Training Manikin Requirements for American Red Cross Certification Courses

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1 Training Manikin Requirements for American Red Cross Certification Courses Introduction We are pleased to announce the release of the requirements for training manikins. These requirements apply to all American Red Cross Health and Safety courses that result in certification. These requirements clarify the guidance that was originally issued in Numbered Notice 120, September 22, 1993; "that while the Red Cross does not require any particular brand of manikins to be used, the manikins must permit all CPR skills to be performed correctly." The manikin requirements were created by national headquarters with input from and final approval of the American Red Cross Advisory Council on First Aid and Safety (ACFAS). As the leader in first aid, CPR and AED training, the American Red Cross believes the creation of these requirements is necessary to ensure the quality and consistency of the training given by the American Red Cross and its authorized providers. Background In the spring of 2004, chapters were surveyed by the Regions/Service Areas. They were asked to report on the type(s) of manikins that were in use; 138 chapters responded. All known manufacturers within the United States of those training manikins as reported by chapters were contacted and given a copy of the requirements. The manufacturers were asked to provide the American Red Cross with evidence that their training manikins met our requirements. While some manufacturers eagerly accepted our request and understood our intentions, others, despite numerous requests declined to provide results. The American Red Cross made the process as easy as possible for manufacturers to demonstrate how their training manikins met our requirements. Manufacturers self-certified their results and provided us with the specific, testing process used and the results for each training manikin for the following: Lung capacity (tidal volume); Depth of chest compressions; and Durability. Results The following list of training manikins meet or exceed Red Cross requirements and manufacturers have submitted the required evidence of documentation and results of testing. Additional training manikins will be added to this list of approved manikins when the required information and test results are submitted by the manufacturers. Effective immediately, chapters are not permitted to purchase training manikins other than those on this approved list. There is no deadline for the implementation of these guidelines. Chapters and Authorized Providers simply purchase new manikins as needed to support program growth or to replace any non-functioning manikins. Approved Training Manikins for all course and presentations: Adult Manikins: Actar D-fib - Armstrong Ambu Man - Ambu Ambu CPR Pal - Ambu Little Anne - Laerdal Little Joe / Brad / Paul - Armstrong/Simulaids Resuci Anne - Laerdal Child Manikins: Little Junior - Laerdal Resuci Junior - Laerdal Infant Manikins: Ambu Baby CPR - Ambu Baby Anne - Laerdal Resuci Baby - Laerdal Chris Baby Armstrong (Approved 2/6/06) In addition to the manikins listed above, the following manikins may be used for any Lay Responder or noncertification course or presentation: Adult Manikins: None at this time 1 5/6/2008

2 Child Manikins: Kyle - Simulaids Infant Manikins: Actar Infantry Armstrong (Approved 5/22/06) Kim - Simulaids In addition to the above listed manikins, any manikin that meets the following requirements may be used for any non-certification course or presentation: The manikin must permit all demonstrated skills to be performed correctly; and Must have realistic simulated anatomical landmarks (nipples, sternum, ribs); and All materials and reusable airway parts must be capable of being cleaned and decontaminated per CDC and manufacturer's guidelines; and All manikins must have written cleaning, decontamination and maintenance guidelines provided by the manufacturer; and Must contain no latex on, or in any part, component or subcomponent in which participants may come into contact. For more information, please contact your local American Red Cross chapter or instructorscorner@usa.redcross.org. 2 5/6/2008

3 Adult CPR Manikin Requirements Minimum features of adult CPR manikins that are required when conducting American Red Cross First Aid, CPR and AED certification courses 1. Lung Capacity ml: i. Chest should begin to rise only when 700ml of air is ventilated into the manikin or should indicate when this amount is used. ii. Ability for gastric distension for incorrect head placement or volumes. (Preferred exceeds minimum requirements) 2. Airway: i. Must allow the course participants to correct an anatomical airway obstruction by appropriately performing: 1. Head Tilt Chin Lift; 2. Jaw Thrust Maneuver. 3. Breathing: i. Must allow the course participants to appropriately perform: 1. Mouth-to-mouth breathing (with or without breathing barrier); a. Nostrils must be able to be pinched closed; (Preferred exceeds minimum requirements) 2. Mouth-to-nose breathing. (Preferred exceeds minimum requirements) 4. Circulation: i. Must allow the course participants to demonstrate a pulse check (Carotid) 5. Compressions: i. Must have realistic simulated anatomical landmarks (nipples, sternum, ribs) which allow for proper hand positioning; and ii. Chest must be flexible enough to allow participants to compress about 2 inches. 6. Defibrillation: i. Must allow proper placement of AED training pads. 7. Decontamination: i. All materials and reusable airway parts must be capable of being cleaned and decontaminated per CDC and manufacturer s guidelines; and ii. All manikins must have written cleaning, decontamination and maintenance guidelines provided by the manufacturer. 8. Materials: i. Must be of durable construction and able to withstand 125 student uses (minimum) (125 uses would equal 328,125 compressions and 21,875 ventilations) and normal transport use; and ii. Must contain no latex on, or in any part, component or subcomponent in which participants may come into contact; and iii. Must realistically represent the size and shape of an adult.

