Best Practices in Teaching CPR

Using Effective and Easy to Understand Training Materials That Complement Learning I believe to be effective the training video should mirror the statements in the written training manual. To insure the integrity of the materials certified experts in the field should review each section to make sure they meet the learning objective. The American Heart Association has taken pains to try and produce the best materials and training aids possible. What they have not done is make sure the materials accurately depict and is easily understood by the average person taking a CPR course. If the video presentation conflicts with the written training material it makes it more difficult for the student to develop their confidence. Thankfully many of the snafus in the 2010 version are addressed by the CPR instructors in the class room. I have developed a series of guidelines which supplement the course materials. Why CAB?

  • Effective compressions are most important
  • Start compressions immediately
  • You don’t know how long the person is down
  • Compressions keep the brain alive
  • Oxygenated blood is pumped to the brain
  • Good chance of resuscitation
  • Abbreviated recovery period

You Can Make A Difference

  • Everyone is capable of delivering effective compressions.
  • Effective compressions pump oxygenated blood to the brain, keeping it alive.
  • If you don’t help the victim, who will?
  • If the victim could speak, they would say please help me.
  • A human mind should not go to waste

Adult CPR Sequence

  • Push straight down at least 2” more if possible
  • Let the chest come completely back up before starting the next compression.
  • Perform 2 minutes or 5 cycles if you can comfortably do so. Switch when you feel tired.
  • If you can’t switch, rest for the count of 5 then start over again for as long as you can.
  • When the AED arrives immediately put pads on while one rescuer continues compressions.

The AED Has Arrived

  • Once the AED is plugged in it will analyze
  • Make sure you or your partner is not touching the victim.
  • Once the analyze sequence starts: SWITCH POSITIONS
  • The compressor moves to the head and the person at the head moves to compressor spot.
  • Once the AED says shock is necessary the person at the head makes sure no one is touching the victim. Do a final check before pushing the flashing yellow shock button.
  • Once the shock is delivered immediately start compressions

Adult CPR Sequence

  • Check for Scene Safety: electricity, hazards
  • Shake and shout: is the person sleeping?
  • Check for breathing and check pulse – 10 sec.
  • No pulse: Call 911 (use cell phone)
  • Start CPR by placing heel of your hand in center of the chest between the nipples.
  • Bring your shoulder over your wrist and keep your arms straight. Push straight down on chest.

A Confident Team is a Good Team When everyone is confident that they have mastered the techniques of CPR they will be able to function effectively as individuals or with the help of other team members be even more effective. Delivering Effective Breaths

  • Place your non-preferred hand over top of the mask. Tilt the head back by pressing on forehead.
  • Put the thumb of preferred hand over bottom of mask and grip the jaw bone with remaining fingers and lift the chin to face the sky. Chin to the sky (ceiling), they never die.
  • Blow the air in gently over one second to make the chest rise visibly.

How Fast Should I Push

  • To make sure the heart is pushing blood to the brain effectively you should push at a rate of at least 100 to 120 pushes per minute or 1 ½ per second.
  • When pushing, concentrate on saying to yourself: One an Two an Three etc. This will keep the pace up to at least 100 per minute. Faster is better, so you have room to go when you get tired and start to slow down.

Why is the Adult Ratio Always 30 to 2?

  • Studies have shown that delivering 30 compressions and 2 breaths is best for keeping the adult fatigued or diseased heart alive and the brain fed with a sufficient supply of oxygenated blood.
  • The heart has arteries feeding it blood and you must keep the pressure in those arteries up or the heart muscle itself will die.

Consult With Experts

  • Book learning is good, but it is no substitute for experience. Consult with experts in the field to make sure the training materials accomplish the objective of the student delivering effective CPR on a consistent basis.
  • Utilizing different expert points of view will enable you to thoroughly develop effective training materials and aids.

Keep Like Things Together The Video Host and student materials should specify the difference between delivering 30 compressions and 2 breaths as differentiated from providing continuous compressions when an advanced airway is in place. Then you perform continuous compressions and deliver one breath every 6 minutes regardless of adult, child, or infant. What’s Different About Children

  • One: If you don’t see the child collapse and are alone you should deliver 2 minutes of CPR before calling 911.
  • Two: If you do see the child collapse right in front of you, you need to call 911 if possible and get the AED if there is one close by. Do not leave the child for more than 2 minutes to get help.

Using the AED with Children

  • Do not put the AED pads on until you have delivered 5 cycles of CPR.
  • To make sure the pads don’t touch put one pad on the front and one on the back.
  • The AED recognizes a child as ages 1 to 8
  • If the child is older than 8 or if you can’t determine the age of the child as over or under 8 years, use Adult pads.

Using the AED With Infants

  • An infant is defined as being less than one year old and older than 28 days.
  • After performing 5 cycles of Infant CPR you can put the AED on if you have one.
  • Even if you only have Adult pads you can put them on an infant.
  • Place one pad over the infant’s chest and one pad over the infant’s back, both in a vertical position.
John Careccia

John has been an AHA Instructor Trainer since 1993, and is involved at all levels of CPR science development and the introduction of various CPR enhancement techniques and equipment. Since retiring from the Port Authority in 2000, he has been actively spreading the news of increased effectiveness of improved CPR teaching and training by attending National and Local EMS conferences and presenting at the annual ECCU conference. In addition, he spends a good deal of time teaching AHA CPR and First Aid to doctors, nurses, PCT''s, EMTs, and security personnel in hospitals, doctors and dentists offices, Professional Trainers, gyms, shopping malls and pharmacies in New York and New Jersey. He also volunteers as EMT- BLS IT with the Woodbridge Township Ambulance & Rescue Squad as Chief of Operations and Training Director.

