Automated External Defibrillator (AED)Automated External Defibrillator—Course Outline Notes: To deliver the WorkSafe AED programme all elements must be presented by the instructor

WorkSafe Training Systems

Automated External Defibrillator

(AED)

Version 3.1 January 2016

Lesson Plans

Version 3.1 2 Copyright © WorkSafe Training Systems 2014

Syllabus

WorkSafe Automated External Defibrillator Programme This WorkSafe Instructor Guide is issued to instructors who are approved to deliver the WorkSafe Automated External Defibrillator (AED) training programme. It contains all the information you need to successfully deliver the programme with correct content and to the appropriate level and contains the programme syllabus, recommended duration times and individual lesson plans specific to each part of the AED course. Further information on the layout and sections of this guide, including a symbol key can be found in the front section of the WorkSafe Instructor Folder. The WorkSafe AED programme is a programme of learning designed to teach the safe operation and protocols for use of an automated external defibrillator by anyone involved in pre-hospital care of a casualty in cardiac arrest. This includes lay rescuer first aiders, first responders, emergency service personnel and anyone likely to face a cardiac emergency out of hospital. The course follows a standard syllabus laid down by WorkSafe Training Systems and is based on industry standard best practice for content of AED courses and following recommendations for AED training issued by the UK Resuscitation Council. The WorkSafe AED training programme can be delivered as a standalone course for existing first aiders who wish to add AED to their portfolio or can be delivered alongside any other first aid training course. The time allocated for delivery of each module assumes the standalone course option and includes a section on BLS review which should be used to review and strengthen existing basic life support skills and improve CPR technique. When delivering the AED programme alongside another qualification the BLS review section can be omitted and course duration amended accordingly. WorkSafe AED courses are not specific to any make or model of AED unit. This programme requires students to undertake practice scenarios using an appropriate AED training unit which replicates the commands and functions of the live unit. Ideally a manufacturer specific training unit which looks and functions identical to the live unit (except for the energy delivery) for which students will be expected to use in an emergency will be available but this is not mandatory. Generic AED training units are available which replicate all functions of common AED units and these are considered suitable for use in training, however students should still receive familiarisation for the actual unit in their workplace or environment. For further information or advice on AED live or training units please contact WorkSafe.

Automated External Defibrillation Programme

Copyright © WorkSafe Training Systems 2014 3 Version 3.1

Element Duration Timetable

Element Subject Time Elapsed Time h : min h : min

1.1 Introduction 0:10 0:10

1.2 Chain of Survival 0:15 0:25

1.3 Heart Anatomy and Conditions 0:15 0:40

1.4 Cardiac Arrest and Defibrillation 0:40 1:20

1.5 The AED Device 0:15 1:35

1.6 BLS Review 0:40 2:15

1.8 AED Scenarios 0:45 3:30

1.9 Assessment 0:45 4:15

1.10 Course Completion 0:15 4:30

Note: Timings are for the AED with BLS review programme syllabus

Totals 4:30 4:30

1.7 Using the AED 0:30 2:45

Automated External Defibrillator—Course Outline

Notes: To deliver the WorkSafe AED programme all elements must be presented by the

instructor. The times provided above are a guide designed to assist new instructors with their

delivery. The times are approximate and based on a group of 6-12 students with good learning ability. Refreshment/lunch breaks are not included.

The recommended time for delivery of the course will vary dependant on group

experience and ability. The minimum time must not be not less than 4 instructional contact hours unless the course is a supplement to another WorkSafe first aid programme.

For successful completion of the WorkSafe AED programme every student must

complete all elements. Absent or partially absent students will not achieve the qualification unless additional time is spent with the course instructor to meet the minimum time and content stipulation above.

The instructor is responsible for the continual and final assessment of students and their ability to perform the skills delivered.



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Assessment Process All WorkSafe Training programmes have a clearly defined and documented assessment process to ensure students have obtained a successful level of knowledge and understanding. The overall assessment policy and further information on assessment methods can be found in the WorkSafe Code of Practice for First Aid Assessments. The assessment process for the WorkSafe AED programme will consist of:

Continuous assessment of students, undertaken by the instructor Completion of WorkSafe Self-Assessment worksheet to evidence knowledge of

AED use. Peer assessment of AED use during practical scenarios. Direct observation by instructor of learner using the AED in a safe and effective

manner. The WorkSafe AED course will be delivered and assessed by the course instructor. The assessment process for WorkSafe AED courses must be clearly explained to all students during the Introduction element. A documented appeals process exists and should also be explained to students. The continuous assessment method will ensure the ability of students is assessed and allows for staged progression throughout the course and observations carried out by the instructor, in a stress-free environment that will not distract students from the skills on which they are focused. A code of practice, applicable specifically to WorkSafe assessments can be found in the assessments section of the WorkSafe instructor guide and must be adhered to when undertaking assessment of a WorkSafe AED programme. Self-Assessment matrices can be found in every WorkSafe BLS & AED training pack.

Assessment Automated External Defibrillation Programme


Introduction

Learning Outcomes:

Awareness of Health, Safety and Housekeeping requirements. Understand the programme syllabus, schedule and final qualification. Receive WorkSafe student training pack with contents explained. Understand the assessment strategy for the qualification. Understand the WorkSafe complaints/appeals procedures.

Instructor Activity:

Welcome students onto the course and ensure appropriate introductions. Identify any prior knowledge within the students. Detail Health, Safety & Housekeeping arrangements during the course. Explain course syllabus and assessment process. Refer to the assessment

chapter at the start if this guide for information on Assessment Strategy. Hand out student course material and explain content. Detail the WorkSafe complaints and appeals procedure. Ensure all students complete the WorkSafe Course Register.

Element: 1-1


Materials/Equipment:

WorkSafe BLS & AED Student Training Packs WorkSafe AED Ver. 3.1 PowerPoint Presentation and suitable presentation

media

Presentation Slides: 1-6 Element Duration: 10 mins


Introduction

Student Activity:

Complete the course registration document in block letters. The student’s

name must be spelt in the same format as will appear on the completion certificate.

Provide a brief introduction of themselves, job role and first aid/AED experience.

Agree to participate in practice sessions for the programme.

Background Information:

As the teacher, keep in mind the purpose of your introduction is to help the students to feel comfortable and keen to be learning from a credible expert. You’ll want to share your professional background and credentials as well as include one or two non-professional interests. Course introductions are a great opportunity to run an ice-breaker activity to get students interacting, sharing experiences and starting to relax into the learning environment. Consider using an ice-breaker as part of your introduction. AEDs are becoming far more common in public locations and workplaces. The HSE now state that any workplace that has an AED device should training people who are expected to use it. The UK Resuscitation council recommend training not exceeding every 12 months but also state that if in an emergency a patient may benefit from the use of an AED but no trained person is available then any untrained responder may use the AED. AEDs are proven to be reliable and failsafe and make a huge difference to survival from Sudden Cardiac Arrest out of hospital. Their use should be promoted wherever possible. AEDs are now manufactured by many companies and although they all follow similar operating principles many have slightly different methods of operation. All persons receiving training should be familiarised with the unit they are likely to use in the event of an emergency. Training should also cover the maintenance aspect of the AED and responsibilities for ensuring consumable items such as electrodes are maintained within their expiry date and additional contents are checked.

Assessment: The instructor should assess existing knowledge and experience within

the students through initial introductions. Some students may be re-qualifying from a previous qualification.

Instructors should assess their existing knowledge and vary the level of input appropriately.


Element: 1-1


Chain of Survival

Learning Outcomes:

Identify the Chain of Survival concept. To provide information time dependencies of resuscitation. Recognise how successful resuscitation decreases directly with time.


Emphasise the Chain of Survival concept for resuscitation of cardiac related emergencies.

Identify the four links in the Chain of Survival. The slide image is an almost universally recognised image for promoting this concept.

Utilise the information contained in the survival rates slide to identify the time sensitive events during resuscitation and defibrillation.

Element: 1-2



None.



Chain of Survival

Student Activity:

Refer to information in student reference manual.


