1. CPR
Level C
Cardiopulmonary Resuscitation & Automated External Defibrillator
Use this websites to get up to date figures and interesting facts to share with your participants. (i.e. heart attack, stoke, heart disease, causes of a cardiac arrest etc…)
Current (Oct 2010) examples:
Heart disease claimed 17.1 million lives globally last year – most heart disease is preventable.
Causes of a Heart Attack
Atherosclerosis – narrowing of the coronary arteries causes 90% of heart attacks.

2. Course Outline Welcome, Introductions, Administration Mission & Vision
Good Samaritan Act & Legal Issues
Disease Transmission & Barrier Devices
The heart
Risk Factors for Heart Disease
Stroke, T.I.A, Angina and Heart Attack
Adult Cardiopulmonary Resuscitation (CPR)
Recovery Position
Infant and Child CPR
Choking
Cardiac Arrest Information
Heart Rhythms
Automated External Defibrillator (AED)
Quiz
Questions and Wrap Up
please insert the times for each module based on the start and end times for your course.

3. canfitpro Mission Vision
United as members, canfitpro delivers the world’s best, accessible, affordable, and attainable fitness education and experiences.
Vision
As the leading global provider of fitness and wellness education, canfitpro empowers people to lead passionate and fulfilling lives through safe, fun, and effective physical activity.
Review the mission and vision for canfitpro

4. Five Common Fears Doing the wrong thing / making things worse
Getting sued
Personal safety
Diseases
Dealing with blood / gross situations
KEY POINTS:
Participants can relieve some of these fears by taking first aid courses, keeping a first aid kit handy and making sure the scene is safe.
How do we make things worse? (moving people, doing things we are not trained to do, do nothing?)
Discuss HIV, Hep.B, Hep.C. (blood bourne pathogens)
Wearing gloves, glasses, masks, etc.

5. (no cutting, sewing or poking) Stay with victim
The Good Samaritan Act
Identify yourself
Ask Permission
Act Reasonable
(no cutting, sewing or poking)
Stay with victim
KEY POINTS:
Ontario – Bill 20, April 2001 (refer to page 4 for all other provinces)
Must ask casualty if they want us to help them, casualty’s have the right to refuse help. (Consent)
We can help unconscious casualty’s because of implied consent. This means casualty’s who are unconscious would want us to help them in an emergency.
Only do what you are trained to do, nothing more, nothing less.
Don’t leave casualty till another trained rescuer takes over, or EMS arrives. (Abandonment)

6. Legal Issues
Once you initiate aid to a victim, you must continue CPR unless:
It is necessary in order to activate EMS (infant CPR sequence)
Someone with equal or greater training takes over
Continuing to provide assistance would be unsafe
You are physically exhausted
If a bystander does initiate aid to a victim, they must not leave the scene unless:
It is necessary, in order to activate EMS
Someone with equal or higher training arrives and can take over
Continuing to give aid is unsafe
If the victim is a child, consent must be obtained from a parent or guardian. However, if the parent or guardian is absent, intoxicated, or delusional (or if the rescuer has a reasonable belief that they are), consent is implied.
REFERENCES:
Good Samaritan Law (n.d.). Retrieved December 8, 2006 from

7. Legal Issues
Consent must be obtained from a victim before a rescuer can provide assistance.
Consent is implied if;
Victim is unconscious
Victim is under 18 yrs of age and no guardian is available
The victim is intoxicated or delusional, or the rescuer at least believes they are
Consent to provide aid is implied if the victim is unconscious
If the victim is conscious and over 18yrs of age, consent to provide aid must be obtained (unless the victim is intoxicated or delusional, or the rescuer has reasonable belief they are, in which case, the courts are very forgiving. The legal phrase is “peril invites rescue”.)
REFERENCES:
Good Samaritan Law (n.d.). Retrieved December 8, 2006 from

