SUNY Lifesaver Program

Student Manual

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Preparation for the Course

Please read this manual carefully and review the related DVD. The

manual will take you through the important information related to

CPR and use of an Automated External Defibrillator or AED. The

DVD will familiarize you with the skills so that you will be ready to

practice when you arrive in class. It will only take about 30 minutes!

As you can see, this manual has both a written and audio

component with visuals to help you learn these lifesaving skills.

This approach to education will help maximize your learning and

retention of the core skills. If you would rather not listen to the

audio, simply turn down the volume on your speakers.

CPR and Defibrillation Save Lives

The primary message for the SUNY Lifesaver Program is simple;

Early CPR and Early Defibrillation save the lives of victims of

sudden cardiac arrest!

You have chosen to serve as a SUNY Lifesaver and we appreciate

your commitment. Remember, the skills you learn in this course are

not just for the workplace or school setting. They can be valuable at

home for loved ones and friends. Hopefully you will never have to

use these skills but if you do it could be one of the most rewarding

and important experiences of your life.

CPR Defibrillation

What is Sudden Cardiac Arrest?

Sudden cardiac arrest is one of the leading causes of death in the

United States. Each year approximately 340,000 people die from

sudden cardiac arrest. That equals about 900 people a day!

The most common cause of sudden cardiac arrest is an abnormal

heart rhythm called ventricular fibrillation or VF. VF is a chaotic,

quivering heart that results in no blood flow to vital organs. If left

untreated most people will die within 6 minutes.

However, if CPR is performed immediately and an electric shock of

the heart called defibrillation is provided early, the heart can convert

back to a normal rhythm, restoring blood flow to vital organs. In fact,

the only effective treatments for VF are CPR and defibrillation of the

heart.

Ventricular Fibrillation (VF)

Time and AEDs

0

20

40

60

80

100

1

min.

3

min.

6

min.

10

min.

Survival

Survival from sudden cardiac arrest is very time dependant.

Every minute that passes from the moment of collapse until

defibrillation is administered will reduce the chance for

survival by about 7 to 10 percent. During that time CPR can

help deliver blood to vital organs until the heart is restored to

an effective rhythm by shocking the heart with a defibrillator.

Learning CPR and AED

In this course you will be learning the skills of CPR and use of an AED

using a teaching method called practice-while-watching video

instruction. This type of training and been proven in scientific studies to

be a highly effective way to learn and remember the skills of CPR and

use of an AED.

For this program to be successful three things must occur.

1. You much watch the video carefully and perform the

skill exactly as shown on the screen paying close

attention to each detail.

2. You must continue to practice as long as the skill is

shown on the screen. The key to learning is consistent

and

repetitive practice!

3. You will practice skills one more time at the end of the

program to reinforce and remember each part.

Actions for a collapsed victim?

When encountering a collapsed victim you should start by

checking to see if the victim is responsive by tapping the victim’s

shoulder and shouting “Are you alright”. Does the victim

respond? Does the victim move? If the victim does not wake or

move, you must quickly direct someone, “Go call the Emergency

Response System and get an AED”. If you are alone, call the

emergency response number, get an AED, and come back. You

should be familiar with your facilities number. Hopefully, more

times than not, you will not be alone. If you do send someone,

you should perform CPR until that person returns with the AED.

Check for ResponseCall Emergency

Response Number

Know your local emergency response

number.

Check for Breathing

Once you send someone to call and get the AED check to

see if the victim is breathing. Put one hand on the

forehead and two fingers on the boney part of the chin.

Tilt the head back and lift the chin. Place your ear and

cheek next to the victim’s mouth and nose and listen and

feel for air movement. Also look for chest rise.

Check for BreathingLook carefully at the position of the rescuer’s fingers on the chin and hand on the forehead.

Rescue Breathing

If there is no air movement or chest rise, provide two rescue

breaths using the mouth to mask device. Position the mask, seal

the upper portion with your index finger and thumb. Pinch

the lower portion between your thumb and two fingers at the

base of the chin. Tilt the head way back and provide a rescue

breath through the opening at the top of the mask while observing

for chest rise.

Rescue Breathing Look carefully at the position of the rescuer’s hands on the mask

device. Also note the head tilt and observation of chest rise.

Chest Compressions

After delivering two breaths begin chest compressions. Remove

clothing, place your hands between the victim’s two nipples,

position your shoulders over your hands and begin

compressions. Once again, compress hard and compress fast

at a rate of 100 compressions per minute. Be sure to allow the

chest wall to return to its normal position after each compression.

Move the breastbone approximately 1 ½ to 2 inches.

Chest Compressions Look carefully at the position of

the rescuer’s body, arms, and hands.

Summary of Adult CPR

Check for Response

Call Emergency Response

Number/Get AED

Check for Breathing Rescue Breathing

Until Chest rises

Chest Compressions

Hard and Fast

Use of an AED

Using an AED may seem like a challenging skill but it is truly the

easiest part of this program. An AED is a computerized defibrillator

that talks you through the procedure of defibrillation. Once you turn

the device on by opening the cover, it will instruct you to remove

clothing and attach the AED pads. The machine will then advise you

to clear the victim and proceed to analyze the victim’s heart rhythm.

If the victim is in ventricular fibrillation it will charge and deliver a

shock to the victim’s heart. You will be instructed to start CPR. The

machine will actually coach you through the procedure of CPR. You

will continue the process of CPR, analysis of the rhythm until one of

two things happen. The victim wakes up and begins to move or EMS

arrives on the scene and advises you to stop CPR. It is really that

simple.

