Emergency

Oxygen
Instructor Guide
Preview
Emergency Oxygen
Instructor Guide, Version 7.0

Purpose of this Guide

This ASHI Emergency Oxygen Version 7.0 Instructor Guide is solely intend-
ed to give information on the presentation and administration of ASHI
Emergency Oxygen certified training classes. The information in this book is
furnished for that purpose and is subject to change without notice.

Notice of Rights
No part of this ASHI Emergency Oxygen Version 7.0 Instructor Guide may be
reproduced or transmitted in any form or by any means, electronic or
mechanical, including photocopying and recording, or by any information
storage and retrieval system, without written permission from the American
Safety & Health Institute.

Trademarks
American Safety & Health Institute and the ASHI logo are registered trade-
marks of the American Safety & Health Institute.

American Safety & Health Institute

1450 Westec Drive
Eugene, OR 97402 USA
800-447-3177
E-mail: [email protected]
Visit our website at hsi.com/ashi
Copyright © 2013 by the American Safety & Health Institute.
All rights reserved. Printed in the United States of America.

First Edition—2013

American Safety & Health Institute is a

member of the HSI family of brands.
ISBN 978-1-936515-56-1 INSTO2-10
Acknowledgements
(Adult — XX minutes; Child and Infant — XX minutes; Adult, Child, and Infant — XX minutes)

Staff/Technical Consultants /Expert Reviewers

Steve Barnett, MBA Ted T. Crites, CHES
VP, Brand Management, Emergency Care Director, Production
Health & Safety Institute Health & Safety Institute

Production Team
Carolyn Claman (Daves); John Hambelton; Donna Medina; Dana Midles; Rob Neidig; Carol Perez-Vitier;
Jan Twombley

Medical Director
Greg Ciottone, MD

Technical Consultants
Corey Abraham, MS Ed William Rowe, FF/EMT-P (Ret.)
Director of Enterprise Sales VP, Brand Management, Professional Responders
Health & Safety Institute Health & Safety Institute

Craig S. Aman, MBA, MICP Zigmund Sawzak, EMT-P

Principal, CEO
Firehat Consulting LifeLine Health & Safety, LLC
Lieutenant/Paramedic Portland, OR
Seattle Fire Department Seattle, WA
Ralph Shenefelt, FF/EMT-P (Ret.)
Christopher J. Le Baudour, MS Ed, EMT VP, Strategic Compliance
EMT Program Director Health & Safety Institute
San Francisco Paramedic Association
San Francisco, CA Marcy Thobaben, LPN, NREMT-B
OSHA Outreach Trainer
Jeff Lindsey, PhD, PM, CFOD, EFO President/CEO
Chief Learning Officer Bluegrass Health & Safety, Inc.
Health & Safety Institute Wilmore, KY

W. Daniel Rosenthal, RN, BS, CCHC

President
Workplace Nurses, LLC
Gretna, LA

Emergency Oxygen i
 HSI Program Advisory Group
Marcy Thobaben, LPN, NREMT-B W. Daniel Rosenthal, RN, BS, CCHC Captain Larry Zettwoch, Esq.
OSHA Outreach Trainer President EMT-B, DMT
President/CEO Workplace Nurses, LLC Master Trainer
Bluegrass Health & Safety, Inc. Gretna, LA ASHI/MEDIC First Aid
Wilmore, KY DAN Examiner
Howard Main, Islamorada, FL
Kira Miller, BA, EMT-B CCEMT-P, NREMT-P
Owner Owner Cathy Statham, EMT-B
CPR Training Solutions Health Educational Services Owner
San Jose, CA Salinas, CA Heartline
El Dorado Hills, CA
John Mateus, EMT-B, RN, Tana Sawzak, BS, NREMT-Basic
MICN, BSN Education Director Mark Register, NREMT-P, BS
Owner LifeLine Health & Safety EMS Chief
Less Stress Instructional Services Portland, OR Savannah River Site
Hawthorne, NJ Fire Department
Bradford A. (Brad) Dykens, EMT-P Aiken, SC
Kim Dennison, RN, BSN, COHC, Lieutenant (Ret.)
COHN-S, ACLS St. Petersburg Fire and Rescue
Owner Owner
Absolute Learning Success, LLC Rescuer Education Services
Perry, MI St. Petersburg, FL