8. Disease Transmission / Barrier Devices
Barrier devices are typically available as a face shield or face mask. A face mask is ideal as it reduces exposure to the rescuer (a face shield does not reduce risk as much as a face mask).
Disease transmission during CPR practice (during a course) has not been noted in research that began tracking in 1960
Over the last 30 years, only 15 cases of disease transmission have been noted
In an effort to reduce the risk of disease transmission, the following is recommended:
If you are a first aid responder at your workplace, gloves and a barrier device should be provided
Barrier devices should have a one way valve to prevent the transfer of fluid from the victim to the rescuer
Barrier devices and gloves should be included in all first aid kits
If CPR has been performed, every effort should be made to determine if the victim had any contagious disease. In addition, medical treatment should be provided to the rescuer
This same access to medical care should be provided to the victim to reduce his or her risk from exposure to the rescuer
This picture depicts a face shield (top left), a face mask (top right) and gloves (bottom)
REFERENCES:
American Heart Association. (2006). Heartsaver AED Student Workbook. Author.
Disease Transmission and Cardiopulmonary resuscitation. (n.d.). Retrieved December 11, 2006 from

9. The Human Heart
The function of the heart is to circulate (pump) blood throughout the body to provide oxygen and nutrients and to remove waste products.
Your heart is a muscular organ that acts like a pump to send blood throughout your body all the time
The heart:
is a muscle about the size of your fist
weighs approximately one pound
is located behind and slightly to the left of the breastbone
pumps about 5 liters of blood every minute, or 7000 liters of blood every day.

10. The Human Heart The heart has four chambers
The upper and lower chambers are separated by walls of non-conducting tissue, which contain one-way valves to allow blood to flow between them. These heart valves also ensure the forward motion of blood.
The heart is separated into right and left sides, with each side performing a unique function:
The right side of the heart receives deoxygenated blood from the body and sends it to the lungs to pick up oxygen.
The left side of the heart receives oxygenated blood from the lungs and sends it to the rest of the body where the oxygen is delivered to organs such as the brain and kidneys.

11. The Human Heart The Heart’s Electrical Path
The heart's electrical system controls the synchronized and rhythmic pumping efficiency of the heart.
In order for the heart to squeeze and pump blood, it needs a sort of spark plug, an electrical impulse, to start a heartbeat. The electrical impulse starts on the right side of the upper chamber in an area called the sinus node. The sinus node is the normal pacemaker of the heart and controls the heart rate. The heart normally beats faster when you are exercising or excited and it beats more slowly when you are at rest or sleeping.
The impulse leaves the sinus node and travels a set path through the upper chambers, the atria, causing them to contract and squeeze blood into the lower chambers.
The electrical signal then reaches the atrioventricular (AV) node. The AV node is in the middle of the heart, between the atrium and the ventricle. The signal is delayed in the AV node and then spreads through the lower chambers. The ventricles contract, sending blood throughout the body. The entire heartbeat starts again, beginning with an impulse in the sinus node.
In summary, the SA node is the impulse-generating (pacemaker) tissue located in the right atrium of the heart, and thus the generator of normal sinus rhythm. It is a group of cells positioned on the wall of the right atrium, near the entrance of the superior vena cava. These cells are modified cardiac myocytes. Though they possess some contractile filaments, they do not contract.

12. The Human Heart
Problems with the heart's electrical system can cause heart rhythm disorders that may lead to sudden cardiac arrest (SCA).
An irregularity in the heart's electrical system is called an arrhythmia, which can cause the heart to beat too slowly (bradycardia), too fast (tachycardia), or not in sequence (asynchrony). An arrhythmia can compromise the heart's ability to pump and circulate blood through the body and brain.

