Pratical Exam

Question 1

Glove Removal

Answer 1

1. Pinch the palm side of one glove on the outside near your wrist.
2. Pull the glove toward your fingertips, turning it inside out as you
   pull it off your hand.
3. Hold the glove in the palm of your other (still-gloved) hand.
4. Carefully slip two fingers under the wrist of the other glove. Avoid
   touching the outside of the glove.
5. Pull the glove towards your fingertips, turning it inside out as you
   pull it off your hand. The other glove is now contained inside
6. Dispose of the gloves properly and wash your hands.

Question 2

Recovery Position

Answer 2

• Extend the person’s arm that is closest to you above the person’s head
• Roll the person toward yourself onto their side, so that the person’s head rests on their extended arm.
• Bend both of the person’s knees to stabilize the body

Question 3

Checking an Unconscious Person

Answer 3

• Check for responsiveness and breathing for about 5-10 seconds. Gasping is not breathing.
• If the person remiains unreponsive, call 911 or the DEN and obtain an AED and first aid kit.
• If the person is faced down, roll them over onto thier back.
• Immediately begin CPR and use an AED as soon as possible.

Question 4

Checking an Conscious Person

Answer 4

• Check for responsiveness and breathing for about 5-10 seconds. Gasping is not breathing.
• Call 911 or DEN obtain a first aid kit and AED.
• Interview Bystanders (SAMPLE) and do a head-to-toe check to gather more information

Question 5

CPR (Adult)

Answer 5

1. Verify that the person is unresponsive and
   not breathing.
   ■ Shout to get the person’s attention, using the
   person’s name if you know it. tap the person’s shoulder andshout again while checking for normal breathing.
   ■ If the person does not respond and is not
   breathing or only gasping, continue to step 2.
2. Place the person on their back on a firm, flat surface. Kneel beside the person.
3. Give 30 chest compressions.
   ■ Place the heel of one hand in the center of the
   person’s chest, with your other hand on top.
   Position your body so that your shoulders are
   directly over your hands.
   ■ Keeping your arms straight, push down at least
   2 inches, and then let the chest return to its
   normal position.
   ■ Push hard and push fast! Give compressions
   at a rate of between 100 and 120 compressions
   per minute.
   ▼
4. Give 2 rescue breaths.
   ■ Place the breathing barrier over the person’s
   nose and mouth.
   ■ Open the airway. (Put one hand on the forehead
   and two fingers on the bony part of the chin and
   tilt the head back to a past-neutral position.)
   ■ Pinch the nose shut and make a complete seal
   over the person’s mouth with your mouth.
   ■ Take a normal breath and blow into the person’s mouth for about 1 second, looking
   to see that the chest rises.
   ■ Take another breath, make a seal, then give the second rescue breath.
   Note: If the first rescue breath does not cause the chest to rise, retilt the head and ensure a
   proper seal before giving the second rescue breath. If the second breath does not make the
   chest rise, an object may be blocking the airway. After the next set of chest compressions and
   before attempting rescue breaths, open the mouth, look for an object and, if seen, remove it
   using a finger sweep. Continue to check the person’s mouth for an object after each set of
   compressions until the rescue breaths go in.
5. Continue giving sets of 30 chest compressions and 2 rescue breaths until:
   ■ You notice an obvious sign of life.
   ■ An AED is ready to use, and no other trained responders are available to assist you
   with the AED.
   ■ You have performed approximately 2 minutes of CPR (5 sets of 30:2), and another
   trained responder is available to take over compressions.
   ■ EMS personnel take over.
   ■ You are alone and too tired to continue.
   ■ The scene becomes unsafe

Question 6

CPR (Child)

