Appropriate Community Technology - A Training Manual (Peace Corps, 1982, 685 p.): Phase V: Solar agricultural dryers: Session 16. Cardiopulmonary resuscitation

DETACH

HIGHLIGHTING

Appropriate Community Technology - A Training Manual (Peace Corps, 1982, 685 p.)

Phase V: Solar agricultural dryers

		(introduction...)
		Phase V Calendar
		Session 1. Introduction to agricultural dryers
		Session 2. Tour of solar dryers
		Session 3. Solar agricultural dryer design procedures and rules of thumb
		Session 4. Two-hour dryer construction
		Session 5. Review of existing solar dryer plans
		Session 6. Smoke testing solar dryers
		Session 7. Introducing new technologies: solar dryers
		Session 8. Design of solar agricultural dryers
		Session 9. Site selection and preparation
		Session 10. Construction of solar agricultural dryers
		Session 11. Issues and methods in development and diffusion of appropriate technology
		Session 12. Natural cooling
		Session 13. Approaches to health systems
		Session 14. Nutritional gardening
		Session 15. Practical drying tips
		Session 16. Cardiopulmonary resuscitation
		Session 17. Dryer assessment and modification
		Session 18. Introduction to cost benefit analysis (cba)
		Session 19. Presentation of solar dryers
		Session 20. Introduction to the final phase of the training program

Session 16. Cardiopulmonary resuscitation

Total time:	4 hours
Objectives:	* To perform effective CPR techniques on adult and infant mannequins
	* To complete a written CPR examination
	* To discuss appropriate applications for CPR
	* To gain certification as "Basic Resuscitators" for the period of one year
Resources:	* American Heart Association, A Manual for Instructors of Basic Cardiac Life Support
	* American Red Cross, Instructor's Manual Cardiopulmonary Resuscitation
	* Films: "Citizens for Life" or "New Pulse for Life," available from either American Heart Association or American Red Cross
	* Attachment V-16-A, "Circulation and Bones in the Chest"
	* Attachment V-16-B, "Performance Test"
	* Attachment V-16-C, "Basic CPR Exam"
Materials:	Newsprint and felt-tip pens; movie screen and projector; timing devices; infant and adult mannequins designed for CPR practice; blankets

Trainer Notes

This CPR session prepares the participant for one-year certification as a "Basic Resuscitator," according to the American Heart Association requirements. It easily can be adapted to meet American Red Cross certification requirements as well.

There should be a certified instructor for every 12 people. (Any participants who are already certified as Basic Resuscitators can assist with the demonstrations and with the skill practice groups.)

If you are not a certified "Basic Life Support Instructor," you should contact the nearest Red Cross office and invite an instructor to lead the session.

Procedures:

Step 1. (15 minutes)
Review and clarify the session objectives and activities.

Trainer Notes

Clarify your role as a Basic Life Support Instructor and explain that participants who successfully complete this CPR course will be officially certified by the American Heart Association as "Basic Resuscitators" for one year.

Explain that CPR is part of this program because it is seen as an important technology for health.

Present any other certified Basic Resuscitators from among the group who will be on hand to assist you (see Trainer Notes, under Materials).

Step 2. (20 minutes)
Show the film.

Trainer Notes

The films listed in the resource section are excellent for this session. If the film is not used, refer to the cited manuals for alternative procedures.

It is important to note any obsolete information and carefully emphasize updates. Explain that standards are regularly updated as research and experience refine CPR techniques.

Ask the participants while watching the film to take note of any misconceptions about CPR they held prior to viewing it.

Step 3. (10 minutes)
Distribute and review Attachment V-16-A, "Circulation and Bones of the Chest."

Trainer Notes

Ask if there are any comments or points from the film that require clarification or emphasis.

Step 4. (15 minutes)
Demonstrate various CPR techniques.

Trainer Notes

Demonstrate and explain the following techniques:

* One person adult CPR
* Two-person CPR (include the "switch")
* CPR on an infant

Step 5. (5 minutes)
Distribute and review Attachment V-16-B, "Performance Test."

Trainer Notes

Explain the evaluation process by indicating that there will be a test of CPR skills before certification. Also mention that the written test is part of the certification process.

