Responding to Emergencies Comprehensive First Aid/CPR/AED

536 Pages·2012·20.59 MB·English

by  American Red Cross

Responding to Emergencies
Comprehensive First Aid/CPR/AED

Responding to Emergencies
Comprehensive First Aid/CPR/AED

Responding to Emergencies
Comprehensive First Aid/CPR/AED

Thank You for Participating in the American Red Cross
Responding to Emergencies: Comprehensive First
Aid/CPR/AED Program

This comprehensive program is designed to give you the knowledge and skills
necessary to help save lives in emergency situations. This participant’s manual covers:

Assessments • Cardiac and Breathing Emergencies • CPR and AED • Sudden
Illness and Injuries • Substance Abuse • Care in Special Situations • And More.

Be sure to keep skills sharp with free online refreshers and renew your certification
every two years. Visit redcross.org to learn more.

The Responding to Emergencies: Comprehensive First Aid/CPR/AED program:

•
Is approved by the American Red Cross Scientific Advisory Council.

•
Meets 2010 Consensus on Science for CPR and Emergency
Cardiovascular Care (ECC).

•
Meets Guidelines 2010 for First Aid.

The American Red Cross Scientific Advisory Council is a panel of nationally
recognized experts in emergency medicine, sports medicine, emergency medical
services (EMS), emergency preparedness, disaster mobilization and other public
health and safety fields. The Council ensures that courses, training materials
and products incorporate the latest scientific and technical information.

Each year the American Red Cross shelters, feeds and provides emotional support to
victims of disasters, teaches lifesaving skills to more than 15 million people, supplies
nearly half of the nation’s blood, provides international humanitarian aid, supports
military members and their families, teaches swimming and water safety to more than
2 million people and trains over 300,000 lifeguards.

redcross.org
1-800-RED-CROSS

Stock No. 656138

Scan this code with your
smartphone to access free
skill refreshers, or visit
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Responding to Emergencies
Comprehensive First Aid/CPR/AED

Stock No. 656138

Scan this code with your
smartphone to access free
skill refreshers, or visit
redcross.org/RTErefresher.

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Responding to
Emergencies:
Comprehensive
First Aid/CPR/AED

This participant’s textbook is part of the American Red Cross Responding to Emergencies:
Comprehensive First Aid/CPR/AED program. By itself, it does not constitute complete and
comprehensive training. Visit redcross.org to learn more about this program.

The emergency care procedures outlined in this book reflect the standard of knowledge and
accepted emergency practices in the United States at the time this book was published. It is the
reader’s responsibility to stay informed of changes in emergency care procedures.

PLEASE READ THE FOLLOWING TERMS AND CONDITIONS BEFORE AGREEING
TO ACCESS AND DOWNLOAD THE AMERICAN RED CROSS MATERIALS. BY
DOWNLOADING THE MATERIALS, YOU HEREBY AGREE TO BE BOUND BY THE
TERMS AND CONDITIONS.

The downloadable electronic materials, including all content, graphics, images, and logos, are
copyrighted by and the exclusive property of The American National Red Cross (“Red Cross”).
Unless otherwise indicated in writing by the Red Cross, the Red Cross grants you (“recipient”)
the limited right to download, print, photocopy and use the electronic materials, subject to the
following restrictions:

■
The recipient is prohibited from selling electronic versions of the materials.

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The recipient is prohibited from revising, altering, adapting, or modifying the materials.

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The recipient is prohibited from creating any derivative works incorporating, in part or in
whole, the content of the materials.

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The recipient is prohibited from downloading the materials and putting them on their own
website without Red Cross permission.

Any rights not expressly granted herein are reserved by the Red Cross. The Red Cross does not
permit its materials to be reproduced or published without advance written permission from
the Red Cross. To request permission to reproduce or publish Red Cross materials, please
submit your written request to The American National Red Cross.

© 2012 American National Red Cross. ALL RIGHTS RESERVED.

The Red Cross emblem, American Red Cross® and the American Red Cross logo are trademarks
of The American National Red Cross and protected by various national statutes.

Published by Krames StayWell Strategic Partnerships Division

Printed in the United States of America

ISBN: 978-1-58480-558-8
Scan this code with your
smartphone to access free
skill refreshers, or visit
redcross.org/RTErefresher.

