CPR Revision Session

CPR (cardiopulmonary resuscitation) is the bread and butter of first aid. We usually cover it right at the beginning of all the first aid we do and rightly see it as one of the most important things we learn/teach! Yet despite this assumption that we should be really good at it, after this initial learning we quite often forget to review it or just assume that we will still be as slick and awesome as we were before! Another challenge is that old-timers who have performed CPR for real in the heat and pressure of the moment and have done plenty of CPR sessions in the past often don't see a revision session on CPR and resuscitation as that applicable to them! But it is! If anything, it applies even more to them because they are the role models of the newer first aiders and the people off whom they will learn.

So how do you stretch and engage these old-timers without losing their attention and without completely losing the newer people? This article outlines a session plan that seemed to go pretty well when we ran it as a revision session on CPR. We'd love to hear what you think so why not leave a comment at the bottom of the page?

The basic structure for this session is as follows:
  1. Brief re-cap of the resuscitation basics
  2. A variety of resuscitation scenarios for groups to rotate round that test specific skills or learning objectives
The Re-cap
Starting with a brief recap makes sure that everyone is still on the same page. Anyone who did their initial training a while ago might need reminding of any updates that have been introduced (perhaps after a report from the Resus Council) and the newer first aiders might just need a refresh on those basic skills. You can do this introductory section however you like. You might find it useful to add a little structure by using a powerpoint (this might work well for larger groups) or you might prefer to simply talk your way through things whilst doing active demonstrations. Another way that you could run it (which could be part of a powerpoint or talking section) would be to get people in the group to teach, run-through or demonstrate bits of it out the front. Having to show or explain a skill or concept to someone else can be a great way of cementing that knowledge into their own heads!

The Scenarios: (You can download them at the bottom of the page)
We've then moved on (for the majority of the session in terms of time) to a number of specifically designed scenarios that aim to test a specific area of resuscitation. Yes, you could just get them to grab a CPR doll and run through a bit of CPR (and this is definitely useful at times, particularly when learning it for the first time), this does remove some of the reality from the situation and potentially simplifies it a little too much for those have done it before (how many times have your actually done CPR in a really nice clear space with no complications that you have to work around?). Split the group into smaller groups (probably a maximum of 4 in each) and get them to rotate through the scenarios. Ideally, you'd have a facilitator for each scenario. We'd suggest giving 10-15 minutes for each scenario before rotating round. We've outlined each of the suggested scenarios below along with what we think is learnt:

1. Bog-standard (if there is such a thing) Resus:
This first scenario is a really simple resuscitation scenario with no added complications. It's designed to test the basics. The first aiders should be able to do this one in their sleep - if they can't do this scenario then they really need to do some more practice and go over the skills they should know. Don't be scared to make a group re-do this one again to learn from any mistakes that are made because it's so important that the basics are nailed. You want to see the group to a really quick and slick primary survey and then the full works of whatever they are trained to (whether that's just CPR and AED or including oxygen, airway adjuncts, BVM etc..).

2. Patient found on a bed:
CPR just isn't effective if carried out on a patient's bed. This scenario is designed to get the first aiders to spot this as the patient will be on the bed on their arrival. Again, the first aiders should capable with dealing with the situation relatively easily. You can always get a family member to be doing CPR on the bed on the first aiders arrival as well (as the first aiders might just carry on with that and would be a good way of teaching them the opposite). It's something that is so obvious when we say in training to move a patient off of their bed, but in the heat of the moment, if we haven't faced a practice scenario where this was the case, it would be easy for that to go out of the window.

3. Infant CPR:
This third scenario tests the first aiders with dealing with a resus situation for a baby with the terrified mother also on the scene. This will challenge them to remember to do those 5 rescue breaths (and whatever compression-breath ratio your organisation trains them to do) but will also force them to have to manage the scene well and remember that the baby is not the only person who needs their attention. This is a situation we never want to be in, but it's worth trying to prepare yourself by training with scenarios like this in the safety of the training environment.

4. Confined space CPR
It always seems that people will collapse in the smallest and awkward places rather than the vast open rooms we always train in don't they? This scenario is designed to test the decision making skills of the first aiders as they will find a patient not breathing in confined conditions that mean that it is difficult to perform effective CPR. Hopefully, the first aiders will realise that the best thing to do is to quickly move the patient a few metres into a more open environment where they can work on the patient more effectively.

5. Drowning:
Another of those rare situations that we often only ever do in a textbook form - drowning. The actions of the first aiders will be pretty much the same (assuming that the patient is now on dry land of course!) but this scenario will test if they remember to start with those rescue breaths or to dry the patient's chest quickly before attaching the defib. The additional dangers associated with being near the water could also come into the scenario if you wanted them to.

6. Catastrophic Bleed Cause:
We always need to be looking out for the reversible causes of a cardiac arrest. This scenario presents with a patient who has a major bleed. If the bleed is not also dealt with, every time the first aiders compress the chest, the patient will just bleed out more. It gets the first aiders to remember that doing CPR isn't the only thing they need to be doing and thinking about when faced with a patient who isn't breathing. The question of 'why' is also an important one - usually the first aider won't be able to do anything about it except pass information on to an ambulance or other higher skill level but in this situation, they definitely can try and stem the bleeding.

7. Screwdriver CPR:
This last scenario in our list will get the first aiders thinking. The patient has a screwdriver sticking out of the centre of their chest meaning that it is very difficult to give effective compressions. You'll probably find that the first aiders end up having a bit of a debate as to what they should do. The purpose of the scenario is to remind them that the arrest isn't going to be the nice 'straight-forward' situation they always see in the classroom. We need people who can think on their feet and adapt their normal good practices to do the best they can for a patient in any given situation.

Download the scenarios:
Scenario 1: Simple CPR - Download PDF
Scenario 2: Bed CPR - Download PDF
Scenario 3: Infant CPR - Download PDF
Scenario 4: Confined Space CPR - Download PDF
Scenario 5: Drowning Scenario - Download PDF
Scenario 6: Catastrophic Bleed - Download PDF
Scenario 7: Screwdriver CPR - Download PDF

Practical Tips:
  • It's important to have an ethos of everyone wanting to learn from mistakes in training rather than pointing the fingure and telling people they should know somthing (which the probably should) because otherwise they won't want to take part in case they get some of the basics wrong...but then will go and do it on a real patient.
  • A facilitator on each station helps give the first aiders effective feedback and they can spot the things that can be improved.
  • You will probably find it useful to have someone keeping a check on the time and telling the groups when to move on to the next scenario.
  • If you are short on time, your could always split it over two sessions or pick out the scenarios that address specific learning needs in the group.

Comments: Have you tried this idea out? Let us know how it went or give us your top tips to make it work well! If you are logged in, your usename will be assigned to the comment.
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