SAMPLE USE NOT SAMPLE - EMS Safety Services Safety Services Task Book 1 CPR, ... 5. Instructor CPR Written Exam a. ... Task Mentor SAMPLE DO NOT USE SAMPLE

EMS Safety Services Task Book 1

CPR, AED AND FIRST AID MENTOR INSTRUCTOR TASK BOOK

EMS SAFETY SERVICES, INC.

www.emssafety.com/mentor

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TABLE OF CONTENTS

The Mentor Process - Defined ...................................................................................................................... 3

How to Become a Mentor Instructor ........................................................................................................ 3

When to Choose Mentoring ..................................................................................................................... 3

Qualifications to Become an Instructor Trainee ....................................................................................... 3

Before You Begin ....................................................................................................................................... 4

MENTORING PROCESS .................................................................................................................................. 6

TASKS ............................................................................................................................................................ 7

Instructor Manual, Section 1: Course Administration .............................................................................. 7

Instructor Manual, Section 2: Lecture Guide .......................................................................................... 14

Instructor and Student Portals: www.emssafety.com ........................................................................... 16

Skill Checks .............................................................................................................................................. 17

Co-Teaching Requirements ..................................................................................................................... 18

INSTRUCTOR TRAINER VIDEO SERIES ...................................................................................................... 22

FORMS ......................................................................................................................................................... 22

Lecture Evaluation Form (1) .................................................................................................................... 23

Lecture Evaluation Form (2) .................................................................................................................... 24

Skill Demonstration and Feedback Evaluation Form (1) ......................................................................... 25

Skill Demonstration and Feedback Evaluation Form (2) ......................................................................... 26

Skill Sheet 1: Glove Removal ................................................................................................................... 27

Skill Sheet 2: Adult CPR and AED Use ..................................................................................................... 28

Skill Sheet 3: Child and Infant CPR .......................................................................................................... 29

Skill Sheet 4: Assessment ........................................................................................................................ 30

Skill Sheet 5: Bleeding and Bandaging .................................................................................................... 31

Skill Sheet 6: Adult and Child Choking Care ............................................................................................ 32

Skill Sheet 7: Infant Choking Care ........................................................................................................... 33

Skill Sheet 8: Epinephrine Auto-Injector ................................................................................................. 34

Instructor Registration Form ................................................................................................................... 35

Final Trainee Sign Off .................................................................................................................................. 36

Submission Instructions .......................................................................................................................... 36

Copyright © 2017 EMS Safety Services, Inc. V1.1

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The Mentor Process - Defined Instructor mentoring is a simple process that involves Trainee orientation to course administration and

resources, teaching in a classroom environment and completion of a short series of learning videos and

associated knowledge checks.

The Task Book is used by a certified EMS Safety Mentor Instructor (must have completed the process to

become a Mentor Instructor) to develop a Trainee (prospective Instructor) to become a certified

Instructor. The Mentor Instructor will use the Task Book to orient the Trainee to all aspects of EMS Safety’s

training, then observe and provide feedback to the Trainee in a classroom setting.

Although the Mentor Instructor is responsible for initialing completed objectives, it is the Trainee’s

responsibility to maintain, complete and submit the Task Book when completed.

How to Become a Mentor Instructor To qualify as a Mentor Instructor, a currently certified EMS Safety Instructor must have taught at least

two (2) CPR/AED AND two (2) First Aid courses using the EMS Safety program (verified by submitted

rosters) and have completed the Mentor Instructor Video Series and associated knowledge checks. Once

you have completed these two steps, contact EMS Safety and your Instructor credential will be

upgraded to Mentor Instructor. This is a prerequisite to mentor a new Instructor. There is no charge to

become a Mentor Instructor.

When to Choose Mentoring Instructor mentoring is used to train one (1) or two (2) Trainees at a time. Instructor mentoring is not used

for more than two (2) Trainees at a time, as mentoring more than two (2) Trainees at a time dilutes the

mentoring process. In this instance, a formal Instructor class is required.

Qualifications to Become an Instructor Trainee An EMS Safety Instructor Trainee must possess a current CPR certification from a nationally recognized

agency. Approved training agencies include: EMS Safety Services, American Heart Association, American

Red Cross, Health and Safety Institute (HSI, ASHI, MFA), National Safety Council, Emergency Care and

Safety Institute and Emergency First Response.

Instructor Mentoring may be provided by an EMS Safety Instructor Trainer (IT) or a certified Mentor

Instructor.

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Before You Begin Mentor Instructor must:

1. Complete process to become a Mentor Instructor

2. Purchase and present required EMS Safety Mentor CORE Instructor Kit to Trainee. Kit includes:

a. Mentor Instructor Task Book

b. Instructor Manual

c. EMS Safety DVD

d. Sample student workbooks

3. Review the Task Book

4. Visit www.emssafety.com and review the “Mentor” page

5. Contact EMS Safety with any questions about the Instructor mentoring process

Trainee must:

1. Locate a certified Mentor Instructor (not all Instructors are qualified as Mentor Instructors)

2. Provide copy of current CPR certification from nationally recognized agency to Mentor

3. Receive required EMS Safety Mentor CORE Instructor Kit from Mentor Instructor. Kit includes:

a. Mentor Instructor Task Book

b. Instructor Manual

c. EMS Safety DVD

d. Sample student workbooks

4. Review Instructor Manual sections, including:

a. Course Administration

b. Lecture Guide

c. Master Documents

5. Review course DVD: CPR, AED and First Aid

6. Review student workbook: CPR, AED and First Aid

7. Review the Task Book

8. Schedule orientation and training dates with a certified Mentor Instructor

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http://www.emssafety.com/


Mentor Instructor Information

Only a certified EMS Safety Mentor Instructor or Instructor Trainer may assist with the Instructor

mentoring process and initial the Task Book. A Trainee may have more than one Mentor Instructor.