International Reviewers
Ross N. Drysdale John Zenios
Chief Executive Officer Master Trainer
EMP New Zealand, Ltd. Director
New Zealand and Australia EMP MEDIC First Aid, Ltd.
Cyprus and Greece
Chikako Uramoto
President
MFA Japan, Ltd.
Japan

ii Emergency Oxygen
Emergency Oxygen March 2013
(Adult — XX minutes; Child and Infant — XX minutes; Adult, Child, and Infant — XX minutes)

Table of Contents
Program Standards . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
Core Learning Objectives ...................................................................... 2
Knowledge Objectives . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2
Skill Objectives .............................................................................. 2

Program Overview
Focus . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3
Flexibility . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3
Initial Training . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3
Program Segments and Practices . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4
Recommended Class Schedule ................................................................. 5
Integration . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5
Renewal . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5
Challenging the Program . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5
Online Blended Training . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 5

Instructional Design
Four-Step Instructional Approach . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6

Program Materials
Instructor Guide . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6
Student Handbook . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7
Program Video . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7
PowerPoint® Presentation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7
Scenario Sheets . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7
Class Roster/Student Record . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7
Performance Evaluations . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 7
Written Exams . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8
Rate Your Program . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8

Class Requirements
Administration . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8
Equipment . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 9
Materials ................................................................................... 9
Health and Safety ............................................................................ 9
Classroom . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10
Classroom Safety . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 10

Emergency Oxygen iii

 Emergency Oxygen

Section 1 — Introduction
The Case for Emergency Oxygen . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11
Integrating the Use of Emergency Oxygen . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 12

Section 2 — Delivery Systems

Emergency Oxygen Delivery Systems . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13

Section 3 — Pulse Oximetry

Integrating Pulse Oximetry with Emergency Oxygen . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15

Section 4 — Oxygen Delivery

17
Oxygen Delivery for a Breathing Person . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Oxygen Delivery for a Nonbreathing Person . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 18

Section 5 — Other Considerations

After-use Considerations . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 21
Safety Precautions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 23

Wrapping Up a Training Course .................................................................. 25

References ..................................................................................... 27

iv Emergency Oxygen
Emergency Oxygen

Program Standards

Emergency Oxygen
Intended Audience Individuals who desire or are required to be trained in the administration of
Emergency Oxygen.

Instructor Requirement A current and properly authorized ASHI Instructor in good standing

Participant Prerequisites It is required that a CPR or CPR/first aid training course be completed within the
previous 24 months prior to taking the Emergency Oxygen training class.

Required • ASHI Emergency Oxygen Student Pack (one per participant, print or digital)
Training Materials • ASHI Emergency Oxygen Instructor Guide (one per Instructor, print or digital)
• ASHI Emergency Oxygen presentation media (DVD, PowerPoint®, or Blended)

Course Length • Varies by class type (initial, refresher) and method (classroom, blended,
challenge)
• Initial class, about 1.5 to 2 hrs
• Successful completion is based on achievement of the core learning objectives
rather than a prescribed instruction time.

Maximum Student-to-Instructor 12:1 (6:1 recommended)

Ratio
Certification Requirements ■ Skills Evaluation — Students must perform the following skills competently with-
out assistance. Skill performance can be documented individually on the Class
Roster/Student Record or by using Performance Evaluations.
– Oxygen Delivery for a Breathing Person
– Oxygen Delivery for a Nonbreathing Person
– Students must demonstrate the use of gloves and a ventilation mask.
■ Written Evaluation — Required when specified by organizational, local, or state
regulation. It is recommended for designated responders with a duty or employer
expectation to respond in an emergency and provide first aid care. Successful
completion requires a correct score of 70% or better.

Card Issued

Certification Period May not exceed 24 months from class completion date. More frequent reinforce-
ment of skills is recommended.

Emergency Oxygen 1
 Emergency Oxygen

Core Learning Objectives

ASHI Emergency Oxygen is an objectives-driven, skills-based training program. To receive certification, students are
required to demonstrate the following knowledge and skill objectives to a currently authorized ASHI Instructor.

