SUNY Lifesaver
Program
Student Manual
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Preparation for the Course
Please read this manual carefully and review the related DVD. The
manual will take you through the important information related to
CPR and use of an Automated External Defibrillator or AED. The
DVD will familiarize you with the skills so that you will be ready to
practice when you arrive in class. It will only take about 30 minutes!
As you can see, this manual has both a written and audio
component with visuals to help you learn these lifesaving skills.
This approach to education will help maximize your learning and
retention of the core skills. If you would rather not listen to the
audio, simply turn down the volume on your speakers.
CPR and Defibrillation Save Lives
The primary message for the SUNY Lifesaver Program is simple;
Early CPR and Early Defibrillation save the lives of victims of
sudden cardiac arrest!
You have chosen to serve as a SUNY Lifesaver and we appreciate
your commitment. Remember, the skills you learn in this course are
not just for the workplace or school setting. They can be valuable at
home for loved ones and friends. Hopefully you will never have to
use these skills but if you do it could be one of the most rewarding
and important experiences of your life.
CPR
Defibrillation
What is Sudden Cardiac Arrest?
Sudden cardiac arrest is one of the leading causes of death in the
United States. Each year approximately 340,000 people die from
sudden cardiac arrest. That equals about 900 people a day!
The most common cause of sudden cardiac arrest is an abnormal
heart rhythm called ventricular fibrillation or VF. VF is a chaotic,
quivering heart that results in no blood flow to vital organs. If left
untreated most people will die within 6 minutes.
However, if CPR is performed immediately and an electric shock of
the heart called defibrillation is provided early, the heart can convert
back to a normal rhythm, restoring blood flow to vital organs. In fact,
the only effective treatments for VF are CPR and defibrillation of the
heart.
Ventricular Fibrillation (VF)
Time and AEDs
Survival from sudden cardiac arrest is very time dependant.
Every minute that passes from the moment of collapse until
defibrillation is administered will reduce the chance for survival
by about 7 to 10 percent. During that time CPR can help
deliver blood to vital organs until the heart is restored to an
effective rhythm by shocking the heart with a defibrillator.
100
80
60
Survival
40
20
0
1
min.
3
min.
6
min.
10
min.
Learning CPR and AED
In this course you will be learning the skills of CPR and use of an AED
using a teaching method called practice-while-watching video
instruction. This type of training and been proven in scientific studies to
be a highly effective way to learn and remember the skills of CPR and
use of an AED.
For this program to be successful three things must occur.
1.
You much watch the video carefully and perform the
skill exactly as shown on the screen paying close
attention to each detail.
2.
You must continue to practice as long as the skill is
shown on the screen. The key to learning is consistent and
repetitive practice!
3.
You will practice skills one more time at the end of the
program to reinforce and remember each part.
Actions for a collapsed victim?
When encountering a collapsed victim you should start by
checking to see if the victim is responsive by tapping the victim’s
shoulder and shouting “Are you alright”. Does the victim
respond? Does the victim move? If the victim does not wake or
move, you must quickly direct someone, “Go call the Emergency
Response System and get an AED”. If you are alone, call the
emergency response number, get an AED, and come back. You
should be familiar with your facilities number. Hopefully, more
times than not, you will not be alone. If you do send someone,
you should perform CPR until that person returns with the AED.
Check for Response
Call Emergency
Response Number
Know your local
emergency response
number.
Check for Breathing
Once you send someone to call and get the AED check to
see if the victim is breathing. Put one hand on the
forehead and two fingers on the boney part of the chin.
Tilt the head back and lift the chin. Place your ear and
cheek next to the victim’s mouth and nose and listen and
feel for air movement. Also look for chest rise.
Check for Breathing
Look carefully at the position
of the rescuer’s fingers on the
chin and hand on the forehead.
Rescue Breathing
If there is no air movement or chest rise, provide two rescue
breaths using the mouth to mask device. Position the mask, seal
the upper portion with your index finger and thumb. Pinch
the lower portion between your thumb and two fingers at the
base of the chin. Tilt the head way back and provide a rescue
breath through the opening at the top of the mask while observing
for chest rise.
Rescue Breathing
Look carefully at the position of
the rescuer’s hands on the mask
device. Also note the head tilt
and observation of chest rise.
Chest Compressions
After delivering two breaths begin chest compressions. Remove
clothing, place your hands between the victim’s two nipples,
position your shoulders over your hands and begin
compressions. Once again, compress hard and compress fast
at a rate of 100 compressions per minute. Be sure to allow the
chest wall to return to its normal position after each compression.
Move the breastbone approximately 1 ½ to 2 inches.
Chest Compressions
Look carefully at the position of
the rescuer’s body, arms, and
hands.
Summary of Adult CPR
Check for
Response
Check for
Breathing
Call Emergency
Response
Number/Get
AED
Rescue Breathing
Until Chest rises
Chest
Compressions
Hard and Fast
Use of an AED
Using an AED may seem like a challenging skill but it is truly the
easiest part of this program. An AED is a computerized defibrillator
that talks you through the procedure of defibrillation. Once you turn
the device on by opening the cover, it will instruct you to remove
clothing and attach the AED pads. The machine will then advise you
to clear the victim and proceed to analyze the victim’s heart rhythm. If
the victim is in ventricular fibrillation it will charge and deliver a shock
to the victim’s heart. You will be instructed to start CPR. The
machine will actually coach you through the procedure of CPR. You
will continue the process of CPR, analysis of the rhythm until one of
two things happen. The victim wakes up and begins to move or EMS
arrives on the scene and advises you to stop CPR. It is really that
simple.
AED Operation – Pad Placement
Position the AED next to the victim on the opposite side of the CPR
rescuer. Open the case and follow the instructions. Unwrap the
pads…remove the covering from the pads surface…place them as
directed by the AED. Look carefully at the picture below to see the
proper position of the electrode pads. This position allows the
electrical current to travel through the heart and help convert the
victim’s heart rhythm.
AED Operation – Clear and Shock
Once the pads are attached…stop CPR…clear everyone from the
victim and allow the device to analyze the rhythm. If the heart is in a
rhythm that requires a shock, the machine will automatically charge.
Again, make sure that everyone is clear of the victim, including
yourself. It will warn of the shock and deliver a single shock. After
the shock immediately start chest compressions and provide 5 cycles
of CPR. This will take approximately 2 minutes.
AED Operation – Clear and Shock
At the end of 5 cycles the machine will prompt you to reanalyze the
rhythm. When this occurs, stop CPR and allow the machine to
analyze. The machine will either shock the victim or advise to
perform CPR. Again simply follow the instructions. Let’s review the
steps one more time:
Summary of Steps of AED Operation