Trainee

First Name: __________________________________ Last Name: _______________________________

Signature: ________________________________________________________ Initials: _____________

Mentor 1 (Must be a certified Mentor Instructor)



EMS Safety Mentor Instructor Number: _______________________________ Expires: _____________




EMS Safety Mentor Instructor Number: ________________________________ Expires: _____________




EMS Safety Mentor Instructor Number: ________________________________ Expires: _____________

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MENTORING PROCESS The Trainee and Mentor Instructor(s) will work together to complete the objectives in the Task Book.

Once the Task Book has been completed, the Trainee is eligible to complete the Instructor Exam, located

on the “Mentor” page of the EMS Safety website.

The Mentor Instructor will discuss, observe and test the Trainee in the following activities:

1. Instructor Orientation with Trainee

a. Completed in a one-on-one setting

b. Review and complete the criteria outlined in the Task Book

c. Initial as each element is completed

2. Skills Review

a. Completed in a one-on-one setting

b. Use the Trainee Skill Check Forms in the Task Book

c. Provide remediation as needed

3. Co-Teach 3 classes with Mentor

a. Mentor is the Lead Instructor, and Trainee is the Assisting Instructor

b. Must be documented on 3 separate EMS Safety course rosters

c. Trainee participates in pre- and post-course activities and assists with the courses

d. Lecture demonstrations

i. The Mentor and Trainee select two (2) lecture topics from the Lecture

Evaluation Form

ii. The Mentor and Trainee select two (2) skills from the Skill Demonstration Form

e. The Trainee delivers two (2) lectures and two (2) skill demonstrations during any of the

attended courses

i. The lecture and skill demonstrations may be repeated until minimum scores are

achieved. Multiple attempts are permitted.

1. Use the Lecture and Skill Demonstration Forms to provide feedback.

Make additional copies as needed.

ii. Mentor observes Trainee and provides feedback on:

1. Lecture and presentation

2. Skill demonstration and feedback

4. Instructor development videos and knowledge checks

a. Trainee views a series of short videos and completes the associated knowledge checks.

Videos are located at www.emssafety.com under the “Mentor” page.

5. Instructor CPR Written Exam

a. Exam completed by Trainee after the Task Book has been submitted to EMS Safety

i. Must pass exam with 80% or higher

b. Exam may be found at www.emssafety.com under the “Mentor” page

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TASKS Each task involves one of the following types of activities:

• D: Discussion

o Review reference pages and media, and discuss the topic in person or in a classroom

• Obs: Observation

o Activity performed by Trainee and observed by Mentor

o Observations are made during the one-on-one session and the co-teach process

o Mentor initials when Trainee has demonstrated proficiency and provides feedback

• Skill: Skill Check

o Trainee’s provider skills are evaluated by Mentor in a one-on-one setting

o Trainee’s Instructor skills are assessed during co-teach process

Task Activity Date Trainee Initials

Mentor Initials

Instructor Manual, Section 1: Course Administration

Program Overview (Admin, Page 5)

1. Training methods and learning objectives 2. Guidelines and program approvals 3. Prerequisites and minimum ages

D

Training Materials and Resources (Admin, Pages 6-7)

1. Instructor Manual a. Course Administration b. Lecture Guide c. Master Forms

D

2. DVD and Videos a. Location in the Instructor Manual b. Can teach all CORE courses with 1 DVD c. Must be shown in every course d. Videos available to stream online in Instructor Portal

D

3. Student Workbooks a. Each student is required to have an original EMS

Safety workbook in every class b. Workbook corresponds with course title and course

certification card c. Digital workbooks are available in Student Portal as a

resource for students receiving a digital certification

D

4. Instructor and Student Portals a. Instructor Portal

Visit regularly for current versions of master documents, programs, teaching tips and administrative updates

D

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b. Student Portal i. Access to digital workbook, resources and copy of

digital card (if issued) ii. Renewal reminders

D

Training Courses (Admin, Pages 8-11)

1. Regulations a. Research state, local, county and workplace

regulations b. Follow local regulations and protocols when they

differ (e.g. auto-injector, inhaler)

D

2. Instructor-to-Student Ratio a. CPR, AED = 1:12 b. First Aid = 1:20 c. CPR, AED & First Aid = 1:12 d. Add additional Instructors as needed e. Document Assisting Instructor on Course Roster

D

3. Flexibility and Accommodation a. Class can be adapted to workplace or student needs

i. Not permitted to delete required chapters ii. Modules can be combined as needed (e.g. adult

CPR with or without AED) iii. Additional time may be spent on specific needs iv. Identify additional content, local or workplace

policy as not provided by EMS Safety b. Scenarios

i. Used during practice and testing to increase retention and help translate knowledge into action

ii. Skill sheets have sample scenarios iii. Can change scenarios to meet specific needs

