Archive for the 'Training Tips' Category

Become an Emergency First Response Instructor Trainer

Emergency Responders save many lives each year by rendering CPR and first aid. As an EFR Instructor, you play an important role in this process but you can make even more of a difference by becoming an EFR Instructor Trainer. EFR Instructor Trainers have trained hundreds of new EFR Instructors around the world, and you can join this elite group.

To enter the EFR Instructor Trainer course, you must:

  • Be an active EFR Primary and Secondary Care and Care for Children Instructor.
  • Have issued 25 Course Completion Authorization cards for any EFR course, or have taught at least five separate EFR courses.
  • Have no verified quality assurance issues on file within the past 12 months.

The EFR Instructor Trainer course – based on the same instructional design and educational protocols as other EFR courses – was designed for busy people and has built in flexibility. Participants accomplish knowledge development through an online program that is flexible and easy to understand. Instructor candidates progress at their own pace and complete the course as their schedule permits. The online component is followed by a live practical training session with a current EFR Instructor Trainer.

To get started, contact your local EFR Office to register for the course. After registration, you’ll receive your EFR Instructor Trainer materials and a web link to the online knowledge development course.

The online course consists of three curriculum presentations and a Self Study Knowledge Review. You also have the opportunity to develop a basic marketing plan for your EFR provider- and instructor-level training.

After completing the online portion, it is simple to complete the course by attending a prescheduled Instructor Trainer Practical Session available in your area. You can complete these sessions in about four hours. For more information about practical session course dates and locations, contact your local Emergency First Response office.

During the practical sessions, candidates discuss their marketing plan and consult with an EFR Instructor Trainer to help develop a successful instructor training business. Candidates also participate in hands-on teaching demonstrations and positive coaching techniques. The practical session concludes with an evaluation of the Self Study Knowledge Review completed during the online course and a written final exam.

After you successfully complete the practical session, you may submit your EFR Instructor Trainer application to the local EFR Office. Once you are notified that Emergency First Response has approved your application, you are authorized to advertise and offer EFR Instructor courses.

Get started now by contacting your local EFR office.

Youth Retention of Emergency Training

How effective is teaching youth CPR and AED skills? Do they retain knowledge and can they effectively perform CPR or other emergency response skills? A study conducted by Fritz Sterz from the Medical University of Vienna, Austria recently attempted to answer these questions. He studied 147 nine-year-old children who had received six hours of training that included CPR, AED, usage of the recovery position and calling for emergency services. The study found that four months after the training, 86 percent of the participants performed CPR correctly.

Interestingly, the children’s body mass index – a statistical measurement comparing a person’s height and weight – was the biggest influence on compression depth and amount of air inhaled. Age did not play a role, indicating that a well-built nine-year-old can be just as capable of delivering effective care as an older child. Sterz said, “We found that students as young as nine years [of age] are able to successfully and effectively learn basic life support skills. As in adults, physical strength may limit depth of chest compressions and ventilation volumes, but skill retention is good.”

Children have long learned first aid skills and stories of youth making a difference in an emergency are not uncommon. Emergency First Response provider programs recognize this potential and is one reason why EFR programs are performance-based and do not have a minimum age. Participants meeting all performance requirements and objectives are entitled to receive a course completion card regardless of age. Those who lack maturity or unable to meet performance requirements are encouraged to study and work on their skills until they can meet the requirements.

Spicing Things Up With Media

A great way to keep your Emergency First Response® participants engaged and on their toes is to introduce different media. Start the class by showing a funny video to engage participants immediately and get them in the mood for a great course. There are many videos available from the web, like this YouTube video of Mr. Bean at the bus stop.

 You can also have some fun by playing the Bee Gees song “Stayin’ Alive” during the CPR portion of the class. Not only will participants enjoy it, but the song also has the perfect tempo for delivering chest compressions at the correct rate.