Answer 6

1. Verify that the child is unresponsive and not breathing.
   ■ Shout to get the child’s attention, using the
   child’s name if you know it. If the child does
   not respond, tap the child’s shoulder and shout
   again while checking for normal breathing.
   ■ If the child does not respond and is not
   breathing or only gasping, continue to step 2.
   ▼
2. Place the child on their back on a firm, flat surface. Kneel beside the child.
   ▼
3. Give 30 chest compressions.
   ■ Place the heel of one hand in the center of
   the child’s chest, with your other hand on top.
   Position your body so that your shoulders are
   directly over your hands. (Alternatively, in a
   small child, you can use a one-handed CPR
   technique: place the heel of one hand in the
   center of the child’s chest.)
   ■ Keeping your arms straight, push down about 2 inches, and then let the chest
   return to its normal position.
   ■ Push hard and push fast! Give compressions at a rate of between 100 and
   120 compressions per minute.
   ▼
4. Give 2 rescue breaths.
   ■ Place the breathing barrier over the child’s nose
   and mouth.
   ■ Open the airway. (Put one hand on the forehead
   and two fingers on the bony part of the chin and tilt
   the head back to a slightly past-neutral position.)
   ■ Pinch the nose shut and make a complete seal over the child’s mouth with
   your mouth.
   ■ Take a normal breath and blow into the child’s mouth for about 1 second, looking to
   see that the chest rises.
   ■ Take another breath, make a seal, then give the second rescue breath.
5. Continue giving sets of 30 chest compressions and 2 rescue breaths until:
   ■ You notice an obvious sign of life.
   ■ An AED is ready to use, and no other trained responders are available to assist you
   with the AED.
   ■ You have performed approximately 2 minutes of CPR (5 sets of 30:2), and another
   trained responder is available to take over compressions.
   ■ You have performed approximately 2 minutes of CPR (5 sets of 30:2), you are alone
   and caring for a child, and you need to call 9-1-1 or the designated emergency number.
   ■ EMS personnel take over.
   ■ You are alone and too tired to continue.
   ■ The scene becomes unsafe.

Question 7

CPR (Infant)

Answer 7

1. Verify that the infant is unresponsive and not breathing.
   ■ Shout to get the infant’s attention, using the
   infant’s name if you know it. If the infant does not
   respond, tap the bottom of the infant’s foot and
   shout again while checking for normal breathing.
   ■ If the infant does not respond and is not breathing
   or only gasping, continue to step 2.
   ▼
2. Place the infant on their back on a firm, flat surface. Stand or kneel next to the infant.
   ▼
3. Give 30 chest compressions.
   ■ Place one hand on the infant’s forehead.
   ■ Place the pad of two fingers on the center of the
   infant’s chest, just below the nipple line.
   ■ Compress the chest about 1½ inches, and then
   let the chest return to its normal position.
   ■ Push hard and push fast! Give compressions at a
   rate of between 100 and 120 compressions per minute.
   ▼
4. Give 2 rescue breaths.
   ■ Place the breathing barrier over the infant’s nose
   and mouth.
   ■ Open the airway. (Put one hand on the forehead
   and two fingers on the bony part of the chin and
   tilt the head back to a neutral position.)
   ■ Make a complete seal over the infant’s nose and
   mouth with your mouth.
   ■ Take a normal breath and blow into the infant’s nose and mouth for about 1 second,
   looking to see that the chest rises.
   ■ Take another breath, make a seal, then give the second rescue breath.
   Note: If the first rescue breath does not cause the chest to rise, retilt the head and ensure a
   proper seal before giving the second rescue breath. If the second breath does not make the
   chest rise, an object may be blocking the airway. After the next set of chest compressions and
   before attempting rescue breaths, open the mouth, look for an object and, if seen, remove
   it using a finger sweep. Continue to check the infant’s mouth for an object after each set of
   compressions until the rescue breaths go in.
5. Continue giving sets of 30 chest compressions and 2 rescue breaths until:
   ■ You notice an obvious sign of life.
   ■ An AED is ready to use and no other trained responders are available to assist you
   with the AED.
   ■ You have performed approximately 2 minutes of CPR (5 sets of 30:2) and another
   trained responder is available to take over compressions.
   ■ You have performed approximately 2 minutes of CPR (5 sets of 30:2), you are
   alone and caring for an infant, and you need to call 9-1-1 or the designated
   emergency number.
   ■ EMS personnel take over.
   ■ You are too tired to continue.
   ■ The scene becomes unsafe

Question 8

Choking Conscious (Adult and Child)

Answer 8

When a responsive adult or child is choking, give a combination of 5 back blows (blows between the shoulder blades) followed by 5 abdominal thrusts (inward and upward thrusts just above the navel). The goal of giving back blows and abdominal thrusts is to force the object out of the
airway, allowing the person to breathe.

Question 9

Choking Conscious (Infant)

Answer 9

When a responsive infant is choking, give a combination of 5 back blows followed by 5 chest thrusts (instead of abdominal thrusts). You can sit, kneel or stand to give first aid care to a choking infant, as long as you are able to support the infant on your thigh with the infant’s head lower than their chest. If the infant is large or your hands are small, you may find it easiest to sit or kneel.