D

4. Duration of Courses Review table and discuss how course length can vary D

5. Course Records a. Ensure current version of rosters, skill sheets and

exams (found in Instructor Portal and Instructor Manual, Section 3: Master Documents)

b. Course is not valid without a completed course roster (either written or digital)

c. Course Roster (written) i. It is the Instructor and organization’s course record

ii. EMS Safety roster must be legible and complete iii. Record control numbers for each certification card iv. Instructor’s signature verifies student’s training

and proficiency of required skills

D

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d. Digital rosters can be completed and stored on the Instructor Portal

e. Optional Skills Documentation i. Skills Summary

1-page document used to record skill checks for entire class

ii. Skill Sheets 1. For more formal skills training and testing 2. Detailed page for each skill that provides

instructions, scenario and criteria 3. Use one set per student 4. Check off each required action as it is completed

correctly and in sequence 5. If used, keep as part of course records

f. Written Exams i. Optional tool, but may be required by a workplace

or regulatory agency ii. Retain completed Written Exam Answer Sheets as

part of course records

D

iii. Locate the following in the Master Documents section:

1. Course Roster 2. Skill Summary 3. Skill Sheets 4. Written Exams

Obs

6. Documenting Skill Proficiency a. Skill Checks

i. Group activity ii. Instructor observes, gives feedback

iii. First aid skills are usually Skill Checks iv. May use optional Skills Summary page for

additional documentation of skills practice b. Skill Tests

i. A formal test of student’s skills without coaching ii. 1 or 2 students at a time

iii. CPR skills are usually Skill Tests

D

7. Recordkeeping a. Keep records for at least 3 years, even if Instructor is

expired b. Records are public information and may be

requested by EMS Safety; a federal, state or local agency or board; a court of law; a student’s or Instructor’s employer

c. EMS Safety Instructors must provide course records within 1 week of records request

D

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Requirements for Student Certification (Admin, Pages 12-14)

1. Initial Certification a. Participation in all course activities b. Demonstration of proficiency in all required skills

D

2. Certification of Skills a. Yes/No on certification card for Adult CPR, AED use,

Child CPR and Infant CPR b. Locate ‘Filling out a Certification Card’ in the

Instructor Manual and identify Yes/No checkboxes

Obs

3. Discuss and Define a. Remediation b. Recertification

i. Certification must be current ii. Review recertification course requirements

c. Skills Refresher i. Recommend every 6 months

ii. No testing or certification, just review and practice d. Challenge

i. Certification must be current ii. Instructor is not allowed to demonstrate or coach

e. Participation Award i. Not a certification

ii. Student participates, but does not demonstrate proficiency

iii. Available on the Instructor Portal

D

4. Certification Cards a. Issuance

i. Distribute to students within 2 weeks of the course ii. Not valid without course Roster to authenticate it

iii. Write card control numbers on roster b. Completing Cards

i. Sold in quantities of 4 with student workbook ii. Butterfly style, adhesive cards; must complete and

carefully peel and fold iii. May be hand written or printed legibly

1. Printing template available on the Instructor Portal

2. Change printer settings to card stock and highest quality print

c. Replacing a Certification Card i. Replacement cards may only be issued by the Lead

Instructor ii. May charge reasonable fee to replace card

iii. Update control number on course roster

D

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d. Digital Certification Cards i. Cards may be issued digitally

ii. Instructor purchases digital credits as needed iii. Courses can be listed on the Instructor Portal iv. Complete digital course roster and automatically

email students their cards

D

Instructor Requirements (Admin, Pages 15-16)

1. Instructor Conduct a. Professional manner and dress b. Respond within 1 week to all EMS Safety

administrative requests c. Do not represent yourself as an EMS Safety

employee d. Obtain updates from EMS Safety’s Instructor Portal

at least annually e. Only teach what you’re certified to teach f. Follow payment policies g. Maintain current contact information with EMS

Safety

D

2. Training Materials a. Become familiar with the flow between the DVD,

student workbooks and Instructor Manual b. Do not create own training or certification materials

i. Only certification cards created, produced and distributed by EMS safety are valid

ii. Copying EMS Safety copyrighted materials, including workbooks, is prohibited by law

c. Refresh your skills and knowledge regularly

D

3. Training Course a. Create a safe and non-threatening classroom

environment b. Provide each student with a workbook, equipment

and supplies for required skill practice c. Show corresponding video, teach all required topics

and provide adequate hands-on practice for all required skills

d. Answer questions, provide feedback and help students meet course objectives

e. Inform students of requirements for certification at the beginning of class

f. Ensure students meet certification requirements before issuing cards

g. Issue cards within 2 weeks h. Identify state, local or workplace regulations

D

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i. Confirm level and type of certification needed with each student before class

j. Encourage course feedback k. Keep complete and legible course records on file for

3 years

D

4. Instructor Certification a. EMS Safety reserves the right to suspend, revoke or

not renew an Instructor’s certification at its sole discretion

b. EMS Safety Instructor Certification must be active and current to teach EMS Safety courses

D

5. Instructor Recertification a. Must recertify every 2 years b. Eligible if you have taught at least 2 courses or pass

recertification exam c. Must recertify before Instructor expiration date as

there is no grace period

D

Running a Course (Admin, Pages 17-21)

1. Preparation Download documents from the Instructor Portal or make copies from Section 3: Master Documents

D

2. How to Order Materials a. Materials ship from San Clemente, CA b. Orders ship ground delivery, but expedited shipping

is available upon request c. Ordering methods

i. Online: www.emssafety.com ii. Phone: (800) 215-9555

iii. Email: [email protected] iv. Fax: (949) 388-2776

d. Current purchasing policies on website

D

3. Classroom Requirements and Set Up a. Comfortable environment with adequate space b. Unobstructed view c. Good lighting and acoustics