Acknowledgments
iii

This textbook is dedicated to the thousands of employees and volunteers of the American Red Cross who contribute their
time and talent to supporting and teaching lifesaving skills worldwide and to the thousands of course participants and
other readers who have decided to be prepared to take action when an emergency strikes. Many individuals shared in
the development and revision process in various supportive, technical and creative ways. Responding to Emergencies:
Comprehensive First Aid/CPR/AED was developed through the dedication of both employees and volunteers. Their
commitment to excellence made this textbook possible.

This textbook reflects the 2010 Consensus on Science for Cardiopulmonary Resuscitation and Emergency Cardiovascular
Care (ECC) and the Guidelines 2010 for First Aid. These treatment recommendations and related training guidelines have
been reviewed by the American Red Cross Scientific Advisory Council. The American Red Cross Scientific Advisory Council
is a panel of nationally recognized experts in the fields of emergency medicine, sports medicine, emergency medical services
(EMS), emergency preparedness, disaster mobilization, and other public health and safety fields.

A special thanks to the following members of the American Red Cross Scientific Advisory Council for
their guidance and review:

Acknowledgments

David Markenson, MD, FAAP, EMT-P
Chair, American Red Cross Scientific Advisory Council
Chief, Pediatric Emergency Medicine
Maria Fareri Children’s Hospital
Westchester Medical Center
Valhalla, New York

Jonathan L. Epstein, MEMS, NREMT-P
Vice Chair, American Red Cross Scientific Advisory Council
Northeast EMS, Inc.
Wakefield, Massachusetts

Andrew MacPherson, MD, CCFP-EM, FCFP
Chair, First Aid Subcouncil, American Red Cross Scientific
Advisory Council
Canadian Red Cross National Medical Advisory Committee
Department of Emergency Medicine
Victoria, British Columbia, Canada

Peter Wernicki, MD
Aquatics Chair, American Red Cross
Scientific Advisory Council
Sports Medicine Orthopedic Surgeon
International Lifesaving Federation Medical
Committee Past Chair
U.S. Lifesaving Association
Medical Advisor
Vero Beach, Florida

David C. Berry, PhD, ATC, EMT-B
Member, American Red Cross Scientific Advisory Council
Associate Professor of Kinesiology and Athletic Training
Education Program Director Saginaw Valley State
University
University Center, Michigan

Jeffrey L. Pellegrino, Ph.D.
Member, American Red Cross Scientific Advisory Council
Faculty Professional Development Center
Kent State University
Kent, Ohio

Joseph W. Rossano, MD,
FACC, FAAP
Member, American Red Cross Scientific
Advisory Council
Medical Director, Heart Transplantation
Attending Physician Cardiac Intensive Care Unit
Assistant Professor of Pediatrics
Children’s Hospital of Philadelphia
Perelman School of Medicine at the University of
Pennsylvania
Philadelphia, Pennsylvania

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Responding to Emergencies: Comprehensive First Aid/CPR/AED

Table of Contents

About This Course _________________________________________________ xiv

Health Precautions and Guidelines During Training ____________________ xix

PART ONE
INTRODUCTION ________________________1

Chapter 1:
If Not You . . . Who? _________________________________3

Chapter 2:
Responding to an Emergency _____________________ 17

Chapter 3:
Before Giving Care _______________________________ 27

PART TWO
ASSESSMENT _______________________ 43

Chapter 4:
The Human Body ________________________________ 45

Chapter 5:
Checking the Person _____________________________ 67

PART THREE LIFE-THREATENING
EMERGENCIES ______________________ 91

Chapter 6:
Cardiac Emergencies _____________________________ 93

Chapter 7:
Breathing Emergencies _________________________ 125

Chapter 8:
Bleeding _______________________________________ 155

Chapter 9:
Shock _________________________________________ 167

PART FOUR
INJURIES __________________________ 175

Chapter 10:
Soft Tissue Injuries______________________________ 177

Chapter 11:
Musculoskeletal Injuries _________________________ 203

Chapter 12:
Injuries to the Extremities ________________________ 219

Chapter 13:
Injuries to the Head, Neck and Spine ______________ 243

Chapter 14:
Injuries to the Chest, Abdomen and Pelvis _________ 261

Contents
v

PART FIVE
MEDICAL EMERGENCIES ___________ 273

Chapter 15:
Sudden Illnesses ______________________________ 275

Chapter 16:
Poisoning _____________________________________ 295

Chapter 17:
Bites and Stings _______________________________ 315

Chapter 18:
Substance Abuse and Misuse ___________________ 333

Chapter 19:
Heat-Related Illnesses and
Cold-Related Emergencies ______________________ 351