 Plus, you can make your own media. Take photos throughout the course of participants completing different activities or practicing skills. Then, show them as a slide show at the end of the course to reinforce how much the participants have accomplished

EFR Success in Kona

Kona CPR is now a thriving CPR and first aid business in Kona, Hawaii, USA, but that wasn’t always the case. After becoming an Emergency First Response Instructor in 2007, Kara Osada issued just seven completion cards. But, since that modest start, her business has produced more than 230 Emergency First Responders and is on track to exceed that mark this year. In this interview, Osada shares her perspective and experiences implementing Emergency First Response programs.

The Responder (TR): To what do you attribute the success of your EFR business?
Kara Osada (KO):
Not just doing the basics, but making it a fun, enjoyable and quality class. Kona CPR fills a prefect niche in Kona, Hawaii. Kona CPR has been able to come in and provide quality training classes weekly for individuals or groups at business locations. I have started classes as early as 7 am or as late as 6 pm – depending upon the participants’ needs.

TR: Do you have a specific market that you target and if so, how did you identify that market?
When I started, I thought I would be teaching mostly fisherman and scuba groups, but I was so wrong. I teach massage therapy students, teachers, industrial workers, construction workers, tour operators, nurses, physical therapist, baby sitters, health care workers, day care centers and so many more. The people I have met through teaching tend to be the most amazing people as they have chosen careers that offer assistance and care to others.

TR: What is your marketing and advertising strategy? How do you attract new participants?
Build a great website. I have also used the paper, though word of mouth works wonders once you get started.

TR: What, if any, challenges did you encounter during the development of your business?
The biggest struggle I face is people not knowing the name of Emergency First Response. I have spent a lot of time getting Emergency First Response programs approved by companies for their employees. I have also run into problems because of the temporary card that is issued at the time of completion. Many people are applying for jobs that same day and need cards that don’t say temporary on them. I have found that keeping Certificates of Completion on hand is helpful in these cases.

TR: From a business perspective, what has been your most important lesson as an Emergency First Response Instructor?
As a new company, you have to find your niche. Here, it was providing quality training at times when people could make it. In other places, it may be as simple as having a large space for companies to send large groups when they cannot hold training at their site. It’s all about looking at your market and seeing what might work!

TR: What do you think is the ideal class size and participant to mannequin ratio?
I teach with one mannequin for every two people. I have found that with three to one ratios, participants grow tired at the length of the course. I think the most learning occurs with class sizes of six to eight. It’s big enough that one participant doesn’t feel pressured, yet small enough that I can watch and comment on technique.

TR: How do you use the EFR materials to efficiently teach your courses?
I hand out guides and books at the start of the course. For the participants I work with, it’s not practical for them to review material prior to the course. Participants fill in knowledge reviews while watching the video. We go through the knowledge review after the video. As participants go through the skills sets, I refer them to the book on sections for further reading and review.

TR: What are some of your favorite role-playing scenarios for the final exercise?
I can’t say I have a favorite. I try to pick scenarios they will be likely to see. For individuals who work as health care providers, we talk about how they can manage on their own. With large companies that have many employees getting certified, we talk about how they can best manage a scene without having everyone do the same thing. I really try to personalize the training with exercises for the group I’m training, which also makes it fun for me, as every class is unique.

EFR Training Saves a Life – by Jan Kmiecik

I was swimming in a lake with my then eight year old boy. We were starting the 320 metre/350 yard return journey from the dam to the western end of the reservoir when I saw my stepfather enter the water to swim. As we neared him I thought he was lying on his back, floating, but soon realized he was moving only in the slight eddy, and was face down in the water. I yelled for help, instructed my little boy to leave the water by the shortest route, and swam rapidly to my stepfather’s assistance. I rolled him onto his back, and used the recovery method to swim with him to the edge of the lake.