It is important that the participants understand the skill test process and that specific checkpoints will be covered in the test which are listed in the attachment.

Step 6. (1 hour)
Have the participants form skill practice groups of five people per mannequin.

Trainer Notes

* Emphasize that each group member should spend time learning and practicing each of the demonstrated CPR techniques.

* Explain that as each person practices, the Performance Test sheets can be used to check the performance.

* Encourage the group members to critique one another's performance.

* Circulate among the groups to assist whenever necessary. (Other certified Basic Resuscitators should also help.)

Step 7. (30 minutes)
Distribute Attachment V-16-C, "Basic CPR Exam," and give participants time to answer the questions and encourage them to share their answers.

Trainer Notes

* Guide an exchange of answers by having participants read a question and answer it. This time can also be used to elaborate on any additional CPR points.

* Have people rate their scores and keep the exam.

Step 8. (1 hour)
Carry out the performance testing.

Trainer Notes

The performance testing should be carried out in the following manner:

* Set up a testing station with an adult and infant mannequin.
* Call one person at a time to be tested.
* Collect each person's CPR Exam and Performance Test, making certain they are signed.
* Have each person demonstrate the three techniques for meeting certification requirements.
* Present each participant with signed certificates.

Encourage those who are waiting to be tested to continue with their practice.

Step 9. (10 minutes)
Reconvene the participants and facilitate a discussion of the appropriate application of CPR in an in-country situation, concentrating on cultural norms and sex roses.

Step 10. (10 minutes)
Review and discuss the session objectives and activities.

Trainer Notes

Some questions to stimulate discussion include:

* How effective was the film in conveying techniques and information?
* Did your practice groups give useful feedback to help improve your skill level?
* Did you have enough time in your practice period to learn the necessary CPR techniques?
* Do you feel confident to use CPR when appropriate and necessary to save someone's life?
* Do you think you will attempt to get re-certified after one year?
* Were the session objectives met?

Step 11. (5 minutes)
Conclude by encouraging the participants to contact organizations for standards and compliance with local regulations, once they are in-country.

CIRCULATION

BONES IN THE CHEST

AMERICAN HEART ASSOCIATION
CARDIOPULMONARY RESUSCITATION AND EMERGENCY CARDIAC CARE PERFORMANCE TEST FOR ONE AND TWO RESCUER CPR

NAME:______________________
Date:________________________

	ELAPSED TIME(Seconds)		ACTIVITY AND TIME (Seconds)	CRITICAL PERFORMANCE	PASS	FAIL
	Min	Max
ONE RESCUER	4	10	Establish unresponsive ness & call out for help. Allow 1 to 10 sec. If face down and turning is required.	Shake shoulder, shout "Are you OK?" Call out-"Help"' Turn if necessary
				Adequate time
	7	15	Open airway. Establish	Kneels properly
			breathlessness (Look Listen and Feel) (3-5 seconds)	Head tilt with one hand on forehead and neck lift or chinlift with other hand.
				Ear over mouth, observe chest.
	10	20	Four ventilations (3-5 seconds)	Ventilate properly 4 times and observe chest rise.
	15	30	Establish pulse and simulate activation of EMS system (5-10 seconds)	Fingers palpate for carotid pulse on near side (other hand on forehead maintains head tilt)
				Know local EMS number
				Adequate time
	69	96	Four cycles of 15 compressions 2 ventilations (54-66 seconds)	Proper body Position
				Landmark check each time
				Position of hands
				Vertical compression
				Says mnemonic
				Proper rate
				Proper ratio
				No bouncing
				Ventilates properly
	72	101	Check for return of pulse and spontaneous breathing. (Pupil check optional) (3-5 seconds)	Check pulse and breathing. (Pupil check optional)
	77	106	Second rescuer check for pulse (5 seconds)	Five-second pause to check pulse
TWO RESCUERS	85	116	Minimum of two cycles of 5 compressions and 1 ventilation (8-10 seconds)	Changes rate of compression
			Switch and repeat until examiner is satisfied.	Says mnemonic
				Interposes breath
				No pause for ventilation
				Calls for switch
				Switches
				Switches back
				Checks pulse
				(Pupil 1 check - optional)
				Technique as above

