Rookie Patrol First Aid Primary assessment: hazards & ABCs 11 · LIFESAVING SOCIETY 12 SWIM PATROL AWARD GUIDE Rookie Patrol First Aid. Rescue breathing Item 12 To support breathing

Primary assessment:hazards & ABCs Item 11

To assess an unconscious breathing victim with respect to hazards and ABCs.

Purpose

• Victim is classified as an adult. If

alone, rescuer phones Emergency

Medical System (EMS) right

away. If another person is avail-

able, rescuer directs him or her to

phone EMS.

• To establish unresponsiveness,

rescuer may shake shoulder and

ask "Are you OK?" Other tech-

niques are acceptable.

• Rescuer opens airway using

head-tilt/chin-lift technique.

• See suggested learning

activities, p. 81

Notes

❏ Assessment of environment for hazards

❏ Establish unresponsiveness

❏ Activate Emergency Medical System

❏ Position victim (turn if necessary)

❏ Open airway

❏ Check for breathing: look, listen and feel (no more than 10 sec.)

❏ Recovery position for breathing victim

Must See

Demonstrate a primary assessment including hazards and ABCs on an unconscious, breathing victim.

12LIFESAVING SOCIETY SWIM PATROL AWARD GUIDE

Rookie PatrolFirst Aid

Rescue breathingItem 12

To support breathing in an unconscious, non-breathing victim.

Purpose

• Victim is classified as an adult.

Send bystander to phone EMS. If

alone, rescuer phones EMS right

away.



• Rescue breaths: rescuer delivers

normal breaths (each over 1

second) that make chest rise.


activities, p. 83-4.

• See Canadian Lifesaving

Manual, Appendix B for guide-

lines on rescue breathing prac-

tice.

Notes




❏ Open airway


❏ 2 rescue breaths: observe chest rise

❏ Continue rescue breathing and attempt to recruit a CPR-qualified person for assistance

Must See

Demonstrate rescue breathing on a manikin.


Rookie PatrolFirst Aid

Rescue breathingItem 13

To support breathing in an unconscious, non-breathing victim.

Purpose


Send bystander to phone EMS.

If alone, rescuer phones EMS

right away.




normal breaths (each over 1

second) that make chest rise.


activities, p. 84

• See Canadian Lifesaving

Manual, Appendix B for

guidelines on rescue breathing

practice.

Notes




❏ Open airway


❏ 2 rescue breaths: observe chest rise

❏ Continue rescue breathing and attempt to recruit a CPR-qualified person for assistance

❏ Ability to clear the airway when victim vomits

Must See

Demonstrate rescue breathing and the ability to manage vomiting.


Ranger PatrolFirst Aid

Obstructed airway— conscious victim Item 14

To acquaint lifesavers with the appearance of a conscious victim with an obstructed airway and tointroduce the appropriate lifesaving skills.

Purpose

• Supervise candidates carefully

during training in obstructed

airway techniques. Caution

rescuers to simulate treatment:

misplaced or excessive thrusts

can be dangerous.

• Conscious victim simulates

either mild or severe airway

obstruction. To signal the type

of assistance needed, teach the

universal choking signal.

• Rescuer assumes severe obstruc-

tion if victim nods “yes” when

asked “Are you choking?” or if

victim clutches neck or cannot

speak or breath.


activities, p. 84-5.

Notes

❏ Assessment of degree of obstruction – ask: “Are you choking?”

❏ Selection of appropriate procedures

Mild obstruction

❏ Coughing encouraged

❏ Reassurance for victim

Severe obstruction

❏ Shout for help

❏ Careful landmarking

❏ Repeated abdominal thrusts (chest thrusts for pregnant or obese victim) until the airway is clear

❏ If successful, victim directed to see a physician to rule out complications from the obstruction or treatment

Must See

Simulate the appearance and treatment of a conscious victim with an obstructed airway.


Ranger PatrolFirst Aid

Obstructed airway — unconscious victim Item 15

To clear airway obstruction and restore normal breathing in an unconscious victim.

Purpose


Send bystander to phone EMS.