The Chain of Survival was developed to provide a method to simply explain the importance of rapid management of cardiac emergencies. The four links are: Early Recognition of Heart Problems and calling 999/112 Early CPR Early Defibrillation Early Advanced Cardiac Life Support (ACLS) It is important that anyone trained to respond to a cardiac emergency should understand the Chain of Survival concept to identify how their actions can directly influence survival from cardiac arrest. Early defibrillation using an AED is proving to increase the survival from cardiac arrest but an AED will not provide the ‘magic’ solution unless other links in the chain are strong. Good CPR forms an important part of the link to provide basic and limited oxygenation to a person in cardiac arrest enabling the defibrillation to re-sequence the hearts pacemaker and provide an effective pumping action.

Assessment: Assess understanding using questions to the group.


Element: 1-2


Heart Anatomy & Heart Conditions

Learning Outcomes:

To increase knowledge of Anatomy of the Heart Be able to recognise and provide initial care for Angina. To recognise Heart Attack, differentiate from Angina and provide initial

care.


Review anatomy of the heart. Use appropriate levels of detail suitable for

the ability of the group. Provide information on cause, signs, symptoms and treatment for Angina. Differentiate between stable and unstable angina. Provide information on cause, signs, symptoms of Heart Attack.

Element: 1-3



Optional: - 3D Heart model is useful for explanation in this element



Heart Anatomy & Heart Conditions

Student Activity:

Be able to list signs and symptoms and cause of Angina and Heart Attack. Be able to provide recommended treatment for Angina and understand

the difference between stable and unstable angina. Be able to recognise and carry out appropriate actions when dealing with

a suspected Heart Attack.


Angina is chest pain that occurs when the blood supply to the muscles of the heart is restricted. It usually happens because the arteries supplying the heart become hardened and narrowed. The pain and discomfort of angina feels like a dull, heavy or tight pain in the chest that can sometimes spread to the left arm, neck, jaw or back. The pain is usually triggered by physical activity or stress and typically only lasts for a few minutes. This is often referred to as an angina attack. Stable angina - where angina attacks occur due to an obvious trigger (such as exercise) and improve with medication and rest and is a warning but not normally life threatening. Unstable angina - where angina attacks are more unpredictable, occurring with no obvious trigger and continuing despite resting and should be treated as a medical emergency. A heart attack is a serious medical emergency in which the supply of blood to the heart is suddenly blocked, usually by a blood clot. Lack of blood to the heart can seriously damage the heart muscle. A heart attack is known medically as a myocardial infarction or MI.



Element: 1-3


Cardiac Arrest & Defibrillation

Learning Outcomes:

To differentiate heart problems from cardiac arrest. Knowledge of all causes of sudden cardiac arrest. Have a basic understanding of the electrical system of the heart. Basic awareness of shockable and non-shockable heart rhythms. Understanding of the process of defibrillation.


Discuss the facts based around Sudden Cardiac Arrest. Provide input on different causes of Sudden Cardiac Arrest with

appropriate detail of each. Utilise the Under Pressure movie to provide background information. Define defibrillation and explain what this achieves. Identify shockable and non-shockable rhythms.

Element: 1-4



Under Pressure video clip Other video can be used if desired to aid understanding



Cardiac Arrest & Defibrillation

Student Activity:

Understand the different causes of cardiac arrest. Be able to state names for shockable and non-shockable rhythms. Be aware of the hazards associated with defibrillation.


Cardiac arrest, also known as cardiopulmonary arrest or circulatory arrest, is a sudden stop in effective blood circulation due to failure of the heart to contract effectively or at all. Medical personnel may refer to an unexpected cardiac arrest as a sudden cardiac arrest (SCA). A cardiac arrest is different from (but may be caused by) a heart attack, where blood flow to the muscle of the heart is impaired. It is different from congestive heart failure, where circulation is substandard, but the heart is still pumping sufficient blood to sustain life. Arrested blood circulation prevents delivery of oxygen and glucose to the body. Lack of oxygen and glucose to the brain causes loss of consciousness, which then results in abnormal or absent breathing. Brain injury is likely to happen if cardiac arrest goes untreated for more than five minutes. For the best chance of survival and neurological recovery, immediate and decisive treatment is imperative. Cardiac arrest is a medical emergency that, in certain situations, is potentially reversible if treated early. Unexpected cardiac arrest can lead to death within minutes: this is called sudden cardiac death (SCD). The treatment for cardiac arrest is immediate defibrillation if a "shockable" rhythm is present, while cardiopulmonary resuscitation (CPR) is used to provide circulatory support and/or to induce a "shockable" rhythm.



