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BasicPlusCPR, AED, andFirst Aid For Adults

BasicPlusCPR, AED, and First Aid For Adults

Student Guide Version 7.0

Purpose of this GuideThis MEDIC First Aid BasicPlus Version 7.0Student Guide is solely intended to facilitate cer-tification in a MEDIC First Aid BasicPlus CPR,AED, and First Aid training class. The informationin this guide is furnished for that purpose and issubject to change without notice.

MEDIC First Aid certification may only be issuedwhen a MEDIC First Aid-authorized Instructor ver-ifies a student has successfully completed therequired core knowledge and skill objectives ofthe program.

Notice of RightsNo part of this MEDIC First Aid BasicPlusVersion 7.0 Student Guide may be reproduced ortransmitted in any form or by any means, electronicor mechanical, including photocopying and record-ing, or by any information storage and retrieval sys-tem, without written permission from MEDIC FIRSTAID International, Inc. Some images used underlicense ©2006 Custom Medical Stock Photo.

TrademarksMEDIC First Aid and the MEDIC First Aid logoare registered trademarks of MEDIC FIRST AIDInternational, Inc.

MEDIC FIRST AID International, Inc.1450 Westec DriveEugene, OR 97402

800-447-3177 � 541-344-7099

E-mail: [email protected] our website at hsi.com/medicfirstaid

Copyright © 2011 by MEDIC FIRST AID International, Inc.All Rights Reserved. Printed in the United States of America

First Edition—2011

MEDIC First Aid is a member of the HSI family of brands.

ISBN 978-936515-22-6 5070 (8/11)

BasicPlus CPR, AED, and First Aid for Adults i

Table of ContentsThe First Aid ProviderThe First Aid Provider .................... 1Legal Considerations .................... 3Recognizing an Emergencyand Deciding to Help ................. 4

Personal Safety ............................. 6Disease Transmission andUniversal Precautions ................ 7

Removing Contaminated GlovesSkill Sheet 1 ................................... 9

Emergency Medical Services(EMS) ......................................... 10

Sudden Cardiac ArrestRespiratory and CirculatorySystems ..................................... 12

Sudden Cardiac Arrest .................. 13Early Defibrillation ......................... 14Chain of Survival ........................... 15

Basic CPR SkillsChest Compressions ..................... 16Chest Compressions

Skill Sheet 2 ................................... 17Rescue Breaths ............................. 18Rescue Breaths — CPR Mask

Skill Sheet 3 ................................... 20Rescue Breaths — CPR Shield

Skill Sheet 4 ................................... 21Primary Assessment —Unresponsive Person ................ 22

Primary Assessment —Unresponsive PersonSkill Sheet 5 ................................... 23

Basic Life Support CareUnresponsive and Breathing ......... 24Unresponsive and Breathing —Recovery Position Skill Sheet 6 ................................... 25

Unresponsive and Not Breathing —CPR ........................................... 26

Unresponsive andNot Breathing — CPR Skill Sheet 7 ................................... 27

Automated External Defibrillators ... 28Basic AED Operation .................... 29Using an AED

Skill Sheet 8 ................................... 30Troubleshooting ............................. 31Other Considerations .................... 32

Foreign Body Airway ObstructionChoking ......................................... 33Choking

Skill Sheet 9 ................................... 34

First Aid AssessmentPrimary Assessment —Responsive Person .................... 35

Primary Assessment —Responsive Person Skill Sheet 10 ................................. 36

Secondary Assessment ................ 37Secondary Assessment

Skill Sheet 11 ................................. 36

Caring for Serious InjuryControl of Bleeding ....................... 40Control of Bleeding

Skill Sheet 12 ................................. 41Internal Bleeding ........................... 42Managing Shock ........................... 43Head, Neck, or Back Injury ........... 44Brain Injury .................................... 45Spinal Motion Restriction

Skill Sheet 13 ................................. 46Swollen, Painful, Deformed Limb ... 47Swollen, Painful, Deformed Limb

Skill Sheet 14 ................................. 48

BurnsBurns ............................................. 49

Caring for Sudden IllnessWarning Signs of Sudden Illness ... 51Altered Mental Status .................... 52Stroke ............................................ 53Diabetic Emergencies ................... 54

Table of Contents

ii BasicPlus CPR, AED, and First Aid for Adults

Table of Contents

Seizure ........................................... 55Breathing Difficulty, Shortnessof Breath .................................... 56

Asthma .......................................... 57Severe Allergic Reaction ............... 58Pain, Severe Pressure, orDiscomfort in the Chest ............. 59

Severe Abdominal Pain ................. 61

PoisoningIngested Poisoning ........................ 62Inhaled Poisoning .......................... 63