If alone, rescuer phones EMS

right away.

• If practicing this skill item on a

person (versus a manikin) res-

cuers simulate compressions to

prevent injury.

• Victim simulates severe airway

obstruction.

• Candidates should also practice

a sequence that begins with a

conscious victim who becomes

unconscious. Rescuer begins

with ABC assessment of uncon-

scious victim.

• Use of barrier devices is recom-

mended.


activities, p. 85

Notes




❏ Attempt to recruit a CPR-qualified person for assistance

❏ Open airway

❏ Check for breathing: look, listen, feel (no more than 10 sec.)

❏ If breathing is absent, 2 rescue breaths: observe chest rise

❏ If unsuccessful, reposition airway and re-attempt to ventilate

❏ If unsuccessful, careful landmarking and 30 chest compressions

❏ Foreign body check: look in mouth and if object can be seen, attempt to remove it

❏ Attempt to ventilate: if successful, reassess responsiveness and breathing and treat appropriately

❏ If unsuccessful, repeat sequence (reposition head, re-attempt to ventilate, chest compressions,foreign body check) until successful.

Must See

Simulate the treatment of an unconscious victim with an obstructed airway.


Star PatrolFirst Aid

Adult CPRItem 10

To restore breathing and circulation in an unconscious, non-breathing and pulseless victim.

Purpose

• Send bystander to phone EMS. If

alone with an adult victim, res-

cuer phones EMS right away. If

alone with a child or infant vic-

tim, rescuer phones EMS after

about 5 cycles of 30:2 compres-

sions to breaths.

• If an Automated External

Defibrillator (AED) and AED-

trained responder are available,

rescuer should send for them

after activating EMS and assist

the AED responder as directed.




normal breaths (each over 1 sec-

ond) that make chest rise.

• Compressions: push hard and

fast allowing chest to recoil

completely between compres-

sions.


mended.

• See Canadian LifesavingManual, Appendix B for guide-

lines on rescue breathing

practice.

Reference:CLM Chapter 7.2 The ABC Priorities;7.4 Rescue Breathing;7.5 Cardiopulmonary Resuscitation

Notes




❏ Attempt to obtain AED and recruit AED-trained responder if available

❏ Open airway



❏ Careful landmarking and chest compressions (30 compressions: 2 rescue breaths)

❏ CPR continued until EMS takes over treatment, or an AED-trained responder begins treatment with an AED, or the victim begins to move

❏ If victim begins to move, reassess ABCs and treat appropriately

Must See

Demonstrate single rescuer adult cardiopulmonary resuscitation (CPR) on a manikin.

11LIFESAVING SOCIETY BRONZE MEDAL AWARDS

Bronze StarFirst Aid

* One-rescuer CPR:adult & child Item 7

To support breathing and circulation in an unconscious, non-breathing, and pulseless victim.

Purpose

• Send bystander to phone EMS. If

alone with an adult victim, res-

cuer phones EMS right away. If

alone with a child or infant vic-

tim, rescuer phones EMS after

about 5 cycles of 30:2 compres-

sions to breaths.

• If an Automated External

Defibrillator (AED) and AED-

trained responder are available,

rescuer should send for them

after activating EMS and assist

the AED responder as directed.




normal breaths (each over 1 sec-

ond) that make chest rise.

• Compressions: push hard and

fast allowing chest to recoil

completely between compres-

sions.


mended.

• See Canadian LifesavingManual, Appendix B for guide-

lines on rescue breathing

practice.


Notes



❏ Activate Emergency Medical System (EMS)


❏ Open airway






Must See

Demonstrate rescue breathing and cardiopulmonary resuscitation (CPR) on a manikin, including:• Adult and child victims• Complications in resuscitation (vomiting)• Adaptations (mouth-to-nose, stoma)


Bronze MedallionFirst Aid

* Obstructed airway:conscious victim Item8a

To enable lifesavers to recognize a conscious victim with an obstructed airway and to perform theappropriate lifesaving techniques.

Purpose


during training in obstructed

airway techniques. Caution

rescuers to simulate treatment

– misplaced or excessive

thrusts can be dangerous.



obstruction. To signal the type

of assistance needed, teach the


• Rescuer assumes severe

obstruction if victim nods “yes”

when asked “Are you chok-

ing?” or if victim clutches neck

or victim cannot speak or

breath.

Reference:CLM Chapter 7.2 The ABC Priorities;7.3 Coping with Complications during theABCs; 8.3 Airway and Breathing Problems

Notes

❏ Assessment of degree of obstruction – ask, “Are you choking?”

❏ Selection of appropriate procedures:

Mild obstruction



Severe obstruction

❏ Shout for help



❏ If successful, victim directed to see a physician to rule out complications from the obstruction or the abdominal thrusts

Must See

Simulate the treatment of: • A conscious adult or child with an obstructed airway• Complications – a pregnant woman and a person who is obese



Item8b

To clear an airway obstruction and restore normal breathing in an unconscious victim.

Purpose

• Send bystander to phone EMS. Ifalone with an adult victim, res-cuer phones EMS right away. Ifalone with a child or infant vic-tim, rescuer phones EMS afterabout 5 cycles of 30:2 compres-sions to breaths.

• If an Automated ExternalDefibrillator (AED) and AED-trained responder are available,rescuer should send for themafter activating EMS and assistthe AED responder as directed.

• If practicing this skill item on aperson (versus a manikin) res-cuers simulate compressions toprevent injury.

• Victim simulates severe airwayobstruction.

• Candidates should also practicea sequence that begins with aconscious victim who becomesunconscious. Rescuer beginswith ABC assessment of uncon-scious victim.

• Use of barrier devices is recom-mended.

• See Canadian Lifesaving Manual,Appendix B for guidelines onrescue breathing practice.


Notes



❏ Activate Emergency Medical Services (EMS)


❏ Open airway






❏ Attempt to ventilate: if successful continue CPR sequence

❏ If unsuccessful, repeat sequence (reposition head, re-attempt to ventilate, chest compressions,foreign body check) until successful

Must See

Simulate the treatment of an unconscious adult or child with an obstructed airway.



* Obstructed airway:unconscious victim

* First aid assessment Item 4

To demonstrate proficiency in assessing an injured victim.

Purpose

• This item is designed to empha-

size the principles and proce-

dures of victim assessment.

• Candidates assess both con-

scious and unconscious victims.

• Candidates are not expected to

demonstrate treatment of

injuries.

• Scene survey includes mecha-

nism of injury and assessing

risk of spinal injury.

Reference:CLM Chapter 6.2–6.6 First Aid: TheRescue Process; 7.2 The ABC Priorities

Notes

❏ Evaluation of the rescue scene

❏ Removal of or from danger with assistance as required

❏ Appropriate communication with victim

❏ Appropriate assessment technique for the victim type – conscious versus unconscious

❏ Care taken in moving victim with assistance as required especially if further injuries suspected (for example, spinal injury)

Primary assessment

❏ Level of consciousness

❏ Determine mechanism of injury

❏ Assessment of airway, breathing, circulation (bleeding, and shock)

❏ Check for major bleeding

Secondary assessment

❏ Relevant history (accident, medical, personal)

❏ Taking and recording vital signs (level of consciousness, respiration, pulse, pupils,skin colour and temperature)

❏ Systematic head-to-toe examination

❏ Airway maintained

Must See

Demonstrate primary assessment of a consciousvictim and an unconscious victim, including:• Level of consciousness • Airway• Breathing• Circulation• Major bleeding• Mechanism of injury

Demonstrate secondary assessment of a victimincluding:• Vital signs • Head-to-toe survey• History


Bronze CrossFirst Aid

* One-rescuer CPRItem 5


Purpose



• Rescuer opens airway usinghead-tilt/chin-lift technique.

• Rescue breaths: rescuer deliversnormal breaths (each over 1 sec-ond) that make chest rise.

• Compressions: push hard andfast allowing chest to recoilcompletely between compres-sions.




