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Advanced Resuscitation Techniques CertificateLearner Guide
PUAEME003C Administer oxygen in an emergency situationPUAOPE010C Operate an automated external defibrillator in an emergencyHLTFA404A Apply advanced resuscitation techniquesSeptember 2012
Candidate Name:
Assessment ID:
Registered Training Organisation 21799
THIS BOOK MUST BE COMPLETED IN FULL AND RETURNED TO LIFE SAVING VICTORIA BEFORE AWARD PROCESSING WILL BEGIN
1
Advanced Resuscitation Techniques Certificate
Learner Guide
Plagiarism declaration:
All of the information and evidence provided in and attached to this workbook is authentic and my own work.
Candidate signature: Date: / /
2 Advanced Resuscitation Techniques Certificate Learner Guide
Acknowledgments
This education resource has been developed by the Australian Lifesaving Academy.
Surf Life Saving Australia (SLSA) wishes to thank the editorial team for who developed the resources
for this course:
Marcia Fife (Surf Life Saving Queensland), Debbi Booth (Surf Life Saving New South Wales), Nikki
Chubb (Surf Life Saving New South Wales), Roslyn McMahon (Surf Life Saving New South Wales),
Robert O’Brien (Surf Life Saving Australia) and Bob Powell (Surf Life Saving New South Wales).
SLSA would also like to acknowledge the following people who contributed their time and expertise to
support the development of this resource:
Surf Life Saving Sydney Branch members: Michael Bretherton, Gary Daly, Keith Grima, Marissa Jank
and Peter Quartly.
Life Saving Victoria (LSV) wishes to acknowledge the following people who contributed their time and
expertise to adapting this resource for Victoria:
• StuartWall–Director–StateTrainingandAssessment
• DanielleSmith–StateResearchResourceandDevelopmentOfficer
• MurrayColvin–FirstAidandEmergencyCareSpecialInterestGroupMember
• EmmaEichhorn–BrightonLifeSavingClub
• JeremySturges–BrightonLifeSavingClub
SLSA would like to acknowledge the financial support it has received from the Federal Department
ofEducation,EmploymentandWorkplaceRelations.Theviewsexpressedhereindonotnecessarily
represent the views of the Commonwealth of Australia. The Commonwealth of Australia does not give
any warranty or accept any liability in relation to the content of this work.
© Surf Life Saving Australia Ltd 2011.
This work is copyright, but permission is given to SLSA trainers and assessors to make copies for
use within their own training environment. This permission does not extend to making copies for use
outside the immediate training environment for which they are made, or the making of copies for hire
or resale to third parties.
For permission outside these guidelines, apply in writing to:
Surf Life Saving Australia
Locked Bag 1010, Rosebery NSW 2018
Ph: (02) 9215 8000
Fax: (02) 9215 8180
Web www.sls.com.au
For information on other training programs available from the Australian Lifesaving Academy please
visit our website at www.ala.edu.au
3Advanced Resuscitation Techniques Certificate Learner Guide
Contents
Acknowledgments 2Terminology 5Icons 6CourseIntroduction 7
Prerequisites 7Courseoutcomes 7Your current skills and knowledge 8What you need to complete this course 9How to use this Learner Guide 9
How to supply feedback on improving this resource 9Course enrolment 11VETCodeofPractice 12Topic1–FirstAidandResuscitationReview 14
Introduction 14Reviewoffirstaidandresuscitationprinciplesandlegalities 14Activity(individual)1.1:Advancedresuscitationandthechainofsurvival 17Emergencyactionplan 17Activity (group) 1.2: Jaw thrust 19Activity (group) 1.3: CPR review 20Assessment Task 1: Written questions 22
Topic2–AdvancedResuscitationandOxygenAdministration 23Why use oxygen? 23Respiratory system 23Oxygenresuscitationequipment 27Activity (group) 2.1: Oxygen equipment 30Routine check of equipment 30Oxygen equipment 31Activity (group) 2.2: Routine equipment checks 32Storing oxygen equipment 32Administering oxygen therapy 32Mouth-to-mask resuscitation with oxygen 33Airbag oxygen resuscitator 33Airbagchecks 34Activity(group)2.3:Airbagchecks 34AssessmentTask2:Peerassessment–oxygenequipmentchecks 34Usingoxygenandairbagduringresuscitation 34Activity(group)2.4:CPRwithoxygen 36Equipmentmaintenance 36AssessmentTask1:Writtenquestions 36Oropharyngealairways 37Activity(group)2.5:InsertingOPairways 39AssessmentTask3:Peerassessment–oropharyngealairway 39Assessment Task 1: Written questions 39
4 Advanced Resuscitation Techniques Certificate Learner Guide
Topic3–Suction 40Suction 40Activity(individual)3.1:Suctionequipment 42Activity(group)3.2:Administeringsuction 43AssessmentTask4:Peerassessment–suction 43AssessmentTask1:Writtenquestions 43
Topic4–Defibrillation 44Whatisdefibrillation? 44Circulatorysystem 44Electrocardiogram(ECG) 46Automatedexternaldefibrillators(AED) 47Defibrillationpads 49AEDoperation 50Set protocols for shock delivery 51Activity(group)4.1:ApplyinganAED 52Post-defibrillation casualty care 52Post-defibrillation equipment maintenance 52Assessment Task 1: Written questions 52Activity(group)4.2:Usingoxygenequipment,oropharyngealairways, suctionandanAEDduringresuscitation 53
AssessmentInformation 54AssessmentTasks 54Assessmenttask1:Writtenquestions 54AssessmentTasks2,3and4:Peerassessment 54Assessmenttask5:Scenario–airwaymanagementandoxygenuse 55AssessmentTask6:Scenarioreview–verbalquestions 56Assessmenttask7:Scenario–defibrillation 56Assessmenttask8:Incidentdocumentation 56
AssessmentPortfolio 57Learnerdetails 57Competencyrecord 57Assessment Summary 58
Assessment task 1: Written questions 59Assessmenttask2:Peerassessment–oxygenequipmentchecks 65Assessmenttask3:Peerassessment–OPairway 66Assessmenttask4:Peerassessment–suction 67AssessmentRask8:Incidentdocumentation 68Courseevaluation 71AdvancedResuscitationTechniquesCertificate–checklist 73
5Advanced Resuscitation Techniques Certificate Learner Guide
Terminology
The following terms are used throughout this guide.
Arrhythmia an abnormal rhythm of the heart
Perfused the passage of a fluid through the vessels of a specific organ or tissue
Occlude to obstruct the path. Also used to describe blocking the vent on a suction catheter used with an oxygen or electric powered device, which then ensures that air is drawn through the end of the catheter, creating the suction
Stress a disturbing physiological or psychological influence which produces a state of severe tension in an individual
Agonal respirations intermittent gasps from a casualty who is unresponsive. Agonal respirations are not classed as normal breathing.
Pre-operational check inspection and testing of equipment to confirm its suitability for its intended purpose before commencing shift as a first aider
6 Advanced Resuscitation Techniques Certificate Learner Guide
Icons
The following icons (symbols) are used throughout Australian Lifesaving Academy training resources to indicate the types of activities you will be undertaking as you work through your course.
Course Aim and ObjectivesThis icon is used to bring attention to the course aim and objectives.
ReadingThis icon indicates that learners are required to undertake an individual reading task.
Individual Learning ActivityThis icon indicates that learners are required to undertake an individual learning activity. This will usually involve the documenting of individual thoughts and ideas.
Group Learning ActivityThis icon indicates that learners are required to undertake a group learning activity. Group activities may be completed in pairs, trios or larger groups.
Case StudyThis icon indicates that learners are required to undertake an analysis of a particular case or situation used as a basis for drawing conclusions in similar situations.
Remember this!This icon is used to recap important and critical issues or content that learners should pay particular attention to.
Assessment ActivityThis icon indicates that learners are required to undertake an individual assessment of their skills and/or knowledge. This may involve completion of a scenario, a set of multiple choice questions and/or a written exam.
7Advanced Resuscitation Techniques Certificate Learner Guide
CourseIntroduction
The aim of the Advanced Resuscitation Techniques Certificate course is to develop your skills and
knowledge to use oxygen, airway management devices, and automated external defibrillators during
resuscitation, and to administer oxygen to conscious or unconscious breathing casualties.
You will also develop knowledge and skills to enable you to demonstrate competence in the nationally
recognised units of competency:
•HLTFA404CApplyadvancedresuscitationtechniques
•PUAEME003CAdministeroxygeninanemergencysituation
•PUAOPE010COperateanautomatedexternaldefibrillatorinanemergency
The Public Safety Training Package units (units starting with PUA) form a part of the nationally
recognisedPUA31310CertificateIIIinPublicSafety(AquaticSearchandRescue).
PrerequisitesCandidates must meet ALL of the following conditions:
• beatleast15yearsofageonthedateoffinalassessment
• holdONEofthefollowingSLSAawards:
– BronzeMedallion/CertificateIIinPublicSafety(AquaticRescue),OR
– Basicemergencycarecertificate,OR
– Apply(Senior)firstaidcertificate,OR
– Resuscitationcertificate
• HavealreadyachievedONEofthefollowingunitsofcompetency:
– HLTCPR201A/BorHLTCPR211A-PerformCPR,OR
– HLTFA201A/BorHLTFA211A-Providebasicemergencylifesupport,OR
– HLTFA301B/CorHLTFA311A-Applyfirstaid
Course outcomesBy the end of this course, you should be able to:
•assessthecasualtyanddevelopamanagementplan
•checkresuscitationequipment
•maintainanairwayby:
– usingsuction
– usingoropharyngealairways(OPairways)
•resuscitateacasualtyusingoxygen
•useoxygentoprovidetherapy
•recoverandrestoreoxygenequipment
•checkdefibrillationequipment
•attachandoperateadefibrillator
•recoverandrestoredefibrillationequipment.
8 Advanced Resuscitation Techniques Certificate Learner Guide
Your current skills and knowledgeYou may already have some of the required skills and/or knowledge for this course. Perhaps you have
completed similar training activities in previous work, learned them from performing your job or in
another training course.
IfyoucandemonstratetoyourFacilitator/Assessorthatyouarecompetentinaparticularunitof
competency, you will not need to repeat the training for it. This is called Recognition of Prior Learning
or RPL.
Ifyoufeelconfidentyoualreadyhavesomeorallofthecompetenciesdeliveredinthiscourse,ask
yourFacilitator/AssessorforacopyoftheRPLInformationKitwhichincludesaSelf-Assessment
Checklist. You can check if you are likely to be found competent by completing the checklist.
Ifyoufeelthatyoucandemonstratecompetency,talktoyourFacilitator/Assessorabouthavingthis
formally recognised. Your Facilitator/Assessor will then help you to provide evidence of competency.
Competency can be demonstrated in a number of ways, and most commonly it is done by:
•showingthatyoualreadyhavearecognisedqualificationwhichdeliveredthesameunit/sof
competency OR
•undertakingtheassessmenttasksforthecourse.
Talk to your Facilitator/Assessor for more information about RPL.
9Advanced Resuscitation Techniques Certificate Learner Guide
What you need to complete this courseYou need:
•atrainer/facilitator
•acopyofthisLearnerGuide
•accesstoaCPRtrainingmanikin
•accesstooxygenequipment
•accesstoasuctiondevicefortraining
•accesstoatrainingdefibrillator
•tobeapartofatrainingsquadoffourorhaveadditionalpersonneltoparticipateintraining
scenarios with you.
How to use this Learner Guide• thiscoursewillbedeliveredusingavarietyofstrategiesforlearning
• readthroughtheguidecarefully.Thetopicscovertheknowledgeandskillsrequiredtocomplete
this course and to prepare you for the assessment activities
• workthroughtheinformationandcompletetheactivities
• youwillbesupportedbyyourTrainer/Facilitatorwhowillshowyouthecorrectwaytodothings
• therewillbeopportunitiesforyoutoaskquestionsandseekguidancewhileworkingthroughthe
guide
• oncompletionofthecourseyouwillbeaskedforfeedback.
How to supply feedback on improving this resourceAll resources developed by the Australian Lifesaving Academy are reviewed at least annually and
updatedasrequired.FeedbackcanbesuppliedthroughtheonlineImprovementRequestsformon
the Resource Development Page at www.sls.com.au or in writing to:
TrainingImprovementRequestsSurfLifeSavingAustraliaLockedBag1010
RoseberyNSW2026
10 Advanced Resuscitation Techniques Certificate Learner Guide
11Advanced Resuscitation Techniques Certificate Learner Guide
Course enrolment
TO ENROL
Simply fill in the enrolment form and submit with your completed learner guide to your assessor or directly to:
LifeSavingVictoriaPOBox353SouthMelbourneDCVIC3205 | Phone0396766900 | Fax0396818211
Course type: Advanced Resuscitation Techniques Certificate
Course Venue Course Date / /
ENROLMENT FORM [all fields are mandatory]
Mr Miss Ms Mrs Other (tick one box) First Name Surname
Residential Address Postcode
Postal Address (if different from residential) Postcode
Phone(h) Phone(w) Mobile Email
Male Female Date of Birth / / Victorian Student Number (if known)
1) CULTURAL BACKGROUND & LANGUAGE
Were you born in Australia? Yes No (if no, please specify)
DoyouspeakalanguageotherthanEnglishathome? No,Englishonly Yes, other (please specify)
HowwelldoyouspeakEnglish?(tickonebox) Very well Well Not well Not at all
AreyouofAboriginalorTorresStraitIslanderorigin? No Yes, Aboriginal Yes,TorresStraitIslander
2) MEDICAL CONDITION
Do you consider yourself to have a disability, impairment or long term condition? Yes No (if yes, tick any of the applicable boxes below)
Vision Hearing/Deaf Intellectual AcquiredBrainImpairment MentalIllness
Learning Physical Medical Condition Other (please specify)
3) EDUCATION
WhatisyourhighestCOMPLETEDschoollevel?(tickoneboxonly)
Year 12 or equivalent Year 11 or equivalent Year 10 or equivalent Year 9 or equivalent Year 8 or below
Inwhichyeardidyoucompletethatschoollevel? Areyoustillattendingsecondaryschool? Yes No
4) PRIOR QUALIFICATIONS
Have you successfully completed any of the following qualifications? (see below) Yes No (if yes, please tick appropriate boxes)
Bachelor Degree or Higher Advanced Diploma or Associate Degree Diploma CertificateIV
CertificateIII CertificateII CertificateI Certificate other than above
5) EMPLOYMENT
Of the following categories, which best describes your current employment status? (tick one box only)
Full-timeEmployee SelfEmployed–Notemployingothers Part-timeEmployee
Employer NotEmployed–Notseekingwork Employed–Unpaid,workinginafamilybusiness
Unemployed–Seekingfull-timework Unemployed–Seekingpart-timework
6) STUDY REASON
Of the following categories, which best describes your main reason for undertaking this course/traineeship/apprenticeship? (tick one box only)
To get a job To develop my existing business To start my own business
To try for a different career To get a better job or promotion Itwasarequirementofmyjob
Iwantedextraskillsformyjob To get into another course of study For personal interest or self-development
Other reasons
IhavereadandunderstoodtheVETCodeofPracticeandterms&conditionsattached Signed Date / /
12 Advanced Resuscitation Techniques Certificate Learner Guide
VETCodeofPractice
Life Saving Victoria (LSV) has developed a Code of Practice to address and establish its commitment to the maintenance of high standards in the provision of vocational education and training. This code of practice pervades all policies and procedures and it is a requirement ofemploymentthatallLSVpersonnel(includingfull-time&casualemployeesandvolunteers),members and clients abide by it.
LEGISLATIONInformationaboutcurrentlegislativeandregulatoryrequirementseffectingparticipant’strainingcan be found in:• VictorianRegistration&QualificationsAuthority:providesfortheadministrationofa
vocational education and training system www.vrqa.vic.gov.au Australian Quality Training Framework: www.training.com.au
• OccupationalHealthandSafetyAct2004:providesfordutiesandobligationsrelatedtoworkplace health and safety.
• EqualOpportunityAct1995:providesforprohibitionofdiscriminationandotherspecifiedconduct and provides for the investigation into complaints in relation to discrimination.