Environmental EmergenciesHeat Exhaustion ............................ 64Heat Stroke ................................... 65Hypothermia .................................. 66Frostbite ........................................ 67

Additional ConsiderationsEmergency Moves ......................... 68Emotional Considerations ............. 69

Specific First Aid Topics —Specific InjuriesCaring for Specific First AidProblems ................................... 70

Amputation .................................... 71Impaled Object .............................. 72Open Chest Injury ......................... 73Open Abdominal Injury .................. 74Impaled Object in the Eye ............. 75Chemicals in the Eye ..................... 76Nosebleed ..................................... 77Injured Tooth .................................. 78Pregnancy Complications ............. 79Bites and Stings ............................ 80Snakebites ..................................... 81Spider Bites ................................... 82Stinging Insects ............................. 83Tick Bites ....................................... 84Marine Animal Stings .................... 85Human and Animal Bites ............... 86

References and End Notes ...... 87

Glossary ....................................... 89

Class Evaluation ........................ 93

Sudden Cardiac Arrest


Sudden cardiac arrest, or SCA, can occur without warning to anyone, at anytime. It is one of the leading causes of death among adults in the United States.

Sudden cardiac arrest happens when the normal electrical impulses in the heartunexpectedly become disorganized. The normally coordinated mechanical con -traction of the heart muscle is lost, and a chaotic, quivering condition known asventricular fibrillation can occur.

Blood flow to the brain and body abruptly stops. The lack of blood and oxygento the brain causes the person to quickly lose consciousness, collapse, and stopbreathing.

Brain tissue is especiallysensitive to a lack of oxygen.When oxygen is cut off, braindeath can occur quickly,within a matter of minutes.Without early recognitionand care from a bystander,the person will not survive.

� Heart disease� Electrical shock� Severe blood loss� Drug overdose� Severe allergic reaction� Drowning

Causes of SCA

BasicPlus CPR, AED, and First Aid for Adults 13


Early DefibrillationCardiopulmonary resuscitation, or CPR, allows a bystander to restore some oxy-gen to the brain through a combination of chest compressions and rescuebreaths.

By itself, CPR is only a tem-porary measure that can buytime until more advancedcare can be provided. Themost effective treatment forventricular fibrillation is defib-rillation.

To defibrillate, electrodepads are applied to the chestand an electrical shock issent between the padsthrough the heart. This shockstops ventricular fibrillation,so the heart’s normal electri-cal activity can return and restoreblood flow.

Successful defibrillation is oftendependent on how quickly a personis defibrillated. For each minute a per-son is in cardiac arrest, his/herchance of surviving decreases byabout 10 percent. After as little as 10minutes, defibrillation is rarely suc-cessful. The amount of time it takesto recognize a problem, activate EMS,and have EMS respond and defibril-late is usually longer than 10 minutes.In most cases, it’s too late.

An automated external defibrillator, orAED, is a small, portable, computer-ized device that is simple for a mini-mally trained bystander like you tooperate.

Turning on an AED is as simple asopening a lid or pushing a power but-ton. Once it is on, an AED will providevoice instructions to guide youthrough its use.

An AED automatically analyzes theheart rhythm, determines if a shock isneeded, and charges itself to beready to defibrillate. An operator sim-ply pushes a button to deliver theshock when told to by the AED.

In many cases of sudden cardiacarrest, if defibrillation can be deliveredsooner, before EMS arrives, morepeople would survive. Immediate,high-quality CPR and defibrillationwith an AED from a bystander candouble or even triple the chance forsurvival.

14 BasicPlus CPR, AED, and First Aid for Adults

Basic CPR Skills

Chest Compressions

If the heart stops, it is possible to restore at least some blood flow through thecirculatory system by way of external chest compressions. The most effectivechest compressions occur with the rhythmic application of downward pressureon the center of the chest.

External compressions in crease pressure inside the chest and directly compressthe heart, forcing blood to move from the heart to the brain and other organs.

Always compress fast and deep when performing compressions. Without losingcontact, allow the chest to fully rebound at the top of each compression.

Blood pressure is created and maintained with well-performed compressions. Ifcompressions stop, pressure is quickly lost and has to be built up again. Minimizeany interruptions when doing compressions.

When compressing properly, you may hear and feel changes in the chest wall.This is normal. Forceful external chest compression is critical if the person is tosurvive.


Basic CPR Skills


Chest CompressionsSkill Sheet 2

� Position person face up onflat, firm surface. Kneelclose to chest. Place heel ofone hand on center ofchest.

� Place heel of second handon top of first. You can inter-lace your fingers to helpkeep off chest.

� Position your shouldersdirectly above your hands.Lock your elbows and useupper body weight to push.

� Push hard, straight down atleast 2 inches. Lift handsand allow chest to fullyrebound.

