CHALLENGE CPRAED FOR THE Lay Responder CHALLENGES Challenges

CHALLENGE CPR/AED FOR THE Lay Responder

CHALLENGES Challenges provide an opportunity for those with current or expired certifications to recertify or to extend the length of their certifications without taking a complete course. Participants must pass the written test with a score of 80% or higher and be able to successfully demonstrate the appropriate skills to the instructor without prior demonstration from the instructor. This Power. Point presentation is designed to assist in preparation of a successful Challenge. The format is very brief because we are making this available to lifeguards who are Challenging in order to extend their Lifeguard Training Certification. Our assumption is that you are using this material as a review and should not require the specifics for each topic. If you have questions, refer to your text or question the instructor before the Challenge begins.

CHALLENGE COURSE OUTLINE • Written Exam: 30 -55 Questions. 80% +. Skills. • o o o Removing Gloves. Primary Survey. Rescue Breathing (Adult, Child, Infant) Conscious Choking (Adult, Child) Unconscious Choking (Adult, Child, Infant) Adult CPR/AED o o o Child CPR/AED Infant CPR Standard First Aid Student CPR Training Mask Must Be Used During Rescue Breathing.

Concerns for Lay Responders • • Liability Unsure what to do Disease Transmission Afraid of causing more pain/injury Scene not safe Other people watching Not knowing it’s an emergency

OBTAIN CONSENT • Tell the victim your name & your level of training. • Can I help? • What may be wrong -- what I can do to help.

VICTIM DOES NOT GIVE CONSENT? • DO NOT GIVE CARE. • Call 9 -1 -1. • Victim is unconscious, confused, seriously ill, under age -- not able to give consent -- consent is implied.

STANDARD PRECAUTIONS • Avoid contact – o o • Protective equipment— o o o • Blood. Other body fluids. Disposable gloves. Breathing barriers. Footwear. Wash hands with soap and water.

PREVENTIVE STEPS WHEN BLOOD SPILL OCCURS • Clean up immediately. • Use protective equipment. • Wipe up the spill. • Flood area for 20 minutes -- ¼ cup bleach/1 gallon water. • Dispose of material properly.

EMERGENCY ACTION STEPS CHECK CALL CARE

CHECK THE SCENE • • • Scene is safe ? What happened ? Victims ? Bystanders ? Anyone providing care ? 9 -1 -1 ? CHECK THE VICTIM

MOVING A VICTIM • MOVE ONLY IF: o o o Prep. Plus Scene becoming unsafe. To reach another victim with more serious injury. To provide proper care. • MOVES: o Clothing Drag. o Two-Person Seat Carry. o Walking Assist. o Blanket Drag. o Foot Drag. WATER SAFETY THROUGH EDUCATION

CHECK FOR SIGNS OF LIFE A = AIRWAY B = BREATHING C = CIRCULATION

TO OPEN THE AIRWAY DO A HEAD TILT AND CHIN LIFT NO BREATHING? GIVE 2 BREATHS FOR 1 SECOND EACH

ADULT – 12 YEARS AND UP If breaths went in, look for severe bleeding as you place your hands to start chest compressions. CHILD – 1 YEAR TO 12 If breaths go in, check for pulse, groove at side of the neck for 10 seconds INFANT – NEWBORN TO 1 If breaths go in, check for pulse, on inside of arm between elbow and shoulder for 10 secnds

CALL 9 -1 -1 ADULT – FIRST IF THEY ARE UNCONSCIOUS CHILD OR INFANT - AFTER 2 MINUTES OF CARE IF ALONE AND NO KNOWN HEART CONDITION OR DID NOT WITNESS COLLAPSE

CARE FOR THE CONDITIONS YOU FIND ADULT No breathing 2 breaths and begin CPR 30 COMPRESSIONS/2 BREATHS CHILD/INFANT No breathing has pulse – Rescue Breathing 1 breath/3 seconds = 40 breaths /2 minutes then recheck pulse No breathing/no pulse begin CPR 30 COMRESSIONS/2 BREATHS 2 minutes=5 cycles of 30/2

AIRWAY OBSTRUCTION • • VICTIM CLUTCHING THROAT WITH BOTH HANDS – USUALLY CHOKING. UNCONSCIOUS – TONGUE OFTEN BLOCKS AIRWAY. • PARTIAL OBSTRUCTION – WHEEZING SOUDS – STILL MOVING AIR. • COMPLETE – CANNOT SPEAK – BREATHE – COUGH.