• HealthAct1958:Specifically–Health(InfectiousDiseases)Regulations2001
All of the above are available on the Victorian Legislation and Parliamentary Documents website: www.legislation.vic.gov.au• FederalPrivacyAct:Relatingtothecollection,useandstorageofpersonaldataisavailable
on: www.privacy.gov.au• www.comlaw.gov.au
ACCESS, EQUITY, PARTICIPANT SELECTION AND ADMISSIONEveryparticipantwhomeetstheentryrequirements(ifapplicable)asprescribedbytheappropriate Training Package will be accepted into any training/assessment program.
LSV incorporates the principles of equity into all programs.
LSV’s personnel have been instructed in their responsibilities with regards to Access and Equityprinciples.
Participants have equitable access to all programs irrespective of their gender, culture, linguistic background, race, location or socio-economic background.
InthePublicSafetyIndustrythereis,duetothenatureofworkperformed,arequirementfor the majority of people to be able-bodied. However, to enable participation in the training offered by LSV by all members of the community, special needs may be addressed in relation to those units, which can accommodate special needs.
This will see all non-discriminatory enrolment criteria fulfilled along with further aquatic safety evaluation, deemed necessary by LSV and upon the advice of special interest groups.
The importance of water safety, rescue and survival cannot be over stressed when conducting training for aquatic based community rescue activities, for all training conducted under the auspices of LSV. (Further detail regarding participation requirements please refer to the Limiting and Permanent Disability Policy).
Some programs may have a limited number of vacancies and these will be filled in a chronological order upon completion of enrolment.
Admission procedures will therefore be free of discrimination, and if an individual does not meet entry requirements, all attempts are made to assist them to identify alternative courses of action.
NATIONAL RECOGNITION AND RECOGNITION OF PRIOR LEARNINGLSV recognises the Australian Qualifications Framework (AQF) qualifications and statements of attainment issued by any other Registered Training Organisation (RTO). Where relevant national recognition of qualifications is applied at no cost to the candidate.
Recognition of prior learning/current competence assessment is available to all participants. Participants wishing to be assessed in this mode can either provide sufficient evidence of competence or undertake the required assessment tasks. Participants wishing to apply for Recognition should contact their trainer/assessor. A fee may apply to Recognition of prior learningassessments.Ifthereisacost,thiswillbeevaluatedonanindividualbasisinrelationto the amount of work required and the level of assessor involvement required.
ENROLMENT INDUCTION AND ORIENTATIONLSV conducts an enrolment, induction and orientation program for all participants. This program reviews the Code of Practice and also includes the completion of an enrolment form and any specific needs of the individual participant with regard to:
• language,literacyandnumeracysupport;• venuesafetyandfacilityarrangements;• relevantlegislativerequirementsandaccessibility;• reviewofthetrainingandassessmentprogramandflexiblelearningandassessment;• participantsupport,welfareandguidanceservicesarrangements;• appealsandcomplaintsprocedures;• disciplinaryprocedures;and• recognitionarrangementsandcredittransfer.
PRIVACYLSV collects personal information solely for the purpose of operating under the Australian Quality Training Framework administered by the Victorian Government who is the registering authority. Pursuant to this role the registering authority may require the release of your personal information for the purposes of audit and survey. This may include surveys conducted by The Social Research Centre on behalf of the National Centre for Vocational EducationResearch(NCVER)whocollectinformationaboutpeoplewhohavecompletedrecognised vocational training in the previous calendar year and provides information on vocational education and training in Australia to governments, the education and training sector, industry and the community. Under the National Privacy Principles you can access personal information we hold on you and you may request the correction of information that is incorrect or out of date.
MARKETINGShould LSV market or advertise its products and services, it will do so in an ethical manner. LSV will market its products and services with integrity, accuracy and professionalism, avoidingvagueandambiguousstatements.Intheprovisionofthisinformation,nofalseormisleading comparisons will be drawn with any other provider or course. Specific course information, including content and vocational outcomes is available prior to enrolment.
Ethical Marketing Practices:LSV will adopt policies and management practices which maintain highly professional standards in the marketing and delivery of its products and services and which safeguard the interests and welfare of all participants.
LSV will maintain an educational environment that is conducive for all participants to achieve the pre-determined competencies.
LSV will always gain a participant’s written permission before using information about that individual in any marketing materials and will respect any conditions of permission imposed by the participant.
LSV will always accurately represent training products and services to prospective participants.
LSV ensures that participants are provided with full details of conditions in any contractual arrangements with the organisation.
Accurate and Clear Marketing:Where advertisements and/or advertising materials refer to LSV’s RTO status, the products and services covered by the organisation’s scope of registration are clearly identified. LSV only advertises those AQF qualifications it is registered to issue. Advertisements and advertising materials utilised by LSV identify nationally recognised products separately from courses recognised by other bodies or without recognised status. The names of training packages, qualifications and/or accredited courses listed in advertising materials utilised by LSV comply with the names/titles recognised by the State Registration Authority. Full information on specific courses is available from LSV prior to enrolment.
LANGUAGE, LITERACY AND NUMERACYLSV recognises that all vocational training includes language, literacy and numeracy tasks and all LSV trainers and assessors provide:• materials,resourcesandassessmenttoolsandtasksthatdonotrequireparticipantsto
have language, literacy and numeracy skills of more complexity than those used in the workplaceforthecompetenciesbeingtaught/assessed;
• clearmodelsofthelanguage/literacy/numeracytask;• opportunitiesforrepeatedandsupportedpractice;and• opportunitiesforindependentpractice
Where some participants require additional practice and training, LSV arranges appropriate language, literacy and numeracy support.
DELIVERYLSV ensures that all resources meet the requirements of the relevant endorsed training package(s) and/or accredited course(s), for the delivery, assessment and issuing of qualifications, LSV affirms that it has in place and applies the following resources:• deliverypersonnelwithappropriatequalifications,andexperience,includingassessor
requirementsasidentifiedintherelevantTrainingPackageassessmentguidelines;• deliveryandassessmentresourcesappropriatetothemethodsofdeliveryandassessment
requirements;and• relevantTrainingPackageand/oraccreditedcoursedocumentsandsupportmaterials,
with necessary copyright authorisations
Delivery strategies utilised by LSV are always selected to best achieve the required elements of competence while giving full consideration to the learning style of the participant. The provision of training may include a flexible combination of off and on-the-job delivery and assessment.
ASSESSMENTLSV has demonstrable experience and skill in providing or facilitating assessments which meet the endorsed components of relevant training package(s) and/or accredited courses in the areas of recognition sought. LSV is committed to ensuring valid and reliable assessment of achievements against industry competency standards and all assessment undertaken by LSV remains consistent with the National Assessment Principles and the requirements of Training Packages.
Assessment Principles:LSV ensures that all assessment conducted within the organisation is reliable, flexible, fair and valid.• Reliable–Allassessmentmethodsandprocedureswillensurethatunitsofcompetency
are assessed consistently and that there is always consistency in the interpretation of evidence.
• Flexible–Assessmentwillbeofferedintheworkplace(on-the-job),inthetrainingenvironment (off-the-job), in a combination of both or via recognition of prior learning/recognition of current competence. LSV will ensure that all assessment methods and practices allow for diversity with regard to how, where and when competence has been/will be acquired.
• Fair–Assessmentmethodsandprocedureswillnot,underanycircumstance,disadvantage any participant.
• Valid–Assessmentactivitieswillalwaysmeettherequirementsasspecifiedintheunitof competency. Sufficient evidence will always be collected, and will be relevant to the standard/module being assessed.
13Advanced Resuscitation Techniques Certificate Learner Guide
Assessment Pathways:LSV offers participants a number of assessment pathways appropriate to the qualification outcome. Assessment conducted for the purposes of national recognition may lead to a part or a full qualification under the Australian Qualifications Framework (AQF). The main assessment pathways to a qualification can be listed as follows:• off-the-jobtrainingandassessment• workplaceassessment• recognitionofpriorlearning/recognitionorcurrentcompetence• nationalrecognition/credittransfer• on-the-jobtrainingandassessment
Assessor Qualifications:LSV ensures that personnel involved in assessment activities always meet the assessor requirements as set by either:• theassessmentguidelinesoftrainingpackages;and/ortheassessmentrequirements
ofaccreditedcourses;IfLSVpersonneldonothavethevocationalcompetencetoassess identified areas, appropriately qualified personnel will be employed to provide this expertise within the assessment process. LSV may also utilise auspiced assessment arrangements in situations where individual LSV personnel do not meet the total assessor requirements. Such auspiced arrangements may involve LSV personnel assessing in conjunction with workplace supervisors, industry specialists and/or qualified external assessors.
Assessment Resources:LSV, when designing assessment resources, ensures that all aspects of competence are covered, including:• taskskills(performanceofindividualtasks);• taskmanagementskills(managinganumberofdifferenttaskswithinthejob);• contingencymanagementskills(respondingtoproblems,breakdownsandchangesin
routine);and• job/roleenvironmentskills(dealingwiththeresponsibilitiesandexpectationsofthe
workplace)
All assessment reporting systems will indicate the units of competency that the individual has attained.
Conducting Assessment:When conducting assessment, LSV ensures it has personnel with appropriate qualifications and adheres to the requirements of the Training Package and the Australian Qualifications Training Framework Standards for Registered Training Organisations.
LSV ensures that the personnel conducting assessment utilise appropriate methods for recording, storing and accessing assessment outcomes.
Assessment activities undertaken by LSV always follow the methodology outlined below:1. Assessment procedures are fully explained to participants. Throughout all training,
participants are regularly reminded of the ongoing opportunity to be assessed when they are ready.
2. Opportunities for Recognition (recognition of prior learning/recognition of current competence and credit transfer) are also discussed, as are any available flexible methods of assessment. The appeals and reassessment process is also outlined.
3. The assessment requirements of the unit(s) of competence/module(s) are outlined, and any particular arrangements for the workplace/training environment are arranged.
4.Allevidence-gatheringmethodsremainreliable,flexible,fairandvalid.5. As assessments are undertaken, LSV trainers/assessors record individual participant
assessment results. Sample copies of the assessment instrument are kept by the trainer/assessor.
6.Post-assessmentguidanceisalwaysavailabletoparticipants.7.Studentswillbegiventheopportunityforatleastonereassessmentforanycompetencies
not achieved on the first attempt.8. A fair and impartial appeals process is always available.9.Evaluationofassessmentprocessesandproceduresisgatheredonanon-going
(informal) basis.
EvidencegatheringmethodscommonlyutilisedbyLSVinclude,butareinnowaylimitedto:• graphicpresentation • questioning• projects/assignments • workplaceperformance• audio/visualdisplay • role-play• writtentests • simulation• skillsportfolio • oralpresentation• demonstration
CHEATING AND PLAGIARISMCandidates must not engage in any action that provides an unfair advantage or disadvantage to themselves or any other person in any assessment situation. Plagiarism, collusion, fabrication and cheating are not acceptable.
COMPLAINTSParticipantfeedbackisimportanttothecontinuousimprovementoftheVETservicesprovided by LSV. Should a participant have a complaint about a training course, the participantshouldcontacttheManager–TrainingServices.
Where training is conducted for a member by a lifesaving club, the participant can make their initial complaint to their club committee representative responsible for training and assessment,generallytheclubChiefInstructor.Allcomplaintsmadeinwritingwillreceiveawritten response. Appeal to the outcome of a complaint is available and will be heard by an independent person/panel.
APPEALS PROCESSAn appeals and reassessment process is an integral part of all training and assessment pathways leading to a nationally recognised qualification or Statement of Attainment under the Australian Recognition Framework.
AfairandimpartialappealsprocessisavailabletoparticipantsofLSV.Ifaparticipantwishesto appeal his/her assessment result, he/she may first discuss the issue with the trainer/assessor.Iftheparticipantwouldliketoproceedfurtherwiththerequestafterdiscussionswith the trainer/assessor a formal request is made in writing outlining the reason(s) for the appeal. LSV’s time period for the acceptance of appeals is 28 days after the participant has been informed of the results of their assessment.
Everyeffortismadetosettletheappealtoboththeparticipant’sandLSV’ssatisfaction.Eachappealmaybeheardbyanindependentpersonorpanel.Eachappellanthasanopportunityto formally present his or her case and is given a written statement of the appeal outcomes, including reasons for the decision. Should the outcome not be acceptable to the participant, they will be informed, in writing, of the opportunity to lodge a complaint with the Victorian Qualifications Authority.
FEES, CHARGES & REFUNDSWhere a program is conducted by a lifesaving club, the club will be invoiced the set fees and charges upon issue of the certification. Standard terms will apply to the payment of invoices. LSV does not receive payment of course fees more than ten weeks in advance of a course.
Cancellation Fee:As per club guidelines
Transfer Fee:As per club guidelines
TESTAMURSIssuance of TestamursThe LSV will issue a Certificate where a participant has successfully completed all the requirements for a qualification (as specified in the appropriate Training Package).
When a Certificate for a qualification is issued, a Statement of Attainment listing all the units of competency or modules that the participant has completed for that Certificate will also be issued.
A Statement of Attainment will be issued to participants when they withdraw or cancel their enrolment in the qualification. However, a Statement of Attainment will only be issued if a participant has successfully completed one or more units of competency or modules or an accredited short course, but has not otherwise met the requirements for a qualification (as specified in the appropriate Training Package). The Statement of Attainment will list all of the units of competency or modules completed by the participant.
Forfeiture or Returning TestamursThe LSV may forfeit a Certificate or require the participant to return a Certificate to the issuing RTO in circumstances where:• theQualification/Certificate/StatementofAttainmenthasbeenimproperlyobtained• applicationismadeforareplacementCertificateduetodamageorlegalnamechange• aQualification/Certificate/StatementofAttainmenthasbeenproducedinerror
Reprinting TestamursReprint of Certificates or Statements of Attainment which contain an error are processed and issued at no charge to the participant. Reprint of lost Certificates or Statements of Attainment will incur a fee of $5.50.
PARTICIPANT WELFARE, GUIDANCE AND SUPPORT SERVICESAll participants of the LSV RTO are treated as individuals and are offered advice and support services which assist participants in achieving their identified outcomes.
LSV does not offer formal welfare or guidance services but every effort will be made to assist participants to access appropriate support agencies.
DISCIPLINARY PROCEDURESAll LSV participants are expected to take responsibility, in line with all current workplace practices and legislation, for their own learning and behaviour during both on- and off-the-job training and assessment. Any breaches of discipline will result in the participant being given a verbal warning. Further breaches will result in the participant having to “show cause” as to why they should not be excluded from further participation in the program.
ACCESS TO PARTICIPANT’S RECORDSEachparticipant’srecordsareavailabletothemonrequest.Participants’recordsarenotavailable to other people unless LSV is requested in writing by the participant to allow such access.
WAIVERImeettheprerequisiterequirementsofthecourseIamenrollinginaboveandhaveattachedevidence for non-LSV qualifications.
Irecognisethatthecomponentsoftheaquaticcoursesinvolveactivitiesthatmaybecarriedout in both deep and shallow water, some of which are quite strenuous and require a reasonableleveloffitnessandswimmingability.IauthoriseLSVtoobtainmedicalassistancethattheydeemnecessaryshouldanymedicalproblemoraccidentoccur,andIagreetopayallmedicalexpensesincurredonmybehalfandIfurtherauthorisequalifiedmedicalpractitioners to administer an anaesthetic if necessary.
Itakefullresponsibilityforanyinjury,illness,lossordamagetomypersonand/orpropertythat may directly or indirectly result from my participation in the training program. This waiver, release and discharge shall be and operate separately in favour of all persons, corporations and bodies involved or otherwise engaged in promotion or staging the training program and the servants, agents, representatives and officers of any of them and shall so operate whether or not the loss, injury or damage is attributed to the act neglect of any or more of them.
Iagreetodiscloseanydisability,medicalorotherissuethatmayinhibitmyabilitytoundertaketheprogramasoutlined/Iknowofnoreasonmedicalorotherwisethatwouldinhibit me from participation.
