Trainer’s Manual Health Clinic ໂຮງໝນ ອຍ CPR First Aid Trainning for VHV First Aid for National Village Health Volunteers By: Lao National First Aid Curriculum Development Technical Working Group Forward According to the International Federation of Red Cross and Red Crescent Societies, First Aid is defined as “immediate help provided to a sick or injured person until professional help arrives. It is concerned not only with physical injury or illness but also with other initial care, including psychosocial support for people suffering emotional distress from experiencing or witnessing a traumatic event”1. First Aid is considered a key component of emergency care, as it can help to improve the chance of survival and reduce the effects of all types of injuries, including those caused by natural disasters, motor accidents, and in the case of Lao PDR in particular, those caused by Unexploded Ordnance (UXOs). Having first responders at the village level who are trained in basic First Aid is an important step towards effective emergency intervention. This is particularly essential in remote areas where sub-district health centers and hospitals are not immediately accessible. In rural Laos, this first responder role often falls on Village Health Volunteers (VHV) and Village Health Committees. In the past, several government and non-government agencies have worked to create First Aid training materials and provide First Aid trainings for these key community health workers. However, this work was being done in isolation and with little consensus between stakeholders regarding training content. This resulted in varying training materials, training duration, and outcomes connected to First Aid knowledge and skills across Laos. Therefore, in an effort to create consistency and ensure high Quality First Aid training for VHV and other first responders throughout the country, the Center for Medical Rehabilitation has worked in collaboration with World Education, Laos and the First Aid Technical Working Group and with the oversight of the Ministry of Health to identify VHV First Aid competencies and subseQuently create the curriculum and training materials provided in this manual. This curriculum was piloted on three separate occasions in Sangthong District, Vientiane Province and Sekong Province during 2014. The pilot results provided a basis on which to revise and adapt contents and activities and create a curriculum to better meet the needs of Laos Village Health Volunteers. This manual is a resource for First Aid instructors. It is divided into three sections. Section One, “Notes to the Trainer”, provides information and guidelines regarding the implementation of the curriculum in accordance with its intentional design. It also includes training data collection and assessment tools. Section Two consists of lesson plans for 18 Core Sessions based on VHV First Aid competencies and basic First Aid principles. It is designed to be facilitated over a training period of three days. Section Three includes seven Optional Sessions that can be utilized in follow-up trainings. Lesson 1 IFRC, IFRC International First Aid and Resuscitation Guidelines 2011, p. 13. plans for Core and Optional Sessions include learning objectives, lists of materials needed, estimated duration, key first aid and medical content, learning activities and assessments. We acknowledge that, while aligned with international standards and intentionally designed for the context, this manual is not without fault or error. As a result, the creators welcome any comments or suggestions on the manual itself that will increase the overall effectiveness of First Aid training in Laos. We want to thank the Technical First Aid Working Group members, pilot participants in Sangthong and Sekong, and all those who were actively involved in the process of creating this manual. Without a doubt, your support and participation has been a key factor in efforts to ensure consistent and high Quality First Aid training for Village Health Volunteers across the country. Vientiane Capital, Laos November 2014 VHV First Aid Curriculum Table of Contents Notes to the Trainer Training Duration……………………………………………………………………………………..…………1 Core Topics………………………………………………………………………………………………..……….1 Additional Topics……………………………………………………………………..…………………………2 Training Agenda…………………………………………………………………………….……………………3 Organization……………………………………………………………………………………………………….5 Curriculum Activities…………………………………………………………………………………………..6 Assessment……………………………………………………………………………………..………………….7 Adapting the Curriculum…………………………………………………………………………………….9 Do’s and Don’ts…………………………………………………………………………………………………10 Documentation……………………………………………………………………………….………………..11 Lesson Plans (Core Topics) Day 1 1. Introduction to First Aid…………………………………………………………..