BREATHING EMERGENCIES NEAR DROWNING CHOKING ILLNESS HEART DISEASE SHOCK ELECTRIC SHOCK HEART ATTACK STRESS INJURY TO CHEST OR LUNGS ALLERGIC POISONING DRUGS

SIGNS OF RESPIRATORY DISTRESS • • BREATHING o • • • o • Prep. Plus o o SLOW OR RAPID SHORTNESS OF BREATH DIZZINESS LIGHTHEADED TINGLING SKIN • • HANDS – FEET CHEST PAIN WATER SAFETY THROUGH EDUCATION FLUSHED PALE ASHEN BLUISH GASPING NOISES o o o WHEEZING GARGLING HIGH-PITCHED

CHOKING: CHOKING MOST COMMON CAUSE OF RESPIRATORY EMERGENCY. Prep. Plus WATER SAFETY THROUGH EDUCATION

SKILL CHECK: CONSCIOUS CHOKING – ADULT/CHILD ü SURVEY SCENE – CHECK VICTIM. ü ASK VICTIM: “ARE YOU CHOKING? ” ü GET CONSENT. ü VICTIM CANNOT COUGH – SPEAK – BREATHE. ü 9 -1 -1. ü BEHIND VICTIM – ONE FOOT BETWEEN LEGS – KEEP YOUR HEAD TO SIDE. ü CHILD? – STAND OR KNEEL. ü PLACE FIST AGAINST ABDOMEN. ü GRAB FIST – GIVE QUICK, UPWRD THRUSTS. ü CONTINUE – OBJECT FORCED OUT – VICTIM BEGINS TO BREATHE OR COUGH FORCEFULLY – VICTIM UNCONSCIOUS. Prep. Plus WATER SAFETY THROUGH EDUCATION

RESPIRATORY DISTRESS RESPIRATORY ARREST Prep. Plus WATER SAFETY THROUGH EDUCATION

SKILL CHECK: RESCUE BREATHING -- ADULT ü SURVEY SCENE – CHECK VICTIM – CONSCIOUS? ü TAP & SHOUT – RESPONDS? NO – 9 -1 -1! ü HEAD TILT CHIN LIFT – OPEN AIRWAY – LOOKLISTEN-FEEL – 5 SECONDS. ü NOT BREATHING – MASK -- GIVE 2 RESCUE BREATHS. ü BREATHS GO IN – CHECK SIGNS OF CIRCULATION – REMOVE MASK – FEEL FOR PULSE & LOOK-LISTEN -FEEL FOR SIGNS OF CIRCULATION – NO MORE THAN 10 SECONDS. ü LOOK FOR SEVERE BLEEDING. ü YOU FIND SIGNS OF CIRCULATION – GIVE 1 BREATH PER 5 SECONDS. Prep. Plus WATER SAFETY THROUGH EDUCATION

SKILL CHECK: RESCUE BREATHING -- ADULT ü 1 MINUTE OF RESCUE BREATHING (ABOUT 12 BREATHS) – RECHECK SIGNS OF CIRCULATION & BREATHING – <10 SECONDS. ü STILL NOT BREATHING – CONTINUE RESCUE BREATHING. STOP AND CHECK EACH MINUTE. ü NO SIGNS OF CIRCULATION – GIVE CPR. Prep. Plus WATER SAFETY THROUGH EDUCATION

SKILL CHECK: RESCUE BREATHING -- CHILD ü SURVEY SCENE – CHECK VICTIM – CONSCIOUS? ü TAP & SHOUT – RESPONDS? NO – 9 -1 -1! ü HEAD TILT CHIN LIFT – OPEN AIRWAY – LOOKLISTEN-FEEL – 5 SECONDS. ü NOT BREATHING – MASK -- GIVE 2 RESCUE BREATHS. ü BREATHS GO IN – CHECK SIGNS OF CIRCULATION – REMOVE MASK – FEEL FOR PULSE & LOOK-LISTEN -FEEL FOR SIGNS OF CIRCULATION – NO MORE THAN 10 SECONDS. ü LOOK FOR SEVERE BLEEDING. ü YOU FIND SIGNS OF CIRCULATION – GIVE 1 BREATH PER 3 SECONDS. Prep. Plus WATER SAFETY THROUGH EDUCATION

