20.1 Hands-on skills practice and evaluation

Hands-on practice is crucial for mastering life-saving skills. This section covers essential techniques like CPR, AED use, and wound care. Students will learn to perform these skills confidently and effectively in emergency situations.

Practical evaluations ensure students can apply their knowledge under pressure. By practicing scenarios and receiving feedback, future first responders develop the muscle memory and decision-making abilities needed to save lives when it matters most.

Basic Life Support Skills

Cardiopulmonary Resuscitation (CPR) and Automated External Defibrillator (AED) Use

• Perform high-quality CPR by providing chest compressions at a rate of 100-120 per minute and a depth of at least 2 inches (5 cm) for adults, allowing the chest to fully recoil between compressions
• Minimize interruptions in chest compressions and avoid excessive ventilation during CPR to maintain adequate blood flow to vital organs (brain, heart)
• Operate an AED by turning on the device, following the voice prompts, and delivering a shock when advised to restore a normal heart rhythm in cases of ventricular fibrillation or pulseless ventricular tachycardia
• Alternate CPR with AED use, resuming chest compressions immediately after delivering a shock, until emergency medical services arrive or the patient shows signs of life (movement, breathing, pulse)

Airway Management and Choking Relief

• Place an unresponsive patient who is breathing normally in the recovery position (lateral recumbent position) to maintain an open airway and prevent aspiration of fluids (vomit, blood, saliva)
• Perform the Heimlich maneuver (abdominal thrusts) on a choking patient who is responsive but unable to cough or speak by standing behind the patient, placing a fist above the navel, and delivering quick, upward thrusts until the foreign object is expelled
• For a choking infant, deliver back blows and chest thrusts, alternating between the two until the object is dislodged or the infant becomes unresponsive, at which point CPR should be initiated

Trauma Management

Wound Care and Bleeding Control

• Control external bleeding by applying direct pressure to the wound using a clean cloth or dressing, elevating the affected limb above the heart level (if possible), and applying a pressure bandage or tourniquet (for severe, life-threatening bleeding)
• Clean wounds with clean water or sterile saline solution to remove dirt, debris, and foreign objects, and apply antibiotic ointment and a sterile dressing to prevent infection
• Use proper bandaging techniques, such as a circular or spiral wrap, to secure dressings and apply even pressure to the wound, ensuring the bandage is snug but not too tight to avoid impairing circulation

Fracture and Sprain Management

• Immobilize suspected fractures and sprains using splints or slings to prevent further injury and reduce pain by minimizing movement of the affected area
• Apply ice packs to the injured area for 15-20 minutes every hour to reduce swelling, inflammation, and pain in the acute stage of the injury (first 24-48 hours)
• Create makeshift splints using available materials (cardboard, newspapers, sticks) when commercial splints are not accessible, padding the splint for comfort and securing it with bandages or cloth strips

Patient Evaluation

Primary and Secondary Assessment

• Conduct a primary assessment using the ABCDE approach (Airway, Breathing, Circulation, Disability, Exposure) to identify and manage life-threatening conditions rapidly
• Perform a secondary assessment, including a head-to-toe examination and SAMPLE history (Signs/Symptoms, Allergies, Medications, Past medical history, Last meal, Events leading to the incident), to gather additional information and identify non-life-threatening injuries or illnesses
• Reassess the patient's condition regularly, monitoring for changes in level of consciousness, breathing, and circulation, and adjust treatment as needed

Vital Signs Measurement and Interpretation

• Measure and interpret vital signs, including heart rate (60-100 beats per minute), respiratory rate (12-20 breaths per minute), blood pressure (120/80 mmHg), and body temperature (98.6°F or 37°C), to assess the patient's overall health status
• Use a pulse oximeter, if available, to measure the patient's oxygen saturation level (SpO2), which should be above 95% in a healthy individual
• Monitor the patient's level of consciousness using the AVPU scale (Alert, Verbal, Pain, Unresponsive) or Glasgow Coma Scale (GCS) to detect changes in mental status that may indicate a deteriorating condition (head injury, shock, hypoxia)