13. What is the number one killer of north americans?
Cardiovascular Disease is number one.
30% of premature deaths in Canada is heart disease
Cardiovascular diseases include heat attack, sudden cardiac arrest and stroke.
Statistics Canada: 13

14. Risk Factors Diabetes Age High Blood Pressure Being Overweight Gender
High Blood Cholesterol
Excessive Alcohol Consumption
Family History
Physical Inactivity
Smoking
Stress
This slide indicates the different risk factors for heart attack and stroke in no particular order.
Show this slide in preparation of a more in depth discussion on risk factors.
SUGGESTED TEACHING TIPS:
Stand Up/Sit Down Game: With this list showing on the screen, have participants identify a risk factor as preventable by standing up. If they feel a risk factor is not preventable, have them sit down. The next slide will show them the correct category for each risk factor.
REFERENCES:
Heart and Stroke Foundation. (2006). Taking Control. [Brochure].

15. Risk Factors Preventable Not preventable Diabetes Age
High Blood Pressure
High Blood Cholesterol
Being Overweight
Excessive Alcohol Consumption
Physical Inactivity
Smoking
Stress
Not preventable
Age
Gender
Family History
This slide depicts the correct categorization for the different risk factors.
If you played the game, have course participants see how many they correctly identified as preventable or not preventable.
REFERENCES:
Heart and Stroke Foundation. (2006). Taking Control. [Brochure].

16. Signs and Symptoms
Signs: A sign is an objective indication of something that is typically detected by a physician; a sign is discovered by a physician.
Symptoms: A symptom is a subjective indication of something that is typically reported by a patient; a symptom is experienced by a patient.
Discuss the definitions of signs and symptoms and the difference between the two
Have participants come up with things they feel would be signs and symptoms (and which category they would fall in) for heart disease
REFERENCES:
Lifesaving Society. (2006). First Aid Award Guide, Training Guide for First Aid, CPR and AED Programs. Author

17. Heart Attack, Angina & Cardiac Arrest
Angina: a disease caused by the narrowing of the coronary artery.
Heart Attack: death to an area of the HEART muscle due to a lack of oxygen.
Cardiac Arrest: complete cessation of cardiac activity (heartbeat).
Define each term
KEY POINTS:
Damage to the heart muscle is caused by a blockage to one of the coronary arteries by a build up of plaque, blood clots, etc.
Once heart stops beating casualty is clinically dead = cardiac arrest

18. Heart Attack KEY POINTS:
Explain the diagram showing heart attack (Death of cardiac tissue and muscle)

19. Heart Attack P A S ale nxious .O.B. weat I T O N ndigestion ightness
verall Weakness
ausea
KEY POINTS:
Activity: Give your hand a heart attack
Get class to stand and raise one arm over head and tell them to open and close their fists for a minute or two; ask participants what they feel (should be similar to s/s of a heart attack), put other hand down in front of you and bring hand down beside the other (hands should be side by side), look at both hands and explain the differences between each hand
Lead into signs and symptoms of heart attack.
Pain
DO NOT FORGET DENIAL!
Fear/Denial

20. Stroke & TIA Ischemic Stroke
Ischemic stroke is a life-threatening event in which part of the brain does not receive enough oxygen, usually due to a blood clot lodged in a cerebral artery.
Explain picture to show what causes stroke.
TIA = Transient Ischemic Stroke

21. Stroke & TIA Signs and Symptoms numbness sudden weakness
trouble speaking
vision problems
severe headache
dizziness
KEY POINTS:
Blood flow is blocked to brain
Ask class: What do you do in the case of a stroke? – answer: Call EMS(911), If casualty is conscious lay on back with head and shoulders slightly elevated,
Ask class: would you do CPR? Answer – Yes, if unconscious, assess ABC’s. However, if they are breathing place in the HAINES recovery position and make sure 911 has been called.

22. Assess Environment Check for hazards (ladder, glass, chemicals, etc.)
What is the risk to you? What, if any, further risk is there to the victim?
What happened?
How many victims are there?
Is the scene changing?
Is there an AED or First Aid kit close by?
Discuss things that rescuers might be looking for should they come across a victim
Utilize scenarios specific to the locations some of the class participants might be working for examples (e.g., a fitness centre).
Activity: Make cue cards with the sequence of CPR on them, mix them up and give them to the participants. Give them a few minutes to guess the order and then take it up together. Once they pick the first thing, pull up the slide and go through each sequence point as they guess.
REFERENCES:
American Heart Association. (2005) American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care. Circulation, 112(24) (Supply.).
American Heart Association. (2006). Heartsaver Instructor Manual. Author.

