in the Appendix of the guide) for course completion.
Submit the appropriate Emergency First Response course completion document to your
Emergency First Response Regional Headquarters within seven days of course completion, for
each participant meeting the course performance requirements. Appropriate course completion
documents may be obtained from your Emergency First Response Regional Headquarters.
A completion card is not needed by a participant to render emergency care. Completion cards simply
indicate participants have successfully completed training. This differs from certification cards or
licensures that allow the bearer to engage in certain activities.
Emergency First Response Refresher Courses

Emergency First Response Refresher Courses are for people who have received training in CPR
and/or first aid and want to refresh their training. Encourage your Emergency Responders to take
refresher courses at least every 24 months.
Prerequisites-any previous CPR and/or first aid training (Emergency First Response or other).
Course Content-You can offer refresher training in Primary/Secondary Care together or separately.
Follow the Skill Development segment of the course(s) the participant needs refreshed. You can
do this by having Refresher Course participants join the skill development portion of a regular class
or you may conduct a stand alone refresher course. Be sure to also review any new developments
or changes to primary care or secondary care techniques since participants last completed training.
Keep in mind that this is an opportunity to teach or refresh skills on AED and Emergency Oxygen
Use as well. Participants must take the exam for the course they are refreshing.
Materials Requirements: Reference required and recommended materials for the individual
course you are teaching.
Recognition: When participants successfully complete an Emergency First Response Refresher
Course, submit the appropriate Course Completion Authorization (Primary Care (CPR) and/
or Secondary Care (First Aid) to your Emergency First Response Regional Headquarters.
Participants will receive a new card(s) for the course they refreshed, showing that their skills for that
course are current.
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Membership Commitment
The Emergency First Response organization’s success comes from many factors not the least of
which is the professionalism and excellence demonstrated by Emergency First Response Instructors
and Trainers. When you become an Emergency First Response Instructor, you agree to abide
by standards and procedures described in Emergency First Response instructor guides for the
Emergency First Response courses you teach. In this way, Emergency First Response courses have
common consistency throughout the world.
Everyone benefits when you use the educational system as intended and when you comply with the
standards within it: Participants receive thorough training; instructors enhance their courses by using
a tested educational system; and the Emergency First Response organization’s reputation for quality
remains intact. Emergency First Response Headquarters throughout the world provide you education,
guidance and counseling regarding your use of the Emergency First Response system of education.
Emergency First Response monitors courses for quality control by sending course evaluation
questionnaires to participants. These surveys ask participants specific questions about their training
and how they were instructed. When survey participants provide answers that indicate possible
noncompliance with Emergency First Response Standards, the Regional Headquarters follows
up with the instructor. The Quality Management Committee at Emergency First Response is
committed to excellence and handles all such issues using standardized procedures that are based on
equal application. The process is proactive and helps to ensure that all instructors understand their
responsibility to adhere to Emergency First Response standards and procedures. When there is a
problem in this area, Emergency First Response will make every effort to reorient the instructor to
standards and get the instructor back on track. In rare instances an instructor may be required to
retrain; or, when the seriousness of a situation justifies it, the instructor may no longer be eligible to
teach Emergency First Response courses.
Code of Practice
Along with the benefits they receive, Emergency First Response Instructors take on the
responsibility to conduct themselves appropriately as professionals. The following ethical
requirements define how Emergency First Response Instructors are expected to interact with
Emergency First Response, other Emergency First Response Instructors and the Emergency First
Response community in general.
As an Emergency First Response Instructor, you agree to:
1. Abide by the requirements and intent of Emergency First Response Standards and procedures
as published in the Emergency First Response Instructor Manual, The Responder and other
updates while conducting Emergency First Response courses and programs.
2. Conduct yourself and your Emergency First Response-related activities in a professional
manner.
3. Represent yourself as an Emergency First Response Instructor only when you are in Teaching
status.
4. Not disparage the Emergency First Response organization, Emergency First Response
Instructors or any other industry professionals.
5. Exhibit common honesty in your Emergency First Response related activities.
6. Cooperate during official Emergency First Response investigations by responding fully and
promptly to inquiries.
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7. Accept that a criminal conviction involving abuse of a minor either during or prior to
becoming an Emergency First Response Instructor is grounds for denial or termination of
your instructor status.
8. Accept that a criminal conviction involving sexual abuse of an adult either during or prior to
becoming an Emergency First Response Instructor is grounds for denial or termination of
your instructor status.
9. Follow a strict code of conduct and abide by the requirements and intent of the Youth
Leader’s Commitment whenever teaching or supervising children.
Youth Leader’s Commitment

1. Look after the children’s health, safety and welfare.
2. Ensure appropriate supervision during all instructional activities.
3. Whenever possible, meet the children’s parents or guardians and share program goals and
objectives.
4. Strive to keep parents or guardians involved and informed through verbal reports and updates
as often as possible.
5. Treat children, parents or guardians with respect regardless of age, race, gender and religious
affiliation.
6. Honor commitments made to children.
7. Discuss disciplinary problems with parents or guardians.
8. Do not engage in inappropriate contact with children.
9. Respect children’s rights to privacy and intrude only when health and safety demand.
10. Whenever possible, ensure two adults are with children.
®
Emergency First Response Instructor Renewal
Requirements
To maintain authorization to teach, you must renew your Emergency First Response Instructor
rating every two years and agree to stay up-to-date with Emergency First Response course
standards and implement any changes announced in The Responder.
If your renewal lapses and the term of your Emergency First Response Instructor credential expires,
contact your Emergency First Response Regional Headquarters for information on how you can
reactivate your authorization to teach.
You may need to fulfill other requirements such as attending a refresher, if local requirements must
be met or major program revisions or significant standards changes occur. Where legally required for
official recognition, other renewal requirements may apply. Check your Emergency First Response
Instructor Renewal Application for specifics or contact your Emergency First Response Regional
Headquarters.
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Emergency Responders in Action

When Emergency Responders use their skills to care for an injured or ill person, it’s significant
and worth sharing. If you know of any Emergency Responders who have used their Emergency
First Response skills in an emergency situation or if you’ve used your training to help someone in
need, please send the information describing the action to Emergency First Response by using The
Responder in Action Report form found in the Appendix of
this guide.
The Emergency Responders involved will receive formal
recognition for their efforts. With permission, their stories
may be posted on the Emergency First Response website and
generally shared with the Emergency Responder community.
Examples of Emergency Responders in action help inspire and
motivate others to use their skills when situations arise.
Course Sequence
Use this recommended course sequence to organize training sessions and meet program requirements.
You may adapt this schedule to meet participant needs and to fulfill local requirements.
Primary Care (CPR)

Independent Study or Knowledge Development topics
I. Course Introduction
II. Helping Others in Need
III. The Emotional Aspects of Being an Emergency Responder
IV. Keeping Your Skills Refreshed
V. Leading a Healthy Lifestyle
VI. Protecting Yourself Against Bloodborne Pathogens
VII. Recognizing Life-Threatening Problems
VIII. Primary Care Definitions and Background Information
IX. Using the Cycle of Care and AB-CABS Memory Word During Primary Care
¨ Administer Final Exam (may be conducted anytime before course completion)
Skill Development sequence
Primary Care Skill 1 Scene Assessment
Primary Care Skill 2 Barrier Use
Primary Care Skill 3 Primary Assessment
Primary Care Skill 4 CPR – Chest Compressions
Primary Care Skill 5 CPR – Chest Compressions Combined With Rescue Breathing
Optional Primary Care Skill — Automated External Defibrillator Use
Primary Care Skill 6 Serious Bleeding Management
Primary Care Skill 7 Shock Management
Primary Care Skill 8 Spinal Injury Management
Primary Care Skill 9 Conscious/Unconscious Choking Adult
Optional Primary Care Skill — Emergency Oxygen Use Orientation
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Scenario Practice sequence

Scenario One — Collapsed Family Member
Scenario Two — Down in Public
Scenario Three — Recreational Accident
Scenario Four — Major Multiperson Accident
¨ Complete and submit Course Completion Authorization
Secondary Care (First Aid)

Independent Study or Knowledge Development topics
I. Course Introduction
II. Secondary Care (First Aid) Definitions and Background Information
¨ Administer Final Exam (may be conducted anytime before course completion)
Skill Development sequence
¨ If conducting as a stand alone course, review scene assessment and barrier use with participants.
Secondary Care Skill 1 Injury Assessment
Secondary Care Skill 2 Illness Assessment
Secondary Care Skill 3 Bandaging
Secondary Care Skill 4 Splinting for Dislocations and Fractures
Scenario Practice sequence
Scenario — Fallen Friend
¨ Complete and submit Course Completion Authorization
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Section Two – Knowledge Development
Two
Knowledge Development
When materials are available, participants should study the course information independently using
the Emergency First Response Participant Manual, and Video. In situations where the manual, and
video are not available in a language participants understand, use the Knowledge Development
Outlines in this section to elaborate on necessary information. Use these outlines for both the
Emergency First Response Primary Care (CPR) and Secondary Care (First Aid) courses.
Independent Study
Independent study has several major educational and logistical advantages.
1. Better participant preparation. Research shows that participants who study independently,
learn better. Primary reasons include: 1) allows participants to learn at their own pace and
2) better accommodation of individual learning styles. Both of these contribute to effective
learning and better preparation before skill development. Participants viewing the video will
be better prepared to participate in the Skill Development and Scenario Practice sessions.
2. More effective use of time. Independent study of CPR and first aid background information in
the Emergency First Response Participant Manual allows instructors to focus completely on Skill
Development and Scenario Practice. Also, participants watching Skill Development segments in
the Emergency First Response Video are better prepared for hands-on training than those who did
not see a preview. This makes courses shorter, accommodating individuals with busy schedules.
3. Ability to focus on regional CPR and first aid differences. When participants independently
study the background CPR and first aid information, you can focus class time on reviewing
information and teaching optional skills required by regional CPR and first aid governing bodies.
4. Better business opportunities. Since independent study allows for shorter instructor-to-
participant contact time, you can price your Emergency First Response Primary Care (CPR)
and Secondary Care (First Aid) courses competitively. In contrast, course flexibility also allows
you to add time as needed, or required, by a client or regional governing body.
5. Better use of instructor time. An Emergency First Response Instructor’s time is best spent
conducting the Skill Development and Scenario Practice sessions. Further, independent
study media cannot address specific participant needs and issues while at the same time
orienting him to specific regional training protocols and needs. Only an instructor can
accomplish this. Only an instructor can evaluate a participant’s learning progress and first aid
skills, plus recommend specific remedial training.
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Motivating Independent Study

The biggest challenge of independent study is motivating participants to study. In a business,
accommodating customers’ needs seemingly conflicts with a need for participants to read the
Emergency First Response Participant Manual, watch the Emergency First Response Video before the Skill
Development and Scenario Practice session.
With respect to both Emergency First Response courses, you shouldn’t pressure participants to
complete their independent study prior to the Skill Development session. It is best if they do, but
if they don’t, continue with the Skill Development session and motivate participants to read their
Emergency First Response Participant Manual and watch the Emergency First Response Video after class.
For participants who haven’t watched the video before the Skill Development session you’ll need to
spend extra time demonstrating skills. You may even need to show video segments in class if many
participants haven’t seen it.
Here are a few tips to motivate participants to complete independent study:
1. Be sure participants know what is expected of them. Encourage them to read the
introduction to the Emergency First Response Participant Manual. The introduction clearly
outlines what is expected of participants prior to the Skill Development and Scenario
Practice session.
2. Establish value. You’re less likely to have difficulties when you make it clear that reading the
Emergency First Response Participant Manual and watching the Emergency First Response Video
makes the Skill Development and Scenario Practice session go quickly and efficiently. Depending
on your situation, and how you personally wish to organize your course, you may choose to
exclude participants from the Skill Development and Scenario Practice session if they have not
completed their independent study. In this case, they will have to wait for the next course.
3. Have a procedure. Inevitably, some participants show up without having completed their
independent study. This happens for a variety of acceptable reasons. Regardless, be prepared
to reschedule or accommodate individuals in as flexible a manner as possible.
4. During independent study, encourage participants to read a section in their participant
manual then watch the corresponding segment of the video. This will help to focus learning
by alternating media types.
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Participant Knowledge Evaluation

Review participant Knowledge Review answers
and elaborate as necessary to ensure understanding.
Participants must take the Emergency First Response CPR and first aid training
Primary Care Final Exam to successfully complete guidelines in some regions require
the Primary Care (CPR) course and the Secondary extended participant-to-instructor
Care (First Aid) Final Exam to successfully complete contact time. In these situations it is
the Secondary Care (First Aid) course. Participants still required to provide participants
must complete all questions correctly or you must with the Emergency First Response
thoroughly review each missed item until participants Participant Manual and have them
understand the information. view the Emergency First Response
Video if they are in a language
Use the Final Exams found in the Appendix of this
participants understand. However, to
guide or obtain Emergency First Response Participant
extend the participant-to-instructor
Exam booklets and answer sheets from Emergency First
contact time, use the presentation
Response Corp.
notes in this section as needed.
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Instructor Led Approach

Knowledge Development Outlines
Primary Care (CPR)
Presentation – Course Introduction
A. Introductions – Self and Assistants
B. Signing In – Complete course paperwork
C. Questions You’ll be able to Answer by the End of this Presentation
1. What assumption about access to Emergency Medical Services does both Emergency First
Response courses make?
2. How are the two Emergency First Response courses, Primary Care (CPR) and Secondary
Care (First Aid), different?
3. Why is the Emergency First Response Primary Care (CPR) course a prerequisite to the
Secondary Care (First Aid) course?
4. Who may enroll in each course and what are the prerequisites?
5. What nine skills will you learn in the Emergency First Response Primary Care (CPR) course?
6. What two optional skills might you also learn in the Emergency First Response Primary
Care (CPR) course?
7. What four skills will you learn in the Emergency First Response Secondary Care (First Aid)
course and why should you take this course as well?
8. In what five ways can you get the most out of your course?
D. Course Context
1. The two courses covered in this program - Emergency First Response Primary Care (CPR)
and Secondary Care (First Aid) – assume that you, the Emergency Responder, have quick
access to Emergency Medical Services (also called EMS) and that they can be summoned
quickly to provide a patient with advanced life support.
2. Caring for a patient well beyond quick access to EMS, requires additional skills. Commonly,
these additional skills are found in wilderness or remote location type first aid courses.
E. About the Emergency First Response Primary Care (CPR) and Secondary Care (First Aid) Courses
1. Two Different Courses – One Emergency Care Protocol
a. Both courses will prepare you to respond to those in need of emergency care.
b. The Emergency First Response Primary Care (CPR) course prepares you to render
emergency care for life-threatening problems such as heart and breathing problems,
choking, serious bleeding, shock and spinal injuries.
c. The Emergency First Response Secondary Care (First Aid) course prepares you to render
emergency care for common first aid problems that are not immediately life-threatening. In
this course, you begin to learn what to do when EMS personnel are delayed or unavailable.
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d. Both courses use the same, singular emergency care procedure. This will help you
remember what to do when a real life emergency raises your stress.
2. Prerequisite Course Flow
a. You must complete the Emergency First Response Primary Care (CPR) course before taking
the Secondary Care (First Aid) course.
b. This requirement exists because anytime you approach a patient and provide emergency
care, regardless of the injury or illness, you always begin with the skills you learn in the
Emergency First Response Primary Care (CPR) course.
c. You need the skills learned in the Primary Care (CPR) course to adequately deliver
secondary care (first aid) to an injured or ill patient. You never know when the patient
could get worse and need priority care.
3. Who May Enroll
a. Anyone of any age may enroll in the Emergency First Response Primary Care (CPR)
course. Since the course is performance-based, if you complete the requirements you can
receive a course completion card.
4. Primary Care Skills
a. Skill 1 - Scene Assessment
b. Skill 2 - Barrier Use
c. Skill 3 - Primary Assessment
d. Skill 4 – CPR: Chest Compressions
e. Skill 5 - CPR: Chest Compressions Combined With Rescue Breathing
f. Optional Skill – Automated External Defibrillator Use
g. Skill 6 - Serious Bleeding Management
h. Skill 7 - Shock Management
i. Skill 8 - Spinal Injury Management
j. Skill 9 - Conscious/Unconscious Choking Adult
k. Optional Skill - Emergency Oxygen Use Orientation
5. Secondary Care Skills:
a. Skill 1 - Injury Assessment
b. Skill 2 - Illness Assessment
c. Skill 3 - Bandaging
d. Skill 4 - Splinting for Dislocations and Fractures
6. The Secondary Care (First Aid) course complements the Emergency First Response Primary
Care (CPR) course by introducing additional first aid skills. You will continue to refine your
primary care assessments and discover different ways to assist those needing emergency care
when professional medical care is either delayed or unavailable. We would encourage you to
enroll and complete this course if you have not already done so.
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F. Learning Tips – Getting the Most from Your Course

1. Don’t focus on perfection. A common misconception with emergency care is that the
smallest error will hurt or kill a patient. This is seldom true. If you focus on perfection, there’s
a tendency to do nothing in a real emergency because you will fear not doing everything
“perfectly.” Don’t get caught in that trap — it’s not hard to provide adequate care. Always
remember – Adequate care provided is better than perfect care withheld.
2. Don’t be intimidated. You’re learning something new, so don’t be surprised if you’re not
immediately comfortable with a skill or need some guidance. If you already knew how to do
it, you wouldn’t be there. Mistakes aren’t a problem — they’re an important part of learning.
3. Have fun. That may sound odd given the seriousness of what you’re learning, but the truth is,
you’ll learn more and learn faster if you and your classmates keep things light.
4. Be decisive and then act. There’s more than one way to help a person who is injured or ill.
When you practice the scenarios, you’ll find that circumstances don’t always give you a clear
direction in exactly how to best apply the priorities of care.
5. It all comes back. When you’re practicing the scenarios, you may notice that as you follow the
priorities of care explained in all Emergency First Response courses, the things you “forgot”
come back to you — not necessarily smoothly at first, but adequately so that you’re capable of
providing emergency care. Remember that feeling. If you’ve ever faced a real emergency and
have doubts about remembering what to do, recall this feeling. Regardless of what you do or
don’t do, remember when helping someone in need that “Adequate care provided is better than
perfect care withheld.”
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Presentation – Helping Others in Need

A. Sample Contact Statement
Most people are proud of the fact that they’ve helped another in need. As an Emergency Responder you
will probably have opportunities to use your new knowledge and skills to assist others having medical
emergencies. No doubt you too will be proud of these times as well.
B. Questions You’ll be able to Answer by the End of this Presentation
1. Why is time critical when someone needs emergency care?
2. Why should you assist someone who needs emergency care?
3. What are six reasons people hesitate to provide emergency care to a patient – even if they are
trained in CPR and first aid?
4. What is a Good Samaritan law?
5. In general, what are the six ways you should act to be protected by most Good Samaritan laws?
6. What are the Chain of Survival’s four links and which three involve an Emergency Responder?
7. How do you ask for permission to help a patient?
8. Why is it important to activate an Emergency Medical Service immediately when an
emergency arises?
9. When should you activate the Emergency Medical Service once you find an unresponsive
adult or child who needs emergency care?
10. How do you activate Emergency Medical Services in your area?
C. Helping Others When Seconds Count
1. If you encounter someone who needs emergency care and you’ve assessed the scene for your
own personal safety (more on this later), you should render assistance immediately – even
seconds count.
2. The chances of successful resuscitation diminish with time. When a person has no heartbeat
and is not breathing, irreversible brain damage can occur within minutes.
3. Many medical emergencies, like sudden cardiac
arrest, require the secondary assistance of EMS
personnel. Get them on the scene fast – seconds
count.
D. Assisting Someone Who Needs Emergency Care
1. You can save or restore a patient’s life.
2. You can help reduce a patient’s recovery time,
either in the hospital or at home.
3. You can make the difference between a patient
having a temporary or a lifelong disability.
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E. Why People Hesitate to Provide Emergency Care

1. Anxiety. People may hesitate due to general nervousness or anxiousness. This is a perfectly
normal reaction when helping those in need. However, as emphasized, trust your training.
When you follow the priorities of care as outlined in this course, you are giving your patient
the best chance for survival or revival.
2. Guilt. People may hesitate when thinking about how they might feel if the patient doesn’t
recover after delivering first aid. You can’t guarantee that a patient will live or fully recover
— there’s too much beyond anyone’s control. Be confident that any help you offer is a
contribution to another human being and has the potential to make a difference in the
patient’s outcome. Even in the worst of outcomes, you can take heart in the fact that you used
your skills and gave the patient more of a chance than he had alone.
3. Fear of imperfect performance. People may hesitate because they feel they cannot properly
help an injured or ill person. It is seldom true that the smallest error will hurt or kill a patient.
During this course, you will learn what’s critical and what’s not. If you focus on perfection,
you’ll have a tendency to do nothing in a real emergency. Don’t get caught in that trap —it’s
not hard to provide adequate care, and adequate care provided is always better than perfect
care withheld.
4. Fear of making a person worse. The most serious medical emergency is when a patient isn’t
breathing and has no heartbeat. Sometimes people hesitate to help such a patient, fearing
they will make him worse. As an Emergency Responder, realize that you cannot make such
a person worse. A person with no breathing and no heartbeat is already in the worst state of
health. You can trust your training. Take a moment to relax, think of your training, then step
forward and help.
5. Fear of infection. People may hesitate because they are afraid of being infected by the person
they are assisting. Keep in mind that a large percentage of all CPR is performed in the home
or for a loved one or friend. In these cases, risk of infection is low and fear of infection should
not cause you to withhold CPR or emergency care. Infection is a concern, but your training
includes learning to use protective barriers to minimize the risk of disease transmission. By
using barriers, you’re highly unlikely to get any disease or infection from someone you help.
Further, research has shown that the chance of disease transmission is very rare when providing
CPR.
6. Responsibility. People may hesitate because they are afraid of being sued. In general, the fear
of being sued should not stop Emergency Responders from providing emergency care. In
many regions of the world, Good Samaritan laws have been put in place to encourage people
to come to the aid of others.
INSTRUCTOR NOTE – Allow participants to speak openly about each reason.

Discuss with participants why they shouldn’t hesitate for any of these reasons.
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F. Good Samaritan Laws

1. Good Samaritan laws (or related, local laws) are enacted to encourage people to come to the aid
of others. In general, they protect individuals who voluntarily offer assistance to those in need.
They are created to provide immunity against liability.
2. Often, a Good Samaritan law imposes no legal duty to help a stranger in need. However, local
laws may vary on this point and in some areas people are required to provide aid.
INSTRUCTOR NOTE – Be prepared to share with participants the Good Samaritan

laws in your local area. There may not be Good Samaritan laws in your local area.
3. There are six ways you should act to be protected by Good Samaritan laws.
They are:
a. Only provide care that is within the scope of your training as an Emergency Responder.
b. Ask for permission to help.
c. Act in good faith.
d. Do not be reckless or negligent.
e. Act as a prudent person would.
f. Do not abandon the patient once you begin care. The exception to this is if you must do
so to protect yourself from imminent danger.
INSTRUCTOR NOTE – Local laws may vary on how to act to be protected by Good
Samaritan laws.
G. The Chain of Survival and You – The Emergency Responder

1. The Chain of Survival is a metaphor emphasizing the teamwork needed in emergency
situations between layperson Emergency Responders (you, after completing this course) and
professional emergency care providers.
Chain of Survival
Early Recognition and Early CPR Early Automated External Early Professional Care
Call for Help Defibrillation (AED) and Follow-up
combined with CPR
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2. When you recognize a potentially life-threatening emergency, you help with the first three links
in the Chain of Survival. The fourth link involves only professional emergency care providers –
EMTs, Paramedics, nurses and doctors. Here are the four links in the Chain of Survival:
a. Early Recognition and Call for Help. As an Emergency Responder, you must first
recognize that an emergency exists and evaluate the scene to determine whether you can
safely assist the patient. This link involves you, the Emergency Responder. For a patient
with a life-threatening problem, rapid activation of EMS is critical. This is the Call First
concept. Further, ask someone to bring an automated external defibrillator (AED), if one
is available.
INSTRUCTOR NOTE – Discuss why this step is located at this point within the Chain
of Survival. For a patient with a life-threatening problem, rapid activation of EMS is
critical. This is the Call First concept. Tell participants that there is more on this later.
b. Early CPR. A person who is not breathing normally and has no heartbeat needs CPR
immediately. Early CPR is the best treatment for cardiac arrest until a defibrillator and
more advanced trained professionals arrive. Effective and immediate chest compressions
prolong the window of time during which defibrillation can occur and provides a small
amount of blood flow to the heart, brain, and other vital organs. Immediate CPR can
double or triple a patient’s chance of survival from irregular heartbeats or sudden cardiac
arrest. This link also involves you, the Emergency Responder.
c. Early Defibrillation. Combined with CPR, early
defibrillation by you, the Emergency Responder,
or EMS personnel, can significantly increase the
probability of survival of a patient in cardiac arrest.
During your Primary Care course, you may learn
how to use an Automated External Defibrillator
(AED). If you witness a cardiac arrest and an AED
is immediately available, you should begin chest
compressions and use the AED as soon as possible
(more on this later). When applied to a person in
cardiac arrest, an AED automatically analyzes the
patient’s heart rhythm and indicates if an electric
shock is needed to help restore a normal heartbeat. If
you learn how to use an AED in this course, this link
involves you, the Emergency Responder. Most EMS
personnel also use AED units.
d. Early Professional Care and Follow-up. EMS personnel can provide advanced patient
care that you can not. The advanced care EMS personnel can provide includes artificial
airways, oxygen, cardiac drugs and defibrillation (when an AED is unavailable). After
initial on-scene care, EMS personnel take the patient to the hospital for more advanced
medical procedures. The patient remains hospitalized until no longer needing constant,
direct medical attention.
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H. Asking a Patient for Permission to Help

1. When an injured or ill responsive adult needs emergency
care, ask permission before you assist the person. Asking for
permission to help also reassures the patient, noting that
you are trained appropriately.
2. You ask for permission to help with the Responder
Statement. You simply say, Hello? My name is ____________.
I’m an Emergency Responder. May I help you?
3. It’s important to get the patient’s agreement if he is alert
and responsive.
4. If the patient agrees or doesn’t respond, you can proceed
with emergency care.
5. If a patient is unresponsive, there is implied permission – meaning you can proceed with
emergency care.
6. If an injured or ill responsive adult refuses emergency care, do not force it on the person. If
possible, talk with the individual and monitor the patient’s condition by observation without
providing actual care. You could, however, activate EMS at this time.
I. Activating Emergency Medical Service – Call First and Care First
1. In the Chain of Survival your role as the Emergency
Responder is to summon emergency medical aid and to
assist the patient until it arrives. Activating EMS is so
important that in most circumstances, if you’re alone and
there’s no one else to activate the EMS for you, you Call
First, then assist the patient.
2. After establishing patient unresponsiveness, and identifying
that he is not breathing normally, you should leave the
patient to call an ambulance or activate the EMS. If a
bystander is available, direct them to activate the EMS
while you provide care. Further, ask someone to bring an
automated external defibrillator (AED), if one is available.
3. An exception to the Call First rule is if the patient is a child
or an adult who has experienced submersion in water. In
these cases, you provide CPR for a short time, particularly rescue breaths to the patient, and
THEN call EMS. This is called Care First. The various resuscitation councils define a “short
time” differently. In North, South and Central America, Asia and the Pacific Island countries
(AHA Guidelines) it’s defined as providing care for approximately 2 minutes; the European
Resuscitation Council defines a “short time” as 1 minute.
INSTRUCTOR NOTE – If the patient’s problem could be a drowning or other

respiratory problem, give Care First. This means that you provide CPR for a short
time, particularly rescue breaths to the patient, and THEN call EMS.
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4. With EMS on the way, the care you provide increases the chance that advanced care will help
the patient when it arrives. Your training in this course is based on handling emergencies
where you have an Emergency Medical System. If you may need to provide emergency aid in
areas away from EMS support, you should continue your education with more advanced first
aid training.
5. In the local area, the Emergency Medical Service is activated by calling:_________________.
Presentation – The Emotional Aspects of Being an Emergency

Responder
Helping another person in need is satisfying and feels good. Depending on the circumstances, however, it
may also produce a certain amount of stress and some fearfulness. In most cases, a little stress may actually
assist you when helping others by preparing you physically and mentally.
1. Why should you never fear harming a patient when performing CPR on an individual whose
heart has stopped?
2. Why is CPR no guarantee that the patient’s heart will restart?
3. How can you care for yourself as an Emergency Responder after you’ve provided emergency
care in stressful situations?
C. CPR – Cardiopulmonary Resuscitation – is no Guarantee of a Successful Outcome
1. CPR is a two-step process - pressing on a patient’s chest and breathing for the person.
2. Most of the time, even with CPR, the patient’s heart doesn’t restart. Nevertheless, CPR does
keep the blood flowing to the core organs with some oxygen, allowing time for defibrillation
and advanced care by Emergency Medical Services. Even though CPR doesn’t always result
in a successful outcome, it is a very important link in the Chain of Survival.
3. Within reason, there’s very little relationship between CPR technique and a patient’s heart
restarting. For the most part, the CPR you give a patient in need is as effective as CPR
performed by medical professionals.
4. This means that you can never know if providing CPR would have made a difference unless
you step forward and help.
5. If you provide CPR and the patient’s heart doesn’t restart when EMS personnel arrive, don’t
second-guess yourself. You contributed to the possibility of patient revival.
6. But, if you could have provided CPR and didn’t, you may spend the rest of your life
wondering if it could have made a difference. Don’t let that happen – trust your training.
Remember – adequate care provided is better than perfect care withheld. In the next section
you’ll learn more about CPR.
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D. Caring for Yourself

