2024 First Aid Rules - Redline

SECTION II
2024
FIRST AID RULES
2024 FIRST AID
RULES INDEX
Title Page
General Rules ........................................................................................................................... 1

Materials List ............................................................................................................................ 2
Guidelines and Procedures .................................................................................................... 4
Ties ............................................................................................................................................. 7
Written Examination ............................................................................................................... 7
Appeals ..................................................................................................................................... 8
Discounts .................................................................................................................................. 9
Scorecard A.......................................................................................................................... 12
Scorecard B .......................................................................................................................... 16
Cardiopulmonary Resuscitation ......................................................................................... 17
Artificial Ventilation.............................................................................................................. 18
Initial Assessment .................................................................................................................. 19
Patient Assessment ................................................................................................................ 20
CPR .......................................................................................................................................... 21
One-Person CPR (Manikin Only) ..................................................................................... 21
Two-Rescuer CPR with AED (No Spinal Injury – Manikin Only) .............................. 23
Two-Rescuer CPR with AED (With Spinal Injury – Manikin Only) ........................... 25
Mouth-To-Mask Resuscitation ............................................................................................ 27
Airway Obstruction (Unconscious Victim – Witnessed) ................................................. 28
Sucking Chest Wound .......................................................................................................... 30
Life-Threatening Bleeding .................................................................................................... 30
Tourniquet .............................................................................................................................. 32
Dressings and Bandaging – Open Wounds ....................................................................... 33
Two-Person Log Roll............................................................................................................. 35
Three-Person Log Roll .......................................................................................................... 36
Splinting .................................................................................................................................. 37
Splinting (Rigid) Upper Extremity Fractures and Dislocations................................... 37
Splinting (Soft) Upper Extremity Fractures and Dislocations (Wrist and Hand) ..... 38
Splinting (Rigid or Soft) Pelvic Girdle, Thigh, Knee, and Lower Leg......................... 39
Splinting (Soft) Lower Extremity Fractures and Dislocations (Ankle and Foot) ...... 41
Splinting Upper Extremity/Lower Extremity Fractures (Air Splint) ......................... 42
Splinting – Flail Chest ........................................................................................................ 43
One Rescuer Blanket Drag ................................................................................................... 44
Two Rescuer Extremity Ground Lift .................................................................................. 45
Shirt Drag................................................................................................................................ 46
Establishing Airway-Suspected Cervical Spine (Neck) Injury ....................................... 47
Shock ....................................................................................................................................... 48
Immobilization – Long Spine Board (Backboard) ............................................................ 49
Immobilization of Cervical Spine ........................................................................................ 50
Burns........................................................................................................................................ 51
Early or Superficial Frostbite ............................................................................................... 53
Late or Deep Cold Injury ...................................................................................................... 54
Mild Hyperthermia (Heat) ................................................................................................... 55
Severe Hyperthermia ............................................................................................................ 56
First Aid Statements of Fact ................................................................................................. 57
FIRST AID RULES
GENERAL RULES
First Aid rules were designed as a training tool for first aid teams. They were
developed for contest purposes only. Discretion should be used in actual mine
emergency situations.
1. The Contest Director(s) will establish a reasonable amount of time for each team to
complete the problem. All teams will be notified of the established time prior to
beginning to work the problem. Any teams working beyond the established time period
will be notified by the Judge that they must leave the station.
2. Problems will be kept in unsealed envelopes, retained by the judges, and given to the
team after the timing device has been started. Judges shall place the patient in the
required position as stated in the problem to be worked.
A. If props are to be utilized during the working of the problem, such props must be
readily available to the working teams and in working condition. Props (except
props used to simulate an injury) must be identified by the judges to the team
members prior to starting the timing device and must be located within the
designated working area. Props will not be utilized in lieu of first aid equipment
for treatment of patient(s). Props will be limited to items related to
communication and mechanism of injury for effects unless skill sheets are
provided. Props shall be within the application of the skill sheets used for
treatment of the injury/conditions.
3. The First Aid team must furnish the basic first aid supplies needed to complete the
problem unless specified by the contest coordinator that the supplies will be available at a
specific station.
A. The material list below is a recommended materials list that could be used to treat
injuries.
B. Problems should be designed utilizing no more than the minimum material listed
below.
C. For contest purposes, all bandaging materials will be considered sterile and four by
four dressings need not be opened before use for treatment.
D. All cravat tails or excess material not being utilized will be tucked or cut after
bandaging completed.
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MATERIALS LIST
24 Triangular Bandages
6 Adhesive compresses
24 Sterile gauzes, (4”x4”) and/or 4” Compresses
6 Roller Bandages
3 Blankets
1 Scissors, EMT Utility
6 Pairs of Examination Gloves
2 Mask/face shields or masks and goggles combination meeting blood
borne pathogen requirements
2 Heat Pack - Simulated
4 Cold packs - Simulated
2 Oval Eye Pads
1 Pen and paper set
1 Barrier devices with one-way valve for performing AV/CPR
1 White bag (i.e., plastic garbage bag)
1 Compliment of splints (may be pre-padded but not assembled)
1 Long back board with straps (Aluminum, Wood, etc.)
2 Air splints (1 full arm and 1 full leg)
1 Adhesive Tape
1 Burn Sheet, Sterile (40” x 80” minimum)
1 Rigid Extrication Collar
4 Trauma Dressings (minimum of 10” X 30”)
1 Eye Shield/Cup
1 Pen Light
4 Tourniquets (a device used to cut off all blood supply)
2 Towels
1 Pillow
4 Occlusive Dressing
2 Sticks, Wooden Dowels or equivalent
1 Watch/Timing Device
1 Headset (long spine board)
1 500 ml sterile water (for contest purposes expiration date not applicable)
Compliment of Straps for Long Spine Board (buckle straps, spider straps, etc.)
Automated External Defibrillator Training Unit (do not power up)
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4. All injuries presented during the First Aid Problem, if feasible, will be created
using moulage to be as realistic as possible. If feasible, no tape, tattoos, or photos
describing the injury will be used. All material used to solve the first aid problem
will be picked up by the team prior to moving on to their next prospective station.
A. Local/Regional contests may use the following for the creation of injuries (if not
using moulage). Injuries/conditions requiring treatment will be identified by cards,
envelopes or labels attached to the patient at or as near the location of the injury as
possible on the outside of the clothing, be identified by simulated wounds, or be in
the reading of the problem. Signs, symptoms, or mechanisms of injury may be used.
If signs and symptoms are used, all signs and symptoms shall be identified by cards,
envelopes or labels placed on patient. All signs and symptoms will be given to the
teams in writing. Wounds that are listed in the reading of the problem shall also be
placed on patient. (Exception: If the wound is on the eyelid or an impaled object in the
eye, the label will NOT be placed on the eye, but in an obvious area near the eye).
B. During the initial or patient assessment, teams may find an envelope attached to the
patient(s) or be provided an envelope by the judges which contains patient
information that needs immediate attention. If repositioning of patient(s) is required
for treatment, patient(s) must be placed in the proper position prior to treatment.
Upon completion of treatment of these conditions, the initial or patient assessment will
be resumed at the point where team left off. The patient(s) will already be marked
upon arrival of the team.
C. If used, lettering on the cards and/or labels will be at least ¼ - inch in height and all
life-threatening conditions will be in red.
Example: 2-INCH WOUND ON FOREHEAD
If required by the problem, Cardiopulmonary Resuscitation (CPR) with an AED

and rescue breathing will only be performed on a manikin. A barrier device must
be used when contacting manikin. The face masks/shields may be removed when the
team is required to give artificial ventilation, CPR, inflating splints, etc.
5. WARNING ... Any team whose member(s) intentionally disturb or destroy any
component on a competition field will immediately be disqualified. This is to be
determined/concurred by at least two judges and after consultation with
Contest Director(s).
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GUIDELINES AND PROCEDURES
1. A first aid team will consist of three members of the 8-person registered mine rescue
team.
2. Multiple first aid teams from a single mine rescue team may enter the event.
3. The first aid team members who will be associated with the mine rescue team for the
combination award must be designated at the time the mine rescue team is registered.
4. Changes to the designated first aid team members may be made up to the time the team
members report for lock-up prior to their event. This change will be submitted, in
writing, to the Chief Judge of the First Aid event and/or the Contest Director(s) and
must be signed by a representative of the team and the Contest Official.
5. First aid teams not designated to a mine rescue team for the combination award can
compete in the First Aid event, and their scores will only be used to determine their
ranking within that event.
6. Registration for the first aid team(s) competition will be made during the mine rescue
team registration.
7. All first aid team members will remain in isolation until their team is called. Teams will
receive a briefing on the problem scenario when they arrive at the first aid station.
8. Each participating team must be under guard before the start of the contest. Any team or
team member receiving information concerning a contest problem prior to arriving at the
working area will be disqualified by the Chief Judge and Director(s).
If participating teams need additional help, such as transporting or moving a patient, help
will be provided by contest officials.
9. There will be a minimum of two (2) judges at the first aid station.
10. Judges will be assigned specific tasks to be scored prior to the judging and will record
their findings on a specific scoring card issued prior to the contest.
11. Judges must be trained in first aid methods and knowledgeable in the scenario they will
be judging.
12. There will be one first aid station, including:
A. Patient assessment, control of bleeding, physical shock, wounds, burns,

scalds, musculoskeletal injuries, and transportation.
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B. Cardiopulmonary Resuscitation (CPR) with and AED and Artificial Respiration may
be incorporated into the problem. The Contest Director will provide recording
manikins of the same type, if required by the problem. Teams will not be allowed
to use their own manikin in lieu of the ones provided by the Contest Director.
Teams will be afforded the opportunity to practice on the provided manikin for a
maximum of 5 minutes on designated First-Aid Field prior to working the problem,
this will be done in conjunction with the First-Aid equipment being laid out if the
team wants to do that. At the end of the 5 minutes, teams will be expected to be
ready to work the problem.
13. Problems will be kept in unsealed envelopes, retained by the judges, and given to the
team after the timing device has been started. Judges shall place the patient in the
required position as stated in the problem to be worked. The working time for a problem
will start when the team starts the timing device.
14. The problem will end, and teams will stop the timing device when all conditions have
been located and treated. The timekeeper/judge must time the problem in minutes and
seconds and consult with the team upon completion of the problem to verify the time.
15. Problem will be designed from the Skill Sheets approved by the Rules Committee. Teams
will be required to triage the accident scene if more than one patient. Problem may have
up to three patients at the scene.
16. Contest officials will designate a space (15 feet by 15 feet minimum) for teams to work,
with a minimum of 3 feet by 15 feet area for the team’s equipment. All equipment and
team members will be kept behind a baseline designated by a contest official. All
problems will be worked in the designated area which shall contain only the judges,
bystanders/patients, and the contesting teams.
17. After stopping the timing device, team members will remain with the patient(s) until
released by the judges. Any physical treatment(s) not performed, i.e., bandage, splint
not correctly placed or utilized will be pointed out to team at this time. **No docks will
be added for any physical treatment(s) not performed, i.e., bandage, splint not correctly
placed or utilized that was not pointed out after the team leaves the working field.
18. If no time limit is set for the problem, a calculated time will be determined by contest
officials by averaging the working time of all teams participating in the contest (1
discount per 3-minute overtime or fraction thereof). When a time limit is utilized the
average working time will not be in problems.
A. The accumulation of individual discounts within a procedure shall not exceed the
discounts for failure to perform that procedure. (Example AV, CPR, etc.)
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19. Judges must keep an accurate time and record it on scoring sheets for tie breaker
purposes.
20. Judges will not discuss any first aid problem with team members (prior to the
working of the problem) unless there are technical problems.
21. Only judges, contest officials, escorted photographers, and news media approved
by the Contest Director(s) will be permitted in the first aid station. A separate area will
be provided for spectators to observe the teams during competition.
22. On the day prior to the contest, a meeting will be held to discuss officials’ and
judges’ assignments and training.
23. The Eleventh Edition of Brady “Emergency Medical Responder – First on the Scene”
(Chapters: 3, 4, 6, 9, 10, 11, 12, 13, 14, 15, 16, 17, 18, 19, 20, 21, 22, 23 and 27), and the
current American Heart Association BLS Student Handbook (as of January 1st of the
contest year) are authorized for reference and guidance.
24. The team will not be permitted to use first aid manuals for reference purposes
during the working of the problem. No practicing will be allowed on the field before the
beginning of the contest, with the exception of familiarization of AED and Manikin.
25. Liquids applied for the purposes of washing eyes, moistening dressings, and
rinsing contaminated skin may be simulated. All dressings and splints must be placed
properly. (If traction splints are used “DO NOT APPLY TRACTION TO THE SPLINT”)
26. Team members are not allowed to leave the working area to obtain materials for
the problem.
27. Rough treatment of patient is not allowed.
Handling of a patient by a team or team member in such a manner that could compromise
condition of the patient. (Examples: Mishandling extremities, stepping across patient, etc.)
(Straddling is only acceptable for patient loading during 2-person extremity lift, or
fireman’s drag.) (This does not include the rolling of the patient to the side that is injured
or rolling a patient more than one time that has signs/symptoms of spinal injury. When
teams are required to roll a patient with signs/symptoms of spinal injury, the correct log
roll procedure skill sheet for the selected log roll technique, whether it is two- or three-
person log roll will be followed).
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28. If a tourniquet is required in First Aid problem, do not secure tightly. Upon
proper application of the tourniquet (as per skill sheet), bleeding will be considered
controlled and acknowledged by the judge.
29. Assistance in treatment from a supposedly unconscious patient (if patient is provided by
the working team) is not allowed. Patient cannot talk, direct, or assist unless stated in the
problem. (Reactionary or unintentional movements by the patient should not be
discounted)
30. A predetermined amount of trophies will be awarded for the First Aid
Competition based on the best cumulative team scores (least amount of
discounts).
TIES
In the event of ties in the contest, Scorecard A (First Aid Procedures and Critical
Skills) discounts will be the first tie breaker, Scorecard B (AV/CPR) discounts will be
the second tie breaker, written exam will be the third tie breaker and actual working
time, in minutes and seconds, of the team will be the fourth tie breaker.
WRITTEN EXAMINATION
1. At a designated time During isolation, contest officials will administer a written