23. Determine Responsiveness
Shout or speak loudly to victim and ask if they are okay. Squeeze or pinch shoulders.
Discuss the importance of checking for responsiveness
Ensure participants know that when they ask victim if they are okay, it must be done in a loud, audible voice
Good note: approach from feet (kick) to determine responsiveness before going to the head (so they don’t punch you in the face)
REFERENCES:
American Heart Association. (2005) American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care. Circulation, 112(24) (Suppl.).
American Heart Association. (2006). Heartsaver Instructor Manual. Author.

24. Activate EMS
The subsequent slides describe what information is required in order to properly activate EMS

25. Activate EMS
Provide the dispatcher with the number of victims, age, gender condition and location of emergency.
Stay on line until the dispatcher tells you it is okay to hang up.
If a bystander calls EMS, ask them to report back to you to ensure that EMS has been activated.
Ask dispatcher the estimated time of arrival for EMS.
Discuss how you activate EMS (typically it is by calling 911, but often, there are other ways. E.g., universities have their own internal emergency system, remote towns may have a different emergency number)
Review the key pieces of information that should be given to the EMS dispatcher
Have participants practice making EMS calls, and having a bystander make the call on his or her behalf
SUGGESTED TEACHING TIPS:
Set up an area in the classroom that is designated as the “phone”
Have participants simulate real calls by going to this area and picking up phone (a cell phone could be used as a prop for this skill)
REFERENCES:
American Heart Association. (2005) American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care. Circulation, 112(24) (Suppl.).
American Heart Association. (2006). Heartsaver Instructor Manual. Author.

26. Utilizing Bystanders Phone EMS Wait for EMS AED available
Remove hazards from scene
Crowd control
Get supplies (e.g., blankets)
Protect victim’s belongings
Write down details of incident
Bystanders are often available at the scene of emergencies, and can be very helpful to the rescuer.
This slide depicts some of the ways in which a bystander could be used.
SUGGESTED TEACHING TIPS:
Before showing the content on this slide, have participants brainstorm about different ways a bystander can assist in a rescue
Have participants practice giving instructions to a partner as if they were a bystander (note if the instructions are clear, concise, and helpful to the rescue)
REFERENCES:
American Heart Association. (2005) American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care. Circulation, 112(24) (Suppl.).
American Heart Association. (2006). Heartsaver Instructor Manual. Author.

27. Open Airway
Perform a head tilt, chin lift by placing the heel of one hand on the victim’s forehead, and the fingers of the other hand under victim’s chin. Tilt head back to allow airway to open.
The key to successful rescue breathing is a proper head tilt/chin lift
Show a demonstration of a proper head tilt/chin lift, and have participants practice this skill on a partner and/or mannequin
Activity: Explain that chin lift is important to move tongue from base of mouth. Have group look at the ceiling and try to swallow. This is very
hard then have them try to breath quite easy as epiglottis creates airway and discuss gastric distension.
REFERENCES:
American Heart Association. (2005) American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care. Circulation, 112(24) (Suppl.).
American Heart Association. (2006). Heartsaver Instructor Manual. Author.

28. Check for Breathing
Place your ear over the victim’s mouth and nose to allow you to be able to listen and feel for exhaled air (5 sec). Watch the victim’s chest to see if there is any movement.
A victim that is gasping for air is not considered “breathing”.
Before initiating the CPR sequence, you must ensure that the victim is not breathing
To do this, place your ear over the victim’s mouth and nose. Listen and feel for breath, and watch to see if the chest rises
This breathing check must last a minimum of 5 seconds
REFERENCES:
American Heart Association. (2005) American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care. Circulation, 112(24) (Suppl.).
American Heart Association. (2006). Heartsaver Instructor Manual. Author.