D

4. Locate and Review Equipment and Supply List Obs

5. Student Health and Safety a. Prevention of:

i. Disease transmission ii. Injury or sudden illness

iii. Allergic reaction to latex b. Provide adequate supervision

D

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6. Students with Reading Difficulties, Disabilities or Medical Conditions

a. The Americans with Disabilities Act (ADA) ensures equal opportunity and prevents discrimination against persons with disabilities

i. Do not assume a student is unable to successfully demonstrate a skill or prevent a person from participating in a course

ii. Discuss options, requirements and possible modifications to help achieve the course objectives

b. Allow modified demonstration of a required skill i. May modify techniques as long as the result is the

same ii. Allow frequent breaks

iii. Spend additional time and make accommodations as needed

c. May give oral exam if student has difficulty reading or understanding a written exam

D

7. Locate and Review Suggested Time Per Topic Obs

Move on to next section

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Task

Activity Date Trainee Initials

Mentor Initials

Instructor Manual, Section 2: Lecture Guide

How to Use the Lecture Guide (Page 1)

1. 3-in-1 Tool for All CORE Courses a. Combined CPR, AED and First Aid b. CPR only. Optional modules include:

i. AED ii. Child CPR

iii. Infant CPR c. First Aid only

D

2. Review Icon Key D

3. Review Status Bar a. When to play DVD and what chapter to play b. How to locate corresponding student

workbook page and when to practice a skill

D

4. Lecture Guide Features a. Learning objectives and recommended time b. Student workbook pages on the right c. Instructor information on the left

i. Commonly asked questions and examples ii. Discussions

d. What would you do? Photo discussions

D

Table of Contents (Page 2)

1. Trainee Identifies a. Location of Skill Practice pages b. Optional topics c. First Aid topics

Obs

Review Introduction; Protection from Infection (Pages 3-6) How to use video with Lecture Guide

1. Read status bar. Trainee identifies: a. Video chapter b. Student workbook page number c. Objectives d. Length of time e. Skill to practice

Obs

2. Introduce the topic before showing video a. What topics will be covered and why it’s

important b. Let class know they will discuss and review

workbook content after watching video

D

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3. Watch the video Protection from Infection Obs

4. Review left/right side of Instructor Manual (Pages 4-5)

a. Video pauses for practice, discussion or knowledge checks

b. Review workbook for each topic and define objectives, blue terms and bold terms

c. Discuss icons i. When to insert discussions and questions to

ensure each topic is covered through reading, viewing the images and using the discussion topics and questions

ii. Review ‘Demonstrate and Practice’ Icon

D

5. Review Skill Check: Glove Removal (Page 6) a. Identify and discuss:

i. Goal ii. What you will need

iii. Steps iv. Actions

b. Each skill check page is set up the same way

D

6. Review Skill Sheet 1: Glove Removal a. Identify and discuss:

i. Instructions ii. Statement

iii. Scenario iv. Steps v. Rescuer actions

b. Instructor initials and Instructor # *Skill Sheets are an optional tool

D

Review Moving an Ill or Injured Person (Page 12)

1. Every topic does not have a video chapter a. Video icon = ‘None’ b. If no video chapter, the Instructor lectures:

i. State objectives and why it’s important ii. Review workbook content

iii. Cover discussion and question icons c. Recap main points and answer questions

D

2. If teaching First Aid only a. Instructor chooses course title on the opening

DVD menu or video from Portal i. CPR, AED and First Aid

D

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ii. CPR only iii. First Aid only

b. Identify where to turn in Instructor Manual

c. The beginning of the CPR and First Aid courses are the same

d. Skip CPR topics when teaching First Aid only D

Review CPR and AED Practice Stations 1. CPR Practice Station Set Up (Page 15)

a. Use same set up for Adult, Child and Infant CPR

b. One student will practice and others will observe and interact

c. Partner manikins with groups of students and switch roles until everyone has practiced

d. Limit the number of people you observe at one time

D

2. AED Practice Station Set Up (Page 26) a. Discuss ‘You Will Need’ b. 1 or 2 rescuers:

i. If 2 rescuers, 1 rescuer performs CPR while the other prepares the AED

ii. Switch roles and repeat c. Discuss ‘AED Practice Tips’

D


Mentor Initials

Instructor and Student Portals: www.emssafety.com

Review Instructor Portal and Student Portal 1. Instructor Login 2. Master documents 3. Account management 4. Digital vs. Physical Certifications 5. Digital Recordkeeping

D

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Skill Checks

Use the Skill Sheets in the back of this Task Book to practice and check the Trainee’s skills

D

Required Skills 1. Glove Removal

Skill

2. Adult CPR and AED Use Skill

3. Child and Infant CPR Skill

4. Assessment Skill

5. Bleeding Control and Bandaging Skill

6. Adult & Child Choking Care Skill

7. Infant Choking Care Skill

8. Epinephrine Auto-Injector Skill

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Co-Teaching Requirements

Trainee will assist Mentor Instructor in 3 courses 1. Perform pre- and post-course tasks 2. Give 2 lectures 3. Lead a practice session for 2 skills

D

ASSIGNED DATES

Course One:

1. Date: _____________________________

2. Location: __________________________

3. Mentor Instructor: ___________________

D

Course Two:

1. Date: _____________________________

2. Location: __________________________


D

Course Three:

1. Date: _____________________________

2. Location: __________________________


D

SELECT AND DISCUSS LECTURE AND SKILL TOPICS

Lecture Topics: Choose 2 topics from the list on the Lecture Evaluation Forms in the back of this Task Book

1. Trainee will prepare ahead of time and teach the chosen lecture topics

2. Mentor Instructor will evaluate Trainee using the Lecture Evaluation Forms

D

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Lecture 1: Course Date: ________________________

Lecture Topic: _______________________

D

Lecture 2: Course Date: ________________________

Lecture Topic: _______________________

D

During Lecture, Trainee will be evaluated on: 1. Organization 2. Use of materials 3. Voice 4. Engagement of the audience 5. Body language 6. Subject knowledge (weighted)

D

Review the Lecture Evaluation Form 0bs

Skill Topics: Choose 2 skills from the list on the Skill Demonstration and Feedback Evaluation Form in the back of this Task Book

1. Trainee will prepare ahead of time and demonstrate chosen skills, then provide feedback as students practice

2. Mentor Instructor will evaluate Trainee using the Skill Demonstration and Feedback Evaluation Form

D

Skill 1: Course Date: ________________________

Skill: _______________________________

D

Skill 2: Course Date: ________________________

Skill: _______________________________

D

During the Skill Demonstration and Feedback, Trainee will be evaluated on:

1. Organization 2. Use of materials 3. Voice 4. Demonstration

D

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5. Feedback to the students 6. Body language 7. Subject knowledge (weighted)

D

Review the Skill Demonstration and Feedback Evaluation Form

Obs

PREPARING FOR LECTURE AND SKILL DEMONSTRATION

1. Review the video chapter with Instructor Manual to learn content and flow between the two resources

2. Teach topics to the mirror 3. Record and watch practice lectures; identify areas

for improvement; repeat the process 4. Practice the skills

a. Watch video chapters b. Review skill pages c. Review Skill Sheets d. Practice skill

5. Practice demonstrating and giving feedback to family members and friends

D

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BEFORE THE COURSE

Trainee must arrive early for: 1. Classroom set up

Obs

2. Manikin assembly Obs

3. Skill station set up Obs

4. Audio/visual set up Obs

5. Roster/student sign in Obs

DURING THE COURSE

1. Lecture 1: Complete Lecture Evaluation Form Obs

2. Lecture 2: Complete Lecture Evaluation Form Obs

3. Skill 1: Complete Skill Demonstration and Feedback Evaluation Form

Obs

4. Skill 2: Complete Skill Demonstration and Feedback Evaluation Form

Obs

AFTER THE COURSE

Trainee must stay late to: 1. Ensure roster is complete and legible Obs

2. Clean and decontaminate CPR manikins Obs

3. Complete certification cards (physical or digital) Obs

a. Review course record requirements and retention policy

b. Missing, incomplete or illegible rosters are not valid

D

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INSTRUCTOR TRAINEE VIDEO SERIES

Visit “Mentor” page at www.emssafety.com to view the videos and complete the knowledge checks

1. About EMS Safety N/A N/A

2. Conducting a Successful Course N/A N/A

3. Common Instructor Mistakes N/A N/A

4. The Instructor Portal N/A N/A

5. Course Completion Requirements N/A N/A

6. Using Instructor Manual N/A N/A

INSTRUCTOR EXAM

Visit "Mentor” page at www.emssafety.com and select the Instructor Exam link to take the exam

1. Complete CPR Instructor Exam a. Minimum passing score is 80% - submitted

electronically N/A N/A

FORMS • Lecture Evaluations

• Skills Demonstration and Feedback Evaluations

• Skill Sheets (1 through 8)

• Registration Form

• Sign Off

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Lecture Evaluation Form (1) Instructions: Observe Trainee in each area below, and identify areas for improvement. Score lecture

presentations based on the scale below. Tally each score and provide a total score.

1=Poor 2=Below Average 3=Average 4=Good 5=Expert

*The Subject Knowledge score is weighted: Multiply the Subject Knowledge score by 2 (e.g. a good

score of 4 would be scored as an 8)

Topic: _________________________________________________ Workbook Page Number: _________

Trainee Name: __________________________________ Mentor Instructor Initials: _____ Date: _____

Criteria Positive Attributes IT Comments Score

Organization

• Follows Instructor Manual

• Establishes importance

• Contains intro, body, conclusion

• Recaps main points

• Takes questions

Use of Materials

• Uses Lecture Guide

• Refers to workbook pages

• Discusses key words and images

• Use of props, gear as needed

Voice

• Positive, varied tone

• Adequate volume

• Appropriate, varied pacing

• Avoids fillers (e.g. ‘um’ and ’like’)

Engages Audience

• Establishes eye contact

• Confident posture

• Uses gestures properly

• Keeps hands out of pockets

• Moves around the stage

*Subject Knowledge multiply this score x2

• Instructor-level knowledge

• Stays within treatment guidelines and recommendations

• Able to answer questions

Additional Comments Total Score →

Lecture Presentation: Trainee must achieve a minimum score of 18. Repeat activity and replace forms as needed until minimum score is achieved.