Knowledge Objectives
Upon completion of this training program, a student will be able to:
1. Explain the importance of emergency oxygen.
2. Identify all the components of an emergency oxygen system and explain their function.
3. Describe safe storage practices.
4. Describe safe handling practices.
5. Explain when and how to check, and maintain, an oxygen system.
6. Explain when and how to administer emergency oxygen.
7. Describe how to perform effective rescue breaths using a CPR mask.
8. Describe the steps of a primary assessment for a responsive victim.
9. Describe the steps of a primary assessment for an unresponsive person.
10. Explain how pulse oximetry can be used to help determine the need for, and monitor the effectiveness of,
emergency oxygen.
11. List the situations when a person may benefit from emergency oxygen.
12. Describe how to deliver emergency oxygen to a breathing person.
13. Describe how to deliver emergency oxygen to a nonbreathing person.

Skill Objectives
Upon completion of this training program, a student will be able to:
1. Correctly demonstrate the removal of contaminated gloves.
2. Correctly demonstrate rescue breaths using a CPR mask.
3. Correctly perform a primary assessment for an unresponsive person.
4. Correctly perform a primary assessment for a responsive person.
5. Correctly demonstrate how to assemble an emergency oxygen system.
6. Correctly demonstrate how to turn an emergency oxygen system on and off and determine if oxygen is
flowing.
7. Correctly demonstrate how to attach oxygen tubing to a delivery device.
8. Correctly demonstrate how to safely integrate use of emergency oxygen when providing emergency care
to a responsive person who is breathing.
9. Correctly demonstrate how to safely integrate use of emergency oxygen when providing emergency care
to an unresponsive person who is not breathing (may include integration of CPR and AED skills).

2 Emergency Oxygen
Emergency Oxygen

Program Overview Initial Training

Students are required to meet the knowledge and skill
The ASHI Emergency Oxygen training program pro- objectives listed in this program to receive an initial
vides training and skills in the administration of emer- certification card. These core learning objectives rep-
gency oxygen. The goal of this training is to help resent the minimum content a student needs to un-
students develop the knowledge, skills, and confi- derstand in order to manage a medical emergency. In
dence to respond in a medical emergency. addition to this core content, the ASHI Emergency
Oxygen program materials include supplemental and
optional content. Instructors determine the depth to
Focus
which the core content is covered and which supple-
This program is designed to focus on caring for mental or optional content to cover in a training class.
injured or ill adults in a variety of settings by integrat-
ing the use of emergency oxygen as part of the care Flexibility is desirable; individual students may re-
provided. quest specific content, and employers may require
specific content to be covered. Occupational regula-
tory or licensing agencies may also require additional
Flexibility content, hours of instruction, or other practices.
The program is intended to be flexible in content. It
can be customized to meet the teaching styles of the
Instructor, the learning needs of the student, and the
regulatory needs of an employer.
In the United States, Canada, and most other indus-
trialized countries, workplace safety regulations and
occupational licensing requirements may call for spe-
cific training content to be covered. Instructors must
be familiar with the regulations and licensing require-
ments of the students they offer training and certifi-
cation to.
This ASHI Emergency Oxygen training program has
listed core learning objectives that must be covered
in order to issue certification cards. Instructors bear
the responsibility of ensuring that each student meets
the learning objectives for successful completion.

Emergency Oxygen 3
 Emergency Oxygen

Program Segments and Practices

The following table provides an overview of the primary topics and student activities/practices found within the ASHI
Emergency Oxygen training program. Required activities, segments, and practices are in bold.

Segments Demonstration and Practice

Introduction
Introduction to the Course None
Delivery Systems
Emergency Oxygen Delivery Systems Demonstration: Instructor demonstration of emer-
gency oxygen delivery system components that stu-
dent will use in class.
Pulse Oximetry Demonstration: Instructor demonstration of pulse
oximetry equipment (Optional).
Student Practice: Using Pulse Oximetry Equipment
(Optional)
Oxygen Delivery
Breathing Person Demonstration: Instructor demonstration of Oxygen
Delivery for Breathing Person
Student Practice: Oxygen Delivery for a Breathing
Person
Nonbreathing Person Demonstration: Instructor demonstration of Oxygen
Delivery for Nonbreathing Person
Student Practice: Oxygen Delivery for a Nonbreathing
Person
Other Considerations
After-use Considerations Demonstration: Instructor demonstration of After-use
Considerations
Student Practice: Oxygen Equipment
Disassembly and Reassembly (Optional)
Safety Precautions
Wrap Up
Written Exam (Optional)

4 Emergency Oxygen
Emergency Oxygen

Recommended Class Schedules Renewal training can also be accomplished by re-

peating an initial training class.
Classes are often populated by students with different
levels of experience. This makes a single minute-by-
minute approach to lesson planning unrealistic. The Challenging the Program
recommended class schedule does not include time Experienced students can challenge the ASHI Emer-
for the Optional Skills. If any of those skills are in- gency Oxygen training program using performance
cluded in the curriculum, the instructor should allow evaluations. Participants must arrive prepared for skill
additional time. Instructors should always ask about testing and must perform competently without assis-
previous training and attempt to connect participants’ tance on all performance evaluations. A warm-up or
past experience and knowledge to the current learn- skills review session may be conducted before the
ing experience. challenge, but must be clearly separated from the
challenge itself. Students who cannot perform com-
petently without assistance have not successfully
Core
completed the challenge. If unsuccessful, students
Introduction: The Case for Emergency Oxygen/ still seeking certification must attend and complete a
Integrating the Use of Emergency Oxygen 10 training class.
Oxygen Delivery Systems 10
Pulse Oximetry (20 min. with skill practice) 10–20
Online Blended Training
Oxygen Delivery: Breathing Person 15 Blended training combines the convenience of online
learning with a shortened practical skills session in
Oxygen Delivery: Nonbreathing Person 15
order to meet both knowledge and skill objectives.
After-use Considerations
(20 min. with skill practice) 10–20 The online learning platform used for ASHI blended
Safety Precautions 10 training classes is ASHI Learning. This specially de-
Wrapping Up a Training Class 10–20 signed, web-based learning system allows for a vari-
ety of sensory interactions to provide users with a
Total Approximate Minutes 90–120 low-stress, easy-to-use, and convenient way to learn
Total Approximate Hours 1.5–2.0 cognitive information.
It is important to note that students must successfully
complete both the online and skills portions of
blended training. Completion of the online portion
Integration alone will not result in certification.
The ASHI Emergency Oxygen training program may
The entire administrative process for blended training
be integrated with other ASHI programs where nec-
is done through Training Center Manager. A Training
essary or desired. Other programs that can be inte-
Center purchases blended training credits, which in-
grated include the ASHI Basic First Aid, ASHI CPR
clude a student seat in an online class and a Student
PRO for the Professional Rescuer, and ASHI CPR and
Handbook.
AED programs.
Training Centers schedule classes and add students.
Renewal Students are notified by email of enrollment in the on-
Students returning before the end of their certification line class. Student progress can be monitored online.
period can renew their certification in a training class To successfully complete the online class, students
that focuses on achieving the listed core skills objec- complete all of the lessons. Check marks will indicate
tives through skills practice and evaluation. As the which lessons have been completed. When all of the
training progresses, instructors need to constantly lessons are finished, the student will have the capa-
evaluate the level of cognitive understanding within bility of printing a completion certificate for the online
the group being trained and review core knowledge portion. If a class exam is included in the class, a stu-
objectives as needed. dent will have to achieve a passing score in order to
Renewal training is typically shorter than initial train- complete the online class.
ing. However, the amount of reduced time is depend-
ent on the level to which the group still understands
the cognitive information within the program. Fre-
quent refreshers during the certification period can
help improve this.