29. Recovery Position
An unconscious adult or child who is breathing and has no other life threatening emergencies should be placed in the recovery position.
While a victim is in the recovery position, you are able to continually reassess his or her status, check vitals, and maintain an open airway.
discuss times when you would use recovery position and when you would not use recovery position
you WOULD use recovery position when: victim is unconscious and breathing; victim is conscious but lightheaded; rescue breathing and/or CPR has been successful and victim begins to breathe
you would NOT use the recovery position if: victim is not breathing; a head or neck injury is suspected; any other life threatening injuries exist
The following explains how to place a victim in to recovery position:
place victim in a semi-prone position (as long as a spinal injury is not suspected)
put the arm nearest you straight out above the victim’s body
hold palm of farthest arm and pull to place it under the victim’s ear or neck
bend the knee of the far leg so it points up and pull the bent knee towards you (protecting head while rolling)
rest top leg on ground in front of bottom leg to stabilize lower body
position allows you to continually assess victim for any changes
REFERENCES:
American Heart Association. (2005) American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care. Circulation, 112(24) (Suppl.).
Canadian Red Cross. (2001). Basic Life Support CPR/AED. [Brochure]. Author.
Lifesaving Society. (2006). First Aid Award Guide, Training Guide for First Aid, CPR and AED Programs. Author.

30. Compressions Place heel of one of your hands on the victim’s chest.
Centre this hand between the victim’s nipples.
Place your other hand on top of this hand (one or two hands depending on the size of the child).
Push hard and fast (rate should be 100 compressions per minute).
Count “one and, two and, three and”, etc.
Be sure to allow chest to come back to normal position between compressions.
Chest compressions create blood flow by increasing intrathoracic pressure and compressing the heart
This blood flow that is generated delivers a small, but very important amount of oxygen and other matters to the brain and heart
Compressions are most effective when performed on a hard surface
Depression of the sternum (breastbone) should be about 2 inches or 5 cm for an adult and 1/3 the depth of the chest for a child/infant
The chest should return to its normal position between compressions to allow the return of blood to the heart
The rate of 100 compressions every minute was established using animal studies in which it was found that the greatest success rate for CPR occurred when compressions were delivered at a rate of 80 or more per minute
SUGGESTED TEACHING TIPS:
Have participants get a piece of paper and draw a line on it that they think is 2 inches, or 5 cm long. This should help give them an idea of how deep a compression should be
Have participants practice compressions on a mannequin while a partner counts the number of compressions being delivered over a one minute period
REFERENCES:
American Heart Association. (2005) American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care. Circulation, 112(24) (Suppl.).
American Heart Association. (2006). Heartsaver Instructor Manual. Author.

31. Compressions
Landmarking for compressions is just between the nipples of the victim.
Compression depth should be 5 cm, or 2 inches.
Aim for ~100 compressions every minute, or just under two compressions per second.
show participants how much 5cm or 2inches is on a ruler or other device
Have participants practice landmarking and providing compressions on a partner or mannequin
Ensure that participants know the chest must fully return to its starting position between each compression
Time the class while doing compressions to ensure that they are performing them at an appropriate pace
Can use the song Another One Bites the Dust (morbid version but make a joke out of it – they didn’t survive so we don’t it again) or Staying Alive – This will give them an idea of how tiring CPR can be (About 5-10 minutes of practice)
REFERENCES:
American Heart Association. (2005) American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care. Circulation, 112(24) (Suppl.).
American Heart Association. (2006). Heartsaver Instructor Manual. Author.

32. PRACTICE Rescue Breathing
Seal victim’s mouth and pinch the nose closed.
Give two normal breaths (allow each breath to be delivered over one second).
Ensure the victim’s chest rises.
To provide a rescue breath, you must ensure that there is a tight seal around the victim’s mouth, either with your mouth or a barrier device
Pinch the victim’s nose. This prevents the breath you provide from escaping out the nose without ever making it to the lungs
The rescuer should watch the victim’s chest to ensure it rises with each breath. This will ensure that the breath is going in (no obstruction)
Before providing the second breath, ensure that the chest has returned to its’ normal position
REFERENCES:
American Heart Association. (2005) American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care. Circulation, 112(24) (Suppl.).
American Heart Association. (2006). Heartsaver Instructor Manual. Author.
Allow chest to return to normal position before providing next breath.
PRACTICE

33. Adult CPR (One Rescuer Sequencing)
Assess environment
Determine unresponsiveness
Activate EMS
Attempt to get AED
Open airway
Check for breathing
Landmark and begin compressions
Provide two rescue breaths
30 compressions:2 breaths until EMS arrives or victim responds to treatment
Review the proper sequencing of Adult CPR (One rescuer) with the participants
Have them practice the entire sequence in proper order on a partner or mannequin
Correct sequencing is provided below:
1)     assess environment
2)     determine unresponsiveness
3)     activate EMS (Emergency Medical System)
4)     attempt to get AED-trained responder if possible
5)     open airway
6)     check for breathing (no more than 5 sec.)
7)     landmark and begin chest compressions (30 compressions:2 breaths)
8)     depth of compressions is approximately 5 cm, or 2 inches)
9) aim for approximately 100 compressions every minute (or just under two compressions per second)
provide two rescue breaths (watch for chest to rise)
11) continue with this until EMS takes over or an AED-trained responder takes over, or victim responds
if victim moves, reassess and treat accordingly
REFERENCES:
American Heart Association. (2005) American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care. Circulation, 112(24) (Suppl.).
American Heart Association. (2006). Heartsaver Instructor Manual. Author.

34. Child CPR: Differences
Depth of compressions is 1/3 the depth of the chest.
One or two hands depending on the size of the child.
Five cycles of compressions and breaths are performed before activating EMS.
Child CPR is very similar to adult CPR
The differences are important to note as the depth of compressions is described in relation to the size of the child as opposed to cm or inches (1/3 the depth of the chest)
Because a child has a much smaller chest, it may not be necessary to perform compressions using two hands – use one or two hands depending on the size of the child. Begin landmarking as you would for an adult victim, but for a child, only use one hand to provide compressions
If a child is found to be unresponsive, 5 cycles of compressions and breaths should be given before EMS is called. This differs from adult CPR in which EMS is immediately activated (note: if a bystander is available, it is always better to have EMS activated immediately by them. These guidelines apply only if a rescuer is alone)
REFERENCES:
American Heart Association. (2006). Heartsaver AED Student Workbook. Author.
Canadian Red Cross. (2001). Basic Life Support CPR/AED. [Brochure]. Author.

35. Infant CPR: Differences
Scratch foot to determine responsiveness.
Compression depth is 1/3 the depth of the chest.
Two fingers used for compressions (just below nipple line).
Breaths are puffs and mouth and nose are sealed with your mouth.
Five cycles of compressions and breaths are performed before activating EMS.
Infant CPR is very similar to adult CPR
The differences are important to note as the depth of compressions is described in relation to the size of the infant as opposed to cm or inches (1/3 the depth of the chest)
Because an infant has a much smaller chest, it is not necessary to perform compressions using two hands. The fingers of one hand often provide enough strength to compress the chest to the proper depth (landmarking is done just below the nipple line of the infant)
If an infant is found to be unresponsive, 5 cycles of compressions and breaths should be given before EMS is called. This differs from adult CPR in which EMS is immediately activated (note: if a bystander is available, it is always better to have EMS activated immediately by them. These guidelines apply only if a rescuer is alone)
REFERENCES:
American Heart Association. (2006). Heartsaver AED Student Workbook. Author.
Canadian Red Cross. (2001). Basic Life Support CPR/AED. [Brochure]. Author.

