CPR Manual (CPT)



OCFD CPR PROGRAM PROCEDURES MANUAL

TABLE OF CONTENTS

SHIFT CPR COORDINATOR PROGRAM 2

DISTRICT CPR COORDINATOR PROGRAM 2

TRAINING CENTER FACULTY 3

CPR INSTRUCTOR 3

PERSONNEL CPR TRAINING PROGRAM 4

HEALTHCARE PROVIDER DESCRIPTIONS: 4

AHA PERFORMANCE TESTS: 4

RETRAINING 4

INSTRUCTOR AND TRAINING CENTER FACULTY 4

INSTRUCTOR 4

TRAINING CENTER FACULTY 4

INSTRUCTOR COURSE DESCRIPTIONS 5

CITIZEN CPR TRAINING 5

CITIZEN CPR INVENTORY 6

BIG PUSH (CPR FOR FAMILY AND FRIENDS) TRAINING GUIDELINES 6

COURSE OBJECTIVES 6

KNOWLEDGE (COGNITIVE) OBJECTIVES 7

SKILLS (PSYCHOMOTOR) OBJECTIVES 7

CPR FOR FAMILY AND FRIENDS 7

MODULE 1 ADULT BASIC LIFE SUPPORT 7

MODULE 2-PEDIATRIC BASIC LIFE SUPPORT 8

CPR COURSE TAUGHT OFF DUTY 9

CPR TRAINING SUPPLIES 9

TESTS 9

COURSE COMPLETION CARDS 9

RECORD KEEPING 9

MANIKIN CLEANING, MAINTENANCE, AND INVENTORY 9

ORDERING SUPPLIES 10

MANIKIN SUPPLIES AND INVENTORY 10

SAMPLE COURSE ROSTER 10

CPR INSTRUCTOR EVALUATION FORM 11

NO FEE CPR TRAINING AGREEMENT 11

SHIFT CPR COORDINATOR PROGRAM

1. Each shift will need a Coordinator and alternate Shift CPR Coordinator.

a. The Shift CPR Coordinator should be an AHA Training Center Faculty, if possible.

b. The Shift CPR Coordinator will be the District CPR Coordinator for their district.

2. The following list of tasks performed by the Shift CPR Coordinator will assist with the management of CPR training on each shift:

a. Perform all District CPR Coordinator tasks.

b. Coordinate the scheduling of Training Center Faculty assigned on their shift for annual retraining at the Training Center with District Officers.

c. Coordinate district level CPR Instructor retraining with District Coordinators, Training Center Faculty, and District Officers.

d. Confirm with District CPR Coordinators that all personnel have a current CPR card.

e. Following District CPR training or anytime required, District CPR Coordinators will review the monthly CPR expiration report sent by the EMS Training Office. This report can be used to ensure that all new expiration dates have been entered correctly and/or that all personnel have been retrained.

DISTRICT CPR COORDINATOR PROGRAM

1. Each district and shift will need a District CPR Coordinator and an alternate for each coordinator.

a. The Coordinator should be a CPR Instructor or Training Center Faculty.

2. The following tasks, performed by the District CPR Coordinator, will assist with the management of CPR training within each district:

a. Coordination of the district CPR Healthcare Provider training with the District Officers.

b. Coordinating with the District Officers and Shift CPR Coordinators for the scheduling of all CPR Instructors within their district for retraining.

c. Confirming that all personnel within their district have a current CPR card.

d. Ensuring that CPR Instructors within their district are teaching the required number of courses.

e. A Shift Coordinator will assist with ordering required CPR supplies located in the EMS supplies order form.

f. Maintain inventory of all CPR equipment and supplies for district.

g. Coordinating with station officers to assist with citizen CPR training when instructors and/or staffing is needed

h. Following District CPR training or anytime required, District CPR Coordinators will review the monthly CPR expiration report sent by the EMS Training Office. This report can be used to ensure that all new expiration dates have been entered correctly and/or that all personnel have been retrained.

TRAINING CENTER FACULTY

1. The following list of tasks performed by the CPR Training Center Faculty will assist with the management of the OCFD CPR program:

a. Follow all CPR instructor tasks and responsibilities.

b. Assist the Shift CPR Coordinator by providing CPR Instructor retraining to all CPR instructors on their shift.

c. Monitor CPR Healthcare Provider courses to ensure AHA standards and guidelines are followed.

d. Advise District CPR Coordinator of Training Center Faculty card expiration date 90 days prior the expiration.

e. Conduct all initial CPR instructor courses at the Training Center as assigned by the Shift CPR Coordinator.

f. The Training Center Faculty will be responsible for maintaining a current CPR instructor card.

g. Provide OCFD CPR Instructors with up to date instructive and technical support and to latest scientific research and guidelines. Must attend one AHA update meeting per year or receive the information from Regional Faculty.

CPR INSTRUCTOR

1. All Oklahoma City Fire Department CPR Instructors and Training Center Faculty must be current American Heart Association BLS instructors.

2. The following list of tasks and responsibilities performed by the instructor will assist with OCFD CPR training:

a. Instruct “Healthcare Provider courses” to suppression and other personnel as assigned by the District Coordinator.

b. Assist with citizen CPR training program, as directed by the District CPR coordinator.

c. Instruct “CPR for Family and Friends” to citizens as needed.

d. Forward orders to District Coordinator of all training aids and supplies needed to conduct CPR classes at least 30 days in advance.

e. Forward completed course rosters and tests in large envelope to EMS Administration. A copy of rosters and course completion cards will be returned by interoffice mail. Cards will then be issued to students by the Instructor.

f. Retain copies of all CPR rosters of courses taught for a minimum of two years.

g. Maintain station CPR equipment inventory.

h. Assure all personnel at your station have a current “Healthcare Provider” CPR card.

i. Assure all training adheres to AHA standards and guidelines.

j. Advise District CPR Coordinator of instructor card expiration date 90 days prior to expiration.

k. Accept responsibility for recertification requirements.

PERSONNEL CPR TRAINING PROGRAM

CPR training is available to all OCFD personnel. Suppression division personnel are required to maintain current “Healthcare Provider” CPR training status. All other personnel are encouraged to receive and maintain CPR training.

Support personnel may schedule initial CPR training or retraining of employees at any time. To schedule CPR training and verify Instructor and equipment availability, contact the CPR Coordinator 30 days in advance of the selected training day.

Instructors will ensure that proper techniques are being performed as required by the American Heart Association by personnel during training and retraining classes. The Instructor is responsible for all paper work associated with training and retraining; ensuring it is completed properly with accurate information legible. A copy of the OCFD AHA roster is provided at the back of this document on page 18.

By conducting two classes per year in CPR in each of the six districts, individuals in those districts will have an opportunity to either train or retrain in one of the two classes. All personnel may participate in the CPR training, however if your card does not expire within 6 months of the training you should participate in the training, but do not sign the roster.

HEALTHCARE PROVIDER DESCRIPTIONS:

Initial Course

Healthcare Provider CPR training will include one and two rescuer adult, child, infant and adult, child, and infant obstructed airway techniques. Mouth-to-mask ventilation, cricoid pressure, modified jaw thrust, BVM and demand valve, and AED techniques are mandatory for the Healthcare Provider level training. Students must attend and successfully complete the full course with a written test score of 84% or above.

AHA PERFORMANCE TESTS:

One and Two rescuer adult and child CPR; infant one rescuer CPR; adult, child, and infant obstructed airway, pocket mask, demand valve and BVM. Instructor/manikin/student ratio is 1:1:6. Course length is a minimum of 6-8 hours with proficiency being the determinant of required time. Cards expire 2 years from date of issue with recommended annual re-training.

RETRAINING

Repeat Healthcare Provider CPR Course or successfully completed Healthcare Provider CPR Retraining. Recommended course length is 3 to 4 hours with proficiency being the determinant of required time. Instructor/manikin/student ratio is 1:1:6. Card expires two years from date of issue. Instructors must incorporate the use of AED, airway adjuncts (i.e., oral airways, demand valve, bag-valve-mask (BVM) with 100% O2 and pocket mask). The instructor will assure these are disinfected properly after each use.

INSTRUCTOR AND TRAINING CENTER FACULTY

INSTRUCTOR

CPR Instructor initial training will be conducted at the OCFD Training Center. Class dates will be scheduled on an as needed basis. BLS Instructors must teach a minimum of four courses per year. CPR Instructor retraining will be conducted at the station level by shift Training Center Faculty. All CPR Instructors will be retrained as needed by the Training Center Faculty. The District CPR Coordinators will coordinate with the Training Center Faculty in the development of schedules for the retraining of all CPR Instructors each year.

TRAINING CENTER FACULTY

Training Center Faculty initial training and retraining will be conducted at the OCFD Training Center. All retraining courses will be scheduled in the OCFD Training Center training schedule. Initial training courses will be scheduled as needed.

BLS Instructors must teach or be present for a minimum of four courses in two years. It is up to each instructor to achieve this requirement. The District CPR Coordinators will assist with the requirement by coordinating District CPR training with district CPR Instructors. Training Center Faculty is responsible for providing quality/performance improvement, updates, monitoring, and teaching Instructor Courses.

INSTRUCTOR AND TRAINING CENTER FACULTY - continued

INSTRUCTOR COURSE DESCRIPTIONS

Instructor

Recommended length of class is 8 hours with proficiency being the determinant of time. Course agenda is located in BLS Instructors Manual. Instructors must have copy of OCFD CPR Policies and Procedures Manual, and a current copy of the AHA BLS HealthCare Provider Instructor Manual at least 10 days before the class date. Attend and successfully complete full course and written test (50 questions) with score of 84% or above. Card expires two years from date of issue. Instructor/manikin/student ratio is 1:1:5. Within one year of completing the course the Instructor candidate must successfully demonstrate his/her teaching skills while being monitored during a Provider or Provider renewal course.

Instructor-Retraining

Within two years of training, must teach or be present for a minimum of four courses. Copies of course rosters and current training card must be submitted at the time of retraining. Written test score of 84% or above. If prerequisite requirements are NOT met, the instructor wishing to be retrained must successfully complete a full Instructor training course. Retraining should be completed on or before current training expires. Instructors cannot teach any CPR courses after their card expires.

Training Center Faculty

Individual must have been trained as an Instructor for a minimum of 2 years with current Instructor training. Must have taught a minimum of 4 courses during the past 24 months. Must have copy of OCFD CPR Policies and Procedures Manual and other materials required at the Instructor level. Attend and successfully complete requirements for instructor retraining. CPR Instructor wanting to become Training Center Faculty must contact the EMS Officer.

Training Center Faculty Retraining

Within the year of training the Training Center Faculty must teach a minimum of 4 courses. The Training Center Faculty must attend or give an annual AHA update.

CITIZEN CPR TRAINING

The Oklahoma City Fire Department is actively involved in Citizen CPR Training. This will promote a good relationship with the public and will enable them to help us in saving lives. For our pre-hospital defibrillation program to continue successfully, we need early Basic Life Support (BLS) to be initiated. Early CPR will help to increase an already successful save rate. Big Push is the name of the Oklahoma City Fire Department citizen CPR program. The Big Push citizen CPR training will continue year round.

BEGINNING AUGUST 1, 2001, OKLAHOMA CITY FIRE DEPARTMENT WILL TEACH ONLY THE “CPR FOR FAMILY AND FRIENDS”, ADULT OR PEDIATRIC, TO THE PUBLIC.

Each citizen will be issued one “CPR for Family and Friends” manual. A course participation card is located in the back of each manual and will be filled out by the Instructor at the end of the course. When calls come in from citizens and businesses requesting a CPR class, they will be given the phone number of the station closest to them that has a CPR class being offered in the right time frame. The station officer at that station will then receive the call from the person requesting the training. The officer will obtain the following information:

1. Name and call back number of party requesting training.

2. Name of business or organization, if applicable.

3. Type of course and number of students.

4. Location training will take place (at their location or at the fire station).

5. Date training is desired (date should be at least 14 days in advance).

The officer will schedule CPR training only on the shift the officer is assigned. If the party requesting CPR training wants the training on a day that is on another shift, the officer will tell the calling party that the Station Officer will call them. The officer receiving the call will notify the officer on the shift of class date desired.

CITIZEN CPR TRAINING - continued

Citizen CPR Classes will be taught on duty and scheduled a least 14 days in advance to allow time for request of materials and scheduling of staffing. Exceptions can be made if equipment and staffing are available. When a CPR Instructor is teaching a CPR course, either at the station or at the student’s location, the Instructor will not be assigned to an apparatus until the course is completed. If the station does not have a CPR Instructor and/or staffing will not allow training on scheduled date, the officer will coordinate with the District Officer and the District CPR Coordinator so arrangements can be made concerning CPR Instructors and/or staffing.

The station “Little Anne” manikins will be used for citizen CPR training. If more manikins are needed to accommodate class size, the Shift CPR Coordinator and/or the District CPR Coordinator may access additional manikins from other stations or the EMS Training Office. All equipment will be returned to the district stations properly sanitized and stored in the proper container.

CITIZEN CPR INVENTORY

Each station should have the following inventory for citizen CPR training:

▪ 2 Little Anne manikins with carrying case

▪ 10 disposable lungs and 10 face pieces for the Little Anne manikins

▪ Citizen CPR training box with 2 CPR training Videos, 10 Family and Friends student manuals, (Family and Friends CPR course participation cards are located inside manuals). 5 course rosters, CPR/First Aid student handouts and a Family and Friends lesson plan.

BIG PUSH (CPR FOR FAMILY AND FRIENDS) TRAINING GUIDELINES

Preparation:

Prepare Room, check all equipment and supplies.

▪ 2 training videos, (adult and pediatric).

▪ Instructor lesson plan.

▪ Little Anne manikins with a face piece for each student.

▪ Student roster (have students print names).

▪ Family and Friends course student training manuals, (one per student for them to keep).

COURSE OBJECTIVES

The AHA developed the CPR for Family and Friends Course curriculum to achieve one ultimate objective: to increase survival from sudden cardiac arrest by increasing the number of rescuers prepared to call 911 and provide early CPR. By strengthening the early access and early CPR links in the Chain of Survival in every community, the AHA should meet its mission: to reduce death and disability caused by cardiovascular diseases and stroke. In addition, the course is designed to prevent death and disability and the need for CPR by teaching the warning signs of heart attack and stroke in adults, and teaching methods to reduce death caused by sudden infant death syndrome in infants and injuries in children.

COURSE OBJECTIVES - continued

KNOWLEDGE (COGNITIVE) OBJECTIVES

The major knowledge (cognitive) objectives of the CPR for Family and Friends Course are that at the end of the course, the participant will be able to:

1. Describe the links in the AHA Chain of Survival, including the importance of:

a. Calling 911

b. Performing CPR

c. Increasing the probability of early defibrillation by calling 911

d. Ensuring the arrival of early advanced care by calling 911

2. Describe the steps of CPR and relief of FBAO:

a. Describe when to start CPR

b. Describe when to start rescue breathing

c. Describe how to check for normal breathing or signs of circulation

d. Describe the “A,B,C” sequence of CPR

e. Describe the signs of severe or complete foreign body airway obstruction

f. Describe how to relieve FBAO in the responsive victim.

3. Describe the signs of 4 major emergencies in adults:

a. Heart attack

b. Stroke

c. Cardiac arrest

d. Foreign-body airway obstruction (FBAO)

4. Describe strategies to prevent sudden infant death syndrome in infants and injuries in infants and children.

SKILLS (PSYCHOMOTOR) OBJECTIVES

The major skill (psychomotor) objectives of the course are that at the end of the course, the participant will be able to demonstrate the following skills using an adult and/or an infant and child manikin (determined by the course modules completed) and a telephone:

1. Calling 911

2. Rescue breathing using mouth-to-mouth ventilation

3. One-rescuer CPR

4. Relief of FBAO in the responsive victim

CPR FOR FAMILY AND FRIENDS

Course Agenda (participant/Instructor Ratio-6:1, Participant/Manikin Ratio-3:1)

MODULE 1 ADULT BASIC LIFE SUPPORT

(One hour and 44 minutes to 2 hours and 2 minutes. Total course time range for adult and pediatric modules: 4 hours to 4 hours, 38 minutes).

Welcome and Introduction and video: CPR for Family and Friends, Adult segment. Video participants should have book open to follow teaching points.

1. The Chain of Survival

2. Heart Attack and Cardiac Arrest: Recognition and Management

3. Stroke: Recognition and Management

4. Choking: Recognition and Management

Instructor-led discussion of sign of heart attack, cardiac arrest, stroke, and choking. Participants should discuss contents from book and video. Watch-then practice video instruction (3:1 student to manikin ratio)

1. Mouth-to-mouth rescue breathing

2. Assessment of signs of circulation, Chest Compressions

3. One-rescuer CPR

4. Relief of FBAO in responsive victim

Scenario and Peer Practice

1. Relief of FBAO in responsive adult

2. One rescuer CPR

CPR FOR FAMILY AND FRIENDS - continued

MODULE 2-PEDIATRIC BASIC LIFE SUPPORT

(Two hours and 16 minutes to 2 hours and 38 minutes).

Welcome and introduction and video: The infant and child.

Video participants should have books open to follow teaching points.

1. Pediatric Chain of Survival

2. Epidemiology of pediatric cardiac arrest

3. Injury Prevention

Instructor led discussion of signs of heart attack, cardiac arrest, stroke, and choking (participants should discuss contents from books and video). Watch then practice video instruction (3:1 student to manikin ratio).

Infant Skills

1. Mouth to mouth and nose rescue breathing

2. Signs of Circulation, Chest Compressions

3. One Rescuer CPR

4. Minutes

5. Relief of FBAO in responsive infant

Watch then practice video instruction (3:1 student to manikin ratio).

Child Skills:

1. Mouth to mouth rescue breathing

2. Minutes

3. Signs of Circulation, chest Compressions

4. One Rescuer CPR

5. Relief of FBAO in responsive child

Scenario Peer Practice:

1. Infant FBAO (responsive)

2. Infant CPR and rescue Breathing

3. Child FBAO (responsive) can be practiced with 6 participants

4. CPR and Rescue Breathing

Training recommendations:

1. Ventilation should make chest rise.

2. Promote smooth rhythmic compressions and ventilation.

3. Encourage student to count out loud to regulate their rates for compression.

4. Take breaks as needed.

5. TV/VCR should be located in the same room as skills practice.

6. Review and answer questions.

Post course instructions:

1. Have the students complete the AHA course participation cards in the back of their Family and Friends manuals.

2. Explain to students their completion card is valid for two years and annual retraining is highly recommended.

3. Have students fill out instructor evaluation form.

4. Contact Oklahoma City Fire for retraining.

5. Dismiss class.

6. Turn in completed roster and instructor evaluation forms to the office of the EMS Officer.

7. Complete EMS supply order form if any supplies are needed.

CPR COURSE TAUGHT OFF DUTY

AHA CPR courses taught by instructors of their own time and are not fire department related are encouraged and must follow these guidelines:

Manikins and supplies for these classes may be obtained at the Fire Training Center if they are available on the dates requested. However, the instructor cannot use the manikins and supplies if charging a fee for the course. The instructor, upon checking out equipment will sign a “NO FEE” agreement form, (see page 17). All equipment and supplies will be reserved in advance to ensure availability. Equipment will be returned properly sanitized and stored in the proper container.

CPR TRAINING SUPPLIES

All printed material for CPR training will be made available at the OCFD Training Center or at the EMS supply office.

All supplies to maintain the district CPR manikins, (i.e., lungs, shields, face wipes, etc.) will be ordered on the EMS supply order forms by the Red shift. CPR supplies ordered will be returned to the instructor with EMS supply orders. It is necessary to order supplies at least 30 days in advance. Supplies can be picked up at EMS supply building on an emergency basis only.

TESTS

It is the responsibility of the instructor to maintain the security of the tests, making sure that all test and answers sheets are in the instructor’s possession at the end of the course.