Element: 1-4


The AED Device

Learning Outcomes: To identify key functions of an AED. Recognise that although many manufacturers exist principles are the same. Familiarisation with the live AED unit that students will be expected to use

in emergency. To identify correct electrode placement positions. To understand how to operate the AED. Identify differences in operation between Fully and Semi-Automatic AEDs


Use a live unit or matching trainer unit to explain operation and functions of the AED unit that students will be expected to use in a real incident.

Identify key parts of the AED such as electrodes, battery, carry case. Demonstrate electrode positions and alternative positions. Demonstrate via an old set of electrodes where possible how sticky the live

electrodes are. AED use on children is covered later in the syllabus.

Element: 1-5


Materials/Equipment: Live AED device that students will be using Trainer AED device Resuscitation manikins Example electrodes and AED accessory pack



The AED Device

Student Activity:

Become familiar with the AED for which they will be responsible. Identify key components of the AED. Be able to apply electrodes in correct positions.


There are many manufacturers now producing portable defibrillators. Almost all have a similar operating principle requiring the unit to be turned on and the only other interaction is to press to deliver a shock if advised. Some units are fully automatic and the user does not need to press the ‘Shock’ button. Often these are found within Public Access Defibrillation schemes. It is important that students receive familiarisation in the unit which they will be required to operate in an emergency. The storage and procedures for alerting AED trained staff should also be discussed during this element. It is also important to recognise that some AED manufacturers have differing performance in terms of energy levels delivered and time to shock. For advice on AED specific models please contact either the manufacturer direct or the WorkSafe offices.



Element: 1-5


BLS Review

Learning Outcomes:

To refresh Basic Life Support skills. To remind on the importance of calling 999/112 quickly. To improve confidence and skills in resuscitation skills. To introduce use of the Pocket mask.


Ensure students BLS skills are effective and to current protocols. Demonstrate Basic Life Support scenario using DRABC approach (unless

running the course alongside a full first aid course in which case this element can be omitted).

Concentrate on good quality CPR and minimal interruptions to compressions.

Demonstrate use of pocket mask during CPR.

Element: 1-6



Resuscitation Manikins, ratio 1 per 3 students Faceshields and manikin hygiene supplies Optional:- Pocket masks



BLS Review

Student Activity:

Practice CPR on an adult training manikin at least once each and as part

of the Primary Survey process. Use opportunity to increase quality of CPR.


The WorkSafe AED programme may be integrated with another first aid training programme. In this situation the BLS module may be omitted. Current requirements are for all AED operators to hold a certificate of Basic Life Support skills. Good CPR is as important as the use of the AED. It has been found that good quality CPR will increase the change of effective defibrillation in most casualties.

Assessment: Learners ability to undertake BLS and good quality CPR should be as-

sessed by direct observation of practice sessions. BLS Self-assessment matrices can be utilised for peer assessment of BLS

skills.


Element: 1-6


Using the AED

Learning Outcomes:

To recognise when to apply an AED to a casualty. To understand the sequence/algorithm for using the AED. To be able to ‘prepare’ the chest for AED application. Awareness of safety considerations relating to the casualty and the environ-

ment where the AED is to be used. Identify age ranges for AED use.


Provide information to only attach the AED to a casualty who is not breathing.

Discuss the AED algorithm that all AEDs will follow. Discuss re-programming of AED’s by manufacturer if protocols change. Provide information on proper chest preparation. Ensure all learning outcomes are met for this element. Discuss the use of AED on children with or without Paediatric electrodes

available. Identify the standard AED sign adopted for UK use.

Element: 1-7



Resuscitation Manikins AED Trainer units



Using the AED

Student Activity:

Be able to prepare a chest for AED attachment and identify hazards. Understand the criteria when to attach the AED to a casualty. Be able to follow the AED prompts and act on any information supplied by

the AED. Ensure safety checks are carried out prior to pressing ‘shock’. Understand maintenance requirements and data downloads.