14 Advanced Resuscitation Techniques Certificate Learner Guide
IntroductionThe prerequisites of this course are that participants already have an understanding of resuscitation
and basic first aid. This topic is a review of relevant first aid and resuscitation principles to assist
participants with understanding where the use of advanced resuscitation techniques, such as
defibrillation, oxygen and advanced airway management techniques, will support and improve the care
they can provide to a casualty.
Participants who require more information in this topic can find complete descriptions in the Australian
LifesavingAcademyFirstAidTrainingManual2ndEditionortheSurfLifeSavingAustraliaPublic
SafetyandAquaticRescue33rdEditionmanual.
Review of first aid and resuscitation principles and legalities
What is first aid?
First aid is the initial care of the suddenly sick or injured until medical aid arrives or the casualty
recovers. Medical aid, on the other hand, is professional medical treatment by a doctor, registered
nurse, or ambulance paramedic.
Aims of first aid
The aims of first aid are to:
•preservelife
•protecttheunconscious
•preventtheconditionfromworseningandtorelievepain
•promoterecovery.
As a first aider you also aim to prevent:
•furtherdamagetoyourself,othersandthecasualty
•thecasualty’sconditionfrombecomingworse
•delayinthecasualty’srecovery
•anyharmfulintervention.
Legalities of first aid
Consent
A person who is touched without consenting to it can take legal action for assault. A first aider must
seekpermissionfromthevictimbeforeprovidingfirstaid.Ifthevictimisunresponsiveorunableto
communicate,thelawassumesthatconsentwouldhavebeengiven.Ifthevictimisachild,consent
forfirstaidmustbeobtainedfromaparentorlegalguardian.Ifthereisthreattolifeandaparentor
guardian is unavailable, consent is implied and first aid should be provided.
Duty of care
Australian law does not impose a duty of care on any person to give assistance unless that person
already owes a duty of care to the sick or injured person. A first aider at a work site has an implied
duty of care, as does someone caring for children. There is no such clear duty for a volunteer, but
once a person starts to act, that person becomes the caregiver and should stay with the sick or
injured person until professional help arrives.
Always work within your training, following organisational procedures and manufacturers’ instructions
for equipment where required.
Topic1–FirstAidandResuscitationReview
15Advanced Resuscitation Techniques Certificate Learner Guide
Documentation (record keeping) Documentation serves the following purposes:
• toassistthefirstaiderinmanagingtheircasualty’sinjuriesorillnessesandbeingabletoperforman
accurate handover to ambulance personnel
• tobealegalrecordandstatisticalinformation.
Organisations providing a first aid service will have first aid forms to assist in information gathering
andreporting.(SLSAmembersshouldfilloutanIncidentReportformforallmajorfirstaidand
resuscitation cases).
Confidentiality
All information relating to a casualty’s injury or condition must be kept confidential. However, you must
give all relevant information to medical personnel when they arrive.
First aid safety
Infection control
First aiders should always follow standard precautions when performing first aid. These include using
the following barrier devices during first aid and resuscitation:
•gloves
•resuscitationmask
•safetyglasses
Contaminated waste disposal
First aid supplies and tools or other items that have come in contact with bodily fluids such as vomit or
blood should be disposed of in clinical waste bags.
Post-traumatic stress
An unsuccessful resuscitation, not knowing the ultimate outcome, or even a successful resuscitation
or emergency response can all take an emotional toll on the first aider. This is known as post-
traumaticstress.Ifyou,oracolleague,areexperiencingstressafteranincident,itisimportanttoseek
out support. Surf Life Saving provides support to its members. Further information regarding stress
management after a critical incident can be found in Volume One of the Guidelines for Safer Surf
Clubs.
Airway obstructions
An airway obstruction (blockage) can be either partial or total. The more the airway is blocked, the
more the casualty is in danger of losing consciousness. Causes of airway obstructions include swelling
of the throat tissues and choking.
Figure 1.1 Flow chart for management of foreign body airway obstruction (Source: Australian Resuscitation Council)
Conscious Unconscious
Effective CoughMild Airway Obstruction
Encourage Coughing
Continue to check victim until recovery
or deterioration
Call ambulance Call ambulance
Give up to 5Back Blows.If not effectivegive up to 5
Chest Thrusts
Call ambulance
Commence CPR
Ineffective CoughSevere Airway Obstruction
Assess Severity
16 Advanced Resuscitation Techniques Certificate Learner Guide
Chain of survival
Figure 1.2 Chain of survival
In1990,theAmericanHeartAssociationintroducedatreatmentmodelforcasualtiesofsudden
cardiacarrestcalledthechainofsurvival.Itoutlinesthespecificsequenceofeventsthatneedsto
happen for a casualty to survive and recover from sudden cardiac arrest.
Early access
This first step occurs when someone suspects or determines that the casualty is in sudden cardiac
arrest and calls for help.
Early CPR
This second step is about buying time for the casualty. Cardiopulmonary resuscitation (CPR) keeps the
casualty’s blood flowing until defibrillation can begin. At this stage any attempt at CPR is better than
no attempt. While a person with current training in CPR is ideal, any attempt by a bystander whether
trained or not will contribute to this stage in the chain.
Early defibrillation
This third step is about resetting the heart’s rhythm by shocking the casualty as quickly as possible
with a defibrillator. Studies show that this is the most critical link in the chain of survival.
Early advanced life support
This fourth step occurs when medical personnel provide advanced care that can include airway
support, medications and hospital.
Early access Early CPR Early defibrillation Early advanced life support
17Advanced Resuscitation Techniques Certificate Learner Guide
management equipment will contribute to the chain of survival.
Emergency action plan
Many variables exist when dealing with emergencies. Knowing when to do what in a first aid situation,
despite the number of possible variables, is the key to giving the casualty or casualties the best
chance of a full recovery.
Inanyfirstaidsituationthefirstaidermusthaveanactionplan.Theplanofactionforfirstaidersis
knownastheemergencyactionplan(EAP).ThestepsintheEAParelistedbelow:
• pauseandplan
• callforemergencyassistance
• primaryassessment
• secondaryassessment
– managementofinjuries
– vitalsignssurvey
– history
– bodycheck
– treatment
• ongoingmanagement
Pause and plan
The aim of pause and plan is to remind the first aider to remain calm, and to stop and think.
Any time you are called to an incident, consider the following questions:
• istheareasafe?
• doyouhavetheappropriatefirstaidkitandequipmenttomanagetheincident?
As a first aider trained in advanced resuscitation techniques, you should also consider bringing
oxygen equipment and a defibrillator with you when responding to an incident.
• howlongcouldyoubeoutintheelements?
• doyouhavearadioormobilephone?
• areyoulikelytoneedassistance?
• doyouneedtocall000beforeyouattendtheincident?
Through an understanding of your environment and the injuries you are likely to encounter you should
already have answered most of these questions. The couple of seconds it takes to pause and plan will
save you minutes down the track.
Activity (individual) 1.1: Advanced resuscitation and the chain of survivalDuring this course you will be learning how to use oxygen resuscitation equipment, airway
management devices (oropharyngeal airways and suction) and a defibrillation unit. The value of
defibrillation is clearly defined in stage three of the chain of survival.
Using your current knowledge of CPR, identify where the use of oxygen resuscitation and airway
18 Advanced Resuscitation Techniques Certificate Learner Guide
Call for emergency assistance
Itisessentialthatemergencyservicesarecontactedassoonaspossible.Thisisnowpartofthe
Primary assessment and should occur after checking for a response.
The four Ps: Position, Problem, People and Progress can be used to remember the information
that will need to be supplied to an emergency services operator or, when working as part of a first
responder organisation such as surf lifesaving, via radio to your communications centre.
Position What is the exact location of the emergency?
The first aider should be ready to give the street address and suburb, or a description of
thelocationsuchasthenearestintersectionorlandmark.Itisalsousefultopassonthe
telephone number they are calling from.
Problem What is the problem?
The caller should be ready to explain what has happened.
People How many people are hurt (sick)? The caller must be prepared to list the number of
people involved in the incident including their gender, ages and condition.
Progress What has been done (progress) to assist the casualty?
The caller may be asked if he or she is with the casualty at the time and what treatment
has been provided so far.
Primary assessment
As covered in previous training, primary assessment is the initial assessment of the scene and the
casualty for dangers to the first aider, bystanders and the casualty, and for response and breathing of
the casualty. Primary assessment also includes cardiopulmonary resuscitation and defibrillation.
Danger
Make sure that there is no danger to yourself and no further danger to bystanders or the casualty.
Response
Assess the consciousness of the casualty.
Send for Help
Call for emergency assistance.
Airway
Ensuringaclearairwayisakeyaspectofsuccessfullyresuscitatingacasualty.Theuseofsuction
devices to clear foreign matter from the mouth, and the use of oropharyngeal airways to assist in
ensuring that the tongue does not block the airway, can assist in maintaining the casualty’s airway.
These devices are an addition to good airway management, first aiders should continue to manage
the airway ensuring head tilt and chin lift. When using an airbag during resuscitation, the jaw
thrust method should be used to apply head tilt and chin lift and ensure a good seal between the
resuscitation mask and the casualty’s face.
19Advanced Resuscitation Techniques Certificate Learner Guide
Activity (group) 1.2: Jaw thrustYou should have learned how to perform jaw thrust in your previous first aid training. This technique is
essential when using an airbag during CPR. Refresh your skills in jaw thrust by practising on a partner
or a resuscitation manikin.
Ifyouhavenotpreviouslylearnedjawthrust,askyourtrainertoexplainhowthisisdonenow.Afull
explanation of how to perform jaw thrust can be found in chapter two of the Australian Lifesaving
AcademyFirstAidTrainingManual2ndEditionorinchapterfouroftheSurfLifeSavingAustralia,
PublicSafetyandAquaticRescue33rdEditionmanual.
Breathing
Performing rescue breaths using expired air during resuscitation will provide the casualty with
approximately16%oxygenineachbreath.Usinganoxygenresuscitationdevicesuchasanairbag
resuscitatorwithareservoirattachedwillprovideupto95%oxygenwitheachcompressionofthe
airbag. The benefit of this additional oxygen during CPR is invaluable and should be used during CPR
whenever equipment and a trained operator is available.
Compressions
CPR should be commenced if the unconscious casualty is unresponsive and not breathing normally.
BasicCPRskillsareessentialtoensurethebestoutcomeforacasualty;theseskillsshouldnotbe
neglected in favour of using other resuscitation devices. As an experienced first aider, other first aiders
in your team may look to you for guidance. You will need to be confident in your resuscitation skills to
be able to provide direction to your team. You may also be required to instruct bystanders in assisting
with CPR to allow you to access and use the additional equipment in which you have been trained.
CPR rates
Body type
Compression: rescue breaths
Cycles per 2 minutes
Depth of compression
Number of hands
Location of compression Head tilt
Adult 30:2 51/3 depth of
chest2 hands
centre of chest
maximum
Child 30:2 51/3 depth of
chest1–2hands
centre of chest
maximum
Infant 30:2 51/3 depth of
chest2 fingers
centre of chest
no head tilt
20 Advanced Resuscitation Techniques Certificate Learner Guide
Activity (group) 1.3: CPR reviewYou will have learned basic CPR skills in your first aid training. Working in pairs, refresh your skills in
CPR by practising on a resuscitation manikin. Have your partner or your trainer provide feedback on:
• yourhandpositioning
– isitinthecentreofthechest?
– isyourcompressingarmstraight?
– areyourcompressionsvertical?
• thedepthandrateofyourcompressions
– areyourcompressionsdeepenough?
– areyoucomingallthewayupattheendofeachcompression?
– areyourcompressionsfastenough?
• rescuebreaths
– areyouprovidingadequateheadtiltandjawthrust?
– areyoublowingintoomuch/toolittleair?
Once you have refreshed your CPR skills, work with your partner and practise giving them directions
as if they do not know CPR or have not refreshed their knowledge in many years.
A full explanation of basic CPR can be found in chapter two of the Australian Lifesaving Academy First
AidTrainingManual2ndEditionorinchapterfouroftheSurfLifeSavingAustralia,PublicSafetyand
AquaticRescue33rdEditionmanual.
Defibrillation
Defibrillation should be administered as soon as possible. When working in a team, a first aider who
is trained in the use of a defibrillator should be the operator. The operator of the defibrillator must take
control of the team performing resuscitation as they will be responsible for the delivery of the shock
and ensuring the safety of the team.
Secondary assessment
The secondary assessment is a systematic means of finding other conditions that were not apparent
during the primary assessment. The secondary assessment should not be undertaken if life-
threatening conditions are still present.
Before conducting a secondary assessment, always:
• introduceyourselftothecasualtyandasktheirname
• explainyourintentionstothecasualty
• seekconsenttotreatthecasualty
• considerandrespectthecasualty’sprivacy.
Management of injuries
After completing the primary assessment and having identified that the casualty is breathing, the first
aidercanbeginmanagingotherinjuries.ItisimportanttorememberthatCPRmustnotbeinterrupted
to treat other injuries.
Order of treatment
The control of major bleeding is the first priority after the completion of the primary assessment. Then
manage any major burns, treat the casualty for shock, stabilise any fractures and treat any other
injuries.
NOTE:
A key issue in managing a casualty is treating shock. Beyond treating the cause of shock (e.g. a
major bleed), the introduction of oxygen to provide therapy at this stage is the single most effective
treatment available to a first aider.
21Advanced Resuscitation Techniques Certificate Learner Guide
Casualty position
The casualty should be moved or assisted into the most comfortable position for their condition. Does
the casualty require protection from the sun, wind or rain?
Call for further assistance if required
The first aider should now consider what further assistance or equipment may be needed to treat the
casualty, and call 000 if necessary and not already done.
Vital signs
Vital signs are essential for not only establishing how well or sick the casualty is, but for monitoring
trends in their condition and assessing the effectiveness of the treatment.
ADULT NORMAL ABNORMAL
Pulse 60–100beatsperminute <60or>100beatsperminute
Breathing 12–20breathsperminute >20breathsperminute
Skin (colour and temperature) Warm and pink Cool or hot, pale, moist,
flushed/red, blue/cyanosed
Conscious state Alert and orientated Drowsy or unconscious
History
A history is relevant information about a casualty’s current injury/illness, their present symptoms and
relevant previous illnesses. You can obtain a history by:
• observingthescene
• listeningtowhatissaidbythecasualtyandbystanders
• askingquestions.
AppropriatequestionscanberememberedbytheacronymSAMPLE:
• Signsandsymptoms
• Allergies
• Medication
• Previousmedicalhistory(lookforaMedicAlertbraceletornecklace)
• Lastoralintake
• Event.
Ifthecasualtyisunconsciousorhasanalteredlevelofconsciousness,theremaybecompanions
or bystanders who have witnessed the incident and who can be asked for information about what
happened. You can make the casualty feel less anxious by remaining calm, speaking clearly and
simply, reassuring the casualty and referring to them by name.
Body check
The body check is a systematic check of the casualty which may be done in the following order:
1 neck, up over the head and down across the face
2 shoulders and front of the chest, abdomen and pelvis including ribs
3 front and back of upper limbs
4 frontandbackoflowerlimbs
5 back
22 Advanced Resuscitation Techniques Certificate Learner Guide
Ongoing management
After completing treatment of injuries and illnesses identified during the primary and secondary
assessments, the first aider will need to decide if referral to hospital or other medical aid is required,
and call 000 for an ambulance if necessary.
Once the decision has been made to refer the casualty to medical aid, ongoing monitoring and
management of the casualty’s condition is important. Using oxygen to provide
Therapytoacasualtywithotherillnessesandinjuriesisalsouseful.Itcanbegivensafelytoany
casualty that the first aider is concerned about.
Ongoing monitoring and management while waiting for medical assistance should include:
• reassessingthecasualty’svitalsignsatregularintervals
• continuingtoidentifyactualorpotentialproblemsandplanappropriatecare
• notifyingtheambulanceserviceofanychangetothecasualty’sstatusasappropriate
• handingoverthecasualtytoambulancepersonnel.
Who should be sent to hospital?
Anyone to whom any of the following applies should be sent to hospital:
• haslostconsciousness,evenforabriefperiod
• hasrequiredeitherinitialrescuebreathingorCPR
• mayhaveasecondarycondition,suchasaheartattackoraneckinjury
• hasapersistentcoughoranabnormalskincolour
• mayhaveinhaledanyamountoffluidorgas.