More articles by the writer

Using Effective and Easy to Understand Training Materials That Complement Learning I believe to be effective the training video should mirror the statements in the written training manual. To insure the integrity of the materials certified experts in the field should review each section to make sure they meet the learning objective. The American Heart Association has taken pains to try and produce the best materials and training aids possible. What they have not done is make sure the materials accurately depict and is easily understood by the average person taking a CPR course. If the video presentation conflicts with the written training material it makes it more difficult for the student to develop their confidence. Thankfully many of the snafus in the 2010 version are addressed by the CPR instructors in the class room. I have developed a series of guidelines which supplement the course materials. Why CAB?

  • Effective compressions are most important
  • Start compressions immediately
  • You don’t know how long the person is down
  • Compressions keep the brain alive
  • Oxygenated blood is pumped to the brain
  • Good chance of resuscitation
  • Abbreviated recovery period

You Can Make A Difference

  • Everyone is capable of delivering effective compressions.
  • Effective compressions pump oxygenated blood to the brain, keeping it alive.
  • If you don’t help the victim, who will?
  • If the victim could speak, they would say please help me.
  • A human mind should not go to waste

Adult CPR Sequence

  • Push straight down at least 2” more if possible
  • Let the chest come completely back up before starting the next compression.
  • Perform 2 minutes or 5 cycles if you can comfortably do so. Switch when you feel tired.
  • If you can’t switch, rest for the count of 5 then start over again for as long as you can.
  • When the AED arrives immediately put pads on while one rescuer continues compressions.

The AED Has Arrived

  • Once the AED is plugged in it will analyze
  • Make sure you or your partner is not touching the victim.
  • Once the analyze sequence starts: SWITCH POSITIONS
  • The compressor moves to the head and the person at the head moves to compressor spot.
  • Once the AED says shock is necessary the person at the head makes sure no one is touching the victim. Do a final check before pushing the flashing yellow shock button.
  • Once the shock is delivered immediately start compressions

Adult CPR Sequence

  • Check for Scene Safety: electricity, hazards
  • Shake and shout: is the person sleeping?
  • Check for breathing and check pulse – 10 sec.
  • No pulse: Call 911 (use cell phone)
  • Start CPR by placing heel of your hand in center of the chest between the nipples.
  • Bring your shoulder over your wrist and keep your arms straight. Push straight down on chest.

A Confident Team is a Good Team When everyone is confident that they have mastered the techniques of CPR they will be able to function effectively as individuals or with the help of other team members be even more effective. Delivering Effective Breaths

  • Place your non-preferred hand over top of the mask. Tilt the head back by pressing on forehead.
  • Put the thumb of preferred hand over bottom of mask and grip the jaw bone with remaining fingers and lift the chin to face the sky. Chin to the sky (ceiling), they never die.
  • Blow the air in gently over one second to make the chest rise visibly.

How Fast Should I Push

  • To make sure the heart is pushing blood to the brain effectively you should push at a rate of at least 100 to 120 pushes per minute or 1 ½ per second.
  • When pushing, concentrate on saying to yourself: One an Two an Three etc. This will keep the pace up to at least 100 per minute. Faster is better, so you have room to go when you get tired and start to slow down.

Why is the Adult Ratio Always 30 to 2?

  • Studies have shown that delivering 30 compressions and 2 breaths is best for keeping the adult fatigued or diseased heart alive and the brain fed with a sufficient supply of oxygenated blood.
  • The heart has arteries feeding it blood and you must keep the pressure in those arteries up or the heart muscle itself will die.

Consult With Experts

  • Book learning is good, but it is no substitute for experience. Consult with experts in the field to make sure the training materials accomplish the objective of the student delivering effective CPR on a consistent basis.
  • Utilizing different expert points of view will enable you to thoroughly develop effective training materials and aids.

Keep Like Things Together The Video Host and student materials should specify the difference between delivering 30 compressions and 2 breaths as differentiated from providing continuous compressions when an advanced airway is in place. Then you perform continuous compressions and deliver one breath every 6 minutes regardless of adult, child, or infant. What’s Different About Children

  • One: If you don’t see the child collapse and are alone you should deliver 2 minutes of CPR before calling 911.
  • Two: If you do see the child collapse right in front of you, you need to call 911 if possible and get the AED if there is one close by. Do not leave the child for more than 2 minutes to get help.

Using the AED with Children

  • Do not put the AED pads on until you have delivered 5 cycles of CPR.
  • To make sure the pads don’t touch put one pad on the front and one on the back.
  • The AED recognizes a child as ages 1 to 8
  • If the child is older than 8 or if you can’t determine the age of the child as over or under 8 years, use Adult pads.

Using the AED With Infants

  • An infant is defined as being less than one year old and older than 28 days.
  • After performing 5 cycles of Infant CPR you can put the AED on if you have one.
  • Even if you only have Adult pads you can put them on an infant.
  • Place one pad over the infant’s chest and one pad over the infant’s back, both in a vertical position.

Vlad Magdalin

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