36. Choking Unable to speak Unable to cough Hands at throat
Face changing colour
KEY POINTS:
What do choking victims look like? (look of panic, face red and hands at throat, etc)
Food is most common cause of obstruction for adults
Avoid talking/laughing with food in mouth
Keep small objects out of reach of children
Casualty may become unconscious in less than 45 seconds
4 to 6 minutes brain cells start to die
At 10 minutes some permanent brain damage
Activity: How long can you hold your breath?; first ask “how long do you think it takes before someone goes unconscious” (participant answers/discussion), have them all hold breath at same time while you time to see how long they last - Correct answers: 45 seconds = pass out; 4-6 minutes = organ damage; 10 minutes = irreversible damage

37. Choking Determine severity of obstruction.
Conscious Adult or Child
Determine severity of obstruction.
If mild, encourage coughing and reassure victim.
If severe, shout for help, start cycles of 5 back blows and 5 abdominal thrusts until airway is clear, or victim becomes unconscious.
To landmark for back blows and abdominal thrusts
Back Blows: heel of your hand between the shoulder blades of the victim
Abdominal Thrusts: make a fist and put thumb above the belly button. Grab this fist with the other hand
Here is the sequencing for Obstructed Airway Management for a Conscious Victim (Adult or Child)
determine how severe the obstruction is
if mild, encourage coughing and reassure victim
if severe, shout for help, start cycles of 5 back blows and 5 abdominal thrusts until airway is clear, or victim becomes unconscious. (**see steps for unconscious victims, start at step 3)
**NOTE: If the rescuer is unable to get his or her arms around a victim due to either obesity or pregnancy, cycles of back blows (with victim leaning slightly forward) and chest thrusts, such as those performed during CPR should be provided**
Have participants practice obstructed airway management on a mannequin or partner
Activity: Partner Role Play; Partner 1 leaves the room while partner 2 is given a chocking scenario from PRO TRAINER (i.e. pregnant, wheel chair, mild vs severe etc…)
REFERENCES:
American Heart Association. (2006). Heartsaver AED Student Workbook. Author.
Canadian Red Cross. (2001). Basic Life Support CPR/AED. [Brochure]. Author.

38. Choking Unconscious Adult or Child Assess environment
Determine responsiveness
Activate EMS
Attempt to obtain AED
Open airway
Assess breathing
Landmark and provide 30 chest
compressions
Look in mouth for object (remove only if object seen)
Give one rescue breath, if it fails reposition head and try again
Repeat sequence until successful or EMS arrives
Choking for an unconscious Adult or Child – explain that in this situation you would go into the CPR sequence as they are unconscious and not breathing
REFERENCES:
American Heart Association. (2006). Heartsaver AED Student Workbook. Author.
Canadian Red Cross. (2001). Basic Life Support CPR/AED. [Brochure]. Author.

39. Choking: Infant Determine severity of obstruction.
Conscious to Unconscious
Determine severity of obstruction.
Perform five back blows followed by five chest thrusts.
Continue until airway becomes clear or victim becomes unconscious.
If the infant becomes unconscious begin the infant CPR sequence.
have participants practice infant choking on a doll or mannequin
Landmarking for chest thrusts is the same as that for infant CPR
Here is the proper sequencing for Obstructed Airway Management for a Conscious Victim (Infant)
determine how severe the obstruction is
perform 5 back blows followed by 5 chest thrusts
continue until obstruction is removed or victim becomes unconscious (see steps for unconscious victim, but begin at chest compressions)
If victim regains consciousness and/or breathing, direct caregiver to take victim to physician
Note: if infant becomes unconscious, follow steps for infant CPR beginning at chest compressions)
REFERENCES:
American Heart Association. (2006). Heartsaver AED Student Workbook. Author.
Canadian Red Cross. (2001). Basic Life Support CPR/AED. [Brochure]. Author.

40. CPR Quiz
Give out quiz and allow students enough time to complete the quiz 40

41. Questions? Comments?
Be sure to allow ample time at the end of the course to answer any questions participants may have
This is also a good time to review any areas that you feel need extra attention 41

42. 42

43. Thank you! 43 Be sure to thank all participants for their time
Stay after class to be available to answer any questions
Have additional canfitpro material with you should any participants be interested in other certification courses (i.e. your business card, brochures, your upcoming dates, etc.) 43