First Responder EMS Curriculum for Training Centers in Eurasia

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one per second, each with the intention of creating enough of an "artificial cough" todislodge the foreign body.6. If the airway remains obstructed, repeat the sequence of up to five back blows and upto five chest thrusts until the object is removed or the victim becomes unresponsive.b. Abdominal thrusts (Heimlich maneuver) in the responsive child1. Stand or kneel behind the victim, arms directly under the victim's armpits, encirclingthe victim's torso.2. Place the flat, thumb side of one fist against the victim's abdomen in the midlineslightly above the navel and well below the tip of the xiphoid process.3. Grasp the fist with the other hand and exert a series of up to five quick inward andupward thrusts. Do not touch the xiphoid process or the lower margins of the ribcage, because force applied to these structures may damage internal organs.4. Each thrust should be a separate, distinct movement, delivered with the intent torelieve the obstruction. Continue the series of up to five thrusts until the foreign bodyis expelled or the victim becomes unresponsive.c. Unresponsive infant1. Open the victim's airway using a tongue-jaw lift and look for an object in thepharynx. If an object is visible, remove it with a finger sweep. Do not perform ablind finger sweep.2. Open the airway with a head tilt-chin lift and attempt to provide rescue breaths. If thebreaths are not effective, reposition the head and reattempt ventilation.3. If the breaths are still not effective, perform the sequence of up to five back blowsand up to five chest thrusts.4. Repeat steps 1 through 3 until the object is dislodged and the airway is patent or forapproximately 1 minute. If the infant remains unresponsive after approximately 1minute, activate the EMS system.5. If breaths are effective, check for signs of circulation and continue CPR as needed, orplace the infant in a recovery position if the infant demonstrates adequate breathingand signs of circulation.d. Unresponsive child1. Open the victim's airway using a tongue-jaw lift and look for an object in thepharynx. If an object is visible, remove it with a finger sweep. However, do notperform a blind finger sweep.2. Open the airway with a head tilt-chin lift, and attempt to provide rescue breaths. Ifbreaths are not effective, reposition the head and reattempt ventilation.3. If the breaths are still not effective, kneel beside the victim or straddle the victim'ships and prepare to perform the Heimlich maneuver abdominal thrusts as follows:• Place the heel of one hand on the child's abdomen in the midline slightly abovethe navel and well below the rib cage and xiphoid process. Place the other handon top of the first.• Press both hands onto the abdomen with a quick inward and upward thrust. Directeach thrust upward in the midline and not to either side of the abdomen. Ifnecessary, perform a series of up to five thrusts. Each thrust should be a separateand distinct movement of sufficient force to attempt to dislodge the airwayobstruction.4. Repeat steps 1 through 3 until the object is retrieved or rescuer breaths are effective.272 First Responder EMS Curriculum/AIHA, July 2002
5. Once effective breaths are delivered, assess for signs of circulation and provideadditional CPR as needed or place the child in a recovery position if the childdemonstrates adequate breathing and signs of circulation.First Responder EMS Curriculum/AIHA, July 2002 273
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PrefaceIn the region of Central and
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Practical Lab MaterialsAirway .....
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Guidelines for Conducting the First
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sheets supplied in this guide will
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should have attended a workshop tha
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Job Description: First ResponderThe
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c. Additional Skills1. Use of the t
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as possible. After students have pr
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Guidelines for Case-Based Practical
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General Lecturing GuidelinesChapter
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discussing the different methods of
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survival. First Responders include
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medical director functions to ensur
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First Responder EMS Curriculum/AIHA
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Well-Being of the First ResponderCo
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and family. Do not become defensive
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1. Eye protection. Safety glasses m
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Legal and Ethical IssuesContents1.
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a. Expressed ConsentExpressed conse
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14. DocumentationProviding written
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The Human Body: A Systems ApproachC
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that the pharynx performs the dual
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c. Kinesthetic (Doing)1. Students w
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38 First Responder EMS Curriculum/A
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Lifting and Moving PatientsContents
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If the patient is on the floor or g
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7. Application of Content Materiala
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14. Describe how to clear a foreign
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Precautions1. Finger must not press
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. Finger SweepsThis method involves
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4. Place your other fingers along t
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. Management of the Obstructed Airw
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5. Students will practice ventilati
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19. Explain what additional questio
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can be determined by questioning th
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Determine estimated time of arrival
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E - Events Leading to the Injury or
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c. Kinesthetic (Doing)1. Students w
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100 First Responder EMS Curriculum/
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CirculationContents1. Objectivesa.
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Veins are the vessels that carry bl
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Step 5:Step 6:Step 7:Step 8:Step 9:
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Steps of Infant CPRStep 1: Assess r
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a. Use of the Semiautomatic Externa
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PracticalEvaluate the actions of th
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Medical EmergenciesContents1. Objec
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5. Demonstrate the steps in providi
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additional emergency medical person
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this internal temperature, adverse
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Signs and SymptomsSigns and symptom
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3. Ask questions in a calm, reassur
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EvaluationWrittenDevelop evaluation
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2. Attend to the feelings of the pa
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transmission of disease to yourself
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Sharp, pointed objects cause penetr
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c. Chemical BurnsChemical burns fro
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6. Partial-thickness burns7. Full-t
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2. Demonstrate opening the airway i
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3. Try to pad the extremity to prev
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soft tissue injuries. Remember, the
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2. IntroductionChildbirth can occur
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a. Delivery ProceduresWhen assistin
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5. Student Activitiesa. Auditory (H
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Infants and ChildrenContents1. Obje
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Suctioning the airway also is an im
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6. Common Problems in Infants and C
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Remember that parents will be in ag
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Vigorous shaking of a baby may show
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Page 251 and 252: First Responder EMS Curriculum/AIHA
Page 253: First Responder EMS Curriculum/AIHA
Page 256 and 257: 3. DispatchDispatch is the communic
Page 258 and 259: in the absence of airway problems,
Page 265 and 266: Documentation and Quality Managemen
Page 267 and 268: Identify concrete, specific project
Page 273 and 274: Practical Lab: AirwayObjectives1. C
Page 275: 6. Students will practice insertion
Page 278 and 279: Assistant Instructor:The instructor
Page 281 and 282: Practical Lab: CirculationObjective
Page 283 and 284: Practical Lab: Illness and InjuryOb
Page 285 and 286: Instructor will demonstrate the pro
Page 287: 19. Students will practice manual s
Page 290 and 291: Assistant InstructorThe instructor-
Page 293 and 294: Practical Lab: Lifting and Moving P
Page 295: EvaluationPracticalEvaluate the act
Page 298 and 299: 4. Insert it posteriorly. Bevel sho
Page 300 and 301: • 20 breaths per minute for child
Page 305 and 306: Skill Descriptions: Patient Assessm
Page 307 and 308: Skill Descriptions: CirculationNote
Page 309 and 310: 4. To determine whether the victim
Page 311 and 312: • Place the two fingers of one ha
Page 313 and 314: Skill Descriptions: Illness and Inj
Page 315: • Apply enough pressure to contro
Page 318 and 319: 12. As the feet are delivered, gras
Page 320 and 321: 2. The rescuer at the head places o
Page 322 and 323: Skill Algorithms: AirwayForeign Bod
Page 325 and 326: Trauma PatientSkill Algorithms: Pat
Page 327: Skill Algorithms: Patient Assessmen
Page 330 and 331: Two-Person CPRSkill Algorithms: Cir
Page 333 and 334: External BleedingSkill Algorithms:
Page 335: Skill Algorithms: Illness and Injur
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Page 341 and 342: Skill Algorithms: Lifting and Movin
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Page 347: Sample Case Scenario - Patient Asse
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Sample Case Scenario - Childbirth a
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• Demonstrate the extremity lift.
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Figure 6. Check for unresponsivenes
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Head Tilt-Chin Lift ManeuverTo acco
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help. Monitor the victim, particula
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necessary to open the victim's mout
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In the second technique (lateral te
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is important to note that this smal
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CirculationAssessment: No Pulse Che
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these arteries even when hypotensio
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the nipples. This method has been u
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Current evidence indicates that the
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assess the victim's responsiveness
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arrhythmias should be instructed to
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jaw lift, for use in unresponsive v
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Figure 29. Mouth-to-mouth breathing
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Types of Ventilation Bags (Manual R
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Gastric Inflation. Increasing inspi
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. Specificity (ability to correctly
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After provision of approximately 20
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Chest Compression in the Infant (<
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ventilation after every fifth compr
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Coordination of Compressions and Re
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necessary to maintain optimal venti
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5. Keep foreign objects (i.e., marb
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Figure 38. Subdiaphragmaticabdomina
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tongue. Then use a hooking action t
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APPENDIX DRelief of Foreign-Body Ai
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Figure 41. Infant back blows to rel
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4. Repeat steps 1 through 3 until t
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6. It may be necessary for the Firs
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18. The correct rate to deliver che
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30. What is the greatest danger to
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First Responder Post-Course Test1.
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12. Which of the following statemen
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24. Components of an ongoing assess
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36. An adult patient sustains burns
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48. Which of the following is true?
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First Responder Extra Test Question
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11. Negligence is the deviation fro
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Answer KeyFirst Responder Extra Tes
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First Responder EMS Curriculum for Training Centers in Eurasia

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