AED Operation – Pad Placement

Position the AED next to the victim on the opposite side of the CPR

rescuer. Open the case and follow the instructions. Unwrap the

pads…remove the covering from the pads surface…place them as

directed by the AED. Look carefully at the picture below to see the

proper position of the electrode pads. This position allows the

electrical current to travel through the heart and help convert the

victim’s heart rhythm.

AED Operation – Clear and Shock

Once the pads are attached…stop CPR…clear everyone from the

victim and allow the device to analyze the rhythm. If the heart is in a

rhythm that requires a shock, the machine will automatically charge.

Again, make sure that everyone is clear of the victim, including

yourself. It will warn of the shock and deliver a single shock. After

the shock immediately start chest compressions and provide 5 cycles

of CPR. This will take approximately 2 minutes.

AED Operation – Clear and Shock

At the end of 5 cycles the machine will prompt you to reanalyze the

rhythm. When this occurs, stop CPR and allow the machine to

analyze. The machine will either shock the victim or advise to

perform CPR. Again simply follow the instructions. Let’s review

the steps one more time:

Summary of Steps of AED Operation

Place the AED opposite side of the CPR rescuer.

Open the lid and follow the instructions.

Remove clothing if not already done.

Attach pads as shown on the AED.

Clear the victim.

Allow the machine to analyze.

Make sure the everyone is clear.

The machine will deliver a shock.

Start 30 to 2 cycles of compressions and breaths.

Perform 5 cycles and continue until the victim wakes up or EMS directs you to stop.

AED Operation – Special Situations

There are special situations that may have to be addressed when using an AED.

These include victims; with a hairy chest, those that are found in water, those with

an implanted pacemaker-defibrillator, or those who are wearing a medication patch.

Hairy Chest - When a victim has a very hairy chest the electrode pad may not

adhere to the skin. If this occurs the device will prompt you to check the electrode.

In this situation, press firmly on each electrode and allow the AED to re-analyze the

heart rhythm. If the message occurs again, remove the electrode pads, quickly

shave the chest with the razor in your kit and apply a second set of electrodes.

Water - Water is a good conductor of electricity. If the victim is lying in water they

should be moved to a dry location to avoid injuring rescuers. The chest of the

victim should also be dried with a towel before attaching the electrode pads.

Implanted Pacemaker-Defibrillator - A victim may be found with a “lump”

on his or her chest wall in the same location as where an AED electrode is applied.

The lump will look like the shape of a deck of cards under the skin. If this is noted

place the AED pads approximately an inch away from the pacemaker.

Medication Patch - A victim may be found with a medication patch placed on

their chest such as a nicotine or nitroglycerin patch. This can interfere with the

function of the AED electrode pad. If you note a patch, remove it and clean the

area with a dry towel.

Choking

Every year approximately 3,900 people

die from choking. Management of a

choking episode is fairly simple and

involves recognition and actions.

When you encounter someone who

appears to be choking ask, “Are you

choking.” If he or she nods their head

but cannot speak, perform abdominal

thrusts just above the navel and well

below the breastbone until the person

can speak or cough. If the victim

becomes unconscious, perform CPR.

When you are opening the airway to

breathe, look for a foreign body. If you

see it, remove it.

Child CPR

The good news is that Child CPR is almost exactly the same

as adult CPR. The only significant difference is that you

decrease the depth of chest compressions and breathe less

volume into the lungs. When providing rescue breathing,

breathe until the chest rises. When compressing the chest

move the breastbone about 1/3 to 1/2 the distance of the

chest from front to back. The compression rate remains at

100 compressions per minute and the ratio of compressions

to ventilations remains at 30:2. With smaller children, you

can use one arm to perform compressions.

Child AED

The use of AEDs on children is also the same as an adult. For the

purposes of AED use, a child is defined as someone who is 1 to 8

years of age. The only difference is that the child pads are used which

reduce the delivered energy to the heart. You should be careful not to

use child AED pads on adults since the energy may not be sufficient to

convert the heart rhythm. The pads are placed in the same position

as an adult. However, some AEDS recommend an alternate position

with one pad in front and the other pad in back. Check the

manufactures recommendation on your device. At this time the

American Heart Association does not recommend for or against the

use of AEDs for infants less than one year of age.

Infant CPR

The main differences when performing CPR on an infant

victim is that you breathe less during rescue breathing and

compress less during chest compressions. You use your

fingers rather your hand to compress the chest. When

compressing the chest move the breastbone about 1/3 to

1/2 the distance of the chest from front to back. The

compression rate remains at 100 compressions per minute

and the ratio of compressions to ventilations remains at

30:2.

Answer the following questions to review the

knowledge you have just learned.

What 2 skills can help save the life of a

sudden cardiac arrest victim?

Answer:CPR and defibrillation

For every minute that passes without CPR and/or defibrillation, how much will the chance for survival

decrease for victims of sudden cardiac arrest?

Answer:7 to 10% per minute

What is the first 3 actions you should

take when encountering an adult

collapsed victim?

Answer:Check for response,

send someone to call the emergency

response number and get the AED.

How do you know if a rescue breath is

effective?

Answer:

The chest rises with each breath.

Describe three qualities of effective chest compressions.

•Answer:

Compress hard (1 1/2 to 2 inches)

Compress fast (100 compressions per minute)

Allow the chest wall to return to its normal position after each compression.

What are the correct locations to place

the AED pads?•Answer: