A M E R I C A N S A F E T Y & H E A LT H I N S T I T U T E
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1 A M E R I C A N S A F E T Y & H E A LT H I N S T I T U T E
2 American Safety & Health Institute 1450 Westec Drive Eugene, OR USA ashinstitute.org Copyright 2008 by American Safety & Health Institute. All Rights Reserved. Revised Second Edition November No part of the material protected by this copyright notice may be reproduced or utilized in any form, electronic or mechanical, including photocopying, recording, or by any information storage and retrieval system, without written permission from the American Safety & Health Institute. The procedures and protocols in this book are furnished for informational use only and are subject to change without notice. The publisher, however, makes no guarantee as to, and assumes no responsibility for, the correctness, sufficiency, or completeness of such information or recommendations. Other or additional emergency, safety, or health measures may be required under particular circumstances. Printed in the United States of America. INSTO2-5 (3/08)
3 Preface Emergency Oxygen Administration ASHI is a member of the National First Aid Science Advisory Board co-founded by the American Red Cross and American Heart Association, Inc., and a contributor to the 2005 Consensus of First Aid Science and Treatment Recommendations. Emergency Oxygen Administration is based upon the following standards, guidelines, regulations, and recommendations: ASTM International Standard F Standard Guideline Defining the Performance of First Aid Providers in Occupational Settings April National Guidelines for First Aid Training in Occupational Settings. Guidelines for a first aid oxygen administration enrichment program. National First Aid Science Advisory Board. American Heart Association and the American National Red Cross. Compressed Gas Association. U.S. Department of Transportation. ASHI offers training and certification programs in emergency care and occupational safety and health for corporate America, government agencies, and emergency responders. To learn more about ASHI, visit ASHI has used reasonable effort to provide up-to-date, accurate information that conforms to generally accepted recommendations at the time of publication. Science and technology are constantly creating new knowledge and practice. Like any printed material, this publication may become out of date over time. Guidelines for safety and recommendations for treatment cannot be given that will apply in all cases as the circumstances of each incident often vary widely. These recommendations supersede recommendations made in previous ASHI programs. Alert Emergency Medical Services (EMS) or activate your emergency action plan immediately if you are not sure an emergency exists or when any victim is unresponsive, badly hurt, looks/acts very ill or quickly gets worse. Signs and symptoms may be incomplete and can vary from person to person. Do not use the information in this program as a substitute for professional evaluation and diagnosis from an appropriately qualified and licensed physician or other health care provider. Local or organizational physician-directed practice protocols may supersede recommendations in this program. Municipal, state, provincial, national or federal regulations are governmental orders having the force of law. In the United States, Canada and most other industrialized countries, workplace safety regulations and occupational licensing requirements prescribe scope of practice, rules, standards and conditions that every training agency, program, Instructor and licensed person must comply with. ASHI Training Centers and their authorized Instructors must be completely familiar with the regulations and licensing requirements of persons to whom they offer training and certification. Training Centers and authorized Instructors must not advertise, represent or otherwise promote that their programs will meet specific regulations or licensing requirements unless and until such is confirmed with the licensing authority and/or ASHI. American Safety & Health Institute 4148 Louis Avenue Holiday, FL USA Copyright 2007 by American Safety & Health Institute. All Rights Reserved. Revised First Edition January 2007 No part of the material protected by this copyright notice may be reproduced or utilized in any form, electronic or mechanical, including photocopying, recording or by any information storage and retrieval system, without written permission from the American Safety & Health Institute. The procedures and protocols in this book are furnished for informational use only and are subject to change without notice. The publisher, however, makes no guarantee as to, and assumes no responsibility for, the correctness, sufficiency or completeness of such information or recommendations. Other or additional emergency, safety or health measures may be required under particular circumstances. Printed in the United States of America. 1