Approved Lecture Topics

• Chain of Survival

• CPR Overview

• CPR and AED Considerations

• Shock

• Heart Attack

• Stroke

• Seizures

• Diabetic Emergencies

• Burns

• Difficulty Breathing

• Poisoning

• Heat-Related Emergencies

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Lecture Evaluation Form (2) Instructions: Observe Trainee in each area below, and identify areas for improvement. Score lecture

presentations based on the scale below. Tally each score and provide a total score.


*The Subject Knowledge score is weighted: Multiply the Subject Knowledge score by 2 (e.g. a good score

of 4 would be scored as an 8)

Topic: _________________________________________________ Workbook Page Number: _________



Organization

• Follows Instructor Manual

• Establishes importance

• Contains intro, body, conclusion


• Takes questions

Use of Materials

• Uses Lecture Guide

• Refers to workbook pages

• Discusses key words and images

• Use of props, gear as needed

Voice


• Adequate volume

• Appropriate, varied pacing


Engages Audience

• Establishes eye contact

• Confident posture

• Uses gestures properly

• Keeps hands out of pockets

• Moves around the stage

* Subject Knowledge multiply this score x2





Lecture Presentation: Trainee must achieve a minimum score of 18. Repeat activity and replace forms as needed until minimum score is achieved.

Approved Lecture Topics

• Chain of Survival

• CPR Overview

• CPR and AED Considerations

• Shock

• Heart Attack

• Stroke

• Seizures

• Diabetic Emergencies

• Burns

• Difficulty Breathing

• Poisoning

• Heat-Related Emergencies

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Skill Demonstration and Feedback Evaluation Form (1) Instructions: Observe Trainee in each area below, and identify areas for improvement. Score the

demonstration and feedback based on the scale. Tally each score and provide a total score.


The Subject Knowledge score is weighted: Multiply the Subject Knowledge score by 2 (e.g. a good score

of 4 would be scored as an 8).

Topic: _______________________________________________________ IM Page Number: _________



Organization • Easy to follow


• Takes questions

Use of Materials

• Instructor Manual, Skill Pages

• Use of props, gear

Voice • Positive, varied tone

• Adequate volume


Demonstration

• Accurate

• Easy to understand

• Answers questions

Feedback

• Identifies errors

• Immediate

• Positive

• Constructive

Body Language • Neutral

• At student’s level

• Open and positive

Subject Knowledge multiply this score x2





Skill Demo & Feedback: Trainee must achieve a minimum score of 26. Repeat activity and replace forms as needed until minimum score is achieved.

Approved Skills

• Adult CPR

• Infant CPR

• Child CPR

• Assessment

• Adult Choking Care

• Infant Choking Care

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Skill Demonstration and Feedback Evaluation Form (2) Instructions: Observe Trainee in each area below, and identify areas for improvement. Score the

demonstration and feedback based on the scale. Tally each score and provide a total score.


*The Subject Knowledge score is weighted: Multiply the Subject Knowledge score by 2 (e.g. a good score

of 4 would be scored as an 8).

Topic: _______________________________________________________ IM Page Number: _________



Organization • Easy to follow


• Takes questions

Use of Materials

• Instructor Manual, Skill Pages

• Use of props, gear

Voice


• Adequate volume


Demonstration • Accurate

• Easy to understand

• Answers questions

Feedback

• Identifies errors

• Immediate

• Positive

• Constructive

Body Language

• Neutral

• At student’s level

• Open and positive

*Subject Knowledge multiply this score x2





Skill Demo & Feedback: Trainee must achieve a minimum score of 26. Repeat activity and replace forms as needed until minimum score is achieved.

Approved Skills

• Adult CPR

• Infant CPR

• Child CPR

• Assessment

• Adult Choking Care

• Infant Choking Care

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V1

Instructions: Check off actions as they are performed correctly and in sequence. If not performed correctly, provide feedback and retest the student from the beginning of the scenario. Student should be wearing exam gloves to start the scenario.

Read this Statement: This is a skill test. I cannot coach you. After hearing the scenario, take the actions you feel are best. Continue until you are told to stop.

Scenario: You have assisted in a first aid emergency. It’s time to remove your contaminated gloves. Remove the gloves without touching the outside of them.

Glove removal skill training is required for both CPR and First Aid certification.

Student Name: Test Date:

STEPS RESCUER ACTIONS Test 1 Test 2 CONTAMINATED GLOVE REMOVAL

1st Glove Pinch the base of 1 glove and gently peel it off; hold in gloved hand 2nd Glove Slip ungloved fingers under base of glove; slowly peel glove back Finish End with gloves inside out, one inside the other Say or simulate Dispose of gloves properly and wash hands

Stop the test after all actions are observed. NOT READY PASS

Instructor Initials: Instructor #:

Skill Sheet 1: Glove Removal

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Instructions: Check off actions as they are performed correctly and in sequence. If errors are observed during the first cycle of CPR, stop the test. Make corrections and retest the student from the beginning of the scenario. Read this Statement: This is a skill test. I cannot coach you. After hearing the scenario, take the actions you feel are best. Continue cycles of CPR until you are told to stop. Scenario: You are at a high school football game when you see an adult man clutch his chest. He appears unsteady and is assisted to the ground. He stops moving. You have gloves and a CPR barrier with you. There is an AED nearby and bystanders are present.

*AED skill testing is required for AED certification, an optional topic in CPR courses.