COURSE COMPLETION CARDS

At the completion of EMS Healthcare Provider or CPR for Family and Friends courses, the Instructor will forward the completed roster and test to the OCFD EMS Office in a large envelope. When Healthcare Provider course rosters are received, Healthcare provider’s cards will be issued according to the number of students listed on the course roster. Instructors and Training Center Faculty teaching less than 10 Non Fire Department BLS Healthcare Provider students per year, for no fee, may receive cards free of charge. A copy of the course roster and cards will be returned to the Instructor. Healthcare Provider and Heartsaver cards for citizens may be purchased through the support staff in Operations, at cost plus shipping. When CPR for Family and Friends course rosters are received, a copy of the course roster will be mailed back to the instructor with replacement student manuals.

RECORD KEEPING

When CPR training or retraining course are completed, the Instructor will complete the course roster, front and back. The Instructor will then forward the roster and test answer sheet to the EMS Office. The roster will be copied and forwarded to the Instructor with the appropriate cards. The EMS Training office will keep a copy of the CPR for Family and Friends course roster for a minimum of three years.

MANIKIN CLEANING, MAINTENANCE, AND INVENTORY

Cleaning And Maintenance

The following cleaning procedures will be carried out to ensure the safety and health of all employees and citizens who utilize this equipment:

All equipment will be cleaned after each use. All equipment including manikins and airway adjuncts (i.e., oral airways, demand valve masks, bag valve masks, etc.) will be disinfected with the proper solution from the disinfection station and air-dried. It is the responsibility of the Instructor to assure these procedures are followed.

ORDERING SUPPLIES

Ensure that all manikins are in good working order before each class. Order any missing parts or supplies needed on the EMS Supply order form. Coordinate ordering supplies and parts with the Red shift.

MANIKIN SUPPLIES AND INVENTORY

1. Each station should have two Little Anne manikins with five face pieces for each. These manikins are to be used for citizen training and defibrillator Inservices only.

2. Each station should have a BIG PUSH citizen CPR training box with all supplies. See Citizen CPR training section for box inventory.

3. Each District Chief should have:

1ea. Chris clean adult manikin with five face/nose pieces.

2ea. Resusci Baby infant manikins with five face pieces for each.

1ea. Resisci Junior child manikin.

1ea. Little junior child manikin.

Enough supplies for district/station CPR training should be on hand at all times.

All District Manikins and supplies should be returned to the district station at the completion of the course.

SAMPLE COURSE ROSTER

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CPR INSTRUCTOR EVALUATION FORM

CPR Instructor Evaluation Form

CPR Instructors:_______________________________________

Class:________________________________________________

Rating Scale

5- Excellent

4- Above average

3- Average

2- Less than average

1- Poor

_____1. Organizes classroom content in a manner which is meaningful to the student.

_____2. Is fair and objective in the evaluation of the student.

_____3. Is available to the students as a resource person.

_____4. Is flexible when the occasion calls for it.

_____5. Displays a sense of humor.

_____6. Identifies the students strengths and weaknesses by verbal and written feedback.

_____7. Makes students feel free to ask questions or ask for help.

_____8. Permits freedom of discussion and venting of feelings.

_____9. Shares own ideas with students.

_____10. Stresses important material

_____11. Is informed on technical and professional advances.

_____12. Encourages student participation in class.

_____13. Has speaking voice conducive to learning.

_____14. Classroom material was presented in an organized manner.

_____15. Utilizes alternative teaching techniques (ie. Visual aids).

_____16. Stimulated my curiosity about the subject matter.

_____17. Makes students aware of professional accountability.

_____18. Sets realistic goals for the student.

Additional Comments or suggestions to improve instruction of material: ______________________________________________________________________________________________________________________________________________________________________________________________________

NO FEE CPR TRAINING AGREEMENT

-----------------------

OKLAHOMA CITY FIRE DEPARTMENT

NO FEE AGREEMENT FOR CPR TRAINING

I, , serving as a BLS Instructor/Training Center Faculty for the American Heart Association and Oklahoma City Fire Department agree that I will not receive any fees or gratuities while using any equipment or supplies owned by City of Oklahoma City Fire Department for materials cost or profit.

Signature: .

Date: .

UPDATED 7/1/05

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