Question 10

Choking Unconscious (All)

Answer 10

f a person who is choking becomes unresponsive, carefully lower them to the ground and begin CPR, starting with chest compressions. After each set of chest compressions and before attempting rescue breaths, open the person’s mouth and look for the object. If you see an object in the person’s mouth, remove it using your finger. Never put your finger in the person’s mouth unless you actually see the object. If you cannot see the object and you put your finger in the person’s mouth, you might accidentally push the object deeper into the person’s throat.

Question 11

AED

Answer 11

1. Turn on the AED and follow the voice prompts.
   ▼
2. Remove all clothing covering the chest and, if necessary, wipe the chest dry.
   ▼
3. Place the pads.
   ■ Place one pad on the upper right side of the
   chest and the other on the lower left side of
   the chest below the armpit.
   ■ If the pads may touch (e.g., on an infant or
   small child), place one pad in the middle of the
   chest and the other pad on the back between
   the shoulder blades.
   ▼
4. Plug the connector cable into the AED, if necessary.
5. Prepare to let the AED analyze the
   heart’s rhythm.
   ■ Make sure no one, including you, is
   touching the person. Say, “EVERYONE
   CLEAR!” in a loud, commanding voice.
   ■ If the AED tells you to, push the “analyze”
   button to start this process.
   ▼
6. Deliver a shock, if the AED determines one
   is needed.
   ■ Make sure no one, including you, is
   touching the person. Say, “EVERYONE
   CLEAR!” in a loud, commanding voice.
   ■ Push the “shock” button to deliver
   the shock.
   ▼
7. After the AED delivers the shock, or if no shock is advised:
   ■ Immediately begin CPR, starting with compressions. Continue giving CPR (about
   2 minutes, or 5 sets of 30:2) until prompted by the AED.
   ■ Continue giving CPR and following the AED’s prompts until you see an obvious sign
   of life or EMS personnel arrive.

Question 12

Arm Splint

Answer 12

Do not move or straighten the injured area. Stabilize the injury in the
position found.
■ Control any external bleeding with direct pressure, unless the bleeding is
located directly over a suspected fracture. With a fracture, apply pressure
around the area. Always wear disposable latex-free gloves or use another
protective barrier.
■ If you must transport or move the person, and it does not cause more pain,
splint an upper arm injury using a padded rigid splint on the outside of the arm.
{ If the elbow can be comfortably bent, place the upper extremity in a
sling and binder to further stabilize the injury.
{ If the elbow cannot be comfortably bent, or if the rigid splint you
are using is longer than the upper arm, keep the arm straight at the
person’s side and wrap bandages or binders around the arm and
chest.
■ Apply a cold pack.
■ Take steps to minimize shock. Most people with an injured shoulder or upper arm will prefer to be in a
seated or semi-recumbent position and will have difficulty lying down.

Question 13

Sling

Answer 13

1. Get consent.
2. Support the injured part.
   ■ Support both above and below the site of
   the injury.
3. Check for circulation.
   ■ Check for feeling, warmth and color beyond
   the injury.
4. Position the sling.
   ■ Place a triangular bandage under the injured arm
   and over the uninjured shoulder to form a sling.
   Applying a Sling and Binder Continued
5. Secure the sling.
   ■ Tie the ends of the sling at the side of the neck.
   TIP: Pad the knots at the neck and side of the binder
   for comfort.
6. Bind with the bandage.
   ■ Bind the injured body part to the chest with a
   folded triangular bandage.
7. Recheck for circulation.
   ■ Recheck for feeling, warmth and color.