Notes





❏ Open airway






Must See

Demonstrate rescue breathing and cardiopulmonary resuscitation (CPR) on a manikin, including:• Adult, child, and infant victims• Complications in resuscitation (vomiting)• Adaptations (mouth-to-nose, stoma)



* Two-rescuer CPRItem 6


Purpose

• Two-rescuer CPR: both rescuers

are trained. Two options:

rescuers take turns doing

one-rescuer CPR, or one rescuer

performs chest compressions

while the other does rescue

breathing. Rescuers switch

roles approsimately every 2

minutes (5 cycles of 30:2) to

minimize fatigue. Rescuers

communicate and cooperate in

decision-making and CPR

performance.

• Use of barrier devices is

recommended.

• See Canadian Lifesaving Manual,Appendix B for guidelines on

rescue breathing practice.


Notes

Rescuer #1

❏ Performs one-rescuer CPR sequence

Rescuer #2

❏ Identifies self as CPR trained and confirms EMS activation

Both rescuers

❏ Continue CPR and switch roles with as little interruption as possible

❏ Continue CPR until EMS takes over, or an AED-trained responder begins treatment withan AED unit, or the victim begins to move

❏ If the victim begins to move, reassess ABCs and treat appropriately

Must See

Demonstrate two-rescuer adult, child, and infant cardiopulmonary resuscitation (CPR) on a manikin.



* Obstructed airway:conscious adult or child

Item7a

To enable lifesavers to recognize a conscious victim with an obstructed airway and to perform appropriate lifesaving techniques.

Purpose


during training in obstructed air-

way techniques. Caution res-

cuers to simulate abdominal or

chest thrusts. Misplaced or exces-

sive thrusts can be dangerous.



obstruction. To signal the type of

assistance needed, teach the



obstruction if victim nods “yes”

when asked “Are you chok-

ing?” or if victim clutches neck

or victim cannot speak or

breath.


Notes

❏ Assessment of degree of obstruction – ask, “Are you choking?”


Mild obstruction



Severe obstruction

❏ Shout for help



❏ If successful, victim directed to see a physician to rule out complications from the obstruction or the abdominal thrusts

Must See

Simulate the treatment of: • A conscious adult or child with an obstructed airway• Complications – a pregnant woman and a person who is obese



* Obstructed airway:conscious infant Item7b

To enable lifesavers to recognize a conscious infant with an obstructed airway and to perform appro-priate lifesaving techniques.

Purpose


obstruction if victim cannot

cough or make any sound.

• Use a manikin for safe teaching

and practice.


Notes

❏ Assessment of degree of obstruction


Mild obstruction



Severe obstruction

❏ Shout for help

❏ 5 back blows and 5 chest thrusts

❏ Repeat back blows and chest thrusts until object is expelled or infantbecomes unresponsive

❏ If successful, caregiver directed to take victim to see physician to rule outcomplications from the obstruction or treatment

Must See

On a manikin, demonstrate the treatment of a conscious infant with an obstructed airway.



* Obstructed airway:unconscious victim Item7c

To clear airway obstruction and restore normal breathing to an unconscious victim.

Purpose



• If practicing this skill item on aperson (versus a manikin) res-cuers simulate compressions toprevent injury.

• Victim simulates severe airwayobstruction.

• Candidates should also practicea sequence that begins with aconscious victim who becomesunconscious. Rescuer beginswith ABC assessment of uncon-scious victim.



Reference:CLM Chapter 7.2 The ABC Priorities;7.3 Coping with Complications duringthe ABCs; 8.3 Airway and BreathingProblems

Notes





❏ Open airway






❏ Attempt to ventilate: if successful continue CPR sequence

❏ If unsuccessful, repeat sequence (reposition head, re-attempt to ventilate, chest compressions,foreign body check) until successful

Must See

Simulate the treatment of an unwitnessed unconscious adult, child, or infant with an obstructed airway.



Spinal injury management Item10

To demonstrate the treatment of a breathing victim with a suspected spinal injury.

Purpose

• This is a skill demonstration,

not a rescue.

• Bystander is trained to the

Bronze Cross level.

• Recognition is based on an

understanding of mechanism of

injury.

• The distance of the carry from

deep to shallow water should

be short (e.g., 5 m).

• Use of a spineboard is not

recommended and must not be

evaluated.

Reference:CLM Chapter 5.10 Rescue Procedures forSpinal Injuries; 7.2 The ABC Priorities;9.3 Swimming Skills

Notes

❏ Quick, accurate recognition and appropriate entry

❏ Immobilization of head and neck

❏ Smooth turnover

❏ Effective carry

❏ Victim assessment – ABCs

❏ Movement of victim minimized throughout

❏ Effective direction of bystander


❏ Ability to clear the airway while maintaining immobilization

Must See

Recover and immobilize a face-down breathing victim with a cervical spinal injury found in deep water.Transport to shallow water. Recruit and direct a trained bystander to assist. Demonstrate the abilityto manage vomiting while maintaining immobilization.


Bronze CrossRecognition & Rescue

❏ Quick entry and descent

❏ Rapid ascent

❏ Secure hold on victim during ascent

❏ Protection of airway during ascent and thereafter

❏ Quickest route to point where CPR may be effectively initiated and complications dealt with(side of pool, shallow water, rescue craft)

❏ Victim assessment (ABCs) and effective CPR (See Appendix A for Must Sees)

❏ Ability to deal with complications (vomiting, obstructed airway) at any point in performance

❏ Safe and effective removal with lifeguard or bystander assistance

❏ EMS activated at earliest possible moment

❏ Effective use of barrier devices where appropriate

❏ Appropriate and effective direction of bystanders when applicable

Management of submerged non-breathing victim

Item 3b

To demonstrate effective individual skills in the management of a submerged non-breathing victim.

Purpose

Must See

Demonstrate effective management of a submerged non-breathing victim.

• Emphasis is on the candidate’sindividual skill ability rather thana team response.

• Item is performed without anaid.

• Deep-water rescue breathingshould not be performed unlessall complications can be dealtwith adequately.

• Victim condition may include anycombination of:

• Airway obstruction

• Vomiting

Reference:Canadian Lifesaving Manual, Chapter4 The Rescue of Others; Chapter 7Lifesaving Priorities: The ABCs: Rescuebreathing

Notes

LIFESAVING SOCIETY NATIONAL LIFEGUARD AWARD GUIDE

*National LifeguardCore

6


❏ Smooth rollover performed if necessary

❏ Immobilization of the spine during rollover and throughout (to extent possible)

❏ Victim assessment: level of consciousness and ABCs

❏ Effective CPR if required


❏ Ability to deal with complications (vomiting, obstructed airway)


❏ Stabilization with spineboard or other appropriate device (in-water victim only)

❏ Preparation for transportation and removal (in-water victim only)

❏ Safe removal from water where possible (in-water victim only)

❏ Secondary assessment where feasible


Management ofspinal-injured victim Item 3c

To demonstrate effective individual skills in the management of a breathing or non-breathing victimwith a spinal injury.

Purpose

Must See

Demonstrate effective management of a victim with a suspected spinal injury.

National LifeguardCore

Notes

7LIFESAVING SOCIETY NATIONAL LIFEGUARD AWARD GUIDE

*

• Emphasis is on the candidate’sindividual skill and ability ratherthan a team response. The skill isdemonstrated with otherlifeguards as back-up. Design theevaluation activity to permiteach candidate to demonstrateall “Must Sees”.

• Instructors must take care toensure that evaluation resultsrelate directly to a candidate’sskill and not a teamperformance.

• Instructors should NOT evaluatescenarios with only one trainedresponder.

• Types of spinal injuries includecervical and lumbar.

• Victims are located in deep orshallow water, on land, orwalking. Deep-water victims areremoved from shallow waterwhere possible.

• Victim condition might includeany combination of:

• Breathing

• Non-breathing

• Airway obstruction

• Vomiting

• Aim for prompt removal andpreparation for transport.