Ifnoneofthepreviousconditionsapplies,butifthefirstaiderhasanydoubtaboutthecasualty’sstate
of health, the casualty should be advised to seek medical advice as soon as possible.
Hand over
Ifanambulancehasbeencalled,thefirstaidershouldremainwiththecasualtyuntiltheycanhand
over to the ambulance paramedics. You should be aware of the standard ambulance response times
to your club/area of operation.
Assessment Task 1: Written questionsCompletequestions1–10inyourassessmentportfolionow.
23Advanced Resuscitation Techniques Certificate Learner Guide
Why use oxygen?Oxygen administration is useful for any casualty who does not appear to be adequately perfused or
is not maintaining sufficient oxygen levels. Qualified personnel may safely administer oxygen to any
casualty who is not adequately perfused. Casualties likely to benefit from oxygen include those with
the following conditions, signs or symptoms:
• unconsciousness
• shock
• bloodloss
• chestpain
• shortnessofbreath,includingasthma
•severepain
• injuries
•afterresuscitation
•absentbreathing
•abnormalbreathing
•circulatorydistress
Respiratory systemThe respiratory system supplies the body with a constant supply of oxygen.
Figure 2.1 The respiratory system
Topic2–AdvancedResuscitationandOxygen Administration
24 Advanced Resuscitation Techniques Certificate Learner Guide
Upper respiratory tract
The upper respiratory tract includes the nostrils, nasal cavity, mouth, pharynx (throat) and larynx (voice
box).Thethroatisacommonpassagewayforbothfoodandair.Itstarts
from the cavity at the back of the mouth and nose and extends down to where it divides into two
separate tubes, the trachea and the oesophagus. The trachea allows the passage of air to and from
thelungs.Itsitsinfrontoftheoesophagusandisclosesttotheskin.Theoesophaguscarriesfood
and liquid to the stomach from the mouth and in reverse during vomiting or regurgitation.
The upper respiratory tract is the most common location for an airway obstruction.
Lower respiratory tract
The lower respiratory tract consists of the trachea and the bronchi which divide into two, going into
the left and the right lung. The bronchi then progressively divide into smaller bronchioles and eventually
end up as alveoli and alveolar sacs.
The lungs fill most of the chest cavity, which is separated from the abdomen by a large sheet of
muscle known as the diaphragm. The lungs are spongy, elastic organs that move during inhalation
and exhalation.
The breathing process
Breathing is the act of moving air in and out of the lungs.
Breathinginisknownasinhalation.Itisaninvoluntarymuscleactioncausedwhenthediaphragmis
pulled down (contracts) and flattened. This sucks air into the body via the mouth or nose.
Breathing out is known as exhalation. When muscles relax they recoil back to their original location
and force the air out of the mouth or nose.
Theaverageadulttakesabout12–15breathsperminute.Theaverageamountofairinhaledand
exhaledisabout500ml(anormalbreath).Ininfantsthenormalbreathingratecanbebetween25–50
breaths per minute.
Respiratory noises
Inahealthypersonthereshouldbenoaudiblesoundastheybreatheinandout.Whereacasualty
has some respiratory distress, this may be accompanied by noises. Noises can include cough,
inspiratory/expiratorywheeze,stridororwetgurglingnoises.Acasualtyinsevererespiratorydistress
may make no sound at all.
Cough a sudden expulsion of air from the lungs (with a characteristic noise), may be associated
with mild airway obstructions, or inflammation of the upper and/or lower airways
Wheeze a whistling sound when breathing in or out, most commonly encountered by first
aiders treating casualties with asthma and may also be associated with other chronic
obstructive airways diseases
Stridor alouderorharshersoundthanawheeze,maybeassociatedwithapartialairway
obstruction
Gurgling a broken irregular sound similar to moving water may be associated with fluid or mucus
in the lower airways
No sound no vocal sound, even with a casualty showing an effort to breathe. A casualty with a
complete airway obstruction may make no sound, the effort to breathe may also take in
the use of accessory muscles.
First aid conditions which require additional oxygen
The body requires a constant supply of oxygen and when it does not receive enough, hypoxia results.
Itisessentialtobeabletorecognisebreathingdifficultiesandtoprovideimmediatefirstaidincluding
supplementary oxygen to treat the casualty.
25Advanced Resuscitation Techniques Certificate Learner Guide
Respiratory distress or hypoxia can be caused by:
• airwayobstruction,suchas:
– foreignmaterialorvomit
– tissueswelling(allergicreaction)
– incorrectheadpositionduringunconsciousness(acasualtyslumpedforwardintheseatoftheir
vehicle after a car crash)
• trauma(headinjury)
• drugs(egheroin,whichslowsdownbreathingtothepointwhereacasualtymaystopbreathing
altogether)
• neardrowning
• asthma
• impairmentofnervesand/ormusclesofbreathing
– spinalcorddamage
– chestinjuries
– somepoisonsandvenom.
Hypoventilation
Hypoventilation is breathing that is not adequate to meet the needs of the body (too shallow or too slow),
or reduced lung function. The carbon dioxide level rises, leading to inadequate oxygen in the blood.
Respiratory arrest can follow if a casualty’s condition deteriorates, and is a life- threatening emergency.
Ifthebody’sothersystemsarenotreceivingoxygentheywillfailtofunction.Forexample,ifbreathing
stops, the heart will stop beating soon after.
Asthma
Asthma is an inflammatory disorder of the lower respiratory system in which the lungs and air
passages become sensitive and sometimes narrow, making it hard for the person to breathe.
Managing an asthma attack
Ifthecasualtyhastheirownasthmaplan,youshouldfollowit,butifthereisnoplanoritisasevere
asthma attack, follow the plan below:
Step 1
• sitthecasualtyinanuprightposition
• don’tleavethecasualtyalone
• remaincalmandreassurethecasualty
• administeroxygentherapy
• havesomeonebringyouthecasualty’smedicationortheasthmaemergencykit/bluerelieverpuffer
and spacer.
Step 2
• shakethebluerelieverpufferandremovethecap
• insertthepufferintothespacer,ensuringthatthecasualtyplacestheirmouthoverthemouthpiece
and gets a good seal
• pressdownonceonthepufferthenhavethecasualtybreatheinandoutfourtimes
• repeatsothatthepersonreceivesfourseparatepuffs,takingfourbreathsaftereachpuff
• continueoxygenadministrationbetweenadministrationsofmedication.
Step 3
• waitfourminutes
• ifasthmaisrelieved,discontinuemedication.
Step 4
• ifthereislittleornoimprovementrepeatsteps2and3(fourpuffs,takefourbreathsaftereachpuff;
wait four minutes)
• ifthereisnoimprovement,thecasualty’sconditionworsens,oryouareconcerned:
– callanambulanceimmediately(000)
– continuetorepeatsteps2and3whilewaitingfortheambulance
• CPRmayberequiredifthecasualtybecomesunconscious.
26 Advanced Resuscitation Techniques Certificate Learner Guide
Chronic Obstructive Airways Diseases (COAD)
Chronic Obstructive Airways Diseases (COAD) include emphysema, chronic bronchitis and other
airways diseases. COAD is an ongoing illness, the casualty will be aware of their condition and,
subject to having enough breath to speak, will be able to tell you of their condition.
Inhealthypeople,highcarbondioxidelevelsareastimulustobreathe.COADcasualties,who
chronically have high carbon dioxide levels, loose this reflex and instead their breathing control centre
relies on low levels of oxygen in their body to stimulate them to breathe.
Due to their body relying on low levels of oxygen to stimulate breathing, casualties with COAD are
normallytreatedwithlowlevelsofoxygen(eg:twolitresperminute).Ifthehigherconcentrationsof
oxygen commonly available in first responder oxygen equipment (eight litres per minute or more) are
used to treat a COAD casualty it may cause them to under breathe.
Management of COAD
• DRSABCD
• reassurethecasualty
• provideoxygentherapy,withthecasualtysittinginanuprightpositiontoensuremaximumspace
for lung action
• continuallymonitorresponse,airwayandbreathingandcommenceCPRifthecasualtyis
unresponsive and not breathing normally.
• seekmedicalaid–call000foranambulanceifrequired.
• donotleavethecasualtyunattended,especiallyifreceivingoxygen.Documentobservationsin
order to identify trends.
NOTE:Anycasualtypresentingwithbreathingdifficultiesshouldbetreatedwithoxygen.
Supplemental oxygen administration must take precedence over the concern that a casualty may
under breathe due to being administered high oxygen concentration levels.
Hyperventilation
Hyperventilation is the result of over-breathing that can be stress-related, deliberate or from medical
conditions. The rate and depth of breathing are more than is necessary to maintain a normal level of
carbon dioxide in the blood. As hyperventilation does not cause a lack of oxygen, the casualty should
not be administered oxygen therapy in this situation.
Management of hyperventilation
• DRSABCD
• reassurethecasualty
• removethecasualtyfromtheenvironmentcontributingtotheover-breathing
• encouragethecasualtytobreathenormallybyhavingthemcopyyouasyoubreatheinthrough
your nose and out through your mouth
• seekmedicalaid–call000foranambulanceifrequired.
27Advanced Resuscitation Techniques Certificate Learner Guide
Oxygen resuscitation equipment
Approval of equipment
All oxygen resuscitation kits must meet Australian Standards. To check that your equipment meets
Australian Standards, look for the Australian Standards logo on your equipment or packaging.
Figure 2.2 Examples of oxygen resuscitation kits
NOTE:
For use within surf lifesaving, new types of oxygen equipment must be trialled in accordance with
policy1.6(newandModifiedEquipment),beforetheyarecertifiedforapprovalassurfrescue
equipment.
TheSLAOxygenEquipmentPolicyislocatedontheSLSAwebsiteatwww.sls.com.au
28 Advanced Resuscitation Techniques Certificate Learner Guide
The components of oxygen resuscitation equipment
Itisimportantforthosetrainedintheuseofoxygenresuscitationunitstoensurethattheyarefamiliar
with the components and operation of the unit(s) in use at their location. The basic components are
labeled below:
Figure 2.3 Components included in an oxygen resuscitation kit
Equipment descriptions
Protective case
Thishousesalltherelevantequipment.Itmaybeasoftbagorhardplasticormetalcase.Insome
models, it incorporates the oxygen cylinder itself.
Medical oxygen cylinder
Medical oxygen cylinders are all white. Previously cylinders were black with a white shoulder, and this
was phased out between September 2009 and June 2011.
The cylinder has two locating pin holes next to the main outlet. These holes mate with pins on the
mounting yoke of the oxygen equipment. A fresh, full cylinder will usually have a protective wrapping
of blue or white plastic around the oxygen outlet to prevent dust and dirt from entering during
transportation. Before attaching the cylinder to the oxygen equipment, all wrapping must be removed
and the cylinder ‘cracked’ by quickly opening and closing the outlet valve.
Cylinder cradle
This provides support for the oxygen cylinder.
Cylinder yoke
Thisistheconnectionfortheoxygencylinder.Insomeinstances,itispartofthecase;otherwise,it
may be attached as part of the regulator.
Sealing washer
This fits in the yoke to prevent leakage from the cylinder joint. Spare seals are kept in the oxygen
equipment case.
Locating pins
These are positioned in the yoke, so that the operator can locate the oxygen cylinder correctly.
Thumb screw
This helps to secure and maintain the cylinder in position.
29Advanced Resuscitation Techniques Certificate Learner Guide
Cylinder key wheel
This is used to open or close the cylinder valve.
External cylinder connection
Thisallowslargeroxygencylinderstobeattached.Itisimportanttorememberthatwhenanexternal
cylinder is in use, a small cylinder or the yoke plug should be firmly in place to prevent oxygen leaking.
This connection is not found on all units.
Contents gauge
This indicates the amount of oxygen in the cylinder.
Regulator
This regulates the oxygen pressure and flow of oxygen.
OP airways
Oropharyngeal airways help maintain a clear airway.
Airbag
Thissilicone-basedapparatusisusedforinflatingacasualty’slungsbysqueezing,whichsupplies
oxygen from an oxygen reservoir bag.
Oxygen reservoir bag
Isattachedtotheairbagandstoresoxygentoensurethatmaximumoxygenisdeliveredtothe
casualty.
Tubing
Depending on the unit, there will be either one or two tubes, usually clear and/or green in colour.
Control valves
These are turned on when using the airbag resuscitator or oxygen therapy, giving a fixed flow rate of
oxygen. On some models, the control valve and flow rate are built into the regulator.
Resuscitation masks
Eachunitshouldcontainatleastoneadultandonechild-sizedmask.
Therapy masks
Eachunitcontainsatleastoneadultandonechild-sizedmask.Thesemasksmaybethetherapytype
or the non-rebreather type of mask. Therapy masks are single use only.
Chalk
This is used to mark the volume of oxygen in the cylinder.
Gloves
Used for personal protection.
Pens, pencils and paper
Used for taking records during oxygen usage.
Patient filter (optional)
A patient filter is inserted between the resuscitation mask and the patient valve on the airbag. This filter
stops any vomit, blood or saliva from entering and clogging the patient valve during resuscitation. The
patient filter is single use only.
Other equipment
The equipment below may also be a part of your oxygen resuscitation kit.
Automatic oxygen-powered resuscitator
These devices deliver oxygen under high pressure to inflate the lungs of casualties who are not
breathing. (These devices are not approved for use by surf lifesaving members).
Suction
This feature helps the operator to remove fluids from the casualty’s mouth.
30 Advanced Resuscitation Techniques Certificate Learner Guide
Activity (group) 2.1: Oxygen equipmentInpairsorsmallgroups,taketurnsatnamingallthepiecesofequipmentinyourkit.Assome
equipment may vary slightly, you may need to check with your trainer. Once you and your partner are
confident that you can remember all the items, remove an item or two without your partner watching,
and then have them review the kit and identify the missing item(s).
protective case
medical oxygen cylinder
cylinder yoke
sealing washer
thumb screw
cylinder key wheel
contents gauge
regulator
OP airways (Oropharyngeal airways)
airbag
oxygen reservoir bag
tubing
control valve(s)
resuscitation masks (adult and child)
masks–therapyornon-rebreather(adultandchild)
chalk
gloves
pen/pencil and paper
Routine check of equipment
Oxygen cylinder
•beforeacylinderisfittedtotheoxygenequipment,checktheheatwarningtag(rejectanycylinders
with melted or deformed tags), and remove the protective plastic wrapping
•‘crack’thecylinderbyturningitonandoffverybriefly,keepingitasuprightaspossibleandtaking
care that the outlet is not pointed at any person or potential danger (eg sand). Cracking the cylinder
removes any foreign matter from its valve opening
•checkthatthesealingwasherispresentandisnotdamagedordirty.Replacemissingordamaged
sealing washers, otherwise the equipment is inoperable and cannot be used
•thecylindermustbeinsertedintotheyoke
ensuring that the inlet and outlet holes are
aligned. This is achieved by ensuring that the
locating pins on the yoke are aligned to the
locating pin holes on the cylinder valve. Then
tighten the thumb screw
•checkthecontentsofthecylinderbyusing
the cylinder key wheel to slowly open the
cylinder valve until the gauge reaches a
steady point. This slow build-up of pressure
saves damage to the regulator and gauge,
which can occur from a sudden rush of
pressure. Open the cylinder valves fully, and
then turn the key wheel back half a turn to
prevent locking. The gauge should register
‘full’. This may be indicated by the word ‘full’
or a green mark on the cylinder. Where a
cylinder is less than half full, reject it and fit a
new cylinder.Figure 2.3 Components of a medical oxygen cylinder
cylinder Valve
oxygen outlet
locating pin holes
heat tag
white shoulder
label
black body
(changing to an
all white cylinder
between September
2009 and June
2011)
31Advanced Resuscitation Techniques Certificate Learner Guide
Control valve Oxygen nipple Gauge Yoke Thumb screw
Figure 2.4 Components of an oxygen regulator
SAFETYPRECAUTIONSWHENUSINGOXYGEN:
Oxygen must be used with care and respect at all times:
• neveruseoxygennearanopenflame
• neveruseoxygennearcigarettes
• neverusegreaseoroilwithoxygenequipment
• neveruseoxygenwhendeliveringashockviaadefibrillator(refertopage44)
Oxygen equipment
To ensure that oxygen equipment is ready for use:
• checktheoxygentubingforcracksorotherdamage.Ensurethattheopenendwillfiteasilytoboth
therapy masks, as well as the oxygen nipple of the airbag
• checktheflowofoxygenfromthecylinderthroughthetubing
• checkthatthereisnoodorfromtheoxygenbeingexpelledfromthetubing
• checktheairbag
• closethecylindervalve,andthendrainoxygenfromthesystembyoperatingthedeliverysystem
(where the unit has two ensure both are operated) and check that the needle on the contents
gaugefallstozero
• markthecylinderwiththecontents,timeanddateofinspection.
