instructor's guide todmmu.eha-health.org/assets/uploads/downloads/20160617_146614… ·...

Instructor's Guide to

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CONTENTS

TOPIC PAGE

Forward................................................................ 2Introduction........................................................... 3-6 Message from the DEEM Coordinator ................. 7

First Aid

Objectives.............................................................. 8-9Lesson 1- Introduction........................................... 10-11Lesson 2- Triage.................................................... 12Lesson 3- Breathing difficulty................................. 13Lesson 4- Choking................................................. 14-15

16Lesson 6- Heart Attack.......................................... 17Lesson 7- Diabetics or low blood sugar................. 18Lesson 8- Stroke................................................... 19Lesson 9- Seizure................................................. 20Lesson 10- Bleeding you can see......................... 21-22Lesson 11- Bleeding you cannot see.................... 23Lesson 12- Injury................................................... 24-25Lesson 13- Poisoning........................................... 26Lesson 14- Insect Sting........................................ 27Lesson 15- Snake bite.......................................... 28Lesson 16- Heat related Emergencies................. 29Lesson 17- Cold related Emergencies................. 30Lesson 18- Burn care........................................... 31-32Lesson 19- Conclusion......................................... 33-34

Formsi. Volunteer Application ii. Registration iii. Multiple Choice Questionsiv. Instructors Commitment v. Feedback

FirstAid4FirstResponders (F4F)

Instructor's Guide toFirst Aid For First RespondersTraining v4g

F4F EHA's DEEM Training Program I 1


Forward

There has been an increasing trend of disaster events across the globe with increasing risk of loss of lives and injuries.

About 40% of those who had a chance to survive but died in the first hours or days, could have been kept alive by simple first aid actions, found in a study in the US.

The First Aid training is designed to save those lives, that are needlessly lost, due to lack of such training.

The one day First Aid course presented by Emmanuel Hospital Association (EHA) introduced as F4F is developed to equip volunteers to be able to help save lives, in all circumstances, in the spirit of the Good Samaritan. However, the course can be tailored depending on the need.

First Aiders leave their mark of humanity for their actions without seeking recognition and hence they must be encouraged and promoted.

Our vision is to see this act of goodness spread across the humanity.

Executive DirectorEmmanuel Hospital Association, India.



First AidHelp given to a sick or injured person until full medical treatment isavailable.

Introduction

Emmanuel Hospital Association (EHA) has been in the field of humanitarian aid action since early 1990s with its main focus on medical emergency response.

With the increasing event of major disasters and constant engagement with large scale relief programs EHA formed its nodal disaster management Unit in the year 2006. The Disaster Management & Mitigation Unit began to work toward disaster preparedness to improve response capabilities. This led to launch the DEEM (Disaster Education and Emergency Medicine) training programs for training its staff and volunteers in the year 2007.

Training programs meant for volunteers such as – First Aid, Basic Life Support*, Advanced Cardiac Life Support*, Basics to Disaster Response, Disaster Relief Management, Community based Post Disaster Psychosocial Care, Fire Safety & Rescue were rolled out eventually. (*American Heart Association)

Advanced training programs like Hospital Disaster Preparedness & Response modules were developed for healthcare leaders.

EHA mobilized more than 17000 volunteers and trained them in various disaster response skill areas as mentioned above.

The training programs are reviewed from time to time to keep up with newer developments and depending on the need.



First Aid For First Responders or F4F

For whomThe F4F training program for volunteers who are willing to equip themselves as First Responders. Every individual has the potential to protect and save lives and hence the objective is to reach all levels of community – from educational institutions to corporates, from rural community to disaster response organizations.

EHA has taken special interest to equip people with disabilities by including them using various disable-friendly tools.

For whatThe F4F manual will equip volunteers to effectively respond to a disaster scenario by

quickly assessing a victim and provide immediate assistance, in the spirit of the Good

Samaritan.

Training manualThis training manual is meant to be used by certified instructors for better result and productivity. The content of this training manual will raise the level of confidence of volunteers to be able to decide and handle a situation efficiently, effectively and timely.

The training manual contains materials from American Heart Association's Heartsaver modules.

The F4F trainingIn order to maintain minimum standards of training, a certified instructor can take 15 trainees maximum at a given time depending on the quality of trainees and modules to cover.



The training program is very interactive and practice is compulsory to ensure quality learning. A test (MCQ) is conducted at the end of the course to assess the level of skills acquired by participants.

This training will equip and enhance skill as a First Aider and will guide to provide immediate assistance to help save lives, in the absence of which, may cause death or disability.

Training toolkitTraining manual, PowerPoint/AV or Flip charts are used. First Aid kits is essential for practice. Ideal sitting arrangement is suggested to follow with participants sitting either in 'U' or 'V' shape. Each participant will have a FA booklet for future use. Generally, FA kits are provided to a center (organization/institution) where trained volunteers can collect and use when necessary. Instructor kit are made available under F4F Scheme.

Training formalitiesAppropriate record of the overall training is essential such as – sign in (volunteer) form, attendance register, feedback/evaluation form, Identity badge, certificates, white board marker/chalk and SR Kits. An F4F certificate card is issued to those who secure a minimum of 60% in the (MCQ) test. The certificate card is valid for 24 months.

Dress codeParticipants are suggested to wear comfortable dress keeping in mind the training will have practical sessions that would require physical exertions like – kneeling, bending, leaning etc.

Instructor course Any individual certified as First Aider can become an instructor by undergoing an additional 16 hours course designed for the purpose,



within 24 months of the F4F course. The instructor course consist of monitoring course.

F4F SchemeInstructors can make use of the limited assistance/fund available under F4F scheme available from time to time for conducting training program in their locality, congregation or workplace. On request, forms can be made available from DEEM Coordinator ([email protected]) for such philanthropic activities.

The sole objective of the F4F Scheme is to help save lives by engaging and equipping increasing number volunteers with the life-saving skills.

As a common practice, EHA keep reviewing and updating its training materials from time to time. The current version (v4g) is generic and reviewed during 2015 across various sessions with panel of experts from relevant fields.

Peniel Malakar.Coordinator- DEEM Training Program, DelhiHead- Disaster Management & Mitigation UnitEMMANUEL HOSPITAL ASSOCIATION


mailto:[email protected]


Dear Instructor

Thank you being part of EHA's DEEM Training Program. We heartily welcome you.

As you undertake the course, kindly read the manual repeatedly before you take sessions. Plan well in advance and practice to ensure you give best within the limited time.

Try to collect information about the participants/trainees in advance. This will help you address them effectively. Make sure thateach participants 'practice'. Without practice, one will not be able to apply the skills and help save lives.

Ensure all teaching aid and tools are available. Improvise them if required in situation where there is no electricity or in rural villages. Training in local language is the best ways of imparting the knowledge.

Please remember, you have every scope to learn from every session you take. So break any barrier between the trainees and you for best learning results. Remember, the level of performances depend mostly on the ability to imparting skills.

Kindly maintain self-discipline during the training, such as – timeliness, switching off mobile, clarity of voice & speech, interaction, practice and completion of documentation/reporting.

EHA's DEEM Training Program team wishes you all the best.

Coordinator – Deem Training



Objective

To 'Build a Cadre of Local Trainers' enabling them to equip community (natural first responders) to help save lives and prevent disabilities.

Some observations:

Much of First Aid is common sense. FA doesn't take long to learn but can help to save lives. Communities are the natural first responders to any

disaster event.

Some learning tips for trainees

Attend full course Participate & Practice Ask questions if not clear Switch off your phone MCQ compulsory to certify

Why including people with disabilities It is their right. Remove all possible barriers to allow them participate. They have every potential to help save lives as yours. Being vulnerable.



First Aid care DO NOT replace qualified medical care.

First Aiders must remember THREE very critical initial assessments

Ensure if the victim is breathing Stop bleeding, if visible Skillfully manage fractures to prevent further injury that

could lead to disability

Introductory 1. Introduce yourself –

◦ Full name, Experience/s as a Certified Instructor◦ Mention one think you liked the most in the course

2. Briefly mention about the organization – ◦ EHA, the Partner and/or the Project◦ Team, if present

3. Welcome participants4. Self introduction of participants –

◦ Full name, locality/organization

5. Announce that the registration is closed. Collect the register and 'roll call'.



1 Lesson: Introduction

Meaning of First Aid

Help given to a sick or injured person until full medical treatment is available.

Immediate care provided to an injured victim till a qualified medical assistance is available to save life.

Initial important things to remember...

Provider (your) safety first, then Safety of the victim After you quickly ASSESS the victim's condition Check for response of the victim Tap on the shoulder… Hello...Hello...Are you OK?

Be courteous!

- If the victim responds, then introduce yourselfMy name is “Anju” or “Anuj”. I am trained in First Aid.May I help you?

- No response? Or you are not sure what to do?

- Call for assistance…

If the place is crowded, direct your instruction saying-

...YOU... CALL for Ambulance… or arrange a vehicle



If you have cell phone, Call # (108) or any local ambulance number.

Remember the followings when you call

Provide clear inform about the victim's condition Give proper location…

◦ use popular landmarks e.g. hotel, cinema hall, temple, large mall, govt office etc.

...then, follow these steps Open the airway to check and allow for normal breathing

(head tilt- chin lift) Look-listen-feel Look for any visible injury



2 Lesson: Triage

Triage is sorting victims quickly identifying and tagging as per the status following a disaster event/mass casualty

If skillfully done, can save lives. Is helpful when emergency resources like transport, medicine, trained personnel is in short supply…

Color code Specifications

BLACK The victim without any response at all andseemingly deceased

RED The victim require immediate medical attention and need to be transported for advanced medical assistance. For example: uncontrolled bleeding, no response, fractures etc…

YELLOW Treatment can be delayed.

GREEN First Aider can manage.



3 Lesson: Breathing difficulty Caused by:

an object blocking the airway, a bad allergic reaction, infection

injuries to the head, neck or chest

Signs: Breathe very fast or very slow Noisy breathing Cannot speak or make any sound

Action: Ask, if the victim has prescribed medicine/inhaler… help get it

If the victim stop responding- Call for help Ready to start steps of CPR (cardinal-pulmonary-resuscitation)**

(** CPR training is conducted separately).



4 Lesson: Choking

Caused by: an object blocking the airway

◦ it can be either a nut or a coin or anything◦ generally happens while eating

Signs: Cannot breathe, speak or make any sound Quiet cough High-pitched noisy breathing (for children: cannot cry) Bluish lips or skin Makes the choking sign (universal sign)

Action: Ask, “are you choking?”

◦ If the victims nod or shakes his head Say, “I am trained and going to help you”

Stand behind the victim in firm position. Position: putting 1 of your leg between the 2 legs of the

victim. Kneel down if the victim is shorter or a child Wrap the victim from behind Place your fist (support your fist with the other hand)

above the navel but below the chest bone. Give upward thrust until the object comes out or victim

becomes unresponsive...



- If the victim stops responding… Make the victim lie to her/his back and try to see the object If you can see, take out. If not, do not blindly search…

Call for helpStart steps of CPR**



5 Lesson: Bed allergic reaction

Caused by: The environment

◦ Certain food stuffs or clothing's or insect or bee sting etc.

Signs: Stuffy nose, sneezing, itching around the eyes or the body Red rash on the body or face Swelling of tongue and face Trouble breathing

Action: Call for help. Stay with the victim till a medical help arrive Ready to start steps of CPR** if the victim stops responding If possible save the sample of that caused the reaction.



6 Lesson: Heart Attack

Signs: Chest discomfort- pressure, squeezing, fullness or pain Discomfort in other areas of the upper body –

◦ arms, neck, jaw or stomach Shortness of breath Cold sweat, nausea or light-headedness

Action: Let the victim sit quietly Call for help Ready to start steps of CPR**, if the victim stops

responding



7 Lesson: Diabetics or Low Blood Sugar

Signs: Change in behavior – confusion, irritability Sleepiness or even not responding Hunger, thirst or weakness Sweating, pale skin color Seizure

Action: Look for medical jewel Give victim sugar or any juice containing sugar Help victim sit quietly or lie down

If the victim does not feel better- Call for help Ready to start steps of CPR**, if the victim stop responding



8 Lesson: Stroke

Caused by: When blood stops flowing to a part of the brain due to

bleeding or block in the blood vesselSigns:

Sudden numbness or weakness of the face, arm or leg esp. on one side of the body

Sudden confusion, trouble speaking/understanding Sudden trouble seeing in one or both eyes Sudden trouble walking, dizziness, loss of balance or

coordination Sudden severe headache with no known cause

Action: Call for help Ready to start steps of CPR**, if the victim stops

responding



9 Lesson: Seizure

Caused by: Head injury, low blood sugar, heat related injury or poison

Signs: Loss of muscle control Fall to the ground Have jerking movements of the arms and legs & sometimes

other parts of the body Stop responding

Action: Protect victim from injury by moving nearby objects away Place a thick cloth below the head to avoid head injury

Call for help Check for breathing Ready to start steps of CPR**, if the victim stops

responding

- If the victim has no injury Roll the victim aside so that the output (saliva etc.) flow

away from the sides Stay with the victim until he or she response or a help

arrives



10 Lesson: Bleeding you can see

Cut injurySmall cuts can be easily stoppedBut, in case of a large or deep cut (blood vessel) the victim can loose a large amount of blood

Steps: Wash in running water, if available Put a dressing pad or a piece of clean cloth over the

bleeding area and put enough pressureIf bleeding does not stop -

Put another dressing above the first one and put enough pressure. Do not remove the previous one

In case you suspect Head, Neck or Spine injury and or the bleeding does not stop at all

Call for help

Nose bleedsIt is difficult to know how much did the victim bleed due toswallowing of blood. This can cause the victim to vomit.Steps:

Press on both side of the victim's nostril (breathe through mouth)

Ask the victim to lean forward Continue to put pressure on the nostril for a few more

minutes



Call for help, if the bleeding does not stop in about 15 minutes

Or the victim has trouble breathing…

PunctureAn object such as knife or sharp stick can cause puncture injury.It is very important that you do not remove the object because if you do so, it would lead to continuous bleeding.

Steps: Wash the wound properly and cover it with gauze or clean

cloth Stop any bleeding you can see Ask the victim not to move Call for help



11 Lesson: Bleeding you can NOT see

A strong blow in the chest or abdomen, or falling from a height canmake injury and bleeding inside the body, which we may not seeany bleeding outside.

Steps: Call for help Let the victim sit or lie down Be with the victim until help arrives Start CPR**, if the victim stops responding



12 Lesson: Injury

Head, Neck, Spine injuryA person can have head injury by falling from a height, hit in thehead during a car accidents etc.

If spine bones are broken, the spinal cord may be injured and thevictim may not be able to move his or her legs or arms

Steps: Phone for help Hold the head and neck to stabilize so that they do not

move, bent or twist Only turn or move the victim, if the victim is in danger Or

the victim is vomiting

If the victim does not respond: Start CPR**

Broken bones, Sprain

Injuries to bones, joints, muscles & bruises (black & blue spots) arecommon. Joint sprains results from a twisting injury, which causes tears in themuscles and other structures around the joint.

Steps: Do not try to straighten or move any injured part i.e., bent,



deformed or possibly broken Cover any open wound with gauze or a clean cloth Put a towel over the wound and put ice pack above the

towel Raise the injured body part, if the victim does not feel pain

in doing so Call for help if there is a large open wound or the injured

part is abnormally bent. Ask the victim not to use the injured part.



13 Lesson: Poisoning

Remove any objects from the victim's mouth, if visible. Try to determine what poison was swallowed and how much.

Signs: Abdominal cramping or pain Nausea and/or vomiting Diarrhea Burns, stains and odor in and around month Drowsiness/Unconsciousness Poisonous plants, poison containers, poisonous gases in the

area/room

Action: Do not just rush the scene Assess the scene for clues (poisonous gas?) and safety If the scene is not safe, shift the victim away to a safer

place (remember your safety in important)

If scene is safe - Check for response Position the victim on his/her left side and attempt to get

more information Alert the Poison Control Center of your locality or Call for help Prepare for CPR**



14 Lesson: Insect stings

Look for stinger embedded in skin. Only honeybees leave a stinger embedded. A venom sac may also be attached. If stinger is found –

Action: Remove the stinger by scraping with debit/credit card r

scissors edge or knife (using tweezers or fingers will help spread venom into the victim's body)

Wash the site with soap and clean water Apply cold pack for 15-20 minutes Do not leave the victim unattended if visible allergic

reaction, or breathing difficulty

If the victim become unconscious Call or help



15 Lesson: Snake bite

If the victim is responding Steps:

Collect some description of the snake, if he saw it Help him calm down Avoid running or hectic activity to avoid spread of poison Do not cut skin or attempt to suck the venom

If there is no response, call for help



16 Lesson: Heat-related Emergencies

Remove the victim from the hot environment and place in a cool, shaded place.