1. Providing care under emergency situations can be very stressful:
2. To reduce your physical and emotional stress after providing emergency care.
a. Try to relax after the incident. Lower your heartbeat and
blood pressure by resting or walking slowly. Relaxing
will reduce elevated adrenaline produced by your body to
help you through the stress of providing emergency care.
b. Avoid stimuli such as caffeine, nicotine or alcohol.
c. Talk about the incident to others. Sharing your
experience with others helps in processing thoughts
and emotions, therefore reducing stress and anxiety.
Talk can be healing.
d. If you experience physical or emotional problems such
as prolonged depression, sleeping disorders, persistent
anxiety or eating disorders, seek the help of a health
care professional.
e. Spend time with others. Reach out – people care.
Presentation – Keeping Your Skills Fresh

Think of a sport you use to participate in years ago but haven’t tried recently. Do you think you could return
to the sport this very moment, and be as successful as you once were? Probably not. The same is true with
emergency care skills. Keeping your skills fresh is important if you are ever called upon to help another in
need. Be a good citizen, practice your skills periodically.
1. Why should you practice primary care skills after the course is over?
2. How can you practice and refresh your skills?
C. Practicing Your Skills Once the Course is Finished
1. When not used or practiced, all skills deteriorate over time. Research shows that CPR and
first aid skills begin to deteriorate as soon as six months from initial training.
2. Hopefully, you won’t have to use your emergency skills in an actual situation. If you don’t, you
will still have to practice them at home to keep them fresh and properly sequenced.
3. Everyone is nervous when they arrive on the scene of badly injured individuals. Practicing
your skills and keeping them fresh in your mind will reduce your nervousness.
D. How Can You Practice and Refresh Your Skills?
1. You can review and practice your skills on your own by:
a. Reviewing your Emergency First Response Video.
b. Reading through your Emergency First Response Participant Manual.
c. Role-playing scenarios with your family members or friends.
d. Walking through the CPR sequence using a pillow or appropriately-sized stuffed bag.
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2. You can practice and fine-tune your skills by enrolling in an Emergency First Response
Refresher course.
a. During the refresher, you’ll practice your skills by once again completing just the Skill
Development portion of an Emergency First Response course (Primary Care, Secondary
Care and/or Care for Children). You’ll also retake the exam as part of the refresher
course.
b. By completing a refresher, you’ll be issued a new Emergency First Response completion
card.
c. It’s a good idea to take a refresher course at least every 12 to 24 months to keep your skills
and completion card current. In some areas, regional guidelines highlight the need for
frequent skill review and practice.
d. Our next Emergency First Response Refresher course is: _________.
Presentation – Leading a Healthy Lifestyle

This course focuses on helping others, however learning how to keep your own heart healthy is just
as important – if not more so. By staying healthy you’ll avoid invasive surgeries to correct heart and
cardiovascular problems or the need to take drugs to correct acquired diseases. By staying healthy you’ll also
be fit enough to help others in need.
1. What five ways can you keep your own heart healthy and avoid coronary heart disease?
2. How can you lead an all-around healthy lifestyle?
C. Five Ways to Lead a Healthy Lifestyle
1. By making healthy lifestyle choices, your risk for heart disease and stroke are minimized.
Some risk factors cannot be controlled, but many can.
2. In many countries, more men and women die from coronary heart disease each year than
from all other causes of death combined, including cancer and AIDS.
3. It is fitting to discuss how you can reduce your own risk of coronary heart disease and lead a
healthy lifestyle. Also, if you lead a healthy lifestyle you will be a fit Emergency Responder.
Here are five ways you can lead a healthy lifestyle.
a. Avoid exposure to cigarette smoke.
b. Reduce and manage stress.
c. Eat a diet low in saturated fat, trans-fat, highly refined carbohydrates and cholesterol.
Also, keep your weight within accepted guidelines for your height.
d. Exercise regularly with your physician’s guidance. To maintain a moderate level of fitness,
health and fitness professionals recommend a minimum of 30 to 60 minutes of exercise, on
most days of the week, at 50 to 80 percent of your maximum capacity. Your exercise should
include resistance training and cardiovascular training for optimum health and fitness.
e. If you have high blood pressure or diabetes, keep up with the treatment procedures agreed
upon with your doctor. Both high blood pressure and diabetes are risk factors for heart disease.
In general, get regular checkups by your physician.
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4. There are other ways to lead an all-around healthy lifestyle. Consider the following.
a. Learn to relax, but don’t be lethargic.
b. Manage stress. Don’t merely focus on how to avoid it.
c. Take care of yourself so you are able to function effectively as an Emergency Responder.
Helping others in their time of need will put stress on your body – both emotionally and
physically.
Presentation – Protecting Yourself Against Bloodborne Pathogens

Infections – viruses, bacteria or other microorganisms – carried by the blood are called bloodborne
pathogens. As an Emergency Responder you will want to avoid these infections. Fear of disease
transmission is a common reason why laypersons trained in CPR avoid action. However, it is important to
note that research has shown that the chance of disease transmission is very rare when providing CPR and
other emergency care. Don’t delay helping a person in need just because barriers are not available.
1. What three bloodborne pathogens are of greatest concern to Emergency Responders?
2. As an Emergency Responder, what four ways can
you protect yourself against bloodborne pathogens?
3. As an Emergency Responder, what general rule
may help you avoid infection by bloodborne
pathogens?
C. Bloodborne Pathogens of Greatest Concern to
Emergency Responders.
1. Hepatitis C virus.
2. Hepatitis B virus
3. Human immunodeficiency virus (HIV) Combination plastic eye shield and face mask
D. A General Rule to Help You Avoid Infection by for protection against disease transmission. This
Bloodborne Pathogens type of barrier can be carried in a first aid kit.
1. When possible, place a barrier between you and any moist or wet substance originating from
another person.
2. All blood and body fluid should be considered potentially infectious. Take precautions to
protect yourself against them:
E. Four Ways to Protect Yourself against Disease Transmission
1. Use gloves
2. Use ventilation masks or shields when giving mouth-to-mouth rescue breathing.
3. Use eye or face shields; including eyeglasses or sunglasses, goggles and face masks.
4. Always wash your hands or any other area with antibacterial soap and water after providing
primary (CPR) and secondary (first aid) care. Scrub vigorously, creating lots of lather. If
water is not available, use antibacterial wipes or soapless liquids.
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F. Provide Immediate Care

1. IMPORTANT: Do NOT delay emergency patient care if barriers are not available.
Remember: Research has shown that the chance of disease transmission is very rare when
providing CPR and other emergency care.
2. If gloves and ventilation barriers are immediately available, use them during CPR to protect
yourself and the patient from possible disease transmission.
3. When available, use eye shields and facemasks when patients have serious bleeding.
Presentation – Recognizing Life-Threatening Problems

If you witness a serious car accident or watch someone take a bad fall, it’s reasonable to assume the patient
will have life-threatening injuries. Even if you don’t see the accident occur, many accident scenes clearly
point to medical emergencies. Unfortunately, not all life-threatening emergencies are so obvious. Some
serious conditions occur due to illness or subtle accidents. Sometimes the patient’s symptoms come on quickly
and other times the patient gets progressively worse over time. Because time is critical, as you’ve already
learned, you need to be able to recognize all life-threatening conditions and then provide appropriate
emergency medical care.
1. How can you recognize life-threatening emergencies such as
• Heart attack?
• Cardiac arrest?
• Stroke?
• Complete/Severe airway obstruction?
C. Recognizing a heart attack.
1. A heart attack occurs when blood flow to part of the
patient’s heart is stopped or greatly reduced.
2. The most common symptom of a heart attack is
pain accompanied by an uncomfortable pressure
or squeezing in the center of the chest behind the
breastbone that lasts for more than a few minutes,
or goes away and comes back.
3. Pain described as an ache, heartburn or indigestion.
This pain often spreads to the shoulders, back, neck, jaw or arms.
4. Other signs and symptoms include fainting, nausea, shortness of breath, sweating, extreme
fatigue, dizziness, and/or lightheadedness.
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D. Recognizing cardiac arrest.

1. Caused by a blocked artery, depriving oxygen to the heart. The heart stops beating or quivers.
This quivering of a heart is called ventricular fibrillation.
2. Two ways to recognize:
a. Patient does not respond when you speak or touch him.
b. No signs of circulation – no movement, breathing or coughing.
E. Recognizing a stroke.
1. Caused by blocked or ruptured blood vessel in the brain – depriving the brain of oxygen.
2. Use the memory word FAST to help you identify warning signs of stroke.
a. F = Face. Ask the patient to smile. Does one side of their face droop?.
b. A = Arms. Ask the patient to raise both arms. Does one arm drift downward?
c. S = Speech. Ask the person to repeat a simple phrase. Is their speech slurred or strange?.
d. T = Time. If you observe any of these signs, call EMS immediately.
3. Common signs and symptoms of stroke:
a. Sudden weakness or numbness of the face, arm, or leg, especially on one side of the body
or on both sides
b. Sudden confusion or drowsiness
c. Trouble speaking, understanding or swallowing
d. Sudden vision trouble from one or both eyes
e. Sudden trouble walking, dizziness, loss of balance or coordination
f. Sudden severe headache with no known cause
F. Recognizing complete (severe) airway obstruction.
1. Grasping, clutching the neck (universal distress signal for choking).
2. Unable to speak, breathe or cough.
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Presentation – Primary Care Definitions and Background

Information
The Emergency First Response courses, Primary Care (CPR) and Secondary Care (First Aid), are skill
intensive. However, skills alone are not enough. Knowing how, why and when to apply your skills during
an emergency is important as well. The definitions and background information in this presentation will
give you the confidence to use your skills – knowing you are giving the correct care in the correct sequence.
1. What is Primary Assessment and Primary Care?
2. What does CPR stand for, what is it and how does it work?
3. How do you determine if a person is unresponsive and not breathing normally?
4. What causes a person to stop breathing?
5. How does rescue breathing work?
6. What five situations might require you to move an injured or ill person?
C. Primary Assessment and Primary Care
1. Primary means first in a series or sequence – most important.
2. An assessment is an evaluation or an appraisal.
3. Therefore, in terms of emergency care, primary assessment is an Emergency Responder’s first
evaluation of an injured or ill person. Primary assessment is the first step of emergency care.
4. Primary assessment also refers to evaluation of a patient for ANY life-threatening conditions
needing immediate attention – heart and breathing problems, choking, serious bleeding,
shock and spinal injuries.
5. Emergency Responders provide primary care to patients with life-threatening injuries or
illnesses.
D. CPR
1. CPR stands for Cardiopulmonary Resuscitation. Cardio – means “heart.” Pulmonary
– means “concerning the lungs and breathing.” Resuscitation – means “to revive from
unconsciousness.”
2. If a patient is unresponsive and not breathing normally, you begin CPR immediately. We’ll
discuss what we mean by “not breathing normally” later.
3. As discussed earlier, CPR is a two-step process. First, press on a patient’s chest and second,
blow in the patient’s mouth providing him oxygen.
4. Complete CPR combines manual chest compressions with rescue breathing.
E. How Does CPR Work
1. The heart pumps oxygen-rich blood throughout the body. It also returns the oxygen-poor
blood to the lungs for more oxygen.
2. If the heart is beating erratically or not beating at all, rescue breathing alone is ineffective.
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3. If a patient’s heart has stopped, you substitute manual chest compressions for the heart’s
pumping action to circulate blood through the body.
4. Chest compressions force blood from the heart through the arteries and deliver oxygen-rich
blood to vital organs.
INSTRUCTOR NOTE – Delays in, and interruptions of, chest compressions should
be minimized whenever you assist someone who is unresponsive and not breathing
normally. Chest compressions can be started immediately. Delaying chest
compressions for any reason is counterproductive.
5. Manual chest compressions deliver no more than one third of normal blood flow to the
body. Therefore, as an Emergency Responder you must begin compressions immediately
and minimize interruptions during CPR. Delaying chest compressions for any reason is
counterproductive.
6. CPR is used as an interim emergency care procedure until an AED and/or EMS personnel
arrive. However, it is a vital link in the Chain of Survival. CPR extends the window of
opportunity for resuscitation – greatly increasing the patient’s chance of revival.
7. CPR rescue efforts are difficult to sustain for long periods. From an Emergency Responder
perspective, CPR is exhausting. This is another reason to call the EMS immediately. Also, if
feasible, change rescuers every few minutes to prevent rescuer fatigue and deterioration in
chest compression quality.
8. Regarding CPR, if you are unable or feel uncomfortable giving a nonbreathing patient
rescue breaths – RELAX! Simply give the patient continuous chest compressions. Chest
compressions alone are very beneficial to a patient who is unresponsive and not breathing
normally. Your efforts may still help circulate blood that contains some oxygen. Remember:
Adequate care provided is better than perfect care withheld.
9. You will learn adult CPR during the Primary Care Skill Development session.
F. Unresponsive Patients Who Are Not Breathing Normally
1. Rapid recognition of cardiac arrest is important when helping someone who is unresponsive,
not breathing or not breathing normally. Unresponsive patients who are not breathing
normally may be in cardiac arrest.
2. After you’ve determined that a patient is unresponsive and not breathing normally, activate
the Emergency Medical System immediately.
3. Next, you begin CPR, chest compressions.
4. What does unresponsive mean? A patient who is unresponsive shows no sign of movement
and does not respond to stimulation, such as a tap on the collarbone or loud talking. This is
also known as unconsciousness.
5. What does “not breathing normally” mean? An unresponsive person taking gasping breaths is
NOT breathing normally. In the first few minutes after cardiac arrest, a patient may be barely
breathing, or taking infrequent, slow and noisy gasps. Do not confuse this with normal breathing.
A patient barely breathing, or taking infrequent, slow and noisy gasps needs CPR immediately.
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6. How do you determine if an unresponsive person is breathing normally? Most unresponsive

individuals in cardiac arrest will not be breathing at all. During the Primary Care Skill
Development sessions you will learn how to quickly check a patient for responsiveness and
normal breathing.
INSTRUCTOR NOTE – Do not take time to check for a pulse. Studies show that
even healthcare providers have difficulty detecting a pulse on unresponsive
patients. Checking for a pulse takes too much time – time that can be used to
immediately initiate CPR.
G. Reasons for a Person to Stop Breathing

1. A person may not be breathing for a number of reasons.
a. Heart attack or sudden cardiac arrest
b. Submersion and near drowning
c. Stroke
d. Foreign body airway obstruction – choking
e. Smoke inhalation
f. Drug overdose
g Electrocution, suffocation
h. Injuries
i. Lightning strike
j. Coma
H. How Rescue Breathing Works
1. If after providing chest compressions to an unresponsive patient you decide to give him
rescue breaths, there is plenty of unused oxygen in your expired breath to help a nonbreathing
patient.
2. The air we breathe contains 21 percent oxygen. We use about five percent for ourselves. This
leaves a very high percentage of oxygen in the air we exhale after each breath.
3. This unused oxygen can be used for rescue breathing to support a nonbreathing patient.
4. You will learn how to perform and will practice giving rescue breaths in your Skill
Development session.
INSTRUCTOR NOTE – If you are unable or feel uncomfortable giving an

unresponsive patient rescue breaths – RELAX. Simply give the patient
continuous chest compressions. Chest compressions alone are very beneficial
to a patient without a heartbeat. Your efforts may still help circulate blood that
contains some oxygen.
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Presentation – Using AB-CABS and the Cycle of Care to Prioritize

Primary Care
Have you ever used a memory device to remember important information or difficult to remember
sequences? How about “I before E, except after C or when sounding like A.” This little memory phrase
(mnemonic) can help you spell such words as receipt, friend, or weigh. Or, how about “ROY G. BIV?” This
memory device can help you remember the proper sequence of hues in the visible spectrum and rainbows:
Red, Orange, Yellow, Green, Blue, Indigo, and Violet. Just as easy, you can remember how to help someone
with a life-threatening illness or injury by using AB-CABS. Let’s see how.
1. What does the AB-CABS memory word mean?
2. What is meant by the Cycle of Care?
3. What do you do if you discover a patient is not breathing normally?
4. What is defibrillation and why is it important to a patient whose heart has stopped?
5. When a patient’s heart is beating erratically or quivering (ventricular fibrillation), how can it
be restored to a normal heart rhythm?
6. What is an Automated External Defibrillator (AED)?
7. What are the three types of bleeding and how is each identified?
8. What is shock, what can cause it, and what are the
nine indications of shock?
9. What does the spinal cord do in the human body and
why is it important to protect the spinal cord during
primary care.
10. What eight indications might signal the need for
spinal injury management
11. In what nine circumstances should you always suspect
a spinal injury?
12. What are the five situations when you might want to
move an injured or ill person?
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C. The AB-CABS Mnemonic – Remembering How to Help

1. What is a mnemonic? The word mnemonic (pronounced: “ne•mon•ic”) means, “aiding
the memory.” A mnemonic is a learning device or in this case a memory word that helps
you remember a procedure or information. Mnemonic learning devices work because
they provide a meaningful connection between hard to remember informational items or
procedures with memory.
2. The memory word AB-CABS speaks directly to the pathway and priorities for emergency
care. By learning this memory word, you’ll know what to do first, second, third and so
on when a person with a life-threatening illness or injury needs you. The meaning and
prioritized flow of AB-CABS is:
A = Airway Open?
B = Breathing Normally?
C = Chest Compressions
A = Airway Open
B = Breathing for the Patient
S = Serious Bleeding, Shock, Spinal Injury
3. The first “A” in the memory word AB-CABS can mean more than simply asking the question
“Airway Open?” It can also remind you to Assess the Scene and Apply Barriers. These are all
skills you’ll learn in this course.
D. The AB-CABS Cycle of Care Graphic
1. When combined with a graphic, a memory word like AB-CABS is easier to remember.
Help or AED Arrives

Continue Until
AB C
Chest
Airway Breathing
Open? Normally?
Compressions
AA irway Open
BB reathing
for Patient
hock
Spinal Injury
Check Unresponsive Responsive

Quickly & Not Breathing & Breathing
Normally Normally
2. When you first begin to assist a patient with a life-threatening illness or injury, reflect on the
AB-CABS graphic. First begin with the “AB” portion of the memory word. This is a quick
check of the patient’s Airway to see if it’s open and if the patient is Breathing normally.
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3. Next, move to the “CAB” portion of the memory word (in the blue sphere). If the patient
is not breathing normally you must act immediately to provide Chest Compressions. After
chest compressions you open the patient’s Airway and then Breathe for the patient (CAB).
As defined earlier, this is how CPR is administered.
4. Once you are finished providing rescue breaths for the patient, you return to Chest
Compressions and begin again. You continue CPR in a continuous cycle of chest compressions
and rescue breaths. We call this the Cycle of Care.
5. If a patient is breathing normally, then he does not need CPR. You SKIP all the steps in the
blue sphere – the CAB portion of the memory word.
6. If the patient is breathing normally you move along the Cycle of Care to the S portion of “CABS”
and treat for Serious bleeding, Shock and Spinal injury.
Help or AED Arrives

Continue Until
AB C
Chest
Airway Breathing
Open? Normally?
Compressions
AA irway Open
BB reathing
for Patient
hock
Spinal Injury
7. Notice that if you are performing CPR on a patient that is not breathing normally you
continue with Chest Compressions, opening the Airway and providing rescue Breaths –
CAB. You do not attempt to treat the patient for serious bleeding, shock and spinal injury.
CPR takes priority over all other concerns.
E. Continually Move Through The Cycle of Care
1. Regardless of the patient’s situation upon your arrival, you begin a primary assessment using
the memory word AB-CABS to help you remember how to begin and what steps to follow.
Remember the word AB-CABS and think of the Cycle of Care graphic.
2. The phrase, “Continually move through the Cycle of Care” helps you maintain appropriate
primary care sequencing.
3. In a continual Cycle of Care you apply CPR, remembering the CAB portion of the memory
word. You do this until professional help (ambulance or Emergency Medical Services) arrives
or an Automated External Defibrillator (AED) is located and brought to the patient. More
on AED’s later.
4. Let’s apply the priorities indicated by the Cycle of Care to two different situations.
Situation One. You are alone and find a patient lying in his yard. He is unresponsive and not
breathing normally. He has fallen on a sharp gardening implement and it’s impaled his leg. His
leg is bleeding. For this patient, what is the sequence of emergency care?
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INSTRUCTOR NOTE: Break participants into groups. Using the Cycle of Care,
have them explain the order of emergency care priorities and what they would
do to help this person. Keep the discussion general and focused on the Cycle
of Care. Answers may vary depending on how bad the patient is bleeding. In
general however, using the Cycle of Care the rescuer would: 1) Assess the scene
for unknown dangers to yourself and the patient and apply barriers, 2) Check
for an open airway and normal breathing, 3) Alert EMS, 4) Provide patient with
chest compressions, 5) Open the patient’s airway, 6) Provide patient with rescue
breaths, 7) Continue CPR until help or an AED arrives.
Situation Two. A painter falls from a tall ladder onto cement. When you find him he is moaning and
talking, but obviously hurt. For this patient, what is the proper sequence of emergency care?
INSTRUCTOR NOTE – Again, have the groups explain the order of emergency care
priorities and what they would do the help this person by using the Cycle of Care.
Of course in this example, the rescuer would provide care for possible bleeding,
shock and spinal injury. Keep the discussion general and focused on the Cycle of
Care. Answers may vary, but in general using the Cycle of Care the rescuer would:
1) Assess the scene for unknown dangers to yourself and the patient, 2) Check
for an open airway and normal breathing, 3) Alert EMS, 4) Look for and treat
suspected bleeding, shock and/or spinal injury, 5) Continually move through the
Cycle of Care until EMS arrives.
In this situation the patient is responsive and talking. If a patient talks and
moans, then he has an open airway and is breathing. He does not need CPR,
so you skip the CAB portion of the Cycle of Care. You would provide care for
possible Serious bleeding, Shock and/or Spinal injury.
F. Cycle of Care
1. On the AB-CABS Cycle of Care graphic you continually move from Chest Compressions, to
Airway Opening, to Breathing for the patient, and then back to Chest Compressions.
2. You continue this Cycle of Care until either EMS personnel arrive and take over or an AED is
located and brought to the patient.
Help or AED Arrives

Continue Until
AB C
Chest
Airway Breathing
Open? Normally?
Compressions
AA irway Open
BB reathing
for Patient
hock
Spinal Injury
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G. Importance of an AED and Defibrillation

1. A heartbeat is triggered by electrical impulses.
2. When these natural electrical impulses malfunction, the
heart stops beating and just quivers erratically. This is
called ventricular fibrillation. Fibrillation means to twitch.
3. Ventricular fibrillation causes sudden heart attacks.
4. To stop the heart from twitching erratically, AEDs
deliver an electrical shock, which disrupts this abnormal
twitching. The momentary disruption can allow the heart’s normal heartbeat to return.
5. Administering an electrical shock from an AED is called defibrillation.
6. Since ventricular fibrillation is one of the most common life-threatening heart-related
emergencies, prompt defibrillation is vital to the Chain of Survival.
7. Securing an AED is so important to a patient that is unresponsive and not breathing
normally that when asking someone to call EMS, you also ask them to bring an AED if one
is available.
H. How AEDs Work
1. An Automated External Defibrillator (AED) – is a portable machine that automatically
delivers a shock to a patient who is not breathing normally and whose heart has stopped
beating or is beating irregularly.
2. AEDs connect to a patient via two chest pads.
3. When the AED is turned on, its computer analyzes the patient’s need for a shock.
4. If the AED detects a shockable heart rhythm, the machine will indicate that a shock is
advised. Depending on the type of AED, the Emergency Responder will activate the shock
or the machine does so automatically.
5. You may have an orientation to an AED as an optional skill in the Emergency First
Response Primary Care (CPR) course.
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I. The Meaning of the “S” in AB-CABS
Help or AED Arrives

Continue Until
AB C
Chest
Airway Breathing
Open? Normally?
Compressions
AA irway Open
BB reathing
for Patient
hock
Spinal Injury
1. If a patient’s Airway is open and he’s Breathing normally (AB), then there is NO need to:
• Provide Chest Compressions.
• Make sure the Airway is open.
• Or Breathe for the patient.
2. There is no need to act on the CAB portion of the Cycle of Care.
3. Next, you move on to check the patient for Serious bleeding, Shock, and Spinal Injury. These
comprise the “S” in the word CABS. Let’s look at each separately.
J. Serious Bleeding
1. Serious bleeding is life-threatening. It must be discovered and managed during the primary
assessment.
2. The human body contains about six litres/quarts of blood. Rapid loss of even one litre/quart
can lead to death.
3. The three types of bleeding are:
a. Arterial Bleeding – bright red blood that spurts from a wound in rhythm with the
heartbeat. This is the most serious type of bleeding since blood loss occurs very quickly.
If a major artery is cut, death can occur in one minute if not treated. Activate EMS
immediately.
b. Venous Bleeding – dark red blood that steadily flows from a usually deep wound. Venous
bleeding does not display rhythmic spurts. This bleeding is also life-threatening and must
be controlled. Monitor the patient’s Cycle of Care and activate your local EMS
c. Capillary Bleeding – Slow bleeding that is typically controllable. Monitor the patient’s
Cycle of Care and activate EMS if necessary.
4. During the Skill Development session, you will learn how to control bleeding and provide
emergency care.
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K. Shock
1. Any injury or illness, serious or minor that stresses the body, may result in shock. In reaction
to a medical condition, the body pools blood into one or more vital organs. This reduces
normal blood flow to other body tissues depriving cells of oxygen. During shock, the body
begins to shut down.
2. Nine common signs of shock are:
a. Rapid, weak pulse
b. Pale or bluish tissue color
c. Moist, clammy skin – possibly with shivering
d. Mental confusion, anxiety, restlessness or irritability
e. Altered consciousness
f. Nausea and perhaps vomiting
g Thirst
h. Lackluster eyes, dazed look
i Shallow, but rapid, labored breathing
3. Even if you don’t recognize any of these signs and symptoms in a patient, continue to
manage for shock when you provide emergency care to an injured or ill patient.
4. It’s better to prevent shock than to let it complicate a patient’s condition
5. During primary assessment and care, you take the first steps to managing shock by dealing
with other life-threatening conditions. Checking that a patient is breathing, has adequate
circulation and is not bleeding profusely helps the patient’s body maintain normal blood
flow. You render additional care by keeping the patient still and maintaining the patient’s
body temperature. You may elevate the patient’s legs if it won’t aggravate another injury.
Continuing to monitor the patient’s lifeline until EMS arrives also contributes to shock
management.
6. During the Skill Development session, you will learn how to control shock and provide
emergency care.
L. Spinal Injury
1. Your spinal cord connects the brain to the rest of the body and organs.
2. It is essential for life and runs down through the vertebrae in the neck and spine.
3. Vertebrae are rings of bones surrounding the spinal cord and run from the neck to the lower
back. These bones make up the backbone, or spinal column.
4. A spinal cord injury may result in permanent paralysis or death. The higher up in the
spinal column the injury, the more likely it will cause a serious disability. This is why it’s so
important to guard the head, neck and spine when attending to an injured patient.
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M. Nine Indications Signaling the Possible Need for Spinal Injury Management
1. Change of consciousness – like fainting
2. Difficulty breathing
3. Vision problems
4. Inability to move a body part
5. Headache
6. Vomiting
7. Loss of balance
8. Tingling or numbness in hands, fingers and feet and/or toes
9. Pain in back of neck area
N. When You Should Always Suspect a Spinal Injury
INSTRUCTOR NOTE – There may be other circumstances when you should suspect
a spinal injury, but in these cases you should always suspect a spinal injury.
1. Traffic/car accident
2. Being thrown from a motorized vehicle
3. Falling from a height greater than patient’s own height
4. A penetration wound, such as a gunshot wound
5. Severe blow to the head, neck or back
6. Swimming pool, head-first dive accident
7. Lightning strike
8. Serious impact injury
9. Patient complains of pain in neck or back
O. Protecting the Spinal Cord During Primary Care
1. Important Primary Care Concept: Never move a patient unless absolutely necessary.
2. If a spinal cord injury is suspected during the primary assessment, support the head and
minimize its movement during CPR or other emergency care.
3. During skill development, you’ll practice turning a patient while protecting the neck
and spine. This technique for moving a patient is called the log roll. You’ll learn to roll a
patient by yourself and with the assistance of another Emergency Responder.
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P. Situations Where You Might Need to Move an Injured or Ill Patient

1. You should only move an injured or ill person if it’s absolutely necessary.
2. It is necessary to move a patient when there is clear and direct danger to you and the
patient’s life, or if emergency care is impossible due to a patient’s location or position.
3. Situations in which you may need to move a patient to give emergency care include:
• Patient is in water.
• Patient is near a burning object or structure that may explode.
• Patient is under an unstable structure that may collapse.
• Patient is on an unstable slope.
• Patient is on a roadway and you can’t effectively direct traffic away from patient’s location.
4. Many other situations may apply. Can you think of others? During skill development, you’ll
learn how to assess an accident scene to help protect yourself from life threatening hazards
and prevent the patient from suffering further harm.
5. Also during skill development, you’ll practice turning a patient while protecting the neck and
spine. This technique for moving a patient is called the log roll. You’ll learn to roll a patient
by yourself and with the assistance of another Emergency Responder.
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Instructor Led Approach Knowledge

