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PediatricPlusCPR, AED, and First Aid forChildren, Infants, and Adults

InstructorGuide

Preview

MEDIC First Aid is amember of the HSI family of brands.

ISBN 978-936515-33-2 4371 (11/11)

PediatricPlus CPR, AED, and First Aidfor Children, Infants, and AdultsInstructor Guide, Version 7.0

Purpose of this GuideThis MEDIC First Aid PediatricPlus Version 7.0 Instructor Guide is solelyintended to give information on the presentation and administration ofMEDIC First Aid PediatricPlus CPR, AED, and First Aid certified trainingclasses. The information in this book is furnished for that purpose and issubject to change without notice.

Notice of RightsNo part of this MEDIC First Aid PediatricPlus Version 7.0 Instructor Guidemay be reproduced or transmitted in any form or by any means, electronicor mechanical, including photocopying and recording, or by any informationstorage and retrieval system, without written permission from MEDIC FIRSTAID International, Inc.

TrademarksMEDIC First Aid and the MEDIC First Aid logo are registered trademarks ofMEDIC FIRST AID International, Inc.

MEDIC FIRST AID International, Inc.1450 Westec DriveEugene, OR 97402

800-447-3177541-344-7099

E-mail: [email protected] our website at hsi.com/medicfirstaid

Copyright © 2011 by MEDIC FIRST AID International, Inc.All rights reserved. Printed in the United States of America.

First Edition—2011

PediatricPlus CPR, AED, and First Aid for Children, Infants, and Adults MEDIC First Aid i

Steve Barnett Ted CritesVP, Brand Management, Emergency Care Director, ProductionHealth & Safety Institute Health & Safety Institute

Production TeamCarolyn Daves; John Hambelton; Dana Midles; Rob Neidig; Carol Perez-Vitier; Jan Twombley; Jason Williams;Steve Zagar

Medical DirectorGreg Ciottone, MD

Technical Consultants

Corey Abraham, MS EdDirector of Enterprise SalesHealth & Safety Institute

Craig S. Aman, MBA, MICPPrincipal, Firehat ConsultingLieutenant/ Paramedic Seattle Fire DepartmentSeattle, WA

Christopher J. Le Baudour, MS Ed, EMTEMT Program DirectorSan Francisco Paramedic AssociationSan Francisco, CA

Jeff Lindsey, PhD, PM, CFOD, EFOChief Learning OfficerHealth & Safety Institute

W. Daniel Rosenthal RN, BS, CCHCPresidentWorkplace Nurses, LLCGretna, LA

William Rowe, FF/EMT-P (Ret.)VP, Brand Management, Professional RespondersHealth & Safety Institute

Zigmund Sawzak, EMT-PCEOLifeLine Health & Safety, LLCPortland, OR

Ralph Shenefelt, FF/EMT-P (ret.)VP, Strategic ComplianceHealth & Safety Institute

Marcy Thobaben, LPN, NREMT-B501 OSHA Outreach TrainerPresident/CEOBluegrass Health & Safety, Inc.Wilmore, KY

AcknowledgementsStaff/Technical Consultants/Expert Reviewers

ii MEDIC First Aid PediatricPlus CPR, AED, and First Aid for Children, Infants, and Adults

HSI Program Advisory Group

Marcy Thobaben, LPN, NREMT-B501 OSHA Outreach TrainerPresident/CEOBluegrass Health & Safety, Inc.Wilmore, KY

Kira Miller, BA, EMT-B OwnerCPR Training SolutionsSan Jose, CA

John Mateus, EMT-B, RN,MICN, BSNOwnerLess Stress Instructional ServicesHawthorne, NJ

Kim Dennison, RN, BSN, COHC,COHN-S, ACLSOwnerAbsolute Learning Success, LLCPerry, MI

W. Daniel Rosenthal RN, BS, CCHCPresidentWorkplace Nurses, LLCGretna, LA

Howard Main,CCEMT-P, NREMT-POwnerHealth Educational ServicesSalinas, CA

Tana Sawzak, EMT-BEducation DirectorLifeLine Health & SafetyPortland, OR

Bradford A. (Brad) Dykens, EMT-PLieutenant (Ret.),St. Petersburg Fire and RescueOwnerRescuer Education ServicesSt. Petersburg, FL

Captain Larry Zettwoch, Esq.EMT-B, DMTMaster Trainer, ASHI/ MEDIC First AidDAN ExaminerIslamorada, FL

Cathy Statham, EMT-BOwner HeartlineEl Dorado Hills, CA

Mark Register, NREMT-P, BSEMS Chief Savannah River SiteFire Department Aiken, SC

International Reviewers

Ross N. DrysdaleChief Executive OfficerEMP New Zealand, Ltd.New Zealand and Australia

Chikako UramotoPresidentMFA Japan, Ltd.Japan

John Zenios Master TrainerDirectorEMP MEDIC First Aid, Ltd.Cyprus and Greece

PediatricPlus CPR, AED, and First Aid for Children, Infants, and Adults MEDIC First Aid iii

Table of ContentsPediatricPlus CPR and AED

Instructor InformationProgram Standards . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1Core Learning Objectives . . . . . . . . . . . . . . . . . . . . . . . . 2Knowledge Objectives . . . . . . . . . . . . . . . . . . . . . . . . . . . 2Skill Objectives . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2Program Overview . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3Flexibility . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3Initial Training . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3Program Segments and Practices . . . . . . . . . . . . . . . . . . 4Recommended Time to Complete . . . . . . . . . . . . . . . . . . 6Skills Practice . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6Integration . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6Renewal . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7Challenging the Program . . . . . . . . . . . . . . . . . . . . . . . . . 7Online Blended Training . . . . . . . . . . . . . . . . . . . . . . . . . . 7Video Guided Practice . . . . . . . . . . . . . . . . . . . . . . . . . . . 7Remote Skills Practice and Evaluation . . . . . . . . . . . . . . 8Program Materials . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8Class Requirements . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9

The First Aid ProviderThe First Aid Provider . . . . . . . . . . . . . . . . . . . . . . . . . . . 12Recognizing an Emergency and Deciding to Help . . . . . 18Personal Safety . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 20Removing Contaminated Gloves

Small Group Practice . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 25Legal Considerations . . . . . . . . . . . . . . . . . . . . . . . . . . . . 26Emergency Medical Services (EMS) . . . . . . . . . . . . . . . . 30

Sudden Cardiac ArrestRespiratory and Circulatory Systems . . . . . . . . . . . . . . . 38Sudden Cardiac Arrest and Early Defibrillation . . . . . . . . 40Chain of Survival . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 46

Basic CPR SkillsChest Compressions . . . . . . . . . . . . . . . . . . . . . . . . . . . . 50Chest Compressions

Small Group Practice . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 53Rescue Breaths . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 54Rescue Breaths

Small Group Practice . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 60Primary Assessment — Unresponsive Child . . . . . . . . . . 62Primary Assessment — Unresponsive Child