examination to the three working team members of each working team.
2. The written examination will consist of 15 multiple choice questions taken from the
Statements of Fact which are listed in the rules. These statements were which will be
selected from the Eleventh Edition of Brady “Emergency Medical Responder – First on
the Scene” taken from (Chapters: 3, 4, 6, 9, 10, 11, 12, 13, 14, 15, 16, 17, 18, 19, 20, 21, 22,
22, 23 and 27 and the most current edition of American Heart Association BLS Student
Handbook (as of January 1st of the contest year).
3. Each question shall contain a blank space which shall represent a key word, with no
more than two consecutive blanks per statement. Answers will be multiple choice with
three choices. Answers will not be intentionally misspelled. “None of the above” shall
not be used as one of the choices.
4. A maximum of 20 minutes will be allowed for the team member to take the test.
5. Team members taking the written examination will not be permitted to take any
written material or information into the testing area.
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6. No wireless communication or electronic device, including Apple watches or similar
devices, will be permitted in the testing area.
7. There will be no discussion during the time that written examinations are being taken.
8. Team members from the same team will not be allowed to sit at the same table
while taking the written examination.
9. In any case, the judges will not explain the meaning of questions.
10. Scoring of the test will be completed by at least two qualified judges.
APPEALS
1. Upon completion of the examination of the patient by the judges, the team will be
informed of any infractions regarding treatment while at the station. The team
will be permitted to verbally appeal any infractions either with the field judge or
the chief judge. If not resolved, the chief judge will make the final decision until
an appeal can be filed by the team.
2. During the verbal appeal process, all questionable splints/dressings must remain
intact until any verbal appeal is resolved. If any questionable splints/dressings
are removed or altered by the team prior to being resolved, the appeal will not be
allowed.
3. At the conclusion of the competition, the team members will be instructed to report
to the area designated for 30-minute looks. A schedule will be posted near the 30-
minute look location. The first aid team and team trainer will have thirty (30)
minutes to review the judges’ scorecards and the team’s written test scores. At the
conclusion of the 30-minute look, the first aid team and/or trainer may submit a
written appeal for any discount received to the person in charge of the review.
Written appeals are not to exceed one page for any discount assessed and will be
forwarded to the First Aid Appeals Committee. No additional appeals will be
accepted after the 30-minute look.
4. Documentation (contest rules and other documents used in the contest) supporting
the appeal will be accepted. Any protest(s) will be considered by the First Aid
Appeals Committee. A discount summary sheet will be used to list the discounts.
All discounts except time will be listed and totaled. Both the first aid team and the
review judge will sign the team discount summary sheet to certify they have
reviewed the discounts and verified the totals. All appeals will be considered by the
committee and their decision will be binding and final.
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5. If a wireless internet connection is available, the Contest Director(s) may approve an
option where the teams can review their results electronically. In those cases, the team
must provide an email address that will be used for the review on the form provided at
registration. The form must be completed and submitted at registration. Contest officials
will email the scorecards, written examination, etc. to the email address on record when
they are ready for review. The team will have 45 minutes to review the material starting
upon the “read receipt” of the email, but no more than two hours from the time it was
posted outside the appeals area and email any protests back to the Contest Officials.
DISCOUNTS
1. The team is required to call for help/call 911, once during the working of the
problem. This statement must be made prior to starting triage.
2. Each critical skill identified with an asterisk (*) shall be clearly verbalized by
the team as it is being conducted not utilizing moulage. Each critical skill
identified with a double asterisk (**) shall be clearly verbalized by the team as
it is being conducted at all contests.
3. When using acronyms required in the Eleventh Edition of Brady “Emergency

Medical Responder – First on the Scene” i.e., BP-DOC and after initially stating
what it stands for, the team will not be required to explain the Acronym again.
4. Discounts will not be added to the team score once the judges have signed their
discount sheets following a review with team members. This does not preclude
changes due to administrative errors or a misapplication of a rule.
5. Teams will not be discounted more than once for any one mistake in the same
problem where such mistake may qualify under more than one discount. Judges
will confer and assess the highest single discount.
6. Teams will be additionally discounted for repetition of the same mistakes in the
same problem. For example, improper bandaging on two separate wounds (2
times the appropriate discount), three granny knots (3 times the appropriate
discount), etc.
7. Teams will not be discounted for doing more than the problem calls for unless it
is detrimental to the patient or improper care.
8. If the discount is not listed on the discount sheet and if it is not covered under one
of the approved rules of the contest, judges will not improvise a discount to cover
the suspected violation.
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9. Prior to stopping the clock, the team must reassess the patient’s level of
consciousness, respiratory status, and patient response.
10. If moulage is not being used Teams must make statement to judge, “Removing
clothing, exposing and cleaning wound surface(s)”. This statement is only
required to be made once during the working of the problem, prior to treating first
wound.
11. Rapid Assessment consists of Initial Assessment and Patient Assessment.
12. If the Rapid Assessment has been performed, all life-threatening injuries are
treated, and transportation is delayed, the detailed patient assessment will be
performed and will consist only of the procedures (no critical skills on patient
assessment) with treating all injuries when found.
Information for this table taken from Chart figure 27.5– Start Triage System
IMMEDIATE DELAYED MINOR DECEASED
Respirations >30 per minute <30 per minute <30 per minute Absent
Capillary refill Capillary refill Capillary refill

>2 seconds or <2 seconds or <2 seconds or
Perfusion Absent
radial pulse radial pulse radial pulse
absent present present
Unable to Able to follow

Able to follow
Mental Status follow commands Absent
commands
commands (Can Walk)
Table Reference: Emergency Medical Responder, Eleventh edition by Le Baudour and

Bergeron
IMMEDIATE
Teams will systematically conduct initial assessment, treating all life-

threatening injuries/conditions. Life threatening conditions include breathing
difficulties, no pulse, life threatening bleeding, spinal injury, skull fracture or a
sucking chest wound. The team will perform a rapid patient assessment
according to the patient assessment skill sheet. To perform a rapid patient
assessment, teams will examine each area of the body in its entirety, verbalizing
critical skills and injuries/conditions found. No treatment is required for non-
life-threatening conditions/injuries found during the rapid patient assessment.
After completing rapid assessment and treating life threatening conditions, if
transportation is delayed patient treatment will continue until transportation is
available. A detailed patient assessment would be required, treating
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conditions/injuries as found. Straps may be released as necessary. Support would
have to be taken as required. Team will re-strap and transport when
transportation is available, or treatment completed. Patient is then prepared for
transport and/or transported as required by written problem. To prepare for
transportation, a team will be required to properly place and secure a patient on a
backboard as outlined in the skill sheets, cover with a blanket the team will
verbalize – “transporting patient”. (If instructions are given that transportation is
delayed prior to or during a rapid assessment a complete detailed patient
assessment only will be required)
DELAYED
Teams will systematically conduct the patient assessment according to procedures of the
patient assessment skill sheet. Each area of the body shall be examined in its entirety prior
to treating injuries in that area (except taking support). All injuries must be treated on the
area being examined prior to moving to the next area to be examined. The sling for
fractured ribs may be applied after upper extremity has been surveyed/treated. If
treatment has been started and can be completed by one team member (except injuries
requiring a backboard), the other team member may continue the examination to the next
area and begin treatment. (Systemically, legs are treated before the arms.)
MINOR
Teams will systematically conduct the patient assessment according to procedures

of the patient assessment skill sheet. Each area of the body shall be examined in
its entirety prior to treating injuries in that area (except taking support). All
injuries must be treated on the area being examined prior to moving to the next
area to be examined. The sling for fractured ribs may be applied after upper
extremity has been surveyed/treated. If treatment has been started and can be
completed by one team member (except injuries requiring a backboard), the other
team member may continue the examination to the next area and begin treatment.
(Systemically, legs are treated before the arms.)
DECEASED
Once the determination that a patient is deceased the team will be required to cover the
patient before stopping the timing device(s).
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SCORECARD A DISCOUNTS
1. All life-threatening conditions shall be located and started before patient

assessment can begin. 20
Life threatening conditions will be considered a patient having any one or more
of the following conditions: breathing difficulties, no pulse, life threatening
bleeding, spinal injury, skull fracture, a sucking chest wound
Patient assessment can begin after all life-threatening conditions have been
located and treatment started. Environmental and Medical Emergencies can be
treated anytime during the working of the problem after initial assessment.
2. When the team encounters life-threatening bleeding, no work other than

controlling bleeding shall be done until bleeding is controlled. Bleeding is
controlled when notified by the Judge (judge makes a statement that bleeding is
controlled). If treatment has been started and one team member can complete that
treatment, the other team member may continue to work. 10 each infraction
3. During the course of the problem, teams may encounter a card, envelope or
label stating various conditions. Upon completion of treatment of these
conditions, resume patient assessment at the point where team left off. 5 each
infraction.
4. Patient cannot talk, direct, or assist unless stated in the problem. (Reactionary or
unintentional movements by the patient should not be discounted) 5 each
infraction
5. The bystander/patient if used as a bystander must be shown the correct method of

support. 2
The bystander must be shown the correct method of support and maintaining the
open airway by a team member or members any time during the working of the
problem, but before taking support.
6. No practicing will be allowed on the field before the beginning of the contest. No
reference books or training material will be permitted in the working area during
the working or reading of the problems. 5
NOTE: Teams will only be afforded the opportunity to practice on the provided
manikin for a maximum of 5 minutes on designated First-Aid Field prior to
working the problem.
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7. All team members shall be dressed uniformly. Shoes need not be identical.
The pants/shorts shall be the same color. 1
8. The team’s material and equipment (jump kits, splints, etc.) may not be
assembled or donned (excluding BSI) until after the timing device is started. The
manikin may be placed in the designated area prior to starting the timing device.
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9. Handling of a patient by a team or team member in such a manner that could

compromise condition of the patient. (Examples: Mishandling extremities,
stepping across patient, etc.) (Straddling is only acceptable for patient loading.)
(This does not include the rolling of the patient to the side that is injured or
rolling a patient more than one time that has signs/symptoms of spinal injury.
When teams are required to roll a patient with signs/symptoms of spinal injury,
the correct log roll procedure skill sheet for the selected log roll technique,
whether it is two- or three-person log roll will be followed).
5 each infraction
10. All injuries and/or conditions shall be treated (example: wound,

fracture, frostbite). 20 each infraction
11. Failure to perform a required critical skill. Each CRITICAL SKILL shall be
performed as identified on the skill sheets. 2 each infraction (except for
CPR/AV covered by scorecard B)
12. During patient assessment, failure to verbally state the location physically
examined and each condition found. 1 each infraction.
13. Working out of order (assessment, procedure, critical skill). 2
14. Failure to follow written instructions. 5
15. Teams shall not pad around the head and neck of the patient, for a suspected
spinal injury, before the patient is placed onto the backboard. 1
16. Protective equipment must be donned prior to patient(s) contact (gloves, masks,
and eye protection). Only BSI may be donned prior to starting the timing
device. 5 each infraction
17. Gloves shall be changed if there would be contamination because of a glove tear or
due to other contamination (such as contacting multiple patients.) 2 each
infraction
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18. The broken-back board splint may be preassembled and padded. Other splints
may be pre-padded but not assembled. (Cravat bandages cannot be
preassembled on the back board, except for tying padding.) 5 each infraction
19. Failure to take support of a fracture or dislocation (not supporting fracture

or dislocation). 10 each infraction
A. Support of Extremities – Above and below the fracture or dislocation