Ancillary equipment
To ensure that ancillary equipment is ready for use:
• checkboththerapymasksforcleanlinessandserviceability
• checktheconditionoftheresuscitationmaskcuffsforfit,perishingorcracks
• ensurethataminimumoftwolarger(adult)sizeoropharyngealairwaysarepresentandsealedin
their original packaging
• checkinthecasefor:
– chalk,formarkingtheamountofoxygeninthecylinder
– pens,pencilsandpaperforkeepingrecords
– gloves,forpersonalprotectionduringemergencycare
– sparesealingwashers,toreplacedefectiveormissingseals,asrequired.
Casing and additional equipment
General care of the case and optional equipment includes:
• keepingthewholeunitcleanandfreefromsand,seawater,oilandgrease
• checkingadditionalequipment(egsuction,automaticoxygen-poweredresuscitators).
32 Advanced Resuscitation Techniques Certificate Learner Guide
Activity (group) 2.2: Routine equipment checksInpairsorsmallgroups,taketurnscheckingthattheoxygenequipmentandancillaryitemsare
available and serviceable. Have your partner test you by following the processes outlined previously.
Storing oxygen equipment
Oxygen equipment should be stored:
• inacoolbutaccessibleplace,asheatcausesrubberandplasticcomponentstodeteriorate(spare
oxygen cylinders should be stored in a cool and accessible place, near the oxygen equipment)
• awayfrombusytrafficareasandsandanddustcontamination
• awayfromoilorgrease–thesesubstancescancausefirewhenincontactwithhigh-pressure
oxygen
• inaventilatedspace–anyleakageinanenclosedspacecouldcauseanincreasedconcentration
of oxygen which could be dangerous in the event of a fire
• uncovered–anyleakageofacoveredunitcouldcauseanincreasedconcentrationofoxygeninthe
unit
• withoutanypressureinthesystem–turnoffthecylinderthendrainoxygenfromthesystemby
operating the delivery system
• inalocationdesignatedasano-smokingareaandnotnearnakedflames;leakingoxygencanfuel
a fire.
Emptyoxygencylindersshouldbereturnedforrefillingwithoutdelay.Cylindersthatarehalffullorless
can be used for training.
Material Safety Data Sheets (MSDS)
YourcluborserviceshouldhaveaMaterialSafetyDataSheetforeachhazardoussubstancestored
on the premises. These may be stored in a central folder or each sheet may be stored with the
hazardoussubstance.Materialsafetydatasheetscontaininformationonhowthesubstanceshould
be stored and what to do if poisoning occurs.
Administering oxygen therapy
To administer oxygen therapy:
• checkoxygenequipmentbeforeeachuse
• placetheequipmentsothattheoperatorcanreachiteasilyandseethe
contents gauge
• connectthetherapymasktothetubingandturnontheoxygen;you
should be able to feel and hear the oxygen coming through the mask
• reassurethecasualtyandtellthemwhatyouareabouttodo,thenput
the mask on the casualty’s face and ensure that it is secure by adjusting
the elastic and pinching the metal noseband
• placeunconsciouscasualtiesinthelateralposition.
Figure 2.6 Correctly fitted therapy mask
NOTE:
Ifaconsciouscasualtydoesnotwanttousethemask,theycanholdthemaskinfrontoftheir
face, or remove the tubing from it and direct the oxygen flow around the mouth and nose
33Advanced Resuscitation Techniques Certificate Learner Guide
Mouth-to-mask resuscitation with oxygen
Research has shown that adding oxygen during mouth to mask resuscitation can increase the oxygen
receivedbythecasualtyfrom16%to50%(16%istheoxygencontentofexpiredair).Ifthetherapy
setting of eight litres per minute is used, the concentration of oxygen in the casualty’s lungs will be
almost45%,butiftheresuscitationsettingof14–15litresperminuteisusedandthesealisgood,the
concentrationforthecasualtywillbegreater(ie>50%).Itisrecommendedthatthehighersettingbe
usedifthereisenoughoxygenavailableforthetimeresuscitationisexpectedtolast.Ifnot,theflowof
eight litres per minute is satisfactory.
A number of different facemasks are approved for use in mouth-to-mask resuscitation. Some of these
have oxygen ports that allow the oxygen therapy tubing to be connected.
Mouth-to-maskresuscitationwithoxygencanbeaone-personoperation;however,itispreferable
that two operators are used. One person needs to do mouth-to-mask resuscitation while a second
person handles the oxygen unit. The oxygen is turned to the appropriate setting and the tubing fitted
either to the oxygen port, through the opening of the mask, or between the cheek and the mask if an
adequate seal is maintained. Masks with ports are highly recommended for this procedure.
Airbag oxygen resuscitator
Figure 2.7 Components of an airbag resuscitation device
The airbag resuscitator with oxygen reservoir is a manually operated, soft-recoil silicone bag with a
secondary bag attached. This secondary bag acts as a reservoir for oxygen when connected to an
external oxygen supply.
Theresuscitatorwithoxygenreservoirwillprovidethecasualtywithupto95%oxygenwhen
connectedtoanoxygensupply,withaflowrateof14–15litresperminute.
Casualties who are not breathing should be treated initially using CPR, but they will always benefit
from the administration of oxygen by trained personnel.
When the oxygen unit arrives and is being set up, the first operator should continue with the mouth-
to-mask resuscitation method (or change to it, if a mask was not previously available) while preparing
to change over to the bag. This may take some time, however, and resuscitation must continue during
thechangeoverperiod.Itispossibletogivemouth-to-maskresuscitationwithoxygenbrieflyusing
the therapy tubing before the bag is ready, with units that have two separate tubes (eg Oxyviva brand
units).
Patient valve Airbag
Oxygen nipple
Patient
filter
Resuscitation
mask Oxygen reservoir Air inlet valve
34 Advanced Resuscitation Techniques Certificate Learner Guide
Airbag checks
To ensure the airbag is ready for use:
•checktheairbagforleaksanddirectionofairflowby:
– blockingthepatientvalvewiththethumborhandandcompressingthebagunderreasonable
pressure
– checkingthatairdoesnotleakoutoftherearvalve,thebagorthecasualtyvalve
– releasingthethumborhand,whenthebagshouldcompressandrefillrapidly
• checkthefunctionoftheyellowdiscmembraneonthepatientvalveby:
– placingtheoxygenreservoirbagoverthecasualtyvalveandinflatingitfullybysqueezingthe
ventilation bag
– squeezingthereservoirbaggently.Theyellowdiscmembranewilllift(duringresuscitation,the
casualty exhales through this disc membrane)
•checktheoverflowvalveoftheoxygenreservoirby:
– inflatingthereservoirbagasdescribedaboveandconnectingittothereservoirvalve
– compressingthereservoirbagrapidlyandwatchingthediscinthevalvelift(thismembrane
ensures that the reservoir bag cannot be overfilled with oxygen)
• checktheair-intakemembranewhichislocatedintherearvalveoftheairbagby:
– checkingitsfunctionbyinflatingthereservoirbagasdescribedaboveandconnectingittothe
airbag
– repeatedlycompressingtheairbag.Thereservoirbagwillemptyandtheairbagwilldrawinair
through the air-intake membrane.
Activity (group) 2.3: Airbag checksInpairsorsmallgroups,taketurnscheckingthatthevalvesoftheairbagareoperationalandall
components are serviceable. Have your partner test you by following the processes previously
outlined.
Assessment Task 2: Peer assessment – oxygen equipment checksAsk a peer to assess you as you check the oxygen equipment for operational readiness
(detailspage65).
Using oxygen and airbag during resuscitation
Setting up the airbag
• theoperatorneedstoinformotherfirstaidersaboutwhotheyareandtheirqualificationstooperate
the equipment
• theoperatorsetsuptheequipmentclearofthecasualtyandfirstaiders,butinapositionwherethe
gauge is clearly visible
• immediatelyonopeningthecase,asuitablysizedresuscitationmaskispassedtotherescue
breathingoperatortochangetothemouth-to-maskresuscitationmethod.Ifmouth-to-mask
resuscitation is in progress, however, the airbag oxygen resuscitator can be fitted directly to the
mask (after an operational check)
• theoperatorshouldquicklycheck:
– thecorrectoperationofthepatientvalve
– thevalvetotheoxygenreservoirbag
– theconnectiontotheoxygensupply
• theoxygenisthenturnedonto14–15litresperminutetoallowinflationoftheairbagreservoir
• whenthereservoirbagisinflated,compresstheairbagtoexpelanyairfromtheunit.
Thisshouldthenleavetheairbagwith100%oxygen
35Advanced Resuscitation Techniques Certificate Learner Guide
Operating the airbag
To apply the airbag during resuscitation:
• telltheotheroperatorthattheairbagisreadyforuse,whentheoxygenreservoirisinflatedagain
• positionthecasualtyvalveintheresuscitationmaskandcompresstheairbagsothatthereisno
change at all in the timing of resuscitation, which is important if CPR is being performed
• compresstheairbagwithtwohands(foranadult)usingagentlesqueezingmotion,takingatleast
1.5–2secondsforthechesttorise.Theamountofoxygentobeforcedintothecasualty’schestis
the amount required to make the chest rise
• releasetheairbagandallowittorefillreadyforthenextventilation
NOTE:
The rise and fall of the casualty’s chest should be watched at all times during this procedure
• therescuebreathingoperatorcontrolsthebackwardheadtiltandensuresapropersealbetween
the mask and the casualty’s face
• ensurethatthecasualty’schestriseswitheachinflationandfallsasairexitsthelungs:
– boththeairbagrescuebreathingoperatorsareresponsibleforthis
– ifatanytime,eitheroperatorisnothappywiththefunctioningoftheoxygenequipment,the
equipment must be removed immediately and rescue breathing must continue by the mouth-to-
mask, mouth-to-mouth or mouth-to-nose method.
IftheairbagoxygenresuscitatorisbeingusedduringCPR,atleasttwofirstaidersmustbepresent,
although it is highly recommended that there are three. One controls the casualty’s airway and ensures
thesealoftheresuscitationmask;thesecondactivatestheoxygenequipment;andthethirdperforms
chestcompressions.Ifonlytwooperatorsarepresent,oneshouldcontroltheairway,ensurethemask
seal and activate the oxygen equipment while the second operator performs chest compressions.
Ifoxygenequipmentisbeingusedonachild,thepaediatricairbag(ifavailable)shouldbeusedand
compressed with one hand. When the child’s chest is seen to rise, stop compression of the bag.
Airbag resuscitators not specifically manufactured for the exclusive use on infants should not be used
on infants.
Iftheoxygenbottleisdepletedduringresuscitation,continuetousetheairbagresuscitatorequipment
and remove the reservoir bag.
36 Advanced Resuscitation Techniques Certificate Learner Guide
Activity (group) 2.4: CPR with oxygenInteamsofthree,practiseperformingCPRusingtheairbagresuscitator
Operational time
Afull‘C’cylinder(440–490litres)willhavethefollowingapproximateoperationaltimes:
• 50minutes,withcontinuoususeofoxygentherapyat8litresperminute
• 30minutes,withcontinuoususeofairbag(andoxygen)at14–15litresperminute
Equipment maintenance
General care
• themachineshouldbekeptcleanandfreeofsandandforeignmaterials
• toensureitscorrectoperation,equipmentmustbecheckedbeforestartingoperationalduties(eg
patrol) each day and after any use (including training sessions)
• whenevertheoxygenequipmentshowsdefectsthatmaycauseittooperateincorrectly,the
machine must be taken out of service immediately and repaired by the manufacturer
• theoxygenequipmentshouldbeservicedatleastevery12months,oraccordingtothe
manufacturer’s recommendations.
Care after use
After every use, the resuscitator should be disassembled, cleaned, disinfected, reassembled and
tested in an orderly sequence by:
• sendingoxygentherapymaskstohospitalwiththecasualtyordisposingofthemafteruse
• washingtheresuscitationmasksthoroughlyinwarmsoapywatersothatallforeignmaterialis
removed, then rinsing them with fresh running water
• disassemblingandwashingthecasualtyvalveandtherearvalveinwarmsoapywater,thenrinsing
them in fresh running water and reassembling them
•washingtheairbaginwarmsoapywater,thenrinsingitinfreshrunningwater
• washingthereservoirvalve(ontheLaerdalbag)andoxygenreservoirinwarmsoapywater,then
rinsing them in fresh running water
• soakingallcontaminatedpartsinasolutionof70%alcoholicchlorhexidineorahypochlorite
solution (bleach) for at least two minutes, then rinsing and drying them
• testingallpartsoftheequipmentafterdryingandbeforestoragetoensurethattheequipmentis
ready for use the next time it is needed.
Major faults
A major fault is any fault that cannot be repaired through basic maintenance (eg cleaning and
replacement of spare or missing parts that are routinely stocked in the first aid room) and that
affects the safety or ability to use the equipment properly. All major faults should be logged in the
appropriate organisational logs (eg SLSA Patrol log for SLSA members) and reported to the Club/
Service First Aid Officer.
Assessment Task 1: Written questionsCompletequestions11–29inyourassessmentportfolionow.
37Advanced Resuscitation Techniques Certificate Learner Guide
Oropharyngeal airways
Oropharyngeal (OP) airways are curved plastic devices that help keep the airway clear in the
unconscious casualty by depressing the tongue and keeping the teeth and lips apart. The OP airway
by itself does not replace correct airway management practices and should be considered only as a
tool to assist in the management of a casualty’s airway. An OP airway is a plastic device consisting of
a rigid flange and a hollow curved tube. The flange, when properly fitted, rests against the casualty’s
lips. This flange does not prevent an adequate seal from a facemask being achieved.
OPairwayscomeinvarioussizesfordifferent-sizedcasualties.
The smallest OP airways are approximately 5 cm long and the
largest are more than 10cm. OP airways are inserted using the
‘rotation’ method which is explained in the following pages. This
method is not recommended for infants or children under the
age of eight because the roof of their mouth is still soft and easily
damaged. SLSA does not teach members the methods for OP
airway insertion into infants and children, therefore members
should not attempt to insert an OP airway into children under the
age of eight years.
Figure 2.8 An airway blocked by the tongue (top) and
using an OP airway to assist with a clear airway (bottom)
NOTE:PersonalProtection
For first aiders’ own safety, it is strongly recommended that they wear protective gloves and use a
resuscitation mask for every resuscitation case.
Care of OP airways
OP airways must be kept in their original packaging. They should be easily accessible in the first aid
kit, oxygen unit and first aid rooms. OP airways packaging should be checked to ensure that it has not
been opened and is still intact.
After use on a casualty, the contaminated OP airway should be disposed of in a safe manner,
preferablyinaclinical-wastebagprovidedbyattendingambulanceormedicalpersonnel.Ifthisisnot
possible, the contaminated OP airway should be placed in a clinical-waste bag and stored in a safe
place until proper disposal can be organised.
Choosing the appropriate-sized OP airway
NOTE:
OP airways must be inserted only into deeply unconscious casualties.
TochooseanOPairwayofthecorrectsize,placetheairwayagainstthe
side of the casualty’s face. The flange (top flattened end) of the airway will
extend just past the centre of the casualty’s lips. The curve of the airway is
thenrunsidewaysalongthecasualty’sjaw.Thecorrectsizedairwayisthe
one that reaches the angle of the casualty’s jaw.