Small Group Practice . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 66

Basic Life Support CareUnresponsive and Breathing . . . . . . . . . . . . . . . . . . . . . . . 68Unresponsive and Breathing — Recovery Position

Optional Small Group Practice . . . . . . . . . . . . . . . . . . . . . . . . 71Unresponsive and Not Breathing . . . . . . . . . . . . . . . . . . . 72Unresponsive and Not Breathing

Small Group Practice . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 79Automated External Defibrillators . . . . . . . . . . . . . . . . . . 80Basic AED Operation . . . . . . . . . . . . . . . . . . . . . . . . . . . . 82Using an AED

Optional Small Group Practice . . . . . . . . . . . . . . . . . . . . . . . . 86Troubleshooting and Other Considerations . . . . . . . . . . . 88

Foreign Body Airway ObstructionChoking . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 94Choking

Optional Small Group Practice . . . . . . . . . . . . . . . . . . . . . . . . 101

First Aid AssessmentPrimary Assessment — Responsive Child . . . . . . . . . . . 102Primary Assessment — Responsive Child

Small Group Practice . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 106Secondary Assessment . . . . . . . . . . . . . . . . . . . . . . . . . . 108Secondary Assessment

Optional Small Group Practice . . . . . . . . . . . . . . . . . . . . . . . . 113

Caring for Serious InjuryControl of Bleeding . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 114Control of Bleeding

Small Group Practice . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 119Optional Topic— Tourniquets . . . . . . . . . . . . . . . . . . . . . 120Optional Topic— Using a Commercial Tourniquet

Small Group Practice . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 124Optional Topic— Using an Improvised Tourniquet

Small Group Practice . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 125Internal Bleeding . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 126Managing Shock . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 128Head, Neck, or Back Injury . . . . . . . . . . . . . . . . . . . . . . . 130Spinal Motion Restriction

Small Group Practice . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 136Swollen, Painful, Deformed Limb . . . . . . . . . . . . . . . . . . 138Swollen, Painful, Deformed Limb

Small Group Practice . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 144Optional Topic— Splinting . . . . . . . . . . . . . . . . . . . . . . . 146Optional Topic— Using an Improvised Rigid Splint

Small Group Practice . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 149

Minor InjuriesMinor Injuries . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 150

BurnsBurns . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 154Chemical Burns . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 158Electrical Burns . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 160

Facial InjuriesObjects in the Eye . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 162Chemicals in the Eye . . . . . . . . . . . . . . . . . . . . . . . . . . . . 164Nosebleeds . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 166Injured Tooth . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 168

Caring for Sudden IllnessWarning Signs of Sudden Illness . . . . . . . . . . . . . . . . . . . 170Altered Mental Status . . . . . . . . . . . . . . . . . . . . . . . . . . . 174Stroke . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 176Diabetic Emergencies . . . . . . . . . . . . . . . . . . . . . . . . . . . 178Seizure . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 180Breathing Difficulty, Shortness of Breath . . . . . . . . . . . . . 182Asthma . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 184Optional Topic— Metered-Dose Inhalers . . . . . . . . . . . . 188Optional Topic— Using a Metered-Dose Inhaler

Small Group Practice . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 191Optional Topic— Nebulizers . . . . . . . . . . . . . . . . . . . . . . 192Optional Topic— Using a Nebulizer

Small Group Practice . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 195Severe Allergic Reaction . . . . . . . . . . . . . . . . . . . . . . . . . 196Optional Topic— EpiPen® Auto-Injectors . . . . . . . . . . . . 198Optional Topic— Using an EpiPen®

Small Group Practice . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 201Pain, Severe Pressure, or Discomfort in the Chest . . . . . 202Severe Abdominal Pain . . . . . . . . . . . . . . . . . . . . . . . . . . 206

iv MEDIC First Aid PediatricPlus CPR, AED, and First Aid for Children, Infants, and Adults

PoisoningIngested Poisoning . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 208Inhaled Poisoning . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 210

Bites and StingsBites and Stings . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 212Snakebites . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 214Spider Bites . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 218Stinging Insects . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 220Animal and Human Bites . . . . . . . . . . . . . . . . . . . . . . . . . 222

Environmental EmergenciesHeat Exhaustion . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 224Heat Stroke . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 226Hypothermia . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 228Frostbite . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 230

Additional ConsiderationsEmergency Moves . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 232Emotional Considerations . . . . . . . . . . . . . . . . . . . . . . . . 234

Wrapping Up a Training Class . . . . . . . . . . . . . . . . . 238

References and End Notes . . . . . . . . . . . . . . . . . . . . 240

Specific First Aid TopicsAmputation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 245Impaled Object . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 246Open Chest Injury . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 247Open Abdominal Injury . . . . . . . . . . . . . . . . . . . . . . . . . . 248Pregnancy Complications . . . . . . . . . . . . . . . . . . . . . . . . 249Tick Bites . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 250Marine Animal Stings . . . . . . . . . . . . . . . . . . . . . . . . . . . . 251

PediatricPlus CPR, AED, and First Aid for Children, Infants, and Adults MEDIC First Aid 1

Program StandardsPediatricPlus CPR, AED, and First Aid for Children, Infants, and Adults

PediatricPlusIntended Audience Individuals who desire or are required to be certified in Pediatric First Aid, CPR, and

AED.

Instructor Requirement A current and properly authorized MEDIC First Aid Instructor in good standing.

Participant Prerequisites None

RequiredTraining Materials

� MEDIC First Aid PediatricPlus Student Pack (one per participant)

� MEDIC First Aid PediatricPlus Instructor Guide (one per Instructor)

� MEDIC First Aid PediatricPlus presentation media (DVD or Blended)

Course Length � Varies by class type (initial, refresher) and method (classroom, blended,challenge)

� Initial class, all ages, about 5 hrs (see note)

� Successful completion is based on achievement of the core learning objectivesrather than a prescribed instruction time.

Student-to-Instructor RatioSkill Session Maximum

12:1 (6:1 recommended)

Certification Requirements � Skills Evaluation — Students must perform the following skills competently with-out assistance. Skill performance can be documented individually on the ClassRoster/Student Record or by using Performance Evaluations.– Removal of contaminated gloves– External chest compressions (for all age groups)– Rescue breaths using a CPR mask or shield (for all age groups)– Primary assessment for an unresponsive person – CPR as a single provider (for all age groups)– Primary assessment for a responsive person– Control of severe bleeding– Stabilization of a suspected head, neck, or back injury– Stabilization of a swollen, painful, deformed limb

� Written Evaluation — Required when specified by organizational, local, or stateregulation. It is recommended for designated responders with a duty or employerexpectation to respond in an emergency and provide first aid care. Successfulcompletion requires a correct score of 70% or better.

Card Issued

Certification Period May not exceed 24 months from class completion date. More frequent reinforce-ment of skills is recommended.