� Without interruption, pushfast at a rate of at least 100times per minute.

� Keep up the force andspeed of compressions.

Basic Life Support Care


Unresponsive and Breathing

Even if a person is breath-ing normally, a lack ofresponsiveness is still con-sidered to be a life-threaten-ing condition that requiresimmediate care.

There are a variety of thingsthat can result in unrespon-siveness, including medicalconditions such as stroke orseizures, or external factors,such as alcohol or drug over-dose. Regardless of thecause, the greatest treatment concern is the ability of the person to maintain aclear and open airway.

Positioning an uninjured, unresponsive person in the recovery position can helpmaintain and protect the airway. This position uses gravity to drain fluids from themouth and keep the tongue from blocking the airway.

If an unresponsive person has been seriously in jured, do not move the personunless fluids are collecting in the mouth and airway, or you are alone and needto leave to get help.

Frequently assess thebreathing of anyone placedin a recovery position. Thecondition can quicklybecome worse and requireadditional care.

This version of the recovery position is alsodescribed as the High Arm in Endangered Spine, orHAINES, position and can be used when someoneis injured.

HAINES Position

Basic Life Support Care


Unresponsive and Breathing — Recovery PositionSkill Sheet 6

Assess Person� If safe, tap or squeeze

shoulder. Ask loudly, “Areyou okay?”

No response!� Have someone alert EMS

and get an AED.� Look quickly at face and

chest for normal breathing.Normal breathing present!

Prepare� Extend arm nearest to you

up alongside head. � Bring far arm across chest

and place back of handagainst cheek.

� Grasp far leg just aboveknee and pull it up so foot isflat on ground.

Roll� Grasp shoulder and hip and

roll patient toward you. Rollin a single motion, keepinghead, shoulders, and torsofrom twisting.

� Roll far enough for face tobe angled forward.

� Position elbow and knee tostabilize head and body.

Suspected Injury� If person has been seriously

injured, do not move unlessfluids are collecting in air-way, or you are alone andneed to leave to get help.

� During roll, make sure headends up resting onextended arm and head,neck, and torso are inline.

Caring for Sudden Illness

Pain, Severe Pressure, orDiscomfort in the Chest

Acute coronary syndrome, or ACS, occurs when there is reduced blood flowto the tissues of the heart. Often described as a heart attack, ACS is a seriouscondition that can result in significant damage to the heart.

Someone with ACS will generally experience pain, severe pressure, or discomfortin the chest. Women often do not experience these signs and will describe indi-gestion, weakness, or fatigue. Shortness of breath, nausea, and lightheadednesscan also occur. The person’s skin may be pale, cool, and sweaty.

A person who has had previous heart problems is at risk for recurrence. Ask theperson or any bystanders about prior problems or medications being taken.

Activate EMS immediately, even if the person does not want you to. If an AED isavailable, have someone get it and keep it nearby. Do not try to transport the per-son to a hospital yourself.

Allow the person to find the most comfortable position in which to breathe.


Caring for Sudden Illness


Loosen tight clothing. Calm,comfort, and reassure theperson.

A person who is having aheart attack may deny it.This is a common occur-rence in ACS. Accept it, butnever let this alter yourapproach to care.

Someone with a heart condi-tion may carry a prescribedmedication known as nitro-glycerin. Assist the person intaking it.

Aspirin can be lifesaving for a personhaving a heart attack. While waitingfor EMS providers to arrive, encour-age the person to chew one non-coated adult (325 mg) or twolow-dose (81 mg) “baby” aspirin. Do

not encourage aspirin use if the per-son has an allergy to aspirin, evidenceof a stroke, or a recent bleeding prob-lem.

Whenever a heart attack is sus-pected, be prepared for the possibilityof sudden cardiac arrest, and the

need for CPR and the useof an AED. Continue toreassure the person untilanother provider or EMSpersonnel take over.

Heart disease, through heart attacks and strokes, isthe leading cause of death for men and women inthe United States. Statistics indicate more than onein four deaths was related to heart disease; half ofthe deaths were women.

A healthy lifestyle can lower the risk of heart disease:

� Follow a healthy diet to prevent or reducehigh blood pressure and high bloodcholesterol

� Maintain a healthy weight� Control alcohol intake� Don’t smoke� Exercise regularly

Heart Disease

Health & Safety InstituteWe Make Learning to Save Lives Easy®

MEDIC First Aid is a member of the HSI family of brands.

MEDIC FIRST AID International, Inc.1450 Westec DriveEugene, OR 97402 USA800-447-3177 � 541-344-7099 � 541-344-7429 faxhsi.com/medicfirstaid

ISBN 978-936515-22-6© 2011 MEDIC FIRST AID International, Inc. 5070 (8/11)

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