Development Outlines
Presentation – Course Introduction
A. Introductions – Self and Assistants
B. Signing In – Complete course paperwork
C. Questions You’ll be able to Answer by the End of this Presentation
1. Why is completing Primary Care – CPR training a prerequisite to the Emergency First
Response Secondary Care (First Aid) course?
2. What four skills will you learn in the Emergency First Response Secondary Care (First Aid)
course?
D. Course Context
1. The two courses covered in this program - Emergency First Response Primary Care (CPR)
and Secondary Care (First Aid) – assume that you, the Emergency Responder, have quick
access to Emergency Medical Services (also called EMS) and that they can be summoned
quickly to provide a patient with advanced life support.
2. Caring for a patient well beyond quick access to EMS, requires additional skills. Commonly,
these additional skills are found in wilderness or remote location type first aid courses.
E. About the Emergency First Response Secondary Care (First Aid) Course
1. The Emergency First Response Secondary Care (First Aid) course prepares you to render
emergency care for common, first aid problems that are not immediately life-threatening.
2. Why is completing Primary Care – CPR training a prerequisite to the Emergency First
Response Secondary Care (First Aid) course?
a. Any time you approach a patient to provide emergency care, regardless of the injury or
illness, you perform a Primary Care Assessment and use the Cycle of Care to continually
monitor his medical status.
INSTRUCTOR NOTE – Explain the memory word AB-CABS in relationship to the

Cycle of Care to participants from other primary care backgrounds.
b. Also, primary care skills are needed during this course. Further, at any time a responsive patient
can become unresponsive and even stop breathing thereby needing Primary Care – CPR.
3. Skills Learned in the Emergency First Response Secondary Care (First Aid) Course
a. Skill 1 - Injury Assessment
b. Skill 2 - Illness Assessment
c. Skill 3 - Bandaging
d. Skill 4 – Splinting for Dislocations and Fractures
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4. This course complements CPR training by teaching

additional first aid skills and providing additional
Primary Care Assessment practice.
5. In this course, you begin to learn what to do when EMS
are unavailable or delayed. If an EMS is close at hand,
you may never need to use the skills in this course. You
need only complete a Primary Assessment then wait for
EMS personnel to handle all emergency care. However,
if EMS personnel are some distance and time away or
unavailable, you may need to assist a patient using the
skills in this course and render first aid.
Presentation – Secondary Care (First Aid) Definitions and

Background Information
The Emergency First Response courses, Primary Care (CPR) and Secondary Care (First Aid), are skill
intensive. Skills alone, however is not enough. Knowing how, why and when to apply your skills during
an emergency is important as well. The background information in this presentation will give you the
confidence to use your skills – knowing you are giving the correct care at the correct time.
1. What is a Secondary Assessment and Secondary Care?
2. What is the difference between injury and illness?
3. What is a “sign” and a “symptom?”
4. In a Secondary Assessment, what does “normal” mean?
5. What is Assessment First Aid?
C. Secondary Assessment and Secondary Care
1. Secondary means second in a series or sequence. Secondary Care follows Primary Care (CPR).
2. An assessment is an evaluation or appraisal.
3. A Secondary Assessment is an Emergency Responder’s second evaluation of an injured or ill
person.
4. Once a patient is stabilized during primary care you attend to the next level of emergency
care – Secondary Care.
5. Secondary Care is what you provide to a patient with injuries or illnesses that are not
immediately life-threatening.
D. The Difference between Injury and Illness
1. An injury is physical harm to the body. Examples include:
a. Cuts, scrapes and bruises
b. Chest injuries
c. Head, eye and dental injuries
d. Burns
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e. Dislocations and fractures

f. Temperature-related injuries such as hypothermia, frostbite, heat exhaustion and heat stroke
g. Electrical injuries
2. An illness is an unhealthy condition of the body. Illnesses may be caused by preexisting
conditions such as allergies or diabetes. Generally, illnesses are determined through a
patient’s signs and symptoms.
3. Signs and Symptoms
a. A sign is something you can see, hear or feel.
• For an injury assessment you look for signs such as wounds, bleeding, discolorations,
or deformities. You also listen for unusual breathing sounds and feel for swelling or
hardness, tissue softness or unusual masses.
• For an illness assessment you look for changes in skin color, breathing rate or patient
awareness along with shivering or seizures. You listen for breathing difficulty and you
feel the patient’s skin temperature and pulse.
b. A symptom is something the patient tells you is wrong.
• For both injury and illness assessments, the patient may complain of nausea, thirst,
dizziness, numbness or pain.
4. What is Normal?
a. It’s difficult to determine if an ill patient’s signs are abnormal if you don’t know what is
“normal.” The fact is that what is normal for one patient may be completely abnormal for
another.
b. There are “normal” ranges for breathing rate, pulse and skin temperature. However, a patient
could be outside the average and still be within a personal “normal” range. This is why it’s
important when giving information to EMS personnel to avoid using the word normal and
simply provide measured rates per minute and use other descriptive terminology.
c. Here are the average ranges that may help guide your assessment:
• The average breathing rate for adults is between 12 and 20 breaths per minute. A
patient who takes less than 8 breaths per minute, or more than 24 breaths per minute,
probably needs immediate medical care.
• The average pulse rate for adults is between 60-80 beats per minute.
• Average skin temperature is warm and skin should feel dry to the touch.
E. Assessment First Aid
1. Assessment first aid is the treatment of conditions that are not immediately life threatening
or uncovered during either an Illness Assessment or an Injury Assessment.
2. To provide secondary care, you may use the skills you learn during this course, or you may
reference your Emergency First Response Participant Manual for important emergency care
information.
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Section Three – Skill Development
Three
Skill Development
Introduction
Skill development is a critical part of the
Emergency First Response program. Participants
first learn the basic steps and subskills, then
practice the skills under peer and instructor
guidance. Repeated practice under controlled
conditions allows participants to fine-tune
performance, gain competence and build for
retention.
This section provides information about teaching
primary care and secondary care skills. It also
includes guidelines for introducing two optional
course skills – Automated External Defibrillator (AED) and Emergency Oxygen Use. By following
step-by-step directions for organizing skill development, you’ll introduce skills, guide practice and
answer participant questions about techniques covered in the Emergency First Response Participant
Manual and the Emergency First Response Video. During skill development, you’ll also provide
participants with encouragement and suggestions for improvement.
3-1
Practice Groups
Why and How
Learning skills require focus, participation, and practice. By dividing participants into small practice
groups, you provide them with a comfortable learning environment that continually engages them
in skill practice. Ideal practice groups consist of a guide, a patient and an Emergency Responder.
The group members alternate roles until all participants have the opportunity to play each role. This
approach allows participants to perform not only a skill, but to also see someone else practice the
skill and to feel what a patient may experience.
When acting as a guide, the participant helps the Emergency Responder through the skill by reading
the How It’s Done steps in the Skill Development section of the Emergency First Response Participant
Manual. Having to direct a peer helps each participant understand the skill steps and increases
overall confidence.
Practicing the skill as the Emergency Responder, especially the first attempt, becomes less stressful
when participants know that a peer is available to guide them. Making initial mistakes in front of
other participants, instead of the instructor, is less intimidating for many people. Practicing in a
group also strongly promotes self-discovery and self-correction.
Having participants act as patients serves two important purposes. First, it adds realism by requiring
the Emergency Responder to approach, touch and
interact with another person. Secondly, it allows
participants to examine emergency care from a
patient’s perspective. This heightens awareness and
reinforces the need to help others whenever possible.
The ideal practice group is made up of three
participants. However, if class size doesn’t allow this
division, place four participants in a group or use
smaller groups with you or an assistant filling in as
necessary. For larger classes, consider reorganizing
groups once or twice during the course to keep
interest levels high.
The Ability to Replicate Skills without Hesitation

Emergency scenes can be intimidating. Even those with professional level CPR and first aid training
can feel helpless, shocked or overwhelmed by what they witness. For this reason, your teaching
environment should be encouraging, positive and nurturing. Learning in this type of environment
promotes participant willingness to help others during actual emergencies. It is easy to create a
nonthreatening atmosphere in your initial skills practice sessions. For examples, see “Positive Coaching”
below. Participants approaching mannequins for the first time can freeze up. Through proper
encouragement, the participant’s fears will likely subside. Remember there are several techniques
to carry out a skill effectively. This is especially important to remember when your participants are
physically challenged.
Your goal is to motivate and provide techniques for participants to do their best. However, keep your
view balanced when it comes to participant performance. Adequate performance in the CPR or first
aid classroom may be enough to make the difference in an actual emergency.
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Positive Coaching –
Encouraging Good Technique
Points to keep in mind during skills practice:
1. If the participant is obviously anxious about the skill, and/or if it is the first time the skill
is practiced, it is often best to let the participant follow through with the skill regardless of
ineffectiveness. Interrupting the skill to correct technique in this situation can cause further
anxiety. Be mindful that the participant is not only performing the skill, but also trying to recall
the sequence and steps of each skill. Work on the sequence first, then technique.
2. There are several nonthreatening ways to correct ineffective technique without singling out or
drawing attention to (and thus embarrassing) any one participant. For example, after the skill
is performed ineffectively, one method is to thank the person, move on to the next participant,
and point out the most effective things that person is doing. By drawing attention to specific,
effective techniques in other participant performance, it sends a message to all participants as to
what you are looking for in performance. This method of “gentle correction” also keeps the class
moving. Be prepared for further practice as those with ineffective technique learn from others
and repeat practice.
3. Another method is to provide impromptu demonstrations yourself (or by your assistant), pointing
out specific elements of the skill you want participants to correct.
4. You can also use the Emergency First Response Video skill demonstrations, turning off the sound,
and pointing out technique during the demonstration.
5. Keep your critiques positive. Give participants encouragement, even when they are performing
poorly. Let them learn by discovery and by watching others, whenever possible. Avoid singling
anyone out and causing embarrassment. Make broad statements such as “I noticed some of you
were ____________________ (name specific problem). It can be more effective to do it like this
[demonstrate technique].”
6. Ask participants to encourage each other and work together for success in their practice groups.
Make sure the “guide” helps the Emergency Responder by reading through the steps and
technique suggestions as needed.
7. Avoid standing over your participants while they perform skills—take a nonthreatening stance, a
bit away, but near enough to monitor and assist as needed.
8. Always commend good technique, and be specific about it. Pointing out effective skills practice
in this manner builds confidence and helps others learn.
Remember that creating a nonthreatening, positive atmosphere in class will promote effective skills
practice, skill retention, and foster a willingness to offer skills in an emergency.
3-3
Teaching the Skills

This section outlines information specific to all primary care and secondary care skills. Listed for
each skill are the performance requirement(s), a value statement, key points, critical steps and
directions for conducting skill practice.
During skill development, the amount of information you deliver and the required detail of your
demonstration depends on the instructional delivery approach you follow — independent study,
video guided or instructor led. Refer to the following material as a general guide for teaching each
skill. Look for special directions regarding instructional delivery approach and other procedural
variations listed under each skill.
Independent Study Approach

1. Introduce the skill – cover performance requirements (called “Your Goal” in participant
manual), value and briefly go over key points.
2. Demonstrate the skill by reviewing the critical steps. Follow this through in each skill
segment.
3. Divide participants into practice groups and have them practice the skill by referring to their
Emergency First Response Participant Manual and Emergency Care at a Glance guide.
4. Debrief the skill providing positive reinforcement, additional important information and
suggestions for improvement.
Video Guided Approach

1. Introduce the skill – cover performance requirements (called “Your Goal” in participant
manual), value and briefly go over key points.
2. Show appropriate skill portion of the video.
3. Demonstrate the skill by reviewing the critical steps. Follow this through in each skill
segment.
4. Divide participants into practice groups and have them practice the skill by referring to their
Emergency First Response Participant Manual and Emergency Care at a Glance guide.
5. Debrief the skill providing positive reinforcement and suggestions for improvement and
conducting a real-time demonstration as directed.
Instructor Led Approach

1. Introduce the skill – cover performance requirements, value and key points.
2. Discuss the skill by going over critical steps. If available, refer to illustrations in the Emergency
First Response Participant Manual.
3. Demonstrate the skill by showing the critical steps.
4. In practice groups, have participants develop proper skill technique.
5. Debrief the skill providing positive reinforcement, suggestions for improvement and
conducting a real-time demonstration as directed.
3-4
In general, you introduce each skill by reviewing the performance requirement, value and key points.
Next, you provide a demonstration, as necessary, using the critical steps. After dividing participants
into practice groups, you monitor practice, provide positive reinforcement, and offer suggestions for
improved technique. Allow for additional practice as necessary to increase participant competence and
confidence.
Because you may have several practice groups working on skills at the same time, make sure you can
adequately supervise development, answer questions, and advise participants. Remember to keep
answers to questions brief and to the point. Consider answering situational or “what-if ” questions by
sending participants back through the Cycle of Care to continually monitor medical status.
Skill development motivates and teaches participants proper emergency care procedures for patients
suffering what might be life-threatening injuries. Stress that the goal is to apply knowledge to actual
circumstances if the need arises.
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Skill Development
Primary Care (CPR)
Primary Care Skill 1
Scene Assessment
Performance Requirement
Demonstrate procedures for assessing an emergency scene for safety.
Value
As an Emergency Responder, you must ensure your safety before you can provide emergency care to
someone in need. You cannot provide care if you become injured. Always assess the scene for safety.
Help or AED Arrives

Continue Until
Assess Scene AB C
Chest
Airway Breathing
Apply Barriers
Open? Normally?
Compressions
AA irway Open
Airway Open?
BB reathing
for Patient
hock
Spinal Injury
The first “A” in the memory word AB-CABS can mean more
than simply asking the question “Airway Open?” It can also
remind you to Assess the Scene.
3-6
Key Points and Critical Steps

STOP – Assess Scene
¨ Ask yourself - What caused the injury?
¨ Are there any hazards? Look for potential hazards such as leaking gas, chemicals, radiation,
downed electrical lines, fire, firearms, the possibility of explosion, oxygen depletion, etc.
¨ Can you make a safe approach? Consider how to make a safe approach. Be alert for possible
dangers, such as oncoming traffic. Do you need to turn off a car’s engine?
¨ Apply barriers as appropriate and if available.
THINK – Formulate safe action plan

¨ Can you remain safe while helping? Remember that your safety must be the first priority.
Know your limitations.
¨ What emergency care may be needed?
¨ How can you activate local EMS? Can you secure an AED?
¨ Think about your training and relax. Now you can ACT.
ACT – Begin providing care

¨ Follow the emergency care guidelines you will learn next.
¨ Continue to consider your safety as you provide care.
Skill Practice
Using the scene assessment illustrations (in either the participant manual or this guide), have
participants work through one or more of the four accidents illustrated – stopping, thinking and
acting in practice groups. Also, provide participants with local contact information to Alert EMS.
Debrief
Allow for additional practice as necessary to increase participant competence and confidence. Tell
participants that they will assess a scene every time they step up to provide care.
3-7
Scene Assessment
Scene Assessment Scenario One
Scene Assessment Scenario Two
3-8
Scene Assessment
Scene Assessment Scenario Three
Scene Assessment Scenario Four
3-9
Barrier Use
Demonstrate procedures for donning, removing and disposing of gloves. This includes removing
gloves without snapping or tearing them. Also, properly position a ventilation barrier on a
mannequin.
Value
Barriers provide protection from the transmission of infectious diseases. Barriers, if available, should
be used to ensure your safety and the patient’s safety.
Help or AED Arrives

Continue Until
Assess Scene
Apply Barriers AB C
Chest
Airway Breathing
Airway Open? Open? Normally?
Compressions
AA irway Open
BB reathing
for Patient
hock
Spinal Injury
The first “A” in the memory word AB-CABS can mean
more than simply asking the question “Airway Open?”
It can also remind you to Apply Barriers.
Key Points
¨ Remember to STOP, THINK and then ACT.
¨ Barriers include gloves, ventilation barriers, eye shields and
face masks.
¨ IMPORTANT: Do NOT delay emergency patient care if
barriers are not available. Research has shown that the chance
of disease transmission is very rare when providing CPR.
¨ If gloves and ventilation barriers are immediately available, use
them during CPR to protect yourself and the patient from possible
disease transmission.
¨ If available, also use eye shields and face masks when patients have
serious bleeding.
¨ Prior to and after all skill practice, wash your hands. After providing
actual emergency care, make sure you wash your hands.
3-10
Critical Steps
Gloves On
1. Quickly put on gloves. Pull them on carefully to avoid tearing. Consider removing sharp
rings on fingers.
Gloves Off
1. To remove the first soiled glove, carefully pinch the
outside portion of the glove at the wrist. Avoid contact
with the outside of the glove. Be careful not to snap or
tear the glove during removal since fluids may disperse
inappropriately.
2. Gently roll the glove off so that the outside portion is
turned inside. Hold the removed glove with the gloved
hand.
3. To remove the remaining glove, place the ungloved hand under the glove at the wrist, next
to the skin, and roll off in the same manner. Roll the glove off and around the previously
removed glove.
4. After removing both gloves, place them in a biohazard bag for disposal.
Ventilation Barriers
Refer participants to their Emergency First Response Participant Manual to review the different types
of ventilation barriers – shields, pocket masks, etc. If possible provide samples of various barriers.
1. Place ventilation barrier over patient’s mouth and/or nose for CPR.
2. Position barrier to allow rescue breaths but prevent the patient’s body fluids from reaching you.
3. Place used disposable ventilation barrier in a biohazard bag.
Skill Practice
INSTRUCTOR NOTE – If a participant has a sensitivity to Latex®, use a glove made
of a different material such as nitrite or vinyl.
In practice groups and following the steps in Emergency First Response Participant Manual, have
participants develop proper techniques for putting on, removal and disposal of gloves. Have
participants also practice placing a ventilation barrier on mannequin.
Debrief
Allow for additional practice as necessary to increase participant competence and confidence.
Discuss or show participants other types of barriers if available – eye shields and face masks. Further,
discuss the need for hand or body washing after emergency care when exposed to body fluids.
3-11
Primary Assessment – Airway Open?

Breathing Normally?
INSTRUCTOR NOTE – Procedures for Primary Assessment vary internationally.
The emergency care procedures outlined within this skill follow the guidelines
set forth by the major resuscitation councils and organizations. If the emergency
care procedure varies in your area, teach participants the local protocol.
Performance Requirements
Demonstrate how to:
¨ Perform a patient responsiveness check by giving the Responder Statement and tapping the
patient’s collarbone.
¨ Check for an open airway using one of two methods - head tilt-chin lift or pistol grip lift.
¨ Check for normal breathing.
¨ Perform a Primary Assessment on a responsive and conscious patient.
¨ Perform a Primary Assessment on an unresponsive and unconscious patient.
¨ Place an unresponsive, breathing patient in the recovery position.
Value
Remember, “primary” means first in a series or sequence. “Assessment” is an evaluation or an
appraisal. Primary assessment helps you recognize life-threatening conditions and prepare to
provide priority emergency care. By conducting a Primary Assessment you will be able to answer
the questions is the Airway Open and is the patient Breathing Normally? This is the “AB” portion of
AB-CABS memory word. After you conduct a Primary Assessment, then you proceed to attend to
life-threatening conditions.
Key Points
¨ Use the Cycle of Care memory word to help you conduct a Primary Assessment.
¨ Deliver the Responder Statement and tap collarbone to check for patient responsiveness.
¨ Check for normal breathing. If the patient is not breathing or is only gasping, then he needs
CPR.
¨ Avoid delaying emergency care by taking the time to locate and put on barriers.
3-12
Help or AED Arrives

Continue Until
AB C
Chest
Airway Breathing
Open? Normally?
Compressions
AA irway Open
BB reathing
for Patient
hock
Spinal Injury
Check Unresponsive Responsive

Quickly & Not Breathing & Breathing
Normally Normally
¨ If an unresponsive patient is obviously breathing normally, use the Cycle of Care to continually
monitor his medical status. Check for Serious bleeding, Shock or Spinal injury. Next, put the
patient in the recovery position.
¨ The recovery position relieves pressure on the patient’s chest, allowing the patient to breathe
more easily. It also ensures the airway remains open and unobstructed while at the same time
decreases the risk of something blocking his airway, and allows fluids to drain should he
vomit.
AB-CABS Priority Care Overview

INSTRUCTOR NOTE – Use this content as a review prior to participants breaking
into groups to perform the skill.
The first “A” in AB-CABS helps you remember to answer the question:
A = Airway Open?
¨ After you deliver your Responder Statement you can quickly check for an open Airway on
the patient. You’ll learn how to open an airway in this skill.
The first “B” in AB-CABS helps you remember to answer the question:
B = Breathing Normally?
¨ Quickly check to see if the patient is breathing normally. A patient barely breathing, or
taking infrequent, slow and noisy gasps is not breathing normally. Gasping is a common sign
or cardiac arrest in an unresponsive patient.
3-13
The “CABS” portion of the memory word AB-CABS reminds you of the priority order necessary
to care for a patient:
C = Chest Compressions
¨ You’ll learn how to perform Chest Compressions in Skill 4: CPR – Chest Compressions.
A = Airway Open
¨ Before you can provide a patient with rescue breathing, you’ll need to open the patient’s
airway.
B = Breathing for the Patient

¨ You’ll learn how to breath for a patient who is unresponsive by performing rescue breaths in
Skill 5: CPR – Chest Compressions Combined with Rescue Breathing.
S = Serious Bleeding, Shock, Spinal Injury

¨ Checking a breathing patient for Serious bleeding, Shock and Spinal injury is part of a
Primary Assessment.
¨ You’ll learn how to provide emergency care for each of these life-threatening problems in
Skills 6, 7 and 8.
How It’s Done

For a responsive patient:
1. Assess the scene for dangers. Check the patient for responsiveness by giving the Responder
Statement:
Hello? My Name is_____________________. I’m an Emergency Responder. May I help you? If
no response to your statement, then tap the patient on collarbone and ask, Are you okay? Are
you okay? The collarbone is sensitive and tapping it will reveal a level of responsiveness.
2. A verbal response from the patient means that he is responsive, confirms he has an open airway,
is breathing normally and has a heartbeat. Therefore, CPR is not needed – do not begin chest
compressions. Specifically, there is NO need to act on the CAB portion of the memory word –
Chest Compressions, opening the Airway or Breathing for the patient.
3. Alert EMS if appropriate. The EMS phone number for this local area
is:__________________.
4. Keep the patient still - do not move the patient (unless you or the patient’s safety is
compromised).
5. Put on barriers if immediately at hand. Do not delay emergency care if barriers are absent.
6. Continue your Primary Assessment with the “S” portion of the memory word CABS –
Serious bleeding, Shock and Spinal injury management. (You’ll learn how to manage these
emergency care concerns later.)
7. Continue with the Cycle of Care to monitor a patient’s medical status. The patient could lapse
into unresponsiveness and stop breathing normally.
3-14
For an unresponsive patient:

1. Assess the scene for safety. Check the patient for responsiveness by giving the Responder
Statement: Hello? My Name is___________________. I’m an Emergency Responder. May
I help you? If no response to your statement, then tap the patient on collarbone and ask,
Are you okay? Are you okay? The collarbone is sensitive and tapping it will reveal a level of
responsiveness.
2. After delivering the Responder Statement, quickly check for an open Airway and normal
Breathing. If you are unsure if the patient’s airway is open or if he is breathing normally:
• Quickly open his airway using the head tilt-chin lift. Place your hand on his forehead
and gently tilt his head back. With your fingertips under the point of his chin, lift the
chin to open the airway.
• Check for normal breathing. Look for chest movement and listen for breathing sounds.
Feel for expired air on your cheek.
• This check for normal breathing must be accomplished quickly. If the patient is not
breathing normally, he needs CPR immediately.
INSTRUCTOR NOTE – Pistol Grip Lift – Alternative to Head Tilt-Chin Lift

• With your thumb and index finger, point it like a pretend
handgun.
• Place your thumb and index finger together, as if you “fired”
the gun.
• Place your thumb and index finger along the patient’s jaw
line. Your thumb is just below the patient’s lip and your index
finger is positioned across the patient’s chin.
• Use your thumb, index finger and middle fingers to open the
patient’s lips and mouth. Keep other fingers off the soft tissue
of the neck. Alternative hand
• Place your other hand on the patient’s forehead. placement for the head
• Gently lift the patient’s jaw with your middle finger and tilt tilt-chin lift.
head back.
3. If the patient is not responsive or breathing normally, ask a bystander to call EMS and secure
an AED if possible. If you are alone, use your mobile phone to call EMS. If you do not have
a mobile phone, leave the patient to call EMS if no other option exists. This is the Call First
approach to emergency care. You Call First to activate Emergency Medical Services, then
you provide assistance.
4. Put on barriers if immediately at hand. Do not delay emergency care if barriers are absent.
5. If the patient is unresponsive and not breathing normally, immediately begin giving CPR.
(You will learn CPR in the next skill. DO NOT PRACTICE CPR ON A FELLOW
CLASS MEMBER.)
6. If the patient is breathing normally, continue your Primary Assessment with the “S” portion
of the memory word CABS – check for Serious bleeding, Shock and Spinal injury. (You
learn how to manage these emergency care concerns later.)
3-15
7. If no serious bleeding, shock or a spinal injury is found or

suspected, place the unresponsive, breathing patient in the recovery
position:
¨ Kneel at the patient’s side and place the arm nearest you out at
a right angle to the patient’s body with the elbow bent and the
palm upward.
¨ Bring the far arm across the chest and hold the back of the
hand against the patient’s cheek nearest you.
¨ With your other hand, grasp the far leg just above the knee and
pull it up, keeping the foot on the ground.
¨ Now, gently pull the patient towards you, putting the patient
on his side. Once on his side, place the patient’s lower hand
near or under the neck for stabilization. If need be, gently pull
back on the patient’s head to assure an open airway.
8. If the patient has to be kept in the recovery position for more than
30 minutes, consider turning the patient to the opposite side to
relieve the pressure on the lower arm.
Skill Practice
In practice groups using the Emergency First Response Participant
Manual, have participants perform a Primary Assessment on a responsive
patient and also on an unresponsive patient who is not breathing normally.
One person is the guide, reading the steps; one is the patient, while the other is the Emergency
Responder. Make sure everyone has the chance to act as the Emergency Responder. Also, for an
unresponsive, normal breathing patient have participants practice putting the patient in the recovery
position.
Remind participants to take their time. There is no time pressure. As CPR and care for serious
bleeding, shock or spinal injury management have not been covered, these skills are not practiced
yet. Even though subsequent skills are referred to, it’s important to introduce skills in order and not
overwhelm participants with too much information.
Debrief
Conclude with a role model, real-time demonstration on an unresponsive, normally breathing
patient. Allow for additional practice as necessary to increase participant competence and confidence.
3-16
CPR – Cardiopulmonary Resuscitation

Chest Compressions
INSTRUCTOR NOTE – Procedures for CPR vary internationally. The emergency
care procedures outlined within this skill follow the guidelines set forth by the
major resuscitation councils and organizations. If the emergency care procedure
varies in your area, teach participants the local protocol.
Demonstrate how to:
¨ Perform adult CPR – chest compressions at a rate of at least 100 chest compressions per
minute and depressing the chest approximately one-third the depth of chest – at least 5
cm/2 inches.
¨ Minimize interruptions in chest compressions.
Value
When a patient stops breathing and his heart is beating erratically or not at all, you can substitute
manual Chest Compressions for the heart’s normal pumping action to circulate blood through the
body. The blood you push through the patient’s body will carry some oxygen to important organs. Your
willingness to respond may increase the patient’s chance for survival until EMS personnel arrive.
Help or AED Arrives

Continue Until
AB C
Chest
Airway Breathing
Open? Normally?
Compressions
AA irway Open
BB reathing
for Patient
hock
Spinal Injury
Key Points
¨ CPR is a two-step process. Step one – chest compressions is followed by step two – rescue
breathing. During this skill, you’ll learn step one.
¨ If you are unable or feel uncomfortable giving a patient the rescue breaths – relax. Give the
patient immediate and continuous chest compressions. Chest compressions alone are very
beneficial to an unresponsive patient who is not breathing normally. Your efforts will still
help circulate blood that contains oxygen.
3-17
¨ Use the Cycle of Care and AB-CABS memory word to help you remember to perform Chest
Compressions before opening a patient’s Airway and Breathing for the patient.
¨ Give the Responder Statement and tap the patient on the collarbone. If the patient is
unresponsive, quickly check for an open airway and normal breathing.
¨ If the patient is not breathing normally, immediately begin Chest Compressions.
¨ The patient must be on his back and on a sturdy surface prior to beginning chest
compressions.
¨ Only practice CPR – chest compressions on a mannequin, never on another participant.
How It’s Done

Statement: Hello? My Name is_____________________. I’m an Emergency Responder. May
responsiveness.
Breathing. If the patient isn’t breathing at all or is only gasping, give CPR immediately.
INSTRUCTOR NOTE – In the first few minutes after cardiac arrest, a patient may be
barely breathing, or taking infrequent, noisy, gasps. This is often termed agonal
breathing and must not be confused with normal breathing.
3. Alert EMS if the patient is unresponsive and not breathing normally. CALL FIRST before
providing care.
¨ Ask a bystander to call EMS and secure an AED if possible.
¨ If you are alone, use your mobile phone to call EMS.
¨ Leave the patient to call EMS if no other option exists.
4. Position patient on his back (if not already in this position).
5. Locate the chest compression site.
¨ Expose the patient’s chest only if necessary to find the
compression site.
¨ Find the compression site by putting the heel of one
hand in the chest center. On some individuals, this
position is between the nipples.
¨ Place your other hand on top of the hand already on the
chest and interlock your fingers.
¨ Use the palm of your hand on the compression site. Keep fingers off the chest.
3-18
6. Deliver chest compressions.

¨ Position yourself so that your shoulders are directly over
your hands and your arms are straight – lock your elbows.
¨ Keep the force of the compressions straight down – avoid
pushing on the rib cage or the lower tip of the breastbone.
With locked elbows, allow your body weight to deliver
the compressions.
¨ To provide effective chest compressions you should
push hard and push fast, depressing the breast bone
approximately one-third the depth of the patient’s chest –
at least 5 centimetres/2 inches.
¨ After each chest compression, release, allowing the chest
to return to its normal position.
¨ Repeat at a pace of – one-two-three-four – and so on, (counting fast) for 30
compressions. Perform the compressions as fluidly as possible. Your rate should be at least
100 compressions per minute. The rate is a lot faster than most people think – Push Hard,
Push Fast.
INSTRUCTOR NOTE – Over the years, one strategy for helping participants
remember the approximate rate of chest compressions is to push on a patient’s
chest to the fast rhythm of a disco tune, like the song “Staying Alive.”
Skill Practice
In their practice groups, have participants perform CPR – chest compressions on a mannequin. One
person is the guide, reading the steps, one watches, while the other is the Emergency Responder.
Walk the participants through the numbered steps slowly to make sure their hand, arm and body
position is appropriate. Next, have participants practice the steps again in real-time. If groups must
take turns with mannequins, have those waiting practice their hand arm and body position on another
participant lying down on his back (remind participants not to actually perform compressions). Allow
participants to practice at their own speed.
Debrief
Conclude with a role-model, real-time demonstration of Chest Compressions using a mannequin.
Allow for additional practice as necessary to increase participant competence and confidence. Remind
participants that they cannot make a patient worse by administering CPR – the patient already lacks a
heartbeat. Remind participants that adequate care provided is better than perfect care withheld.
3-19
CPR – Cardiopulmonary Resuscitation

Chest Compressions Combined With Rescue Breathing
INSTRUCTOR NOTE – Procedures for CPR vary internationally. The emergency
care procedures outlined within this skill follow the guidelines set forth by the
major resuscitation councils and organizations. If the emergency care procedure
varies in your area, teach participants the local protocol.
Demonstrate how to
¨ Perform adult complete CPR – chest compressions and rescue breathing – at a ratio of 30
chest compressions to 2 rescue breaths.
¨ Minimize interruptions in chest compressions.
Value
Chest compressions alone are very beneficial to a patient who is unresponsive and not breathing
normally. However, if you are also willing to provide rescue breaths to a patient in need, you may
further increase the patient’s chance for survival until EMS personnel arrive. After completing
this skill you should trust your training and provide an unresponsive patient who is not breathing
normally with complete CPR – Chest Compressions and Rescue Breathing.
Help or AED Arrives

Continue Until
AB C
Chest
Airway Breathing
Open? Normally?
Compressions
AA irway Open
BB reathing
for Patient
hock
Spinal Injury
Key Points
¨ Use the Cycle of Care and AB-CABS memory word to help you remember to perform Chest
Compressions before opening a patient’s Airway and Breathing for the patient.
¨ Give the Responder Statement and tap the patient on the collarbone. If the patient is
unresponsive, quickly check for an open airway and normal breathing. If the patient is not
breathing normally, immediately begin Chest Compressions.
3-20
¨ If immediately available, use gloves and a ventilation

barrier to protect yourself and patient from disease
transmission. However, do not delay providing
emergency care by trying to locate barriers.
¨ Open the patient’s airway and pinch the nose
closed. Improper positioning of the head tilt-chin
lift to open an airway is the number one reason
rescue breaths are ineffective.
¨ Effective rescue breaths last just over 1 second, with
just enough air to make the patient’s chest rise.
¨ If during an actual situation you are unable or feel uncomfortable giving a non-breathing patient
rescue breaths, give the patient continuous chest compressions. Chest compressions alone are
very beneficial to a patient without a heartbeat. Your efforts may still help circulate blood that
contains some oxygen. Remember – adequate care provided is better than perfect care withheld.
How It’s Done

INSTRUCTOR NOTE – Steps 1-6 are repetitive from Skill 4 – Chest Compressions.
Steps 7-12 add rescue breaths to complete CPR.
Statement: Hello? My Name is_____________________. I’m an Emergency Responder. May
responsiveness.
Breathing.
3. If the patient is not responsive or breathing normally, ask a bystander to call EMS and bring an
AED if one is available. If you are alone, use your mobile phone to call EMS. If you do not have
a mobile phone, leave the patient to call EMS if no other option exists. This is the Call First
approach to emergency care. You Call First to activate EMS, then you provide assistance.
4. Position patient on his back (if not already in this position).
5. Locate the chest compression site.
¨ Expose the patient’s chest only if necessary to find the compression site.
¨ Find the compression site by putting the heel of one hand in the chest center. On some
individuals, this position is between the nipples.
¨ Place your other hand on top of the hand already on the chest and interlock your fingers.
¨ Use the palm of your hand on the compression site. Keep fingers off the chest.
3-21
6. Deliver chest compressions.

¨ Position yourself so that your shoulders are directly over
your hands and your arms are straight – lock your elbows.
¨ Keep the force of the compressions straight down –
avoid pushing on the rib cage or the lower tip of the
breastbone. Allow your body weight to deliver the
compressions.
¨ To provide effective chest compressions you should
push hard and push fast, depressing the breast bone
approximately one-third the depth of the patient’s chest
– at least 5 centimeters/2 inches.
¨ After each chest compression, release, allowing the chest
to return to its normal position.
¨ Repeat at a pace of – one-two-three-four – and so on,
(counting fast) for 30 compressions. Perform
the compressions as fluidly as possible. Your rate
should be at least 100 compressions per minute.
The rate is a lot faster than most people think –
Push Hard, Push Fast.
7. Position a ventilation barrier on the mannequin for
mouth-to-mouth or mouth-to-mask rescue breaths.
8. Open the patient’s airway. Use one of two common
methods.
¨ Use the head tilt-chin lift.
• Place your hand on the patient’s forehead. Apply firm, backward pressure with the palm
of your hand, tilting the head back.
• Place the fingers of your other hand under the bony part of one side of the lower jaw near
the chin. Important: Avoid pushing directly under the chin.
• Lift the jaw upward to bring the chin forward.
¨ Use the pistol grip lift.
• With your thumb and index finger, point it like a
pretend handgun.
• Place your thumb and index finger together, as if you
“fired” the gun.
• Place your thumb and index finger along the patient’s
jaw line. Your thumb is just below the patient’s lip and
your index finger is positioned across the patient’s chin.
• Use your thumb, index finger and middle fingers to open the patient’s lips and mouth.
Keep other fingers off the soft tissue of the neck.
• Place your other hand on the patient’s forehead.
• Gently lift the patient’s jaw with your middle finger and tilt head back.
3-22
INSTRUCTOR NOTE – If patient has an injury to the face or jaw, gently close the
mouth to protect the injured site. While holding the jaw closed, place your mouth
over the barrier covering the nose and give rescue breaths through the nose.
Certain ventilation barriers (such as a ventilation mask) are better for mouth-to-
nose than others. Using a ventilation mask is another form of rescue breathing
called mouth-to-mask.
9. With the patient’s head tilted back and the ventilation barrier in
place, pinch the nose closed.
10. Now, give two rescue breaths. Each breath should last about 1
second. Provide the patient with just enough air to make the
patient’s chest rise. Look for this rise in the patient’s chest.
¨ If you can’t make the patient’s chest rise with the first breath,
repeat the head tilt-chin lift or pistol grip lift to re-open the
airway before attempting another breath. Improperly opening
a patient’s airway is the most common cause for not being able to
inflate a patient’s lungs.
INSTRUCTOR NOTE – Do not try more than twice to give rescue breaths that make
the chest rise. Minimize delay between chest compressions. After two breaths, whether
they make the chest rise or not, begin chest compressions again.
11. After delivering two rescue breaths, immediately begin another cycle of 30 chest compressions.
Minimize delays in providing chest compressions.
12. Continue alternating 30 compressions with two breaths until:
¨ EMS arrives.
¨ You can defibrillate with an AED (Automated External Defibrillator).
¨ The patient becomes responsive and begins to breath normally.
¨ Another Emergency Responder takes over CPR efforts.
¨ You are too exhausted to continue.
INSTRUCTOR NOTE – If more than one Emergency Responder is present consider

alternating care. To avoid fatigue, each provider can deliver CPR for two minutes
and then switch. While switching providers, minimize chest compression
interruptions.
INSTRUCTOR NOTE – If the patient’s problem could be a drowning or other

respiratory problem, give Care First. This means that you provide CPR, particularly
rescue breaths to the patient, and THEN call EMS. The various resuscitation
councils define a “short time” differently. In North, South and Central America, Asia
and the Pacific Island countries (AHA Guidelines) it’s defined as providing care for
approximately 2 minutes; the European Resuscitation Council defines a “short
time” as 1 minute.
3-23
Skill Practice
In their practice groups, have participants perform CPR – chest compressions combined with rescue
breathing on a mannequin. One person is the guide, reading the steps, one watches, while the other
is the Emergency Responder. Walk the participants through the numbered steps slowly to make
sure their hand, arm, and body position is appropriate. Also, make sure each participant masters the
head tilt-chin lift to effectively open an airway allowing them to deliver rescue breaths. Next, have
participants practice the steps again in real-time. If groups must take turns with mannequins, have
those waiting practice their hand arm and body position on another participant lying down on his back
(remind participants not to actually perform compressions). Allow participants to practice at their own
speed.
Debrief
Conclude with a role-model, real-time demonstration of Chest Compressions combined with
Rescue Breaths using a mannequin. Allow for additional practice as necessary to increase participant
competence and confidence. Remind participants to relax if they feel uncomfortable giving a non-
breathing patient rescue breaths. Encourage these participants to give the patient continuous chest
compressions. Chest compressions alone are very beneficial to a patient without a heartbeat. Remind
them that their efforts may still help circulate blood that contains some oxygen. Adequate care
provided is better than perfect care withheld.
3-24
Optional Primary Care Skill
Automated External Defibrillator Use

Demonstrate how to:
¨ Use an Automated External Defibrillator (AED) on a mannequin according to the
machine’s guidelines.
¨ Place AED pads on a patient with no signs of circulation.
¨ Assist a patient who has been successfully defibrillated with an AED.
Value
CPR followed by early defibrillation with an AED is key to reviving a patient suffering from a
cardiac emergency involving ventricular fibrillation.
Help or AED Arrives

Continue Until
AB C
Chest
Airway Breathing
Open? Normally?
Compressions
AA irway Open
BB reathing
for Patient
hock
Spinal Injury
Key Points
¨ An AED is a sophisticated, battery-powered, microprocessor-based device that incorporates a
heart rhythm analysis and a shock-advisory system. AEDs are designed for lay rescuers like you.
¨ The AED connects to the patient via two chest pads. It analyzes a patient’s heart rhythm
automatically and detects when a shock is needed to restore a normal heart rhythm.
¨ In some regions, AED use by laypersons may be restricted.
¨ Remember to stop, think, then act – assess scene and alert EMS. When obtaining help, ask
someone to call EMS and to bring an AED, if one is available.
¨ Protect yourself and patient from disease transmission by using gloves and ventilation
barriers if available. Do not delay emergency care if barriers are not available.
¨ Perform a patient responsiveness check by giving the Responder Statement and then if
unresponsive, tapping the collarbone.
¨ Perform a primary assessment and use the Cycle of Care to continually monitor a patient’s
medical status.
¨ CPR should always be performed while an AED is located and readied for use - even if the
AED is immediately available.
3-25
¨ To minimize interruptions in chest compressions, if there is

more than one rescuer present, continue CPR while the AED is
switched on and the pads are being placed on the patient.
¨ If necessary, prepare chest by wiping off water or shaving hair
where pads are placed.
¨ Never place AED pads over pacemakers – place them two
centimetres/one inch away.
¨ Do not place AED pads directly on top of a transdermal
medication patch.
¨ AEDs may be used on patients resting on a wet surface. Observe
safety rules outlined by the manufacturer of the AED. Keep
defibrillation pads away from damp or conductive surfaces.
Critical Steps
INSTRUCTOR NOTE – The following steps are generic and
universal. Please refer to the manufacturer guidelines and
instructions for use when demonstrating a specific AED.
1. Use the Cycle of Care to continually monitor the patient’s medical

status.
2. If the patient is unresponsive and not breathing normally, first
call EMS or have a bystander call and bring an AED. Next,
immediately begin CPR.
¨ If you are alone and know where to find an AED close by,
continue CPR for a couple of minutes then leave the patient
to quickly secure the AED.
¨ If a bystander can go get an AED, direct them to do so while
you begin or continue CPR. Once the person arrives with
the AED, have them set it up and place the chest pads on the
patient while you continue CPR. This minimizes interruptions
to chest compressions.
3. Position the AED close to the patient’s ear on the same side as
the rescuer.
4. Turn AED power ON – follow device prompts exactly.
5. Bare the patient’s chest. If the patient is wet, consider drying the
chest prior to pad placement. It is not uncommon for a razor to
be included with an AED. If available, use it quickly to shave
excessive body hair.
6. Remove defibrillator pads from packaging – peel away any protective plastic backing from
the pads.
7. As directed by the manufacturer, place defibrillator pads on patient’s bare chest, adhesive side
down (note placement illustrations on pad packaging or pads). Typically:
3-26
¨ One pad goes on the upper-right side of the chest, below the collarbone and next to the
breastbone.
¨ One pad goes on the lower-left side of the chest, to the left and below the nipple line.
8. Plug in AED if needed or prompted. AED will analyze the
patient’s heart rhythm. (Some AEDs require you to push
an Analyze button.)
9. Clear rescuers and bystanders from the patient making
sure no one is touching the patient. Also, make sure no
equipment is touching the patient. Say, I’m clear, you are
clear, everyone is clear.
10. If the AED advises that a shock is needed, the responder
should follow the prompts to provide one shock, followed
by CPR. If the AED does not advise a shock, immediately
resume CPR.
11. The AED will again analyze the patient’s heart rhythm. If
normal breathing is still absent, the AED may prompt you to deliver another shock. Most
AEDs will wait two minutes before analyzing and shocking the patient again. Between that
time, continue CPR.
12. As prompted, continue to give single shocks combined with CPR until the patient resumes
breathing, until relieved by EMS personnel, or until you are physically unable to continue.
13. If the patient begins breathing normally, support the open airway and continue to use the
Cycle of Care to monitor the patient’s medical status.
Skill Practice
In practice groups using the Emergency First Response Participant Manual, have participants practice
using an AED on a mannequin. Have participants follow the protocol listed unless the specific
machine you are using in class has differing guidelines. Always follow the manufacturer’s guidelines.
If participants must share mannequins and AEDs, allow plenty of time
for skill development.
Debrief
Allow for additional practice as necessary to increase participant
competence and confidence. Provide them with the following AED
precautions:
¨ Do not attach an AED to a responsive person.
¨ Do not use an AED on a patient with a medication patch on the
chest. Remove the patch and clean the skin prior
to AED pad placement.
¨ Avoid analyzing patient or defibrillating a
patient with an AED while in a moving vehicle.
The movement may cause the AED to indicate a
shock is needed when it is not. Stop the vehicle
and allow the AED to analyze the patient.
¨ Avoid the use of cell phones or radio equipment
around AEDs.
3-27
Serious Bleeding Management

Demonstrate how to use direct pressure and a pressure bandage to
manage a serious bleeding wound.
Value
Loss of blood and fluids from the patient’s body may be life-
threatening. By controlling serious bleeding, you can maintain the
body’s vital blood supply.
Key Points
¨ Remember to stop, think, then act – assess scene and alert EMS.
¨ Use barriers appropriately. For serious bleeding, appropriate barriers include gloves, eye
shield, and personal facemask. Protect yourself and patient from disease transmission by
using gloves and barriers.
¨ Perform a primary assessment – remember bleeding must be severe to be life-threatening.
Use the Cycle of Care to continually monitor a patient’s medical status.
¨ Reassure the patient as you treat for bleeding.
¨ Assist patient into a position of comfort while treating.
¨ Keep in mind that direct pressure is the first and most successful method for serious bleeding
management.
¨ Using a pressure bandage is the next step to control bleeding. A pressure bandage is anything
that places constant direct pressure on a wound.
Help or AED Arrives

Continue Until
AB C
Chest
Airway Breathing
Open? Normally?
Compressions
AA irway Open
Serious Bleeding
Management
B Breathing
for Patient
hock
Spinal Injury
3-28
Australia and New Zealand Resuscitation Council’s Specific Key Points

¨ To assist in controlling bleeding, where possible: 1) Elevate the bleeding part. 2) Restrict
patient movement. 3) Immobilize the part. 4) Advise the victim to remain at total rest.
¨ Administer oxygen if available.
¨ Do not give patient anything orally, including medications and/or alcohol.
¨ For an embedded object: 1) Do not remove object as it can restrict bleeding. 2) Use indirect
pressure by placing padding around or above/below the object and apply pressure over the pads.
¨ As a last resort and only when other methods of controlling bleeding have failed, a tourniquet
may be applied to a limb to control life-threatening bleeding (e.g., traumatic amputation of a
limb or injuries with massive blood loss. Tourniquet is of at least 5 cm/2 inches wide, placed high
above the bleeding point and tightened to stop bleeding. Time of application should be noted.
Critical Steps
Direct Pressure
1. Give Emergency Responder Statement. Assess scene,
alert EMS and make sure airway is open.
2. Put on barriers – gloves, eye shields, and facemask as
appropriate.
3. Place a clean cloth or sterile dressing over the wound
and apply sustained direct pressure. If a dressing or
cloth is not available, use gloved hand.
4. Release pressure periodically to determine if bleeding has slowed or stopped.
Pressure Bandage
1. While applying sustained direct pressure on the wound, apply another bandage over the
sterile dressing.
2. If the bandage becomes blood soaked, place another clean cloth or dressing on top and
bandage in place.
3. Continue to apply sustained direct pressure to the wound to assist in bleeding control.
4. Don’t remove blood-soaked bandages because blood clots in the dressing help control
bleeding. Add bandages as necessary. (There may be country specific protocols for when to
remove bandages.)
5. Bandage rather tightly – avoiding total restriction of blood flow (no discoloring of fingers or
toes). Keep the pressure bandage flat against wound – avoid allowing the bandage to twist
into a small string.
Skill Practice
In practice groups using the Emergency First Response Participant Manual, have participants begin with
primary assessment and attend to a serious bleeding wound on a patient’s arm. They should progress
from direct pressure to a pressure bandage.
Debrief
3-29
Shock Management
Demonstrate how to manage shock by conducting a primary assessment, protecting the patient
and stabilizing the head.
Value
Shock is a result of circulatory system failure. Therefore, it can be life-threatening and a factor in
almost every injury or illness. By recognizing and treating shock, you prevent further disability.
Key Points
¨ Protect yourself and patient from disease transmission by using gloves and barriers if
available. Do not delay emergency care if barriers are not available.
medical status.
Help or AED Arrives

Continue Until
AB C
Chest
Airway Breathing
Open? Normally?
Compressions
AA irway Open
Shock
B Breathing
for Patient
Management
hock
Spinal Injury
¨ Shock results when an injury or illness makes it difficult for the body’s cardiovascular system
to provide adequate amounts of oxygenated blood to vital organs.
¨ Always treat an injured or ill patient for shock even if signs and symptoms are absent.
¨ For a responsive patient, let the patient determine what position is most comfortable –
sitting, lying down, etc. Unresponsive patients could be placed in the Recovery Position.
3-30
Critical Steps
1. Treat an injured, unresponsive or unconscious patient in the position found. Do not move
if possible.
2. Hold the patient’s head to keep the neck from moving.
3. Maintain patient’s body temperature based on local climate. This may mean covering the
patient with a blanket or exposure protection from the sun.
4. If there are no spinal injuries or leg
fractures suspected, elevate the legs 15-30
centimetres/6-12 inches to allow blood to
return to the heart.
Skill Practice
In practice groups using the Emergency First
Response Participant Manual, have participants begin
with primary assessment and manage shock for
an unconscious patient. Have blankets or towels
available. Encourage participants to be resourceful
and use what is available around them. Use of
barriers is optional for skill practice.
Debrief
Allow for additional practice as necessary to increase
participant competence and confidence.
3-31
Spinal Injury Management

Demonstrate how to manage a suspected spinal injury by conducting a primary assessment,
protecting the patient and stabilizing the head.
Value
Many accidents result in some form of trauma to the head, neck and back. By providing the proper
emergency care, you can prevent further injury to the patient.
Key Points
¨ Suspect a spinal injury for any incident involving a fall, severe blow, crash or other strong
impact. Also suspect spinal injury if a patient complains of back or neck pain or can’t move
an arm or leg.
¨ If possible, perform primary assessment in the position the patient is found. Do not move
patient unless safety is in question. Use the Cycle of Care to continually monitor a patient’s
medical status.
Help or AED Arrives

Continue Until
AB C
Chest
Airway Breathing
Open? Normally?
Compressions
AA irway Open
Spinal Injury
B Breathing
for Patient Management
hock
Spinal Injury
Critical Steps
For a responsive patient who is breathing normally:
1. Stabilize the head by placing a hand on each side to prevent movement. Attempt to anchor
your arms or elbows on the ground or use a similar stable position to assist with minimizing
your hand movement.
2. Instruct the patient to remain still and not move his head or neck while you wait for EMS
to arrive.
3-32
For an unresponsive patient who is not breathing normally:

1. To open the airway, assess breathing and Administer
CPR, the patient must be on his back.
¨ If patient is already on back, use the head tilt-
chin lift method to open the patient’s airway.
Minimize overall head movement, and do not
tilt from side to side.
¨ If the patient is not on his back, use the log roll
to reposition patient.
2. To perform a log roll by yourself:
¨ Kneel at the patient’s side. Leave enough room
so that the patient will not roll into your lap.
¨ Gently straighten the patient’s legs. Straighten
arms against side of patient.
¨ Cradle the patient’s head and neck from behind
with one of your hands.
¨ Place your other hand on the patient’s elbow, on
the patient’s arm that is furthest away from you.
¨ Roll the patient carefully as a unit, head and
body together toward you, onto the side, then
onto the back.
3. If help is available, perform a two-person log roll:
¨ One Emergency Responder stabilizes patient’s
head, one rolls patient. Patient’s head is
stabilized with both hands to keep it from
moving.
¨ Emergency Responder rolling patient, does so
with both hands on patient’s arm above and
below elbow.
¨ Both responders roll patient as one unit onto patient’s back.
Skill Practice
In practice groups using the Emergency First Response Participant Manual, have participants perform
primary assessment on a responsive patient with a suspected spinal injury. Then have participants practice a
log roll and primary assessment on an unconscious patient with a suspected spinal injury who is positioned
face down. If practical, have participants practice both two-person and one-person log rolls. Use of barriers
optional for skill practice.
Debrief
Conclude with a role-model, real-time demonstration of a log roll and primary assessment on an
unconscious patient. Allow for additional practice as necessary to increase participant competence
and confidence.
3-33
Conscious and Unconscious Choking Adult

INSTRUCTOR NOTE – Procedures for handling a conscious choking patient vary
internationally. Teach participants the protocols appropriate for your area. This guide
includes three variations: 1) North, South and Central America, Asia and the Pacific
Island countries (AHA Guidelines), 2) European Resuscitation Council Guidelines
and 3) Australia and New Zealand Resuscitation Council Guidelines.
Demonstrate how to assist a conscious and unconscious choking patient with a partial or
complete (severe) airway obstruction.
Value
Choking is a life-threatening condition that needs immediate resolution. By following a simple
procedure, you may be able to assist a choking patient in expelling an obstruction.
Key Points
¨ Remember to stop, think, and then act.
¨ If the patient is coughing, wheezing or can speak, observe until the patient expels the
obstruction. Reassure and encourage the patient to keep coughing to expel the foreign
material.
Help or AED Arrives

Continue Until
AB C
Chest
Airway Breathing
Open? Normally?
Compressions
AA irway Open
BB reathing
for Patient
Breathing Normally? S SS erious Bleeding

hock
Assist with choking. Spinal Injury
¨ Remember that a conscious adult must give consent before you do anything. A head nod is
sufficient.
¨ If the blockage is severe, the patient will not be able to cough.
¨ Perform chest thrusts on pregnant or obese individuals rather than abdominal thrust.
¨ Patients who receive the treatment for conscious choking should be medically evaluated to
rule out any life-threatening complications.
3-34
Conscious Choking Adult – North, South and Central

America, Asia and the Pacific Island countries (AHA
Guidelines)
How It’s Done
1. Start by asking a responsive patient – “Are you choking?”
2. If the patient cannot speak or is not breathing normally, give the Responder Statement
“Hello? My name is______. I’m an Emergency Responder. May I help you?”
3. When permission is granted (a head nod is sufficient), alert EMS and proceed with attempts
to dislodge the object.
4. Consider chest thrusts if abdominal thrusts are not effective. Begin with chest thrusts on
patients who are pregnant or markedly obese.
Conscious Choking Abdominal Thrusts

1. Stand behind the patient and place your arms around waist.
2. Locate the patient’s navel (belly button) – the thrust site is
two finger widths above it.
3. Make a fist and place the thumb side on the thrust site.
4. Place your other hand over the outside of the fist.
5. Bend your arms and elbows outward to avoid squeezing the
rib cage.
6. Perform quick inward and upward thrusts until the
obstruction is cleared or the patient becomes unconscious.
7. Once the obstruction is cleared, encourage the patient to breathe and monitor the patient.
Conscious Choking Chest Thrusts

1. Stand behind the patient and place your arms around body,
under armpits.
2. Follow the lowest rib upward until you reach the point where
the ribs meet in the center.
3. Feel the notch on the lower half of the breastbone, sternum, and
place your middle and index finger on the notch.
4. Make a fist and place the thumb side on the thrust site above
your fingers on the notch. This is the same compression point as
for CPR.
5. Place the other hand over the outside of the fist.
6. Perform quick inward thrusts until the object is expelled or the
patient becomes unconscious.
7. Avoid putting pressure on the rib cage.
8. Stop if the obstruction clears, encourage the patient to breathe and monitor the patient.
3-35
Conscious Choking Adult – European Resuscitation

Council Guidelines
How It’s Done
2. If the patient cannot speak or is not breathing normally, give the Responder Statement
“Hello? My name is______. I’m an Emergency Responder. May I help you?”
4. Begin with back blows then move to abdominal thrusts. Alternate back blows with abdominal
thrusts until the obstruction is cleared or the patient becomes unconscious.
Conscious Choking Back Blows

1. To deliver back blows, take a position to the side and slightly
behind the patient.
2. Support the chest with one hand, and lean the patient forward.
3. Firmly strike the person between the shoulder blades with the
heel of the other hand five times.
4. If five back blows do not clear the obstruction, switch to
abdominal thrusts.
5. Stop if the obstruction clears, encourage the patient to breathe
and monitor the patient.
Conscious Choking Abdominal Thrusts

1. Stand behind the patient and place both arms round the upper part of the abdomen.
2. Lean the patient forward.
3. Clench your fist and place it between the navel (belly button) and the ribcage.
4. Grasp this hand with your other hand and pull sharply inwards and upwards.
5. Repeat five times.
6. If five abdominal thrusts do not clear the obstruction, switch to back blows.
7. Stop if the obstruction clears, encourage the patient to breathe and monitor the patient.
3-36
Conscious Choking Adult – Australia and New Zealand

Resuscitation Council Guidelines
How It’s Done
2. If the patient cannot speak or is not breathing normally, give the Responder Statement “Hello?
My name is______. I’m an Emergency Responder. May I help you?”
4. Begin with back blows then move to chest thrusts. Alternate back blows with chest thrusts until the
obstruction is cleared or the patient becomes unconscious.
Conscious Choking Back Blows

1. To deliver back blows, take a position to the side and slightly behind the patient.
2. Support the chest with one hand, and lean the patient forward.
3. Firmly strike the person between the shoulder blades with the heel of the other hand five
times. The aim is to relieve the obstruction with each blow rather than to give all five blows.
Stop if the obstruction clears, encourage the patient to breathe and monitor the patient.
4. If five back blows do not clear the obstruction, switch to chest thrusts.
Conscious Choking Chest Thrusts

1. Stand behind the patient and place your arms around body, under armpits.
2. Follow the lowest rib upward until you reach the point where
the ribs meet in the center.
3. Feel the notch on the lower half of the breastbone, sternum, and
place your middle and index finger on the notch.
4. Make a fist and place the thumb side on the thrust site above
your fingers on the notch. This is the same compression point as
for CPR.
5. Place the other hand over the outside of the fist.
6. Perform five quick inward thrusts. Avoid putting pressure on the
rib cage.
7. The aim is to relieve the obstruction with each chest thrust
rather than to give all five chest thrusts. Stop if the obstruction
clears, encourage the patient to breathe and monitor the patient.
3-37
Unconscious Choking Patient – Used in All Regions

1. If a responsive, choking patient becomes unconscious while
you are trying to help, carefully help the unconscious patient
to the ground.
2. Activate EMS if not already called.
3. Begin CPR as per Primary Care Skill 5.
4. Following chest compressions, quickly look in the patient’s
mouth and attempt to remove any visible obstruction. If an
object is seen, you should remove the object with your finger.
5. If no object is seen or the object has been removed, proceed
with two rescue breaths.
6. Continue CPR until obstruction is relieved or EMS arrives.
Skill Practice
In practice groups using the Emergency First Response Participant Manual, have participants assist
a conscious choking adult. Caution participants not to actually perform thrusts on non-choking
participants for practice. Use of barriers is optional for skill practice. Discuss and/or have participants
perform the steps for assisting a patient who has become unconscious from a choking incident.
Debrief
Conclude with a role-model, real-time demonstration on a choking adult. Again, caution participants
not to actually perform thrusts for practice. Allow for additional practice as necessary to increase
participant competence and confidence.
3-38
Optional Primary Care Skill
Emergency Oxygen Use Orientation

Demonstrate how to administer emergency oxygen to a patient with a serious or life-threatening
illness or injury.
Value
Receiving adequate oxygen is crucial, especially after a serious injury, illness, near-drowning incidents
or altitude respiratory problems. You can decrease patient stress and support the respiratory system
by administering emergency oxygen.
Key Points
¨ Protect yourself and patient from disease transmission by using gloves and barriers if available.
Do not delay emergency care if barriers are not available.
unresponsive, tapping the collarbone. Before placing the oxygen mask on a responsive patient
say, This is oxygen, may I place this mask on you?.
Help or AED Arrives

Continue Until
AB C
Chest
Airway Breathing
Open? Normally?
Compressions
AA irway Open
BB reathing
for Patient
Breathing Normally? S SS erious Bleeding

hock
Assist with use of Emergency Spinal Injury
Emergency Oxygen.
medical status.
¨ Become familiar with emergency oxygen units before you need to use them – at home, work,
school, etc.
¨ Use emergency oxygen in a ventilated area away from any source of flame or heat.
¨ Handle oxygen cylinder carefully because contents are under high pressure. Avoid dropping
cylinder or exposing it to heat.
¨ In some regions, oxygen use is restricted.
3-39
Critical Steps
INSTRUCTOR NOTE – Demonstrate oxygen unit set up for participants. Participants
do not need to become proficient at setting up the unit they use for skill practice.
1. Follow system instructions to set up oxygen unit.