PART SIX
SPECIAL SITUATIONS ______________ 369

Chapter 20:
Water-Related Emergencies _____________________ 371

Chapter 21:
Pediatric, Older Adult and Special Situations ______ 383

Chapter 22:
Emergency Childbirth __________________________ 405

Chapter 23:
Disaster, Remote and Wilderness Emergencies ____ 419

Appendix A:
A Safer and Healthier Life ______________________ 443

Appendix B:
Answers to Ready to Respond Questions
and Answers to Study Questions ________________ 461

Glossary ____________________________________________________ 483

Sources _____________________________________________________ 497

Index ________________________________________________________ 503

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Responding to Emergencies: Comprehensive First Aid/CPR/AED

Detailed Table of Contents

About This Course ______________________________________________xiv

Health Precautions and Guidelines During Training _____________________xix

PART ONE: INTRODUCTION _________________________ 1

Chapter 1: If Not You . . . Who? ___________________________ 3

Objectives _________________________________________________________ 4
Key Terms _________________________________________________________ 4
Introduction _______________________________________________________ 5
Types of Emergencies ___________________________________________ 5
Your Role in an Emergency ______________________________________ 5
Incident Stress _______________________________________________ 11
Preparing for an Emergency ___________________________________ 12
Summary ________________________________________________________ 13
Ready to Respond? _______________________________________________ 14
Study Questions __________________________________________________ 15

Chapter 2: Responding To An Emergency ____________ 17

Objectives _______________________________________________________ 18
Key Term ________________________________________________________ 18
Introduction ______________________________________________________ 18
Emergency Action Steps _______________________________________ 18
Summary ________________________________________________________ 24
Ready to Respond? _______________________________________________ 24
Study Questions __________________________________________________ 25

Chapter 3: Before Giving Care __________________________ 27

Objectives _______________________________________________________ 28
Key Terms _______________________________________________________ 28
Introduction ______________________________________________________ 29
Preventing Disease Transmission _______________________________ 29
Legal Considerations __________________________________________ 33
Reaching and Moving a Person _________________________________ 35

Summary ________________________________________________________ 39
Ready to Respond? _______________________________________________ 39
Study Questions __________________________________________________ 40

SKILL SHEET: Removing Gloves ________________________________ 41

Detailed Table of Contents
vii

PART TWO: ASSESSMENT _________________________ 43

Chapter 4: The Human Body ____________________________ 45

Objectives _______________________________________________________ 46
Key Terms _______________________________________________________ 46
Introduction ______________________________________________________ 47

Anatomical Terms _____________________________________________ 47
Body Systems ________________________________________________ 50
Interrelationships of Body Systems _____________________________ 62

Summary ________________________________________________________ 63
Ready to Respond? _______________________________________________ 63
Study Questions __________________________________________________ 64

Chapter 5: Checking the Person _______________________ 67

Objectives _______________________________________________________ 68
Key Terms _______________________________________________________ 68
Introduction ______________________________________________________ 68
Checking for Life-Threatening Conditions _______________________ 68
Checking for Consciousness ___________________________________ 69
Checking an Unconscious Person ______________________________ 69
Checking a Conscious Person _________________________________ 77
Checking for Shock ___________________________________________ 81
Summary ________________________________________________________ 82
Ready to Respond? _______________________________________________ 82
Study Questions __________________________________________________ 83

SKILL SHEET: Checking an Injured or Ill Adult ___________________ 85
SKILL SHEET: Checking an Injured or Ill Child or Infant ___________ 87

PART THREE: LIFE-THREATENING
EMERGENCIES _____________________ 91

Chapter 6: Cardiac Emergencies _______________________ 93

Objectives _______________________________________________________ 94
Key Terms _______________________________________________________ 94
Introduction ______________________________________________________ 95
Cardiovascular Disease ________________________________________ 95
Heart Attack _________________________________________________ 95
Angina Pectoris _______________________________________________ 98
Cardiac Arrest ________________________________________________ 99
Giving CPR _________________________________________________ 100
Automated External Defi brillators _____________________________ 106
Summary _______________________________________________________ 114
Ready to Respond? ______________________________________________ 114