Reference:Alert Lifeguarding in Action, Chapter 3Aquatic Emergencies: Recognition andIntervention; Chapter 4 LifeguardingSkills and Procedures: Management ofspinal injuries

Canadian Lifesaving Manual, Chapter5 Specialized Lifesaving Skills: Rescueprocedures for spinal injuries

LIFESAVING SOCIETY NATIONAL LIFEGUARD AWARD GUIDE27

❏ Appropriate, safe, and efficient entries

❏ Maintenance of ABCs

❏ Care of victim, especially the head

❏ Choice of removal appropriate for the condition of the victim

❏ Recruitment of other lifeguards or bystanders if necessary

❏ Effective communication with victim and assistants

❏ Safe lifting techniques for rescuer

❏ Effective removal

Entries and removalsItem 6

To use an appropriate entry for the situation and to safely remove a victim from further danger.

Purpose

Must See

Demonstrate entries and removals appropriate to wave pools, slides, catch basins, and other waterparkapparatus.

National LifeguardWaterpark Option

• Encourage candidates to wearanti-skid shoes for maximumgrip in the event that they mustdescend a flume.

• Be aware of potential dangerdue to wall height and theeffects of waves and movingwater.

• Advise candidates to avoidentering a wave pool or catchbasin with anything that couldbe tightened around their neck,especially a whistle on a lanyard.

• Demonstrate an effective beachentry for a wave pool.

• Unassisted removals are not arequirement of this item. Asingle lifeguard may recruitbystanders for assistance.

Reference:Alert: Lifeguarding in Action, Chapter4 Lifeguarding Skills and Procedures;Chapter 13 Waterpark Operation andSafety

Canadian Lifesaving Manual,Chapter 4 The Rescue of Others

Notes

*



❏ Smooth rollover performed if necessary

❏ Immobilization of the spine during rollover and throughout (to extent possible)

❏ Victim assessment: level of consciousness and ABCs

❏ Effective CPR if required


❏ Ability to deal with complications (vomiting, obstructed airway)


❏ Stabilization with spineboard or other appropriate device (in-water victim only)

❏ Preparation for transportation and removal (in-water victim only)

❏ Safe removal from water where possible (in-water victim only)

❏ Secondary assessment where feasible


❏ Treatment for shock

Spinal injuryItem 8

To recover and immobilize a spinal-injured victim in a difficult location.

Purpose

Must See

As a member of a team, perform a rescue of a victim with a suspected spinal injury who is located in acatch basin, wave pool, channel, stairs, or who has fallen from a height.

National LifeguardWaterpark Option

• In this rescue item, candidatesrespond as part of a team(which may vary in number).Nevertheless, the individual’sperformance is evaluated, notthe performance of the team asa group.

• Use a manikin to practicerecovery of a victim in a flume.

• Alternate the condition of thevictim: conscious or unconscious,breathing or non-breathing, etc.

• Aim for prompt removal fromwater and preparation fortransport.

• A run-out channel may be at thebottom of a high-speed slide orflume.

Reference:Alert Lifeguarding in Action, Chapter 3Aquatic Emergencies: Recognition andIntervention; Chapter 4 LifeguardingSkills and Procedures: Management ofspinal injuries

Canadian Lifesaving Manual, Chapter5 Specialized Lifesaving Skills: Rescueprocedures for spinal injuries

Notes

*

(Appendix A)

• Send bystander to phone EMS. If alone with anadult victim, rescuer phones EMS right away. Ifalone with a child or infant victim, rescuer phonesEMS after about 5 cycles of 30:2 compressions tobreaths.

• If an Automated External Defibrillator (AED) andAED-trained responders are available, rescuershould send for them after activating EMS andassist the AED responder as directed.

• Rescuer opens airway using head-tilt/chin-lifttechnique.

• Rescue breaths: rescuer delivers normal breaths(each over 1 second) that make chest rise.

• Compressions: push hard and fast allowing chestto recoil completely between compressions.

• Two-rescuer CPR. Two options: rescuers taketurns doing one-rescuer CPR, or one rescuerperforms chest compressions while the other doesrescue breathing. Rescuers switch rolesapproximately every 2 minutes (5 cycles of 30:2)to minimize fatigue. Rescuers communicate andcooperate in decision-making and CPRperformance.