Emergency Oxygen 5
 Emergency Oxygen

Skill practice and evaluation is done face-to-face in a Step 3: Allow Adequate Time for Students to Practice
classroom setting. Instructors must conduct and doc- the Skills
ument student skill performance for the core skill ob- Break students into small groups with the required
jectives listed for the class being taught. Skill practice equipment for the practice. Have one student act as
is accomplished using the same approaches avail- a coach by reading the skill steps from the Skill Guide
able for non-blended classroom training. Sessions while another student performs the skill on a manikin
can be conducted for groups or for individuals. Indi- or on another student who is playing the role of the ill
viduals can also challenge the skills session in order or injured person. Have students rotate through the
to receive certification. roles until all have played each role.
An Instructor should circulate through the classroom,
answering questions, correcting errors in technique,
Instructional Design and providing constructive feedback and positive re-
inforcement. Avoid anxiety-producing, perfection-ori-
ASHI promotes an instructional approach that is ented skill checks. A stimulating, but non-threatening,
based on simple and practical applications. The focus environment is best for learning.
is on gaining the skills and building the confidence to
handle an emergency situation. Skills are best learned Alternatively, when it is available, use video guided in-
and retained by repeat practice. Instructors can make struction to practice. Students watch and practice
the most of class time by limiting lectures to essential along with a video demonstration of skills. Students
knowledge, and focusing on hands-on skill practice. can also practice along with an Instructor doing the
skill. Allow time for each student to adequately imitate
the skills.
Four-step Instructional Approach
More experienced or returning students may enjoy a
Step 1: Present the Knowledge Content
scenario- or problem-based learning approach. Sce-
Sample curricula provide the key information about nario sheets are available to support this approach.
each topic. Lecturing too far beyond this material will
reduce skill practice time and should be avoided. Step 4: Wrap It Up
Ask for and answer questions as briefly and concisely
Step 2: Demonstrate Skills
as you can. If available, finish with a short prob-
Demonstrations may be done live or by video. When lem-solving scenario to help students recall key
demonstrating skills, a high-quality performance is information.
essential because students will tend to copy it.
When giving a demonstration, consider using the
WHOLE-PART-WHOLE method: Program Materials
• WHOLE: Demonstrate the entire skill, begin-
ning to end, briefly naming each action or
step.
Instructor Guide
The ASHI Emergency Oxygen Instructor Guide pro-
• PART: Demonstrate the skill again, step-by-
vides organized instructional guidance on how to
step, integrating information and facts while
conduct a training class. It is integrated with the
pointing out common errors in technique.
Student Handbook, Program Video, and Program
Present only the knowledge necessary to for
PowerPoint® Presentation.
the student to adequately perform the skill. To
help, have students look at the appropriate Information regarding the details of the training pro-
Skill Guide as you demonstrate. gram and how to prepare for a class are provided in
• WHOLE: Demonstrate the entire skill again — the front of the guide. The majority of the guide fol-
in real-time — without comment. Perform it lows a topic-by-topic approach to training that in-
without remarks, interruption, or explanation. cludes available instructional tools, sample curricula,
This helps students get a feel for the tempo of identified practice sessions, and case studies.
the skill and the opportunity to observe the se- Instructions on completing the required class admin-
quence of actions before they practice. istration are also included.

6 Emergency Oxygen
Emergency Oxygen

Student Handbook A Student Record is required when Performance

Evaluations are not used to document competent
The ASHI Student Handbook contains the content
skills. Using the Class Roster/Student Record, check
and skill references a student needs to meet the core
off students who are performing competently without
learning objectives. Students must have access to
assistance as the class progresses through skills
skill training reference materials during the class. The
practice.
Student Handbook provides a convenient way to pro-
vide this information. It is required to provide each If a Written Exam is used, document each student’s
student a personal printed copy of the Student Hand- successful completion on the Class Roster/Student
book to take home or access to a digital version they Record.
can download online.
When finished with a training class, sign and return
the completed Class Roster/Student Record to the
Program Video Training Center responsible for the class.
The ASHI Emergency Oxygen Program Video is a
scenario-based presentation that provides a visual Performance Evaluations
learning tool to accomplish the learning objectives. It
The competent performance of the listed skill objec-
is available on DVD and is also streamed online as a
tives without assistance is required for certification.
component of the online blended class.
Performance evaluation is required when individual
Using the DVD, Instructors can play the entire video skill performance is not documented on the Student
or select individual topics as desired. Record or when specified by organizational, local, or
state requirement.
PowerPoint® Presentation Performance Evaluations can be found online in the
The ASHI Emergency Oxygen training program also document section of Training Center Manager or your
includes a Program PowerPoint® presentation. Instructor Portal.
The presentation is closely integrated with the In- When finished, score students as outstanding (com-
structor Guide and provides a visual tool to reinforce petent), adequate (competent), or inadequate (not
cognitive information, skills practices, and case competent) on each Performance Evaluation. Inade-
studies. quate (not competent) scores require remediation and
re-evaluation. Depending on logistics, this may re-
Scenario Sheets quire individually checking off skills using the Student
Scenario-based practice sheets allow students to Record or completing another class.
make realistic decisions in a simulated setting. This Students who have not had skills checked off on the
alternative small-group practice approach is suited Student Record or have been scored not competent
for more experienced students or as supplemental on the Performance Evaluations have not success-
practice to initial training. fully completed the class.
Scenario Sheets can be found online in the document Sign and return all Performance Evaluations to the
section of Training Center Manager or your Instructor Training Center responsible for the class.
Portal.
When conducting Performance Evaluations:
Class Roster/Student Record • Students must perform and not verbalize
skills.
The Class Roster/Student Record is the primary pa-
perwork for documenting the completion of a ASHI • Students do not have to perform skills per-
Emergency Oxygen training class. It can be found on- fectly, just reasonably to achieve the desired
line in the document section of Training Center Man- outcome.
ager or your Instructor Portal. • Evaluate consistently between students.
A Class Roster is required for every training class. • Avoid excessive communication.
Completely and accurately fill out the class infor- • Do not coach students.
mation. Have students legibly fill out personal
information.

Emergency Oxygen 7
 Emergency Oxygen

Written Exams • It is required that a CPR or CPR/first aid training

course be completed within the previous 24
Written evaluation may be necessary when specified
months prior to taking the Emergency Oxygen
by organizational, local, or state requirement. It is rec-
training class.
ommended for designated responders with a duty or
employer expectation to respond in an emergency • Students must demonstrate the use of gloves
and provide first aid care. and a ventilation (resuscitation) mask during at
least one Performance Evaluation. Instructors
Written Exams for this class can be found online in
should take necessary steps to be aware of stu-
the document section of Training Center Manager or
dents with latex allergies and provide suitable,
your Instructor Portal.
non-latex barrier products for their use in class.
Successful completion of a Written Exam requires a
• There are no minimum age requirements for par-
correct score of 70% or better. Document the suc-
ticipation in a ASHI Emergency Oxygen class.
cessful completion of the written exam (when used),
However, regardless of age, students must be
on the Class Roster/Student Record. When conduct-
able to competently perform the required skill ob-
ing written evaluation, take precautions to prevent
jectives to receive a certification card.
cheating and allow adequate time to complete the
exam. • The maximum allowed ratio is 12 students to 1
Instructor. A ratio of 6 students per Instructor is
Rate Your Program recommended.
Encouraging students to provide feedback and then • The student-to-Instructor ratio for lecture and
using that feedback to improve instruction is an es- discussion may be exceeded when organiza-
sential aspect of any quality educational effort. All stu- tional realities make small class size unachiev-
dents are required to fill out the Rate Your Program able. However, additional ASHI-authorized
class evaluation in order to get a certification card. Instructors must be available to maintain the
student-to-Instructor ratio for skill practice and
Tear-out Rate Your Program class evaluations are
evaluation.
found in the back of each Student Handbook. They
can also be found online in the document section of • Instructors must provide access to the most cur-
Training Center Manager or your Instructor Portal. rent ASHI training materials to students for use
during and after the course. This is especially im-
The evaluation allows students the opportunity to
portant in skill practice sessions. Appropriate
comment on the program materials and on the In-
training materials include video segments, print
structor’s presentation style and effectiveness. Col-
handbooks and skill sheets, scenario sheets, and
lect and return the completed Rate Your Program
projected or mobile computer-based ASHI train-
class evaluations to the Training Center responsible
ing materials. Each course participant must also
for the class.
be provided a print or digital version of the Stu-
dent Handbook.