STEPS RESCUER ACTIONS Test 1 Test 2 CHECK SCENE Quickly check the scene Determine scene is safe Put on PPE Put on gloves or say, “Gloves are on” CHECK & CALL Check response Tap shoulder, shout “Are you ok?” Call for help Send bystander to call 911 and get AED Check breathing Scan face and chest for 5-10 seconds GIVE 30 CHEST COMPRESSIONS Location Center of chest, 2 hands between nipples Push hard Minimum 23 out of 30 compressions are at least 2” deep Push fast Give 30 compressions in 15-18 seconds Do not lean on chest Allow full chest rise between compressions OPEN AIRWAY & GIVE 2 BREATHS Open airway Tilt head back and lift chin

Give breaths Pinch nose or use CPR mask and give 2 breaths Just enough air to see the chest rise

Minimize interruptions to compressions Less than 10 seconds to give 2 breaths & resume compressions

USE AN AED* After 2 CPR cycles, an AED is brought to the scene. Place the AED and turn it on Place near victim’s head; turn on AED

2-Rescuer Option: Rescuer 1 provides CPR; Rescuer 2 uses AED Place the AED and turn it on Place near victim’s head; turn on AED Apply pads Right upper chest, left lower chest Minimize interruptions to compressions 2 rescuers only: Apply pads without stopping CPR Stop CPR when prompted 2 rescuers only: Say, “Stop CPR” to CPR provider Clear victim before shocking Say, “Clear!” and look to see if victim is clear Deliver shock Press shock button when victim is clear Immediately resume CPR Start compressions after it is safe to touch victim Stop the test after all actions are observed. NOT READY PASS


Skill Sheet 2: Adult CPR and AED Use

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Instructions: Check off actions as they are performed correctly and in sequence. If errors are observed during the first cycle of CPR, stop the test. Make corrections and retest the student from the beginning of the scenario. Read this Statement: This is a skill test. I cannot coach you. After hearing the scenario, take the actions you feel are best. Continue cycles of CPR until you are told to stop. Child CPR Scenario: You are at the community pool when you hear someone yelling for help. You see a young boy lifted from the pool and laid on the deck. His face appears blue and he is not moving. You have gloves and a CPR barrier with you. There is an AED in the clubhouse. No lifeguard is on duty. Infant CPR Scenario: You are babysitting your 8-month-old nephew. You check on him shortly after putting him down for a nap, and notice he is twisted up in the blankets. He does not appear to be moving or breathing. Your friend is downstairs, and you have gloves and a CPR barrier. There is not an AED in the home.

STEPS RESCUER ACTIONS Child Infant

Test 1 Test 2 Test 1 Test 2 CHECK SCENE Quickly check the scene Determine scene is safe Put on PPE Put on gloves or say, “Gloves are on” CHECK & CALL

Check response Child: Tap shoulder, shout, “Are you ok?”

Infant: Flick soles of feet, shout

Call for help Child: Send bystander to call 911 and get AED

Infant: Yell for help. Send bystander to call 911

Check breathing Scan face and chest for 5-10 seconds GIVE 30 CHEST COMPRESSIONS

Location Child: Center of chest, 1 or 2 hands between nipples

Infant: Center of chest, 2 fingers just below nipple line

Push hard Child: 23 out of 30 compressions are about 2”

Infant: 23 out of 30 compressions are about 1.5”

Push fast Complete 30 compressions in 15-18 seconds Do not lean on chest Allow full chest rise between compressions OPEN AIRWAY & GIVE 2 BREATHS

Open airway Child: Tilt head back and lift chin Infant: Tilt head back and lift chin to a neutral position

Give breaths Child: Pinch nose or use CPR mask & give 2 breaths

Infant: Give 2 breaths over mouth and nose Just enough air to see the chest rise

Minimize interruptions to compressions

Less than 10 seconds to give 2 breaths & resume compressions




Skill Sheet 3: Child and Infant CPR

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Instructions: Check off actions as they are performed correctly and in sequence. If not performed correctly, provide feedback and retest the student from the beginning of the scenario. Use a manikin or trainer vest as the victim.


Scenario: You are at a restaurant when you witness an adult at the next table clutch his throat and stand up. His face looks panicked and is turning red. He appears unable to speak.

STEPS RESCUER ACTIONS Test 1 Test 2 ADULT OR CHILD CHOKING CARE Quickly check scene Determine scene is safe

Recognize choking Ask person, “Are you choking?”

Abdominal thrusts

From behind, reach under person’s arms and locate navel with finger Make fist with other hand and place thumb-side in, just above navel Grasp fist with free hand Give continuous abdominal thrusts, quick and forceful, inward and upward


Choking care skills training is required for both CPR and First Aid certification.



Skill Sheet 4: Adult & Child Choking Care

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Instructions: Check off actions as they are performed correctly and in sequence. If not performed correctly, provide feedback and retest the student from the beginning of the scenario. Use an infant manikin as the victim.


Scenario: You’re at a picnic when you hear a woman scream, ‘My baby is choking, someone help!” You see an infant on the blanket with several small toys close by. The infant’s face is bright red, and his eyes are bulging.

STEPS RESCUER ACTIONS Test 1 Test 2 INFANT CHOKING CARE Quickly check scene Determine scene is safe Recognize choking Observe infant to confirm severe choking

5 Back blows

Sit or kneel down & hold infant face-down on forearm, with head lower than body

Support the infant’s head Slap forcefully 5 times with the heel of the hand between the shoulder blades

5 Chest thrusts

Hold infant face-up on forearm, with head lower than the body Support the infant’s head Place 2 fingers in the center of the chest just below the nipple line Provide 5 chest thrusts quickly and forcefully downward

Complete at least 2 cycles. Stop the test after all actions are observed. NOT READY PASS

Infant Choking Care training is required only for Infant CPR certification.