IF BREATHS DO NOT GO IN üReposition the airway and try 2 breaths again ü STILL NOT GOING IN? Give up to 30 chest compressions, look in mouth, sweep if you see something and try 2 more breaths Continue until breaths go in, then repeate you’re “A-B-C” and care for conditions found

SKILL CHECK: RESCUE BREATHING – CHILD/INFANT ü SURVEY SCENE – CHECK VICTIM – CONSCIOUS? ü TAP & SHOUT – RESPONDS? NO – 9 -1 -1! ü HEAD TILT CHIN LIFT – OPEN AIRWAY – LOOKLISTEN-FEEL – 10 SECONDS. ü NOT BREATHING – GIVE 2 RESCUE BREATHS. ü BREATHS GO IN – CHECK SIGNS OF CIRCULATION - FEEL FOR PULSE (BRACHIAL) & LOOK-LISTENFEEL FOR SIGNS OF CIRCULATION – NO MORE THAN 10 SECONDS. ü LOOK FOR SEVERE BLEEDING. ü YOU FIND SIGNS OF CIRCULATION – GIVE 1 BREATH PER 3 SECONDS.

SKILL CHECK: RESCUE BREATHING -- INFANT ü 2 MINUTE OF RESCUE BREATHING (ABOUT 40 BREATHS) – RECHECK SIGNS OF CIRCULATION & BREATHING. ü STILL NOT BREATHING – CONTINUE RESCUE BREATHING. STOP AND CHECK EACH MINUTE. ü NO SIGNS OF CIRCULATION – GIVE CPR.

SKILL CHECK: UNCONSCIOUS CHOKING ADULT/CHILD/INFANT ü SURVEY THE SCENE; CHECK VICTIM – CONSCIOUS? ü TAP & SHOUT – RESPONDS? NO – 9 -1 -1! ü HEAD TILT, CHIN LIFT – OPEN AIRWAY – LOOKLISTEN-FEEL – 5 SECONDS. ü NOT BREATHING –GIVE 2 RESCUE BREATHS. ü BREATHS DO NOT GO IN – REPOSITION – GIVE 2 BREATHS AGAIN. ü BREATHS DO NOT GO IN – 30 CHEST COMPRESSIONS ü FOREIGN BODY CHECK (FINGER SWEEP IF VISIBLE AND SURE YOU CAN REACH). ü USE MASK – GIVE 2 RESCUE BREATHS. ü BREATHS STILL DO NOT GO IN – REPEAT SEQUENCE OF 5 ABDOMINAL THRUSTS – FOREIGN BODY CHECK – REATTEMPT RESCUE BREATHS.

HEART ATTACK CARDIAC ARREST

SIGNS OF A HEART ATTACK CHEST PAIN (MORE THAN 3 -5 MINUTES); PAIN/DISCOMFORT SPREADING TO SHOULDER, JAW, ARM, BACK; NAUSEA; BREATHING DIFFICULTY; SWEATING; CHANGE IN SKIN APPEARANCE; DIZZINESS OR UNCONSCIOUSNESS.

ADULT – CARDIO VASCULAR DISEASE CHILD/INFANTBREATHING EMERGENCY, BLOW TO CHEST, TRAUMA Prep. Plus WATER SAFETY THROUGH EDUCATION

CPR • • • COMBINES RESCUE BREATHING – CHEST COMPRESSIONS. CIRCULATES OXYGEN RICH BLOOD TO VITAL ORGANS MUST NOT BE DELAYED MORE SUCCESSFUL WHEN AN AED IS USED AS WELL SAVES LIVES!!!!!!!