2. Always turn the valve on slowly and test that oxygen is flowing to the mask.
3. For a responsive patient, ask if you may provide oxygen and place mask over the patient’s
mouth and nose. Say, “This is oxygen, may I place this mask on you?” Responder takes the first
breath to test mask and show patient it works. Responder does not exhale into mask.
¨ If the patient agrees, have the patient hold the mask in place and tell the patient to
breathe normally.
¨ If the patient can’t hold the mask, use the strap to keep it in place.
4. For a nonresponsive, breathing patient, place the mask on the patient’s nose and mouth and
secure with the strap.
5. For an unconscious, nonbreathing patient, use a mask that allows you to supply rescue
breaths while oxygen flows into the mask.
6. Monitor the oxygen unit pressure gauge to avoid running it empty while the mask is still on
the patient.
7. Additional training in administering emergency oxygen may be required in some regions.
Skill Practice
In practice groups using the Emergency First Response Participant Manual, set up an oxygen unit. Have
participants perform a primary assessment on a responsive patient, and offer a patient emergency
oxygen. Use of barriers optional for skill practice.
Debrief
Allow for additional practice as necessary to increase participant competence and confidence You
may want to seek additional and more advanced oxygen training if you are a scuba diver or frequent
locations with aquatic activities.
3-40
Skill Development
Introduction
This segment covers the four required skills for the Secondary Care (First Aid) course. Secondary
Care (First Aid) teaches Emergency Responders what to do beyond primary care when Emergency
Medical Services (EMS) are either delayed or unavailable.
You’ll find information about each skill and step-by-step directions for organizing skill development.
Listed for each skill are the performance requirement(s), a value statement, key points, critical steps
and suggestions for conducting skill practice.
During skill development, the amount of information you deliver and the required detail of your
demonstration depends on the instructional delivery approach you follow — independent study,
video guided or Instructor Led. Refer to the “How to Use This Guide” at the beginning of Section
Three for special directions regarding instructional delivery approach.
Similar to the Primary Care (CPR) course, you introduce
each skill by reviewing the performance requirement,
value and key points. Next, you provide a demonstration
using the critical steps. After dividing participants into
practice groups, you monitor practice, provide positive
reinforcement and offer suggestions for improved
technique. Allow for additional practice as necessary to
increase participant competence and confidence.
Because you may have several practice groups
working on skills at the same time, make sure you
can adequately supervise development, answer
questions and advise participants. Remember to keep
answers to questions brief and to the point, and to
answer situational or “what-if ” questions by sending
participants back through the Cycle of Care.
3-41
Secondary Care Skill 1
Injury Assessment
Demonstrate how to conduct a head-to-toe injury assessment on a patient and note injuries to
report to Emergency Medical Service (EMS) personnel.
Value
A head-to-toe injury assessment helps you recognize, attend to and report both external and internal
injuries that may affect a patient’s condition.
Key Points
¨ Use this skill to determine what first aid may be needed in the event of any injury – especially
when EMS is either delayed or unavailable.
medical status.
¨ Only perform injury assessments on conscious, responsive patients.
¨ When possible, perform the assessment in the position the patient is found.
¨ If wound dressings are in place, do not remove during the assessment.
¨ Look for wounds, bleeding, discolorations or deformities.
¨ Listen for unusual breathing sounds.
¨ Feel for swelling or hardness, tissue softness, unusual masses, joint tenderness, deformities,
moisture and changes in body temperature. Make mental notes of the assessment and report
findings to EMS personnel.
¨ Avoid giving injured patient anything to eat or drink, as he may need surgery.
Help or AED Arrives

Continue Until
AB C
Chest
Airway Breathing
Open? Normally?
Compressions
AA irway Open
BB reathing
for Patient
hock
Spinal Injury
3-42
Critical Steps
1. Deliver the Responder Statement, asking permission to assist.
Explain what you’ll be doing during the assessment. Put on gloves if
available.
2. Stabilize the patient’s head and neck and instruct the patient to
answer verbally. Do not allow the patient to move or nod his head. 1
3. Immediately stop the assessment if the patient complains of head,
neck or back pain. Continue to stabilize the head and neck, end your
assessment and wait for EMS to arrive. Do not move patient.
4. Start assessment at the head and work your way down the body to
the toes.
3
5. Feel for deformities on the patient’s face by gently running your
fingers over the forehead, cheeks and chin.
6. Check the ears and nose for blood or fluid. If present, suspect head
injury and stop further assessment.
7. Place a finger in front of the patient’s eyes. Without moving the
head, have the patient follow your finger with his eyes. Check the
eyes for smooth tracking. The eyes should move together. If possible,
5
check pupil size and reaction to light.
8. Feel the skull and neck for abnormalities. If the patient complains of
pain, stop the assessment.
9. If you can reach the shoulder blades, slide or place one hand over
each shoulder blade and gently push inwards.
7
10. Move hands outward to the shoulders and press gently inward with
the palm.
11. Run two fingers over the collarbones from the shoulders to the
center.
12. Place one hand on the shoulder to stabilize the arm and gently slide
the other hand down the upper arm, elbow and wrist. Repeat on
the other arm. Ask the patient to wiggle fingers on both hands and
9
squeeze your hands.
13. Inspect chest for deformity. Place a hand, palm in, on each side of
the patient’s rib cage and gently push inward.
14. Gently put your hands under patient to feel the spinal column.
Cover as much area as possible without moving the patient. Gently
touch along the patient’s spine, feeling for abnormalities. 10
15. Using one hand, gently push on the patient’s abdomen. Apply gentle
pressure to the right and left side abdomen, and above and below the
navel (belly button).
16. Move hands gently over the hipbones to check for swelling or
hardness, tissue softness, unusual masses, joint tenderness, and
deformities. Avoid pushing inward on hips. 12
3-43
17. Starting at the thigh, slide your hand down the upper leg, knee,
lower leg and ankle as you did with the arm. Ask the patient
to wiggle toes and press the sole of the foot against your hand.
Repeat on the other leg.
18. Note areas of pain or abnormality for your report to EMS
personnel. Continue to monitor the patient by using the Cycle 17
of Care.
Skill Practice
Using the injury assessment steps (in either Emergency First Response Participant Manual or this
guide), have participants conduct an injury assessment. Have each patient think of an imaginary
injury. The patient should not share this imaginary injury with the Emergency Responder. It is the
Emergency Responder’s job to discover the injury. The patient acts out the injury.
Debrief
Conclude with a role-model, real-time demonstration. Allow for additional practice as necessary to
increase participant competence and confidence.
3-44
Illness Assessment
Demonstrate how to conduct an illness assessment by:
¨ Asking how a patient feels and obtaining information about a patient’s medical history.
¨ Checking a patient’s respirations, pulse rate, temperature, skin moisture and color.
¨ Reporting findings to Emergency Medical Service personnel.
Value
An illness assessment helps you identify and report medical problems that affect a patient’s health
and may aid in the patient’s treatment.
Key Points
¨ Use this skill to determine what first aid may be needed in the event of any illness –
especially when EMS is either delayed or unavailable.
¨ Remember to stop, think, then act – assess scene and alert EMS if necessary.
¨ Perform a patient responsiveness check by giving the Responder Statement and if
medical status.
¨ Only perform illness assessments on conscious, responsive patients.
¨ When giving information to EMS personnel, avoid using the word normal. Provide measured
rates per minute and descriptive terminology.
¨ Use the mnemonic SAMPLE to remember how to conduct an illness assessment. SAMPLE
stands for Signs and Symptoms, Allergies, Medications, Preexisting medical history, Last
meal and Events.
¨ Signs are something you see is wrong with a patient. Symptoms are something the patient
tells you is wrong.
¨ To help guide your assessment, remember that:
• The average breathing rate for adults is between 12 and 20 breaths per minute. A patient
who takes less than eight breaths per minute, or more than 24 breaths per minute, probably
needs immediate medical care.
• The average pulse rate for adults is between 60 and 80 beats per minute.
• Average skin temperature is warm and skin should feel dry to the touch.
• Noticeable skin color changes may indicate heart, lung or circulation problems.
• By conducting an illness assessment on a healthy person in class, you will be able to
recognize differences later when you assist an unhealthy person.
3-45
¨ If a patient complains of chest discomfort or pain call EMS immediately and encourage
patient to:
• Take any prescribed medication for such discomfort, or
• Chew 1 adult, non-coated aspirin (unless patient has an allergy or other contraindication
to aspirin).
Help or AED Arrives

Continue Until
AB C
Chest
Airway Breathing
Open? Normally?
Compressions
AA irway Open
BB reathing
for Patient
hock
Spinal Injury
Critical Steps
1. Find a paper and a pen/pencil to record illness assessment information. Use the Illness and
Injury Assessment Record sheet in the participant manual (This Assessment Record Sheet can
also be found in the Appendix of this guide. Photocopy when necessary.)
2. If possible, get someone else to record information while you attend to the patient.
3. Put on gloves when needed.
SAMPLE – Signs and Symptoms

1. Ask how patient is feeling and what occurred immediately before the onset of illness.
Questions may include:
X How do you feel now?
X What were you doing when you began to feel ill?
X When did the first symptoms occur?
X Where were you when the first symptoms occurred?
Finding Pulse Rate

2. To find pulse rate using the carotid artery:
X Locate the patient’s Adam’s apple with the index and
middle fingers of one hand.
X Slide the fingers down into the groove of the neck on the
side closest to you.
X If you can’t find the pulse on the side closest to you, move
to the opposite side.
3-46
X Never try to feel the carotid pulse on both sides at the same time.
X Count the number of beats in 30 seconds and multiply by two to determine the heartbeats
per minute.
3. To find pulse rate using the radial artery:
X Locate artery on patient’s wrist, thumb side of hand.
X Slide two or three fingers into the groove of the wrist immediately below hand on the thumb
side.
X Do not use your thumb when taking a radial pulse.
X Count the number of beats in 30 seconds and multiply by two to determine the heartbeats
per minute.
4. Determine whether the pulse may be described as rapid, strong or weak.
Checking Respiration
5. Look for signs and symptoms of respiratory distress, including:
X Wheezing, gurgling or high-pitched noises when the patient breathes.
X Patient complains of shortness of breath or feeling dizzy or lightheaded.
X Patient complains of pain in the chest and numbness or tingling in arms or legs.
6. To count the number of times a patient breathes, use one of two methods:
X First method: Simply watch patient’s chest rise and fall and count respirations.
X Second method: If you cannot see the patient’s chest rise and fall, place a hand on the
patient’s abdomen. This position allows you to mask your efforts to obtain a count of the
patient’s respirations. Patients often alter their breathing rate if they become aware their
breaths are being counted.
For both methods, count patient’s respirations for 30 seconds and multiply by two to
determine respiratory rate.
7. Determine whether respirations may be described as fast, slow, labored, wheezing or gasping.
Checking Temperature and Moisture

8. Feel patient’s forehead or cheek with the back of your
hand. Compare with your own temperature using your
other hand on your forehead. Verify if the patient has
perhaps been doing physical exercise.
9. Determine whether the skin is warm, hot, cool, moist,
clammy, etc.
3-47
Determining Color
10. Look for apparent skin color changes that may be described as extremely pale, ashen (grey),
red, blue, yellowish or black-and-blue blotches.
11. If the patient has dark skin, check for color changes on the nail beds, lips, gums, tongue,
palms, whites of the eye and ear lobes.
SAMPLE – Allergies
1. Ask if patient is allergic to anything – food, drugs, airborne matter, etc.
2. Has the patient ingested or taken anything he may be allergic to? Has the patient been bitten
or stung by an organism?
3. Treat severe allergic reactions as a medical emergency and follow primary care procedures.
4. A severe allergic reaction (anaphylaxis) can be treated by epinephrine. People who have
suffered a prior episode of anaphylaxis often have prescribed an auto-injector of epinephrine.
Have the patient use the auto-injector or assist them with its use.
5. In unusual circumstances when advanced medical assistance is not available, a second dose of
epinephrine may be given if symptoms of anaphylaxis persist.
SAMPLE – Medications
1. Ask if patient takes medication for a medical condition. Questions may include:
X Do you take medication?
X If yes, what type of medication do you take?
X Did you take medication today?
X How much medication did you take and when?
2. If possible, collect all medication to give to EMS personnel and/or get name of the doctor
who prescribed the medication.
SAMPLE – Preexisting Medical Conditions

1. Ask if patient has a preexisting medical condition (e.g., heart condition, diabetes, asthma,
epilepsy, etc.)
SAMPLE – Last Meal

1. Ask when patient last had a meal and what patient ate. Ask if he has consumed any alcohol
or recreational drugs.
SAMPLE – Events
1. Ask patient about or note events leading up to illness.
Skill Practice
Using the Illness Assessment Record sheet, either in the Emergency First Response Participant Manual
(Reference Section) or the Appendix of this guide, have participants begin with primary assessment
and work through illness assessment in practice groups. By having participants conduct an illness
assessment on a healthy person in class, they will be able to recognize differences later when they
assist an unhealthy person.
Debrief
3-48
Bandaging
Demonstrate how to bandage a foot, leg, hand or arm using roller bandages and triangular
bandages.
Value
A properly applied bandage can apply direct pressure to a wound and hold dressing in place to
control bleeding. It can also prevent or reduce swelling, and provide support for an extremity or joint.
Key Points
¨ Use this skill in the event of any injury – especially if EMS is either delayed or unavailable.
¨ Protect yourself and your patient from disease transmission by using barriers if available. Do not
delay emergency care if barriers are not available.
Help or AED Arrives

Continue Until
AB C
Chest
Airway Breathing
Open? Normally?
Compressions
AA irway Open
BB reathing
for Patient
hock
Spinal Injury
medical status.
¨ Perform an injury assessment.
¨ A first aid kit may include several different types of bandages including triangular bandages,
adhesive strips, conforming bandages, gauze rollers (nonelastic cotton) and elastic rollers.
¨ Choose the best bandage based on the injury or make the best use of whatever is available.
3-49
Critical Steps
Using Roller Bandages
1. Put on gloves if available.
2. Apply the bandage directly over a sterile dressing covering the
wound.
3. Apply the bandage below the wound and work toward the heart.
4. Wrap roller bandage firmly and consistently, but avoid making a
bandage too loose or too tight.
5. Secure the end of the bandage by tying, tucking or taping it in
place.
6. When bandaging the foot, secure the bandage by wrapping it
around the ankle several times then back over the injury site on
the foot.
7. When bandaging the hand, secure the bandage by wrapping it
over the thumb and around the wrist.
8. If the elbow is involved, bandage below and above the joint to
stabilize the injury site.
9. If the knee is involved, bandage below and above the joint to
stabilize the injury.
10. If there is an impaled object, bandage the object in place and do
not remove.
3-50
Using Triangular Bandages

1. Use triangular bandages to support injuries of the upper arm, ribs
or shoulder.
2. Place the top of the triangular bandage over the shoulder.
3. Bend the arm at the elbow, bring the forearm across the chest
and over the bandage.
4. Bring the lower end of the bandage over the opposite shoulder
and tie off at the back of the neck.
5. Tie off triangular bandage at the patient’s elbow, locking the arm
in the sling.
6. When broken ribs are suspected, use a second triangular bandage
to hold the arm against the injured side of the chest. Simply tie
the bandage over the sling and around the chest.
INSTRUCTOR NOTE – You may wish to add skill development for

a Pressure Immobilization bandage. Step-by-step procedures for
this bandage is located in the Participant Manual’s Emergency
Reference area under Venomous Bites and Stings. In North,
South and Central America, Asia and the Pacific Island countries
(AHA Guidelines) and the Australia and New Zealand
Resuscitation Council’s region you may wish to also have
students practice applying a tourniquet.
Skill Practice
In practice groups using Emergency First Response Participant Manual,
have participants bandage a leg or arm wound using a roller bandage,
then use a triangular bandage to make an arm sling. Encourage
participants to vary wound sites.
Debrief
3-51
Splinting for Dislocations and Fractures

Demonstrate how to apply a splint to a dislocation or fracture.
Value
Splinting may prevent further injury, lessen pain, and reduce the risk of serious bleeding if EMS is
delayed or it is necessary to transport the patient to a medical facility.
Key Points
¨ Use this skill in the event of any injury – especially if EMS is either delayed or unavailable.
¨ Protect yourself and your patient from disease transmission by using barriers if available. Do not
delay emergency care if barriers are not available.
unresponsive, tapping the shoulder or arm.
medical status.
¨ Perform an injury assessment.
¨ Use splinting to protect and immobilize a fractured, dislocated, sprained or strained body part.
¨ Splints may include a variety of rigid devices including commercial splints, improvised splints
(rolled newspapers or magazines, heavy cardboard, padded board, etc.) or securing the injured
part to an uninjured body part (e.g., injured finger to an uninjured finger; injured arm to the
chest, etc.)
Help or AED Arrives

Continue Until
AB C
Chest
Airway Breathing
Open? Normally?
Compressions
AA irway Open
BB reathing
for Patient
hock
Spinal Injury
¨ Splint the injury in the position found. Do not try to straighten. Try to minimize movement
of the extremity until you complete splinting.
¨ If available, place splint materials on both sides of the injury site. This prevents rotation of the
injured extremity and prevents the bones from touching if two or more bones are involved.
¨ Splint only if you can do so without causing more discomfort and pain to the patient.
3-52
Critical Steps
1. Choose a splint long enough to immobilize joints above and below
the injury.
2. When using rigid splints, apply ample padding between the splint
and the injury. Add padding to the natural body hollows as well.
3. Bandage the splint in place by using a roller bandage, a triangular
bandage, an elastic bandage, adhesive tape or other available
materials.
4. Always check circulation before and after splinting. If pulse is
absent, loosen the splint until the pulse returns. To do this, look for
color of tissue in fingernails and toenails.
5. If the fracture is in the upper arm, place arm in sling after splinting.
Skill Practice
In practice groups using Emergency First Response Participant Manual,
have participants splint a leg or arm. Have a variety of splinting material
available. Encourage participants to be resourceful and use what they find
around them. Have participants vary splinting sites. Use of barriers optional
for skill practice.
Debrief
Allow for additional practice as necessary to increase participant
competence and confidence. Consider performing a role-model, real-time
injury assessment together with splinting an injury site.
3-53
3-54
Four
Scenario Practice
Introduction
Emergency scenario practice allows participants to apply the skills they develop to realistic
situations. Each scenario requires participants to evaluate the scene, recall critical steps, and take
appropriate action. The circumstances vary which lets participants use all their skills to work
through different challenges. Practice begins with simple situations and progresses to multiple injury
accidents. Although the nature and context is serious, the practice should encourage discovery, build
confidence, and be as enjoyable as possible.
Overview
This section includes four primary care scenarios
and one secondary care scenario. Each scenario
prompts participants to use specific skills. You’ll
find two suggested scenes for each scenario – Scene
A and B. You may conduct the scenario using
either of these scenes, or modify the situation to
meet local needs. Listed under each scenario are
factors you may change without altering the intent
of the exercise.
You’ll conduct the scenario practice session using
the same procedures no matter which instructional
delivery approach you use (independent study, video guided or instructor led). For each scenario,
you’ll find a situation overview, performance requirement, procedures, and evaluation questions. Use
these instructions to conduct practice.
4-1
Organize practice so each participant has the opportunity to

act as the Emergency Responder for one or more scenarios.
Have participants work in practice groups as they did during
skill development. At your discretion, you may have several
practice groups act out scenarios at the same time. However, be
certain you can adequately supervise practice, answer questions
and advise participants. Although it’s preferable for other
participants or assistants to act as patients in scenarios that
have multiple roles, you may use a mannequin(s) if necessary.
During scenarios, ask participants to respond to the situation
independently with little or no guidance. Explain that there
is no absolute “right” way to approach the scene, but usually
many viable options. Ask participants to focus, remain calm
and make decisions based on their newly acquired knowledge
and skills. Emphasize that this is not a test, but an opportunity
to practice skills in situations similar to those in which they might actually use them. Stress that the
ultimate goal is to have participants use their training to take action. These emergency scenarios will
help them gain confidence.
4-2
Primary Care
Emergency Scenario One

Collapsed Family Member
SCENE A – Situation Overview
Location: Home – kitchen.
Phone is available in next room.
Patient: Grandmother (elderly female relative)
Action: Emergency Responder walks in and finds grandmother
sitting on floor, leaning against counter. Her head is
slumped forward on her chest.
Condition: She is unresponsive, unconscious, but breathing normally.
SCENE B – Situation Overview

Location: Home – backyard.
Phone is just inside back door.
Patient: Uncle (older male relative)
Action: Emergency Responder looks in backyard and finds uncle
sitting on ground, leaning against a tree. His head is
slumped forward on his chest.
Condition: He is nonresponsive, unconscious, but breathing normally.
Factors you can change – Any room or area of a home. Any adult relative or person who lives in
household.
Demonstrate scene assessment and primary assessment procedures for assisting an unconscious,
breathing patient. (Primary Care Skills One – Three)
4-3
Procedures
1. Review the Situation Overview with participants.
2. Break participants into practice groups. Assign roles – patient, Emergency Responder and
guide.
3. Position patient sitting against wall or chair. Have responder approach patient and begin care.
The guide observes and has Emergency First Response Participant Manual available to reference.
4. During scenario, provide direction only as necessary.
5. Stop scenario when Emergency Responder has completed primary assessment and is waiting
for EMS to arrive.
6. Repeat scenario as necessary to allow all participants to act as Emergency Responder.
Consider changing factors to keep it interesting and stimulate further learning.
7. Conclude scenario practice and encourage discussion by asking participants the evaluation
questions. Clarify information, techniques and procedures as necessary.
Evaluation Questions
Use the following questions to discuss participant performance:
1. Did Emergency Responder evaluate the scene before attending to patient?
2. Were barriers used? If not, why?
3. When and how was EMS called?
4. Was primary assessment performed effectively and the patient’s airway managed?
5. Did Emergency Responder move or reposition patient? Why? How?
6. Did Emergency Responder use the Cycle of Care to continually monitor a patient’s medical
status?
4-4
Primary Care
Emergency Scenario Two

Down in Public
Location: Office.
Phone is on desk.
Patient: Male coworker
Action: Emergency Responder finds coworker lying on his side on
the office floor. Another coworker approaches.
Condition: He is nonresponsive, and not breathing normally.

Location: Local store – near counter.
Phone is next to cash register.
Patient: Female cashier
Action: Emergency Responder finds cashier lying behind counter
on her side. Another customer approaches.
Condition: She is nonresponsive, and not breathing normally.
Factors you can change – Any public area and any adult patient.
Demonstrate scene assessment, barrier use, primary assessment and one rescuer CPR for
assisting patient that is unresponsive and not breathing normally. Primary Care Skills One –
Five; including the Optional AED skill if learned by participants.
4-5
Procedures
guide/bystander.
3. Position patient on side on the floor. Explain that Emergency Responder may ask a
bystander for assistance if necessary – however the bystander is not CPR/first aid trained.
Have responder approach patient and begin care. The guide may reference Emergency First
Response Participant Manual as appropriate.
4. During the scenario, provide direction only as necessary. Use mannequin for CPR practice.
5. Stop scenario when Emergency Responder has completed several rescue breathing/
compression cycles during CPR.
4. Was primary assessment performed effectively?
6. Was CPR initiated and performed properly?
7. Did the Emergency Responder use the Cycle of Care to monitor a patients medical status and
treat any problems discovered?
8. Was there an attempt to locate an AED and use it?
4-6
Primary Care
Emergency Scenario Three

Recreational Accident
Location: Swimming pool.
Emergency phone hangs on wall nearby.
Patient: Teenage boy (16-18 years old)
Action: Teenager dives into shallow end of pool and does not
surface. Emergency Responder finds him face down, near
edge of pool, bleeding from a forehead gash. Other people
are in pool area.
Condition: He is nonresponsive and not breathing. His forehead
bleeds steadily. Status: After initiating CPR, he shows
signs of breathing normally.

Location: Horse riding stables.
Phone is on stable wall.
Patient: Young female rider (12-16 years old)
Action: Horse bucks and throws rider off. She lands face first on
hard-packed ground. Emergency Responder finds her face
down, bleeding from a shoulder gash. Other people are
near stable.
Condition: She is nonresponsive, not breathing. Her shoulder bleeds
steadily.
Status: After initiating CPR, she shows signs of breathing
normally.
Factors you can change – Any recreational setting where patient could fall or suffer severe blow. Any
teenager, young adult or adult.
Demonstrate primary care skills including bleeding management, shock management and spinal
injury management. Primary Care Skills One – Eight; including the Optional AED skill if
learned by participants.
4-7
Procedures
guide/bystander.
3. Position patient face down on floor. Explain that Emergency Responder may ask a bystander
for assistance if necessary – however the bystander is not CPR/first aid trained. Have
responder approach patient and begin care. The guide may reference Emergency First Response
Participant Manual as appropriate or available.
4. Remind Emergency Responder that patient shows signs of breathing normally after
initiating CPR. Use mannequin for CPR practice.
6. Stop scenario when Emergency Responder has attended to patient, is using the Cycle of Care,
and is waiting for EMS to arrive.
8. If appropriate and available, review use of an AED and emergency oxygen as it relates to this
scenario.
1. Did Emergency Responder evaluate the scene before attending to patient? Was the location
safe?
4. When and how was EMS called? Was there an attempt to locate an AED?
6. How was the airway opened?
7. Did Emergency Responder practice proper bleeding management?
8. Was spinal injury management performed? Why? How?
9. Did Emergency Responder use the Cycle of Care and treat any problems discovered?
4-8
Primary Care
Emergency Scenario Four

Major Multi-Person Accident
Location: Roadway.
Another motorist has cellular phone.
Patient: Adult male and female
Action: Emergency Responder finds a car in a ditch on side of
busy street.
¨ Male is seated in car with his head bleeding from
hitting the steering wheel.
¨ Female is lying face up on road, one leg at an odd
angle, apparently thrown from car.
¨ Other people stop
Condition: He is responsive and states he is in severe pain. She is
nonresponsive and not breathing normally.

Location: Warehouse.
Phone is in nearby office.
Patient: Two adult male workers
Action: A forklift operator attempts to place a heavy pallet on a
shelf that is 6 metres/20 feet high. The pallet falls.
¨ Forklift operator is hit by flying debris as the pallet
and contents scatter.
¨ Warehouse worker is knocked down by several heavy
objects. A box lies on one arm.
¨ Other workers run over.
Condition: Forklift operator is responsive, yells that he’s in pain
from a serious cut on his arm. The warehouse worker is
nonresponsive and not breathing normally.
Factors you can change – Any accident that could injure two people. Any adults.
4-9
Demonstrate primary care skills by attending to two patients.
(Skills One – Eight Primary Care Skills One – Eight; including Optional AED skill if learned
by participants.)
Procedures
2. Break participants into practice groups. Use mannequin for nonresponsive patient, if
necessary. Assign other roles – responsive patient, Emergency Responder and guide/
bystander.
3. Position responsive patient in a chair. Position nonresponsive patient or mannequin lying
face up on floor. Explain that Emergency Responder may ask guide/bystander for assistance
if necessary. Have responder approach scene and begin care. The guide should also reference
Emergency First Response Participant Manual as appropriate or available.
4. During scenario, provide direction only as necessary. Use mannequin for CPR practice.
5. Stop scenario when Emergency Responder has completed several rescue breathing/
compression cycles during CPR and is waiting for EMS to arrive.
7. Conclude scenario practice by asking participants the evaluation questions and clarifying
information, techniques and procedures as necessary. Reinforce that multiple patients mean
that Emergency Responders should use their judgment and training to attend to the most
life-threatening conditions.
1. Did Emergency Responder evaluate the scene before attending to patient? Was the location
safe?
2. Did Emergency Responder move or reposition one or both patients? Why? How?
5. Was primary assessment performed effectively on both patients?
6. Was CPR initiated and performed properly?
7. Did Emergency Responder practice proper bleeding management?
8. Was spinal injury management performed? Why? How?
9. Did Emergency Responder effectively attend to both patients?
4-10
Secondary Care
Emergency Scenario One

Fallen Friend
Location: Remote hiking destination.
No public phone around and no cellular/wireless
phone service.
Patient: Adult female
Action: Emergency Responder hears scream and thud. Finds
friend on ground. Looks like she fell off a 1.5 metre/
4 foot high ledge onto rocky soil.
Condition: She is responsive and holding her ankle. She has small,
bleeding cuts on both legs. She says she got dizzy and fell,
but claims she is fine, just a little weak and bruised.

Location: Remote park.
No public phone around and no cellular/wireless
phone service.
Patient: Teenage male
Action: Emergency Responder hears thud. Finds young male
wearing rollerblades lying on sidewalk. Looks like he tried
to jump over park bench but failed.
Condition: He is responsive and holding his elbow. He has several
scratches on his arms and face. His breathing is labored
and he’s pale, but he says he’ll be fine in a minute.
Factors you can change – Any common location or activity where someone could sustain nonlife-
threatening injuries. Any teenager, young adult or adult.
Demonstrate primary and secondary care procedures including illness and injury assessment.
4-11
Procedures
guide.
3. Confidentially to patient, assign two injuries – one obvious based on the situation and one
less obvious (e.g., Scene A – injured ankle and tender shoulder, Scene B – injured elbow and
tender hip).
4. Position patient sitting against wall or chair, or lying on ground. Have responder approach
patient and begin care. The guide observes and has Emergency First Response Participant
Manual available to reference.
6. Stop scenario when Emergency Responder has completed injury and/or illness assessment.
Change injury locations or scenarios, as appropriate, to give each participant a chance to
discover unknown injuries/illnesses.
questions clarifying information, techniques and procedures as necessary.
3. Was EMS called? If not, why?
6. Was injury assessment conducted effectively and were all injuries located?
7. Was patient’s head and neck immobilized during assessment?
8. Did Emergency Responder conduct an illness assessment?
9. Did (or could) the Emergency Responder provide any other care for patient? Bandaging?
Splinting? Shock management?
10. Did Emergency Responder use the Cycle of Care to discover the patient’s medical status and
treat any problems discovered?
4-12
Appendix
Appendix
Contents
Primary Care Knowledge Review Answer Key . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . A-2
Secondary Care Knowledge Review Answer Key. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . A-3
Primary Care (CPR) Final Exam . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . A-4
Secondary Care (First Aid) Final Exam . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . A-8
Primary Care (CPR) Final Exam Answer Sheet . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . A-10
Secondary Care (First Aid) Exam Answer Sheet . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . A-11
Primary Care (CPR) Final Exam Answer Key. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . A-12
Secondary Care (First Aid) Final Exam Answer Key. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . A-13
EFR Course Registration Form . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . A-14
Instructor Skills Completion Form . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . A-15
Illness and Injury Assessment Record Sheet . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . A-16
Developing a Marketing Plan – Extending Your Emergency First Response Teaching Opportunities. . A-20
Marketing Presentation – Marketing Emergency First Response . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . A-25
Responders In Action Report Form. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . A-32
Emergency First Response License Agreement . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . A-33
Bid Proposal Letter (Sample) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . A-34
Instructor Independent Learning . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . A-36
Human Body Systems . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . A-37
Emergency Contact Information Sheet . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . A-44
Independent Learning - Self-Study Instructor Knowledge Reviews . . . . . . . . . . . . . . . . . . . . . . . . . . . . A-45
A-1
Emergency First Response ®
Participant Manual
Primary Care Knowledge Review Answer Key
1. b and c arm, or leg, especially on one side of the
2. 1. You can save or restore a patient’s life. body or on both sides.
2. You can help reduce a patient’s recovery b. Sudden confusion or drowsiness.
time; either in the hospital or at home. c. Trouble speaking, understanding or
3. You can make the difference between a swallowing.
patient having a temporary or lifelong d. Sudden vision trouble from one or
disability. both eyes.
3. 1. Anxiety e. Sudden trouble walking, dizziness,
2. Guilt loss of balance or coordination.
3. Fear of imperfect performance f. Sudden severe headache with no
known cause.
4. Fear of making a person worse
14. c
5. Fear of infection
15. Cardiopulmonary Resuscitation
6. Responsibility concerns
16. C=Chest Compressions
4. True A=Airway Open
5. a, b, c, d, f, g B=Breathing for Patient
S=Serious Bleeding
6. a. Early Recognition and Call for Help
17. a
b. Early CPR
18. a = Bright red blood that spurts from a
c. Early Defibrillation wound in rhythm with the heartbeat.
d. Early Professional Care and Follow-up b = Dark red blood, steadily flowing from a
7. b wound without rhythmic spurts.
8. Ask a bystander to call EMS and secure an c = Blood slowly oozing from the wound.
AED if possible. If you are alone, use your 19. a, b, c, d, e, g, h, i, j
mobile phone to call EMS. If you do not
have a mobile phone, leave the patient to call 20. a, b, c, d, e, f
EMS if no other option exists.
9. Answer varies. Should be the appropriate
emergency number for the local area or
country.
10. You really cannot make the person worse.
A person that is unresponsive and not
breathing normally is already in the worse
state of health possible since he probably
does not have a heartbeat.
11. True
12. a
13. a. Sudden weakness or numbness of the face,
A-2
Appendix
Participant Manual
Secondary Care Knowledge Review Answer Key
1. b
2. b
3. physical harm to the body
4. an unhealthy condition of the body
5. a
6. life threatening
A-3
Primary Care (CPR)

Final Exam
Directions: Choose the best answer from the choices provided or follow instructions provided.
DO NOT WRITE IN THIS EXAM BOOKLET.
1. In Emergency First Response courses, you learn to 5. Why should you assist someone who needs
provide emergency care based on the same priorities emergency care.
used by medical professionals to assist injured or ill A You can save or restore a patient’s life.
persons. B You can help reduce a patient’s recovery time.
A True B False C You can make the difference between a patient
having a temporary or lifelong disability.
2. Why is time critical when someone needs emergency
care? D All of the above.
A The chances of successful resuscitation diminish 6. Using the Chain of Survival illustration on your
with time. answer sheet, write the appropriate letters in the
B It becomes impossible to administer first aid. boxes to describe each of the links.
C Emergency Medical Services are typically. A Early Recognition and Call for Help
far away. B Early Professional Care and Followup
D All of the above. C Early CPR
3. Why might a person hesitate to provide emergency D Early Defibrillation
care to an individual.
A Anxiety
B Fear of imperfect performance
Chain of Survival
C Fear of infection
D All of the above
4. In general, to be protected by a Good Samaritan law,

you should: (Check all that apply.)
A Act in good faith.
B Never apply bandages to bleeding patients.
C Act as a prudent person would. 7. Call First means that once you’ve established
D Only provide care that is within the scope of your __________, you immediately call your local
training. Emergency Medical Service.
A a patient is in shock
B that a patient is unresponsive and not breathing
normally
C the temperature of a patient
D None of the above
Product No. 71825 (12/11) Version 1.0 © Emergency First Response, Corp. 2011
A-4
Appendix
8. Each time you perform CPR, the patient’s heart 13. What two ways can you recognize cardiac arrest in a
will restart and you will restore the patient’s life. patient? (Check two responses.)
(Check your response.) A The patient does not respond when you
A True B False speak to or touch him.
B Paralysis of the arm.
9. From the introductory statements below, which one
C Bleeding from the nose and mouth.
would you select when asking permission to help a
patient? (Check your response.) D The patient is not breathing normally.
A Hello? My name is ______, I’m an Emergency 14. How do you activate the Emergency Medical Service
Responder. May I help you? in your area?
B I’m a doctor. May I help you? Phone Number: _____________________________
C Are you hurt? Where?
D None of the above. 15. Common signs and symptoms of stroke include:
(Check all that apply.)
10. If you perform CPR as outlined in this course, you A Sudden confusion or drowsiness
really can not make the patient worse than when you B Sudden weakness or numbness of the face, arm,
first found the individual. or leg
A True B False C Sudden vision trouble from one or both eyes
11. As an Emergency Responder what general rule may D Bleeding from the nose
help you avoid infection by bloodborne pathogens?
A Always place a barrier between you and any
moisture or fluid originating from a patient.
B Ask the patient not to cough when you are giving
him emergency care.
C Have the patient bandage his own bleeding
wounds whenever possible.
D Always use gloves when treating a patient.
12. Using the Cycle of Care graphic on your answer sheet,

write the appropriate letters in the blank boxes to
describe their meaning.
A Breathing for Patient
B Chest Compressions
C Serious Bleeding
D Airway Open
Help or AED Arrives

Continue Until
AB C
Airway Breathing
Open? Normally? A
B
S Shock
Spinal Injury
A-5
16. The universal sign that someone is choking is: 20. Arterial bleeding can be recognized when:
A Sudden unconsciousness. A dark red blood steadily flows from a wound
B Pointing to the throat. B blood slowly oozes from a wound
C Grabbing or clutching neck or throat. C blood is coming only from an arm
D None of the above. D bright red blood spurts from a wound in a
rhythm with heartbeats
17. CPR: (Check all that apply.)
A Stands for Cardiopulmonary Resuscitation. 21. What are indications of shock? (Check all that apply.)
B Is a two step process - chest compressions and A Pale or bluish tissue color
rescue breaths. B Altered consciousness
C Is an interim emergency care procedure until an C Lackluster eyes, dazed look
AED or EMS personnel arrive. D. Rapid, weak pulse
D Should not be used to assist an unresponsive
patient that is breathing normally. 22. Indications that someone might have a spinal injury
include: (Check all that apply.)
A Headache
B Vomiting
C Change of consciousness - like fainting
D Pain in back of neck area
23. How do you determine if a person is unresponsive

and not breathing normally?
A Yell at the patient.
B Check the patient’s pulse.
C Tap patient on the collarbone and look, listen and
feel for patient breathing.
D None of the above.
24. How can you practice and refresh your emergency

care skills? (Check all that apply.)
A Review the Emergency First Response Video.
B Role-play scenarios with family members or
18. Why is defibrillation important to a patient with friends.
cardiac arrest? C Practice CPR sequence using a pillow or
A Defibrillation disrupts the abnormal twitching of a appropriately-sized stuffed bag.
heart, restoring a normal heartbeat. D Reread the Emergency First Response manual.
B Defibrillation causes the heart to beat erratically.
C It keeps the patient from having to go to the
hospital after CPR has been administered.
D All of the above.
19. Rescue breaths can not provide enough oxygen to

support a nonbreathing patient.
A True B False
A-6
Appendix
25. In what circumstances should you always suspect a 31. If you are unable or feel uncomfortable giving a non-
spinal injury? (Check all that apply.) breathing patient rescue breaths you should:
A Lightning strike A Go ahead and give continuous chest
B A penetration wound, such as a gunshot compressions.
C Falling from a height greater than victim’s own B Do nothing at all.
height C Yell for help.
D Swimming pool, head-first dive accident D None of the above
26. The head tilt-chin lift method is used to open a 32. ____________ is the first and most successful
patient’s airway. method for serious bleeding management.
A True B False A Yelling for help
B Sustained direct pressure
27. An unreponsive, breathing patient without a C Elevating the wound area
suspected spinal injury should be:
D Tourniquets
A Given CPR immediately.
B Moved immediately to a hospital. 33. While managing serious bleeding, if a pressure bandage
C Placed in the recovery position. or dressing becomes soaked with blood, you would
D Given back blows. generally remove it and replace it with a new one.
A True B False
28. If an unresponsive, nonbreathing patient’s problem
could be a drowning or other respiratory problem, 34. Shock management often includes elevating the
you _______ then call Emergency Medical Services. patient’s legs 15-30 centimetres/6-12 inches and
A treat for shock ________________.
B give Care First A performing a pulse check
C give rescue breaths first B providing water to drink
D place the patient in the recovery position C taking the patient’s temperature
D protecting from the sun or covering the patient
29. During CPR the ratio of chest compressions to to maintain body temperature based on local
rescue breaths is: climate
A 10 compressions to 1 breath
B 15 compressions to 2 breaths 35. A _____________ allows you to turn a patient on
his back carefully when a spinal injury is suspected
C 30 compressions to 2 breaths
(Check your response.)
D 100 compressions to 2
A log roll
30. During CPR the rate of chest compressions per B fireman’s carry
minute is at least: C hand carry
A 200 D pressure bandage
B 50
C 100
D 150
A-7

Final Exam
Directions: Choose the best answer from the choices provided or follow instructions provided.
DO NOT WRITE IN THIS EXAM BOOKLET.
1. A person can stop breathing due to:

A Drug overdose
B Heart attack or sudden cardiac arrest
C Submersion and near drowning
D All of the above
2. A secondary assessment is your second evaluation of:

A an injured or ill person
B first aid
C bleeding
D an open airway
3. Examples of an injury are: (Check all that apply.)

A Dislocation and fractures
B Allergy
C Bruise
D Poisoning
4. ________________ is an unhealthy condition of the

body.
A A symptom
B An illness
C A sign
D None of the above.
5. Regarding a patient’s condition during an illness or

injury assessment, a sign is:
A Something the patient tells you is wrong.
B Something you can see, hear or feel.
C Something a bystander tells you about an 7. If during an injury assessment the patient complains
accident. of head, neck or back pain you should:
D None of the above. A Attempt to determine exactly where the pain is
coming from.
6. Assessment first aid is the treatment of conditions B Perform an illness assessment.
that ________. C Stop your assessment and stabilize the head and
A are not immediately life threatening. neck – wait for EMS to arrive.
B are life threatening. D None of the above.
C require the use of CPR.
D require the need for EMS care
A-8
Appendix
8. During an illness assessment you use the mnemonic “SAMPLE” to guide you.
SAMPLE stands for: (Write in the correct meaning of each letter.)
S= ______________________________________________________________________________________
A= ______________________________________________________________________________________
M = ______________________________________________________________________________________
P= ______________________________________________________________________________________
L= ______________________________________________________________________________________
E = _______________________________________________________________________________________
9. When bandaging a wound on a hand, arm, leg or foot,

make the bandage as tight as you possibly can.
A True B False
10. Regarding the splinting of an injury:

A Even when commercial splints are unavailable,
avoid using make-shift items such as magazines
blankets and boards as splinting material.
B Splint an injury in the position found.
C Always straighten an injured site prior to
splinting.
D When possible, place splint material on both
sides of an injury site.
A-9
Primary Care (CPR)

Participant Final Exam Answer Sheet
Name _____________________________________________________________________________________________________
(Please Print)
Class No. _____________________________________________________ Date _______________________________________
Directions: Upon making your answer choice, COMPLETELY fill in the space below the proper letter.
If a mistake is made, erase your selection or place a dark X through your first answer.
A B C D 13. □ □ □ □
1. True
False 14. Phone Number:
2. □ □ □ □ ____________________
3. □ □ □ □ 15. □ □ □ □
4. □ □ □ □ 16. □ □ □ □
5. □ □ □ □ 17. □ □ □ □
6. 18. □ □ □ □
19. □ True □
False
20. □ □ □ □
21. □ □ □ □
22. □ □ □ □
23. □ □ □ □
24. □ □ □ □
7. □ □ □ □
25. □ □ □ □
8. □ True
False
26. □ True
False
9. □ □ □ □
27. □ □ □ □
10. □ True
False
28. □ □ □ □
11. □ □ □ □
29. □ □ □ □
12. Cycle of Care: AB-CABS™
30. □ □ □ □
Help or AED Arrives
Continue Until 31. □ □ □ □
C 32. □ □ □ □
AB
Airway Breathing 33. □ True □
False
Open? Normally? A
34. □ □ □ □
B 35. □ □ □ □
S Shock
Spinal Injury
STUDENT STATEMENT: I have had explained to me and I understand the questions I missed.
Student Signature __________________________________________________________________________________
Date _____________________________________________________________________________________________
A-10
Appendix

Participant Final Exam Answer Sheet
Name _____________________________________________________________________________________________________
(Please Print)
Class No. _____________________________________________________ Date _______________________________________
A B C D
1. □ □ □ □
2. □ □ □ □
3. □ □ □ □
4. □ □ □ □
5. □ □ □ □
6. □ □ □ □
7. □ □ □ □
8. S = __________________________________
A = __________________________________
M = _________________________________
P = __________________________________
L = __________________________________
E = __________________________________
9. □ True □
False
10. □ □ □ □

Date _____________________________________________________________________________________________
A-11
Primary Care (CPR)

Participant Final Exam Answer Key
Name _____________________________________________________________________________________________________
(Please Print)
Class No. _____________________________________________________ Date _______________________________________
A B C D 13. 7 □ □ 7
1. 7 True □
False 14. Phone Number:
2. 7 □ □ □ ___(Answer varies)_____
3. □ □ □ 7 15. 7 7 7 □
4. 7 □ 7 7 16. □ □ 7 □
5. □ □ □ 7 17. 7 7 7 7
6. 18. 7 □ □ □
19. □ True 7
False
20. □ □ □ 7
21. 7 7 7 7
22. 7 7 7 7
A C D B 23. □ □ 7 □
7. □
7 □ □ 24. 7 7 7 7
8. □ True False
7 25. 7 7 7 7
9. 7 □ □ □ 26. 7 True False
27. □ □ 7 □
10. 7 True False

28. □ 7 □ □
11. 7 □ □ □
29. □ □ 7 □
12. Cycle of Care: AB-CABS™
30. □ □ 7 □
Help or AED Arrives
Continue Until 31. 7 □ □ □
C 32. □ 7 □ □
AB B
Airway Breathing 33. □ True 7False
Open? Normally? A D
34. □ □ □ 7
B A 35. 7 □ □ □
C
SS hock
Spinal Injury
Date _____________________________________________________________________________________________
A-12
Appendix

Participant Final Exam Answer Key
Name _____________________________________________________________________________________________________
(Please Print)
Class No. _____________________________________________________ Date _______________________________________
A B C D
1. □ □ □ 7
2. 7 □ □ □
3. 7 □ 7 □
4. □ 7 □ □
5. □ 7 □ □
6. 7 □ □ □
7. □ □ 7 □
8. Signs and Symptoms
S = __________________________________
Allergies
A = __________________________________
M = Medication
_________________________________
Preexisting Medical Conditions
P = __________________________________
Last Meal
L = __________________________________
Events
E = __________________________________
9. □ True 7
False
10. □ 7 □ 7
Date _____________________________________________________________________________________________
A-13
EFR® COURSE REGISTRATION FORM

Instructor Name ___________________________________________ Instructor Number _____________
EFR Course completed _________________________________________________________________
Course completion date _____________ Course location ______________________________________

Day / Month / Year City / State or Province / Country
PARTICIPANTS
1. Name _____________________________________________________________________________________________
First Middle Initial Last
Address ___________________________________________________________________________________________
____________________________________________________________________ Phone ________________________
City State or Province Zip/Postal Code Country
Date of Birth _________________ Male □ Female □ email _____________________________________________

Day / Month / Year
2. Name _____________________________________________________________________________________________
Address ___________________________________________________________________________________________
____________________________________________________________________ Phone ________________________

Day / Month / Year
3. Name _____________________________________________________________________________________________
Address ___________________________________________________________________________________________
____________________________________________________________________ Phone ________________________

Day / Month / Year
4. Name _____________________________________________________________________________________________
Address ___________________________________________________________________________________________
____________________________________________________________________ Phone ________________________

Day / Month / Year
5. Name _____________________________________________________________________________________________
Address ___________________________________________________________________________________________
____________________________________________________________________ Phone ________________________

Day / Month / Year
6. Name _____________________________________________________________________________________________
Address ___________________________________________________________________________________________
____________________________________________________________________ Phone ________________________

Day / Month / Year
7. Name _____________________________________________________________________________________________
Address ___________________________________________________________________________________________
____________________________________________________________________ Phone ________________________

Day / Month / Year
8. Name _____________________________________________________________________________________________
Address ___________________________________________________________________________________________
____________________________________________________________________ Phone ________________________

Day / Month / Year
Product No. 10321 (Rev. 6/11) Version 1.02 © Emergency First Response 2011
A-14
Instructor Name _______________________________________________________
®
Emergency First Response
Instructor Skills Completion Form
Primary Care Skills 7. Shock Management Secondary Care Skills
1. Scene Assessment 8. Spinal Injury Management S1. Injury Assessment
2. Barrier Use 9. Conscious/Unconscious Choking Adult S2. Illness Assessment
3. Primary Assessment S3. Bandaging
4. CPR - Chest Compressions Optional Skills S4. Splinting for Dislocations
Course Date 5. CPR - Chest Compressions Combined R1. AED (Automated External Defibrillator) Use and Fractures
With Rescue Breathing R2. Emergency Oxygen Use Orientation
___________ 6. Serious Bleeding Management
Participants 1 2 3 4 5 6 7 8 R1 R2 S1 S2 S3 S4
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
11.
12.
Appendix
Product No. 10235 (Rev. 6/11) Version 2.01 © Emergency First Response Corp. 2011
A-15
A-16
®
Illness and Injury Assessment Record Sheet
X STOP– Assess and observe scene. To help guide your assessment, remember that:
X THINK – Consider your safety and form action plan. X The average pulse rate for adults is between 60 and 80 beats per minute.
X ACT – Check responsiveness and ALERT EMS. X The average pulse rate for children is between 70 and 150 beats per
Treat patient in position found when safe to do so. minute. Toddlers will be on the higher end of this average and older
X Perform a primary assessment and monitor patient using the children will be on the lower side.
Cycle of Care. X The average pulse rate for infants is between 100 and 160 beats per
X Explain Assessment Procedure to Patient – Wear Gloves if available. minute.
X As you record information on this sheet for EMS, provide measured rates X Average breathing rate for adults is between 12 and 20 breaths per
per minute and descriptive terminology. minute. Patients who take less than eight breaths per minute, or more
than 24 breaths per minute probably need immediate medical care.

Patient Information X The average breathing rate for children is between 18 and 40 breaths
Name __________________________________________________________ per minute. Toddlers will be on the higher end of this average and older
□ Male □ Female Date of Birth (Day/Mon/Yr) ______/______/______ children will be on the lower side.
Address _________________________________________________________ X The average breathing rate for infants (less than one year old) is
between 30 and 60 breaths per minute.
City ______________________________________ State/Province ________
X Average skin temperature is warm and skin should feel dry to the touch.
Country _________ Zip/Postal Code _________ Phone __________________ X Noticeable skin color changes may indicate heart, lung or
□ Medical Alert Tag? Type _________________________________________ circulation problems.
Patient Condition at Beginning of Summary – Primary and □ Bandaging

Emergency Responder Care Secondary Care Provided □ Splinting
□ Other ________________________________
□ Conscious □ Unconscious □ CPR
□ Defibrillation ________________________________________
Patient Position Prior to Care □ Serious Bleeding Management
□ Standing □ Sitting □ Lying □ Shock Management Patient Referred to:
□ Spinal Injury Management □ EMS Personnel □ Hospital
□ Conscious Choking Assistance □ Personal Physician □ None
□ Emergency Oxygen Use □ Other ________________________________
□ Illness Assessment
□ Injury Assessment ________________________________________
Page 1 of 4
Illness Assessment
SAMPLE – Signs and Symptoms
1. How do you feel now? __________________________________________________________________________________________________________
____________________________________________________________________________________________________________________________
2. Patient’s pulse rate ________________ (use carotid or radial pulse; count beats for 30 seconds, multiply by two)
3. Describe patient’s pulse: □ Rapid □ Strong □ Weak
4. Patient’s respiration rate ____________________ (count respirations for 30 seconds, multiply by two; avoid telling patient you are counting respirations.)
5. Patient’s breathing is: □ Rapid □ Slow □ Labored □ Wheezing □ Gasping
6. Patient complains of: □ Shortness of breath □ Dizziness/Lightheadedness □ Chest pain □ Numbness □ Tingling in arms/legs
7. Patient’s skin is: □ Warm □ Hot □ Cool □ Clammy □ Wet □ Very dry
8. Color of patient’s skin is: □ Pale □ Ashen □ Red □ Blue □ Yellowish □ Black and Blue
(gray) Blotches
SAMPLE – Allergies
1. Is the patient allergic to any foods, drugs, airborne matter, etc? □ Yes □ No
If yes, what is he/patient allergic to? _______________________________________________________________________________________________
____________________________________________________________________________________________________________________________
2. Ask the patient if he has ingested or taken anything he may be allergic to: □ Yes □ No
3. Stung or bitten by organism? □ Yes □ No
SAMPLE – Medications
1. Ask the patient: Do you take medication? □ Yes □ No
If yes, what type and name? ____________________________________________________________________________________________________
2. Ask the patient: Did you take your medication today? □ Yes □ No
If yes, How much did you take and when? _________________________________________________________________________________________
3. If possible, collect all medication to give to EMS personnel and/or get name of the doctor who prescribed the medication.
____________________________________________________________________________________________________________________________
Page 2 of 4
Appendix
A-17
A-18
Illness Assessment (continued)
SAMPLE – Preexisting Medical Conditions
1. Ask the patient: Do you have a preexisting medical condition? □ Yes □ No
If yes, what type? _____________________________________________________________________________________________________________
SAMPLE – Last Meal

1. Ask the patient: Did you eat recently? □ Yes □ No
If yes, when did you eat? _______________________________________________________________________________________________________
2. What was eaten? _____________________________________________________________________________________________________________
SAMPLE – Events
1. Ask the patient: What events led to your not feeling well?
___________________________________________________________________________________________________________________________
___________________________________________________________________________________________________________________________
2. What were you doing when you began to feel ill?
___________________________________________________________________________________________________________________________
___________________________________________________________________________________________________________________________
3. When did the first symptoms occur?
___________________________________________________________________________________________________________________________
___________________________________________________________________________________________________________________________
4. Where were you when the first symptoms occurred?
___________________________________________________________________________________________________________________________
___________________________________________________________________________________________________________________________
5. Has the patient been exercising? □ Yes □ No
Attach additional Responder notes on separate sheet.
Page 3 of 4
Injury Assessment
History ___________________________________________________________________________________________________________________________
__________________________________________________________________________________________________________________________________
__________________________________________________________________________________________________________________________________
__________________________________________________________________________________________________________________________________
__________________________________________________________________________________________________________________________________
What happened: ____________________________________________________________________________________________________________________
How did the injury happen? ____________________________________________________________________________________________________________
When did the injury occur? ____________________________________________________________________________________________________________
Injury Location (Follows Injury Assessment Order. Use Injury Key to denote condition.) Injury Condition Key
□ Head _______________________________ □ Right Arm ___________________________ A = Abrasion
□ Forehead, Cheeks, Chin _________________ □ Right Hand __________________________ B = Bleeding
□ Ears/Nose ___________________________ □ Left Arm ____________________________ Bu = Burns
□ Tracking Eyes ________________________ □ Left Hand ____________________________ C = Contusion (injury to tissues;
□ Pupils – Size _________________________ □ Rib cage ____________________________ no bone or skin broken)
Equal/Unequal ________________________ □ Spinal Column ________________________ D = Deformity
F = Fracture
Reaction to Light ______________________ □ Abdomen – Left/Right Side ______________
L = Laceration (deep/jagged cut)
□ Skull, Neck __________________________ □ Hips ________________________________ P = Pain
□ Shoulder Blades ______________________ □ Right Leg ____________________________ S = Swelling
□ Shoulders ___________________________ □ Right Foot ___________________________ T = Tenderness
□ Collarbones __________________________ □ Left Leg _____________________________
□ Left Foot ____________________________
Emergency Responder Care Given

__________________________________________________________________________________________________________________________________
__________________________________________________________________________________________________________________________________
__________________________________________________________________________________________________________________________________
__________________________________________________________________________________________________________________________________
Additional Responder Notes

__________________________________________________________________________________________________________________________________
__________________________________________________________________________________________________________________________________
__________________________________________________________________________________________________________________________________
Page 4 of 4 ________________________________________________________________________________________________________________________
Appendix
A-19
Extending Your Emergency First Response® Teaching Opportunities
Developing a Marketing Plan

As with any new business opportunity, it is wise to begin with a focused marketing plan. To help you
get started, use the following outline as a guide to develop your marketing strategy for Emergency
First Response. Listed are some examples to jump-start your thought process.
1. Situational Analysis
PRODUCT PROFILE
Describe your product.
¨ Emergency First Response Primary Care (CPR) and Secondary Care (First Aid)
educational first aid training courses. The Primary Care (CPR) course prepares
participants to render aid to those with life-threatening emergencies. Secondary Care
(First Aid) builds upon what participants learned in Primary Care and helps them assist
those in need when Emergency Medical Services are either delayed or unavailable.
Primary Care (CPR) and Secondary Care (First Aid) can be offered as one complete
course or separately.
¨ The Emergency First Response Care for Children course is an innovative CPR, AED
and First Aid training course that teaches you how to provide emergency care for injured
or ill infants and children. You’ll learn the types of medical emergencies children face and
how they differ from adult conditions. The course also addresses the emotional aspects
of caring for children, secondary care for children and preventing common injuries and
illnesses in children.
The course includes both CPR and first aid skills. The primary care portion of the course
prepares you to render aid to an infant or child with a life-threatening emergency such
as choking or cardiac arrest. Secondary care focuses on developing secondary patient care
skills and building your confidence to give first aid to an infant or child in need. The Care
for Children course content is based on guidelines from the Pediatric Working Group of
ILCOR.
¨ Emergency First Response CPR and AED Course (where applicable). It encompasses
one and two rescuer CPR and AED training for adults with the option to include training
for infants and children. This is the ideal course for businesses that need to meet compliance
requirements while minimizing time spent away from the job.
¨ Emergency First Response First Aid at Work (Great Britain) and Emergency First
Response First Aid at Work (Australia). Visit the EFR Instructor Site/Continuing
Education for details on workplace courses in your area.
¨ Emergency First Response Basic First Aid (Canada) and Emergency First Response
Standard First Aid (Canada).
¨ Visit the EFR Instructor Site/Continuing Education for details on workplace courses in
your area.
A-20
Appendix
TARGET AUDIENCE PROFILE

Identify your target audiences, who are potential Emergency First Response participants?
¨ Family, friends and coworkers.
¨ Instructors and staff at health and sports clubs.
¨ Members of community groups and activity centers.
¨ Teachers, students and administrators at local schools and YMCAs, individuals in
professions with licensing requirements: nurses, child-care workers, lifeguards, swimming
instructors, firemen, police, boat captains, pilots, etc.
¨ Large employers, corporations and other institutional entities.
¨ Don’t forget your refresher course candidates! Institute a system for keeping track of
certifications and send a postcard or email to participants before their cards expire.
MARKET PROFILE
Summarize the existing and projected marketplace in which you will market your product (i.e.,
Emergency First Response). For example:
The market for CPR and first aid programs is extremely competitive. Internationally, there
are several established first aid organizations. Try looking up CPR and first aid training in
the local yellow pages/phone book and on the internet. This will give you an idea of currently
available programs in your local area.
In recent years, several occupations have come to require CPR and first aid training. Due to
society’s litigious nature, it is necessary for these occupations to provide their employees with
the proper training. You can use this opportunity to promote Emergency First Response.
RECENT OR ANTICIPATED COMPETITOR ACTIONS

Document competitor actions.
Existing CPR and first aid organizations are well-established and have contracted with local
and national businesses to exclusively provide their courses to company employees. Because of
their size, credibility and support, some can offer their courses at extremely competitive rates.
Competitive organizations are also enhancing their curriculum by offering Automated
External Defibrillator (AED) instruction. Depending on where you are located you may also
be able to sell AEDs at a profit. Contact your local EFR Office for information.
A-21
STRENGTHS
Compile a list of your product’s and company’s strengths. A strength is something that currently exists
or that you hold, for example:
¨ Can offer Emergency First Response course as one complete program or separately.
¨ Offers flexibility of independent study (corporate participants spend less time away
from jobs).
¨ Educationally superior program (Meets ILCOR Standards and the 2010 Guidelines for
CPR and Emergency Cardiac Care).
¨ Will receive marketing support from Emergency First Response Corp.
¨ Can promote and sell program to an existing student base.
¨ Promotional material for consumers and corporate clients is available.
¨ CPR and AED course is competitively priced for the corporate environment.
¨ EFR consumer website is a rich source of information. You can list yourself in Course
Finder on the EFR consumer site at www.emergencyfirstresponse.com!
WEAKNESSES
Compile a list of your product’s and company’s weaknesses. A weakness is something that currently
exists or that you hold, for example:
¨ You will experience an initial learning curve.
¨ There may be limited market awareness of EFR, so you will need to expend marketing
energy.
¨ There also may be limited market awareness of your individual teaching program in the
community.
OPPORTUNITIES
Compile a list of opportunities off which you can leverage or capitalize on. For example:
¨ There is unlimited market potential, can expand beyond current student base.
¨ The market demands (or local regulations require) layperson emergency care training.
¨ Exploit training opportunities with businesses, organizations, communities, etc.
¨ Many consumers need and want this training.
¨ You can market to your current and new dive students.
THREATS
Compile a list of threats – anything that will take business away from you. For example:
¨ There are many CPR and first aid courses and they are easily accessible.
¨ The competitors are well-established.
¨ The competitors have contracts with several major companies, across all industries, to
provide their programs.
¨ Local regulations/laws governing emergency care training.
A-22
Appendix
2. Conclusions
This is where you would generalize and summarize conclusions from above SWOT (Strengths,
Weaknesses, Opportunities and Threats) analysis. For example:
Need to proactively promote the program to current student base, as well as family and
friends to begin building credibility. Collect testimonials and success stories to market to
outside businesses and organizations. Leverage as much as possible off of Emergency First
Response Corp. marketing efforts, supplementing with flyers, email initiatives, editorial/ad
space in local papers and community and school newsletters.
GOALS
Set the goals you would like to achieve as an instructor for Emergency First Response. These goals could
include the number of course completions you would like to achieve for the year, how much in sales
(gross), selling product with every course, etc. Examples include:
¨ Train 30 Emergency First Response participants in the first year (2.5 per month).
¨ Teach five corporate classes.
¨ Sell promotional materials to each class (DVDs, keychain barriers, etc.) Goal is $
(financial amount) for year.
3. Acquisition Tactics
First, order an EFR marketing kit (Product 00523) if you haven’t already received one. Next, use the
kit to help you identify specific marketing vehicles and develop a media and promotions schedule as well
as unique marketing efforts that are applicable to your area and budget. For example:
ADVERTISING
¨ Develop media strategy to maximize program and product exposure in targeted consumer
promotions.
¨ Consider banner exposure on local community web sites.
¨ Identify other vehicles such as radio, billboards, etc.
¨ Use Emergency First Response clothing, business cards, automobile signs, etc.
MEDIA Average Cost

¨ Daily news circulation 1,000,000 = $3,000
for all advertisements
¨ Church bulletin circulation 3,000 = $300
¨ Football program circulation 20,000 = $700
A-23
ELECTRONIC MEDIA
¨ Evaluate promotions, contests and publicity potential.
¨ Gather testimonials from recent participants and use them to promote your courses.
¨ List all the benefits of the program and features of the product.
¨ Add your information to Course Finder on emergencyfirstresponse.com.
¨ Schedule regular (monthly) email broadcasts listing upcoming classes, promotions, etc.
¨ Begin an email database – “Emergency Care Tip of the Week.”
¨ Set up your own website with a link to the EFR consumer website
(www.emergencyfirstresponse.com).
EVENTS/SHOWS
¨ Use local town meetings, community fairs, church gatherings, Chamber of Commerce, etc.,
as a forum to provide information about the program.
¨ Attend trade shows or consider partnering with a company to display product and
provide program information.
DIRECT MARKETING
¨ Direct mail to local corporations.
¨ Follow-up all direct mail efforts with email reminders and phone calls to increase
frequency.
¨ Use direct marketing to remind past participants of refresher courses.
¨ Develop a referral card and insert it into envelope with your invoice.
COLLATERAL MATERIAL/Point Of Purchase (POP)

¨ Create a flyer listing your class schedule using flyers in your EFR marketing kit.
¨ Distribute to local health and sports clubs, daycare centers, universities, etc.
¨ Bag stuff with purchases.
¨ Use Emergency First Response branded merchandise.
¨ Order EFR dry erase poster. List your next scheduled
course and post it at your community center.
4. Measurement
Make sure to measure the results of each effort.
¨ Develop internal reports to track certifications and
sales.
¨ Develop consumer surveys.
¨ Track responses to all marketing efforts (i.e., ads,
direct mail, promotions, etc.).
¨ Track satisfaction of customers and participants.
A-24
Appendix
Marketing Presentation
Marketing Emergency First Response ®
This presentation is designed to spark creative thinking on ways to market

Emergency First Response courses and to identify potential target markets
for CPR and first aid training. The presentation highlights the relative size of
the CPR/ First Aid market, explains how to identify potential target markets
and how to focus marketing efforts, and also provides sample marketing tools.
Your EFR IT will guide you as you explore ways to promote your Emergency
First Response business.
Think back to your first CPR or first aid course and answer these three questions:
1) What made you enroll? 2) What made you choose that particular course? 3) Did you take any
other courses or go back for a refresher course from the same instructor or facility?
Chances are your answers are all very different, which makes a couple of important points. First,
people have a wide variety of reasons for wanting to learn CPR and first aid procedures. This could
range from wanting to know how to care for an ill family member, to being required to take a course
by an employer.
The second point is that in many areas there are a lot of training choices. Most people don’t have to
look too hard to find a course that fits their schedule and budget. When training is easy to find, you
need to figure out how to make your courses stand out.
The way to keep your Emergency First Response courses full involves good marketing. You need to
decide who your potential participants are and carefully craft your marketing message to appeal to
them. You also need to arrange your courses in a way that is convenient and attractive to potential
participants.
The good news is that almost everyone is a potential participant – the total market is huge. Your
marketing plan is a good way to find your niche and grow from there.
Keep in mind that besides a solid marketing plan, it is just as important to make sure that your
courses are worthwhile and enjoyable because you want participants to refer people to you and return
for emergency first response refreshers or other courses.
During this session, we’ll discuss marketing and help you start to expand your marketing plan by
sharing ideas.
A-25
Overview
The CPR / First Aid Training Market
To truly understand the marketing opportunities for CPR and first aid training, you need to have an
understanding of the relative size of the market. During this segment, we’ll explore the size of the
CPR and first aid training market to identify areas of potential growth.
Potential Participants
Targeting your marketing efforts is an important part of your marketing plan. During this segment
we’ll work together to identify potential participants in the local marketplace.
How to Market EFR

Once a target market is identified, you need to use specific marketing techniques to get you message
out. During this segment we’ll identify who to contact and what information you need to include in
your marketing package.
Sales Techniques
Overcoming objections is a critical part of the sale process. This workshop will outline some
potential objections you may encounter when marketing EFR and ways to overcome them.
Getting the Word Out

Marketing is not only advertising, it’s also about image, reputation, incentives, promotions and
general communication. We’ll look at ways you can spread the word about your Emergency First
Response programs.
A-26
Appendix
Outline
I. CPR and First Aid Industry
A. CPR and First Aid training market
Your EFR IT will provide you with current information on market size.
II. Potential Participants

A. Who are your potential Emergency First Response course participants?
1. As mentioned, anyone with an interest in training may enroll in an Emergency First
Response course. Thus, your potential market may be huge.
2. Make it a point to research who needs and wants CPR and first aid training in your local
area. This will help you focus on specific groups.
a. Emergency care training is often a requirement for recreational and public permits or
certifications.
b. For example, for a scuba diving rescue certification, child care worker’s permit, lifeguard
certification, etc. In some areas, emergency care training may be required before
obtaining a driver’s license.
3. Keep in mind, however, that in some areas CPR and first aid training may be restricted
by government regulations.
a. This is often the case when emergency medical training is required to meet specific
licensure or workplace requirements.
b. Make sure that you understand the regulations in your area and abide by local laws.
List your participants.
This list may include:
1. Family, friends, coworkers and associates.
2. Civic and community groups, clubs, associations, organizations, etc.
3. Schools and universities – teachers, administrators, students, etc.
4. Businesses – employees, management, child-care workers, etc.
5. Professional organizations
A-27
III. How to Market EFR

A. How do you develop a contact?
1. One way is to make a direct call to the business or organization either by phone or in
person to identify a point of contact.
a. For businesses, this is often the human resources department, safety officer, plant
engineer or fitness manager.
b. For organizations, this may be a club president, safety officer or activities director.
2. What you want to find out is who is in charge of employee, member or participant
training.
B. What questions should I ask?
1. Do you offer, or are your employees (or members) required to be trained in CPR/First Aid?
2. What specific safety training is required?
3. Who in the company or organization is responsible for employee training?
4. Who conducts your training?
5. Is the training done by in-house staff or is it by bid?
6. If you’re not able to speak directly to the person responsible for training, ask who you can
send an information package to.
C. What features, advantages and benefits should you point out about EFR?
1. The EFR Primary Care and Secondary Care program offers two courses (CPR and First
Aid) that can be taught in tandem or stand alone.
2. Specific course for Care for Children that focuses on techniques for providing CPR and
first aid to infants and young children.
3. Workplace courses to meet specific regional guidelines (UK, Australia, Canada), or CPR
& AED.
4. Program is based on internationally recognized medical guidelines.
5. EFR incorporates a flexible learning method to meet individual needs. This includes
independent study to increase knowledge retention, focus instruction time on skill
development, and to reduce time employees are away from the job.
6. State of the art self-study materials including participant manual, and DVD. Highlight
cost savings of independent study method. Employees spend less time away from job.
7. Learning takes place in a non-stressful environment.
8. Automated External Defibrillator (AED) training that includes the latest
recommendation for pediatric defibrillation.
9. Oxygen administration module can be included in training.
A-28
Appendix
10. Leverage EFR’s international approvals or acceptances when marketing to general

industry. EFR meets workplace safety program requirements.
a. OSHA (U.S.): Meets intent of OSHA guidelines.
b. HSE: (Great Britain) Meets appointed person in the workplace requirements.
c. Australian Skills Quality Authority (ASQA): National regulator for Australia’s
Vocational Educational Education (VET) sector.
d. COSH (Canada) EFR Basic First Aid and Standard First Aid meet regulations
that govern the workplace requirements in Canada, and also the Province of
Newfoundland and Labrador’s Workplace Health Safety and Compensation
Commission (WHSCC); the Province of Alberta for Workplace Health and Safety;
and Transport Canada.
D. What should you include in a marketing presentation?
1. Your marketing presentation needs to include a proposal letter. When preparing your
letter try to keep it to no more than two pages. [There is a sample proposal letter on the
Emergency First Response Instructor website].
2. Include information on how EFR meets the clients specific needs including local
regulations, job site requirements or time constraints.
3. Include cost breakdown (Material and Instructor fee), or simply quote a price per
participant or per class.
4. Also include EFR corporate acquisition brochure, along with detailed information on
how EFR meets their workplace needs, information on your business with customer
testimonials and set a date to follow up on your information package.
E. How can you increase your marketability?
1. Continuing your professional education as an EFR Instructor will increase your
marketability by taking continuing education courses as they become available.
IV. Sales Techniques Workshop

A. How do you overcome objections?
This workshop is designed to spark thinking on how to overcome objections with
implementing Emergency First Response in the workplace or marketing to large
organizations. There is no wrong answer.
1. Objection 1: You call the company and are unable to speak to or find out who is in charge
of employee training.
What should you do or say?
2. Objection 2: We already offer CPR/First Aid training to our employees.
3. Objection 3: We don’t offer training or require our employees to be CPR/First Aid
trained.
4. Objection 4: Your program costs more than other programs on the market.
A-29
V. Getting the Word Out

A. How can you begin to establish yourself as an Emergency First Response Instructor?
1. Some instructors are fortunate enough to have ready-made classes – for example,
mandatory employee training programs. Other instructors must build their Emergency
First Response programs from scratch. Whether you fall into one of these categories or
somewhere in between, all Emergency First Response Instructors must gain experience
and build a solid reputation.
2. One suggestion is to start by teaching those close to you – family, friends, coworkers, etc.
As a new instructor, this allows you to work your way through the program and fine-tune
your teaching skills in front of people who already value you. You learn from them while
they learn from you in a mutually supportive environment.
3. Your next step may be to expand your program to local community organizations, clubs
and schools. As you teach more courses within the community, you further establish
yourself as an Emergency First Response Instructor and the person to go to for training.
4. Be sure to offer quality programs, because people are likely to spread the word about a
poor class. You want only a positive image of your programs to circulate throughout the
community.
5. As an established Emergency First Response Instructor, your ability to grow your
programs is limited only by your own goals and desires.
B. How can you advertise and promote your Emergency First Response courses?
This list may include:
1. Advertising:
¨ Community calendars and bulletin boards
¨ Newspapers, magazines and other publications
¨ Flyers and direct mail
¨ Emails and websites
¨ Soliciting local businesses and organizations
2. Promotions:
¨ Incentives for participants to refer others to you
¨ In conjunction with other training – babysitting courses, scuba diving courses, teacher
training, etc.
¨ In conjunction with equipment purchases – AEDs, oxygen units, first aid kits, etc.
¨ In conjunction with at-work programs offered in occupational settings such as safety
and manual handling courses.
A-30
Appendix
Summary
The CPR / First Aid Training Market
1. How big is the CPR and First Aid training market?
Potential Participants
2. Who are your potential Emergency First Response course participants?
How to Market EFR

3. How do you develop contact?
4. What features, advantages and benefits should you point out about EFR?
5. What questions should I ask?
6. What should you include in a marketing presentation?
7. How can you increase your marketability?
Sales Techniques
8. How do you overcome objections?
Getting the Word Out

9. How can you begin to establish yourself as an Emergency First Response Instructor?
10. How can you advertise and promote your Emergency First Response courses?
A-31
Responders in Action
Report Form
Responders in Action
When you use your skills as an Emergency Responder to care for an injured or ill person, we’d like to hear about it. The incident
need not be dramatic, involve a life-threatening condition or necessarily have a favorable outcome. Sharing your story motivates and
encourages others to use their skills and provide assistance in emergency situations. This information is also useful to monitor and
gauge the effectiveness of Emergency First Response training and assist in future program development.
Please Type or Print Clearly
Name ________________________________________________________________________________________________________________
Last Name First Name Middle Initial
Address _______________________________________________________________________________________________________________
City ________________________________________ State/Province ______ Country ____________________ Zip/Postal Code _____________
Phone ( ______ ) _____________________________ Email Address _____________________________________________________________
Date of your last Emergency First Response Certification/Recertification Course ______________________________________________________

( Day/Month/Year )
Name of your Emergency First Response
Instructor/Trainer _________________________________________________________________ Instructor No. _________________________
Description of Events
Location of Incident _____________________________________________________________________________________________________
______________________________________________________________________________ Date of Incident _________________________

( Day/Month/Year )
On the back of this form, or on a separate sheet of paper, please describe the incident, including the nature of the injury or illness,
the skills used to render aid, and if possible, information on the outcome. Please type or print neatly and submit your report to your
Emergency First Response Regional Headquarters.
□ By marking this box I understand I am granting Emergency First Response Corp. permission to reprint the details of
this incident for the benefit of other Responders. I understand details that may identify the patient will be omitted
but my name as an Emergency Responder may be used.
________________________________________________________________ ______________________________________________
Signature Date (Month/Day/Year)
Visit emergencyfirstresponse.com for the contact information of your nearest Emergency First Response Regional Headquarters.
Product No. 10237 (Rev. 6/11) Version 2.01 © Emergency First Response, Corp. 2011
A-32
Appendix
EMERGENCY FIRST RESPONSE®

LICENSE AGREEMENT
Emergency First Response Corp. (a California corporation, hereinafter “EFR”) is the owner of certain marks,
including but not limited to, Emergency First Response, The Responder, certain logotypes - including a red heart
with a pulse mark superimposed thereon, as well as other marks, including Specialty and Certification marks.
EFR® relies upon the foregoing marks to indicate the source of origin of its services, certifications and products, so
that the public will be protected; and the instructors, participants and others associated with EFR will receive the
highest-quality services and products pertaining to their business.
To provide EFR Instructors with the ability to advertise, promote and indicate the source of origin of the EFR
services, certifications and products they provide, EFR Instructors are hereby granted a license to use the forgoing
marks on promotional materials only, specifically printed, film or video formats and software; fixed media, such
as floppy disks, hard drives or CD-ROM; or any interactive digital or broadcast media or methods, including, but
not limited to, internet or World Wide Web Sites.
The license shall not extend to the provision of other printed materials, such as manuals, books, instructions,
clothing or products or any other materials whether or not they are manufactured, sold, distributed or licensed to
others by EFR.
This license extended by EFR shall only be with respect to (1.) Printed advertising and promotional materials,
(newspaper and periodical advertisements, telephone-directory advertising, handbills and signs); (2.) Film and
video format promotional materials such as television commercials, slide shows or promotional videos; and (3.)
Software, fixed media, such as floppy disks, hard drives or CD-ROM, or any interactive digital or broadcast me-
dia or methods-based promotion, including, but not limited to, internet or World Wide Web Sites; none of which
shall include use on any item or product intended for resale. The term “Emergency First Response” may not be
used in internet domain names.
The foregoing license for advertising and promotional use shall in all respects follow the exact format, character,
general appearance, type style, background and proportions of the marks originating from EFR. In no case shall
the marks be combined with other marks, symbols, language or be in a format and appearance other than that
actually used by EFR. The full trademark must be used; truncated or partial use of a mark is not authorized.
This license shall be personal to the individual EFR Instructor and shall be nontransferable, nondivisible and not
capable of being sublicensed in any manner through any party.
Notwithstanding the foregoing, EFR shall have the sole right to disapprove of any promotional materials pre-
pared and shall be the sole judge of the criteria of whether it meets the standard of this License Agreement. To
this end, any suggestions or requests by authorized members of the EFR staff as to the usage of the marks shall
be complied with as soon as possible to avoid mistakes, deceptions, dilution or other problems that would be
detrimental to the foregoing marks.
Regardless of the foregoing license, EFR shall have the right to institute and bring any suit or any other action
necessary to protect its marks as to any person, firm or corporation now or prospectively using the marks or any
similar marks, derivations, analogs, trade names, fanciful scripts or designs.
This license shall extend for the term of authorization as an EFR Instructor, which shall be terminated forthwith
upon termination of the EFR Instructor’s relationship with EFR.
PRODUCT NO. 10299 (Rev. 6/11) Version 1.02 © Emergency First Response, Corp. 2011
A-33
<Date>
<Company Name>
<Address>
<City> <State> <Zip
Attention <Contact Name>
Dear <Contact Name>,
Thank you for your interest in <your company name> and the Emergency First Response
training program. At <your company name> we are committed to providing the utmost in
customer service and can customize Emergency First Response courses to meet your specific
emergency response/workplace safety requirements.
Emergency First Response courses are solidly grounded in state-of-the-art educational material
that provides program flexibility to meet your scheduling needs. Additionally, the courses meet
or exceed governmental authority (i.e. OSHA Or COSH)) workplace safety program
requirements for CPR and first aid training. I’ve enclosed a sample of the participant materials
for your review.
The following is a list of services and a proposal to train <number of employees> for
<company name>.
Upon entering into contract, <your company name> will;
• offer Emergency First Response training in specific locations designated by

<company name>.
• assist in class scheduling and logistical support.
• offer training during times specified by <company name>.
• conform to all <company name> policies regarding breaks and lunches.
• provide a class roster and any other information pertaining to the training required
by <company name>.
• notify <company name> in writing within a minimum of ninety days of any
participant approaching the recommended retaining date.
• provide an Emergency First Response instructor for all training. The training
provided by the instructor will include Emergency First Response Primary and
Secondary. Additionally, the instructor will provide training in automated external
defibrillator (AED) use, conscious choking adult management and emergency oxygen
use. Please see enclosed program brochure for complete course content.
A-34
Appendix
• invoice <company name> at <$$$> per class. Maximum class size will be limited
to twelve participants to one instructor. This fee includes all training supplies and
participant materials. Each participant will receive a personal copy of the EFR®
participant manual and video and will retain this material after completion of training.
In the event class size exceeds twelve participants, additional participants will
be billed at <$$$>. <Your company name> will invoice <company name> upon
completion of each class. Payment is due upon receipt of invoice.
• in the event of class cancellation by <company name> a cancellation fee of <$$$>
per scheduled class will be assessed.
• in the event of cancellation by <your company name>, any deposit will be refunded
in full.
Thank you for considering <your company name>for your workplace CPR and first aid training
needs. I look forward to receiving your reply by <date>. If you have any questions, please
contact me at <your contact information>.
Sincerely,
<Your Name>
<Title>
A-35
Instructor Independent
Learning
The following pages cover foundational knowledge needed for the Emergency First Response
Instructor Course. The Human Body Systems segment covers how the various systems in the human
body work and how they relate to the Emergency Responder. As an Emergency First Response
instructor candidate, you’ll read this information along with the Medical Emergencies section in the
Emergency First Response Primary Care and Secondary Care Participant Manual and answer related
questions in the self-study Instructor Knowledge Reviews.
A-36
Appendix
Human Body Systems

When you witness a serious car accident or watch someone take a bad fall, it’s
reasonable to assume the patient will have life-threatening injuries. Although
it may not be obvious at first glance, many accident scenes call for emergency
medical care.
Unfortunately, not all life-threatening emergencies are so obvious. Some serious
conditions occur due to illness or subtle accidents. Sometimes the patient’s
symptoms come on quickly and other times the patient gets progressively worse
over time. Because response time is critical, Emergency Responders need to be
able to recognize all life-threatening conditions and then provide appropriate The miraculous machine
we call the human body.
emergency medical care.
Providing effective emergency care to an injured or ill patient does not require an
in-depth knowledge of the human body. Using the Cycle of Care allows Emergency
Responders to handle most life-threatening emergencies. However, knowing how the body works
provides a basis for ensuring that you are helping a patient in accordance with first aid principles.
The miraculous machine we call the human body is made up of billions of cells. Individually
different cells make up tissues. Similar tissues make up organs. A collection of organs and other
structures that perform specific body functions are called systems. For the body to work properly, all
of its systems must work together. When a patient is either injured or ill, one or more systems may
be affected. Often, an injury or illness that affects one system can affect others.
Most life-threatening emergencies affect one or more of the body’s three most important and
sensitive systems – respiratory, circulatory and nervous. The major organs of these three systems are
the heart, lungs, brain and spinal cord. All of the body’s systems are important, but failure of these
can cause rapid and severe damage or death.
Respiratory System
The respiratory system keeps the body supplied with oxygen and
removes carbon dioxide - the waste gas of metabolism. Breathing
is initiated when the brain detects an increase in carbon dioxide
in the blood. As carbon dioxide levels increase, the brain signals
the diaphragm, a large muscle below the chest, to flatten and push
downward. When the diaphragm flattens and the ribs are lifted up
and out, the volume of the lungs increase pulling air into the body
through the mouth or nose. Air entering the body is moistened and
filtered.
Once air enters the body, it travels around the tongue, down the
throat or pharynx and past the epiglottis – a flap that prevents food
or fluid from entering the lungs. Here, the pharynx divides into The respiratory system keeps the body
supplied with oxygen and removes carbon
two passageways, one for food (esophagus) and the other for air. The dioxide - the waste gas of metabolism.
passageway for the air is called the trachea or windpipe. The trachea
branches into the left and right bronchi, which lead into each of the
two lungs.
A-37
The lungs are like sponges protected by the rib cage. In the
lungs the bronchi branch into smaller and smaller air passages.
The smallest bronchi end in thousands of tiny air sacs called
alveoli. Each air sac is enclosed in a network of capillaries.
The walls that separate the air sacs and the capillaries are very
thin. All exchange of gases in the lungs occurs in the alveoli.
Through those walls, oxygen combines with the red blood cells
and is carried through the body. Waste carbon dioxide in the
blood moves across the capillary walls, into the air sacs and is
then exhaled from the body.
The lungs are like sponges protected by the rib cage.
Importance for Emergency Responders In the lungs the bronchi branch into smaller and
smaller air passages.
Respiratory problems require the immediate attention of
Emergency Responders because without oxygen, the brain
begins to die within a few minutes. It’s important to first check Tongue
if an unresponsive and unconscious patient is breathing.

