Heartsaver® Instructor Course Module

Teaching Glove Use:

Proper glove use is fundamental for personal protection and preventing cross-contamination when providing first aid. Instructors must ensure students can don and doff gloves correctly.

Key Teaching Points for Donning Gloves:

• Select appropriately sized gloves.
• Check gloves for rips or tears before donning.
• Avoid touching the outside of the gloves with bare hands as much as possible during donning.
• Ensure gloves cover the wrists.

Key Teaching Points for Doffing Gloves (to avoid self-contamination):

• Step 1: Pinch the palm of one gloved hand near the wrist with the other gloved hand.
• Step 2: Pull the glove off, turning it inside out as it comes off. Hold the removed glove in the still-gloved hand.
• Step 3: Slide two ungloved fingers under the wrist of the remaining glove. Be careful not to touch the outside of the glove.
• Step 4: Peel the second glove off, turning it inside out and creating a "bag" for both gloves.
• Step 5: Dispose of gloves properly in a biohazard bag or designated container.
• Step 6: Perform hand hygiene (wash hands with soap and water or use alcohol-based hand sanitizer) immediately after removing gloves.

Before providing any care, lay rescuers must ensure their own safety and quickly assess the situation and the person. This systematic approach is crucial.

Teaching Scene Safety: "Make sure the scene is safe!"

• Look for dangers to yourself and the ill/injured person (e.g., traffic, fire, downed power lines, unstable surfaces, aggressive individuals).
• If the scene is unsafe, do not enter. Call for professional help and wait for them to secure the scene.
• Consider the number of ill/injured people.

Teaching Initial Assessment Steps:

• Check for Responsiveness: Tap the person's shoulder and shout, "Are you OK?"
• Shout for Help: If unresponsive, immediately shout for nearby help. Tell a specific bystander to call emergency services (e.g., 911 or local emergency number) and get an AED and first aid kit if available. If alone, call emergency services yourself and get an AED if readily available.
• Check for Breathing: Scan the chest for rise and fall for at least 5 seconds but no more than 10 seconds. Agonal gasps (occasional, irregular gasping breaths) are NOT normal breathing.
• Check for Obvious Signs of Injury/Bleeding: Quickly look for life-threatening bleeding.

Rapid control of severe, life-threatening bleeding is a critical first aid skill.

Teaching Steps for Bleeding Control (Direct Pressure):

• Ensure Scene Safety and Wear Personal Protective Equipment (Gloves).
• Apply Direct Pressure: Place a clean dressing or cloth (or gloved hand if no dressing is available) directly onto the wound.
• Press Firmly: Use firm, continuous pressure with the palm of your hand (or both hands if needed).
• Add More Dressings if Needed: If blood soaks through the first dressing, do NOT remove it. Add more dressings on top and continue to apply pressure.
• Maintain Pressure: Continue pressure until help arrives or the bleeding stops.
• Tourniquets (Brief Mention for Awareness): While detailed tourniquet application may be part of advanced first aid, Heartsaver courses should make students aware that tourniquets are used for life-threatening bleeding on an arm or leg when direct pressure is not effective or possible. Emphasize that proper training is needed for tourniquet use and they should follow dispatcher instructions if guided.

Teaching the use of an epinephrine auto-injector is vital for responding to severe allergic reactions (anaphylaxis). Students should be taught to assist a person with their prescribed auto-injector.

Key Teaching Points for EpiPen Administration (General Steps - refer to specific device instructions):

• Recognize signs of a severe allergic reaction (e.g., trouble breathing, swelling of face/tongue, dizziness, hives).
• Confirm the person has a prescribed epinephrine auto-injector. Ask if they need help using it.
• Follow Device Instructions: Emphasize that different auto-injectors may have slightly different steps. The user (or person assisting) should always follow the instructions on the device itself or its packaging. Many devices have voice prompts.
• General Steps (using a common type as an example - e.g., EpiPen):
  • Form a fist around the auto-injector and pull off the safety cap (often blue). "Blue to the sky, orange to the thigh."
  • Place the orange tip against the outer mid-thigh. It can be given through clothing.
  • Push the auto-injector firmly against the thigh until it 'clicks' (or activates).
  • Hold it firmly in place for the recommended time (e.g., 3 seconds for EpiPen - verify device instructions).
  • Remove the auto-injector. The needle will be covered.
  • Massage the injection site for about 10 seconds.
• Call Emergency Services (e.g., 911) IMMEDIATELY after using the epinephrine auto-injector, even if the person feels better. Anaphylaxis can recur.
• Note the time the injection was given.
• Safely store the used auto-injector to give to EMS personnel (needle protected).

High-quality CPR is the cornerstone of resuscitation. Instructors must ensure students master the specific techniques for adults, children, and infants.

Universal CPR Principles to Emphasize:

• Scene Safety and Initial Assessment (as covered in HS 1.2) are prerequisites.
• Compressions: Push hard and fast. Allow full chest recoil between compressions. Minimize interruptions.
• Breaths: Give breaths that make the chest rise. Avoid excessive ventilation.
• Cycles: Typically 30 compressions followed by 2 breaths (for single rescuers).

Teaching Adult CPR (Puberty and Older):

• Hand Placement: Heel of one hand in the center of the chest (lower half of the sternum), with the other hand on top.
• Compression Depth: At least 2 inches (5 cm), but not more than 2.4 inches (6 cm).
• Compression Rate: 100 to 120 per minute.
• Airway: Head-tilt/chin-lift maneuver.
• Breaths: Each breath over 1 second, watch for chest rise.

Teaching Child CPR (Age 1 to Puberty):

• Hand Placement: One or two hands (depending on child size and rescuer strength) in the center of the chest (lower half of the sternum).
• Compression Depth: AT LEAST 1/3 the depth of the chest, approximately 2 inches (5 cm).
• Compression Rate: 100 to 120 per minute.
• Airway: Head-tilt/chin-lift maneuver.
• Breaths: Each breath over 1 second, watch for chest rise.
• If unwitnessed collapse (and alone): Provide 2 minutes of CPR before leaving to call EMS and get an AED if not already done.

Teaching Infant CPR (Under 1 Year of Age, excluding newborns):

• Hand Placement (Single Rescuer): Two fingers in the center of the chest, just below the nipple line.
• Hand Placement (Two Rescuers - preferred): Two thumb-encircling hands technique.
• Compression Depth: AT LEAST 1/3 the depth of the chest, approximately 1.5 inches (4 cm).
• Compression Rate: 100 to 120 per minute.
• Airway: Head-tilt/chin-lift to a neutral or slightly extended position (avoid overextension).
• Breaths: Cover infant's mouth AND nose with your mouth. Each breath over 1 second, watch for chest rise.
• If unwitnessed collapse (and alone): Provide 2 minutes of CPR before leaving to call EMS and get an AED if not already done.