Notes: California Training Standards for Child Care Providers requires licensed child careproviders have no less than eight hours in pediatric first aid and pediatric CPR atleast every two years. Other significant regulations apply.See http://www.emsa/ca.gov/laws/files/dayregs2.pdf or contact HSI CustomerService for more information

2 MEDIC First Aid PediatricPlus CPR, AED, and First Aid for Children, Infants, and Adults

Instructor InformationPediatricPlus CPR, AED, and First Aid for Children, Infants, and Adults

Core Learning ObjectivesMEDIC First Aid PediatricPlus CPR, AED, and First Aidfor Children, Infants, and Adults is an objectives-driven,skills-based training program. To receive certification, stu-dents are required to demonstrate the following knowl-edge and skill objectives to a currently authorized MEDICFirst Aid Instructor.

Knowledge ObjectivesUpon completion of this training program, a student willbe able to (for all age groups):

1. Explain the priority of personal safety when re-sponding to an emergency situation.

2. Explain the importance of Universal Precautionsand using protective barriers.

3. Identify how to activate emergency medicalservices (EMS) or an occupational emergencyaction plan.

4. Describe how to recognize and provide first aidtreatment for sudden cardiac arrest.

5. Explain how to perform effective chestcompressions.

6. Describe how to perform effective rescue breathsusing a CPR mask or shield.

7. Describe the steps of a primary assessment foran unresponsive person.

8. Explain how to protect the airway of an unre-sponsive, breathing victim.

9. Describe the steps of performing CPR as a singleprovider.

10. Describe the steps for safely and correctly at-taching and operating an automated external de-fibrillator (AED).

11. Describe how to recognize and provide first aidtreatment for choking.

12. Describe the steps of a primary assessment fora responsive victim.

13. Describe how to recognize and provide first aidtreatment for severe bleeding.

14. Describe how to recognize and provide first aidtreatment for shock.

15. Describe how to recognize and provide first aidtreatment for a head, neck, or back injury.

16. Describe how to recognize and provide first aidtreatment for a swollen, painful, deformed limb.

17. Describe how to recognize and provide first aidtreatment for a burn.

18. Describe how to recognize and provide first aidtreatment for a person with an altered mentalstatus.

19. Describe how to recognize and provide first aidtreatment for stroke.

20. Describe how to recognize and provide first aidtreatment for breathing difficulty or shortness ofbreath.

21. Describe how to recognize and provide first aidtreatment for asthma.

22. Describe how to recognize and provide first aidtreatment for a severe allergic reaction.

23. Describe how to recognize and provide first aidtreatment for pain, severe pressure, or discomfortin the chest.

24. Describe how to recognize and provide first aidtreatment for poisoning.

25. Describe how to recognize and provide first aidtreatment for heat-related emergencies.

26. Describe how to recognize and provide first aidtreatment for cold-related emergencies.

27. Describe how and when to perform an emer-gency move.

Skill ObjectivesUpon completion of this training program, a student willbe able to:

1. Correctly demonstrate the removal of contami-nated gloves.

2. Correctly demonstrate external chest compres-sions.

3. Correctly demonstrate rescue breaths using aCPR mask or shield.

4. Correctly perform a primary assessment for anunresponsive person.

5. Correctly demonstrate CPR as a single provider.

6. Correctly perform a primary assessment for a re-sponsive person.

7. Correctly demonstrate how to control severebleeding.

8. Correctly demonstrate how to stabilize a sus-pected head, neck, or back injury.

9. Correctly demonstrate how to stabilize a swollen,painful, deformed limb.



This MEDIC First Aid PediatricPlus training program haslisted core learning objectives that must be covered inorder to issue certification cards. Instructors bear the re-sponsibility of ensuring that each student meets the learn-ing objectives for successful completion.

To meet additional training requirements, the programmaterials also include supplemental topics and contentthat can be included to varying degrees at the discretionof the Instructor. Supplemental content is intended forreference, further reading, continuing education, or adapt-ing the class to the specific needs of an employer or stu-dent.

A few optional topics have also been included. Thesetopics are not recommended for most students but canbe added in very specific circumstances. They are:

� Tourniquets

� Splinting

� Metered-Dose Inhalers

� Nebulizers

� EpiPen® Auto-injectors

Initial TrainingStudents are required to meet the knowledge and skillobjectives listed in this program to receive an initial certi-fication card. These core learning objectives representthe minimum content a student needs to understand inorder to manage a medical emergency.

In addition to this core content, the MEDIC First Aid Pe-diatricPlus program materials include supplemental andoptional content. Instructors determine the depth to whichthe core content is covered and which supplemental oroptional content to cover in a training class.

Flexibility is desirable; individual students may requestspecific content, and employers may require specific con-tent to be covered. Occupational regulatory or licensingagencies may also require additional content, hours ofinstruction, or other practices.

Program OverviewThe MEDIC First Aid PediatricPlus CPR, AED, and FirstAid for Children, Infants, and Adults training program pro-vides training in CPR, AED, and basic first aid emergencyskills. The goal of this training is to help students developthe knowledge, skills, and confidence to respond in amedical emergency.

MEDIC First Aid training programs use a proven seeing,hearing, speaking, feeling, and doing approach to makelearning easier and more enjoyable. Varied ways of ex-posing the student to the information helps create betterretention. As a result, students develop more confidencein their ability to respond to an actual emergency.

MEDIC First Aid training programs are divided into specificconceptual, skill or sequence segments. Each segmentuses some combination of video, print, demonstration,and practice to present information to a student. Seg-ments build on each other, reinforcing the core skills, andthen gradually come together to show how those skillscan be integrated into the overall care process.

Two vital components of the instructional system are theprogram video and the small group practices. The requiredvideo uses short, scenario-based video pieces to relayessential cognitive information and to give students real-life demonstrations of skill technique and application.

For hands-on practice, students are arranged in smallgroups and take turns assuming the roles of first aidprovider, patient, and coach. This multifaceted approachexposes students to the same information from differentperspectives.

Overall, the instructional system fosters more self-dis-covery on the part of the student. Instructors assumemore of a facilitator role during class, spending less timetalking or lecturing and spending most of the class timecreating and maintaining an effective learning environmentfor students.

FlexibilityThe program is intended to be flexible in content. It canbe customized to meet the teaching styles of the Instruc-tor, the learning needs of the student, and the regulatoryneeds of an employer.

In the United States, Canada, and most other industrial-ized countries, workplace safety regulations and occu-pational licensing requirements may call for specific train-ing content to be covered. Instructors must be familiarwith the regulations and licensing requirements of thestudents they offer training and certification to.