For Heat exhaustionSigns:

Painful muscle cramps Moist, cool skin Heavy sweating

Action: Loosen or remove excess clothing Sponge with cool water and fan the victim Give water or saline solution if not nauseated

For Heat stroke

This is a life threatening condition. Call for help immediately. Signs:

Hot, dry, red skin Confusion or unconsciousness Little or no sweating Full, rapid pulse



17 Lesson: Cold related Emergencies

Signs: Shivering Slurred speech Stumbling or staggering Body core temperature below 90 degree F or 37.78 degree

CAction:

Insulate the victim Removal from cold environment or shift to warm room Replace wet clothing with dry Provide a hat, blankets, coats Handle victim very gently. Avoid rough handling. Do not allow the victim to walk or exert.

If the victim is not responding – • Call for help



18 Lesson: Burn care

Steps: • Stop the burning by using water and smothering flames.• Cool the burn by applying cool water, wet clothes until pain

decreases (10-40 minutes). Do not apply cold to more thanan area equivalent to the size of victim's entire chest or back (20% of body surface area).

• Cover the burn with clean, dry cloth or sterile dressing. Non-stick dressings are the best on burns.

Alert: DO NOT remove any clothing sticking to the burned area. Remove jewelry such as rings, watches and bracelets.

Signs of 1st Degree or Superficial burn Skin is red and dry, usually painful

Signs of 2nd Degree or Partial Thickness burn • Top layers of skin are burned• Skin will be red and have blisters• Painful

Sings of 3rd Degree or Full thickness All layers of skin are destroyed as well as underlying

structure (fat, muscle, bones, and nerves)

Action: Seek medical attention if any of these conditions exist -



• breathing difficulty• head, hands, feet, or genitals involved• victim's age is under 5 or over 60 years• involved electricity or chemical burn • 2nd or 3rd degree burn

Chemical burns – • If possible, protect your skin and eyes• If a dry powder, brush off before flushing with water• Flush with large amount of water for at least 15-20 minutes

Electrical burns – • Check for scene safety • Check for response

If no response- • Call for helpless• Ready for CPR**, if no response



Lesson 19: Conclusion

Managing training kit

Taking care of the training kit and supplies by yourself is a good practice. It shows how you care for what you use. Maintaining quality of tool kits and replenishing supplies can help improve overall management of training and improve delivery efficacy.

Feedback and Evaluation Reading through the feedback and evaluation form help improve your performance. Make sure you note them to adapt as far as they are feasible.

Relax & RejuvenateAs mentioned in the 'Forward', the First Aiders leave their mark of humanity for their actions without seeking recognition. It is likely that the volunteers get exhausted during the Action due to relentlessly helping to save lives. Hence, self-care is essential.

Once the response is over, it is ideal to Stop, Relax and Unwind yourself.



Debriefing is essential after a Response or Action

The debriefing session is led by the team leader or in-charge of the team. Debriefing can be Collective and Individual.

Particulars Collective Individual

For whom All involved Yourself

Who leads Team leader Team leader

When At the end of an Action Any time

How In a group meeting while relaxing Face to face discussion and in relaxed atmosphere

What Detailed account of the Action, follow-up. Sharing of feelings, reactions, painful emotions.Can also advise on Coping Mechanism

Any important issue. Converting experiences into beneficial learning. Affect or impact.

What should notbe included

Judgmental. Revenge or settling scores. Etc.

Punishments. Criticism.

Potential outcome

Team reinforcement and team management. Improvements in Coping mechanism

Adjustment or alignment of assignment. Support forpersonal development.

Documentation & ReportingThis is the last but most important area you must complete. Sign upsheets, attendance register, MCQ sheets with final scores need to be submitted to the DEEM Coordinator/Training-in-charge.



Forms


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