When to insert an OP airway
The use of an OP airway is optional. First aiders should take less than 15
secondstocorrectlysizeandinsertanOPairwayintoacasualty’smouth.
Whether an OP airway is used or not, the management principles of
DRSABCDdonotchange.Ideally,theOPairwayshouldbeinsertedinto
an unconscious casualty’s mouth after the casualty has been rolled onto
their side and their airway cleared.
Figure 2.9 Measuring an airway from the centre of the lips to the corner of the jaw
38 Advanced Resuscitation Techniques Certificate Learner Guide
TheairwaycanalsobeinsertedduringCPRwhilethecasualtyisontheirback.Inthiscase,stopCPR
and quickly insert the airway before continuing resuscitation.
IMPORTANT:
OP airways should not be used:
• ifthecasualtyisconsciousorsemi-conscious–insertionofanOPairwayintoaconscious
casualty may induce vomiting or gagging
• ifanairwayofthecorrectsizeisnotavailable
• ifthereisalargeamountofvomit
• ifthecasualtyisundereightyearsofage
Inserting an OP airway
Onceyouhaveselectedthecorrectsizeairway:
• tiltthecasualty’sheadbackwards;openthecasualty’s
mouth with one hand using jaw support or jaw thrust, if
necessary
• visuallycheckthecasualty’sairway,andmanuallyclearit,if
necessary
• measureandchooseanOPairwayofthecorrectsize
• removetheOPairwayfromthepacketandlubricateit,using
moisture from the lips of the casualty, or water
• holdtheOPairwaybytheflange.Withthetippointing
towards the roof of the casualty’s mouth, insert the airway to
approximately one-third of its length
• whenone-thirdoftheairwayisinsidethemouth,rotateit
180° until the tip points downwards, at the same time sliding
it over the casualty’s tongue in one smooth movement into
the back of the pharynx until the flange is touching the lips
• itshouldslipeasilyintoplace.Ifitisdifficult,stopand
reposition the casualty’s lower jaw and tongue before trying
again. Never force it into position. Care is needed to avoid
damage to the mouth and throat.Figure 2.10 Inserting an OP Airway
NOTE:
The OP airw cardiac co the airway should not be inserted during the delivery of external cardiac
commpressions, as this may impede the successful and cause unnecessary injury to the casualty
39Advanced Resuscitation Techniques Certificate Learner Guide
Activity (group) 2.5: Inserting OP airwaysInpairs,practisechoosingthecorrectsizeOPairwayforyourpartner.Ifanairwaymanikinisavailable,
practiseinsertingtheOPairway;otherwisedescribetheprocesstoyourpartnerinyourownwords.
NOTE:PrecautionwheninsertinganOPairway
• ensurethatthelowerlipisnotpinchedbetweenthecasualty’steethandtheOPairway
• ensurethattheOPairwaydoesnotpushthetonguebackwardsandblockthecasualty’sairway
• ensurethatyouhaveadequateheadtiltbeforeinsertingtheOPairway
• don’tforcetheOPairwayintothemouth–itshouldslideineasily.
Removing the OP airway
IfthecasualtyshowsanysignsofrejectingtheOPairway,removeitimmediately.Inmanycases,the
casualty may spit it out. The OP airway can be removed easily by sliding it out of the mouth following
its natural curve.
NOTE:
Donotattempttorotatetheairwayonremoval.Itisunnecessaryandmaycausedamagetothe
mouth and throat
Assessment Task 3: Peer assessment – oropharyngeal airwayAskapeertoassessyouasyousizeandinsertanOPairway(detailspage66).
Assessment Task 1: Written questionsCompletequestions30–33inyourassessmentportfolionow.
40 Advanced Resuscitation Techniques Certificate Learner Guide
Suction
Clearing of a casualty’s airway can be achieved by using
manual finger sweeps. However, if you have a unit available
with suctioning capability, you may clear additional fluids from
the upper airway by using the suction component of the unit.
Suctioning is a skill that will require practice to become
proficient. Regular checking and cleaning of the suction device
will ensure that you remain familiar with the device(s) used by
your club/service.
Figure 3.1: Using suction to clear a casualty’s airway
Suction comes in three types:
•manual
•oxygenpowered(vacuumbottle)
• battery(orelectric)powered.
Suction device components
While there are many variations to suction devices based on
the type and the manufacturer, there are four components
common to most suction devices. These are:
Suction catheter: A plastic tube which is inserted into the
casualty’s mouth to suction out any foreign material. Suction
catheters are single use only and should be disposed of in
clinical-waste containers.
Collection jar: Fluids and foreign material suctioned from the casualty are collected in the jar.
Collection jars are usually single-use with the jar being disposed of along with the contents in clinical-
waste containers.
Jar cap and connection port: The jar cap and connection port keeps the contents in the collection
jar and includes the fittings to connect the suction catheter and the device which provides the suction
power.
Suction device: The device which provides the suction power and is the suction pump handle in
manual devices, oxygen equipment in oxygen powered devices or the electric pump in a battery or
electric powered device.
NOTE:
SLSA has currently approved the use of manual suction devices only during surf lifesaving
operations
Hypoxia cause by suction
Hypoxia (lack of oxygen) is always a risk when suction is used. For this reason manual suction should
be on for only 15 seconds at a time with a break for at least five seconds in between operations.
This reduces the amount of oxygen taken from the casualty. Due to their constant suctioning action,
powered suctioning devices should only be used for five seconds before a five second break.
Topic3–Suction
Figure 3.2: Components of a manual suction device
41Advanced Resuscitation Techniques Certificate Learner Guide
Suction checks
• ensurethatthedeviceiscleanandthatallcomponentsare
available including:
– suctioncatheter
– collectionjar
– collectionjarcap
– suctiontubing(ifrequired)
– suctiondevice
• operatethemanualsuctiondevice(orturnsuctiononfor
powered devices)
•testforsuctionagainstthumborfingerbyplacingitoverthe
vacuum port (port should stick to the thumb or finger)
• turnoff(powereddevicesonly)
• returnthesuctiondevicetothecaseinitsoriginalposition.
Figure 3.3: Vacuum port
42 Advanced Resuscitation Techniques Certificate Learner Guide
Activity (individual) 3.1: Suction equipmentLook at the suction equipment that your club/service has available for use or the equipment you have
beenprovidedtotrainwith.Identifythefollowingcomponents:
•suctioncatheter
•collectionjar
•jarcapandconnectionport
•suctiondevice
•vacuumport
Ifyoucannotidentifyallofthecomponentscheckwithyourtrainer.Yourdevicemaynothavethese
exact components but will have something that performs the same function
Test the function of your suction device by performing the checks described above.
Administering suction
To remove mucus, fluid or blood from a casualty’s airway using suction, follow the steps outlined
below:1 check the suction device for correct operation
(asdescribedonpage40)
2 select the catheter and remove it from the
sealed packaging, leaving a contact point
within the wrapper
3 put on gloves
4 connectthesuctioncathetertotheconnection
port (or tubing for powered suction devices)
5 completely remove catheter from wrapper (turn
on the suction source for powered devices)
6 measurethemaximumlengthofinsertionby
placing the tip of the catheter at the corner of
the jaw and measuring to the centre of the lips.
Mark this point with a finger. (This will ensure
that you insert the catheter no further than the
back teeth)
Figure 3.4 Measuring insertion length
7 insertthecatheterintothelowercheekofthe
casualty (in the lateral position), ensuring that
the catheter is inserted no further than the
point marked by the operator’s finger
Figure 3.5 Inserting catheter no further than length marked by fingers
8 do not operate manual suction during
insertion (or occlude the catheter to operate
powered suction devices)
9 operate suction for no longer than 15
seconds with manual suction devices before
afivesecondbreak.(Ifusingpowered
devices suction only for five seconds before a
five second break).
10 rotate the catheter within the casualty’s lower
cheek, ensuring that the action is smooth and
gentle, to prevent damage
11 ensure that only two-thirds of the container is
filled
12 turn off suction on the completion of the
procedure (if using powered suction)
13 dispose of the catheter in the appropriate
manner.
43Advanced Resuscitation Techniques Certificate Learner Guide
Activity (group) 3.2: Administering suctionInpairsorgroupsofthree,practiseassemblingyoursuctionequipmentandsizingtheinsertion
distanceonyourpartner.Ifanappropriatemanikinisavailablepractiseperformingsuction.
NOTE:
To ensure infection-free training, do not place the suction catheter in your own mouth or that of
your partner(s).
Post-use maintenance of the suction unit
• disposeofdisposablejarsinasuitablemanner
• reusablejarscanbeflushedwithcleancoldwaterandrinsedwithantisepticsolution
• ensurethatallunitcomponentsaredisassembledandthoroughlycleanedasperARCguidelines.
Trouble shooting suctioning
Thereareanumberofreasonswhysuctionequipmentcanfailornotoperatecorrectly.Ifexperiencing
problems, check the following:
•isthesuctiontubingblocked
•isthecontentsbottlefullorcracked
•isthesealmissingorperished
•istheunitnotturnedon
•istheoxygensupplyexhausted(foroxygenpoweredunits)
•isthebatteryflat(ifbatterypoweredunit).
Assessment Task 4: Peer assessment – suctionAskapeertoassessyouusingthesuctiondevicetoprovideclearanairway(detailspage67).
Assessment Task 1: Written questionsCompletequestions34–36inyourassessmentportfolionow.
44 Advanced Resuscitation Techniques Certificate Learner Guide
Topic4–Defibrillation
What is defibrillation?Defibrillation is the delivery of an electrical current to the heart to correct an ineffective irregular heart
beat. The electricity is delivered indirectly to the heart via the chest wall.
Today in Australia public access defibrillators are becoming more widely available and training in their
use is easily accessed.
The Australian Resuscitation Council supports the implementation of public access defibrillation
programs and recommends that defibrillation should preferably be undertaken by trained lay people or
health professionals.
Figure 4.1 Comparison of survival rates from sudden cardiac arrest showing the difference made by defibrillation
Circulatory systemDespiteitsvitalimportance,theheartdoesnotworkalone.Itispartofthecardiovascular(circulatory)
system which also includes the kilometres of blood vessels that run through the body. Tissue cells
takeinnutrientsandoxygenandexpelwaste24hoursperday.
This can happen only with the continuous beating of the heart, a muscular organ that pumps blood
through a system of arteries and veins.
Arteries are large blood vessels which carry oxygen-rich blood from the heart to the rest of the body.
The arteries subdivide into smaller blood vessels and ultimately become capillaries. The capillaries
transport blood to all the cells of the body. After the oxygen is given to the cells, veins carry the blood
low in oxygen back to the heart.
45Advanced Resuscitation Techniques Certificate Learner Guide
Conditions which require first aid and defibrillation
The delivery of oxygen to the body can be threatened by the following cardiovascular conditions:
• bloodlosscausedbyseverebleeding(internalorexternal)
• impairedcirculation
• failureofthehearttopumpadequately,egheartattack,ordysrhythmia(irregularheartbeat).
Ifbodytissuesdonotreceiveoxygen,theyaredamagedbeyondrepair,egstroke.Strokeiswhenone
of the arteries supplying the brain is blocked or ruptures, resulting in an area of the brain receiving no
blood and the tissues becoming damaged. A similar effect occurs when one of the arteries supplying
theheartwithbloodbecomesblocked;thehearttissuesaredamagedbythelackofoxygenanda
heart attack is a possible outcome.
Iftheheartstopsbeating(cardiacarrest),itisinevitablethatbreathingwillalsocease.Theremaybe
some agonal respirations but these are not enough to sustain life.
The heart
Therelativesizeandweightoftheheartcontradictsitsincrediblestrengthandendurance.Aboutthe
sizeofyourfist,thehollowconeshapelooksnothingliketheheartthatistraditionallyshown.The
heartweighsabout250–350gramsandisabout12–14cmlong.Approximatelytwo-thirdsofthe
heart is located just to the left of the sternum (breastbone).
Thehearthastwoactions,mechanicalandelectrical.Electricalstimuluscausesmechanicalreaction
which results in a coordinated pumping action leading to effective circulation.
Mechanical action
The mechanical action of the heart pumps blood through its structures in the following way:
• fromthebody(upperandlower)
– totherightatrium
– totherightventricle
– tothelungs
• thenfromthelungs
– totheleftatrium
– totheleftventricle
• andouttothebody(upperandlower).
Electrical action
Inanormalheart,electricalimpulsestravelawell-defined
pathway:
• sinoatrial(SA)node
• atrioventricular(AV)node
• rightandleftbundlebranches
• conductionpathways(Purkinjefibres)
This electrical conduction pathway synchronises the atria
and ventricles to contract and relax in a coordinated motion
necessary to pump blood efficiently.
From lower body To lower bodyFigure 4.2 Mechanical action of the heart
Figure 4.3 Electrical action of the heart
46 Advanced Resuscitation Techniques Certificate Learner Guide
Electrocardiogram (ECG)
The electrical impulses passing through the heart can be mapped on a graph called an
electrocardiogram(ECG).Whenaperson’sheartbecomesstressed,changescanbeseeninthe
ECG.
Anautomatedexternaldefibrillator(AED)measurestheelectricalactivityinacasualty’sheart,through
electrodes placed on their chest, and recognises life-threatening abnormal rhythms (arrhythmias) such
as ventricular fibrillation and pulseless ventricular tachycardia.
Sinus rhythm
Thenormalrhythmofahealthyheartiscalledsinusrhythm.AnAEDwillnotrecommendashockifit
detects this rhythm in a casualty.
Figure 4.4 ECG of a sinus rhythm
Ventricular fibrillation
Ventricular fibrillation (VF) is a life-threatening heart arrhythmia which is characterised by chaotic
electrical and mechanical heart activity and which produces a quivering action rather than co-
ordinatedcontractions.Itismostcommonlyassociatedwithcoronaryarterydiseaseandheartattack
(myocardialinfarction).Electricalshock,poisoninganddrowningcanalsocauseventricularfibrillation.
Figure 4.5 ECG of ventricular fibrillation
Ventricular tachycardia (VT)
Ventricular tachycardia occurs when the ventricles beat faster than the rhythm generated by the SA
node. The rate will vary, however it is always faster than 100 bpm and generally slower than 200 bpm.
Figure 4.6 ECG of ventricular tachycardia
Ventricular tachycardia can be life-threatening as it may degenerate into Pulseless Ventricular
Tachycardia, inhibiting effective distribution of oxygenated blood throughout the body, leading to
hypoxia and organ damage, which may lead to death.
47Advanced Resuscitation Techniques Certificate Learner Guide
Signs and symptoms of VT include:
• fainting
• difficultybreathingorshortnessofbreath
• veryrapidpulseornopulse
• palpitations–thecasualtymayfeelliketheirheartisracing
• light-headednessordizziness
• chestpain
• pale/greyskincolour
• sweating
• nausea.
Management of VT
• minorcasesmayspontaneouslyreverttonormalsinusrhythmwithouttreatment
• pulselessVTwillrequiretreatmentwithanAED.
Asystole
Asystole refers to the absence of electrical activity in the heart.
Note:AnAEDwillnotrecommendashockasitcanonlycorrecttheheart’selectricalactivity,not
create it from nothing.
Figure 4.7 ECG showing asystole
Automated external defibrillators (AED)
AnAEDisusedtoreversetheeffectofacardiacarrest.
Cardiac arrest occurs when a casualty:
• isnotresponding
• isnotbreathing
AnAEDisonlytobeattachedtocasualtieswhoare
unresponsiveandnotbreathingnormally.However,anAED
should be on standby in all first aid situations where there is
a possibility the patient may go into cardiac arrest.
The defibrillation process uses electricity to contract
(depolarise) the entire heart muscle at one time. Following
this, resting (repolarisation) of the whole heart muscle occurs.
Effectivelytheprocessstopstheheart.Oncerepolarisationhasoccurred,itishopedthattheheart’s
normal electrical activity will resume. Defibrillation is the definitive treatment for Ventricular Fibrillation.
Public access defibrillation
Defibrillation technology and training has reached a level in society where it is making an extremely
positiveimpactinthechainofsurvival.AEDsareeasyformembersofthepublictouseandarewidely
available through public access defibrillation programs in public places such as airports, train stations,
stadiums and shopping malls.