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Responding to Emergencies: Comprehensive First Aid/CPR/AED

Study Questions _________________________________________________ 115

SKILL SHEET: CPR—Adult ____________________________________ 118
SKILL SHEET: CPR—Child ____________________________________ 119
SKILL SHEET: CPR—Infant ___________________________________ 120
SKILL SHEET: AED—Adult or Child ____________________________ 121
SKILL SHEET: AED—Child and Infant __________________________ 123

Chapter 7: Breathing Emergencies ___________________ 125

Objectives ______________________________________________________ 126
Key Terms ______________________________________________________ 126
Introduction _____________________________________________________ 126
The Breathing Process ________________________________________ 127
Respiratory Distress and Respiratory Arrest _____________________ 128
Asthma _____________________________________________________ 133
Choking _____________________________________________________ 137
Summary _______________________________________________________ 145
Ready to Respond? ______________________________________________ 145
Study Questions _________________________________________________ 146

SKILL SHEET: Assisting with an Asthma Inhaler _________________ 148
SKILL SHEET: Conscious Choking—Adult ______________________ 150
SKILL SHEET: Conscious Choking—Child ______________________ 151
SKILL SHEET: Conscious Choking—Infant ______________________ 152
SKILL SHEET: Unconscious Choking—Adult ____________________ 153
SKILL SHEET: Unconscious Choking—Child and Infant __________ 154

Chapter 8: Bleeding ______________________________________ 155

Objectives ______________________________________________________ 156
Key Terms ______________________________________________________ 156
Introduction ____________________________________________________ 156
The Blood and Blood Vessels _________________________________ 157
When Bleeding Occurs _______________________________________ 158
External Bleeding ____________________________________________ 158
Internal Bleeding _____________________________________________ 161
Summary _______________________________________________________ 162
Ready to Respond? ______________________________________________ 163
Study Questions _________________________________________________ 164

SKILL SHEET: Controlling External Bleeding ____________________ 165
SKILL SHEET: Using a Manufactured Tourniquet ________________ 166

Chapter 9: Shock _________________________________________ 167

Objectives ______________________________________________________ 168
Key Term _______________________________________________________ 168
Introduction _____________________________________________________ 168
Shock _______________________________________________________ 168

Detailed Table of Contents
ix

Summary _______________________________________________________ 171
Ready to Respond? ______________________________________________ 172
Study Questions _________________________________________________ 173

PART FOUR: INJURIES ____________________________ 175

Chapter 10: Soft Tissue Injuries _______________________ 177

Objectives ______________________________________________________ 178
Key Terms ______________________________________________________ 178
Introduction _____________________________________________________ 178
The Soft Tissues ____________________________________________ 179
Wounds _____________________________________________________ 179
Burns _______________________________________________________ 189
Summary _______________________________________________________ 197
Ready to Respond? ______________________________________________ 197
Study Questions _________________________________________________ 198

Chapter 11: Musculoskeletal Injuries _________________ 203

Objectives ______________________________________________________ 204
Key Terms ______________________________________________________ 204
Introduction ____________________________________________________ 204
The Musculoskeletal System __________________________________ 205
Injuries to the Musculoskeletal System ________________________ 209
Summary _______________________________________________________ 216
Ready to Respond? ______________________________________________ 216
Study Questions ________________________________________________ 217

Chapter 12: Injuries to the Extremities _______________ 219

Objectives ______________________________________________________ 220
Key Terms ______________________________________________________ 220
Introduction ____________________________________________________ 220
Immobilizing Serious Extremity Injuries ________________________ 221
Upper Extremity Injuries ______________________________________ 223
Lower Extremity Injuries ______________________________________ 227
Summary _______________________________________________________ 231
Ready to Respond? ______________________________________________ 232
Study Questions _________________________________________________ 233

SKILL SHEET: Applying a Sling and Binder _____________________ 235
SKILL SHEET: Applying a Rigid Splint __________________________ 237
SKILL SHEET: Applying an Anatomic Splint _____________________ 239
SKILL SHEET: Applying a Soft Splint ___________________________ 241