Thankfully there was a man passing with his wife, and a mobile telephone. He assisted me in extricating my stepfather from the water. After pulling him out of the water, I was unable to see any signs of self-sustained breathing, so I immediately began CPR and mouth to mouth resuscitation.  I was concerned whilst giving CPR of the sound of cracking, and thought I had broken/cracked his ribs. I then turned him onto his left side to aid in water egress from his mouth, as he recovered consciousness.

A telephone call had been placed during the “excitement” and soon after my stepfather started to come around, the Municipal Police arrived to take notes. It was some 15 minutes or more after that the ambulance arrived. My stepfather was able to speak to me by the time the professionals arrived, and asked what had happened. Being aware of his age (71) and the likely onset of shock, I refrained from telling him what occurred, other than there had been “a bit of a flap”.

He was evacuated to hospital where he spent several days undergoing tests for the cause of his accident. Absolutely nothing was found to be wrong with him, other than the scratches sustained in removing him from the water, up the rocks, and onto the road, which although appeared bad, were trivial.

Looking critically at my actions, I was hasty in starting CPR, as I don’t remember checking for signs of life. The deep, angry purple/blue color of my stepfather’s head was enough to spur me into action immediately.  Thanks to my training with instructor Simon Hoekstra (EFR Instructor – 969857), from Phuket, Thailand, my stepfather is alive.

Improving Business with EFR Approvals

Using Approvals to Get Business

You might have come across the list of accredited organizations when browsing the Emergency First Response website. This is a list of organizations that have recognized Emergency First Response® programs and you can use it to your advantage and increase business? Start by browsing for approvals and target specific businesses or groups using the marketing materials available to you on the Emergency First Response Instructor site.

Here’s an example. Let’s say you decide you want to use the approval from the North Carolina Department of Health and Human Services Division of Child Development. First, pinpoint businesses you’d like to target. Since this is a Department of Child Development approval, you’ll likely solicit schools and day care facilities. Personalize the Preparedness and Compliance Made Easy handout (product no. 10277) from the EFR® marketing tool kit, then prepare a cover letter using the EFR letterhead. Tailor the copy so it speaks directly to the business. Then, send the two out and follow up with phone calls or additional mailers.

If you have questions or would like suggestions on gathering marketing materials, please contact

Manikin Features

Manikin Options For Your EFR Programs

Numerous companies sell adult, child and infant manikins at various price points. These range from the most basic models to those that are so life-like that they are used to help train doctors, paramedics and nurses.

So if you’re looking to purchase manikins for your EFR business, which is the best choice for you? It’s important to note that bulk purchases often offer a substantial discount over individual buys. Packages often also include necessary additional supplies such as manikin lungs.

Here is a partial list of what you might want to look at when considering your manikin purchase:

  • Lung/Mouth systems. If each participant has their own one-piece, disposable lung/mouth protection system, it reduces cross contamination and simplified manikin sanitization.

  • Low Cost Removable face. This allows each participant to have their own and minimize any cross contamination between participants.

  • Carrying bags. These bags often let you transport several fully-assembled manikins or have wheels to make transportation easier.

  • Clicker. A built-in click mechanisms provides positive reinforcement for hand placement and compression depth. If participants hear the click, they know that their hand placement and compression depth is correct. The instructor can also hear if the compression timing is within guidelines.

  • Facial features. A pliable nose and mouth makes sealing the airway a more lifelike experience.

  • Age selector. Some manikins allow instructors to change the compression depth so it is appropriate for children or adult CPR.

  • Materials and durability. Many manikins are constructed from durable materials suitable for outdoor use or near water.

  • Easy to clean. Many modern manikins are relatively simple and easy to clean up.

When choosing your manikin, assess your needs and compare them to the different options available. Oftentimes the more features you add, the more the manikins may cost, so be sure to balance out your budget with your needs and get the most manikin you can afford.

Bring Your EFR CPR and First Aid class to “Life”

Want to make your EFR courses fun and exciting while imparting a sense of realism? Use scenario practice to introduce realism by using props to guide participants through problems they might face in their environment.