AMERICAN HEART ASSOCIATION
CARDIOPULMONARY RESUSCITATION AND EMERGENCY CARDIAC CARE
PERFORMANCE TEST FOR INFANT RESUSCITATION

Name:________________________________________
Social Security Number:__________________________
Date:____________

ELAPSED TIME (Seconds)		ACTIVITY AND TIME (Seconds)	CRITICAL PERFORMANCE	PASS	FAIL
Min	Max
3	5	Establish unresponsiveness including turning (3-5 seconds)	Shake shoulder, shout Infant horizontal
			Adequate time
6	10	Open airway	Tip head back -- Do not hvperextend
		Establish breathlessness (3-5 seconds)	Put ear over mouth to feel for breathing
9	15	Four ventilations (3-5 seconds)	Puff cheeks, uses air in mouth to ventilate
14	25	Establish pulselessness (5-10 seconds)	Use same criteria as before. Carotid or precardial pulse
44	55	8 cycles of 5 compressions and 1 ventilation Continue uninterrupted (30 seconds)	Two fingers for compression 80-100 compressions per minute

Number of compressions 40-50
Number of ventilations 12-14
Instructor:___________________
Check one: PASS_______FAIL______

BASIC CPR EXAMINATION

Select the one correct answer and circle on your answer sheet as indicated:

1. Cardiopulmonary resuscitation can be defined as artificial respiration and artificial circulation. A. True B. False

2. The A, B. C's of cardiopulmonary resuscitation stand for Airway, Breathing and Circulation. A. True B. False

3. One can determine if an unconscious victim is breathing by:

A. booking, listening, feeling for signs of air and chest movement
B. Checking the blood pressure
C. Checking the pulse
D. Checking for cyanosis

4. In mouth-to-mouth resuscitation, tilting the head back is important because:

A. Air cannot enter the stomach
B. It allows the individual doing the breathing to more easily observe the victim's body
C. It extends the neck and lifts the tongue away from the back of the throat

5. CPR is unlikely to restore a victim to his pre-arrest level of brain function if the cardiac arrest has persisted for more than :

A. 1-2 minutes
B. 2-4 minutes
C. 3-5 minutes
D. 46 minutes

6. If vomiting occurs during the resuscitation effort, the best immediate procedure to follow is:

A. Stop CPR until help arrives
B. Pause for a moment unfit the victim appears quiet again, then resume mouth-to-mouth ventilation
C. Turn the victim on his side, sweep out the mouth, then re-position and resume CPR

7. Pain is one of the most common warmings of heart attack. It is frequently confused with indigestion, with uncomfortable pressure and a burning feeling in the lower chest or upper abdomen. A. True B. False

8. In performing CPR, airway (A) and breathing (B) are established adequately before circulation (C) is begun. A. True B. False

9. When performing external cardiac compression on an adult, the sternum should be depressed:

A. 1/2 to 1 inch
B. 1 inch to 11/2 inches
C. 1-1/2 inches to 2 inches
D. 2 to 2-1/2 inches

10. When one rescuer performs CPR, the ratio of chest compressions to lung inflations for any adult victim is:

A. 15 compressions to 2 ventilations
B. 12 compressions to 2 ventilations
C. 7 compressions to 2 ventilations
D. 5 compressions to 2 ventilations

11. CPR is effective when the victim is lying on a soft bed. A. True B. False

12. Artificial circulation is produced when the chest is compressed by squeezing the heart between:

A. The clavicle and the scapula
B. The sternum and the spine
C. The clavicle and the spine
D. The sternum and the xiphoid

13. When performing CPR on an infant, the compression rate is:

A. 60-70 times per minute
B. 100-120 times per minute
C. 120-140 times per minute

14. The universal distress signal characterizing an apparent obstructed airway in the conscious adult is:

A. Rapid heavy breathing
B. Violent choking
C. Victim's hand is at his throat
D. Violent thrashing of the victim's arms

15. Which is the rate of compressions and ventilations when performing two-person rescue?

A. 5 to 1
B. 8 to 1
C. 10 to 2
D. 15 to 2

Prepared by American Heart Association, 2320 Greenville Avenue, Dallas, Texas 75231.