First Responder EMS Curriculum for Training Centers in Eurasia

arrhythmias should be instructed to "phone first" (activate the EMS system before beginningCPR) if they are alone and the child suddenly collapses.Alternatively, there may be exceptions to the "phone first" approach for victims > 8 years of age,including adults. Parents of children > 8 years of age who are at high risk for apnea or respiratoryfailure should be instructed to provide 1 minute of CPR before activating the EMS system if theyare alone and find the child unresponsive. Submersion (near-drowning) victims of all ages whoare unresponsive when pulled from the water should receive approximately 1 minute of BLSsupport (opening of the airway and rescue breathing and chest compressions, if needed) beforethe lone rescuer leaves to phone the local EMS system. Trauma victims or those with a drugoverdose or apparent respiratory arrest of any age may also benefit from 1 minute of CPR beforethe EMS system is contacted. Knowledgeable and experienced providers should use commonsense and "phone first" for any apparent sudden cardiac arrest (i.e., sudden collapse at any age)and "phone fast" in other circumstances in which breathing difficulties are documented or likelyto be present (i.e., trauma or an apparent choking event).The rescuer calling the EMS system should be prepared to provide the following information:1. Location of the emergency, including address and names of streets or landmarks2. Telephone number from which the call is being made3. What happened, i.e., auto accident, submersion4. Number of victims5. Condition of victim(s)6. Nature of aid being given7. Any other information requestedThe caller should hang up only when instructed to do so by the dispatcher, and then caller shouldreport back to rescuer doing CPR.Hospitals and medical facilities and many businesses and building complexes have establishedemergency medical response systems that provide a first response or early response on-site. Sucha response system notifies rescuers of the location of an emergency and the type of responseneeded. If the cardiopulmonary emergency occurs in a facility with an established medicalresponse system, that system should be notified, because it can respond more quickly than EMSpersonnel arriving from outside the facility. For rescuers in these facilities, the emergencymedical response system should replace the EMS system in the sequences below.AirwayPosition the VictimIf the child is unresponsive, move the child as a unit to the supine (face up) position, and placethe child supine on a flat, hard surface, such as a sturdy table, the floor, or the ground. If head orneck trauma is present or suspected, move the child only if necessary and turn the head and torsoas a unit. If the victim is an infant, and no trauma is suspected, carry the child supported by yourforearm (your forearm should support the long axis of the infant's torso, with the infant's legsstraddling your elbow and your hand supporting the infant's head). It may be possible to carry theinfant to the phone in this manner while beginning the steps of CPR.350 First Responder EMS Curriculum/AIHA, July 2002