Question 14

Care for Major Bleeding

Answer 14

A major open wound (for example, one that involves extensive tissue damage or is bleeding heavily or uncontrollably) requires prompt action. Call 9-1-1 or the designated emergency number immediately and then take steps to control the bleeding until help arrives.
Put on disposable latex-free gloves and other PPE as necessary (for example, if blood is spurting, you may need to wear eye and face protection). Cover the area with a sterile gauze pad or other clean dressing and apply direct pressure with your gloved hand until the bleeding stops. This may take as long as 15 minutes. If blood soaks through the first dressing, place another dressing on top of the first and apply additional direct pressure (press harder than you did before, if possible). Repeat with additional dressings as needed, always maintaining direct pressure. Do not remove the blood-soaked dressings because disturbing them may disrupt clot formation and restart the bleeding. When the bleeding stops, check the skin on the side of the injury farthest away from the heart (e.g., the hand or foot) for feeling, warmth and color. Then apply a bandage over the dressing to maintain pressure on the wound and to hold the dressing in place. To apply a roller bandage, hold one end of the roller bandage in place while you wrap the other end around the wound and dressing several times, using overlapping turns. Make sure the dressing is completely covered and allow a margin of several inches on all sides. Tie or tape the bandage to secure it. The bandage should be snug but not too tight. Check for feeling, warmth and color again. If there is a change in feeling, warmth or color from your first check (for example, the skin is cooler or paler than it was before, the area is swollen, or the person complains of a numb or tingly feeling), then the bandage is too tight and needs to be loosened.

Question 15

Care for Minor Wounds

Answer 15

To care for a minor open wound, put on disposable latex-free gloves and other personal protective equipment (PPE) as necessary. Apply direct pressure with a gauze pad to stop the bleeding. It may take several minutes for the bleeding to stop. After the bleeding stops, wash the area with soap and warm water. Rinse under warm running water for about 5 minutes until the wound appears clean and free of debris, and then dry the area. Apply a small amount of antibiotic ointment, cream or gel to the wound if the person has no known allergies or sensitivities to the ingredients. Then cover the area with a sterile gauze pad and a bandage, or apply an adhesive bandage. When you are finished giving care, wash your hands with soap and water, even if you wore gloves.

Question 16

Care for Second Degree Burns

Answer 16

Check the scene for safety by performing a scene
size-up and only approach if it is safe to do so.
■ Stop the burning process by removing the
person from the source of the burn.
■ Check for life-threatening conditions.
■ As soon as possible, cool the burn with
large amounts of cold running water for at
least 10 minutes or until pain is relieved
(Figure 10-23, A). Be careful to not cause
hypothermia when cooling large burns or burns on
small children, who are more prone to hypothermia
than adults due to their greater skin surface area.
■ If possible, have the injured person remove
all rings, bracelets or watches from a burned
extremity. Once the extremity swells, this will be
much more difficult to do.
■ Cover the burn loosely with a dry, sterile dressing
(Figure 10-23, B).
■ Take steps to minimize shock. Have the person
lie down flat on their back and prevent them from
getting chilled or overheated.
■ Comfort and reassure the person.

Question 17

Open Abdominal Wound

Answer 17

Put on disposable latex-free gloves or use
another barrier.
■ Do not apply direct pressure.
■ Do not push any protruding organs back into
the open wound.
■ Remove clothing from around the wound
(Figure 14-8, B).
■ Apply a moist (clean, warm tap water can be
used), sterile or clean dressing loosely over the
wound (Figure 14-8, C).
■ Cover the dressing loosely with plastic wrap,
if available, making an occlusive dressing.
■ Cover the dressing lightly with a folded towel
to maintain warmth (Figure 14-8, D).
■ Keep the person from getting chilled
or overheated.

Question 18

Rib Splint

Answer 18

■ Have the person rest in a position that will make
breathing easier. Encourage the person to breathe
normally if tolerated. Do not move the person if you
suspect a head, neck or spinal injury.
■ Call 9-1-1 or the designated emergency number.
■ Give the person a blanket or pillow to hold against
the fractured ribs to support and immobilize the area
(Figure 14-5).
■ Use a sling and binder to hold the person’s arm
and/or blanket or pillow against the injured side of
the chest.
■ Monitor breathing.
■ Take steps to minimize shock.

Question 19

Sucking Chest Wound

Answer 19

Open chest wounds are due to puncture wounds and range from minor to life threatening. Most injuries to the chest have minor amounts of external bleeding but they can cause more severe, life-threatening internal bleeding. Stab and gunshot wounds are examples of penetrating injuries that may cause an open chest wound.
If the injury penetrates the rib cage and is large enough to remain open, air can pass freely in and out of the chest cavity, and the person cannot breathe normally (Figure 14-6). With each breath the person takes, you hear a sucking sound coming from the wound (although the sound might not be easily heard in a noisy environment). This sound is the primary sign of a penetrating chest injury called a sucking chest wound. Without proper care, the person’s condition will worsen. The affected lung or lungs will fail to function, and breathing will become more difficult.