For some patients, merely opening the airway lifts the tongue
away from the back of the throat allowing breathing to resume.
The tongue is the most common cause of airway obstruction in
unresponsive patients.
Rescue breathing - actually breathing for a patient - can be an In an unconscious patient, the
important part of CPR. The air you take in contains 21 percent tongue often falls back and blocks
the airway.
oxygen but you use only around five percent. Your rescue breaths
contain more than enough oxygen to support a nonbreathing patient.
This is why rescue breathing is so successful with patients who have
a heartbeat.
Complete airway obstruction is another respiratory concern for
Emergency Responders. It usually results when a patient chokes
on food, although any object placed in the mouth could end up
blocking the patient’s airway. Recognizing airway obstruction is
important because the patient can’t speak. Patients also tend to
become embarrassed and try to leave the area.
You may suspect choking if a patient grasps or clutches the neck or
throat area. By asking the patient what’s wrong, you can determine if
the patient can speak, is breathing or is able to cough. A patient with a
complete airway obstruction may become unconscious if the airway is
not cleared quickly.
A-38
Appendix
Circulatory System
Most of the cells in the human body are not in direct contact with
the external environment. The purpose of the circulatory system is
to act as a transport service to provide these cells with the essentials
of life. The circulatory system transports both blood and lymph. The
heart, blood and blood vessels form the cardiovascular system, while
lymph nodes, lymph and lymph vessels form the lymphatic system.
The Cardiovascular System

Blood
Blood is a liquid tissue making up the transport medium of the The purpose of the circulatory system is to
act as a transport service to provide these
circulatory system. A healthy, average size adult’s body has about cells with the essentials of life.
six litres/quarts of blood. Blood transports oxygen and nutrients to
cells and carries carbon dioxide and other waste products away from
them. It also plays a role in defending the body against disease and
regulating body temperature. Blood is composed of a liquid medium and blood solids. These solids
include red blood cells, white blood cells and platelets. The liquid portion, or plasma, makes up about
55 percent of the blood, while solids account for the remaining 45
percent.
Heart
Care for the central organ of the circulatory system, the heart, is of
great importance to Emergency Responders. The heart is a muscular
organ that pumps blood through an intricate network of blood
vessels. Hardly bigger than your fist and shaped like a pear, it beats
more than 70 times a minute – about 2.5 billion times in an average
life span.
The heart lies within the chest cavity, behind the breastbone and
between the two lungs. As you can see in the illustration, the heart
is vertically divided into two sides. The right side pumps blood to
the lungs, while the left pumps blood to the other body parts. Each Care for the central organ of the circulatory
side is further divided into an upper and lower chamber separated by system, the heart, is of great importance to
Emergency Responders.
valves. How the heart pumps blood to the lungs and the body can be
seen in the accompanying illustration.
A-39
Control of the Heartbeat Oxygen poor Oxygen rich

The heart is made up of muscles that contract in waves. blood returning blood returning
from the body to the body
When a first group of cells are stimulated, they in turn
stimulate those next to them and so on. This chain
reaction continues until all of the cells contract. This
wave of activity must spread in a precise and certain way
for the heart to pump efficiently.
One specialized group of heart-muscle cells is located on
the top right portion of the heart. This primary group, Blood flowing
to lungs
called pacemaker cells, initiates the wave and regulates
the rate of contraction for the entire heart. As the wave
of contraction flows down the heart it reaches a second How th
H the hheartt pumps bl
blood
d tto th
the llungs and
d th
the bbody.
d
group of specialized cells a fraction of a second later.
This group relays an electrical impulse to the muscles
that contract the lower portion of the heart. Once both
the top and bottom of the heart finish contracting, one
heartbeat is completed.
If the pacemaker cells are deprived of oxygen by blocked heart arteries, the heart may experience
abnormal electrical activity. The most common abnormal heart rhythm in cases of sudden cardiac
arrest in adults is ventricular fibrillation. You’ll learn more about ventricular fibrillation later.
Blood Vessels, Pulse and Blood Pressure

During each heart contraction, blood surges into the arteries – the vessels
that carry blood away from the heart. Arteries are strong and elastic. As
blood enters an artery after the heart contracts, it stretches. This stretching
can actually be felt when an artery is near the surface of the skin. This
feeling is called a pulse. See the accompanying illustration for locations of
arteries close to the skin where Emergency Responders may find a pulse on
a patient.
Contraction of the heart propels the blood through the arteries with The radial artery near the wrist may
also be used to feel for a pulse.
considerable force. This force is called blood pressure. When an artery
is cut, blood spurts out under pressure in regular intervals. Typically, the
blood is bright red because it is oxygen-rich.
As blood moves away from the heart through the arteries, the vessels get
smaller and smaller. Eventually the arteries branch into a network of tiny
vessels called capillaries. All the body’s cells are in close proximity to a
capillary network. This close association between capillaries and cells allows
for the exchange of materials. Since capillary walls are only one cell thick,
gases and nutrients can easily diffuse into and out of the thin walls.
A small cut or abrasion anywhere on the skin is sure to damage a bed of Carotid is a powerful artery often
used to feel for a pulse.
capillaries. When capillaries are cut, the blood oozes slowly and typically
stops quickly due to clotting.
As the blood flows out of the capillaries back to the heart they merge to
form larger vessels called veins. Veins return blood to the heart. When a vein is cut the blood flows
from the wound steadily without rhythmic spurts. Typically, the blood is dark red because it is
oxygen poor.
A-40
Appendix
Importance for Emergency Responders

Primary care includes management of circulation problems and serious bleeding. Several arteries in the
human body are important for Emergency Responders to know about. The carotid artery on each side
of the neck is very close to the skin and typically easy to locate. The carotid is a powerful artery since it
is close to the heart, taking oxygen rich blood to the brain. For these reasons, the carotid artery is often
used to feel for a pulse.
The radial artery near the wrist may also be used to feel for a pulse. However, a patient may not have
a detectable carotid or radial artery pulse, but may still have a heartbeat. Feeling for a pulse may not
be the best way to determine if a patient has a heartbeat.
Two arteries that may be used as pressure points to reduce serious bleeding are the brachial artery in
each arm and the femoral artery in each leg, which are major blood vessels lying close to the skin and
over a bone. Serious bleeding downstream of these arteries may be controlled by pushing on them
hard to compress them against the bone and restrict blood flow.
The coronary arteries supply blood directly to the heart itself and are also of importance to
Emergency Responders. Heart attacks and cardiac arrest are two major problems. More on this in
the section Medical Emergencies.
Lymphatic System
Like the cardiovascular system, the lymphatic system forms a vast network of vessels and is part of
the body’s circulatory system. The two primary purposes of the lymphatic system are:
¨ Returning fluids that have collected in tissues to the bloodstream.
¨ Filtering from the body, foreign particles, microorganisms and other tissue debris.
Lymph, a transparent yellowish fluid, travels through small vessels passing through small organs
known as lymph nodes. Like beads on a string, these nodes filter the lymph as it passes through. The
lymph nodes contain some of the immune system’s disease-fighting cells. Lymph nodes are grouped
primarily in the neck, armpits and groin. The spleen also contains lymph nodes and has the largest
concentration of disease-fighting cells in the body.

Within the context of primary care, identifying specific lymphatic system problems in an injured
or ill person is of little concern for an Emergency Responder. However, an injury to the abdomen
may cause life-threatening internal bleeding from the spleen. Since a person with an infection may
have inflamed, swollen and tender lymph nodes, you should be on the lookout for these signs and
symptoms during an injury or illness assessment.
The lymphatic system also removes injected venoms following a bite or sting from poisonous
animals. As with any serious injury or illness, you provide initial care for the patient by alerting
Emergency Medical Services.
A-41
Nervous System
All mental and physical activity is controlled by the nervous system – a
complex network of cells that communicate with one another. The division
of labor that exists within the nervous system allows it to control the
human body precisely and efficiently. As a result, a swimmer can move
through the water gracefully, an artist can paint original works and you can
learn from this knowledge development section.
The two main organs of the central nervous system are the brain and the spinal
cord. The brain is the human body’s controlling organ. The spinal cord extends
from the brain and then on to a network of nerves throughout the body.
Information transmitted to and from the brain includes:
¨ Sensory information – touch, taste, sight, sound, smell
¨ Motor functions – movement The two main organs of the central
nervous system are the brain and
¨ Involuntary functions – breathing, circulation, pulse, digestion the spinal cord.
¨ Levels of consciousness – varying degrees of awareness while

awake or asleep
The brain and spinal cord’s delicate nerve cells are surrounded by protective tissue layers that help
keep them safe from injury. Also, the skull protects the brain and spinal column vertebrae protect the
spinal cord. A clear liquid called cerebrospinal fluid provides additional protection.

Primary care includes management of spinal injuries. Suspect a spinal injury for any incident
involving a fall, severe blow, crash or other strong impact. If possible, perform primary assessment in
the position the patient is found. Do not move the patient unless safety is in question.
Digestive and Urinary Systems Oesophagus

The digestive and urinary systems provide the body with essential nutrients
Stomach
and remove waste products. Before your body can use the nutrients in the
Liver
food you eat, they must be broken down physically and chemically. This
process of breaking down food into tiny molecules is called digestion.
The process begins in the mouth with the help of saliva and chewing. The
food passes down the esophagus and into the stomach where breakdown
continues by gastric juices. It is in the small intestine that the nutrients
are absorbed into the blood (assisted by the pancreas and the gall bladder).
Large Small
The leftover material or waste product moves to the large intestine to Intestines Intestines
be eliminated as feces. The kidneys extract liquid waste from blood and
eliminate these from the body as urine.

Although the digestive system can be affected by many illnesses, most do
not require the immediate attention of Emergency Responders. However, The digestive and urinary systems
provide the body with essential
because the digestive system’s primary organs – stomach, liver, small and large nutrients and remove waste products.
intestines – are richly supplied with blood, ingested poisons and internal
bleeding from traumatic injury are concerns for Emergency Responders.
A-42
Appendix
Skeletal System
The adult human body has more than 200 bones organized into an internal
framework called the skeleton. Bones provide a rigid framework against
which muscles can pull, give shape and structure to the body and support
and protect delicate internal organs. Bones also store minerals, such as
calcium and phosphorus that play vital roles in metabolic processes. In
addition, the internal portions of many bones produce red blood cells and
certain types of white blood cells.

Despite their strength, bones crack or even break if they are subjected to
extreme loads, sudden impacts or stresses from unusual directions. Injuries
include fractures, broken or cracked bones and dislocations. Dislocations occur
when a bone dislodges from its joint socket. Emergency Responders learn how
to care for patients with skeletal system disorders in the Primary Care (CPR) Bones provide a rigid framework
against which muscles can pull,
course, which covers how to care for individuals with possible spinal injuries. give shape and structure to the
The Secondary Care (First Aid) course covers how to care for patients with body and support and protect
delicate internal organs.
dislocations and fractures prior to arrival of Emergency Medical Services.
Muscular System
Muscles make up the bulk of the body and account for about one third of its weight. Their ability to
contract not only enables the body to move, but also provides the force that pushes bodily substances,
such as food and blood, through the body. Tendons connect muscles to bones and ligaments are
tough bands of connective tissue that hold the bones of a joint in place. Muscles performing similar,
coordinated movements are called muscle groups. Not only do muscles generate body heat, they also
help protect much of the body’s underlying bones, blood vessels, nerves and organs. Without the
muscular system, none of the other organ systems would be able to function.

Muscles need a rich supply of oxygen and nutrients delivered by the blood
to accomplish their specific jobs within the body. For example, if the heart
muscle is cut off from this supply, it can cause cardiac arrest requiring
Emergency Responders to initiate primary care. Also, skeletal muscle sprains,
tendon tears and other such injuries can cause discomfort and even lifelong
disabilities. The EFR Secondary Care (First Aid) course covers how to provide
limited care for injured, stretched or torn muscles, tendons and ligaments.
Understanding the various systems of the human body provides a
knowledge base from which to apply decisions when faced with an
emergency. Knowing that circulatory, respiratory and nervous system
functionality is integral to maintaining life helps the Emergency Responder
apply primary care skills in an emergency as first priority. Understanding
the various other body systems provides a basis for response in first aid or
secondary care – when life threatening conditions are not present. Muscles need a rich supply of
oxygen and nutrients delivered
This information is also applied in the Medical Emergencies section of the by the blood to accomplish their
specific jobs within the body.
Emergency First Response Instructor Course, when you learn what signs
and symptoms are present in a medical emergency and what treatment is
most effective.
A-43
Emergency Contact Information

Home
To Activate Emergency Services, call _____________________________
Police, call __________________________________________________________________________________
Fire, call _____________________________________________________________________________________
Poison Control Center, call ______________________________________________________________________
• Remain calm
• State the nature of your emergency
• Give your location ________________________________________
_______________________________________________________ Cycle of Care: AB-CABS™
Help or AED Arrives

Continue Until
_______________________________________________________
AB C
• Your phone number ______________________________________ Airway Breathing
Open? Normally?
Chest
Compressions
AA irway Open
• Stay on the line until the operator hangs up BB reathing

for Patient
• Send someone to guide emergency services to your location, if possible. S SS erious Bleeding
hock
Spinal Injury
Emergency Contact Information

Workplace
To Activate Company Emergency Plan, call ________________________
Emergency Services, call ______________________________________
Police, call __________________________________________________________________________________
Fire, call _____________________________________________________________________________________

Poison Control Center, call ______________________________________________________________________
• Remain calm
• State the nature of your emergency
• Give your location ________________________________________ Cycle of Care: AB-CABS™
Help or AED Arrives

Continue Until
_______________________________________________________
AB C
Chest
_______________________________________________________ Airway Breathing
Open? Normally?
Compressions
AA irway Open
• Your phone ext. _________________________________________ BB reathing

for Patient
• Stay on the line until the operator hangs up S SS erious Bleeding

hock
Spinal Injury
• Send someone to guide emergency services to your location, if possible.

A-44
Appendix
Emergency First Response®
Independent
Learning
Self-study
Instructor Knowledge Reviews
A-45
Emergency First Response® Instructor Course
Knowledge Review
Program Standards
After reading the Emergency First Response 5. Goals for both the Emergency First
Primary and Secondary Care Instructor Guide – Response Primary Care (CPR) and
Section One and the introductions to Sections Secondary Care (First Aid) courses include:
Two, Three and Four, answer the following (Check all that apply.)
questions (circle or write in your response): a. Provide a learning environment that
reduces participant anxiety, guilt and fear
1. True or False. Emergency First Response of imperfect performance.
Primary Care (CPR) and Secondary Care b. Increase the percentage of CPR and
(First Aid) courses are medically based, first aid-trained laypersons who use their
following the same priorities of care used by skills without hesitation to assist those in
professional emergency care providers. need.
c. Combine CPR and first aid into one
2. The Emergency First Response Primary simple Emergency Responder protocol
Care (CPR) course focuses on emergency that promotes long-term memory
retention.
care for _____________ situations and
d. Minimize skill development and practice
teaches Emergency Responders to use the
time, while maximizing lectures.
_________________ to continually monitor
e. Teach an internationally consistent course
a patients medical status. flexible enough to accommodate regional
a. nonlife threatening/ABCD’S CPR and first aid protocols and cultural
b. critical/ABCs differences.
c. most life threatening/Cycle of Care
d. nonbreathing/BLS 6. After successfully completing the Emergency
First Response Primary Care (CPR) course,
3. True or False. The Emergency First Response participants should be able to: (Check all that
Secondary Care (First Aid) course covers apply.)
secondary patient assessment assuming that a. Perform a scene assessment and use
Emergency Medical Services personnel are barriers appropriately.
immediately available. b. Perform a patient responsiveness check
and alert Emergency Medical Service at
4. Key features of the Emergency First the appropriate time within the primary
Response program learning philosophy care sequence.
include: (Check all that apply.) c. Determine when CPR is appropriate and
perform one rescuer, adult CPR.
a. Establishing retention through repetition
d. Splint suspected skeletal injuries.
and practice.
e. Explain the importance and timeliness of
b. Providing a low-stress educational
defibrillation within the CPR protocol.
environment.
c. Creating an encouraging atmosphere
that focuses on positive reinforcement.
d. Increasing knowledge retention through
content simplification and independent
study.
A-46
Appendix
7. True or False. After successfully completing 12. Who may enroll in an Emergency First
the Emergency First Response Secondary Response Primary Care (CPR) course?
Care (First Aid) course, participants should a. Anyone, of any age, with an interest.
be able to perform initial and ongoing b. Adults (18 years of age or older).
assessments of an injured or ill person when c. Only people who have proof of previous
Emergency Medical Service personnel will CPR training.
be delayed. d. Anyone eight years of age or older.
8. The Emergency First Response Primary 13. True or False. People who enroll in an
Care (CPR) and Secondary Care (First Aid) Emergency First Response Secondary Care
courses are divided into what three segments? (First Aid) course having taken CPR training
a. Instructor lectures, skill demonstration through another organization need an
and skill practice orientation to these three primary care course
b. Knowledge development, skill subjects – Serious Bleeding Management,
development and scenario practice Shock Management and Spinal Injury
c. Independent study, video review and skill Management.
practice
d. Learning objectives, performance 14. The participant-to-Emergency First
requirements and skill evaluation Response Instructor ratio is:
9. True or False. Because teaching situations a. 4:1 b. 8:1 c. 12:1 d. 16:1

differ, your instructional approach can
be very flexible and may include one (or 15. True or False. The participant-to-Emergency
a combination) of these approaches – First Response Instructor ratio increases to a
Independent Study, Video Guided and maximum of 20:1 when using two qualified
Instructor Led. assistants.
10. Having participants study independently 16. A qualified assistant is defined as:
with the Emergency First Response a. A current Emergency First Response
Participant Manual and Video results in: Instructor.
(Check all that apply.) b. A current CPR/first aid instructor
with another regionally recognized
a. Participants who are better prepared for organization.
skill development.
c. A trained medical professional such
b. Less need to establish base concepts in as a paramedic, EMT, nurse practitioner,
the classroom, allowing more time for etc.
skill development and scenario practice
d. All of the above.
c. More time to focus on regional CPR and
first aid differences. 17. The maximum participant-to-mannequin
d. Better use of instructor and participant ratio is:
time.
a. 4:1 b. 8:1 c. 12:1 d. 16:1
11. True or False. Emergency First Response
program standards may need modification 18. True or False. It’s recommended that CPR
based on regional guidelines, laws or mannequins used for Emergency First
requirements. Response Primary Care (CPR) courses are
capable of simulating an airway obstruction if
the airway is not positioned properly.
A-47
19. Which of the following items must 24. During skill development and scenario
Emergency First Response Instructors practice, the ideal practice group is made up
have when teaching the Emergency First of ________ participants playing the roles of
Response Secondary Care (First Aid) course? _______________ .
(Check all that apply.) a. 2/Emergency Responder and patient.
a. Roller and triangle bandages b. 3/Emergency Responder, patient and
b. Emergency First Response Primary and guide
Secondary Care Instructor Guide c. 3/Emergency Responder, bystander and
c. Splints victim
d. Gloves and barriers d. 4/Emergency Responder, patient, guide
and qualified assistant
20. True or False. Emergency First Response
Instructors must submit a Course 25. When using the Video Guided Approach for
Completion Authorization to Emergency skill development, place the following steps
First Response for each participant in the proper sequence (place a 1 next to the
successfully completing the course. first step, 2 next to the second, etc.)
___ Divide participants into practice
21. To keep completion cards current, groups and have them practice skill
Emergency Responders need to refresh their by referring to their Emergency First
skills every: Response Participant Manuals.
___ Introduce the skill – cover
a. 6 months
performance requirements, value and
b. 12 months briefly go over key points.
c. 24 months ___ Demonstrate the skill by reviewing
d. 36 months the critical steps.
___ Debrief the skill providing positive
22. An Emergency First Response Refresher reinforcement and suggestions for
for the Primary Care (CPR) course should improvement.
include: (Check all that apply.) ___ Show appropriate skill portion of the
a. Skill Development portion of the video.
Primary Care (CPR) course.
b. Instructor Led Knowledge Development 26. True or False. Scenario practice allows each
presentations participant to demonstrate the ability to
c. Review of any new developments or evaluate the scene, recall critical steps and
changes to primary care techniques take appropriate action.
d. All of the above.
23. True or False. Participants must complete

and turn in the Knowledge Review from
their Emergency First Response Participant
Manuals and take the written exam to
successfully complete the Emergency First
Response Primary Care (CPR) course.
A-48
Appendix
Knowledge Review
Human Body Systems
After reading the section on Human Body 6. Without oxygen, the brain begins to die
Systems in the Emergency First Response Instructor within a few __________.
Guide, answer the following questions (circle or a. Seconds
write in your response): b. Minutes
c. Hours
1. What three systems of the human body d. None of the above
are most involved in life-threatening
emergencies? (Choose one.) 7. True or false. The circulatory system
a. Circulatory, musculatory, respiratory transports both blood and lymph.
b. Circulatory, respiratory, nervous 8. A healthy, average size adult’s body has about
c. Circulatory, skeletal, nervous _____________ of blood.
d. Circulatory, respiratory, lymphatic a. 3 litres/quarts
b. 6 litres/quarts
2. What is the general purpose of the c. 10 litres/quarts
respiratory system? (Check all that apply.) d. 12 litres/quarts
a. To supply the body with oxygen
b. To remove oxygen from the body 9. The purpose of blood is to: (Check all
c. To supply the body with carbon dioxide that apply.)
d. To remove carbon dioxide from a. Transport oxygen and nutrients to cells
the body b. Carry carbon dioxide and other waste
products away from cells
3. The pharynx divides into two passageways, c. Help the body defend against disease
the ___________ and the ___________. d. Help regulate body temperature
a. epiglottis/esophagus
b. esophagus/trachea 10. Which blood component is the largest?
c. trachea/epiglottis a. Red blood cells
d. trachea/bronchi b. White blood cells
c. Plasma
4. The air we breathe contains about ______ d. Platelets
oxygen.
a. 21 percent 11. True or false. Ventricular fibrillation is the
b. 30 percent term used for normal heart rhythm.
c. 50 percent
d. 72 percent 12. Contraction of the heart propels blood
through the arteries with considerable force.
5. True or false. Rescue breaths do not contain That force is called:
enough oxygen to support a nonbreathing a. Pulse
patient. b. Ventricular fibrillation
c. Artery stretching
d. Blood pressure
A-49
13. When an artery is cut, bleeding 19. How is the central nervous system protected
_____________ and is _______________ in from injury? (Check all that apply.)
color. a. Tissue layers surrounding the spinal cord
a. Flows steadily/dark red b. The skull and vertebrae
b. Clots easily/bright red c. Blood vessels
c. Spurts rhythmically/bright red d. Cerebrospinal fluid
d. Oozes slowly/dark red
20. True or false. The digestive and urinary
14. Two arteries used as pressure points to reduce systems provide the body with essential
serious bleeding are the ______________ nutrients and remove waste product.
and the ____________________.
a. Brachial in the arm/femoral in the leg 21. What purpose(s) does the skeletal system
b. Carotid in the neck/brachial in the arm have? (Check all that apply.)
c. Carotid in the neck/radial in the wrist a. Support and protect internal organs
d. Brachial in the arm/radial in the wrist b. Store minerals
c. Produce red blood cells and certain types
15. Which areas of the body contain lymph of white blood cells
nodes? (Check all that apply.) d. Eliminate waste products
a. Neck
b. Armpits 22. Injuries to bones include (Check all
that apply.)
c. Groin
d. Spleen a. Sprains
b. Dislocations
16. True or false. The primary purposes of the c. Fractures
lymphatic system are to return fluids that d. Breaks or cracks
have collected in tissues, to the bloodstream;
and to filter foreign particles, microorganisms 23. Pushing bodily substances, such as food and
and other tissue debris from the body. blood, through the body is one of the primary
purposes of the _________ system.
17. The two main organs of the central nervous a. Digestive
system are: b. Musculatory
a. Heart and brain c. Nervous
b. Brain and spinal cord d. Lymphatic
c. Heart and spinal cord
d. Spleen and brain 24. True or false. Muscles need a rich supply of
carbon dioxide and nutrients delivered by the
18. What types of information are transmitted to blood to accomplish their specific jobs within
and from the brain? (Check all that apply.) the body.
a. Sensory information
b. Motor functions
c. Involuntary functions
d. Levels of consciousness
A-50
Appendix
Knowledge Review
Medical Emergencies
After reading the section on Medical 6. When transporting a dislodged tooth to the
Emergencies in the back of the Emergency First dentist:
Response Primary Care (CPR) and Secondary Care a. Keep it submerged in alcohol
(First Aid) Participant Manual: b. Keep it frozen
c. Keep it submerged in saline solution,
1. You should suspect a fracture if, after a fall or milk or water
a blow, the following signs or symptoms are d. Allow it to dry out
present: (Check all that apply.)
a. A limb appears to be in an unnatural 7. Strains and sprains are __________ muscles,
position tendons and ligaments: (Check all that apply.)
b. A limb is unusable a. Injured
c. There is rapid swelling or bruising b. Fractured
d. There is extreme pain at a specific point c. Stretched
d. Torn
2. True or false. Dislocations occur when a great
deal of pressure is placed on a joint. 8. True or false. It’s best to avoid using an area of
the body that has been strained or sprained.
3. Minor cuts, scrapes and bruises are non life-
threatening wounds which include which of 9. Patient care for a chemical splash in the
the following? (Check all that apply.) eye includes flushing the eye with water for
a. Lacerations _____________; or until EMS arrives.
b. Scratches a. 1 minute
c. Deep cuts b. 5 minutes
d. Bumps c. 10 minutes
d. 15 minutes
4. Signs of wound infection include:
(Check all that apply.) 10. Contact with electricity can cause life
a. Redness threatening injuries such as: (Check all
b. Tenderness that apply.)
c. Presence of yellowish/greenish fluid at a. Choking
the wound site b. Cardiopulmonary arrest
d. Drowsiness c. Deep burns
d. Internal tissue damage
5. To administer first aid for bruises,
apply _________ compresses, and 11. Never put ______________ on a burn.
___________________________, if possible. (Check all that apply.)
a. cold/elevate above the heart a. Ice
b. cold/splint the joints above and below b. A moist, sterile bandage
the bruise c. Butter
c. hot/elevate about the heart d. Ointment
d. hot/splint the joints above and below the
bruise
A-51
12. True or false. A severely hypothermic patient 19. Patient Care for diabetic emergencies
will likely be conscious and alert, yet includes: (Check all that apply.)
shivering and displaying slightly impaired a. Giving the conscious/responsive patient
coordination. a small snack, sugar, juice, soda or candy
b. Helping the patient take a prescribed
13. _______________ affects surface skin; medication for diabetes (such as insulin)
_______________ affects entire tissue layers, c. Illness assessment, if the patient is responsive
including muscles, tendons, blood vessels and d. Looking for a medical alert tag
nerves.
a. Superficial frostbite/Deep frostbite 20. When caring for a patient having a seizure:
b. Frostnip/Superficial frostbite (Check all that apply.)
c. Deep frostbite/Superficial frostbite a. Attempt to cushion patient’s head
d. Frostnip/Deep frostbite b. Restrain the patient
c. Move objects out of the way
14. Heat stroke _______________________: d. Protect the patient
a. Patients have cool and clammy skin 21. A severe, life-threatening allergic reaction
b. Is life-threatening (anaphylaxis or anaphylactic shock) can be
c. Is a temperature-related injury treated by _________________________.
d. Is when the body temperature rises a. Antihistamine
dangerously high b. Epinephrine in an autoinjector
c. Antibiotics
15. True or false. Heart attack patients may deny d. Ibuprofen
that chest discomfort is serious enough for
emergency medical care. 22. True or false. Poisoning can occur through
ingestion, inhalation or absorption through
16. Patient care for a responsive heart attack the skin.
patient includes: (Check all that apply.)
a. Illness assessment 23. In the event of suspected poisoning,
b. Help patient take any prescribed contact a local Poison Control Center and
medication for chest pain _________________: (Check all that apply.)
c. Help patient into a comfortable position a. If available, explain what, when and how
d. Administer CPR much poison was ingested
b. If available, read the label on substance
17. True or false. Strokes occur when the heart for poisoning instructions
fibrillates, forcing too much blood into the c. Offer the patient food
brain. d. Save vomitus and the poison container
for EMS personnel
18. Diabetic problems, such as insulin shock,
insulin reaction or hypoglycemia, result from 24. Reaction to venomous bites and stings depends
_____________________________. on the location of the bite or sting and how
much venom was injected. The patient’s reaction
a. High blood pressure
to the venom will also depend on the patient’s
b. High blood sugar
_______________.(Check all that apply.)
c. Low blood proteins
d. Low blood sugar a. Size
b. Current health
c. Body chemistry
d. Age
A-52

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Dear Instructor Candidate,

Creating Confidence to Care®

International Medical Review

Section One - Course Overview and Standards

Section Two - Knowledge Development

Section Four – Scenario Practice

How to Use This Instructor Guide

Regional Resuscitation Councils and Organizations

Patient Care Standards

Cycle of Care: AB-CABS™

Help or AED Arrives

Core Performance Requirements

2. Video Guided Approach – In some instances it is impossible to provide participants with

Supervision and Ratios

Required and Recommended Materials

Instructor Materials Participant Materials

Secondary Care (First Aid) Course Instructor and Participant Materials

Instructor Materials Participant Materials

Barrier Use During the Course

Course Completion Requirements

Emergency First Response Refresher Courses

Youth Leader’s Commitment

Emergency Responders in Action

Primary Care (CPR)

Scenario Practice sequence

Secondary Care (First Aid)

Motivating Independent Study

Participant Knowledge Evaluation

Instructor Led Approach

F. Learning Tips – Getting the Most from Your Course

Presentation – Helping Others in Need

E. Why People Hesitate to Provide Emergency Care

INSTRUCTOR NOTE – Allow participants to speak openly about each reason.

F. Good Samaritan Laws

INSTRUCTOR NOTE – Be prepared to share with participants the Good Samaritan

G. The Chain of Survival and You – The Emergency Responder

H. Asking a Patient for Permission to Help

INSTRUCTOR NOTE – If the patient’s problem could be a drowning or other

5. In the local area, the Emergency Medical Service is activated by calling:_________________.

Presentation – The Emotional Aspects of Being an Emergency

D. Caring for Yourself

Presentation – Keeping Your Skills Fresh

Presentation – Leading a Healthy Lifestyle

Presentation – Protecting Yourself Against Bloodborne Pathogens

F. Provide Immediate Care

Presentation – Recognizing Life-Threatening Problems

D. Recognizing cardiac arrest.

Presentation – Primary Care Definitions and Background

6. How do you determine if an unresponsive person is breathing normally? Most unresponsive

G. Reasons for a Person to Stop Breathing

INSTRUCTOR NOTE – If you are unable or feel uncomfortable giving an

Presentation – Using AB-CABS and the Cycle of Care to Prioritize

C. The AB-CABS Mnemonic – Remembering How to Help

Cycle of Care: AB-CABS™

Help or AED Arrives

Check Unresponsive Responsive

Cycle of Care: AB-CABS™

Help or AED Arrives

Cycle of Care: AB-CABS™

Help or AED Arrives

G. Importance of an AED and Defibrillation

I. The Meaning of the “S” in AB-CABS

Cycle of Care: AB-CABS™