• Use of barrier devices is recommended.

Reference:Canadian Lifesaving Manual, Chapters 6, 7 and 8 containresuscitation and first aid technical information

Notes

One rescuer❏ Assessment of environment for hazards❏ Establish unresponsiveness❏ EMS activated at earliest possible moment❏ Attempt to obtain AED and recruit AED-trained personnel if available❏ Open airway❏ Check for breathing: look, listen, feel (no more than 10 sec.)❏ If breathing is absent, 2 rescue breaths: observe chest rise❏ Careful landmarking and chest compressions (30 compressions: 2 rescue breaths)❏ CPR continued until EMS takes over treatment, or an AED-trained responder begins

treatment with an AED, or the victim begins to move❏ If victim begins to move, reassess ABCs and treat appropriately

Two rescuers

Rescuer #1❏ Performs one-rescuer CPR sequence

Rescuer #2❏ Identifies self as CPR trained and confirms EMS activation

Both rescuers❏ Continue CPR and switch roles with as little interruption as possible❏ Continue CPR until EMS takes over, or an AED-trained responder begins treatment

with an AED unit, or the victim begins to move❏ If the victim begins to move, reassess ABCs and treat appropriately

Resuscitation & first aidevaluation criteria

Must See

Cardiopulmonary resuscitation (CPR)


Conscious victim

• Conscious victim simulates either mild or severeairway obstruction. To signal the type ofassistance needed, teach the universal chokingsignal.

• Rescuer assumes severe obstruction if victim nods“yes” when asked “Are you choking?” or if victimclutches neck or cannot speak or breath.

Unconscious victim• Send back-up / bystander to phone EMS. If alone

with an adult victim, rescuer phones EMS rightaway. If alone with a child or infant victim,rescuer phones EMS after about 5 cycles of 30:2compressions to breaths.

• If an Automated External Defibrillator (AED) andAED-trained responders are available, rescuershould send for them after activating EMS andassist the AED responder as directed.

• If practicing this skill item on a person (versus amanikin) rescuers simulate compressions toprevent injury.

• Victim simulates severe airway obstruction.• Candidates should also practice a sequence that

begins with a conscious victim who becomesunconscious. Rescuer begins with ABC assessmentof unconscious victim.

• Use of barrier devices is recommended.


Notes

Conscious adult or child❏ Assessment of degree of

obstruction—ask, “Are you choking?”❏ Selection of appropriate procedures

Mild obstruction❏ Coughing encouraged❏ Reassurance for victim

Severe obstruction❏ Shout for help❏ Careful landmarking❏ Repeated abdominal thrusts (chest

thrusts for pregnant or obese victim)until the airway is clear

❏ If successful, direct victim to see aphysician to rule out complicationsfrom the obstruction or the abdominalthrusts

Conscious infant❏ Assessment of degree of obstruction❏ Selection of appropriate procedures

Mild obstruction❏ Coughing encouraged❏ Reassurance for victim

Severe obstruction❏ Shout for help❏ 5 back blows and 5 chest thrusts❏ Repeat back blows and chest thrusts

until object is expelled or infantbecomes unresponsive

❏ If successful, direct caregiver to takevictim to see a physician to rule outcomplications from the obstruction ortreatment

Unconscious victim❏ Assessment of environment for

hazards❏ Establish unresponsiveness❏ Activate Emergency Medical System❏ Attempt to obtain AED and recruit

AED-trained personnel if available❏ Open airway❏ Check for breathing: look, listen, feel

(no more than 10 sec.)❏ If breathing is absent, 2 rescue

breaths: observe chest rise❏ If unsuccessful, reposition airway and

re-attempt to ventilate❏ If unsuccessful, careful landmarking

and 30 chest compressions❏ Foreign body check: look in mouth

and if object can be seen, attempt toremove it

❏ Attempt to ventilate: if successfulcontinue CPR sequence

❏ If unsuccessful, repeat sequence(reposition head, re-attempt toventilate, chest compressions, foreignbody check) until successful


Must See

Airway obstruction

National LifeguardAppendix A


Respiratory distress

Asthma

• Candidate should determine history.