Segments Demonstration and PracticeFirst Aid Provider

First Aid Provider

Recognizing an Emergency and Deciding to Help

Personal Safety

Legal Considerations Removing Contaminated Gloves

Emergency Medical Services (EMS)

Sudden Cardiac Arrest

Respiratory and Circulatory Systems

Sudden Cardiac Arrest and Early Defibrillation

Chain of Survival

Basic CPR Skills

Chest Compressions Chest Compressions

Rescue Breaths Rescue Breaths — CPR Maskand/orRescue Breaths — CPR Shield

Primary Assessment — Unresponsive Child Primary Assessment — Unresponsive Child

Basic Life Support Care

Unresponsive and Breathing — Recovery Position Unresponsive and Breathing — Recovery Position (optional)

Unresponsive and Not Breathing — CPR Unresponsive and Not Breathing — CPR

Automated External Defibrillators

Basic AED Operation Using an AED (optional)

Troubleshooting and Other Considerations

Foreign Body Airway Obstruction

Choking Choking (optional)

First Aid Assessment

Primary Assessment — Responsive Child Primary Assessment — Responsive Child

Secondary Assessment (optional) Secondary Assessment (optional)

Caring for Serious Injury

Control of Bleeding Control of Bleeding

Tourniquets (optional) Using a Commercial Tourniquet (optional)

Using an Improvised Tourniquet (optional)

Internal Bleeding

Managing Shock

Head, Neck, or Back Injury Spinal Motion Restriction

Swollen, Painful, Deformed Limb Swollen, Painful, Deformed Limb

Splinting (optional) Using an Improvised Rigid Splint (optional)

Continued on next page �

Program Segments and PracticesThe following table provides an overview of the required segments and practices found within the MEDIC First AidPediatricPlus training program. Optional segments and practices are noted.



Segments Demonstration and PracticeMinor Injuries

Minor Injuries

BurnsBurnsChemical BurnsElectrical Burns

Facial InjuriesObjects in the EyeChemicals in the EyeNosebleedsInjured Tooth

Caring for Sudden IllnessWarning Signs of Sudden IllnessAltered Mental StatusStrokeDiabetic EmergenciesSeizureBreathing Difficulty, Shortness of BreathAsthmaMetered-Dose Inhalers (optional) Using a Metered-Dose Inhaler (optional)Nebulizers (optional) Using a Nebulizer (optional)Severe Allergic ReactionEpiPen® Auto-Injectors (optional) Using an EpiPen® Auto-Injector (optional)Pain, Severe Pressure, or Discomfort in the ChestSevere Abdominal Pain

PoisoningIngested PoisoningInhaled Poisoning

Bites and StingsBites and StingsSnakebitesSpider BitesStinging InsectsHuman and Animal Bites

Environmental EmergenciesHeat ExhaustionHeat StrokeHypothermiaFrostbite

Additional ConsiderationsEmergency MovesEmotional Considerations

Continued on next page �



Recommended Timeto CompleteThere are many factors affecting classroom time, includingthe varying nature of learning, the number of students,the amount and quality of previous training, the amountof equipment available, and the experience level of theInstructor. Because of these factors, a time range is rec-ommended instead of a fixed number of hours.

� PediatricPlus CPR, AED, and First Aidfor Children, Infants, and Adults — 5–6 hours

Allow for additional time when adding optional trainingcomponents such as Optional Topics, Talk-throughScenarios, or Performance Evaluations.

Skills PracticeStudents taking a MEDIC First Aid PediatricPlus trainingclass must get enough hands-on skill practice to be ableto demonstrate competent performance in the skill ob-jectives. Competent performance is required to receive acertification card. An adequate portion of class time shouldbe dedicated to developing competent skills. Small GroupPractices are located throughout the MEDIC First Aid Pe-diatricPlus training program for this purpose. Instructorscan extend or include additional practice sessions asneeded or desired.

Conducting Small Group PracticesMEDIC First Aid training programs utilize a proven seeing,hearing, speaking, feeling, and doing approach to skillspractice. To maximize student participation and the re-tention of skills, always consider the following when con-ducting Small Group Practices:

� Small Group Practices are student exercises de-signed to help students learn a particular skill oremergency sequence. These hands-on practicesessions are essential to each student’s under-standing and retention of the material in theprogram.

� Students are arranged in pairs or small groupsdepending on the skill or sequence being prac-ticed. Instructors are encouraged to create assmall a group as possible.

� During the practice session, students will rotatethrough the roles of coach, provider, and ill or in-jured person.

� Students will play the role of the ill or injured per-son unless a manikin is required due to the phys-ical nature of the skills.

� Coaches are responsible for helping the providerremember and perform the skills indicated.Coaches will refer to the corresponding StudentGuide page during the practice. Only coacheswill use this page. Others in the groups will ob-serve the performance.

� Based on the Student Guide, the coach willprovide corrective feedback on the provider’sperformance.

� Instructors will roam through groups looking forinadequate performance. Positive coaching andgentle correction can be used to improve skills.

� It is important for Instructors to refrain from over-controlling the instructional process. This willmaximize the use of student self-discovery to in-crease understanding and retention.

IntegrationThe MEDIC First Aid PediatricPlus CPR, AED, and FirstAid for Children, Infants, and Adults training program maybe integrated with other MEDIC First Aid programs wherenecessary or desired.

Other programs that can be integrated include the MEDICFirst Aid Bloodborne Pathogens in the Workplace andOxygen First Aid for Emergencies programs.

Segments Demonstration and PracticeSpecific First Aid Topics (all optional)

Amputation

Impaled Object

Open Chest Injury

Open Abdominal Injury

Pregnancy Complications

Tick Bites

Marine Animal Stings



RenewalStudents returning before the end of their certification pe-riod can renew their certification in a training class usingTalk-through Scenarios that focus on achieving the listedcore skills objectives through scenario-based skills prac-tice and evaluation. As the training progresses, instructorsneed to constantly evaluate the level of cognitive under-standing within the group being trained and review coreknowledge objectives as needed.

Renewal training is typically shorter than initial training.However, the amount of reduced time is dependent onthe level to which the group still understands the cognitiveinformation within the program. Frequent refreshers duringthe certification period can help improve this.

Renewal training can also be accomplished by repeatingan initial training class.

Challenging the ProgramExperienced students can challenge the MEDIC First AidPediatricPlus training program using performance evalu-ations. Participants must arrive prepared for skill testingand must perform competently without assistance on allperformance evaluations. A warm-up or skills review ses-sion may be conducted before the challenge, but mustbe clearly separated from the challenge itself. Studentswho cannot perform competently without assistance havenot successfully completed the challenge. If unsuccessful,students still seeking certification must attend and com-plete a training class.

Online Blended TrainingBlended training combines the convenience of onlinelearning with a shortened practical skills session in orderto meet both knowledge and skill objectives.

The online learning platform used for MEDIC First Aidblended training classes is MEDIC University. This spe-cially designed, web-based learning system allows for avariety of sensory interactions to provide users with alow-stress, easy-to-use, and convenient way to learn cog-nitive information.

It is important to note that students must successfullycomplete both the online and skills portions of blendedtraining. Completion of the online portion alone will notresult in certification.

The entire administrative process for blended training isdone through Training Center Manager. A Training Centerpurchases blended training credits, which include a stu-dent seat in an online class and a Student Guide.

Training Centers schedule classes and add students. Stu-dents are notified by email of enrollment in the onlineclass. Student progress can be monitored online.