This element is designed to provide all the information required from initial decision to use the AED through to delivering a shock and all steps in between. The element should be tailored to meet the needs of the AED that the students will be likely to use. Instructors should be aware of the AED algorithm and keep up to date with any future changes which may require the reprogramming of the AED. Instructors should also be aware of protocols in respect of children and AEDs.

Assessment: No assessment of learners is required in this element.


Element: 1-7


AED Scenarios

Learning Outcomes:

To build confidence in use of the AED. To experience different situations when using the AED. To recognise and respond to fault prompts displayed by the AED. To complete peer assessment of using the AED.


Provide scenarios to students to allow confidence building and practical application of using the AED.

Ensure different features and prompts of the AED are utilised. Include Shock and No shock and fault finding scenarios with multiple

shocks and both Return of Spontaneous Circulation (ROSC) and non successful attempts.

Provide scenarios with one and two rescuers. Ensure all students operate the AED safely at least twice during this

element.

Element: 1-8



AED Trainer units Resuscitation Manikins Self-Assessment worksheet from student pack.



AED Scenarios

Student Activity:

Participate in AED scenarios. Take the role of AED operator at least twice during the scenarios. Complete peer assessment worksheets.


Many AED training units have scenarios built into the memory that are accessible via a setting or remote control for the AED. Instructors should be familiar with the scenarios and be able to provide different settings to allow students to experience the many different prompts with which they may be faced by the AED. Some AED training units have a remote control which can be used to change pre-programmed scenarios as well as confirm electrode attachment, shockable rhythms and fault conditions. Students should work through multiple scenarios which include multiple and single shock attempts and conversion to no shock to fully understand the prompts that the AED may present. Fault finding scenarios should also be included.

Assessment: Self-assessment practical skill matrices can be utilised for peer assessment

during this element.


Element: 1-8


Self-Assessment

Learning Outcomes:

Complete the WorkSafe AED Self Assessment questions. Completion of Self Assessment skills matrices with instructor observation of

AED use.


Provide opportunity for students to complete the Self Assessment question sheet from training pack.

Review all answers from self assessment worksheet as a group. Undertake instructor observations of students using the AED to confirm safe

and effective use.

Element: 1-9



AED Trainer Units Resuscitation Mankins Self Assessment worksheets



Assessment

Student Activity:

Complete self assessment worksheet questions individually. Undertake direct observation by instructor for safe use of the AED.


The WorkSafe assessment strategy utilise self assessment which includes peer and instructor review of practical skills. The worksheets should be completed by students during practice sessions of using the AED and BLS for peer review. The instructor should complete as a minimum the AED use section as an observed assessment.

Assessment: Assessment of knowledge via self assessment question sheet. Assessment of practical skills via peer review. Learners must be observed directly for safe and effective use of the AED.


Element: 1-9


Summary & Completion

Learning Outcomes:

Provide evaluation of course. Final opportunity for questions. Provide information on retraining and requalification options. Understand when certificates will be issued.


Ensure all students have received enough input to meet their initial expectations.

Ask for final questions on any subject. Ensure students complete a course evaluation. Make students aware of re-qualification arrangements and qualification

duration. Describe when and how certificates will be issued. Encourage students to register their qualification on the WorkSafe website.

Element: 1-10



Course Evaluation from student training pack.



Summary & Completion

Student Activity:

Complete course evaluation document and hand to instructor. Be aware of how and when certificates will be issued. Be aware of qualification duration and re-training options.


This section is designed to ensure a comprehensive summary is provided along with opportunity to ask final questions. The course evaluation should be completed with no pressure placed on students to provide positive feedback. Adequate time at the end of the session to be allowed for students to provide feedback to WorkSafe. Students name entry on the evaluation is optional.

Assessment: Ask any final questions and summarise key learning points.


Element: 1-10


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Documents

Automated External Defibrillator (AED)Automated External Defibrillator—Course Outline Notes: To deliver the WorkSafe AED programme all elements must be presented by the instructor