B. Support of Hip – Both sides of the fracture or dislocation
C. Support for spinal injury – Stabilization of neck/Modified Jaw
Thrust except for analyzing and shocking with AED patient during
CPR
D. Support for skull fracture – Stabilization of neck/Modified Jaw Thrust
E. No support for fractured ribs,
F. No support of fractures/dislocations of nose, jaw, fingers, and toes
20. Support of fractures and/or dislocations shall not be broken or released. (except
during the use of an AED when analyzing or shock is delivered) 5 each
infraction
When changing support, if support is broken, this discount applies. Change of

support can be done as many times as the team desires provided the support is not
broken.
Support for upper extremity fractures/dislocations shall be maintained until

the sling and swathe are completed. Discount if support of fracture and/or
dislocation is released by support person before sling is completed. Sling and
swath not required with air splints.
21. Fractures/dislocations shall be supported prior to bandaging injuries. Once the

extremity has been assessed, fractures/dislocations must be supported prior to
bandaging injuries on the extremity. 5 each infraction
During initial and patient assessment, teams must physically support/stabilize

fractures and dislocations that require support as they are found. When the
fracture/dislocation is on an extremity and support has been taken, the team must
complete the examination on the extremity treating other injures prior to splinting
the fracture/dislocation.
22. Not applying sling for upper extremity wound. 1 each infraction
A sling and swathe are required for musculoskeletal injuries to the shoulder,
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upper arm, elbows, lower arm, and wrists. Triangular slings are required for all
wounds of upper extremities, including shoulder and armpit wounds. Slings will
not be required for upper extremity burns/deep cold injuries. However, if a
burn/deep cold injury and musculoskeletal injuries wound and/or
fracture/dislocation are present on the same upper extremity, a sling shall be
applied.
23. Failure to determine immediate patients. 10 each infraction
An immediate patient shall be transported immediately (if transportation

is available). This presents a load and go situation.
Immediate conditions are:

 Respirations: >30 respirations per minute
 Perfusion: Capillary refill > 2 seconds or radial pulse absent
 Mental Status: Unable to follow commands. Any one or more of the above
conditions must be clearly visible on the patients.
24. Failure of team to start/stop timing device 2 discount
25. Each incorrect answer on written examination 1 discount
26. Failure to comply with other written adopted National Rules not covered in Discount
Sheets, ___2 each infraction
27. A team member who performs an act(s) that will endanger self, another team member, or
patient, regarding scene safety___5 each infraction per person (15 maximum per
infraction)
NOTE: If the intent of the problem is to identify potential unsafe conditions this should be
clearly identified in the written statement and on placard(s) at the scene.
15
INTERPRETATIONS OF SCORECARD B
ARTIFICIAL VENTILATION/CARDIOPULMONARY RESUSCITATION
1. Failure to determine unresponsiveness (according to Critical Skill Sheet). 1
2. Failure to call for help. 1
3. Failure to open airway. 1
4. Failure to use proper maneuver to open airway (using head-tilt/chin-lift

maneuver when jaw-thrust should be used, vice versa). 1
5. Failure to assess breathlessness within 10 seconds. 1
6. Failure to use one-way valve barrier device when ventilating manikin. 1
7. Failure to state “get AED”. 1
8. Failure to use mouth-to-nose ventilation when required. ___1
9. Failure to keep body and head in line if spinal injury exists. 1
10. Failure to use tongue jaw lift, cross-finger technique, or finger sweep when
required. 1
11. Failure to reposition head when airway obstruction is suspected. 1
12. Failure to give chest compressions when required.

1 (airway obstruction skill sheet)
13. Failure to make pulse prior to giving compressions. 1
14. Failure to assess pulse for 5-10 seconds. 1
15. Failure to correctly locate the carotid pulse. 1
16. Failure to ask judge for presence of a pulse. 1
16
Cardiopulmonary Resuscitation
1. Failure to give AV/CPR when required. 20

(Maximum of 3 sets AV/CPR or combination thereof)
2. Improper Hand placement when giving compressions. 1
3. Failure to make parallel axis with heels of hands. 1
4. Allowing fingers to rest on chest. 1
5. Compressions. Discounts shall apply to each set.
A. Depth. Compression depth shall break the first line for 60 pounds pressure.
Over compressions shall not be discounted. 1
B. Number required. A total of 30 compressions shall be made each cycle. 1

C. Release of upstroke. The release line shall be straight. 1
D. Rate. Compressions shall be made at the rate of 100 to 120 per minute. 1
6. Failure to maintain hand contact with manikin when releasing pressure

during compressions. 1 (This does not apply between cycles).
7. Failure to give 2 breaths between each cycle of compressions. 1
A. Timing (not completing breaths and returning to compressions in less than 10

seconds (This will be measured from the end of last down stroke to the start
of the first down stroke of the next cycle.) 1
B. Volume shall be at least .8 liters (through .7-liter line on new manikins).

Over inflation shall not be discounted. 1
8. Failure to give 5 cycles of 30 compressions and 2 breaths for each set of CPR (point
of first down stroke to peak of last breath). (A cycle is 30 compressions and two (2)
ventilations. A set is 5 cycles.) 1
9. Failure to assess pulse within 10 seconds after each set of CPR. 1

(one discount per set)
10. Failure to give 30 chest compressions when airway obstruction is suspected. 1
17
11. Failure to perform CPR as stated in the problem. Too many or too
few compressions can be detrimental to patient. 1
12. Failure for the number of Rescuer/Rescuers to perform CPR as stated in the
problem. Team performing One-Person CPR when Two-Person CPR is required
and vice versa. (When problem states “Two-Rescuer CPR”, two people are
required to perform CPR as listed in Two-Rescuer CPR skill sheets.) 3
13. Failure to begin with compressions after pulse check is completed or

when changing rescuers. 1
14. Failure to apply the AED when available. 10
15. Failure of rescuers to change positions in 5 seconds or less when performing

two- person CPR. 1
16. Failure of rescuer to ask the judge if the patient has a pulse when CPR is completed.
1
17. Delivery of simulated shock with AED to patient while in contact with the patient
5 each occurrence (add to scorecard)
Artificial Ventilation
1. Failure to give artificial ventilation. (Maximum of 3

sets AV/CPR or combination thereof) 20
2. Failure to give 10-12 breaths in each 58-62-second period. (1

minute of AV = 1 set) 1
3. Failure to provide a breath volume of at least .8 liters (through .7-liter line

on new manikins). Over inflation shall not be discounted. 1
4. Failure of rescuer to check for return of breathing and pulse when

artificial ventilation is completed. 1
5. Failure of rescuer to state that patient is breathing and has a pulse when
artificial ventilation is completed. 1
18
*NOTE: Each critical skill identified with an asterisk (*) shall be clearly verbalized by the
team as it is being conducted at contest not utilizing moulage. Each critical skill
identified with a double asterisk (**) shall be clearly verbalized by the team as it is being
conducted at all contests. After initially stating what BP-DOC- Bleeding, Pain,
Deformities, Open wounds stands for, the team may simply state BP-DOC- Bleeding,
Pain, Deformities, Open wounds when making their checks. Teams my use the acronym
“CSM” when checking circulation, sensation, and motor function.
INITIAL ASSESSMENT
PROCEDURES CRITICAL SKILLS
□ **A. Observe area to ensure safety
1. SCENE SIZE UP
□ **B. Call for help
□ **A. Determine causes of injury, if possible

2. MECHANISM OF
□ **B. Triage: Immediate, Delayed, Minor or Deceased.
INJURY
□ **C. Ask patient (if conscious) what happened
□ **A. Verbalize general impression of the patient(s)

3. INITIAL □ **B. Determine responsiveness/level of
ASSESSMENT consciousness (AVPU) Alert, Verbal, Painful,
Unresponsive
□ **C. Determine chief complaint/apparent life threat
A. Correctly execute head-tilt/chin-lift or jaw thrust
□ maneuver, depending on the presence of cervical
spine (neck) injuries
4. ASSESS AIRWAY B. Look for absence of breathing (no chest rise and
AND BREATHING □
fall) or gasping, which are not considered
adequate (within 10 seconds)
□ C. If present, treat sucking chest wound
□ A. Check for presence of a carotid pulse (5-10

5. ASSESS FOR seconds
□ B. If present, control life threatening bleeding
CIRCULATION
□ C. Start treatment for all other life-threatening
injuries/conditions (Rule 2).
IMMEDIATE: Rapid Patient Assessment treating all life threats Load and Go. If the treatment
interrupts the rapid trauma assessment, the assessment will be completed at the end of the
treatment.
DELAYED: Detailed Patient Assessment treating all injuries and conditions and prepare for
transport.
MINOR: (Can walk) Detailed Patient Assessment treating all injuries and conditions and
prepare for transport. After all IMMEDIATE and DELAYED patient(s) have been treated and
transported.
DECEASED: Cover
19
PATIENT ASSESSMENT

□ **A. Check head for BP-DOC: Bleeding, Pain, Deformities,
Open wounds, Crepitus
□ **B. Check and touch the scalp
□ **C. Check the face
□ **D. Check the ears for bleeding or clear fluids
1. HEAD □ **E. Check the eyes for any discoloration, unequal pupils,
reaction to light, foreign objects and bleeding
□ **F. Check the nose for any bleeding or drainage
□ **G. Check the mouth for loose or broken teeth,
foreign
objects, swelling or injury of tongue, unusual breath
odor and discoloration
□ **A. Check the neck Inspect
2. NECK □ **B. for medical ID
□ **A. Check chest area

□ **B. Feel chest for equal breathing movement on both sides
3. CHEST
□ **C. Feel chest for inward movement in the rib areas
during inhalations
4. ABDOMEN □ **A. Check abdomen (stomach)
□ **A. Check pelvis Inspect pelvis for injury by touch

5. PELVIS □ **B. (Visually inspect and verbally state inspection of crotch
and buttocks areas)
L R
□ □ **A. Check each leg
□ □ B. Inspect legs for injury by touch
□ □ C. Unresponsive: Check legs for paralysis (pinch inner
6. LEGS side of leg on calf)
□ □ **D. Responsive: Check legs for motion; places hand on
bottom of each foot and states “Can you push against
my hand?”
□ □ **E. Check for medical ID bracelet
L R
□ □ **A. Check each arm
□ □ B. Inspect arms for injury by touch
□ □ C. Unresponsive: Check arms for paralysis (pinch inner
side of wrist)
7. ARMS
□ □ **D. Responsive: Check arms for motion (in a conscious
patient; team places fingers in each hand of patient
and states “Can you squeeze my fingers?”
□ □ **E. Check for medical ID bracelet
20
8. BACK
□ **A. Check back
SURFACES
ONE-PERSON CPR (MANIKIN ONLY)

□ A. Tap or gently shake shoulders
□ **B. “Are you OK?”
1. RESCUER ESTABLISH □ C. Determine unconsciousness without compromising
UNRESPONSIVENESS cervical spine (neck) injury
□ **D. “Call for help”
□ **E. “Get AED” (Note: If AED is used, follow local
protocol)
2. RESCUER MONITOR □ A. Look for absence of breathing (no chest rise and fall)
PATIENT FOR or gasping breaths, which are not considered
BREATHING adequate (within 10 seconds)
A. Correctly locate the carotid pulse - on the side of

□
the rescuer, locate the patient’s windpipe with
your index and middle fingers and slide your
fingers in the groove between the windpipe and
3. RESCUER CHECK FOR the muscle in the neck
CAROTID PULSE □ B. Check for presence of carotid pulse for 5 to 10
Seconds
□ **C. Absence of pulse
□ D. Immediately start CPR if no pulse
□ A. Locate the compression point on the breastbone

between the nipples
□ B. Place the heel of one hand on the compression
4. POSITION FOR point and the other hand on top of the first so
COMPRESSIONS hands are parallel
□ C. Do not intentionally rest fingers on the chest
□ D. Keep heel of your hand on chest during and between
compressions
□ A. Give 30 compressions
□ B. Compressions are at the rate of 100-120 per minute
5. DELIVER CARDIAC
□ C. Down stroke for compression must be on or through
COMPRESSION
compression line
□ D. Return to baseline on upstroke of compression
21
□ A. Kneel at the patient’s side near the head
□ B. Correctly execute head-tilt/ chin-lift or jaw thrust
6. ESTABLISH AIRWAY
maneuver depending on the presence of cervical
spine injuries
□ A. Place barrier device (pocket mask / shield with one

way valve) on manikin
□ B. Give 2 breaths 1 second each
7. VENTILATIONS □ C. Each breath - minimum of .8 (through .7-liter line on
BETWEEN new manikins)
COMPRESSIONS □ D. Complete breaths and return to compressions in less
than 10 seconds (This will be measured from the end
of last down stroke to the start of the first down
stroke of the next cycle.)
□ A. Provide 5 cycles of 30 chest compressions and 2

rescue breaths
□ B. To check for pulse, stop chest compressions for no
more than 10 seconds after the first set of CPR
□ C. Rescuer opens airway and checks for adequate
breathing or coughing
8. CONTINUE CPR FOR □ D. Rescuer checks for a carotid pulse
TIME STATED IN □ E. If no signs of circulation are detected, continue
PROBLEM chest compressions and breaths and check for signs
of circulation after each set
□ F. A maximum of 10 seconds will be allowed to
complete ventilations and required pulse checks
between sets (this will be measured from the end of
the last down stroke to the start of the first down
stroke of the next cycle)
□ A. After providing required CPR (outlined in problem),
9. CHECK FOR check for return of pulse (within 10 seconds)
RETURN OF PULSE □ **B. “Ask judge for presence of a pulse.”
22
TWO-RESCUER CPR WITH AED (NO SPINAL INJURY - MANIKIN ONLY)

protocol)
2. RESCUER MONITOR □ A. Look for absence of breathing (no chest rise and fall)
PATIENT FOR or gasping breaths, which are not considered
A. Correctly locate the carotid pulse - on the side of the

□
rescuer, locate the patient’s windpipe with your
index and middle fingers and slide your fingers in
the groove between the windpipe and the muscle in
3. RESCUER CHECK the neck
FOR CAROTID PULSE □ B. Check for presence of carotid pulse for 5 to
10 Seconds
□ **C. Absence of pulse
□ D. Immediately starts CPR if no pulse

between the nipples
□ B. Place the heel of one hand on the compression point
4. RESCUER
and the other hand on top of the first so hands are
POSITION FOR
parallel.
COMPRESSIONS
□ C. Do not intentionally rest fingers on the chest. Keep
heel of your hand on chest during and between
compressions.
□ B. Compressions are at the rate of 100 to 120 per minute
5. RESCUER DELIVER □ C. Down stroke for compression must be on or through
CARDIAC compression line
COMPRESSION □ D. Return to baseline on upstroke of compression
6. RESCUER ESTABLISH □ A. Kneel at the patient’s side near the head

AIRWAY □ B. Correctly execute head-tilt/chin-lift maneuver
23
□ A. Place barrier device (pocket mask/shield with one
way valve) on manikin
□ B. Give 2 breaths 1 second each
□ C. Each breath - minimum of .8 (through .7-liter line
7. RESCUER
VENTILATIONS on new manikins)
□ D. Complete breaths and return to compressions in less
BETWEEN
COMPRESSIONS than 10 seconds (This will be measured from the end
of last down stroke to the start of the first down stroke
of the next cycle.)
□ A. Provide 5 cycles of 30 chest compressions and 2 rescue
breaths
□ B. To check for pulse, stop chest compressions for
no more than 10 seconds after the first set of CPR
□ C. Rescuer at patient’s head maintains airway and
checks for adequate breathing or coughing
□ D. The rescuer at the patient’s head shall feel for a
8. CONTINUE CPR FOR carotid pulse
TIME STATED IN E. If no signs of circulation are detected, continue
□
PROBLEM chest compressions and breaths and check for signs
of circulation after each set
between sets (this will be measured from the end of
the last down stroke to the start of the first down
stroke of the next cycle
□ A. Rescuer continues compressions while other
rescuer turns (simulated) on AED and applies pads.
□ B. RESCUERS SWITCH rescuer clears victim,
9. RESCUER APPLIES allowing AED to analyze. (Judges shall provide an
THE AED (DURING envelope indicating a shockable or non-shockable
THE FIFTH CYCLE rhythm)
OF COMPRESSIONS) □ C. If AED indicates a shockable rhythm, rescuer
clears victim again and delivers shock.
*verbalize shock given
10. RESUME □ A. Rescuer gives 30 compressions immediately

HIGH after shock delivery (2 cycles).
QUALITY CPR □ B. Other rescuer successfully delivers 2 breaths.
□ A. Change of rescuers shall be made in 5 seconds or less

11. CHANGING RESCUERS and will be completed as outlined in the problem.
Team must switch every 5 cycles in less than 5
seconds
□ A. After providing required CPR (outlined in problem),
12. CHECK FOR RETURN check for return of pulse (within 10 seconds)
OF PULSE □
**B. “Ask judge for presence of a pulse.”
24
TWO-RESCUER CPR WITH AED (WITH SPINAL INJURY - MANIKIN ONLY)

protocol)
2. RESCUER
□ A. Look for absence of breathing (no chest rise and fall) or
MONITOR
gasping, which are not considered adequate (within 10
PATIENT FOR
seconds)
BREATHING
□ A. Correctly locate the carotid pulse - on the side of the
rescuer, locate the patient’s windpipe with your index
and middle fingers and slide your fingers in the
3. RESCUER groove between the windpipe and the muscle in the
CHECK FOR neck
CAROTID □ B. Check for presence of carotid pulse for 5 to 10 second
PULSE □ **C. Absence of pulse
□ D. Immediately start CPR if no pulse

between the nipples
4. RESCUER □ B. Place the heel of one hand on sternum the compression
POSITION FOR point and the other hand on top of the first so hands
COMPRESSIONS are parallel
□ C. Do not rest fingers on the chest
Keep heel of your hand on chest during and between
compressions
5. RESCUER □ B. Compressions are at the rate of 100 to 120 per minute
DELIVER □ C. Down stroke for compression must be on or through
CARDIAC compression line
COMPRESSION □ D. Return to baseline on upstroke of compression
6. RESCUER □ A. Kneel at the patient’s head

ESTABLISH □ B. Correctly execute jaw thrust maneuver
AIRWAY
25
□ A. Rescuer should place the barrier device (pocket
mask/Shield with one way valve) on manikin
□ B. Rescuer Gives 2 breaths 1 second each
7. RESCUER □ C. Each breath - minimum of .8 (through .7-liter line
VENTILATIONS on new manikins)
BETWEEN □ D. Complete breaths and return to compressions in less
COMPRESSIONS than 10 seconds (This will be measured from the
end of last down stroke to the start of the first
down stroke of the next cycle.)
□ A. Provide 5 cycles of 30 chest compressions and 2
rescue breaths
□ B. To check pulse, stop chest compressions for no more
than 10 seconds after the first set of CPR
□ C. Rescuer at patient’s head maintains airway and
checks for adequate breathing or coughing
□ D. The rescuer giving compressions shall feel for a
carotid pulse
8. CONTINUE CPR □ E. If no signs of circulation are detected, continue chest
FOR TIME STATED
compressions and breaths and check for signs of
IN PROBLEM
circulation after each set
between sets (this will be measured from the end
of the last down stroke to the start of the first
down stroke of the next cycle
□ A. Rescuer continues compressions while other

rescuer turns on AED and applies pads.
□ B. RESCUERS SWITCH rescuer clears victim,
9. RESCUER APPLIES allowing AED to analyze. (Judges shall provide
THE AED (DURING an envelope indicating a shockable or non-
THE FIFTH CYCLE OF shockable rhythm)
COMPRESSIONS) □
C. If AED indicates a shockable rhythm, rescuer
clears victim again and delivers shock. *verbalize
shock given
□ A. Rescuer gives 30 compressions immediately after
10. RESUME HIGH shock delivery (2 cycles).
QUALITY CPR B. Other rescuer successfully delivers 2 breaths.
□
□ A. Change of rescuers shall be made in 5 seconds or less
11. CHANGING RESCUERS and will be completed as outlined in problem. Team
must switch every 5 cycles in less than 5 seconds.
□ A. After providing required CPR (outlined in
problem), check for return of pulse (within 10
12. CHECK FOR RETURN
seconds)
OF PULSE
□ **B. “Ask judge for presence of a pulse.”
26
MOUTH-TO-MASK RESUSCITATION

□ C. Determine unconsciousness without
1. ESTABLISH compromising C-spine injury
UNRESPONSIVENESS □ **D. “Call for help”
protocol)
2. MONITOR □ A. Look for absence of breathing (no chest rise and

PATIENT FOR fall) or gasping, which are not considered adequate
BREATHING (within 10 seconds)
□ A. Correctly locate the carotid pulse (on the side of

the rescuer)
3. CHECK FOR □ B. Check for presence of carotid pulse for 5 to 10
CAROTID PULSE second.
□ **C. Presence of pulse
A. Correctly execute head tilt / chin lift or jaw thrust

4. ESTABLISH AIRWAY □ maneuver depending on the presence of cervical
□ A. Place barrier device (pocket mask/shield with one-
way valve on manikin
5. VENTILATE PATIENT □
B. Ventilate patient 10 to 12 times per minute. Each
ventilation will be provided at a minimum of .8
(through .7-liter line on new manikins)
□ A. After providing the required number of breaths

6. CHECK FOR RETURN (outlined in problem), check for return of breathing
OF BREATHING AND
and carotid pulse within 10 seconds
PULSE □ **B. “Patient is breathing and has a pulse”
27
AIRWAY OBSTRUCTION (UNCONSCIOUS VICTIM – WITNESSED)

1. INTIALLY ASSESS □ C. Determine unconsciousness without
LEVEL OF compromising C-spin injury
CONSCIOUSNESS □ **D. “Call for help”
protocol)
□ A. Look for absence of breathing (no chest rise and fall)
2. MONITOR
or gasping, which are not considered adequate
PATIENT FOR
(within 10 seconds)
BREATHING
□ A. Correctly locate the carotid pulse - on the side of the

rescuer, locate the patient’s windpipe with your index
and middle fingers and slide your fingers in the
□ groove between the windpipe and muscle in the neck
3. PULSE CHECK
B. Check for presence of carotid pulse for 5 to 10
seconds
□ **C. Patient has pulse
□ A. Correctly execute head-tilt/chin-lift or jaw thrust

maneuver depending on the presence of cervical
4. OPEN AIRWAY
□ **B. “Look for foreign object”
□ A. Place barrier device on manikin

5. ATTEMPT □ B. Seal mouth and nose
VENTILATION □ C. Attempt to give slow breath (1 second duration)
□ **D. Identify if there is an obstruction
□ A. Re-establish airway using correct method and
6. CHECK POSITIONING procedure
□ **B. Identify continued presence of the obstruction
between the nipples
□ B. Place the heel of one hand on sternum the
7. POSITION FOR
compression point and the other hand on top of
COMPRESSIONS
the first so hands are parallel
□ C. Do not rest fingers on the chest keep heel of your
hand on chest during and between
compressions.
28
□ B. Compressions are at the rate of 100-120 per minute
□ C. Down stroke for compression must be on or
8. COMPRESSIONS
through compression line
□ D. Return to baseline on upstroke of compression
□ A. Correctly execute head-tilt / chin-lift or jaw-

thrust maneuver depending on the presence of
9. OPEN AIRWAY
cervical spine (neck) injuries
□ **B. “Look for foreign object”
□ A. Follow with finger sweep, only if the object is seen.
(open mouth, grasping tongue and lower jaw with
10. PERFORM
thumb and fingers, insert index finger of other hand
FINGER SWEEP
down along inside cheek and deeply into throat in a
(IF OBJECT IS SEEN)
hooking action)
□ B. Grasp and remove foreign object
□ A. Correctly make effort to administer breath

□ B. Administer second breath, if first successful and
11. ATTEMPT check pulse
VENTILATION □ C. If unsuccessful repeat sequence of compressions,
mouth check, finger sweep (if object is visible) and
attempt to ventilate
29
SUCKING CHEST WOUND

1. EXPOSE WOUND □ *A. Expose entire wound
□ *A. Place occlusive dressing over wound (If occlusive

2. SEAL WOUND AND dressing is not available use gloved hand)
CONTROL BLEEDING □ B. Apply direct pressure as needed to stop the
bleeding
□ A. Keep patient calm and quiet
□ **B. Explain to the patient what you are doing
□ *C. Ensure dressing is large enough not to be
sucked into the wound (two inches beyond
edges of wound)
3. APPLY AN □ D. Affix dressing with tape
OCCLUSIVE □ *E. Seal on three sides
DRESSING □ **F. Monitor patient closely for increasing difficulty
breathing
□ G. Transport as soon as possible
□ H. Keep patient positioned on the injured side
unless other injuries prohibit
□ **I. Reassess wound to ensure bleeding control
□ **J. Assess level of consciousness (AVPU),
respiratory status and patient response
30
LIFE-THREATENING BLEEDING

□ *A. Apply direct pressure with a gloved hand
□ *B. Apply a dressing to wound (cover entire
wound) and continue to apply direct pressure
1. DIRECT PRESSURE *C. Elevate the extremity except when spinal
□
AND ELEVATION injury exists
□ **D. Bleeding has been controlled
□ *E. If controlled, bandage dressing in place
2. IF NOTIFIED THAT
BLEEDING IS NOT □ A. Apply as per tourniquet skill sheet
CONTROLLED, APPLY
TOURIQUET
External Bleeding
To Control: 1st: direct pressure
2nd: elevation & direct pressure
Last Resort: Tourniquet
Internal Bleeding
**1. Monitor breathing and pulse
**2. Keep patient still
**3. Loosen restrictive clothing
**4. Be alert if patient vomits
**5. Nothing by mouth
**6. Report possibility of internal bleeding as soon as EMS personnel arrive on
31
TOURNIQUET
If these conditions are met, a tourniquet may be the

only alternative:
1. DETERMINE NEED OR □ A. Direct pressure has not been successful in stopping
USING TOURNIQUET bleeding
□ B. Elevation of wound above heart has not been
successful in stopping of bleeding
2. SELECT A. Select a band that will be between 1-4 inches in

□
APPROPRIATE width and can be wrapped six or eight layers deep
MATERIALS for improvised tourniquet or select factory
tourniquet.
Factory Tourniquet
□ A. Wrap band around the extremity proximal to the
wound (one inch above but not on a joint)
Improvised Tourniquet
□ B. Apply a bandage around the extremity proximal to
3. APPLY TOURNIQUET
the wound (one inch above but not on a joint) and
tie a half knot in the bandage
□ C. Place a stick or pencil on top of the knot and tie the
ends of the bandage over the stick in a square knot
□ D. Twist the stick until the bleeding is controlled,
secure the stick in position
□ A. Do not cover the tourniquet with

4. APPLY PRESSURE bandaging material
WITH TOURNIQUET □ **B. Notify other medical personnel caring for the
patient
5. MARK PATIENT □ A. Mark a piece of tape on the patient’s forehead “TQ”

APPROPRIATELY and time applied
□ **A. Assess level of consciousness (AVPU),
6. REASSESS
respiratory status, and patient response
32
DRESSINGS AND BANDAGING – OPEN WOUNDS

□ *A. Control bleeding
1. EMERGENCY CARE □ *B. Prevent further contamination
FOR AN OPEN □ *C. Bandage dressing in place after bleeding has been
WOUND controlled
□ *D. Keep patient lying still
□ A. Use sterile dressing
□ B. Cover entire wound
2. APPLY DRESSING □ C. Control bleeding
□ D. Do not remove dressing
□ A. Do not bandage too tightly.

□ B. Do not bandage too loosely.
3. APPLY BANDAGE □ C. Cover all edges of dressing.
□ D. Do not cover tips of fingers and toes unless they
are injured.
□ E. Bandage from the bottom of the limb to the top
(distal to proximal) if applicable.
Multiple wounds will be treated as per procedures listed in patient

assessment.
Impaled Objects
*1. Do not remove
2. Expose wound
3. Control bleeding
4. Stabilize with a bulky dressing; criss-cross the layers
5. Tie 4in. wide cravats around to hold in place, or tape in place
*6. Check for exit wound (treat when found)
7. Immobilize affected area
Impaled Objects in the Jaw

*1. Examine; inside & outside
2. If end not impaled in mouth – pull it out
3. Position head for drainage: if spinal injury, immobilize 1st and tilt board
4. Dress outside of wound
**5. Gauze on inside only if patient alert, (Simulate only in contest and state, “I would leave
3-4 inches of gauze outside of mouth.”)
Impaled Objects in the Eye
1. Stabilize with 3-inch gauze or folded 4x4
2. Put cup (no Styrofoam) over object and allow cup to rest on roller gauze or 4x4
3. Secure cup with roller gauze (not over top of cup)
*4. Cover uninjured eye too
33
Open Neck Wound (Serious or Life Threatening)
*1. Gloved hand over wound
*2. Occlusive dressing over wound- 2 inches larger than wound site
3. Gauze dressing over occlusive
4. Place roller gauze beside site and wrap around figure 8 under opposite arm
Abdominal Injury
*1. Place on back with legs flexed at the knees (for closed or open wounds)
Additional Steps for Open Abdominal Wounds (Serious or Life Threatening)

**1. Apply moist dressing, then an occlusive dressing
*2. Cover the occlusive with pads or a towel for warmth
*3. If an object is impaled in abs, stabilize it and do not flex legs- leave them in
the position you found them.
Skull Fractures and Brain Injuries

*1. Open airway with jaw thrust
2. Apply collar
*3. Use loose gauze dressing- no direct pressure
**4. Keep at rest, ask them questions
5. Don’t elevate legs (on or off a backboard)
6. After entire body is immobilized- tilt back board, injured side down
Amputations
**1. Wrap in slightly moistened sterile dressing
2. Place in plastic bag or wrap in plastic
*3. Keep part cool avoid freezing
*4. Do not place in water or direct contact with ice
**5. Transport with patient
6. Label with patients’ name
NOTE:
A sling and swathe are required generally effective for musculoskeletal injuries to
the shoulder, upper arm, elbows, lower arm and wrists. Triangular slings are
required for all wounds of upper extremities, including shoulder and armpit
wounds. Slings will not be required for upper extremity burns/deep cold injuries.
However, if a burn/deep cold injury and musculoskeletal injuries wound and/or
fracture/dislocation are present on the same upper extremity, a sling shall be
applied.
34
TWO-PERSON LOG ROLL

1. STABILIZE HEAD □ *A. Stabilize the head and neck
□ A. When placing patient on board place board parallel to

the patient
2. PREPARING □ B. Kneel at the patient’s shoulders opposite the board (if
THE PATIENT used) leaving room to roll the patient toward knees
Raise the patient’s arm, if not injured (the one closer
to the rescuer) above the patient’s head
3. PREPARING □ A. Grasp the patient at the shoulder and pelvis area

THE RESCUER □ B. Give instructions to bystander, if used to support
□ A. While stabilizing the head, roll the patient toward the

rescuer by pulling steadily and evenly at the shoulder
and pelvis areas
□ B. The head and neck should remain on the same plane
4. ROLLING as the torso
THE □ C. Maintain stability by holding patient with one
PATIENT hand and placing board (if used) with other
□ D. Roll the body as a unit onto the board (if used) (board
may be slanted or flat)
□ E. Place the arm alongside the body
35
THREE-PERSON LOG ROLL

□ *A. Stabilize the head and neck
□ B. One rescuer should kneel at the top of the
1. STABILIZE HEAD
patient’s head and hold or stabilize the head and
neck in position found.
□ A. A second rescuer should kneel at the patient’s

side opposite the direction the face is facing.
□ B. When placing patient on board place board
parallel to the patient.
□ C. Quickly assess the patient’s arms to ensure no
2. PREPARING obvious injuries.
THE PATIENT □ D. Kneel at the patient’s shoulders opposite the board (if
used) leaving room to roll the patient toward knees
Raise the patient’s arm, if not injured (the one closer
to the rescuer) above the patient’s head.
□ E. The third rescuer should kneel at the patient’s hips.
□ A. Rescuers should grasp the patient at the

3. PREPARING □ shoulders, hips, knees, and ankles.
THE RESCUER B. Give instructions to bystander (physically show),
if used to support
□ A. While stabilizing the head, the rescuer at the patient’s

head should signal and give directions, all rescuers
should slowly roll the patient toward the rescuers in a
coordinated move, keeping the spine in a neutral, in-
line position.
□ B. On three, slowly roll. One, two, three roll together.
□ C. The head and neck should remain on the same plane as
3. ROLLING the torso, the rescuer holding the head should not
THE initially try to turn the head with the body. (if the head
PATIENT is already facing sideways, allow the body to come into
alignment with the head)
□ D. Maintain stability by holding patient with one hand
and placing board (if used) with other
□ E. Roll the body as a unit onto the board (if used) (board
may be slanted or flat) Center the patient on the
board.
□ F. Place the arm alongside the body
36
SPLINTING (RIGID) UPPER EXTREMITY FRACTURES AND
DISLOCATIONS

□ **A. Check for distal circulation, sensation,
and motor function
1. CARE FOR FRACTURE
 Do not attempt to reduce dislocations (if
applies)
□ A. Selection of appropriate rigid splint of proper
length
□ B. Support affected limb and limit movement
□ C. Apply appropriate padded rigid splint against
injured extremity
2. IMMOBILIZING □ D. Place appropriate roller bandage in hand to
FRACTURE ensure the position of function
□ E. Secure splint to patient with roller bandage,
handkerchiefs, cravats, or cloth strips
□ F. Apply wrap distal to proximal
□ **G. Reassess distal circulation, sensation, and motor
function
□ A. Place sling over chest and under arm
□ B. Hold or stabilize arm
□ C. Triangle should extend behind elbow on injured
side
□ D. Pull sling around neck and tie on uninjured side
3. SECURING WITH
□ E. Pad at the neck (except when C-Collar is
SLING
present)
□ F. Secure excess material at elbow
□ G. Fingertips should be exposed
□ **H. Reassess distal circulation, sensation, and motor
function
□ A. Use triangle cravat or factory swathe
4. SECURING SLING □ B. Swathe is tied around chest and injured arm
WITH SWATHE □ **C. Reassess distal circulation, sensation,
and motor function
ELBOW (STRAIGHT POSITION)

Follow Procedures No. 1 and No. 2 above
FINGER/FINGERS
Immobilize Fracture
1. Tape injured finger to an adjacent uninjured finger; or
2. Tape injured finger to a tongue depressor, aluminum splint, or pen and pencil
3. Secure with sling and swathe
37
COLLAR BONE
Support and limit movement of affected
area Follow Procedures No. 1, No. 3 and
No. 4 above
SHOULDER BLADE
Support and limit movement of affected
area Follow Procedures No. 1, No. 3 and
No. 4 above
NOTE: Do not reposition dislocations
SPLINTING (SOFT) UPPER EXTREMITY FRACTURES AND

DISLOCATIONS (WRIST AND HAND)

□
**A. Check for distal circulation, sensation, and
motor function
1. CARE FOR FRACTURE □
B. Do not attempt to reduce dislocations
(if applies)
□
A. Support affected limb and limit movement
□
B. Place two cravats (triangular bandage) under
2. IMMOBILIZING wrist/hand
FRACTURE □
C. Place pillow length wise under wrist/hand, on
top of cravats (pillow should extend past
fingertips)
□
D. Lower limb, adjust cravats to tie
□
E. Tie cravats distal to proximal
□ A. Place sling over chest and under arm
□ B. Hold or stabilize arm
□ C. Triangle should extend behind elbow or injured
3. SECURING WITH side
SLING □ D. Secure excess material at elbow
□ E. Fingertips should be exposed
□ **F. Reassess distal circulation, sensation,
and motor function
□ A. Use triangle cravat or factory swathe
4. SECURING SLING □ B. Swathe is tied around chest and injured arm
WITH SWATHE □ **C. Reassess distal circulation, sensation, and
motor function
38
SPLINTING (RIGID OR SOFT) PELVIC GIRDLE, THIGH, KNEE
AND LOWER LEG

□ **A. Assess for:
 Pain
1. DETERMINE NEED
 Swelling
FOR SPLINTING
 Deformity
□ B. Determine if splinting is warranted
2. APPLY MANUAL □ A. Support affected limb and limit movement
STABILIZATION  Do not attempt to reduce dislocations
□ A. Select appropriate splinting method depending
3. SELECT
on position of extremity and materials available
APPROPRIATE
□ B. Select appropriate padding material
SPLINT
□ A. Remove or cut away clothing as needed
□ **B. Assess distal circulation, sensation, and
motor function
4. PREPARE
□ C. Cover any open wounds with sterile dressing
FOR
and bandage
SPLINTING
□ D. Measure splint
□ E. Pad around splint for patient comfort
39
□ A. Maintain support while splinting
Living Splint:
□ A. Immobilize the site of the injury
□ B. Carefully place a pillow or folded blanket
between the patients knees/legs
5. SPLINT □ C. Bind the legs together with wide straps or
cravats
□ D. Carefully place patient on long spine board
□ E. Secure the patient to the long spine board (if
primary splint)
and motor function
Padded Board Splint:
□ A. Splint with two long padded splinting boards
(one should be long enough to extend from the
patient’s armpit to beyond the foot. The other
should extend from the groin to beyond the
foot.) (Lower leg requires boards to extend from
knee to below the foot.)
□ B. Cushion with padding in the armpit and groin
and all voids created at the ankle and knee
□ C. Secure the splinting boards with straps and
cravats
□ D. Carefully place the patient on long spine board
primary splint)
and motor function
Other Splints:
□ A. Immobilize the site of the injury
□ B. Pad as needed
□ C. Secure to splint distal to proximal
□ D. Carefully place patient on long spine board
primary splint)
and motor function
6. REASSESS □ **A. Assess patient response and level of comfort
40
SPLINTING (SOFT) LOWER EXTREMITY FRACTURES AND
DISLOCATIONS (ANKLE AND FOOT)

□ **A. Assess for distal circulation, sensation, and
1. CARE FOR motor function
FRACTURE □ B. Do not attempt to reduce dislocations
(if applies)
□ A. Support affected limb and limit movement
□ B. Place three cravats (triangular bandage) under
ankle/foot
□ C. Place pillow length wise under ankle/foot, on
top of cravats (pillow should extend 6 inches
2. IMMOBILIZING
beyond foot)
FRACTURE
□ D. Lower limb, adjust cravats to tie
□ E. Tie cravats distal to proximal
□ F. Elevate with blanket or pillow
□ **G. Reassess distal circulation, sensation, and motor
function
41
SPLINTING UPPER EXTREMITY/LOWER EXTREMITY
FRACTURES (AIR SPLINT)

□ **A. Assess distal circulation, sensation, and motor
1. CARE FOR FRACTURE
function(fingers/toes)
□ A. Grasp above and below the injury site
□ B. Maintain support
2. IMMOBILIZE □ C. Properly apply air splint
FRACTURE □ D. Splint should be relatively free of wrinkles
□
E. Inflate splint to point that slight dent can be
made
□ **F. Reassess distal circulation, sensation, and motor
function (fingers/toes)
□ **A. Periodically check for increase or decrease

in pressure
3. MONITOR AIR- □ **B. Monitor pressure in splint with finger tip
INFLATED SPLINT □ C. Make sure desired pressure is maintained
□ **D. Reassess distal circulation, sensation, and
motor function (fingers/toes)
NOTE: Air splints may not be used with open (protruding bones) fractures.
Air splints may only be used on the lower part of the extremities
(from below the elbow on the arm and below the knee to the leg).
42
SPLINTING – FLAIL CHEST

□ **A. Assess for:
• Pain
1. DETERMINE NEED
• Swelling
FOR SPLINTING
• Deformity
□
*B. Determine if splinting is warranted
2. SELECT APPROPRIATE □ A. Choose a pillow, blanket, trauma dressing, or

SPLINTING MATERIAL other appropriate splinting material
□ *A. Remove or cut away clothing as needed.

3. PREPARE □ B. Cover any open wounds with sterile dressing
FOR and bandage
SPLINTING
□ A. Affix splint to chest with adhesive tape or roller
bandage
□ B. Immobilize the site of injury
4. APPLY SPLINT □
C. Use caution when taping splint to chest
circumferentially
□ **D. Ensure sufficient chest expansion
5. REASSESS □ **A. Assess patient response and level of comfort
6. ASSIST VENTILATIONS □ **A. Assist with ventilation as needed
43
ONE RESCUER BLANKET DRAG

□ A. Properly prepare blanket for use in blanket
drag
1. VICTIM SUPINE
□ B. Spread blanket alongside patient with
ON GROUND
approximately one half the width gathered
lengthwise into pleats
A. Properly roll victim on one side

□
□ B. Take patients arm on side of body opposite to
2. POSITION PATIENT blanket and extend arm over head
□ C. Support head and neck roll patient on side
away from blanket
A. Properly position on blanket

□
□ B. Hold patient on side while pleated portion of
blanket is pulled in close to victim’s back
3. PLACE PATIENT □ C. Roll patient onto blanket, extend opposite arm
ON BLANKET and roll onto opposite side
□
D. Smooth out pleats and roll patient onto back
□ E. Snugly wrap patient in blanket with arms at
sides
□ A. Proper blanket drag of patient

4. PREPARE TO
□ B. Grasp portion of blanket beneath victim’s head
DRAG PATIENT
and drag victim to safety
44
TWO RESCUER EXTREMITY GROUND LIFT

□ A. Rescuer 1 – Kneel at the head of the patient
and place one hand under each of the
1. POSITIONING shoulders
□ B. Rescuer 2 – Kneel by the patients feet and
grasp the patient’s wrist
□ A. Direct rescuer 2-to pull patient into a sitting

position.
2. RAISING □ B. Rescuer 1 – push patient’s shoulders up, slip
PATIENT TO A your arms under the patient’s armpits and
SITTING grasp wrist.
POSITION □ C. Rescuer 2 – Gently pull on patient’s arms
□ A. Rescuer 1 –Once the patient is in a semi

sitting position have rescuer 2 crouch down
and grasp the patient’s legs behind the knees.
□ B. Rescuer 1-Directs rescuer 2 so you both stand
at the same time. Then move as a unit when
3. POSITIONING
carrying the patient.
AND LIFTING
□ C. The rescuer at the head to direct the rescuer at
the feet when to stop the carry and when to
place the patient down in a supine or seated
position.
45
SHIRT DRAG

1. POSITIONING □ A. Rescuer - Kneel at the head of the patient and
place one hand under each of the shoulders
□ A. Rescuer – Grasp shirt at the shoulder area
□ B. Drag patient in a straight (keep spine as
straight as possible avoid dragging a patient
2. MOVING PATIENT
sideways, by one arm, or one leg. A sideways
drag can cause twisting motions of the spine
that could aggravate existing injuries.)
□ A. When using a drag to move a patient down

3. MOVING PATIENT stairs or down an incline, grab the patient
DOWN STAIRS OR under the shoulders and pull the patient head
first as you walk backward. If possible, try to
INCLINE
cradle the patient’s head in your forearms as
you drag.
46
ESTABLISHING AIRWAY–SUSPECTED CERVICAL SPINE (NECK)
INJURY

□ A. Rescuer – Position at top of the victim’s head
1. STABILIZE HEAD □ B. Restrain victim’s head and neck to avoid
voluntary or involuntarymovement/rotation
of the neck
2. ESTABLISH □ A. Use modified jaw thrust maneuver without
AIRWAY causing over-extension of victim’s neck
□ A. Look for absence of breathing (no chest rise

3. CHECK FOR and fall) or gasping, which are not considered
□ **B. State that the victim is/is not breathing
4. MAINTAIN OPEN
□ A. Do not compromise suspected neck injury
AIRWAY
47
SHOCK

□ **A. Check restlessness; anxiety; altered mental
status; increased heart rate; normal to
slightly low blood pressure; mildly
1. CHECK FOR SIGNS increased breathing rate; pale (or bluish) skin
AND SYMPTOMS OF (in victim with dark skin examine inside of
SHOCK mouth and nailbeds for bluish coloration).
□ **B. Check for cool, moist skin; sluggish pupils;
and nausea and vomiting.
□ **C. Check for weakness
□ A. Ensure the ABCs are properly supported.