Class Requirements • As part of an initial training class, Instructors

must conduct all required segments and prac-
tices as outlined in this ASHI Instructor Guide.
The following requirements are necessary to help en-
sure all students and Instructors experience a safe, • As part of an initial training class, Instructors
enjoyable, and satisfying ASHI Emergency Oxygen must use one of the associated visual media
training class. tools designed for the program. These include
the Program Video, Program PowerPoint® pres-
Administration entation, or the online blended training class. Use
• Instructors must teach in accordance with the of a visual media tool is highly recommended for
most recent administrative policies and proce- renewal training. The online blended training
dures as described in the Training Center Admin- class may be used as an alternative approach.
istrative Manual (TCAM). Use of these training tools is highly recom-
mended for renewal training.
• An Instructor must be authorized to teach the
ASHI Emergency Oxygen training program in • During a class, Instructors must provide informal
order to issue certification cards. evaluation and prompt feedback to students about
their skill performance. This will allow students to
evaluate their skills and correct deficiencies.

8 Emergency Oxygen
Emergency Oxygen

• An Instructor must verify that each student has • Optional Instructional Materials
met the required knowledge and skill objectives – ASHI Emergency Oxygen Scenario Sheets
before issuing a certification card. The Instructor
– ASHI Emergency Oxygen Performance
must include their registry number and Training
Evaluations
Center ID on the card to validate it.
– ASHI Emergency Oxygen Written Exam
• Each student must fill out and return to the In-
• Required Student Materials (for each student)
structor the Rate Your Program class evaluation.
Completed evaluations must be returned to the – ASHI Emergency Oxygen Student Handbook
Training Center responsible for the class. (printed or digital)
– ASHI Emergency Oxygen Certification Card
• Instructors must complete a Class Roster/Stu-
dent Record and return it to the Training Center – CPR mask, (ventilation or resuscitation mask
that is responsible for the class. with one-way valve and oxygen inlet, dispos-
able training valves or mouthpieces are okay)
Equipment – Disposable barrier gloves
• Required Equipment • Optional Student Materials
– Visual presentation equipment (television, – Oxygen delivery device (when using students
monitor, projector) as breathing persons in practice)
– Adult CPR training manikins (6:1 maximum
student-to-manikin ratio)
Health and Safety
• Screen students for health or physical conditions
– Emergency oxygen delivery system (6:1 maxi-
that require modifications of skill practice.
mum student-to-system ratio)
– Each delivery system must include: • Follow the manufacturer recommendations for
o Filled medical-grade oxygen cylinder the decontamination of manikins before, during,
and after training.
o Oxygen regulator with flow controller
o Connecting tubing • When using disposable gloves in skills practice,
Instructors must take necessary steps to be
o Ventilation mask (with oxygen inlet)
aware of students with latex allergies and provide
• Oxygen delivery devices for breathing persons suitable, non-latex barrier products for their use
(when not using ventilation mask). This includes in class.
simple masks or non-rebreather masks (6:1 max-
• Caution students to avoid awkward or extreme
imum student-to-device ratio).
postures of the body.
Note: When using students as breathing persons,
• Caution students to avoid certain skills during
Instructors need to provide each student with an
student-on-student practice, including chest
unused oxygen delivery device.
compressions, rescue breaths, and abdominal or
• Optional Equipment chest thrusts. These skills are not appropriate for
– Pulse Oximeter student-on-student practice and must be per-
formed on training manikins designed for that
purpose.
Materials
• Required Instructional Materials • Students must be informed to use proper lifting
and moving techniques during a student-on-stu-
– ASHI Emergency Oxygen Instructor Guide
dent practice in which a simulated ill or injured
(printed or digital)
person is moved. Students should not participate
– ASHI Emergency Oxygen media presentation in these practices if they have a history of back
(Program Video, PowerPoint®) problems.
– ASHI Emergency Oxygen Class Roster/
Student Record

Emergency Oxygen 9
 Emergency Oxygen

Classroom
• Classes need to be conducted in a safe and
comfortable environment conducive to learning.
• A carpeted floor is preferred. However, blankets
or mats may be used for practice sessions.
• Comfortable seating is important and a table or
work area is quite useful.
• A monitor stand can help ensure the monitor is
easily visible to all students.
• An erasable white board, blackboard, or easel
and paper can be very helpful.

Classroom Safety
• All Instructors must ensure a physically safe
learning environment for their students.
• Make sure there are no obvious hazards in the
classroom, such as extension cords that can be
tripped over.
• In addition, Instructors should be aware of the lo-
cation of the nearest phone, first aid kit, AED, fire
alarm pull station, and fire extinguisher.
• Instructors should have an emergency response
plan in case of serious injury or illness, including
evacuation routes from the classroom.
• Students should be discouraged from smoking,
eating, or engaging in disruptive or inappropriate
behavior.