To successfully complete the online class, students com-plete all of the lessons. Check marks will indicate whichlessons have been completed. When all of the lessonsare finished, the student will have the capability of printinga completion certificate for the online portion. If a classexam is included in the class, a student will have toachieve a passing score in order to complete the onlineclass.

Skill practice and evaluation is done face-to-face in aclassroom setting. Instructors must conduct and docu-ment student skill performance for the core skill objectiveslisted for the class being taught. Skill practice is accom-plished using the same approaches available for non-blended classroom training. Sessions can be conductedfor groups or for individuals. Individuals can also challengethe skills session in order to receive certification.

Video Guided PracticeHaving students practice CPR skills along with a videodemonstration has been shown to be an effective meansof acquiring CPR skills. A video guided practice is includedwith the MEDIC First Aid PediatricPlus Program Video forchild, infant, and adult CPR.

Instructors have a choice to use this option when prac-ticing CPR skills. Regardless of the method used to prac-tice, Instructors must still evaluate for the competent per-formance of skills to issue a certification card. Videoguided practice can be used either in the classroom orwithin the online blended class for this program.

To use video guided practice in a classroom, make sureeach student has an appropriate CPR manikin and, ifused in practice, a barrier device for giving rescue breaths.Arrange students in a manner that allows for clear viewingof the video presentation.

Each age group (child, infant, and adult) has a guidedpractice video that progresses through CPR skill learning.First, students will learn how to perform external chestcompressions and then rescue breaths. Next, they willlearn the steps of primary assessment for an unresponsiveperson, and then they will put everything together to prac-tice performing the entire sequence of CPR.

Roam through the class and watch for the competentperformance of skills. Replay segments of the video ifadditional practice is required for that segment. Recordcompetent skill performance on the student record.



Video guided practice is also included in the onlineblended version of this program. Students will first gothrough the cognitive information regarding CPR and thengo through the video guided practice segments. Studentsusing the online class must have access to an appropriateCPR manikin and, if used, a barrier device for giving res-cue breaths.

Students must also have the ability to practice on thefloor with clear viewing of the computer monitor they areusing. Instructor evaluation for reasonable performancecan be done at a separately scheduled face-to-facesession or can be accomplished through remote skillsevaluation.

Remote Skills Practice andEvaluationStudents can practice and be evaluated on their skills re-motely through the use of internet video technology. Boththe Instructor and the student will need an appropriatecomputer and computer video camera that are hookedup to the internet. Adequate internet bandwidth is essen-tial to make sure accurate timing can be measured.

Skills evaluation can be recorded or can be done live.A competent performance of skills is required foracceptance.

If the skills evaluation is recorded and is not acceptable,the Instructor must have a live (phone or online) conversa-tion with the student to remediate skill performance. If theskills evaluation is live, remediation can be done immedi-ately. In either case, the student must be allowed someadditional practice time before being evaluated again.

Program MaterialsInstructor GuideThe MEDIC First Aid PediatricPlus Instructor Guide pro-vides organized instructional guidance on how to conducta training class. It is integrated with the Student Guideand Program Video.

Information regarding the details of the training programand how to prepare for a class are provided in the front ofthe guide. The majority of the guide follows a topic-by-topic approach to training that provides required Instructoractivities and small-group practices. Instructions on com-pleting the required class administration are also included.

Student GuideThe MEDIC First Aid Student Guide contains the contentand skill references a student needs to meet the corelearning objectives. Students must have access to skilltraining reference materials during the class. The StudentGuide provides a convenient way to provide this informa-tion. It is required to provide each student a personal

printed copy of the Student Guide to take home or accessto a digital version they can download online.

Program VideoThe MEDIC First Aid PediatricPlus Program Video is ascenario-based presentation that provides a visual learn-ing tool to accomplish the learning objectives. It is avail-able on DVD and is also streamed online as a componentof the online blended class.

Using the DVD, Instructors can play the entire video orselect individual topics as desired. Supplemental seg-ments on Specific First Aid Topics, Optional Topics, andVideo guided practices are also included.

Talk-through ScenariosTalk-through Scenarios allow students to practice makingrealistic decisions in a simulated setting. This alternativesmall-group practice approach is suited for moreexperienced students or as supplemental practice to initialtraining.

Talk-through Scenarios can be found online in the docu-ment section of Training Center Manager or your InstructorPortal.

Class Roster/Student RecordThe Class Roster/Student Record is the primary paper-work for documenting the completion of a MEDIC FirstAid PediatricPlus training class. It can be found online inthe document section of Training Center Manager or yourInstructor Portal.

A Class Roster is required for every training class. Com-pletely and accurately fill out the class information. Havestudents legibly fill out personal information.

A Student Record is required when Performance Evalua-tions are not used to document competent skills. Usingthe Class Roster/Student Record, check off students whoare performing competently without assistance as theclass progresses through skills practice.

If a Written Exam is used, document each student’s suc-cessful completion on the Class Roster/Student Record.

When finished with a training class, sign and return thecompleted Class Roster/Student Record to the TrainingCenter responsible for the class.

Performance EvaluationsThe competent performance of the listed skill objectiveswithout assistance is required for certification. Perform-ance evaluation is required when individual skill perform-ance is not documented on the Student Record or whenspecified by organizational, local, or state requirement.

Performance Evaluations can be found online in the doc-ument section of Training Center Manager or your Instruc-tor Portal.



When finished, score students as outstanding (compe-tent), adequate (competent), or inadequate (not compe-tent) on each Performance Evaluation. Inadequate (notcompetent) scores require remediation and re-evaluation.Depending on logistics, this may require individuallychecking off skills using the Student Record or completinganother class.

Students who have not had skills checked off on the Stu-dent Record or have been scored incompetent on thePerformance Evaluations have not successfully completedthe class.

Sign and return all Performance Evaluations to the TrainingCenter responsible for the class.

When conducting Performance Evaluations:

� Students must perform and not verbalize skills.

� Students do not have to perform skills perfectly,just reasonably to achieve the desired outcome.

� Evaluate consistently between students.

� Avoid excessive communication.

� Do not coach students.

Written ExamsWritten evaluation may be necessary when specified byorganizational, local, or state requirement. It is recom-mended for designated responders with a duty or em-ployer expectation to respond in an emergency and pro-vide first aid care.

Written Exams for this class can be found online in thedocument section of Training Center Manager or your In-structor Portal.

Successful completion of a Written Exam requires a cor-rect score of 70% or better. Document the successfulcompletion of the written exam (when used), on the ClassRoster/Student Record. When conducting written evalu-ation, take precautions to prevent cheating and allow ad-equate time to complete the exam.

Rate Your Program Class EvaluationEncouraging students to provide feedback and then usingthat feedback to improve instruction is an essential aspectof any quality educational effort. All students are requiredto fill out the Rate Your Program class evaluation in orderto get a certification card.

Tear-out Rate Your Program class evaluations are foundin the back of each Student Guide. They can also befound online in the document section of Training CenterManager or your Instructor Portal.