Question 20

Epi-pen Aid

Answer 20

Different brands of epinephrine auto-injectors are available but all work in a similar fashion. Begin by holding the person’s leg firmly just above the knee to help prevent injury to the person, and then activate the device by pushing it against the person’s mid-outer thigh. Once activated, the device injects the epinephrine into the thigh muscle. The device must be held in place for the recommended amount of, (although the recommended time may vary by device) to deliver the medication. Some medication may still remain in the auto-injector even after the injection is complete. After removing the auto-injector, massage the injection site for several seconds (or have the person massage the injection site). Handle the used device carefully to prevent accidental needlestick injuries. Place the device in a rigid container, and then give the container to EMS personnel for proper disposal.

Question 21

Anatomical Leg Splint

Answer 21

Do not move or straighten the injured area. Stabilize the injury in the position found. Do not forget that the ground acts as an adequate splint. If the person’s lower extremity is supported by the ground, do not move it. Rather, use rolled towels or blankets to support the leg in the position in which you found it.
■ Control any external bleeding with direct pressure, unless the bleeding is located directly over a suspected fracture. With a fracture, apply pressure around the area. Always wear disposable latex-free gloves or use another protective barrier.
■ Call 9-1-1 or the designated emergency number immediately.
■ If you must transport or move the person, and it does not cause more pain, you can create an anatomic splint by securing the injured lower extremity to the uninjured lower extremity with
several wide cravats placed above and below the site of the injury:
{ If one is available, place a pillow or rolled blanket between the lower extremities and bind them together above and below the site of the injury.
■ Apply a cold pack.
■ Take steps to minimize shock.

Question 22

Ankle Splint

Answer 22

Do not move or straighten the injured area.
Stabilize the injury in the position found.
■ Control any external bleeding with direct
pressure, unless the bleeding is located directly
over a suspected fracture. With a fracture,
apply pressure around the area. Always wear
disposable latex-free gloves or use another
protective barrier.
■ If you must transport or move the person, and it
does not cause more pain, immobilize the entire
foot and ankle by using a soft splint, such as a
pillow or rolled blanket (Figure 12-16). Wrap the
injured area with the soft splint, and secure it
with two or three cravats.
■ Apply a cold pack.
■ Take steps to minimize shock.

Question 23

Embedded Object Care

Answer 23

In some cases, an object that causes a wound may remain in the wound. If the embedded object is large (for example, a large piece of glass or metal), do not attempt to remove it. Any movement of the object can result in further tissue damage. Call 9-1-1 or the designated emergency number and put on disposable latex-free gloves. Place several dressings around the
object to begin to control blood loss, and then pack bulk dressings or roller bandages around the embedded object to keep it from moving Bandage the bulk dressingsor roller bandages in place around the object. Remember to monitor the person for signs and symptoms of shock. Wash your hands immediately after giving care.
A small partially embedded object, such as a small splinter less than a ¼ inch in size, can usually be removed using first aid techniques; however, medical care should be sought if the splinter is deep, completely embedded in the skin, located under the nail or in the eye, or if there is severe pain upon trying to remove it. To remove a simple shallow splinter, grasp the end of the splinter with clean tweezers and pull it out.
After removing the splinter from the skin, wash the area with soap and water and rinse the area with tap water for about 5 minutes. After drying the area, cover it with a dressing and bandage to keep it clean. Apply antibiotic ointment or wound gel to the dressing first if there are no known allergies or sensitivities to the medication.
If the splinter is embedded in the eye, do not attempt to remove it. Call 9-1-1 or the designated
emergency number

Question 24

Nosebleed

Answer 24

In most cases, you can stop a nosebleed by having the person pinch their nostrils together while sitting with the head slightly forward (Figure 13-7). (Sitting with the head slightly forward helps to keep blood from pooling in the back of the throat, which can lead to choking or, if the blood is swallowed, vomiting). Keep the nostrils pinched shut for at least 5 minutes before checking to see if the bleeding has stopped. If the bleeding has not stopped after 5 minutes, keep pinching the nostrils shut for another 5 minutes. If the bleeding is severe or gushing, call 9-1-1 or the designated emergency number.

Question 25

Tourniquetting

Answer 25

Severe, life-threatening bleeding that
cannot be controlled using direct pressure.
■ A physical location that makes it impossible to
apply direct pressure to control the bleeding
(e.g., the injured person or the person’s limb is
trapped in a confined space).
■ Multiple people with life-threatening injuries
who need care.
■ A scene that is or becomes unsafe