Teaching CPR and First Aid Safely - Kevin Nation, NZRC

Teaching CPR and First Aid SafelyNZRC logo


By Kevin Nation, Chief Executive, NZ Resuscitation Council

With help from Alastair Reith, Communications and Engagement Advisor, NZ Resuscitation Council

 

People who teach others to save lives have an outstanding commitment to health and safety. Both on and off the job, they help others in need. However, sometimes this very commitment can lead to teachers putting their own personal needs second. Learners need a physically and emotionally safe learning environment. There are multiple aspects that need consideration in the provision of effective, safe teaching.

Resuscitation can be a physically demanding skill to teach and practice. Chest compressions are an intense activity which is why they are practiced on manikins. For those performing them, they require the use of muscles and assumed postures that may not regularly be used outside of this activity. Learners should be informed of the physical requirements and demands before the learning activities begin and have the opportunity to discuss any concerns with the instructor.

The Australia & New Zealand Committee on Resuscitation (ANZCOR) Guideline 10.1 (Basic Life Support Training) provides some useful starting points for this discussion.

CPR training and actual performance is safe in most circumstances. Individuals undertaking Basic Life Support training should be advised of the nature and extent of the physical activity required during the training program. Learners who develop significant symptoms (e.g. chest pain, severe shortness of breath) during CPR should be advised to stop.

When correct procedure is followed, based on an informed understanding of teaching guidelines by trained instructors, it should be possible to avoid physical injury in all but exceptional cases. It is useful to stretch before and between practice, even when performing familiar activities as an instructor. As a general rule, rather than instructors and learners demonstrating skills on each other, clinical interventions should be practiced on manikins or anatomical models to avoid any potential for injury or harm. Should injury occur, a formal process for notification to others in the training team and the organisation should be available.

Educators will generally be familiar with Peyton’s four stage teaching method, sometimes summarised as demonstration, deconstruction, comprehension and execution. This approach is widely used around the world because it helps engage learners with differing learning needs and supports knowledge and skill retention. In essence, it relies on a combination of visual demonstrations, explanation and practice to make links between the theory and practice of a skill.

The four staged approach includes:

1. A silent demonstration, the instructor performing the skill in real-time without a commentary

2. The instructor repeating the skill sequence with an explanatory commentary

3. The instructor demonstrates the skill being guided by a learner’s commentary

4. Each learner demonstrates the skill giving their own commentary.

Emotional, cultural and spiritual safety are also factors that educators must take into account when teaching. The trauma that someone may have experienced in the past may not be known. Adult learners are very reflective, and instructors need to be mindful that learners may have any number of previous experiences and emotions reactivated by training activities. Many organisations will have Health and Safety policies in place, with systems to provide emotional support. There may be occasion where an individual may need help in seeking appropriate assistance from external agencies.

Modern society is, quite rightly, demanding a greater awareness of gender and cultural boundaries. CPR and first aid training and practice will at times require physical contact between individuals and facilitating this requires a respectful approach. Language barriers can also mean that learners find it hard to express their needs. Instructors need to be able to adapt to the needs of individuals and provide a supported learning environment for all.

With a combination of pre-planning, common sense, professionalism and empathy, most potential problems can be avoided. Learners leave training more knowledgeable and capable to respond to urgent or emergency situations. More importantly their empowerment to be able to respond will improve the likelihood of positive outcomes for those in need.

 


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