……………………13 2. First Aid Principles and Action Plan…………………………………….…………………………26 3. Trauma and Community Support……………………………………….…………………………34 4. Basic Body Functions and Basic Life Support……………………..………………………….42 5. CPR: Unconscious and Not Breathing……………………………….…………………………..51 6. Choking………………………………………………………………………….……………………………..60 Day 2 7. First Aid Kit……………………………………………………………………..…………………………….68 8. Bleeding Control……………………………………………………………………………………………75 9. Wound Care………………………………………………………………………………………………….83 10. Bone and Joint Injuries………………………………………………………………………………..92 11. Head Trauma and Spinal Cord Injuries………………………………………………………100 12. Patient Transfer………………………………………………………………………………………..110 Day 3 13. Burns…………………………………………………………………………………………………………125 14. Animal Bites and Stings……………………………………………………..………………………132 15. Documenting Care: Introduction to Keeping Log Books……………….……………145 Final Review Game……………………………………………………………………………….…………156 Final Assessment: Post-Test, Simulations………………………………………………..………165 Final Reflection………………………………………………………………………………………….……177 Lesson Plans (Optional Topics) 16. Introduction to UXOs (Awareness and Prevention)……………………………………181 17. UXO Injuries………………………………………………………………………………………………189 18. Near-Drowning……………………………………………………………………………………….…197 19. Heart Attack………………………………………………………………………………………………206 20. Foreign Bodies…………………………………………………………………………………………..213 21. Fainting and Shock………………………………………………………………………………….…219 22. Strategies for Maintaining First Aid Knowledge and Skills………….………………226 Dear Trainer, The VHV First Aid Trainer’s Manual is a designed to include all the resources you will need to ensure that your training participants meet the First Aid learning objectives. The following sections highlight key information that will help you know how to best utilize all of the components included in this comprehensive tool. Duration The VHV First Aid curriculum has been designed as a 3-day training. Each day is a full day, with lunch and breaks. It is advised that you do not shorten the training, as it will be difficult to meet all of the learning objectives in a shorter amount of time (See Core Topics below) Core Topics (Required) Core Topics are the primary topics of this curriculum. Village Health Volunteers must know about and be able to follow the first aid procedures connected to these topics. It is the trainer’s responsibility to ensure that all participants of the First Aid training meet the learning objectives related to all of these topics. • Definition of First Aid • Bleeding Control • VHV Roles and Responsibilities for • Wound Cleaning First Aid • Bone and Joint Injuries • Use of the First Aid Kit • Head Trauma • First Aid Action Plan • Spinal Cord Injuries • Psychological First Aid • Patient Transfer • Basic Body Functions • Burns • Basic Life Support • Animal Bites and Stings • CPR • Choking • Documenting Care Core Topics (required) Day 1 Day 2 Day 3 1 Additional Topics (Optional) The curriculum includes lesson plans and resources for topics in addition to the core topics identified above. Trainers, organizations and participants can select from these topics in order to better address the needs of a particular community. These topics can be taught in addition to, not in place of the core topics. Therefore, an extra day must be added to the three-day training, or the topics can be taught at a later date in a follow-up or additional training. • UXOs (2 lessons available) • Near-Drowning • Fainting • Shock • Foreign objects (in the ear, eye, nose, etc.) • Heart Attack • Strategies for Maintaining First Aid Knowledge Core Topics (required) Day 1 Day 2 Day 3 Additional Topics Follow-up (optional) Trainings Day 4 2 Agenda (3 days) The following is a suggested sequence and estimated duration of the Core Topics of the curriculum. Please note that breaks are not included below. You can schedule 10-minute breaks (one in the morning and one in the afternoon) as they best fit into the schedule each day (i.e. between two sessions) Day 1 Session Topic Estimated Duration 1. Introduction to First Aid (including Opening Ceremony, Pre-Test, Training Schedule, VHV roles and responsibilities, 2 hours definition of First Aid) 2. First Aid Action Plan (Assess the scene, make a plan, implement the plan, evaluate and continued care) 30 minutes MORNING (3.5 hours) 3. Trauma and Community Support 1 hour 4. Basic Body Functions and Basic Life Support (including 1 hour 25 minutes recovery position) hours) 5. CPR: Unconscious and Not Breathing 1 hour 15 minutes 50 minutes AFTERNOON (3.5 6. Choking 3 Day 2 Session Topic Estimated Duration Morning Review (answer any questions and review any difficult skills and knowledge from Day 1 according to the participants’ 30 minutes needs) 7. First Aid Kit 30 minutes