Step 1 – Research the Environment

The first thing you’ll want to do is research your audience and the environment in which they will apply their skills. If you are teaching a course involving warehouse workers at the local shipping company, consider the hazards they face. Heavy machinery to lift boxes? The boxes or crates themselves? In this case it might be a good idea to walk the area itself to see what the hazards actually are. Another easy way is to interview the safety officer and find out what injuries have actually occurred in the past.

The same goes if your audience is looking to help with incidents in the home. What are the injuries that they face in or around their home?

Last but not least, what about the large scale regional problems? Is the audience in an earthquake zone? In an area prone to tornados? A flood plain?

Step 2 – Props, Props, Props

Now that you know a little bit about the environment in which your participants live or work you can think about what kind of props will add realism.

This is where you can let your imagination run wild. Have a look at the scenarios you’ll be covering in your course then have a walk through your home to see what you can use during practice. Here’s just a partial list of what you might find and what you can use it for:

  • Shaving cream – perfect to simulate blood and show responders where they are touching patients without gloves
  • Adhesive notes – used to assign health problems for patients
  • Stage blood, food coloring, makeup or lipstick – wound simulation
  • Sporting equipment such as football helmets, skateboards or skates – adds realism to scenarios – especially those involving children
  • Jumper cables – great to simulate an electrical emergency
  • Lights, sirens or strobe lights – adds the realism of responders coming to the accident scene
  • Car or motorcycle – great way to practice one of the most common ways your responders will use their skills
  • Empty cardboard boxes and packing paper – for simulated earthquake rubble
  • Newspapers and magazines – splinting material
  • First aid kits or oxygen units – allow participants to use the real thing in practice
  • Mobile phone or two-way radio – to practice calling for help. The two way radio is great because is lets participants interact with someone for added realism.
  • Portable CD player – to add sound effects for wind, rain, lightning, street traffic, etc

Step 3 – Make it Fun

Although Emergency First Response courses deal with a serious topic that doesn’t mean you can’t make learning fun. You can do that by creating games or challenges based on certain skills. The glove removal exercise is a great example. Challenge the participants to see who can remove their gloves without touching the outside. Once they’ve all got a handle on that skill, you can bring in one of your props and up the ante by covering their palms with shaving cream. It seems simple and a bit silly but it’s an effective way of bringing the point home about why participants need to be careful with their glove removal.

Reminder- Any Help Is Better Than No Help


The Emergency First Response philosophy has always been that any help in an emergency is better than no help. Last year the American Heart Association announced chest compression-only CPR. They stated that if a rescuer hasn’t been trained in CPR or doesn’t feel safe or confident in giving rescue breaths, then providing compression-only CPR is acceptable.

If a layperson rescuer isn’t comfortable providing mouth-to-mouth for any reason, studies show the patient may benefit from compressions only. For this reason, existing EFR materials already include information on chest compression-only CPR.

In the EFR Primary Care course, students continue to learn rescue breaths and compressions as usual because this care is always preferable. You will also notice the use of chest compression-only CPR and circumstances in which someone might choose to use it – for example if no barriers are available, if the situation makes giving breaths impossible, or if a lay responder otherwise feels anxious about giving rescue breaths.

“Stayin’ Alive”

Current CPR guidelines emphasis the need for effective chest compressions as a critical component of CPR.  Dr. Gordon Ewy, (Director of the University of Arizona Sarver Heart Center and prominent CPR researcher) identified a clever way to help rescuers remember how fast chest compression should occur during CPR. He pointed out that the 1977 hit song  “Stayin’ Alive,” from the Bee Gee’s has a 100 beats-a-minute tempo, the same rate recommended for chest compression during CPR. Many are now incorporating this tip into their CPR training programs as way to help students remember and maintain the proper rate of compression if ever called upon to perform CPR. After all, “Stayin’ Alive” is what CPR is all about.

Emergency First Response

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July 2020