Skill Sheet 5: Infant Choking Care

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V1

Instructions: Check off actions as they are performed correctly and in sequence. If not performed correctly, provide feedback and retest the student from the beginning of the scenario. Use a volunteer or full-body manikin as the victim. Read this Statement: This is a skill test. I cannot coach you. After hearing the scenario, take the actions you feel are best. Scenario: You are at a construction site when you see a man slip and fall off the bed of a pickup truck. After the fall, he is not moving or attempting to get up. You have gloves with you, and there are bystanders close by with access to a phone, first aid kit and AED.


STEPS RESCUER ACTIONS Test 1 Test 2 CHECK SCENE

Quickly check the scene Determine scene is safe Instructor Prompt: “Scene is safe”

Put on PPE Put on gloves or say, “Gloves are on” CHECK PERSON

Check response Tap shoulder, shout “Are you ok?” Instructor Prompt: “No response”

Call for help Send bystander to call 911 and get the AED

Check breathing Scan face & chest for 5-10 seconds Instructor Prompt: “Normal Breathing”

Check for severe bleeding Look quickly for severe bleeding Instructor Prompt: “Bleeding heavily from forearm”

Apply direct pressure to control bleeding Check head-to-toe Look from head-to-toe for signs of injury CHECK AGAIN

Recheck scene Determine the scene is still safe Instructor Prompt: “Scene is still safe”

Recheck breathing Scan face & chest for 5-10 seconds Instructor Prompt: “Normal breathing”

Recheck if severe bleeding is controlled

Check bandage for blood soaking through



Skill Sheet 6: Assessment

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V1

Instructions: Check off actions as they are performed correctly and in sequence. If not performed correctly, provide feedback and retest the student from the beginning of the scenario. Use a volunteer as the victim. Read this Statement: This is a skill test. I cannot coach you. After hearing the scenario, take the actions you feel are best. Scenario: You are helping a friend move when he cuts his wrist accidentally with a box cutter. The wound is bleeding heavily.


STEPS RESCUER ACTIONS Test 1 Test 2 CHECK SCENE

Quickly check the scene Determine scene is safe Instructor Prompt: “Scene is safe”

Gain consent Ask for permission to help Instructor Prompt: “Your friend gives consent”

Put on PPE Put on gloves or say, “Gloves are on” CONTROL BLEEDING

Apply direct pressure with gauze pads Press firmly directly over the wound Instructor Prompt: “Blood soaks through gauze”

Add dressings Add additional dressings and continue to apply pressure Do not remove any dressings

APPLY BANDAGE Wrap with roll gauze or elastic bandage

Start furthest from the heart and wrap upward

Ensure bandage is not too tight Check for adequate circulation beyond the bandage (can slip a finger under the bandage)

Ensure bleeding is controlled Check bandage for blood soaking through



Skill Sheet 7: Bleeding Control and Bandaging

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Instructions: Check off actions as they are performed correctly and in sequence. If not performed correctly, provide feedback and retest the student from the beginning of the scenario. For training purposes, students will use an auto-injector trainer on themselves. Read this Statement: This is a skill test. I cannot coach you. After hearing the scenario, take the actions you feel are best. Scenario: You are in the breakroom at work when you hear a coworker complain of exposure to peanuts. Within a few moments the employee’s face is swollen around the eyes and lips, he is having difficulty breathing, and you can hear wheezing. The employee asks you to help him use his auto-injector, which is in the next room.

STEPS RESCUER ACTIONS Test 1 Test 2 CHECK SCENE Quickly check scene Determine scene is safe Call for help Send bystander to call 911 USE AUTO-INJECTOR

Injection

Injection site: outer thigh between hip and knee Do not touch bottom end of auto-injector Remove safety cap Jab firmly against injection site and hold for 10 seconds

Rub injection site for 10 seconds

Stop test after all actions are observed. NOT READY PASS


Skill Sheet 8: Epinephrine Auto-Injector

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Final Trainee Sign Off I attest I have reviewed and completed all actions as described in the Task Book and understand I must

follow all EMS Safety Instructor requirements.

Trainee First Name: ____________________________ Last Name: ____________________________

Signature: _________________________________________________ Date: ____________________

The Next Steps

Trainee will:

1. Complete videos and knowledge checks - Instructor development videos

a. Trainee views a series of short videos and completes the associated knowledge checks.

b. Videos found at www.emssafety.com on the “Mentor” page

2. Instructor CPR Written Exam

a. Completed by Trainee once the Task Book has been submitted to EMS Safety (minimum

passing score: 80%)

b. Exam found at www.emssafety.com on the “Mentor” page

Submission Instructions Submit the completed Mentor Task Book and copy of current CPR certification card to EMS Safety for

review and processing. The Mentor Task Book can be scanned and emailed or mailed to EMS Safety.

Trainee maintains the original copy. DO NOT SUBMIT THE ORIGINAL. Trainee must keep it for his/her

records.

• Scan and email EMS Safety at: [email protected].

OR

• Mail Copies to: EMS Safety Services, 1046 Calle Recodo, Suite K, San Clemente, CA 92673

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mailto:[email protected]