WhileAEDsmaybeusedbymembersofthepublic,thebestoutcomesforthecasualtywillbe
achieved when they are used by trained personnel. Accordingly, when working in a team situation,
ateammemberwithspecifictrainingintheuseofanAED(suchasthisAdvancedResuscitation
Techniques Certificate) should operate it.
Figure 4.8 Example of an AED
48 Advanced Resuscitation Techniques Certificate Learner Guide
Use of defibrillators on children
AnAEDcanbeusedonchildrenagedoneandabove.Forchildrenagedonetoeight;iftheAEDhas
asettingthatreducesthejoulesdeliveredthisshouldbeused.Ifthisisnotavailabletheadultsetting
should be used.
AED operator responsibilities
ItistheresponsibilityoftheAEDoperatortoapplyandoperatetheAEDandensurethesafetyof
bystandersandotherfirstaiders.Todothis,theAEDoperatormusttakecontroloftheresuscitation
team,directingteammembersandbystandersasrequiredtoensurethesafeoperationoftheAED.
Approval of equipment
All defibrillation units must meet Australian Standards. For use within surf lifesaving they must also be
trialledbySLSAinaccordancewithPolicy1.6(NewandModifiedEquipment),beforetheyarecertified
for approval as surf rescue equipment.
Defibrillator components
A portable defibrillator of the type commonly used by first aiders consists of a case containing
thebaseunitwithsingle-use,self-adhesiveelectrodepads.InadditiontotheAED,thefollowing
accessories should be kept with the unit (either in the same case if possible or in a case attached to
the unit):
•resuscitationmasks(adult)
•gloves
•shears
•gauzewipes(orsimilar)
•sparebattery(ifapplicabletoAED)
Pre-operational checks
• spareelectrodepads
• spaceblanket
• penandpaper
• chamoisortowel.
AllmodernAEDswillhaveaself-checkmechanismtoensurethattheyareoperational.Thischeck
usually includes ensuring that there is a sufficient level of charge in the battery and that all electronic
components are functioning correctly. You should make yourself familiar with the unit used by your
club/service, including what is included in the automatic self-check and how you check that the unit
has passed the self-check.
At the start of a duty shift, you should check the following:
• AEDhaspassedtheselfcheck
• electrodepadsareindate(thiswillbemarkedontheoutsideofthepackaging)andthatthe
packaging has not been damaged
• alladditionalequipmentaslistedaboveorrequiredbyyourstateorserviceisincludedandinan
operational condition.
Major faults
A major fault is any fault that cannot be repaired through basic maintenance (eg cleaning and
replacement of spare or missing parts that are routinely stocked in the first aid room) and affects the
safety or ability to use the equipment properly. All major faults should be recorded in the relevant
document and reported to the club/service First Aid Officer.
49Advanced Resuscitation Techniques Certificate Learner Guide
Defibrillation pads
Pad positioning
Correct positioning of the electrode pads is essential
for successful defibrillation to take place. The optimal
position is usually indicated on the electrode pads or on
the packaging they come in:
• placethesternumelectrodepadtotherightofthe
sternum (breastbone) below the collarbone and above
the right nipple
• placetheapexelectrodepadtotheleftofthesternum,
with the upper edge of the pad below and to the left of
the left nipple.
• Ifthecasualtyhasanimplantedpacemakeror
defibrillator, make sure the pads are at least 8cm away
from it.
Prepare the casualty
• exposethecasualty’schest(includingremovingundergarments)
• itmaybenecessarytotrimhairifthecasualtyisveryhairy,withscissor/shearsinthelocations
where pads will be placed in order to have good adhesion to the skin
• drythecasualty’sskinifnecessary,duetoimmersionorsweat
• removeanymetaljewelleryandmedicationpatches
• ensurethatthecasualtyisnotlyingonmetalgrates,inpoolsofwateroronotherconductive
material.
NOTE:
LifeSavingVictorianolongersupportstheuseofarazorwhenremovingchesthairasthe
pressure of the situation leads to an increased risk to both the operator and patient of being cut by
therazorwhichaddsfurtherbiohazardousrisktothefirstaiderandpatient.
Safety precautions
A safe working environment must be created before defibrillation occurs. There are three areas of
danger directly related to the defibrillation process:
• contact
no person or conductive material is to be in direct or indirect contact with the casualty at the time of
defibrillation
• conduction
there should be no conductive items near the casualty, such as:
–water/rain(ensurethatyouareclearoftheincomingtideifinabeachenvironment)
–metal/grates
–moistureonthechest(egvomit,bloodorperspiration)
•explosion
–donotdefibrillateifthereisachanceofexplosionduetothepresenceofgases,fumesor
flammable substances.
–Oxygenmasksshouldbemovedawayduringdefibrillationandtheflowofoxygendirectedaway
from the chest.
Sternum Electrode
Apex Electrode
Figure 4.9 Defibrillator pad placement
50 Advanced Resuscitation Techniques Certificate Learner Guide
AED operation
DangerRemember safety precautions
for using an SEDResponse
Send for HelpAirway
BreathingCompressions
Team – perform CPR while waiting for AED
Individual – retrieve AED rather than performing
CPR– or send a bystander for AED if
possible and perform CPR
Take control of resuscitation(if in a team situation)
Introduce yourself and explain what you will do and what you need the team members to do.
Check AED– Check that AED is not
obviously damaged– Check that self test indicator
is showing ready for use
Turn on AEDPress the ON button or open
the lid as appropriate to device
Prepare casualty’s chestas explained on page 49
Apply pads– Positioning as explained on
page 49– Apply the pads in a roll-on
fashion to expel air and ensure good adhesion
Direct first aiders and bystanders not to touch the casualty
AED will prompt “Do not touch the patient, analysing rhythm”
Ensure that no one is touching the casualty
AED will analyse heart rhythm
No shock advisedAED will advise no shock
AED will advise to commence CPR
Ensure that no one is touching the casualty
Press the button to deliver shock
AED will analyse rhythmContinue CPR as
required
Place casualty in recovery position
Leave pads attachedMonitor responsiveness,
airway and breathing
Perform CPR AED may give CPR
directions – these can be ignored; CPR can be performed in line with
operator training
Check for response and normal breathing
AED will analyse rhythm every two minutesContinue CPR
ORcontinue to monitor airway, breathing and responsiveness
Handover to paramedics
Shock advisedAED will advise shock
AED will chargeAED will advise
“Press flashing button”
51Advanced Resuscitation Techniques Certificate Learner Guide
NOTE:
• Donotremoveelectrodesevenafteracasualty’sbreathingresumes.Keeptheminplaceto
allow prompt action should the casualty’s condition deteriorate
• Donotplaceelectrodesovermedicationpatches
• Ifthecasualtyhasanimplantedpacemaker,makesurethatthepadsareatleast10cmaway
from it.
Set protocols for shock delivery
TherearethreemainstepsforoperatinganAED:
•turnthemachineon
•applythepads
•respondtotheprompts.
DifferentAEDmachineshavedifferentprotocolsforshockdelivery.Somehavesetjoulesettings,
others have variable joule settings, and some even measure impedance and calculate the joules
needed.
When to introduce the AED
Inateamsituation–afterthecasualtyhasbeendeclaredas‘unresponsive’and‘notbreathing
normally’,commenceCPRimmediately.AsecondoperatorshouldintroducetheAEDatthesame
time CPR is commenced and prior to Oxygen.
Asanindividual–afterthecasualtyhasbeendeclaredas‘unresponsive’and‘notbreathingnormally’
theAEDisintroducedpriortoCPRandOxygen.CPRshouldbecommencedassoonaspossible.
52 Advanced Resuscitation Techniques Certificate Learner Guide
Activity (group) 4.1: Applying an AEDIngroupsofthree,practiseperformingtwo-operatorCPRwiththethirdpersonarrivingandapplying
theAED.RotatetherolesuntileachpersoninthegrouphasperformedtheroleofAEDoperator.
Make sure that you:
• takecontrolofthesituation
• assessresponse,airwayandbreathing
• preparethecasualty’schest
– removeclothing
– cliphair
– removemetaljewellery
– removemedicationpatches
• applypadstothecasualty
– incorrectpositions
– usingarollingmotion
• followthepromptsoftheAED
• ensurethatallfirstaidersandbystandersareclearofthecasualty
• delivertheshockasindicatedbytheAED
• directtheteamtocontinueCPRasrequired.
EachparticipantshouldalsoapplythedefibrillatorandperformCPRasasingleoperator.
Post-defibrillation casualty care
Ifthedefibrillationhasnotbeensuccessfulandwhenthestandardprotocolisexhausted:
• leavethepadsonthecasualty
•continueCPRuntilrelievedorunabletocontinue
•careforfamilyandfriendsofthecasualty.
Ifthedefibrillationhasbeensuccessful:
• leavethepadsonthecasualty
•checkforbreathing
• iftheyarenotbreathing,continueCPR
•iftheyarebreathing,checkforaresponse
•iftheyarenotresponding,placetheminthelateralposition
• iftheyareresponding,reassureandmakethemcomfortable.
Post-defibrillation equipment maintenance
After every use, the defibrillator should be disassembled, cleaned of sand and debris, reassembled
and tested as per the manufacturer’s instructions. Single-use items such as electrode pads and gloves
should be disposed of and replaced from stores in the first aid room. All other equipment should be
cleaned and disinfected and replaced in the kit.
Assessment Task 1: Written questionsCompletequestions37–45inyourassessmentportfolionow.
53Advanced Resuscitation Techniques Certificate Learner Guide
Activity (group) 4.2: Using oxygen equipment, oropharyngeal airways, suction and an AED during resuscitationThroughout the course you will individually have practised using oxygen equipment, oropharyngeal
airways,suctionandanAEDindividually.Resuscitatingacasualtyusingalloftheequipmentavailable
will provide the greatest chance of success.
Unfortunately each piece of equipment complicates the process which may have a negative impact
ofthechanceofasuccessfulresuscitation.Itisimportantthatyouarewell-practicedinusingthe
equipment together to ensure each piece of equipment is used to best effect at the most appropriate
time.
Your trainer will set you some scenarios to practise using the equipment individually and as a part of a
team.Ensurethatyoudebriefaftereachscenariotounderstandwhatwasdonewellandwhatcould
be improved.
54 Advanced Resuscitation Techniques Certificate Learner Guide
AssessmentInformationThere are eight assessment tasks required to complete the Advanced Resuscitation Techniques
Certificate course. Below is a description of the assessment tasks required to demonstrate
competenceinthiscourse;thissectionisforinformationonly.Allevidenceshouldbecollectedinthe
assessment portfolio section of this Learner Guide.
Assessment Tasks
Assessment task 1: Written questionsAll candidates are required to answers the questions outlined in the assessment portfolio section of
this Learner Guide in their own words.
ItisnotacceptabletocopythewordsdirectlyfromtheLearnerGuideoranothersource.
These questions will be reviewed by your trainer. Once your trainer is satisfied that you have correctly
answered all the questions they will sign the appropriate section of the assessment summary of the
assessment portfolio on page 58 in this Learner Guide.
Assessment Tasks 2, 3 and 4: Peer assessmentOxygenequipmentchecks(Assessmentportfoliopage65)OPairway(Assessmentportfoliopage66)
Suction(Assessmentportfoliopage67)
To complete each of these assessment tasks you will need to find a peer assessor who can watch you
complete the task and sign off that you correctly completed all components.
A peer assessor can be someone who is undertaking the course along with you or somebody who
already holds the qualification.
Your peer assessor will tick actions taken by you, providing relevant comment in the peer assessor’s
notes on delivery.
On successful completion of each peer assessment, present the completed checklist to your trainer
or assessor who will sign the appropriate section of the assessment summary of the assessment
portfolio on page 58 in this Learner Guide.
55Advanced Resuscitation Techniques Certificate Learner Guide
Assessment task 5: Scenario – airway management and oxygen useYour assessor will observe you as you work in a team of three performing CPR using airway
management and oxygen equipment. You will commence the scenario on a live casualty and change
to a manikin when directed.
Your assessor will use the observation list below when judging your competence.
Your assessor will mark the competency outcome and sign the appropriate section of the assessment
summary of the assessment portfolio on page 58 in this Learner Guide.
YourassessormayincludeanothercandidatewhoiscompletingAssessmentTask7inthissame
scenario.
Live Casualty Assessment1. Team checks for danger• hazardsandriskstoself,bystandersand
casualty identified• positionofcasualtyand/orequipment
assessed• PPEputonAssessor to advise that the casualty is unconscious, unresponsive and not breathing• CPRcommencedbyrescuebreathing
operator and chest compression operator
2. Team members assess casualty’s condition• Unconscious,unresponsiveandnotbreathing
normally• physicalappearance• medicalhistory• detailsofincidentandothersignsand
symptoms• callforambulance
3. Oxygen resuscitation operator• selectsappropriateequipment—OPairway
and/or suction (optional)• communicatesactionswithteam.
4.SuctionOxygen resuscitation operator to clear airway using suction, if appropriate to scenario.(Insertiontobedemonstratedonamanikin.)• suctionapparatususedinasafemanner
making sure that the apparatus doesn’t go any further than the back teeth.
• oxygenresuscitationoperatorattachescatheter to suction tubing correctly
• distancemeasuredandcatheterlubricatedcorrectly
• casualty’smouthopenedandheadtiltmaintained
• suctionadministeredcorrectlyensuringprevention of hypoxia and appropriate areas cleaned.
5. OP airway• oxygenresuscitatoroperatortosizeOPairway• OPairwayinsertedinlateralposition,if
appropriate to scenario (use manikin if available otherwise have candidate describe insertion)
CPR and oxygen use on manikin6.Resuscitationmaskandoxygen-
supplemented resuscitation• oxygenresuscitationoperatoradvisesrescue
breathing operator to assume jaw thrust• resuscitationmaskintroducedifnotalreadyin
use• oxygenresuscitatoroperatorprovidesoxygen
therapy tubing for supplemented rescue breathing
7.Oxygenresuscitatoroperator:• demonstratesfullyopenmedicaloxygen
bottle, release pressure by half turn back• checkairbag.(Blockpatientvalvewiththumb
and compress airbag, release and ensure rapid refill)
• checkpatientvalvefunction.(Inflatereservoirbag via patient valve, deflate reservoir bag and check patient valve airflow bypasses return into recoil bag)
• checkoperationofintakevalvefromoxygenreservoir.(Inflatedreservoirbagsqueezedtocheck air flow into recoil bag)
• attachresuscitationtubetooxygenintakenipple.Checkairflowissetat14or15litresper minute
• inflatereservoirbagandpurge• adviserescuebreathingoperatorreadyto
insert patient valve and airbag to casualty• airbagisdepressedcorrectlyforcasualty(two
hands for adult, one hand for child)• reassessthecasualty’sheadtilt,observethe
rise and fall of the casualty’s chest, monitor the OP airway
• maintaincommunicationwithothermembersof the team to facilitate the effective delivery of oxygen.
• assessortoadvisethatcasualty’sbreathinghas resumed
• teamtoreassessbreathingandresponseandmonitor the casualty in appropriate position (lateral unconscious)
• oxygenresuscitatoroperatorprovidesoxygentherapy set at correct flow rate (8 litres per minute)
• oxygenresuscitatorstoresairbagforpossiblere-use
• oxygenresuscitatoroperatorcommunicatesfuture actions with team
• incidentdetailsrecorded• Casualtyreassuredandmadecomfortable
• handovertoambulance.
56 Advanced Resuscitation Techniques Certificate Learner Guide
Assessment Task 6: Scenario review – verbal questionsConduct an incident debrief with your resuscitation team. Once you have done this, your assessor will
ask you questions about your club and the scenario you participated in during Assessment Task 5
1 Where are replacement supplies available at your club?
2 IfinAssessmentTask5theoxygenbottlehadmalfunctionedorrunoutofoxygen,whatwouldyou
have done?
3 Atyourclub,hazardousmaterialisdisposedinwhatmanner?
4 Whatwerethreeareasofimprovementidentifiedduringyourdebrief?
5 What would you do if you or a member of your team was experiencing stress after an incident?
Assessment task 7: Scenario – defibrillationYou will operate the defibrillator while working with a team performing CPR (this may be a team
completing Assessment Task 5). You will commence the scenario on a live casualty and change to a
manikin when directed.