CARDIAC CHAIN OF SURVIVAL

SKILL CHECK: CPR -- ADULT ü SURVEY SCENE – CHECK VICTIM – CONSCIOUS? ü TAP & SHOUT – RESPONDS? NO – 9 -1 -1! ü HEAD TILT CHIN LIFT – OPEN AIRWAY – LOOKLISTEN-FEEL – 10 SECONDS. ü NOT BREATHING – MASK -- GIVE 2 RESCUE BREATHS. ü BREATHS GO IN – CHECK FOR SEVERE BLEEDING. ü BEGIN CPR– LOCATE HAND POSITION – GIVE 30 CHEST COMPRESSIONS (COMPRESS ABOUT 2 INCHES) FOLLOWED BY 2 BREATHS. üCOTINUE UNTIL YOU SEE AN OBVIOUS SIGN OF LIFE, AN AED IS READY TO USE, ADVANCED CARE TAKES OVER, TOO EXHAULSTED TO CONTINUE

SKILL CHECK: CPR -- ADULT ü USE MASK – GIVE 2 BREATHS. ü REPEAT AT LEAST 3 MORE CYCLES OF 15/2 – REMOVE MASK – RECHECK SIGNS OF CIRCULATION & BREATHING FOR NO MORE THAN 10 SECONDS. ü STILL NO SIGNS – CONTINUE CYCLES OF 15/2 – RECHECK SIGNS EVERY FEW MINUTES. Prep. Plus WATER SAFETY THROUGH EDUCATION

SKILL CHECK: CPR -- CHILD ü SURVEY SCENE – CHECK VICTIM – CONSCIOUS? ü TAP & SHOUT – RESPONDS? NO – 9 -1 -1! ü HEAD TILT CHIN LIFT – OPEN AIRWAY – LOOKLISTEN-FEEL – 5 SECONDS. ü NOT BREATHING – MASK -- GIVE 2 RESCUE BREATHS. ü BREATHS GO IN – CHECK SIGNS OF CIRCULATION – REMOVE MASK – FEEL FOR PULSE & LOOK-LISTEN -FEEL FOR SIGNS OF CIRCULATION – NO MORE THAN 10 SECONDS. ü LOOK FOR SEVERE BLEEDING. ü NO SIGNS OF CIRCULATION – LOCATE HAND POSITION – GIVE 5 CHEST COMPRESSIONS USING ONE HAND (COMPRESS ABOUT 1½ INCHES). Prep. Plus WATER SAFETY THROUGH EDUCATION

SKILL CHECK: CPR -- CHILD ü USE MASK – GIVE 1 BREATH. ü REPEAT AT LEAST 11 MORE CYCLES OF 5/1 – REMOVE MASK – RECHECK SIGNS OF CIRCULATION & BREATHING FOR NO MORE THAN 10 SECONDS. ü STILL NO SIGNS – CONTINUE CYCLES OF 5/1 – RECHECK SIGNS EVERY FEW MINUTES. Prep. Plus WATER SAFETY THROUGH EDUCATION

SKILL CHECK: CPR -- INFANT ü SURVEY SCENE – CHECK VICTIM – CONSCIOUS? ü GENTLY TAP & SHOUT – RESPONDS? NO – 9 -1 -1! ü HEAD TILT CHIN LIFT – OPEN AIRWAY – LOOKLISTEN-FEEL – 5 SECONDS. ü NOT BREATHING – MASK -- GIVE 2 RESCUE BREATHS. ü BREATHS GO IN – CHECK SIGNS OF CIRCULATION – REMOVE MASK – FEEL FOR PULSE (USE BRACHIAL PULSE) & LOOK-LISTEN-FEEL FOR SIGNS OF CIRCULATION – NO MORE THAN 10 SECONDS. ü LOOK FOR SEVERE BLEEDING. ü NO SIGNS OF CIRCULATION – LOCATE FINGER POSITION. Prep. Plus WATER SAFETY THROUGH EDUCATION

SKILL CHECK: CPR -- INFANT ü GIVE 5 CHEST COMPRESSIONS IN LESS THEN 3 SECONDS USING TWO FINGERS (OTHER HAND IS ON INFANT’S FOREHEAD) (COMPRESS ABOUT ½ TO 1 INCH). ü USE MASK – GIVE 1 BREATH. ü REPEAT AT LEAST 19 MORE CYCLES OF 5/1 – REMOVE MASK – RECHECK SIGNS OF CIRCULATION & BREATHING FOR NO MORE THAN 10 SECONDS. ü STILL NO SIGNS – CONTINUE CYCLES OF 5/1 – RECHECK SIGNS EVERY FEW MINUTES. Prep. Plus WATER SAFETY THROUGH EDUCATION

SKILL CHECK: TWO-RESCUER CPR -- ADULT ü R-1: SURVEY SCENE – CHECK VICTIM – CONSCIOUS? ü R-1: TAP & SHOUT – RESPONDS? NO – 9 -1 -1! ü R-1: HEAD TILTCHIN LIFT – OPEN AIRWAY – LOOK-LISTEN-FEEL – 5 SECONDS. ü R-1: NOT BREATHING – MASK – GIVE 2 RESCUE BREATHS. ü R-1: BREATHS GO IN – CHECK SIGNS OF CIRCULATION FOR NO MORE THAN 10 SECONDS. ü R-2: NO SIGNS OF CIRCULATION – LOCATE HAND POSITION – GIVE 15 COMPRESSIONS AFTER R-1 SAYS “VICTIM HAS NO SIGNS OF CIRCULATION. BEGIN CPR. ” ü R-1: CHECKS IF COMPRESSIONS ARE EFFECTIVE FEELING CAROTID ARTERY. Prep. Plus WATER SAFETY THROUGH EDUCATION

BAG-VALVE-MASK (BVM) • • • Prep. Plus Used to move more O 2. Use for respiratory distress. Self-inflating bag – one-way valve – mask. • • • Protects against disease. Increases O 2 levels in blood. Highly effective by 2 rescuers – tight seal; effective ventilations. WATER SAFETY THROUGH EDUCATION

SKILL CHECK: BVM RESUCITATOR - TWO-RESCUERS ü R-1: SURVEY SCENE – CHECK VICTIM – CONSCIOUS? ü R-1: TAP & SHOUT – RESPONDS? NO – 9 -1 -1! ü R-1: HEAD TILTCHIN LIFT – OPEN AIRWAY – LOOK-LISTEN-FEEL – 5 SECONDS. ü R-1: NOT BREATHING – MASK – GIVES 2 RESCUE BREATHS. ü R-1: BREATHS GO IN – CHECK SIGNS OF CIRCULATION FOR NO MORE THAN 10 SECONDS – PATIENT HAS SIGNS OF CIRCULATION. ü R-1: ASSEMBLES BVM – POSITIONS MASK OF BVM. ü R-2: SEALS MASK & OPENS AIRWAY. Prep. Plus WATER SAFETY THROUGH EDUCATION

SKILL CHECK: BVM RESUCITATOR - TWO-RESCUERS ü R-1: BEGINS VENTILATIONS BY SQUEEZING BAG JUST ENOUGH FOR CHEST TO CLEARLY RISE. ü R-1: 1 VENTILATION EVERY 5 SECONDS. ü R-2: COUNTS OUT LOUD – “ONE-ONE THOUSAND, TWO-ONE THOUSAND…” ü R-1: CHECKS SIGNS OF CIRCULATION & BREATHING AFTER 12 BREATHS – NO MORE THAN 10 SECONDS. ü VICTIM HAS SIGNS OF CIRCULATION – R-1 REPLACES BVM – R-2 SEALS AND OPENS AIRWAY – R-1 CONTINUES TO VENTILATES. ü VICTIM HAS NO SIGNS OF CIRCULATION – RESCUERS BEGIN 2 PERSON CPR. Prep. Plus WATER SAFETY THROUGH EDUCATION

SKILL CHECK: TWO-RESCUER CPR -- ADULT ü R-1: USE MASK – 2 RESCUE BREATHS. ü R-1 & R-2: REPEAT 3 MORE CYCLES OF 15/2. ü R-1: REMOVES MASK – RECHECKS CIRCULATION & BREATHING – NO MORE THAN 10 SECONDS. ü NO SIGNS OF CIRCULATION – R-1 & R-2 CONTINUE 15/2 CYCLES – RECHECK EVERY FEW MINUTES. TO CHANGE POSITION— ü R-2: CALLS “CHANGE” AT END OF 15. ü R-1: GIVES 2 BREATHS. ü R-2: MOVES TO HEAD – CHECKS FOR CIRCULATION & BREATHING – NO MORE THAN 10 SECONDS. Prep. Plus WATER SAFETY THROUGH EDUCATION

SKILL CHECK: TWO-RESCUER CPR -- ADULT ü ü ü Prep. Plus R-1: MOVES TO CHEST – FINDS HAND POSITION. R-2: “NO PULSE, BEGIN CPR. ” R-1: PROVIDES 15 COMPRESSIONS. R-2: PROVIDES 2 BREATHS. R-1 & R-2: CONTINUE 15/2 CYCLES. WATER SAFETY THROUGH EDUCATION