□ B. Control external bleeding.
□ C. Keep the patient in a supine position.
□ **D. Calm and reassure the patient, and
maintain a normal body temperature.
□ E. Cover with blanket to prevent loss of body
heat and place a blanket under the patient.
(Do not try to place blanket under patient
2. TREATMENT
with possible spinal injuries)
□
F. Continue to monitor and support ABCs
□ G. Do not give the patient anything by mouth.
Do not give any fluids or food and be alert
for vomiting.
□ **H. Monitor the patient’s ABCs at least every five
minutes.
□ **I. Reassure and calm the patient
48
IMMOBILIZATION – LONG SPINE BOARD (Backboard)
□ A. Rescuer One at the head must maintain in-

line immobilization of the head and spine
1. MOVE THE □ B. Rescuer One at the head directs the
PATIENT ONTO movement of the patient
THE LONG SPINE □ C. Other Rescuers control movement of the rest
BOARD of body
□ D. Rescuer Two position themselves on same side
□ E. Upon command of Rescuer One at the head,
roll patient onto side toward Rescuer Two.
□ F. Quickly assess posterior body, if not
already done
□ G. Place long spine board next to the patient
with top of board beyond top of head
□ H. Place patient onto the board at command of
the Rescuer at head while holding in-line
immobilization using methods to limit spinal
movement
□ I. Slide patient into proper position using
smooth coordinated moves keeping spine in
alignment
2. PAD VOIDS BETWEEN □ A. Select and use appropriate padding

PATIENT AND LONG □ B. Place padding as needed under the head
SPINE BOARD □ C. Place padding as needed under torso
3. IMMOBILIZE BODY □ A. Strap and secure body to board ensuring spinal

TO THE LONG SPINE immobilization, beginning at shoulder and
BOARD working toward feet
□ A. Using head set or place rolled towels on each

4. IMMOBILIZE HEAD
side of head
TO THE LONG SPINE
□ B. Tape and/or strap head securely to board,
BOARD
ensuring cervical spine immobilization
□ **A. Reassess distal circulation, sensation, and
5. REASSESS motor function
□ **B. Assess patient response and level of comfort
49
IMMOBILIZATION OF CERVICAL SPINE

□ A. Place head in a neutral, in-line position unless
patient complains of pain or the head is not easily
1. ESTABLISH AND moved into position
MAINTAIN IN-LINE □ B. Place head in alignment with spine
IMMOBILIZATION □ C. Maintain constant manual in-line immobilization
until the patient is properly secured to a
backboard with head immobilized
**A. Assess distal circulation, sensation, and motor
2. ASSESS CSM □
function (on all extremities)
□ **A. Inspect and palpate for injuries or signs of injuries
3. ASSESS CERVICAL
□ B. Remove clothing or jewelry as necessary
REGION AND NECK
4. BANDAGE
□ A. Any neck wounds
ANY WOUND
□ A. Apply properly sized collar or manual
immobilization
One piece C-collar
□ A. Select proper sized collar
□ B. Apply collar
□ C. Ensure that patient’s head is not twisted during
application
5. APPLY CERVICAL
□ D. Ensure airway is open after placement
SPINE
Two-piece C-collar
IMMOBILIZATION
□ A. Select proper sized collar
□ B. Apply rear section to back of neck
□ C. Center rigid support on spine
□ D. Apply front section (overlaps rear section)
□ E. Ensure chin rests in chin cavity
□ F. Secure collar with Velcro straps
□ G. Ensure airway is open after placement
□ A. Immobilize patient to appropriate immobilization
6. SECURE HEAD TO device
APPROPRIATE □ B. Use head set or place rolled blankets or towels on
IMMOBILIZATION each side of head
DEVICE □ C. Tape and or strap head securely to appropriate
immobilization device
□ **A. Reassess distal circulation, sensation, and
7. REASSESS motor function
□ **B. Assess patient response and level of comfort
50
BURNS

□ **A. Determine type
1. DETERMINE  Thermal
BURN TYPE  Chemical
 Electrical
2. DETERMINE □
**A. Determine Body Surface Area (BSA) using rule
BODY SURFACE
of nines
AREA
□ *A. Remove patient from source of burn and
prevent further contamination
□ **B. Consider the type of burn and stopping the
burning process initially with water or saline.
□ C. Do not flush with water unless they involve an
area less than 9% of the total body surface area)
□ D. Remove smoldering clothing (do not remove
any clothing that is melted onto the skin)
jewelry
□ **E. Continually monitor the airway for evidence
of closure
□ F. Prevent further contamination. Keep the burned
4. BURN
area clean by covering it with a dressing. Cover
CARE
partial- and full-thickness burns with dry clean
(All Types)
dressings. In most cases place dry, sterile dressings
onto the burned area.
□ **G. Do not use any type of ointment, lotion or antiseptic
□ **H. Do not break blisters
□ **I. Ensure patient does not get hypothermic
□ J. If eyes or eyelids have been burned, place dressings
or pads over them. Moisten these pads with sterile
water if possible. Both eyes will be covered.
□ K. If serious burn (partial or full-thickness burns)
involves the hands or feet, always place a clean pad
between toes or fingers when completing the
dressing.
51
□ A. Protect yourself from exposure to hazardous
materials
4. CARE FOR □ B. Wear gloves, eye protection, and respiratory
CHEMICAL protection
BURNS □ **C. Flush the burned area for at least 20 minutes. (If
possible and it can be done quickly, try to identify
any chemical powders before applying water)
□ D. Apply a dry, clean dressing.
□ E. If dry lime is the agent causing the burn, do not
flush with water. Instead use a dry dressing to
brush the substance off the patient’s skin, hair, and
clothing.
□ F. Remove any contaminated clothing or jewelry.
□ G. Once this is done, you may flush the area with
water.
□ H. Use caution not to contaminate uninjured areas
when flushing or brushing
□ **A. Ensure safety before removing patient from
5. CARE FOR the electrical source
ELECTRICAL □ **B. If the patient is still in contact with the electrical
BURNS source or you are unsure, do not approach or touch
the patient, contact power company
□ **C. Monitor the patient closely for respiratory
and cardiac arrest
□ D. Treat the soft tissue injuries associated with
the burn
□ **E. Look for both an entrance and exit wound
□ **A. Reassess level of consciousness (AVPU),
6. REASSESS
respiratory status, and patient response
Multiple burns will be treated as per procedures listed in patient assessment.
52
EARLY OR SUPERFICIAL FROSTBITE

1. ASSESS FOR
**A. Patient exhibits signs and symptoms of
FROSTBITE AND □
frostbite or cold injuries
COLD INJURIES
□ A. Blanching of the skin – palpitation of the skin in
which normal color does not return
2. ASSESS FOR
□ B. Loss of feeling and sensation in the injured area
EARLY OR
□ C. Skin remains soft
SUPERFICIAL
□ D. If re-warmed, patient will feel a tingling
FROSTBITE
sensation
□ *A. Remove the patient from the environment
□ B. Protect the cold injured extremity from
3. TREAT EARLY
further injury
OR
□ *C. Remove wet or restrictive clothing
SUPERFICIAL
□ D. Do not rub or massage
INJURY
□ E. Do not re-expose to the cold
4. REASSESS
53
LATE OR DEEP COLD INJURY

1. ASSESS FOR
□ **A. Patient exhibits signs and symptoms of
FROSTBITE AND
frostbite or cold injuries
COLD INJURIES
□ A. White, waxy skin
□ B. Firm to frozen feeling upon palpitation
2. ASSESS FOR □ C. If thawed or partially thawed, the skin may
LATE OR DEEP appear flushed with areas of purple and
COLD INJURY blanching or mottled and cyanotic
□ D. Swelling may be present
□ E. Blisters may be present
□ *A. Remove the patient from the environment
□ B. Protect the cold injured extremity from
3. TREAT LATE OR further injury
DEEP COLD INJURY □ *C. Remove wet or restrictive clothing
□ D. Remove jewelry
□ E. Cover with dry clothing or dressings
□ **F. Do not:
 Break blisters
 Rub or massage area
 Apply heat
 Re-warm
 Allow the patient to walk on the affected
extremity
4. REASSESS
54
MILD HYPERTHERMIA (HEAT)

1. ASSESS FOR hyperthermia:
HYPERTHERMIA  Redness
 Muscular cramps
 Weakness or exhaustion
 Rapid heart rate
 Dizziness or faintness
 Altered mental status to unresponsive
2. PREVIOUS □ **A. Inquire about previous interventions attempted
INTERVENTIONS
3. ASSESS FOR □ **A. Check skin for:
MILD  Normal to cool temperature
HYPERTHERMIA  Pale
(HEAT  Moist
EXHAUSTION)
□ **A.Place in a cool environment
□ **B.Cool patient by fanning
4. TREATMENT □ C.Put in supine position with legs elevated
FOR MILD □ **D.Offer drinking water if patient is responsive
HYPERTHERMIA and not nauseated
□ E. If the patient is unresponsive or is
vomiting, transport to the hospital
□ **A. Reassess level of consciousness
5. REASSESS
(AVPU), respiratory status and patient
response
55
SEVERE HYPERTHERMIA

1. ASSESS FOR hyperthermia:
HYPERTHERMIA  Redness
 Muscular cramps
 Weakness or exhaustion
 Rapid heart rate
 Dizziness or faintness
 Altered mental status to unresponsive
2. PREVIOUS □
**A. Inquire about previous interventions attempted
INTERVENTIONS
3. ASSESS FOR □ **A. Check skin for:
SEVERE  Hot temperature
HYPERTHERMIA  Red
(HEAT STROKE)  Dry or moist
□
**A. Place patient in a cool environment
□
**B. Wet patient skin by applying water from sponge
or wet towels and fan
4. TREATMENT □ C. Put in supine position with legs elevated
FOR SEVERE □ **D. Offer drinking water if patient is responsive
HYPERTHERMIA
and not nauseated
□ *E. Apply cool packs to neck, groin and armpits
□ **F. Transport immediately
□ **A. Reassess level of consciousness

5. REASSESS
(AVPU), respiratory status and patient
response
56
FIRST AID STATEMENTS OF FACT
1. Pertussis, hepatitis, and tetanus are commonly recommended immunization for

health care providers. Ch.-3
2. Hepa mask would be the most important type of PPE to use when caring for a
patient with tuberculosis. Ch.-3
3. Proper body substance isolation (BSI) precautions should be taken for any ill or
injured patient. Ch.-3
4. The lower airway includes the following: Bronchi, alveoli, and trachea. Ch.-4
5. The abdominal cavity contains the liver and part of the large intestine. Ch.-4
6. The kidneys are found in an area behind the abdominal wall. Ch.-4
7. Proper body mechanics are best defined as properly using your body to facilitate
a lift or move. Ch.-6
8. When lifting a patient, your feet should be placed shoulder – width apart. Ch.-6
9. Before restraining a combative patient, the Emergency Medical Responder

should obtain law enforcement assistance. Ch.-6
10. The recommended method for opening the airway of a patient with possible
neck or spinal injury is the jaw-thrust maneuver. Ch.-9
11 A pocket face mask allows the rescuer to provide ventilations while minimizing
direct contact with the patient’s mouth and nose. Ch.-9
12. During rescue breathing you should check for the effectiveness of ventilations by
looking for chest rise / and fall, listening for airflow and observing skin color.
Ch.-9
13. Inserting an oropharyngeal airway improves ventilations delivered by way of a

bag mask device. Ch.-9
14. Poor chest rise, pale or bluish skin color or use of accessory muscles are signs of
difficulty of breathing. Ch.-9
15. When caring for an unresponsive patient, tilting his/her head back improves the
airway by lifting his/her tongue from the back of his/her throat. Ch.-9
16. You have just delivered a shock with an automated external defibrillator you
should begin chest compressions, immediately. Ch.-11
57
17. Over the lower half of the sternum is the most appropriate hand location for
chest compressions on an adult. Ch.-11
18. When assessing circulation for a responsive adult patient you should assess the
radial pulse. Ch.-12
19. The five common vital signs are pulse, respirations, blood pressure, pupils, and
skin signs. Ch.-12
20. Respiratory rate can be assessed by watching and feeling the chest and abdomen
move during breathing. Ch.-12
21. Carotid and femoral are the two pulse points that are referred to as central
pulses. Ch.-12
22. Skin that is bluish in color is called cyanotic. Ch.-12
23. A respiratory rate that is lower than 10 for an adult should be considered
inadequate. Ch.-12
24. The term trending is best defined as the ability to record changes in a patient’s
condition over time. Ch.-12
25. A patient has been involved in a rollover vehicle collision, in this scenario, the
rollover is an example of the mechanism of injury. Ch.-13
26. The steps of primary assessment include forming a general impression, assessing
metal status, assessing ABCs, and determining priority for transport. Ch.-13
27. A patient who presents with normal vital signs and shows no indications of life-
threatening problems may be described as stable. Ch.-13
28. When assessing a trauma patient who has a significant mechanism of injury, the
BP-DOC, assessment tool is designed to look for signs of traumatic injury. Ch.-13
29. The secondary assessment is designed to find and treat non-life-threatening