• Candidate demonstrates an understanding ofthe recognition and assessment of asthmaticcondition.

• Candidate demonstrates an awareness of“relaxed breathing” as a form of treatment (forexample, using diaphragm inhale through nose,hold, exhale through mouth, and repeat).

Anaphylaxis

• Candidates must ensure that victim self-administersmedication according to prescription or themanufacturer’s directions in the case of anEpiPen®.

• Only the victim’s EpiPen® is used. Do NOTadminister another person’s EpiPen®.

• CAUTION: The black tip on the EpiPen® is an auto-injector and very sensitive.


Notes

Respiratory distress ❏ Determination of cause of distress

and removal if possible❏ Victim and scene assessment❏ EMS activated if necessary❏ Victim placed in semi-sitting or most

comfortable position❏ Victim reassured❏ Airway and respiration maintained❏ Appropriate use of barrier devices

Anaphylaxis❏ Victim assisted with administration of

medication (EpiPen®) if available

Asthma ❏ Victim assisted with medication

(inhaler)

Hyperventilation❏ Encouragement of pursed lip

breathing


Must See

Respiratory distress



Burns

• Type of burns might include:

• First, second, or third degree burns

• Sunburn

• Chemical (dry or wet corrosive chemical)

• Electrical burns

• Stress the importance of barrier devices whendusting off dry chemicals.

• Flush chemical burns for 15–20 min.

Facial injury

• Injuries might include:

• Foreign body in the ear or nose

• Laceration or contusion of eyes

• Chemical splashes in eyes

• Puncture or abrasion of eyes

• Burns to eyes

• Bleeding and fluid from ear

• Broken tooth, loose or displacement of tooth,laceration to mouth

• Nose bleed or broken nose

Suspected head injury

• Suspected head injury refers to an internal injury,not a superficial cut/injury.

• Full documentation report of vital sign checks andany related change. Candidates should be able toexplain reason for documentation.

Seizure

• Candidate should demonstrate knowledge ofdifferent types of seizures and appearance of each(e.g., tonic/clonic; absence).

• Candidate should demonstrate understanding ofthe various stimuli that may cause a seizure (e.g.,lack of sleep, medication, or light, drugs or alcoholabuse, high temperature, head injury, or diabetes).

• Candidate should recognize that there may beother injuries as a result of seizure (e.g., hittingobjects).


Notes

Burns ❏ Victim and scene assessment❏ EMS activated if necessary❏ Victim removed from source of injury❏ Determination of burn severity❏ Immediate immersion in cool water if

available at the time of injury and ifthe injury is a localized burn

❏ Burn covered with dry sterile dressing❏ Appropriate use of barrier devices

Wet chemical burns❏ Flush with lots of water

Dry chemical burns❏ Dust before flushing with water

Electrical burns❏ Check for entry and exit burns

Facial injury❏ Victim and scene assessment❏ EMS activated if necessary❏ Determination of cause of injury and

removal from the cause if possible❏ Selected treatment appropriate for

the injury❏ Appropriate use of barrier devices

Suspected head injury❏ Victim and scene assessment❏ EMS activated if necessary❏ Immobilization/bandaging if situation

requires (i.e., if no bleeding ordischarge, no bandage required)

❏ Vital signs monitored including levelof consciousness

❏ Appropriate use of barrier devices

Seizure ❏ Victim and scene assessment❏ EMS activated if necessary❏ Recognition of seizure❏ Protection of head❏ Rescuer does not restrain or

immobilize victim or put anything intothe victim’s mouth

❏ Removal of dangers to victim❏ Victim placed in recovery position

after seizure has stopped❏ Appropriate use of barrier devices


Must See

Burns; Facial injury; Suspected head injury; Seizure



Documents

Rookie Patrol First Aid Primary assessment: hazards & ABCs 11 · LIFESAVING SOCIETY 12 SWIM PATROL AWARD GUIDE Rookie Patrol First Aid. Rescue breathing Item 12 To support breathing