The evaluation allows students the opportunity to com-ment on the program materials and on the Instructor’spresentation style and effectiveness.

Collect and return the completed Rate Your Program classevaluations to the Training Center responsible for the class.

Class RequirementsThe following requirements are necessary to help ensureall students and Instructors experience a safe, enjoyable,and satisfying MEDIC First Aid PediatricPlus training class.

Administration� Instructors must teach in accordance with themost recent administrative policies and proce-dures as described in the Training Center Admin-istrative Manual (TCAM).

� An Instructor must be authorized to teach theMEDIC First Aid PediatricPlus training program inorder to issue certification cards.

� There are no minimum age requirements for par-ticipation in a MEDIC First Aid PediatricPlusclass. However, regardless of age, students mustbe able to competently perform the required skillobjectives to receive a certification card.

� The maximum allowed ratio is 12 students to 1Instructor. A ratio of 6 students per Instructor isrecommended.

� The student-to-Instructor ratio for lecture anddiscussion may be exceeded when organiza-tional realities make small class size unachiev-able. However, additional MEDIC First Aid-autho-rized Instructors must be available to maintainthe student-to-Instructor ratio for skill practiceand evaluation.

� Instructors must provide access to the most cur-rent MEDIC First Aid training materials to stu-dents for use during and after the course. This isespecially important in skill practice sessions.Appropriate training materials include video seg-ments, print handbooks and skill sheets, talk-through scenarios, and projected or mobile com-puter-based MEDIC First Aid training materials.Each course participant must also be provided aprint or digital version of the Student Guide.

� As part of an initial training class, Instructors mustconduct all required segments and practices asoutlined in this MEDIC First Aid Instructor Guide.

� As part of an initial training class, Instructorsmust show all required Program Video segmentsas outlined in this MEDIC First Aid PediatricPlusInstructor Guide. The online blended trainingclass may be used as an alternative approach.Use of these training tools is highly recom-mended for renewal training.



� During a class, Instructors must provide informalevaluation and prompt feedback to studentsabout their skill performance. This will allow stu-dents to evaluate their skills and correct deficien-cies.

� An Instructor must verify that each student hasmet the required knowledge and skill objectivesbefore issuing a certification card. The Instructormust include their registry number and TrainingCenter ID on the card to validate it.

� Each student must fill out and return to the In-structor the Rate Your Program class evaluation.Completed evaluations must be returned to theTraining Center responsible for the class.

� Instructors must complete a Class Roster/Stu-dent Record and return it to the Training Centerthat is responsible for the class.

Equipment� Required Equipment

– Visual presentation equipment (television,monitor, projector)

– Adult CPR training manikins (6:1 maximumstudent-to-manikin ratio; 2:1 recommended)

– Child CPR training manikins (6:1 maximumstudent-to-manikin ratio; 2:1 recommended)

– Infant CPR training manikins (6:1 maximumstudent-to-manikin ratio; 2:1 recommended)

� Optional Equipment

– AED training devices and training pads(6:1 maximum student-to-device ratio;2:1 recommended)

Materials� Required Instructional Materials

– MEDIC First Aid PediatricPlus Instructor Guide(printed or digital)

– MEDIC First Aid PediatricPlus Program Video

– MEDIC First Aid PediatricPlus Class Roster/Stu-dent Record

� Optional Instructional Materials

– MEDIC First Aid PediatricPlus Talk-through Sce-narios

– MEDIC First Aid PediatricPlus PerformanceEvaluations

– MEDIC First Aid PediatricPlus Written Exam

� Required Student Materials (for each student)

– MEDIC First Aid PediatricPlus Student Guide(printed or digital)

– MEDIC First Aid PediatricPlus Certification Card

– CPR mask, shield, or both (disposable mouth-pieces are okay)

– Pair of disposable barrier gloves

– Dressings and bandages

� Optional Student Materials

– Commercial tourniquets (6:1 maximum student-to-device ratio; 3:1 recommended)

– Materials for improvised tourniquets

– Materials for splinting

– Training inhalers (6:1 maximum student-to-de-vice ratio; 3:1 recommended)

– Training nebulizers (6:1 maximum student-to-device ratio; 3:1 recommended)

– EpiPen® trainers (6:1 maximum student-to-device ratio; 3:1 recommended)

Health and Safety� Screen students for health or physical conditionsthat require modifications of skill practice.

� Follow the manufacturer recommendations forthe decontamination of manikins before, during,and after training.

� When using disposable gloves in skills practice,Instructors must take necessary steps to beaware of students with latex allergies and providesuitable, non-latex barrier products for their usein class.

� Caution students to avoid awkward or extremepostures of the body.

� Caution students to avoid certain skills duringstudent-on-student practice, including chestcompressions, rescue breaths, and abdominal orchest thrusts. These skills are not appropriate forstudent-on-student practice and must be per-formed on training manikins designed for thatpurpose.

� Students must be informed to use proper liftingand moving techniques during a student-on-stu-dent practice in which a simulated ill or injuredperson is moved. Students should not participatein these practices if they have a history of backproblems.

Classroom� Classes need to be conducted in a safe andcomfortable environment conducive to learning.

� A carpeted floor is preferred. However, blanketsor mats may be used for practice sessions.

� Comfortable seating is important and a table orwork area is quite useful.



� A monitor stand can help ensure the monitor iseasily visible to all students.

� An erasable white board, blackboard, or easeland paper can be very helpful.

Classroom Safety� All Instructors must ensure a physically safelearning environment for their students.

� Make sure there are no obvious hazards in theclassroom, such as extension cords that can betripped over.

� In addition, Instructors should be aware of the lo-cation of the nearest phone, first aid kit, AED, firealarm pull station, and fire extinguisher.

� Instructors should have an emergency responseplan in case of serious injury or illness, includingevacuation routes from the classroom.

� Students should be discouraged from smoking,eating, or engaging in disruptive or inappropriatebehavior.


The First Aid ProviderThe First Aid Provider

OverviewThe outcome of many medical emergencies can be im-proved by early care from a trained bystander.

Instructor Activity� Video (segment duration 2:14)

- Introduce and show video segment.- Ask for and briefly answer any questions.

� Student Guide- To review “The First Aid Provider” refer topages 1–4 of the Student Guide.

Emphasize Key Points as needed

1. Unintentional injury is the leading cause of deathin the United States for children from 1 to 9 yearsof age. On average, 33 children die each day inthe U.S. from traumatic injuries, and more thannine million children are seen in emergencydepartments for injuries each year.

2. Once an injury or sudden illness has occurred,effective first aid could make the differencebetween a rapid or prolonged recovery, a tempo-rary or permanent disability, and even life ordeath.

3. According to the American Academy ofPediatrics, pediatric first aid is the immediatecare given to a suddenly ill or injured child untilthe responsibility for the medical condition, andeffort to prevent it from becoming worse, can betaken over by a medical professional, parent, orlegal guardian. It does not take the place ofproper medical treatment.