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Responding to Emergencies: Comprehensive First Aid/CPR/AED

Chapter 13: Injuries to the Head,
Neck and Spine ____________________________ 243

Objectives ______________________________________________________ 244
Key Terms ______________________________________________________ 244
Introduction _____________________________________________________ 244
Recognizing Serious Head, Neck and Spinal Injuries _____________ 245
Specifi c Injuries ______________________________________________ 250
Summary _______________________________________________________ 257
Ready to Respond? ______________________________________________ 257
Study Questions _________________________________________________ 258

Chapter 14: Injuries to the Chest, Abdomen
and Pelvis ___________________________________ 261

Objectives ______________________________________________________ 262
Key Terms_______________________________________________________ 262
Introduction _____________________________________________________ 262
Chest Injuries _______________________________________________ 263
Abdominal Injuries ___________________________________________ 266
Pelvic Injuries _______________________________________________ 268
Summary _______________________________________________________ 270
Ready to Respond? ______________________________________________ 270
Study Questions _________________________________________________ 271

PART FIVE: MEDICAL EMERGENCIES _____________ 273

Chapter 15: Sudden Illnesses __________________________ 275

Objectives ______________________________________________________ 276
Key Terms ______________________________________________________ 276
Introduction _____________________________________________________ 277

Sudden Illnesses _____________________________________________ 277
Specifi c Sudden Illnesses ____________________________________ 278
Summary _______________________________________________________ 290
Ready to Respond? ______________________________________________ 290
Study Questions _________________________________________________ 291

Chapter 16: Poisoning ___________________________________ 295

Objectives ______________________________________________________ 296
Key Terms ______________________________________________________ 296
Introduction _____________________________________________________ 296

Poisoning ___________________________________________________ 297
Types of Poisoning ___________________________________________ 299
Anaphylaxis _________________________________________________ 306

Detailed Table of Contents
xi

Summary _______________________________________________________ 309
Ready to Respond? ______________________________________________ 310
Study Questions _________________________________________________ 311

SKILL SHEET: Assisting with an Epinephrine Auto-Injector _______ 313

Chapter 17: Bites and Stings ___________________________ 315

Objectives ______________________________________________________ 316
Key Terms ______________________________________________________ 316
Introduction _____________________________________________________ 316
Insect Stings ________________________________________________ 316
Tick Bites ___________________________________________________ 317
Mosquito Bites—West Nile Virus _______________________________ 321
Spider Bites and Scorpion Stings ______________________________ 321
Venomous Snakebites ________________________________________ 324
Marine Life Stings ____________________________________________ 325
Domestic and Wild Animal Bites _______________________________ 327
Human Bites ________________________________________________ 328
Summary _______________________________________________________ 330
Ready to Respond? ______________________________________________ 330
Study Questions _________________________________________________ 331

Chapter 18: Substance Abuse and Misuse __________ 333

Objectives ______________________________________________________ 334
Key Terms ______________________________________________________ 334
Introduction _____________________________________________________ 335
Forms of Substance Abuse and Misuse ________________________ 335
Abused and Misused Substances ______________________________ 336
Signals of Substance Abuse and Misuse _______________________ 344
Care for Substance Abuse and Misuse _________________________ 345
Summary _______________________________________________________ 347
Ready to Respond? ______________________________________________ 347
Study Questions _________________________________________________ 348

Chapter 19: Heat-Related Illnesses and
Cold-Related Emergencies ______________ 351

Objectives ______________________________________________________ 352
Key Terms ______________________________________________________ 352
Introduction _____________________________________________________ 352
How Body Temperature Is Controlled ___________________________ 353
Types of Heat-Related Illnesses _______________________________ 355
Cold-Related Emergencies ____________________________________ 359

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Responding to Emergencies: Comprehensive First Aid/CPR/AED

Summary _______________________________________________________ 363
Ready to Respond? ______________________________________________ 364
Study Questions _________________________________________________ 365

PART SIX: SPECIAL SITUATIONS __________________ 369

Chapter 20: Water-Related Emergencies _____________ 371

Objectives ______________________________________________________ 372
Key Terms ______________________________________________________ 372
Introduction _____________________________________________________ 372
Water-Related Emergencies __________________________________ 373
Taking Action in a Water-Related Emergency ___________________ 374
Summary _______________________________________________________ 381
Ready to Respond? ______________________________________________ 381
Study Questions _________________________________________________ 382