4 Child CPR Manikin Requirements Minimum features of Child CPR manikins that are required when conducting American Red Cross First Aid, CPR and AED certification courses. 1. Lung Capacity (8-12ml/kg) : i. Chest should begin to rise only when the amount of air which is consistent with the tidal volume for a child of the age and weight represented by the manikin based on 8-12 ml/kg is ventilated into the manikin or should indicate when this amount is used. ii. Ability for gastric distension for incorrect head placement or volumes. (Preferred exceeds minimum requirements) 2. Airway: i. Must allow the course participants to correct an anatomical airway obstruction by appropriately performing: 1. Head Tilt Chin Lift; and 2. Jaw Thrust Maneuver. ii. Must have anatomically correct large occiput requiring padding under torso for correct airway position if child manikin is designed to represent a child of less than 2 years of age. 3. Breathing: i. Must allow the course participants to appropriately perform: 1. Mouth-to-mouth breathing (with or without breathing barrier); a. Nostrils must be able to be pinched closed; (Preferred exceeds minimum requirements) 2. Mouth-to-nose breathing. (Preferred exceeds minimum requirements) 4. Circulation: i. Must allow the course participants to demonstrate a pulse check (Carotid) 5. Compressions: i. Must have realistic simulated anatomical landmarks (nipples, sternum, ribs) which allow for proper hand positioning; and ii. Chest must be flexible enough to allow participants to be able to compress about 1 ½ inch. 6. Defibrillation: i. Must allow proper placement of AED training pads in both the Apical-Sternal (upper right chest and lower left chest) and Anterior-Posterior (front and back if the pads are too large to both fit on the front) placement. 7. Decontamination: i. All materials and reusable airway parts must be capable of being cleaned and decontaminated per CDC and manufacturer s guidelines; and ii. All manikins must have written cleaning, decontamination and maintenance guidelines provided by the manufacturer. 8. Materials: i. Must be of durable construction and able to withstand 125 student uses (minimum) (125 uses would equal 328,125 compressions and 21,875 ventilations) and normal transport; and ii. Must contain no latex on, or in any part, component or subcomponent in which participants may come into contact; and iii. Must realistically represent the size and shape of a child.

5 Infant CPR Manikin Requirements Minimum features of Child CPR manikins that are required when conducting American Red Cross First Aid, CPR and AED certification courses 1. Lung Capacity (8-12 ml/kg): i. Chest should begin to rise only when the amount of air which is consistent with the tidal volume for an infant of the age and weight represented by the manikin based on 8-12 ml/kg is ventilated into the manikin or should indicate when this amount is used. ii. Ability for gastric distension for incorrect head placement or volumes. (Preferred exceeds minimum requirements) 2. Airway: i. Must allow the course participants to correct an anatomical airway obstruction by appropriately performing: 1. Head Tilt Chin Lift; 2. Jaw Thrust Maneuver. ii. Must have anatomically correct large occiput requiring padding under torso for correct airway position. 3. Breathing: i. Must allow the course participants to perform; 1. Mouth-to-mouth and nose breathing (with or without breathing barrier); 2. Mouth-to-nose breathing. (Preferred exceeds minimum requirements) 4. Circulation: i. Must allow the course participants to demonstrate a pulse check (brachial) 5. Compressions/back blows: i. Must have realistic simulated anatomical landmarks (nipples, sternum, ribs, shoulder blades ) which allow for proper hand positioning; and ii. Chest must be flexible enough to allow participants to be able to compress about 1 inch. 6. Decontamination: i. All materials and reusable airway parts must be capable of being cleaned and decontaminated per CDC and manufacturer s guidelines; and ii. All manikins must have written cleaning, decontamination and maintenance guidelines provided by the manufacturer. 7. Materials: i. Must be of durable construction and able to withstand 125 student uses (minimum) (125 uses would equal 328,125 compressions and 21,875 ventilations) and normal transport; and ii. Must contain no latex on, or in any part, component or subcomponent in which participants may come into contact; and iii. Must realistically represent the size and shape of an infant. Must have arms and legs.

6 Training Manikin Frequently Asked Questions Q Do I have to stop using my manikins if they aren t on the list? A No, you may continue using any manikins you currently have provided you can properly demonstrate the required skills on it. Replace any non-compliant manikins when they are no longer usable. Q Can I still purchase manikins that aren t approved? A Specialty manikins such as trauma manikins, Choking Charlie, Airway/Intubation manikins, ACLS manikins or others that are not used in testing CPR/AED skills are not subject to the new manikin requirements and can be purchased as before. Q Why don t I see the manikins we use listed? A Some manikins are no longer manufactured, making data unavailable; also, some companies no longer exist; or the manufacturer refused or failed to provide any of the requested information. Q Can the manikins I currently use be approved? A If manikins meet Red Cross requirements; they can be approved and added to the list once national headquarters is provided the necessary information from the manufacturer. Q What can I do to get my manikins approved? A Contact your supplier and request that the manufacturer contact national headquarters at programadmin@usa.redcross.org or at or about providing the necessary information. Q Do these requirements apply only to courses conducted by the chapter? A No, these requirements apply to all American Red Cross courses, whether offered by the chapter or an authorized provider.