10 Emergency Oxygen
Section 1 — Introduction

The Case for Emergency Oxygen

Reason for Learning
When a serious illness or injury occurs, the body’s ability to use oxygen is likely to be compromised and a condition
called shock will result. Emergency oxygen can help meet a person’s critical need for oxygen.

Core Learning Objectives

Upon completion of this training program, a student will be able to explain the rationale for delivering supplemental
oxygen in medical emergencies.

Instructional Tools Available

• Student Handbook — Refer students to page 2
• PowerPoint® Presentation — Use slides 1–6
• Program Video — 2:23

Instructor Note
Explain to students that state or local regulations regarding the requirement for medical control and direction with
the use of emergency oxygen can vary. Always be familiar with and comply with any state and local regulations.

Sample Curriculum
Knowledge Content
1. Oxygen is essential to sustain life. When a serious illness or injury occurs, the body’s ability to process
oxygen can be compromised.
a. Low levels of oxygen in the body, or hypoxia, can result in a deteriorating condition known as shock.
b. Unless the effects of the decreased amount of oxygen can be reversed, shock can quickly progress
into a life-threatening emergency.
2. Basic priority care, such as maintaining a clear and open airway, ensuring adequate breathing, and con-
trolling external bleeding, should always be a provider’s initial priorities of care for an ill or injured person.
3. The use of emergency oxygen by a first aid provider can help meet an ill or injured person’s critical need
for oxygen to further improve the person’s outcome.
a. Many medical authorities recommend that a person be provided the highest concentration of oxygen
available during many medical emergencies.
4. Air contains about 21% oxygen. In an emergency, oxygen delivery systems can potentially increase oxy-
gen percentages close to 100%.
5. Conditions that could benefit from emergency oxygen include the following:
a. Divers with a decompression injury
b. Serious bleeding
c. Difficulty breathing
d. Suspected internal injury
e. Warning signs of serious illness
f. Serious mechanisms of injury
6. There are few significant medical risks when providing supplemental oxygen in an emergency.
a. When in doubt, provide emergency oxygen for someone who shows signs of respiratory difficulty, if it is
available, local protocols allow, and you are trained in its use.
7. This training program will focus on how to safely and effectively provide supplemental oxygen in a medical
emergency.

Wrap Up
Be sure to ask for and answer any questions students may have.

Introduction Emergency Oxygen 11

References
The ASHI Emergency Oxygen Instructor Guide is based upon the following standards, guidelines, and
recommendations:
• “2010 International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care
Science with Treatment Recommendations.” Circulation 122, suppl. 2 (2010): S250-S581.
• “2010 American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovas-
cular Care Science.” Circulation 122, suppl. 3 (2010): S639-S946.
• “2010 American Heart Association and American Red Cross International Consensus on First Aid Science
With Treatment Recommendations.” Circulation 122, suppl. 2 (2010): S584.
• British Thoracic Society Emergency Oxygen Guideline Group. 2008. Guideline for emergency oxygen use in
adult patients. Thorax 63(Suppl 6):vi1-vi73.
• Educating the Educator: Use of Pulse Oximetry in Athletic Training: Berry DC, Seitz RS. Educating the edu-
cator: use of pulse oximetry in athletic training. AthlTrainEduc J; 2012;7(2):74-80.
• United States Lifeguard Standards: An Evidence-based Review and Report by the United States Lifeguard
Standards Coalition; 46-47;Jan 2011;
• FDA Compliance Policy Guide 7124.10, Chapter 24 - Devices; Oxygen Equipment - Emergency and OTC
Use; 1987; U.S. Food and Drug Administration.
• FDA AND NIOSH Public Health Notification: Oxygen Regulator Fires Resulting from Incorrect Use of CGA
870 Seals. Available: http://www.fda.gov/MedicalDevices/Safety/AlertsandNotices/PublicHealthNotifications/
ucm062088.htm [8 February 2013].
• Other sources of national training and care guidelines.

References Emergency Oxygen 27

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