4. First aid for pediatric emergencies with a child-specific approach is more beneficial than a stan-dardized adult-focused approach. Whendescribing treatment guidelines for children:

� Someone younger than 1 year of age isreferred to as an infant.

� Someone between 1 year and the onset ofpuberty is referred to as a child. The onset ofpuberty can be indicated by breastdevelopment in females and the presence ofarmpit hair in males.

� Anyone at or beyond puberty is considered anadult.

5. First aid does not require making complex deci-sions or having in-depth medical knowledge. It iseasy to learn, remember, and perform.

6. A first aid provider is someone trained in thedelivery of initial emergency procedures, usinglimited equipment to perform a primaryassessment, and administering initial treatmentuntil Emergency Medical Services, or EMS,personnel arrive.

7. The essential responsibilities of a first aidprovider are:

� Recognizing a medical emergency,

� Making the decision to help,

� Identifying hazards and ensuring personalsafety,

� Activating the EMS system, and

� Providing supportive, basic first aid care.

8. This program has been designed to give aprovider specific information on how to managean ill or injured child and the differences requiredin order to care for infants and adults. The goal ofthis training is to help a provider gain the knowl-edge, skills, and confidence necessary tomanage a medical emergency until moreadvanced help is available.

Key Points


Supplemental Key Points1. Children and Emergencies— Organizations with

staff members trained in pediatric first aid,including pediatric CPR, and a facility designedto ensure the safety of children reduce the poten-tial for the death or injury of a child. Whereverchildren are commonly found, it is appropriate tohave an adult trained to assess for and provideinitial treatment for common pediatric injuries, ill-nesses, and life-threatening emergencies.

2. Age-Related Behaviors— Behavior at eachstage of development also carries increased risk.An infant may turn over unexpectedly and fall ifleft unattended on a changing table, couch, orother high surface. At three to six months of ageinfants begin putting things in their mouths. Theirunderdeveloped sense of taste and inability torecognize danger increases the risk of poisoningand choking. As infants learn to move, they canencounter new and unexpected hazards.Toddlers love to independently walk, run, andexplore. They can get into problems quickly,without warning. The risk of injury increases aschildren learn to use new things such asbicycles, scooters, skates, and skateboards.Curiosity can lead to the risk of burns frommatches, lighters, wood stoves, and ovens.

3. Disruption to Routine— Certain circumstancesor disruptions in a child’s routine can increaserisk of a medical emergency. These can includetraveling; a move to a new home; a busy holiday;when the child is hungry or thirsty; whensomeone other than the normal caregiver is tak-ing care of the child; when the child is leftunattended; when another family member is ill, orthe caregiver is tired or stressed.

4. Communication— Another special considerationwhen providing first aid care for children is thatcommunicating with a child is more difficult.Using child-friendly communication techniquescan help a provider more effectively provide care.These include:

� Approaching the child slowly to keep fromincreasing his anxiety;

� Kneeling or sitting at the child’s level andmaintaining a calm, confident tone whilespeaking to him;

� Telling the child your name and asking for his,and then using his name during the course ofyour care;

� Looking and talking to the child and involvinghim in making decisions; and

� Enlisting the aid of a parent or caregiver tohelp communicate with and comfort the child.

5. Child Abuse— Child abuse is any act thatendangers or impairs a child’s physical oremotional health and development. It may bephysical violence, emotional injury, sexual abuse,or consistent neglect. In the United States, anational child abuse hotline has beenestablished. The phone number is 1-800-4ACHILD. For additional information visit onlineat www.childhelp.org.

6. Parental Notification— Whenever a child is seri-ously ill or injured, a parent or guardian should becontacted as soon as possible. However, thisshould never delay calling EMS. Call EMS imme-diately any time you recognize an emergencyexists or you believe a child needs professionalmedical attention.

Reassure the parent or guardian that a staffmember will remain with the child until the parentor guardian assumes responsibility.


Respiratory and Circulatory SystemsSudden Cardiac Arrest

OverviewUnderstanding more about the human body and thesystems that support it can help a first aid provider re-member the essential steps and rationale for providingcare.



� Student Guide- To review “Respiratory and CirculatorySystems” refer to page 17 of the Student Guide.


1. Because the human body cannot store oxygen, itmust continually supply tissues and cells withoxygen through the combined actions of the res-piratory and circulatory systems.

2. The respiratory system includes the lungs, andthe “airway,” the passage from the mouth andnose to the lungs. Expansion of the chest duringbreathing causes suction, which pulls outside aircontaining oxygen through the airway and intothe lungs. Relaxation of the chest increases thepressure within the chest and forces air to beexhaled from the lungs.

3. The circulatory system includes the heart and abody-wide network of blood vessels. Electricalimpulses stimulate mechanical contractions ofthe heart to create pressure that pushes bloodthroughout the body. Blood vessels in the lungsabsorb oxygen from inhaled air. The oxygen-richblood goes to the heart, then out to the rest ofthe body.

4. Large vessels called arteries carry oxygenatedblood away from the heart. Arteries branch downinto very small vessels that allow oxygen to beabsorbed directly into body cells so it can beused for energy production. Veins return oxygen-poor blood back to the heart and lungs where thecycle repeats.

Key Points


Chest CompressionsBasic CPR Skills

OverviewEffective chest compressions are a vital part of high-quality CPR.



� Student Guide- To review “Chest Compressions” refer topages 24–25 of the Student Guide.

� Demonstration- Perform Real-time Demonstration of“Chest Compressions.”- Ask for and briefly answer any questions. Ifnecessary, demonstrate again with explanation.

� Small Group Practice- Conduct the practice session on page 53.


1. If the heart stops, it is possible to restore at leastsome blood flow through the circulatory systemby way of external chest compressions. Themost effective chest compressions occur withthe rhythmic application of downward pressureon the center of the chest.

2. External compressions increase pressure insidethe chest and directly compress the heart,forcing blood to move from the heart to the brainand other organs.

3. Always compress fast and deep when performingcompressions. Without losing contact, allow thechest to fully rebound at the top of eachcompression.

4. Blood pressure and flow is created andmaintained with well-performed compressions. Ifcompressions stop, blood pressure is quickly lostand has to be built up again. Minimize any inter-ruptions when doing compressions.

5. When compressing properly, a provider may hearand feel changes in the chest wall. This isnormal. Forceful external chest compression iscritical if the person is to survive.

Key Points


Small Group PracticeChest Compressions

OverviewSmall Group Practices are student exercises designedto help students learn a particular skill or emergencysequence. These hands-on practice sessions are es-sential to a student’s understanding and retention ofthe material in the program.

Instructor Activity� Small Group Practice

- Conduct a practice session emphasizing theskill of “Chest Compressions.”

- Coaches will talk providers through “ChestCompressions” using Student Guide page 25.

� Video Guided Practice- Instructors can elect to use a video guidedinstructional technique for this practice. TheProgram Video contains specific segments forthis approach.


1. Students are arranged in pairs or small groupsdepending on the skill or sequence to practice.

2. Instructors are encouraged to create as small agroup as possible. Individual training programswill state the minimum and maximum allowedsize for each group.