Your assessor will use the observation list below when judging your competence.
Your assessor will mark the competency outcome and sign the appropriate section of the assessment
summary of the assessment portfolio on page 58 in this Learner Guide.
Live Casualty Assessment• identifyhazardsandriskstoself,casualtyand
bystanders—isolateelectricity,checksliphazard,etc
• assesspositionofcasualtyand/orequipment• PPEputon
Assessor to advise that the casualty is unconscious, unresponsive and not breathing
• callforambulance
Manikin introducedApplyAED–Defibrillatoroperatorto:• communicateactionswithteam•surroundingareaforhazards—conductors,
placement of oxygen unit, etc• TurnonAEDandfollowprompts• preparecasualty’schestreadytoapply
electrodepads—dry,clipexcessivehair,check for pacemaker, medical patches
• applyelectrodepads• Deliverashockinanappropriateandsafe
manner when prompted.•maintaincommunicationwithothermembers
of the team to facilitate the effective delivery of oxygen and compressions
CPR and oxygen use on manikin• CPRoperatorstocommenceCPR• oxygenresuscitatoroperatortooperateairbag
resuscitator
Casualty is now breathing• teamtoreassessresponseandbreathingand
monitor casualty in appropriate position (lateral position if unconscious)
• teamtotreatcasualtyforshock• electrodepadstoremainoncasualtyuntil
ambulance arrives• defibrillationoperatortocommunicatefuture
actions with team• incidentdetailstoberecorded• reassurecasualtyandmakecomfortable• handovertoambulance• defibrillatorunittobecheckedandmadeready
for use
Assessment task 8: Incident documentationComplete the incident report form, in the assessment portfolio section of this Learner Guide, to record
yourcasualty’sdetailsandactionstakenduringeitherAssessmentTask5or7.
Your assessor will review your log to ensure that you have satisfactorily filled it out with all the relevant
information you received during the scenario and then mark the competency outcome and sign the
appropriate section of the assessment summary on page 2 of the assessment portfolio.
57Advanced Resuscitation Techniques Certificate Learner Guide
Assessment PortfolioThis portfolio includes all the evidence you are required to submit to your assessor to demonstrate competence in the Advanced Resuscitation Techniques Certificate and the related competencies listed in the competency record below.
Learner details
First name: Surname:
Date of birth: Club / Group:
Telephone:
Email:
Competency record
SLSA Course Co
mp
eten
t
No
t ye
t
com
pet
ent
Advanced Resuscitation Techniques Certificate
Nationally recognised units of competency
PUAEME003CAdministeroxygeninanemergencysituation
PUAOPE010COperateanautomatedexternaldefibrillatorinanemergency
HLTFA404AApplyadvancedresuscitationtechniques
Assessor Name
Assessor Signature Date
58 Advanced Resuscitation Techniques Certificate Learner Guide
Assessment Summary
Assessment Tasks Dat
e C
om
ple
ted
Sat
isfa
cto
ry/
No
t
Sat
isfa
cto
ry (S
/NS
)
Assessor Signature
Task 1: Written questions
Task2:Peerassessment–oxygenequipmentchecks
Task3:Peerassessment–oropharyngealairway
Task4:Peerassessment–suction
Task5:Scenario–airwaymanagementandoxygenuse
Task6:Scenarioreview–verbalquestions
Task7:Scenario–defibrillation
Task8:Incidentdocumentation
Comments
59Advanced Resuscitation Techniques Certificate Learner Guide
Assessment task 1: Written questionsAll candidates are required to answer the questions in their own words.
ItisnotacceptabletocopythewordsdirectlyfromtheLearnerGuideoranothersource.These
questions will be reviewed and signed off by your trainer/facilitator.
Topic 1 – First Aid and Resuscitation Review1 OxygenresuscitationequipmententerstheChainofSurvivalattheEarlyCPRlink.Trueorfalse?
Circle the correct answer.
TRUE/FALSE
2 You have volunteered to give first aid to competitors at a sporting event. A spectator collapses and
requires resuscitation. Because you are rostered on as a first aider, you have a duty of care to help
thespectator.Isthistrueorfalse?Circlethecorrectanswer.
TRUE/FALSE
3 The catch phrase of the Australian Resuscitation Council is ‘any attempt at resuscitation is better
than no attempt.’ Consider the italicised sentence and explain how bystander CPR contributes to
the Chain of Survival sequence.
4 Explainwhyadvancedresuscitationtechniques(oxygenuseanddefibrillatorshock)canimprovea
casualty’s chance of survival in a cardiac arrest.
5 Once you have gained the award you are training for, what steps can you take to protect yourself
from an action of negligence?
6 Australiaisamulticulturalsocietyandasafirstaideryoumayneedtotreatacasualtywithdifferent
customs and beliefs from you. What should you do to respect their customs and beliefs? Circle the
correct answer.
a do nothing as they may not want you to because of their beliefs
b seek permission before providing any treatment from the casualty or family member if present
c do not worry about their beliefs, providing first aid is more important
d treat them only if a male family member is present to give permission
7 Onceyougaintheawardyouarestudying,whatdoyouneedtodotokeeptheawardcurrent?
8 Following an incident, a fellow club member asks you for specific information about the incident.
Are you able to freely discuss the treatment you provided and give out personal information? Circle
the correct answer.
a yes—solongasthecasualtyisnotidentified
b yes—providedIhaveconsentfromthecasualty
c no—theinformationmustremainconfidential
d no—notevenifthiscasualtyhasgivenconsent
60 Advanced Resuscitation Techniques Certificate Learner Guide
9 What is the standard response time of an ambulance to your club/area of operation?
10 How do you use the first aid and emergency care equipment at your club?
a in accordance with manufacturer’s instructions
b in the lateral position
c in accordance with SLSA standards, policies, procedures and protocols
d both a and c
Topic 2 – Advanced Resuscitation and Oxygen Administration11 On the diagram below:
a label the upper and lower sections of the respiratory system
b label the lungs and draw and label where the diaphragm is located
12 What does inhalation mean and how is it achieved?
13Explainwhathypoventilationis.
14Explainthetreatmentforthefollowingrespiratoryconditions
Asthma
Chronic Obstructive Airways Disease (COAD) (Also note how you will know the casualty has this
illness.)
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15 Following resuscitation, you place a casualty in the lateral position. While waiting for the
ambulance you notice that their breathing becomes noisier. What may this indicate to you?
16 Hypoxiaresultsfromless-than-normaloxygencontentintheorgansandtissuesofthebodyand
causesimpairmentoftheirfunction.Belowisonecauseofhypoxia;nametwoothercauses.
1 Reduced gas (oxygen exchange because of water in lungs)
2
3
17 Duringanoxygen-aidedresuscitationattemptyounotethatthecasualty’schestisnotrisingor
falling. What would you do?
18 Complete the following table:
Oxygen delivery rate Oxygen % delivered
Delivery time full ‘C’ sized
cylinder
Oxygen therapy
Resuscitation using airbag
19 What information is marked on the oxygen cylinder during a pre-patrol check?
20 How frequently should oxygen equipment be serviced?
21 How do you know that your oxygen equipment meets Australian Standards?
22 What are two safety considerations for the handling and storage of oxygen equipment?
23 List four casualty conditions that benefit from oxygen therapy treatment.
1
2
3
4
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24 Whendeliveringoxygen-aidedresuscitationthecasualty’schestisnotobservedrising.Jawthrust
is checked and the casualty’s airway cleared of foreign material. After re-positioning the mask the
chest fails to rise. What would you instruct your team to do next?
25 What is an MSDS, where is it found and what information found in it will be useful to you as a first
aider?
M S D S
26 Inwhatpositionshouldoxygentherapybeadministeredtoanunconscious,breathingcasualty?
a lying flat, with their legs raised
b in the lateral position
c on their back
d the most comfortable position
27 Listthreesafetyprecautionstofollowwhenusingoxygen.
1
2
3
28 When conducting the pre-operational check you find a faulty reservoir bag in the oxygen
resuscitation equipment carried on the ATV. Write down what you would do and how you would
record your actions.
29 After using your oxygen resuscitator to treat a casualty, what would you do to restore the
equipment ready for use?
Oropharyngeal airways
30 During the pre-operational check of oxygen equipment, what should an OP airway be checked
for?
31 When should you insert an oropharyngeal (OP) airway?
32 How will the OP airway assist in the management of a casualty’s airway?
33 When inserting the OP airway what precautions should you observe?
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Topic 3 – Suction34 Howfarcanyouinsertthesuctioncatheterintotheunconsciouscasualty’smouth?
35 What can the operator do to limit hypoxia developing when using suction equipment?
36 Cansuctioncathetersbere-usedonadifferentcasualty?Circlethecorrectanswer.
a yes—inanemergency
b no—mustbediscarded
c yes—aftersterilisation
Topic 4 – Defibrillation37 Fillintheblanksintheparagraphbelow.
stimulus causes a reaction which results in coordinated
leading to effective.
38 Describe the steps you would take to perform a pre-operational check on a defibrillator unit.
39 How frequently should a defibrillation unit be serviced?
40 Duringthepre-operationalcheckyoufindthespareelectrodepadsareoutofdate.Whatwillyou
do to make the defibrillation unit operational?
41 Listthestepsrequiredtoachieveeffectiveadherenceofelectrodepadstothecasualty.
42 Inwhatcircumstanceswouldyounotuseadefibrillatoronacasualty?
43 Thedefibrillatorwillrecogniseandadvisetheoperatorifacasualtyhasashockablearrhythmia.
Circle the term that describes a normal heart rhythm.
a asystole
b ventricular tachycardia
c ventricular fibrillation
d sinus rhythm
64 Advanced Resuscitation Techniques Certificate Learner Guide
44 Defibrillatorpadsshouldberemovedwhenacasualtyregainsconsciousness.Trueorfalse?Circle
the correct answer.
TRUE/FALSE
45 Insomeplacesitmaynotbesafetooperateadefibrillator.Listoneexample.
65Advanced Resuscitation Techniques Certificate Learner Guide
Assessmenttask2:Peerassessment–oxygen equipment checksInstructionstopeerassessor
•ticktheactionstakenbythecandidate,andproviderelevantcommentsinthepeerassessor’s
notes.
• thecandidateshouldverballyidentifyeachpieceofequipmentchecked.
Observation Tick
1 Cylinder check
• removedprotectiveplasticwrappingfromcylinder
• cylinder‘cracked’
• sealingwasherchecked
• cylinderinsertedintoyokecorrectly—locatingpins
• cylindercontentschecked
2 Contents check
• oxygentubingchecked
• oxygenflowchecked
• ensurednoodourfromoxygen
• operationofoxygennippleschecked
• therapyandresuscitationmaskschecked
• oropharyngealairwayschecked
• chalk/marker,gloves,padandpen,sparesealingwasherchecked
3 Airbag and reservoir bag checks
• airbagcheckedforleaksanddirectionofairflow
• functionofthepatientvalve(onewayflow)checked
• functionoftheoverflowmembraneofthereservoirvalve(Laerdalbagonly)checked
• air-intakemembraneoftheairbagchecked
• reservoirbagcheckedforleaks,perforations
4 Restore equipment
• oxygenisfullydrainedfromsystem
• unitcleaned,ensuringfreeofsandanddebris
Peer assessor’s notes
Theparticipanthassuccessfullycompletedthistask:YES/NO
Peer assessor signature: Date:
66 Advanced Resuscitation Techniques Certificate Learner Guide
Assessmenttask3:Peerassessment–OP airway
Instructionstopeerassessor
• ticktheactionstakenbythecandidate,andproviderelevantcommentsinthepeerassessor’s
notes
• thecandidateshoulddescribewhattheyaredoingastheysizeandinserttheOPairway.
Observation Tick
1 Size OP airway
• OPairwayplacedagainstcasualty’sface
• flangeplacedincentreoflipswithairwayextendingtowardscornerofjaw
• OPairwaysizecheckedbyensuringitreachesangleofthecasualty’sjaw
• stepsrepeateduntilcorrectsizeselected
2 Insert OP airway
• casualty’sairwayopened(jawthrust)
• OPairwayheldbyflange
• lubricateOPairway
• OPairwayinsertedupsidedownonethirdoflengthintomouth
• insertioncontinuedwhilerotatingOPairway180degrees
• insertuntilflangerestsagainstcasualty’slips
• ensurethatlipsarenotpinchedbetweenteethandOPairway
3 Remove OP airway
• OPAirwaypulledstraightout(norotation)followingOPairwaycurve
•OPairwaydisposedofincontaminatedwaste
Peer assessor’s notes
Theparticipanthassuccessfullycompletedthistask:YES/NO
Peer assessor signature: Date:
67Advanced Resuscitation Techniques Certificate Learner Guide
Assessmenttask4:Peerassessment–suctionInstructionstopeerassessor
• ticktheactionstakenbythecandidate,andproviderelevantcommentsinthepeerassessor’s
notes
• thecandidateshoulddescribewhattheyaredoingastheyusesuction,andidentifyeachpieceof
equipment checked and the reason for checking.
Observation Tick
Suction
• glovesapplied
• suctiontestedbyplacinghandovernozzleandoperatinghandpump
• correctfittingofdisposablesealedjarchecked
• suctioncatheterremovedfromsealedpackagingandattachedtosuctiondevice
• distancefromcentreoflipstoangleofjawmeasured
• fingersplacedoncathetertiptomarkdistance
• casualty’smouthopened
• catheterinsertednofurtherthanbackofteeth(markeddistanceasmeasuredabove)
• suctionoperatedfornolongerthan15secondswithoutabreak
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IncidentReportLog
69Advanced Resuscitation Techniques Certificate Learner Guide
Peer assessor’s notes
Theparticipanthassuccessfullycompletedthistask:YES/NO
Peer assessor signature: Date:
Resuscitation Report Form
70 Advanced Resuscitation Techniques Certificate Learner Guide
71Advanced Resuscitation Techniques Certificate Learner Guide
Course evaluationCourse date: Location: Your name: (Optional)
Trainer(s) and assessor(s):
Yourevaluationofthisprogramisveryimportant.Itenablesustoimproveourtrainingprogramsandthe quality of our service.
StatementsStrongly disagree
Disagree N/A AgreeStrongly
Agree
Course content
The course was explained to me prior to commencing and met my expectations.
The course had the right balance between theory and practice.
The course was the right duration and intensity.
General comments on course content
Course material
The course materials were clear and easy to follow.
The activities were realistic and effective.
The course materials will be a useful ongoing reference.
General comments on course material
Training personnel
Knowledge was sufficient to effectively deliver the course.
Kept the course interesting and interactive.
Provided clear and complete answers to questions.
General comments for the facilitator
Overall outcomes
My knowledge and skills increased as a result of this course.
This course has helped me meet or clarify my goals.
Course assessment activities were fair and realistic.
General comments about the overall outcomes of the course
Thank you for taking the time to provide this feedback
72 Advanced Resuscitation Techniques Certificate Learner Guide
Advanced Resuscitation Techniques Certificate–checklist
To ensure that your Advanced Resuscitation Techniques Certificate Learner Guide is complete prior to submission, with the assistance of your assessor, please tick the checklist to ensure all items have been completed and attached as required.
CandidatenameandAssessmentIDwrittenonfrontcover
Plagiarismdeclarationsignedanddatedbystudent–page1
Alltasksandactivitiesinworkbookarecompletedbycandidate–pages14–53
Assessment Portfolio is completed with:
AssessmentTask1:Writtenquestions–page59
AssessmentTasks2,3and4:Peerassessment–pages65–67
Assessmenttask5:Scenario–airwaymanagementandoxygenuse–page55
AssessmentTask6:Scenarioreview–verbalquestions–page55
Assessmenttask7:Scenario–defibrillation–page55
Assessmenttask8:Incidentdocumentation–pages68–69
CompetencyRecordcompleted–page57. C / NYC circled, and assessor’s name and signature inserted
AssessmentSummarycompletedandsignedbyassessor/s–page58
CourseEvaluationcompleted–page71
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