4 Table of Contents Emergency Oxygen Administration Program Standards...3 Core Knowledge Objectives...4 Core Skill Objectives...4 Recommended Course Schedule...5 Program Description...5 Instructional Approach...6 Presentation Materials...6 Instructional Approach...10 Written Exams and Performance Evaluation...11 Administration and Classroom Management...12 Health and Safety Precautions...13 Classroom Environment...13 Rate Your Program...14 Americans with Disabilities Act...14 Section 1: Introduction...16 Section 2: Emergency Oxygen Equipment...24 Section 3: Safety and Storage...28 Section 4: Emergency Oxygen Maintenance...32 Section 5: Emergency Action Plan Considerations...36 Section 6: Emergency Action Steps...39 Section 7: Conclusion...44 *NOTE: Written Exams, Performance Evaluations, Course Roster and Student Skill Record are located on the accompanying CD. 2
5 Emergency Oxygen Administration Program Standards Program name Intended audience Prerequisites Required training materials Recommended initial instruction time Recommended renewal instruction time Maximum student-toinstructor ratio Maximum student-tooxygen system ratio Successful completion (certification) Certification period Notes Emergency Oxygen Community and workplace lay rescuers. BLS/CPR (with or without an AED) and Basic First Aid (may be taught concurrently). Emergency Oxygen Administration student text (one per participant), Emergency Oxygen Administration Instructor Guide (one per instructor). About 3 hours. About half the initial instruction time 12:1 (24:1 with assistant instructor). 6:1 Written Exam: Recommended for designated responders * (70% or better on the 14-question written test) Performance Evaluation: Required for all (perform competently without assistance). Up to 2 years, recommended annually. 1. Be prepared for this program by researching the specific emergency oxygen system and delivery devices participants will be using. Be familiar with any local or state emergency oxygen administration regulations and policies. 2. Instructors bear the responsibility of ensuring that each participant meets the skill objectives for successful completion. 3. Occupational regulatory or licensing agencies may require written tests, additional content, additional hours of instruction, or other practices. 4. Recommended instruction time may be reduced via self-instruction, blended learning, or challenges. * Duty or employer expectation to respond. This refers to training in which the knowledge elements reside on a computer or online and the skill elements are demonstrated and practiced in the classroom. Only ASHI-approved web-based media content may be used. 3
6 Emergency Oxygen Administration Core Knowledge Objectives Method: Instructor-led lecture or group discussion and self-instruction (computer resident or Web-based) 1. Explain the importance of emergency oxygen. 2. Describe the difference between emergency oxygen and medical oxygen. 3. Identify the parts of an emergency oxygen system and understand their function. 4. Describe safe storage practices. 5. Describe safe handling practices. 6. Explain when and how to check, maintain, and clean an oxygen system. 7. -Describe an emergency action plan for emergency oxygen use. 8. Explain when and how to administer emergency oxygen. Core Skill Objectives Method: Physical skill demonstration by student in classroom assessed by authorized instructor 1. Demonstrate how to assemble an emergency oxygen system. 2. Demonstrate how to turn an emergency oxygen system on and off and determine if oxygen is flowing. 3. Demonstrate how to attach tubing to a delivery mask. 4. Demonstrate how to safely and correctly integrate use of emergency oxygen when attending to a responsive victim who is breathing. 5. Demonstrate how to safely and correctly integrate use of emergency oxygen when attending to an unresponsive victim who is breathing. 6. Demonstrate how to safely and correctly integrate use of emergency oxygen when attending to an unresponsive victim who is not breathing (may be integrated into CPR performance evaluation) Challenging the Program Experienced students may wish to challenge the Emergency Oxygen Administration course by demonstrating adequate (competent) performance of skills. Skills must be adequately (competently) performed. Participants must arrive prepared for skill testing and must perform competently without assistance on each skill or perform competently without assistance on all three performance evaluations. A warm-up or skills review session may be conducted before the challenge, but must be clearly separated from the challenge itself. Students who cannot perform competently without assistance have not successfully completed the course. If unsuccessful, students seeking certification must complete a full course. 4
7 Recommended Course Schedule Emergency Oxygen Administration Break for at least 5 minutes each hour. Section Time (minutes) Section 1: Introduction 20 Section 2: Emergency Oxygen Equipment 15 Section 3: Safety and Storage 15 Section 4: Emergency Oxygen Maintenance 15 Section 5: Emergency Action Plan Considerations 15 Section 6: Emergency Action Steps 60 Section 7: Conclusion 33 Breaks 15 Total approximate minutes 188 Total approximate hours 3 Program Description Goal The goal of this program is to provide learners a valuable and enjoyable hands-on training experience. The fundamental objective is to teach a simple, practical approach that helps students develop the knowledge, skills, and the confidence necessary to provide first aid care with emergency oxygen for all suddenly ill or injured victims. Definition For the purpose of this program, emergency oxygen is defined as a device has a constant fixed flow rate of not less than six (6) liters per minute that provides oxygen for a minimum of 15 minutes. This program is intended for individuals who do not work in the healthcare field but are required or desire proper training in the first aid use of emergency oxygen, including emergency response teams in business and industry. American Safety and Health Institute (ASHI) certification may only be issued when an ASHI-authorized Instructor verifies the student has successfully completed and competently performed the required core knowledge and skill objectives of this program. Integration This program is designed as a supplement to - not a replacement for - formal training in basic life support (CPR/AED) and first aid. Emergency Oxygen Administration may be integrated with other ASHI Programs where necessary or desired. Shared skill and knowledge objectives need not be repeated. Each student is required to have the approved Student Handbook for each program. Take Home books are strongly recommended. Program standards, including student-to-instructor ratios, must be maintained. 5
8 Emergency Oxygen Administration Endnotes 1 RH Dave Developing and Writing Behavioral Objectives', Simpson E. J. The Classification of Educational Objectives in the Psychomotor Domain. Washington, DC: Gryphon House First Aid Training Curriculum Guidelines. Washington State Dept. of Labor and Industries. Available: [19-Sep-05] 4 National Guidelines for First Aid Training in Occupational Settings, Course Guide (Revised May 2002) 2nd Ed. [Online]. Available: [19-Sep-05]. 5 G. Gibbs Twenty terrible reasons for lecturing, SCED Occasional Paper No. 8, Birmingham Oxford Centre for Staff and Learning Development Available: [16-Sep-05] 6 Conscious Competence Learning Model (Chapman A). Available: [19-Sep-05] 7 National Institute for Occupational Safety and Health, Fatality Assessment and Control Evaluation (FACE) Program. Available: [22-Sep-05] 8 National Guidelines for Educating EMS Instructors. Module 17: Teaching Psychomotor Skills Available: [11-Nov-05] 9 Romizowski, AJ. Basic Steps of Development of Skills Sandman PM. Worst Case Scenarios. Available: [16-Nov-05] 11 Problem-Based Learning. USC Center For Craniofacial Molecular Biology. Available: [16-Sep-05] 12 Sivasailam T, Stolovitah HD, Instructional Simulation Games, in: The Instructional Design Library, Educational Technology Publications, Englewood Cliffs, NJ. 1978: Burgstahler S. Universal Design of Instruction: Definition, Principles, and Examples. Available: [3-Jan-06] 14 National Guidelines For Educating EMS Instructors. August 2002 Available: [3-Jan-06] 15 Student Teacher Achievement Ratio (STAR) Project. Class Size. Research Health & Education Research Operative Services, Inc. Available: [16-Sep- 05]. 16 U.S. Department of Justice. Available: [19-Oct-05]. 17 U.S. Department of Labor, Occupational Safety & Health Administration Bloodborne Pathogens (29CFR ) IX. Summary and Explanation of the Standard Available: [5-Mar- 06] 18 Safe Handling of Compressed Gases in Containers, Compressed Gas Association, Inc. 4/14/2000 [18- Jul-06] 45
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