3. During the practice session, students shouldrotate through the roles of coach, provider, and illor injured person. This seeing, hearing, speaking,feeling, doing approach maximizes sensory inputand learning.

4. A Coach for each group is responsible forcontrolling the practice session. Each studentshould play the role of the Coach during thepractice.

5. Providers are prompted through the practicesteps by their Coaches. Each student shouldplay the role of the Provider during the practice.

6. Unless a manikin is required, a student from eachgroup will play the role of the ill or injured person.Each student should play the role of the ill orinjured person during the practice.

7. Coaches will refer to a Student Guide page orstudent handout for the practice. Only Coachesshould use this guide or handout.

8. Based on the Student Guide or handout,Coaches need to provide corrective feedback onthe Providers’ performances.

9. Instructors should roam through groups lookingfor inadequate performance and use positivecoaching and gentle correction to improvestudents’ skill performances.

10. It is important for Instructors to maximize the stu-dents’ use of self-discovery to increaseunderstanding and retention.

Key Points


Unresponsive and BreathingBasic Life Support Care

OverviewWhen primary assessment indicates a person is unre-sponsive and breathing normally, a provider can supplyessential help by maintaining an open and clear airway.



� Student Guide- To review “Unresponsive and Breathing” referto pages 33–34 of the Student Guide.

� Demonstration- Perform Real-time Demonstration of“Unresponsive and Breathing — RecoveryPosition”- Ask for and briefly answer any questions. Ifnecessary, demonstrate again with explanation.

� Small Group Practice- Conduct the practice session on page 71.


1. Even if a child is breathing normally, a lack ofresponsiveness is still considered to be a life-threatening condition that requires immediatecare.

2. There are a variety of things that can result inunresponsiveness. Regardless of the cause, thegreatest treatment concern is the ability of thechild to maintain a clear and open airway.

3. Positioning an uninjured, unresponsive child inthe recovery position can help maintain and pro-tect the airway. This position uses gravity to drainfluids from the mouth and keep the tongue fromblocking the airway.

4. If an unresponsive child has been seriouslyinjured, a provider should not move him unlessthe provider is alone and needs to leave to gethelp.

5. Frequently assess the breathing of anyoneplaced in a recovery position. The condition canquickly become worse and require additionalcare.

Key Points


Small Group PracticeUnresponsive and Breathing — Recovery Position

OverviewSmall Group Practices are student exercises designedto help students learn a particular skill or emergencysequence. These hands-on practice sessions are es-sential to a student’s understanding and retention ofthe material in the program.

Instructor Activity� Small Group Practice

- Conduct a practice session emphasizing theskill of “Unresponsive and Breathing —Recovery Position.”

- Coaches will talk providers through“Unresponsive and Breathing — RecoveryPosition” using Student Guide page 34.


1. Students are arranged in pairs or small groupsdepending on the skill or sequence to practice.

2. Instructors are encouraged to create as small agroup as possible. Individual training programswill state the minimum and maximum allowedsize for each group.

3. During the practice session, students shouldrotate through the roles of coach, provider, and illor injured person. This seeing, hearing, speaking,feeling, doing approach maximizes sensory inputand learning.

4. A Coach for each group is responsible forcontrolling the practice session. Each studentshould play the role of the Coach during thepractice.

5. Providers are prompted through the practicesteps by their Coaches. Each student shouldplay the role of the Provider during the practice.

6. Unless a manikin is required, a student from eachgroup will play the role of the ill or injured person.Each student should play the role of the ill orinjured person during the practice.

7. Coaches will refer to a Student Guide page orstudent handout for the practice. Only Coachesshould use this guide or handout.

8. Based on the Student Guide or handout,Coaches need to provide corrective feedback onthe Providers’ performances.

9. Instructors should roam through groups lookingfor inadequate performance and use positivecoaching and gentle correction to improvestudents’ skill performances.

10. It is important for Instructors to maximize the stu-dents’ use of self-discovery to increaseunderstanding and retention.

Key Points


Key Points


Warning Signs of Sudden IllnessCaring for Sudden Illness

OverviewEarly recognition of serious signs for sudden illnesscan minimize or prevent more serious complications.



� Student Guide- To review “Warning Signs of Sudden Illness”refer to pages 81–82 of the Student Guide.

1. Medical conditions and illnesses can suddenlytrigger an unexpected medical emergency. Ingeneral, suspect a serious illness when, withoutwarning, a child suddenly appears weak, ill, or insevere pain.

2. In many cases, the human body displays warningsigns to alert us to serious illness. A suddenonset of fever, headache, and stiff neck or ablood-red or purple rash can indicate the possi-bility of severe infection.

3. Other common warning signs of serious illnessinclude:

� Altered mental status

� Breathing difficulty or shortness of breath

� Pain, severe pressure, or discomfort in thechest, and

� Severe abdominal pain

4. Early recognition and reaction to these warningsigns can minimize the underlying problem andimprove the overall outcome.

Supplemental Key Points1. Other Illness Considerations

� Temperature Taking — Body temperature ele-vation is a normal part of a body’s defenseagainst infection. Temperature can bemeasured in the mouth, rectum, armpit, or ear.

� Fever Guidelines— Fevers to note in childrenolder than 4 months include 101°F orally,102°F rectally, 100°F in armpit, and 101°F inear. Get immediate medical attention when achild under 4-months-old has an elevated tem-perature of 101°F rectally or 100°F in thearmpit. Any fever in an infant under 2-months-old should get medical attention within an hour.

� Vomiting— The biggest concern withvomiting is the protection of the airway. Otherconcerns include multiple episodes within 24hours; association with a fever, stiff neck, orhead injury; a green or bloody appearance;and association with a decreased volume ofurine.

� Diarrhea— Concerns with diarrhea includedifficulty in sanitation, blood or mucus in stool,abnormal color (very black or very pale), asso-ciation with a decreased volume of urine, feverand jaundice, or a yellow coloring to skin oreyes.

2. Meningitis/Sepsis— Meningitis can occur as aresult of an infection of the fluid surrounding thebrain and spinal cord. The infected fluid causesinflammation of the protective membranesaround the brain and spinal cord. Common signsinclude a sudden onset of fever, headache, vom-iting, and stiff neck. Sepsis is caused by a body’sresponse to infection which results in widespreadtissue inflammation. Common signs includefever, nausea, vomiting, and blood -red or purpleskin rash.

3. Young children do not fight infections as well asolder children and adults and can quickly end upwith a serious medical condition. When infectionis suspected, early recognition and professionalmedical care is essential.

MEDIC FIRST AID International, Inc.

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Copyright © 2011 by MEDIC FIRST AID, International, Inc. All rights reserved. No part of this publication may bereproduced, stored in a retrieval system, or transmitted by any means, electronic, photocopying, or otherwise,without prior written permission from MEDIC FIRST AID International, Inc.

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ISBN 978-936515-33-2 4371 (11/11)

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