• Understanding the effects of stress, fear of infection, panic; how they interfere with performance; and what to do to overcome these barriers to action;

• Learning the importance of universal precautions and body substance isolation to provide protection from bloodborne pathogens and other potentially infectious materials. Learning about personal protective equipment — gloves, eye protection, masks, and respiratory barrier devices. Appropriate management and disposal of blood-contaminated sharps and surfaces; and awareness of OSHA’s Bloodborne Pathogens standard.

3. Assessing the Scene and the Victim(s) The training program should include instruction in the following:

• Assessing the scene for safety, number of injured, and nature of the event;

• Assessing the toxic potential of the environment and the need for respiratory protection;

• Establishing the presence of a confined space and the need for respiratory protection and specialized training to perform a rescue;

• Prioritizing care when there are several injured;

• Assessing each victim for responsiveness, airway patency (blockage), breathing, circulation and medical alert tags;

• Taking a victim’s history at the scene, including determining the mechanism of injury;

• Performing a logical head-to-toe check for injuries;

• Stressing the need to continuously monitor the victim;

• Emphasizing early activation of EMS;

• Indications for and methods of safely moving and rescuing victims;

• Repositioning ill/injured victims to prevent further injury.

4. Responding to Life-Threatening Emergencies

The training program should be designed or adapted for the specific worksite and may include first-aid instruction in the following:

• Establishing responsiveness;

• Establishing and maintaining an open and clear airway;

• Performing rescue breathing;

• Treating airway obstruction in a conscious victim;

• Performing CPR;

• Using an AED;

• Recognizing the signs and symptoms of shock and providing first aid for shock due to illness or injury;

• Assessing and treating a victim who has an unexplained change in level of consciousness or sudden illness;

• Controlling bleeding with direct pressure;

• Poisoning: Ingested poisons such as alkali, acid, and systemic poisons. Role of the Poison Control Center and how to reach it; inhaled poisons: carbon monoxide; hydrogen sulfide; smoke; and other chemical fumes, vapors, and gases. Assessing the toxic potential of the environment and the need for respirators;

• Knowledge of the chemicals at the worksite and of first aid and treatment for inhalation or ingestion;

• Effects of alcohol and illicit drugs so that the first-aid provider can recognize the physiologic and behavioral effects of these substances;

• Recognizing asphyxiation and the danger of entering a confined space without appropriate respiratory protection. Additional training is required if first-aid personnel will assist in the rescue from the confined space;

• Responding to medical emergencies, such as chest pain, stroke, breathing problems, anaphylactic reaction, hypoglycemia in diabetics taking insulin, seizures, pregnancy complications, abdominal injury, reduced level of consciousness, and an impaled object.

5. Responding to Non-Life-Threatening Emergencies

The training program should be designed for the specific worksite and include first-aid instruction for the management of the following:

• Wounds — assessment and first aid for wounds, including abrasions, cuts, lacerations, punctures, avulsions, amputations and crush injuries;

• Principles of wound care, including infection precautions;

• Principles of body substance isolation, universal precautions and use of personal protective equipment;

• Burns — Assessing the severity of a burn;

• Recognizing whether a burn is thermal, electrical, or chemical and the appropriate first aid;

• Reviewing corrosive chemicals at a specific worksite, along with appropriate first aid;

• Temperature Extremes — Exposure to cold, including frostbite and hypothermia;

• Exposure to heat, including heat cramps, heat exhaustion and heat stroke;

• Musculoskeletal Injuries, including fractures; sprains, strains, contusions and cramps;

• Head, neck, back and spinal injuries;

• Appropriate handling of amputated body parts;

• Temperature Extremes — Exposure to cold, including frostbite and hypothermia;

• Exposure to heat, including heat cramps, heat exhaustion and heat stroke;

• Musculoskeletal Injuries, including fractures; sprains, strains, contusions and cramps;

• Head, neck, back and spinal injuries;

• Appropriate handling of amputated body parts;

• First aid for eye injuries;

• First aid for chemical burns;

• Mouth and teeth injuries;

• Oral injuries; lip and tongue injuries; broken and missing teeth;