injuries or conditions. Ch.-13
30. Angina pectoris, myocardial infarction, and heart failure are all common causes
of cardiac compromise. Ch.-14
31. Heart attack is a leading cause of sudden cardiac arrest describes the relationship
between a heart attack and sudden cardiac arrest. Ch.-14
32. You have arrived on the scene of an unresponsive patient whom you find to be
pulseless and apneic, you should begin chest compressions. Ch.-14
58
33. Your patient has been in respiratory distress for approximately 30 minutes, your
assessment reveals pale skin and cyanosis of the lips, these are signs of hypoxia.
Ch.-15
34. Bronchitis is a medical condition that causes inflammation of the bronchioles,

excess mucus production within the airways and chronic productive cough.
Ch.-15
35. Asthma is characterized by a narrowing of the lower airway, often associated
with exercise or allergies. Ch.-15
36. Protect the patient from injury and place him or her in the recovery position
following the seizure is an example of appropriate care for a seizure patient.
Ch.-16
37. You have responded to a call for a possible overdose, you should first ensure that
the scene is safe. Ch.-16
38. Stroke is a medical emergency that is caused by a disruption of blood flow to the
brain. Ch.-16
39. Removing the patient from the cold environment, protecting him or her from
further heat loss, and monitoring his or her vital signs are all appropriate steps in
the management of a patient with hypothermia. Ch.-17
40. Blood spurts from the wound, the color of the blood is bright red, and blood loss is
often profuse in a short period of time are typical characteristics of arterial bleeding.
Ch.-18
41. A wound where the top layers of skin have been scraped off, commonly seen in falls,
can best be described as an abrasion. Ch.-18
42. You are caring for a patient with a severe soft tissue injury to the lower leg, you
exposed the wound, and it is bleeding you should apply direct pressure. Ch.-18
43. Your patient has burned his hand, the skin is red and blistered and the burn is
extremely painful, this burn would be classified as partial thickness. Ch.-18
44. The appropriate care for an amputated body part is wrap it with clean gauze and place
it on ice. Ch.-18
45. Hemorrhagic shock is the type of shock when the body sustains a significant loss of
blood. Ch.-19
46. Immediate transport is the most important to the survival of a patient showing signs
of shock. Ch.-19
59
47. An injury that is characterized by broken skin above the site of fracture is commonly
described as an open fracture. Ch.-20
48. When assessing a patient with a musculoskeletal injury, it is important to check

circulation, sensation, and motor function. Ch.-20
49. The partial or complete tearing of the ligaments and tendons that support a joint is
called a sprain. Ch.-20
50. You are caring for a patient who has an injury characterized by an open wound, severe
deformity and bleeding, your highest priority should be controlling bleeding. Ch.-20
51. When the distal pulse is absent is a situation where it would be appropriate to place an
angulated extremity back into the anatomical position. Ch.-20
52. It is important to maintain the hand and foot of an injured extremity in a normal and
comfortable position during splinting, this position is called the position of function.
Ch.-20
53. You have just finished applying a splint to a patient’s leg, you should recheck
circulation, sensation, and motor function. Ch.-20
54. You are caring for a patient who has one leg that is shortened with the foot rotated to
one side, these are likely signs of a possible dislocated hip. Ch.-20
55. You are caring for a patient who you suspect has a spinal injury the first thing you
should do is to manually stabilize the patient’s head and neck. Ch.-21
56. Your patient is unresponsive, lying prone on the floor after falling off a high ladder,
the appropriate care for this patient would include using the log-roll maneuver to roll
the patient into the supine position. Ch.-21
57. Your main priority when caring for a patient with a suspected head injury is to, assess
and manage airway, breathing and circulation. Ch.-21
58. You are caring for a patient with a suspected open skull injury, when attempting to
control the bleeding, you should use only enough pressure to slow or stop the
bleeding. Ch.-21
59. Your patient has an open wound to her chest. The wound is bubbling and making
“sucking” noises as she breathes you should cover the wound with an occlusive
dressing. Ch.-22
60. You are caring for a patient with an open chest wound and have covered the wound
with an occlusive dressing, the patient becomes increasingly short of breath, you
should partially remove the dressing to allow air to escape. Ch.-22
60
61. Hypoxia from shallow respirations is a potential complication from a patient who
appears to have injured a rib without a flailed segment, and the patient is alert and
oriented. Ch.-22
62. The most appropriate care for an open abdominal injury is to cover the wound with a
moist, sterile dressing. Ch.-22
63. The first stage of labor begins at the onset of contractions and end when the baby
enters the vaginal canal. Ch.-23
64. You are assisting a woman in active labor. As the baby’s head begins to deliver you
should apply gentle pressure and support the head during delivery. Ch.-23
65. An incident management system is a tool for the command, control, and coordination
of resources at the scene of a large-scale emergency involving multiple agencies.
Ch.-27
66. The triage system was developed to assist in determining those victims who will likely
benefit from immediate care. Ch.-27
67. In the START triage system, patients are categorized based on an assessment of
respirations, perfusion, and mental status. Ch.-27
68. You are triaging an adult patient who presents as unresponsive and breathing at a rate
of 24, the patient should be triaged as immediate. Ch.-27
69. The ratio of chest compressions to breaths when proving CPR to an adult is 30
compressions to 2 breaths.
70. A rate of 100 to 120 compressions per minute and a depth of at least 2 inches are
the rate and depth for chest compressions on an adult.
71. When more rescuers arrive on scene you should assign tasks to other rescuers
and rotate compressors every 2-minutes or more frequently if needed to avoid
fatigue.
72. The preferred method for opening the airway when you suspect an unresponsive
victim has head or neck trauma, is Jaw Thrust.
73. Proportion of time that rescuers preform chest compressions during CPR is
called Chest Compression Fraction.
74. The appropriate first step to take as soon as the AED arrives at the victim’s side
is to power on the AED.
75. Placing the pads on the victim’s bare chest is one of the universal step for
operating an AED.
61
76. Avoid placing the AED pad directly over an implanted pacemaker or
defibrillator.
77. Stand clear of the victim while the AED is analyzing.
78. A successful resuscitation attempt depends on high-quality resuscitation skills,

good communication, and effective team dynamic.
79. Team dynamics during a resuscitation attempt include three elements, roles and
responsibilities, communication, and debriefing.
80. Whether you are a team member or the Team Leader, there may be times when
you need to point out another team member’s incorrect or inappropriate actions.
81. The appropriate action to demonstrate closed-loop communication when the

Team leader assigns you a task is to repeat back to the Team Leader that task
assigned to you.
82. Opioids are medications used primarily for pain relief, common examples are
hydrocodone, morphine, and fentanyl.
83. Too much opioid in the body can overwhelm the brain and depress the natural
drive to breathe, this respiratory depression can result in respiratory arrest and
cardiac arrest.
84. Scene assessment is an important tool for identifying whether opioids may be
involved in a life-threatening emergency.
85. Signs of opioid overdose include slow, shallow or no breathing, choking, or

gurgling sounds, drowsiness or loss of consciousness, small, constricted pupils,
blue skin, lips, or nails.
86. Early recognition of foreign=body airway obstruction is the key to successful

outcome.
87. Foreign bodies may cause a range of signs from mild to severe airway
obstruction.
88. Clutching the throat with the thumb and fingers, making the universal choking
sign indicates the need for help when a victim is choking.
89. Use abdominal thrusts to relieve choking in a responsive adult or child only, ,
not infants.
90. Give each individual thrust with the intervention of relieving the obstruction, it
may be necessary to repeat the thrust several times to clear the airway.
62
91. Pocket mask is a handheld device consisting of a face mask with a one-way
valve, the rescuer places it over a victim’s nose and mouth as a barrier device
when giving rescue breaths during CPR.
92. Shock is a life-threatening condition that occurs when the circulatory system
can’t maintain adequate blood flow.
93. Chest recoil is described as when the chest re-expands and comes back up to its
normal position after a chest compression.
94. Head-tilt-chin lift is a maneuver used to open a victim’s airway before providing
rescue breaths during CPR.
95. Jaw thrust is a maneuver used to open a victim’s airway before providing rescue
breaths during CPR; used when the victim may have a suspected spinal injury or
when the head tilt-chin lift doesn’t work.
96. The first step in determining if a victim is choking is to ask, “Are you choking”. If
the victim nods yes and cannot talk, severe airway obstruction is present.
97. Heart attack is when a blockage or spasm occurs in a blood vessel and severely
restricts or cuts off the flow of blood and oxygen to the heart muscle.
98. Adults and adolescents is anyone with visible signs of puberty (chest or
underarm hair in males; any breast development in females) and older.
99. Respiratory arrest is when a life-threatening emergency that occurs when normal
breathing stops or when breathing is ineffective, if untreated, it will lead to
cardiac arrest, or it can occur at the same time as cardiac arrest.
63

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SECTION II

General Rules ........................................................................................................................... 1

Automated External Defibrillator Training Unit (do not power up)

Example: 2-INCH WOUND ON FOREHEAD

If required by the problem, Cardiopulmonary Resuscitation (CPR) with an AED

12. There will be one first aid station, including:

A. Patient assessment, control of bleeding, physical shock, wounds, burns,

27. Rough treatment of patient is not allowed.

1. At a designated time During isolation, contest officials will administer a written

3. When using acronyms required in the Eleventh Edition of Brady “Emergency

11. Rapid Assessment consists of Initial Assessment and Patient Assessment.

Capillary refill Capillary refill Capillary refill

Unable to Able to follow

Table Reference: Emergency Medical Responder, Eleventh edition by Le Baudour and

Teams will systematically conduct initial assessment, treating all life-

Teams will systematically conduct the patient assessment according to procedures

1. All life-threatening conditions shall be located and started before patient

2. When the team encounters life-threatening bleeding, no work other than

5. The bystander/patient if used as a bystander must be shown the correct method of

9. Handling of a patient by a team or team member in such a manner that could

10. All injuries and/or conditions shall be treated (example: wound,

13. Working out of order (assessment, procedure, critical skill). 2

14. Failure to follow written instructions. 5

19. Failure to take support of a fracture or dislocation (not supporting fracture

A. Support of Extremities – Above and below the fracture or dislocation

When changing support, if support is broken, this discount applies. Change of

Support for upper extremity fractures/dislocations shall be maintained until

21. Fractures/dislocations shall be supported prior to bandaging injuries. Once the

During initial and patient assessment, teams must physically support/stabilize

23. Failure to determine immediate patients. 10 each infraction

An immediate patient shall be transported immediately (if transportation

Immediate conditions are:

24. Failure of team to start/stop timing device 2 discount

25. Each incorrect answer on written examination 1 discount

1. Failure to determine unresponsiveness (according to Critical Skill Sheet). 1

2. Failure to call for help. 1

3. Failure to open airway. 1

4. Failure to use proper maneuver to open airway (using head-tilt/chin-lift

5. Failure to assess breathlessness within 10 seconds. 1

6. Failure to use one-way valve barrier device when ventilating manikin. 1

7. Failure to state “get AED”. 1

8. Failure to use mouth-to-nose ventilation when required. ___1

9. Failure to keep body and head in line if spinal injury exists. 1

11. Failure to reposition head when airway obstruction is suspected. 1

12. Failure to give chest compressions when required.

13. Failure to make pulse prior to giving compressions. 1

14. Failure to assess pulse for 5-10 seconds. 1

15. Failure to correctly locate the carotid pulse. 1

16. Failure to ask judge for presence of a pulse. 1

1. Failure to give AV/CPR when required. 20

2. Improper Hand placement when giving compressions. 1

3. Failure to make parallel axis with heels of hands. 1

4. Allowing fingers to rest on chest. 1

5. Compressions. Discounts shall apply to each set.

B. Number required. A total of 30 compressions shall be made each cycle. 1

6. Failure to maintain hand contact with manikin when releasing pressure

7. Failure to give 2 breaths between each cycle of compressions. 1

A. Timing (not completing breaths and returning to compressions in less than 10

B. Volume shall be at least .8 liters (through .7-liter line on new manikins).

9. Failure to assess pulse within 10 seconds after each set of CPR. 1