Chapter 21: Pediatric, Older Adult and
Special Situations _________________________ 383

Objectives ______________________________________________________ 384
Key Terms ______________________________________________________ 384
Introduction _____________________________________________________ 384

Children and Infants __________________________________________ 385
Older Adults _________________________________________________ 394
People With Disabilities _______________________________________ 397
Language Barriers ___________________________________________ 400
Crime Scenes and Hostile Situations ___________________________ 400
Summary _______________________________________________________ 401
Ready to Respond? ______________________________________________ 401
Study Questions _________________________________________________ 402

Chapter 22: Emergency Childbirth _____________________ 405

Objectives ______________________________________________________ 406
Key Terms ______________________________________________________ 406
Introduction _____________________________________________________ 406

Pregnancy and the Birth Process ______________________________ 407
Assisting With Delivery _______________________________________ 409
Caring for the Newborn and Mother ____________________________ 412
Special Considerations _______________________________________ 413
Summary _______________________________________________________ 415
Ready to Respond? ______________________________________________ 415
Study Questions _________________________________________________ 416

Detailed Table of Contents
xiii

Chapter 23: Disaster, Remote and
Wilderness Emergencies ________________ 419

Objectives ______________________________________________________ 420
Key Terms ______________________________________________________ 420
Introduction _____________________________________________________ 420

Disaster, Remote and Wilderness Emergencies __________________ 421
Taking Action Using Modifi ed CHECK-CALL-CARE _______________ 423
Diffi cult Decisions ____________________________________________ 432
Protection from the Environment _______________________________ 433
Preparing for Emergencies ____________________________________ 434
Summary ______________________________________________438
Ready to Respond? _______________________________________439
Study Questions _________________________________________440

Appendix A: A Safer and Healthier Life _______________ 443

Introduction _____________________________________________________ 443
Injuries _________________________________________________________ 444
Specifi c Safety Actions ___________________________________________ 446
Reducing Your Risk for Illness _____________________________________ 453
Summary ______________________________________________460

Appendix B: Answers to Ready to Respond
Questions and Answers to
Study Questions ___________________________ 461

Glossary ______________________________________________________________ 483

Sources ______________________________________________________________ 497

Photography Credits ___________________________________________________501

Index _________________________________________________________________ 503

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Responding to Emergencies: Comprehensive First Aid/CPR/AED

About This Course

People need to know what to do in an emergency before medical help arrives. It is, after all, lay
responders such at yourself who are most likely to be on the scene of an emergency first. This
course will prepare you to make appropriate decisions regarding first aid care, and equip you to
act on your decisions, whether at home, at your workplace or in the community.

The first critical step in any emergency depends on the presence of someone who will take
appropriate action. After completing this course, you should be able to:

■
Recognize when an emergency has occurred.

■
Follow the emergency action steps: CHECK—CALL—CARE.

■
Provide care for injury or sudden illness until advanced medical personnel arrives.

HOW YOU WILL LEARN

Course content is presented in various ways. The textbook, which will be assigned reading,
contains the information that will be discussed in class, as well as visual support to
illustrate the key skills and concepts you will be learning. In addition, you will view videos
demonstrating how to correctly perform specific skills and aid in skill practice. Participating
in all class activities will increase your confidence in your ability to respond to emergencies.

The course design allows you to frequently evaluate your progress in terms of skills
competency, knowledge and decision making. Certain chapters in the textbook include
directions for skill practice sessions that are designed to help you learn specific first aid
skills. Some of the practice sessions require practice on a manikin. Others give you the
opportunity to practice with another person. This will give you a sense of what it would be
like to care for a real person in an emergency situation and help reduce any concerns or
fears you may have about giving care. Your ability to perform specific skills competently will
be checked by your instructor during the practice sessions.

Your ability to make appropriate decisions when faced with an emergency will be enhanced
as you participate in the class activities. Periodically, you will be given situations in the form
of scenarios that provide you the opportunity to apply the knowledge and skills you have
learned. These scenarios also provide an opportunity to discuss with your instructor the
many different situations that you may encounter in any emergency.