Place the AED opposite side of the CPR rescuer.

Open the lid and follow the instructions.

Remove clothing if not already done.

Attach pads as shown on the AED.

Clear the victim.

Allow the machine to analyze.

Make sure the everyone is clear.

The machine will deliver a shock.

Start 30 to 2 cycles of compressions and breaths.

Perform 5 cycles and continue until the victim wakes
up or EMS directs you to stop.
AED Operation – Special Situations
There are special situations that may have to be addressed when using an AED.
These include victims; with a hairy chest, those that are found in water, those with
an implanted pacemaker-defibrillator, or those who are wearing a medication patch.
Hairy Chest - When a victim has a very hairy chest the electrode pad may not
adhere to the skin. If this occurs the device will prompt you to check the electrode.
In this situation, press firmly on each electrode and allow the AED to re-analyze the
heart rhythm. If the message occurs again, remove the electrode pads, quickly
shave the chest with the razor in your kit and apply a second set of electrodes.
Water - Water is a good conductor of electricity. If the victim is lying in water they
should be moved to a dry location to avoid injuring rescuers. The chest of the
victim should also be dried with a towel before attaching the electrode pads.
Implanted Pacemaker-Defibrillator - A victim may be found with a “lump”
on his or her chest wall in the same location as where an AED electrode is applied.
The lump will look like the shape of a deck of cards under the skin. If this is noted
place the AED pads approximately an inch away from the pacemaker.
Medication Patch - A victim may be found with a medication patch placed on
their chest such as a nicotine or nitroglycerin patch. This can interfere with the
function of the AED electrode pad. If you note a patch, remove it and clean the
area with a dry towel.
Choking
Every year approximately 3,900
people die from choking.
Management of a choking episode is
fairly simple and involves recognition
and actions. When you encounter
someone who appears to be choking
ask, “Are you choking.” If he or she
nods their head but cannot speak,
perform abdominal thrusts just above
the navel and well below the
breastbone until the person can speak
or cough. If the victim becomes
unconscious, perform CPR. When
you are opening the airway to breathe,
look for a foreign body. If you see it,
remove it.
Child CPR
The good news is that Child CPR is almost exactly the same
as adult CPR. The only significant difference is that you
decrease the depth of chest compressions and breathe less
volume into the lungs. When providing rescue breathing,
breathe until the chest rises. When compressing the chest
move the breastbone about 1/3 to 1/2 the distance of the
chest from front to back. The compression rate remains at
100 compressions per minute and the ratio of compressions
to ventilations remains at 30:2. With smaller children, you
can use one arm to perform compressions.
Child AED
The use of AEDs on children is also the same as an adult. For the
purposes of AED use, a child is defined as someone who is 1 to 8 years
of age. The only difference is that the child pads are used which reduce
the delivered energy to the heart. You should be careful not to use
child AED pads on adults since the energy may not be sufficient to
convert the heart rhythm. The pads are placed in the same position as
an adult. However, some AEDS recommend an alternate position with
one pad in front and the other pad in back. Check the manufactures
recommendation on your device. At this time the American Heart
Association does not recommend for or against the use of AEDs for
infants less than one year of age.
Infant CPR
The main differences when performing CPR on an infant
victim is that you breathe less during rescue breathing and
compress less during chest compressions. You use your
fingers rather your hand to compress the chest. When
compressing the chest move the breastbone about 1/3 to
1/2 the distance of the chest from front to back. The
compression rate remains at 100 compressions per minute
and the ratio of compressions to ventilations remains at
30:2.
Answer the following
questions to review the
knowledge you have
just learned.
What 2 skills can help
save the life of a
sudden cardiac arrest
victim?
Answer:
CPR and defibrillation
For every minute that
passes without CPR
and/or defibrillation,
how much will the
chance for survival
decrease for victims of
sudden cardiac arrest?
Answer:
7 to 10% per minute
What is the first 3
actions you should
take when
encountering an adult
collapsed victim?
Answer:
Check for response,
send someone to call
the emergency
response number and
get the AED.
How do you know if
a rescue breath is
effective?
Answer:
The chest rises with
each breath.
Describe three
qualities of effective
chest compressions.
•Answer:
Compress hard (1 1/2 to 2 inches)
Compress fast (100 compressions per minute)
Allow the chest wall to return to its normal
position after each compression.
What are the correct
locations to place
the AED pads?
•
Answer: