Posted in First Aid
Wednesday, 28 December 2011
Last updated: July 13, 2014 at 16:33 pm

Body Composition Information for First Aid

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Anthropometry – quantitative measures of selected human landmarks.
Body composition – two-component model – the amount of fat and fat-free mass of which the body is composed. Fat-free mass is primarily composed of bone, muscle, vital organs, and connective tissue.
Four-component model – fat, protein, mineral, water
Why assess body composition?

  • Suitable body composition is important for health.
  • Establish reasonable fatness ranges for athletes in various sports
  • Accurate measures of body composition are needed to develop sound weight reduction programs
  • Knowledge of bone mineral content in women and children is important.
  • Monitor changes in body composition associated with disease.

I. Essential Fat vs. Storage Fat
Essential fat – fat that is required for normal physiological functioning – structural components of cell membranes, required for the synthesis of certain hormones, transport of fat-soluble vitamins,etc.
Storage fat – fat that is stored in adipose tissue for energy supply purposes. It is located underneath the skin, in the abdominal cavity, and around certain organs.

II. Body Composition of Males vs Females
The average male is taller, heavier, has a larger muscle mass, and a lower total body fat content. For reference male and female, age 20 – 24:
Storage fat – female = 15% – male = 12%
Essential fat – female = 12% – male = 3%
Female has sex specific fat depots in the breasts, pelvic and thigh regions, and probably other areas.
“Male type” obesity – excess fat is deposited on the upper torso and around the abdomen. Male type obesity is associated with higher health risks.
“Female type” obesity – excess fat is deposited below the waist in the thighs, hips, and buttocks (ie) pear shape. After menopause females begin
depositing more fat in the abdominal area
III. Obesity

The combination of diabetes and obesity is one of the largest epidemics the world has faced. The prevalence of overweight and obesity is increasing around the world and the obese are becoming more severely obese. In the past dozen years, scientists have discovered that adipose tissue is not simply a passive storehouse for fat, but an endocrine organ that secretes more than a dozen peptide and non-peptide compounds that trigger changes
throughout the body. When fat cells expand they release more of some of these compounds and less of others. Examples – leptin, adiponectin, inflammatory proteins, etc.

Register for First Aid Training (Click here to pick a course) and learn to recognize signs of cardiovascular emergencies.

Causes of the Obesity Epidemic

  1. Weight gain and obesity occur when energy intake exceeds energy expenditure – too much food and too little activity. For most of human history, survival meant avoiding starvation – our bodies are set up to deal with scarcity, not abundance.
  2. Decreased physical activity – auto-mobiles, increased crowding, crime patterns, technological advances and automation in the home and the workplace, many hours spent watching TV, playing video games, sitting
  3. at the computer
  4. Increased consumption of calories – consumption of large portion size meals, high-fat diets, high sugar intake
  5. Social environment – advertising, pressure to consume, influence of family and friends
  6. Biology – the epidemic of obesity is occurring on genetic backgrounds that have not changed, but it is now clear that genetics plays an important role in the development of obesity.

Data from overfeeding experiments with identical twins demonstrate that some individuals are more at risk than others to gain fat when energy intake surplus is maintained at the same level for everyone and when all
subjects are confined to a sedentary lifestyle.
NEAT – non-exercise activity thermogenesis. It is the energy expended by physical activities other than planned exercise – sitting, standing, walking, fidgeting, etc. In a recent research study, obese participants were
seated for 164 minutes longer per day than were lean participants.

6. Role of viruses? Do some viruses play a role in the expansion of adiposetissue mass? This is a new area of research.

IV. Common Techniques For Assessing Body Composition
Direct methods – chemical analysis of human cadavers Indirect methods – noninvasive techniques used on living persons

A. Height – Weight Tables
Desirable weight with regard to the lowest death rates is predicted from tables that have been developed by insurance actuaries.

  1. These tables do not consider body composition.
  2. Most of the data in the 1983 Metropolitan Life Insurance Height-Weight tables comes from white, middle-class, U.S. adults age 25 to 59 years. This is not a representative sample of the general North American population.
  3. No accepted method has been devised for determining frame size.

B. Body Density and Volume Measurements
Density = mass/volume. Body density will vary with the amount of body fat. Use underwater weighing or volumetry to measure body volume. In recent years the UWW technique has begun to be replaced by air- displacement
plethysmography (BOD POD method) where the subject is immersed not in water but in a closed air-filled chamber (plethysmograph). Measure the volume of air displaced inside the closed chamber. After body density has been determined using one of the above methods, use an equation, such as the equation developed by Siri, to determine percent body fat.

These equations make two basic assumptions:

  1. The human body has two compartments – fat and nonfat
  2. Each of these compartments has densities which are known constants.

Assume that fat has a density of 0.90 g/ml and nonfat a density of 1.10 g/ml.

For decades hydrostatic weighing has been used as a universal method for validating skinfold caliper formulae and all other methods (ie) it has been used as the “gold standard”.
Problems:- cadaver studies (Brussels cadaver study, 1984) have shown that the density of the nonfat compartment varies as a function of age, sex, and racial group. Therefore, a nonfat density value of 1.10 g/ml is not universally applicable. Conclusion – densitometry should not be used as a universal criterion for prediction of percent fat. Equations based on four component models are preferred over equations based on a two component model.

C. Weight – Height Indicies
Body Mass Index (BMI) – used as an indicator of obesity. This index uses the body mass (kg) divided by the height (meters) squared. Classification system for adults (20-70 years old):
BMI less than 18.5 = underweight
BMI of 25.0 to 29.9 = overweight
BMI of 30 or higher = obese
Recent research evidence indicates that these BMI cut-off points may need revision because the relationship between BMI and body composition, and between indices of fat distribution and the actual amount of visceral fat,
differs across ethnic groups. For example, Asian populations have a higher body fat percentage at a lower BMI compared to Caucasians. Change the definition for overweight for Asian populations from 25 to 23?

A 2007 study in Vancouver found that, for the same amount of total body fat, Chinese and South Asian people had a far greater concentration in their inner abdomen, where it poses the greatest risk for diabetes and heart disease. The main assumption of BMI guidelines is that BMI is closely associated with body fatness and consequent morbidity and mortality. However, some individuals who are overweight are not over-fat.

Criticism – BMI does not differentiate body composition.
BMI of NFL football players: Ray Lewis = 33, Nick Mangold = 36.6
BMI of NHL hockey players: Sidney Crosby = 27.8
Accumulating research evidence shows that waist circumference and/or waist-to-hip ratio is a better predictor of obesity related health risks than BMI. The prevalence of overweight and obesity amongst Canadian children and adults has increased significantly in the past 20 years.
D. Skinfold Measurements
Rationale – a relationship exists between the fat located in the depots directly beneath the skin and internal body fat and body density.
There are basically two ways to use fatfolds:

  1. Use the sum of a number of skinfolds as an indication of relative fatness among individuals. Also compare “before” and “after” in the same individual.
  2. Use fatfolds in conjunction with equations or tables to predict percent body fat.

Skinfold caliper formulae to predict percent fat are site and sample specific.
Assumptions in using skinfold measurements to predict percent fat:

  1. Constant densities in a two-compartment model
  2. Proper identification of measurement site and proper measurement technique
  3. Constant compressibility of the skinfold
  4. Fixed adipose tissue patterning
  5. Fixed proportion of internal to external fat

There are two types of body composition prediction equations:

  1. Population specific equations – developed from relatively small, homogeneous (age, sex, state of training, fatness) samples. Their application is limited to that subsample. Example – Sloan, Yuhasz
  2. Generalized equations – developed from large, heterogeneous samples.

These equations have a wider application in terms of age, and fatness. However, these equations should be used cautiously with unique populations such as extremely obese individuals and professional football players.
Example – Jackson and Pollock, Durnin & Womersley, Peterson, Wang
Even when the correct equation is used and the measurements are performed correctly, prediction of percent fat from skinfold measurements has an error of approximately 3-4 %.

E. Canadian Physical Activity, Fitness and Lifestyle Appraisal
This method requires the consideration of three different indicators for a comprehensive assessment of body weight, adiposity, and fat distribution.

  1. Body mass index – is the subject overweight?
  2. Sum of 5 skinfolds – triceps, biceps, subscapular, iliac crest, and medial calf. Is the subject over-fat?
  3. Waist girth – is the subject high in visceral adiposity – male type obesity?

F. O-Scale System
Adiposity rating, proportional weight rating, stanine scale
G. Bioelectrical Impedance Analysis
Electrical impedance units are used to measure the electrical resistance of the body. Impedance is greater in adipose tissue (14 – 22% water) than in bone and muscle (71 – 75% water). Attach electrodes to the subject. A low level electrical current (500 to 800 microamps at 50 kHz) is passed through the subject’s body. The higher the electrical resistance, the fatter the subject. The daily fluctuations in water content from exercise, dehydration, eating and drinking all need to be standardised to obtain optimum impedance results. Clients must adhere to strict pretest guidelines in order to yield valid estimates of their body composition.

The prediction equations that estimate fat free mass are validated using underwater weighing. These equations tend to overestimate fat mass in the lean and underestimate fat mass in the obese. Must use equations specific to given populations Error in percent fat estimation – approx. 3-5% body fat
H. Near-Infrared Interactance (NIR)
NIR is still in the developmental stages and there is much scepticism surrounding the use of NIR to assess body composition.
Principle – the degree of infrared light absorbed and reflected is related to the composition of the tissues. Optical densities are linearly related to subcutaneous and total body fat. The biceps is the best single site for estimating body fat using this method.
I. Other Procedures

  1. Dual energy X-ray absorptiometry – widely used for performing bone mineral density measurements
  2. Total body water – hydrometry
  3. Ultrasound
  4. Magnetic resonance imaging
  5. Computerized tomography
  6. Total body potassium

These laboratory methods are reasonably accurate but they are expensive, cumbersome and require highly trained technicians.

Conclusion – results of estimation of body composition should be interpreted cautiously.

V. Body Composition and Aging
Changes associated with aging in a prosperous, industrialized society:

  1. increased fat mass
  2. decreased muscle mass – sarcopenia
  3. decreased bone mass

These changes can be slowed down by a regular exercise program and proper dietary habits. Recent evidence indicates that skeletal fragility in elderly women is related to failure to obtain an optimal level of bone mass during childhood.

Co-morbidities/Complications Associated With Obesity

  • Type II diabetes mellitus
  • Hypertension
  • Coronary artery disease, and heart failure
  • Higher incidence of certain cancers
  • Dyslipidemia
  • Higher levels of inflammatory markers in the body
  • Stroke
  • Sleep apnea
  • Gallbladder disease
  • Osteoarthritis of the weight-bearing joints
  • Gout
  • Reduced fertility
  • Impaired obstetric performance
  • Reduced physical agility
  • Co-morbidities/Complications Associated With Excessive Thinness
  • Fluid-electrolyte imbalances
  • Osteoporosis
  • Bone fractures
  • Muscle wasting
  • Cardiac arrythmias and sudden death
  • Peripheral edema
  • Renal disorders
  • Reproductive disorders

The prevalence of anorexia nervosa is estimated at 0.5% of the population in the western industrialized countries. 90% of people with anorexia are female, with females between 15 and 19 years old making up 40% of all
cases. A 1990 study reported that the average bone mineral density of the spine of 18 to 27 year old anorexic women was equivalent to that of a 70 year old woman.

The material posted in this blog is for information purposes only for candidates that are looking for more in depth material for first aid training. To register for a course in first aid visit Vancouver First Aid Ltd.

Posted in First Aid
Tuesday, 27 December 2011
Last updated: July 13, 2014 at 16:33 pm

Muscle and Nervous System Information for First Aid

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The information posted on this page is detailed information about the central nervous system and muscular movement structure of the human body. This information will not be covered in this kind of detail in any Red Cross first aid course (more information). This information is supplemental information to the material covered in the basic first aid courses, in particular, head and spinal injuries.

Divisions of The Nervous System
A. Central Nervous System

1. Brain – newer more sophisticated regions are piled on top of older, more primitive regions
a) Forebrain
(i) Cerebrum constitutes about 80% of total brain weight – cerebral cortex, basal nuclei
(ii) Diencephalon – thalamus, hypothalamus

b) Cerebellum

c) Brainstem – continuous with the spinal cord – medulla, pons, midbrain

2. Spinal cord – long cylinder of nerve tissue which extends down from the brainstem to the second lumbar vertebrae. 45 cm long and 2 cm in diameter. Protected by the vertebral column and associated ligaments and muscles, the spinal meninges and the cerebrospinal fluid.

B. Peripheral Nervous System

Consists of 12 pairs of cranial nerves and 31 pairs of spinal nerves

  1. Afferent division – conveys information from the sensors in the periphery to the central nervous system (CNS)
  2. Efferent division
  • Somatic nervous system – nerve fibres innervate skeletal-muscle
  • Autonomic nervous system – nerve fibres innervate smooth and cardiac muscle and glands

(i) sympathetic division
(ii) parasympathetic division

Neuroglia – comprise about 90% of the cells within the CNS. They occupy about half of the volume of the brain. The four major types of glial cells serve as the connective tissue of the CNS and as such help support the neurons both physically and metabolically. It is estimated that there are approximately 100 billion neurons in the brain and one trillion neuroglia. Along with the endocrine system, the nervous system regulates and coordinates the various functions of the body.

Basic Structure of a Nerve

  1. Neuron – a nerve cell. A neurons is specialized to transmit electrical signals. It consists of:
  2. Cell body – soma – contains the nucleus
  3. Axon – a long fiber that conducts impulses away from the cell body. The term “nerve fiber” is generally used in reference to an axon.
  4. Dendrite – short projections from the cell body that transmit impulses toward the cell body

The main purpose of the neuron is to pass messages (impulses) from one part of the body to another

  • Myelin sheath – a discontinuous sheath around the axon. It is composed mainly of lipid and protein.
  • Nodes of Ranvier – spaces between the segments of myelin sheath –> saltatory conduction
  • Myelinated nerve fibers have much faster conduction velocities than un-myelinated fibers
  • Synapse – the connection of an axon of one nerve to the cell body or dendrites of another nerve.

Neurons can be divided into 3 functional classes:

  • Afferent neurons – carry impulses from the sensory receptors into spinal cord or brain
  • Efferent neurons – transmit impulses from the CNS out to the effector organs – muscles (motor neurons) and glands
  • Interneurons – lie entirely within the CNS. They account for 99% of all nerve cells.

Each spinal nerve is actually a nerve trunk – it contains hundreds of individual afferent and efferent nerve fibers that are bound together by connective tissue sheaths.

The Nerve Impulse

Resting membrane potential – due to the selective permeability characteristics of the nerve cell membrane, a potential difference (voltage) exists between the inside and outside of the nerve fiber. A high concentration of positive sodium ions on the outside of the nerve membrane causes it to be electrically positive, while the inside of the nerve is electrically negative.

Action potential – an appropriate stimulus suddenly causes sodium ions to rush to the inside of the nerve –> reversal of polarity. Once the action potential is started, it spreads along the entire length of the nerve fiber.

Nerve to Nerve Synapses

Nervous information is relayed across the synaptic cleft by means of a chemical transmitter substance. Transmitter substances can be either excitatory or inhibitory in their effects on the post synaptic membrane potential

Spatial vs. temporal summation

Neuromuscular junction – nerve to muscle synapse. The chemical transmitter substance is acetylcholine.

Spinal Cord
The spinal cord is enlarged in two regions for innervation of the limbs:

  • a) The cervical enlargement which extends from the C4 through T1 segments of the spinal cord
  • b) The lumbosacral enlargement which extends from the T11 through L1 segments of the spinal cord

Plexus – a network of converging and diverging nerve fibers, or blood vessels. The brain and spinal cord are composed of gray matter and white matter. The nerve cell bodies lie in and constitute the gray matter while the interconnecting tracts of nerve fibers (axons) form the white matter.
Structure of spinal nerves – 31 pairs of spinal nerves are attached to the spinal cord – 8 cervical, 12 thoracic, 5 lumbar, 5 sacral and 1 coccygeal. Each spinal nerve has a dorsal root and a ventral root connected to the spinal cord. The dorsal roots contain afferent (sensory) fibers that carry information from the periphery to the spinal cord and brain. The ventral roots contain efferent (motor) fibers to the skeletal muscle. The cell bodies of the motor axons making up the ventral roots are located in the ventral gray horns of the spinal cord The cell bodies of the sensory axons making up the dorsal roots are outside of the spinal cord in the spinal ganglia.

Ganglion – a collection of nerve cell bodies located outside of the CNS.

Spinal cord injury – transection of the spinal cord results in loss of all sensation and voluntary movement inferior to the point of damage. The patient is quadriplegic if the cord is transected superior to C5. If the transection is above C4, the patient may die of respiratory failure. The patient is paraplegic – paralysis of both lower limbs – if the transection occurs below the cervical segment of the spinal cord.

Deficiency of blood supply (ischemia) to the spinal cord caused by fractures, dislocations, atherosclerosis, etc. affects its function and can lead to muscle weakness and paralysis. When the brain or spinal cord is damaged, in most cases the injured axons do not recover.

Proprioceptors – conduct sensory information to the CNS from muscles, tendons, ligaments, and joints –> kinesthetic sense

A. Muscle Spindles
Structure – several modified muscle fibers, four to 10 millimeters in length, contained in a capsule, with a sensory nerve spiralling around its center. Spindle fibers (intrafusal fibers) lie parallel to the regular fibers (extrafusal
Function – send information to the CNS regarding the degree of muscle stretch –> activation of the exact number of motor units to overcome a given resistance. With increasing degrees of stretch of the muscle spindle, the frequency of impulse transmission up the afferent neuron to the spinal cord progressively increases.

Three ways that the muscle spindle can activate the alpha motor neurons to cause the muscle to contract:

  1. Tonic stretch – concerned with the final length of the muscle fibers
  2. Phasic stretch – spindle responds to the velocity of the change of length
  3. Gamma system – gamma efferent fibers innervate the contractile ends of the intrafusal fibers. When the alpha motor neurons are activated, the gamma motor neurons are also activated (coactivation).

Gamma system provides the mechanism for maintaining the spindle at peak operation at all muscle lengths.

Stretch reflex
Muscle spindles are distributed throughout the muscle. Their density varies with the degree of control required by a given muscle.

B. Golgi Tendon Organs
Location – encapsulated in tendon fibers near the junction of the muscle and tendon fibers. They are approximately one millimeter long and 0.1 millimeters in diameter. They are in series with the muscle fibers rather
than in parallel as are muscle spindles. When a muscle contracts, the GTO is stretched.

Functions – the firing rate of the GTO is very sensitive to changes in the tension of the muscle.

  1. Sensory input from GTO about the tension produced by muscles is useful for a variety of motor acts, such as maintaining a steady grip on an object.
  2. When stimulated by excessive tension or stretch –> send sensory information to the CNS –> causes the contracted muscle to relax (reflex inhibition) – protect the muscle and its connective tissue harness from damage due to excessive loads

C. Joint Receptors
Supply information to the CNS concerning joint angle, acceleration of the joint, etc.

The cerebral cortex and cerebellum are the main centers employed in learning new motor skills. These areas of the brain initiate voluntary control of movement patterns.

Cerebral Cortex

Primary motor cortex – located at the rear of the frontal lobe of the cerebral cortex.
Stimulation of different areas of the primary motor cortex brings about movement in different, specific areas of the body. Contains the motor homunculus. However, no coordinated movement can be elicited. The motor cortex on each side of the brain primarily controls muscles on the opposite side of the body.

Pyramidal tract – corticospinal pathway – long axons which carry impulses from the primary motor cortex where their cell bodies are located directly to lower motorneurons in spinal cord —> spinal nerves. The corticospinal system primarily mediates performance of fine, discrete, voluntary movements of the hands and fingers.

Premotor cortex – one of the three higher areas that command the primary motor cortex. Located on the lateral surface of each cerebral hemisphere in front of the primary motor cortex.

Extra-pyramidal tract – multineuronal pathways – route used to send impulses from the premotor area down to the lower motorneurons of the spinal cord. Instead of synapsing directly with motor neurons, this pathway involves many of the other brain regions, including the cerebellum. These pathways are more concerned with posture and coordination of large muscle groups.

Considerable complex interaction and overlapping of funcion exist between these two systems.

Located behind the brainstem. It functions by means of intricate feedback circuits to monitor and coordinate other areas of the brain involved in motor control. It receives signals concerning motor output from the cortex and sensory information from receptors in muscles, tendons, joints and skin, as well as from visual, auditory and vestibular end organs.

Function – the major comparing, evaluating, and integrating center for postural adjustments, locomotion, maintenance of equilibrium, perceptions of speed of body movement, and general motor coordination.
Damage to the cerebellum results in impaired motor control.

Posted in First Aid
Tuesday, 27 December 2011
Last updated: July 13, 2014 at 16:33 pm

Body Types – Somatotypes

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The material posted on this article about somatotypes is supplemental information to first aid and CPR training. This extensive information is designed to give candidates an understanding of the different body types and how it can relate to first aid scenarios. To learn basic first aid and to apply this information register for a first aid class.

I. Body Image

Body image – the picture an individual has of her own body which she forms in her mind. Individuals assign qualities of size, shape, and attractiveness to their bodies in terms of personalized standards which may bear little
relation to actual body characteristics. Some people love and parade their bodies; others are ashamed of their bodies and hide them.

The primary determinants of body appearance are

  • (a) the skeleton
  • (b) muscle
  • (c) fat

II. The Somatotype

The somatotype is a quantitative description of the present structure and composition of the body. This method of physique classification was developed by W.H. Sheldon in the 1920’s to 1950’s. The real value of somatotyping lies in its contribution toward a better understanding or the individual.

A. Sheldon’s Somatotype

Sheldon designated three primary components of body build:

  1. Endomorphy – refers to the relative predominance of soft roundness throughout the body.
  2. Mesomorphy – refers to relative predominance of muscle, bone, and connective tissue.
  3. Ectomorphy – refers to the relative predominance of linearity and fragility.

Sheldon rated each component on a seven point scale to indicate it’s relative contribution to the total physique. This three numeral rating of a physique is called the “somatotype”.
First numeral = endomorphy
Second numeral = mesomorphy
Third numeral = ectomorphy

Most physiques are dominated by two components.
641 = mesomorphic endomorph
461 = endomorphic mesomorph
244 = mesomorph – ectomorph
333 = balanced
Sheldon studied 15,000 men and identified 88 basic somatotypes. 27 of these somatotypes accounted for 83% of the male population.

B. Male versus Female Somatotypes

On a somatoplot, the distribution of female physique types differs from the male distribution of physique types – sexual dimorphism. Females are more endomorphic and less mesomorphic than males. 1976 – 1978 Canadian data.
Manual. Average somatotypes for males and females aged 15 to 60 years:
Males: 3.9 – 5.2 – 1.9
Females: 4.7 – 4.0 – 2.2
There are also differences in average somatotypes among ethnic groups.

C. Methods of Determining Somatotypes

Several systems of somatotyping have been developed. The Sheldon method and the Heath-Carter method have been the most widely used. The Heath-Carter method has been extensively used on samples of
athletes. In the Heath-Carter method, the rating scale was opened at the top end, from 7 to 12, to accommodate extreme body types. The somatotype doesn’t tell you anything about a person’s height, or about body proportionality – trunk length vs. leg length, etc.

D. Heritability of Somatotype Components

Both genes and environment are important in determining differences in somatotype components. The heritabilities for mesomorphy (85%) and ectomorphy (65%) are higher than for endomorphy (28%)

E. Physical Performance and Somatotype

Both male and female athletes are more mesomorphic and less endomorphic than non-athletes of the same age. There are characteristic somatoplot distributions for each sport. The higher the level of sport the lower the variation in somatoplot distribution.
USA national men’s rugby team – mean somatotypes for backs = 2.4-5.9-1.8; forwards = 3.1-6.6-1.2. The USA national team players have similar somatotypes to national team players from France, Australia, and South Africa.
Some sports are more tolerant of somatotype variation than other  sports. A high mesomorphy is positively correlated with physical fitness tests and endomorphy is negatively correlated. Strength and speed-dependent athletes are more mesomorphic and less ectomorphic than distance-dependent athletes. Very seldom do men and women low in mesomorphy succeed at a high level in sports.

Posted in CPR, First Aid
Monday, 26 December 2011
Last updated: July 13, 2014 at 16:33 pm

Pulmonary Structure and Function for First Aid

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This blog post is designed to provide supplemental information to candidates learning about choking emergencies. The information posted here will not be covered in Red Cross first aid and / or CPR training as it is extensive in detail and information. The material is here for candidates wanting to look further into the breathing structure of the human body.


I. Anatomy of the Respiratory System
Respiratory system consists of nose, pharynx, larynx, trachea, bronchi, and lungs. Bronchi – primary, secondary, and tertiary bronchi —> terminal and respiratory bronchioles —> alveolar ducts —> alveoli.
With branching, supportive cartilage is gradually replaced by smooth muscle. Contraction and relaxation of this smooth muscle constricts or dilates the bronchioles –> major effects on airway resistance. The conducting airways lead inspired air to the alveoli. Volume of conducting airways = anatomic dead space (VD) – 150 ml.

Alveoli – small, thin walled sacs that have capillary beds in their walls; site of gas molecule (O2 & CO2) exchange between air and blood; there are millions of alveoli
Respiratory membrane – alveolar-capillary membranes that separate the air molecules in the alveoli from the blood in the capillaries – average thickness is 0.6 micrometers. The respiratory membrane has a very large
surface area – 70 square meters in the normal adult – size of tennis court. Lungs – contain conducting airways, alveoli, blood vessels, elastic tissue.

II. Mechanics of Breathing
Molecules move from areas of high pressure or concentration to areas of low pressure or concentration. Boyle’s Law – the pressure of a gas is inversely proportional to its volume. The movement of air into and out of the lungs results from a pressure difference between the pulmonary air and the atmosphere.

Inspiration – active process – diaphragm descends and external intercostal muscles contract thus increasing the volume of the thoracic cavity —> decreased pressure in thoracic cavity causing a one or two mm Hg drop in
intra-alveolar pressure at rest compared to the outside atmospheric pressure —> air molecules move through the respiratory tubes into the lungs from the atmosphere following the pressure gradient. Inspiratory muscles, when they work their hardest, can produce a negative pressure as great as -30 mm Hg below atmospheric pressure within the alveoli.

Expiration – passive process at rest. Secondary muscles, such as abdominal muscles become involved in exercise. Forced expiration can produce intra-alveolar pressure as great as +50 mm
Hg above atmospheric pressure. During exercise, mouth breathing tends to replace nasal breathing – less resistance to airflow. Air that enters the respiratory passages via either the nose or the mouth is quickly saturated with water vapor and warmed to body temperature, 37 degrees centigrade, even under conditions when very cold air is inspired. Compliance – the amount of volume change in the lung for a given change in alveolar pressure.
III. Lung Volumes

Normal values at rest:

  • Minute ventilation (VE ) – 6 – 8 liters/min.
  • Tidal volume (VT) – 500 ml per inspiration or expiration
  • Breathing frequency (FR) – 12 – 16 breaths per minute
  • Expiratory reserve volume (ERV) – approximately 25% of vital capacity(VC)
  • Inspiratory capacity (IC) – approximately 75 % of vital capacity (VC)
  • Total lung capacity = vital capacity plus residual volume

In maximal aerobic exercise, breathing frequency can increase up to 60 breaths per minute and tidal volume can increase up to 50% of vital capacity.
Alveolar ventilation(VA) – the volume of air that reaches the alveoli per minute. This value is very important because this is the only air that participates in gas exchange with the blood.
VA = (VT X FR ) – (VD X FR)
= 500 ml X 12 – 150 ml X 12
= 6000 ml – 1800 ml
= 4200 ml/min.

Most volumes and capacities decrease when a person lies down and
increase when standing. Reasons:

  1. Abdominal contents push up against diaphragm
  2. There is an increase in intrapulmonary blood volume in the horizontal position which decreases the space available for pulmonary air.

IV. Pulmonary Disorders
Pulmonary function test norms are usually based on sex, age, and height. It is important to know the size and make-up of the population used to construct the norms. Problems with pulmonary function norms:

  • don’t consider the “size” of the subject, particularly the chest size
  • would be better to use sitting height rather than standing height

Chronic pulmonary dysfunctions can be divided into two categories:
1. Obstructive disorders – blockage or narrowing of the airways causing increased airway resistance – asthma, bronchitis, emphysema. Bronchiolar obstruction can result from inflammation and edema, smooth
muscle constriction, or bronchiolar secretion. Very difficult to move air rapidly in and out of lungs –> decreased FEV1.0, FEV1.0/VC much less than 80%, decreased MBC
Airways collapse during expiration before normal amount of air is emptied from the lung – air trapping —> increased FRC, RV, TLC

2. Restrictive disorders – no problem with the airways but there is damage to the lung tissue – loss of elasticity and compliance – limited expansion of the lung – pulmonary fibrosis, pneumonia.
All lung volumes are reduced – VC, RV, FRC, TLC – because the lung tissue is stiff and can’t be expanded very far. FEV1.0 and MBC are reduced but FEV1.0/VC ratio is frequently 90% or greater.
Pulmonary function tests must be interpreted in relation to a patient’s medical history, occupational history, smoking habits, and a chest X-ray. V. Ventilation During Incremental Exercise

During exercise, minute ventilation increases linearly with increasing exercise intensity and oxygen uptake until approximately 60% of VO2 max. In untrained subjects and 75-80% of VO2 max. in endurance athletes.

Ventilatory threshold – the point at which minute ventilation increases disproportionately with oxygen consumption during graded exercise. For a given individual, the exercise intensity at the ventilatory threshold is
similar to the exercise intensity at the lactate threshold, the point at which lactic acid begins to accumulate in the blood. Prior to this exercise intensity, aerobic metabolism matches the energy requirement of the active muscles and no blood lactate accumulates because lactate production equals lactate disappearance.

For a given work rate, arm or upper body exercise causes a greater minute ventilation than leg exercise – example of arm cycle ergometry versus leg cycle ergometry.

For more information on breathing emergencies and how to treat and react to other first aid scenario enroll in a standard first aid and CPR course. Training centres are located in Vancouver, Richmond, Surrey, Coquitlam and Burnaby. Material posted in this page is for information purposes only.

Posted in First Aid
Monday, 26 December 2011
Last updated: July 13, 2014 at 16:33 pm

Osteology and Arthrology for First Aid

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The information posted on this article is additional material to supplement basic first aid training. This content will not be included in any detail in standard, childcare or emergency first aid programs. This article supplements the sprains and strains and broken bones components of Red Cross first aid training.


A. Functions of the Skeleton
• Provides a supporting framework for the body
• Provides attachment points for muscles, creating a lever system that enables body movement
• Provides protection of vital organs
• Blood cell formation – red bone marrow produces red and white blood cells and platelets. Bone is richly supplied with blood vessels.
• Mineral storage – calcium and phosphorus

B. Structure of Bone
The major building blocks of bone are calcium carbonate, calcium phosphate, collagen fibers, and water. Collagen is a protein that is the main organic constituent of connective tissue. Bone tissue is composed of widely separated cells, called osteocytes, surrounded by matrix. The matrix is about 25% water, 25% protein, and 50% mineral salts. Bone is highly dynamic and is continually being remodeled in response to mechanical stress or even absence of stress. Longitudinal growth of a bone occurs at the epiphyseal plate, which is a layer of cartilage. The proliferating cartilage cells are gradually replaced by bone. The bones of physically active individuals tend to be denser and therefore more mineralized than those of sedentary individuals of the same age and gender.

C. Classification of Bones

  • Long bones
  • Short bones
  • Flat bones
  • Irregular bones

D. Vertebral Column
The vertebral column provides flexible support for the trunk and protects the spinal

  • 33 vertebrae; 26 distinct bones
  • 5 segments
  • 7 cervical vertebrae
  • 12 thoracic vertebrae
  • 5 lumbar vertebrae
  • 5 sacral vertebrae
  • 4 coccygeal vertebrae

The vertebrae articulate with one another by means of facets on the processes of the neural arches (synovial joint) and by means of intervertebral discs between the vertebral bodies (cartilaginous joint). The discs function as shock absorbers and allow slight movement so that the column is flexible and resilient.

Abnormal curves:
1. Scoliosis – an abnormal lateral curvature of the vertebral column.
2. Kyphosis – “hump back” – an exaggerated posterior thoracic curve.
3. Lordosis – “sway back” – an exaggerated anterior lumbar curve.

E. Classification of Joints

  1. Fibrous joint – immoveable
  2. Cartilaginous joint – slightly moveable
  3. Synovial joint – freely moveable

Synovial fluid has two functions:
a) Lubricates the joint surfaces as they slide over each other during joint movement
b) Supplies nutrients to, and removes waste products from, the cartilage cells which have no direct blood supply.
Ligament – fibrous connective tissue that connects bones together.
Tendon – fibrous connective tissue that joins muscle to bone.
Bursa – a small sac or cavity filled with synovial fluid and located at friction points, especially joints. Most bursae are located between tendons and bone.
Frontal plane – divides body into anterior and posterior portions
Sagittal plane – divides the body into right and left sides
Transverse plane – divides the body into superior and inferior portions

G. Terms of Direction

These movements are related to the body as seen in anatomical position.

  1. Flexion, extension
  2. Abduction, adduction
  3. Rotation – inward (medial) rotation; outward (lateral) rotation
  4. Supination, pronation
  5. Elevation, depression
  6. Plantar flexion, dorsiflexion

I. Common Joint Disorders

  1. Sprain
  2. Dislocation
  3. Subluxation
  4. Bursitis
  5. Arthritis

J. Structural Limits To Flexibility

  1.  Bony structure of the joint – can’t be changed by a flexibility program
  2. Ligaments
  3.  Joint capsules
  4. Muscle-tendon unit – muscle and its fascial sheaths – the major focus of
  5. stretching exercises is the elongation of this tissue.

To learn about treatment of first aid emergencies and to recognize sprains, strains and broken bones take a standard first aid course with Vancouver First Aid Ltd. The knowledge learned in a first aid course can help you save a life.

Posted in St Mark James
Monday, 26 December 2011
Last updated: July 13, 2014 at 16:33 pm

Red Cross Swim Preschool Program.

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The Canadian Red Cross provides a number of programs and safety instruction courses to Canadians. The Red cross is extremely popular for CPR training (click here to register) and first aid courses. However, the Red Cross is also the leading provider of swim programs for youth and adults. This page focuses on the swim preschool program provided through the Red Cross.


6.5 hours (2 hours class; 4.5 hours pool)
Definition: Seven-level, stand-alone program that allows swimmers to enter various levels based on age and ability.
Designed for infants, toddlers, preschoolers and their caregivers.

1. Identify the content item and match it to the observation or performance criteria for each level of the Red Cross Swim Preschool program.
2. Demonstrate the ability to apply the Red Cross Swim Preschool program progressions in a peer teaching
3. Identify strategies to teach through a caregiver in the water, for parented levels.
4. Identify effective teaching strategies to meet the needs of the preschool age groups and characteristics.
5. Demonstrate effective supports, holds, and body positions for participants in the Red Cross Swim Preschool
6. Identify the program support materials and use for the Red Cross Swim Preschool program.

Evaluation Criteria

-Demonstrates the ability to plan activities appropriate for the age group and level of Red Cross Swim Preschool program
-Identifies the content item and matches it to the observation or performance criteria for each level of the Red Cross Swim Preschool program
-Demonstrates the ability to apply the Red Cross Swim Preschool program progressions in a peer teaching environment
-Identifies strategies to teach infants and toddlers through a caregiver in the water for parented levels
-Identifies effective teaching strategies to meet the needs of the preschool age groups and characteristics
-Demonstrates effective supports, holds and body positions for swimmers in the Red Cross Swim Preschool program
-Identifies the program support materials and use for the Red Cross Swim Preschool program

Dry Portion: 2 Hours

Activity: Age Characteristics

Objectives: Identify effective teaching strategies to meet the needs of the preschool age groups and characteristics.

Time: 30 minutes.

Materials: Magazine clippings of children in the following Age category

a) 0 – 12 months
b) 13 – 24 months
c) 22 – 36 months
d) 36 – 50 months
e) 48 – 60 months

And cut out of paper listing ball and cookie.


Activity: Divide class into five groups and assign each group an age characteristic:
a) 0 – 12 months
b) 13 – 24 months
c) 22 – 36 months
d) 36 – 50 months
e) 48 – 60 months

Give each group a piece of paper with ball and cookie written on it and the magazine cut out relating to there age group. On a flipchart have the group write down the characteristics associated with that age group. Have the groups take turns presenting the characteristics and have the class discuss them.

Once the have completed presenting the characteristics have the group prepare to act out for the class how there age group would play with a cookie and a ball. After 5 minutes of prep time give each group a turn presenting.

Finally, after these presentations have each group list what considerations or activities should be incorporated into lessons, taking account the listed characteristics. Have each group share their findings with the class.
Activity: Safety Supervision
Materials: Paper and pen provided by each student, Flipchart and felts

Identify strategies to teach through a caregiver in the water, for parented levels.
Identify effective teaching strategies to meet the needs of the preschool age groups and characteristics.

Time: 1 Hour

Wet: Have the class observe a preschool class with parent (Parent n’Tot) and a preschool class without a parent. While observing have the learners list all possible class management and safety concerns observed. List all concerns

Dry: Place the class into appropriate groups and have them combine there answers onto a flipchart. After they are done there group discussions have them present to the class what they have learned. Questions up for discussion in groups and in class setting.

What safety concern are brought up and how, as an instructor, would you eliminate or address these concerns?

Activity: Communication (Enthusiasm)

Identify effective teaching strategies to meet the needs of the preschool age groups and characteristics.

Materials: Flipchart, felts.

Time: 30 minutes

Dry: Divide the class into two teams. Have them list out a number of different emotions relevant to teaching onto a flipchart. Then have a person from each time, one by one, run to the other end of the room where the list has been placed, and get an emotion from the list. S/he then must go back to his/her team and act out the emotions until the team guesses it. Play continues until the list is finished. Relate this to teaching preschoolers.

Discuss how body language and facial expression can affect communication with preschoolers?

On a flipchart, in your group, list the ways that instructors can use their bodies to communicate.
How does our body language influence the emotions and feelings of preschoolers in our classes?

Wet Portion:

Activity: Communication Scenarios

Identify effective teaching strategies to meet the needs of the preschool age groups and characteristics

Materials: Laminated Sheets with the following scenarios written on them

  • 1. Speak to adults as if speaking to infants
  • 2. Speak to infants as if to adults
  • 3. Be completely unenthusiastic
  • 4. Be overly enthusiastic
  • 5. Be very quiet
  • 6. Be inattentive, mind is elsewhere
  • 7. Be upset / angry
  • 8. Be unprepared, stall, don’t know what to say
  • 9. Be overly frustrated over lack of progress with candidates

Time: 1 Hour

Activity: Hand out a laminated sheet of paper with one of the scenarios written on them and hand out to the students. Give them 5 minutes to prepare a segment of a starfish class and incorporate there scenario to the class. After teaching with there scenario for a starfish class have the class determine the problem with the instructor and why it is an issue. Allow for time for questions comments and concerns.
Activity: Teaching Time

Demonstrate the ability to apply the Red Cross Swim Preschool program progressions in a peer teaching

Materials: Prepared homework of lesson plans.

Time: 2.0 hours

Wet: Assign each student one of the 5 preschool levels to teach. If there are more than five have a few groups of two. They are to prepare prior to this activity a lesson plan of twenty minutes focusing on the main progressions of the level and creative ways to teach, critique and incorporate the progressions into there lesson plan. After each presentation have them explain the progression they included and how it fits into the entire preschool program.

Questions? Comments? Concerns? Does this make sense?

Keys: Go through the lessons in the correct order.
Activity: Experience the Canadian Red Cross Preschool Program

Identify effective teaching strategies to meet the needs of the preschool age groups and characteristics.
Demonstrate effective supports, holds, and body positions for participants in the Red Cross Swim Preschool
Identify the program support materials and use for the Red Cross Swim Preschool program.

Materials: Instructors P&T lesson plan, Starfish lesson sheet.

Time: 1.5 Hour

Activity: Using a lesson plan lead the class through a P&T preschool class using dolls and infants actars. Lead the learners through songs and games for infants and candidates. Lead the class through a thirty minute class. Go through the holding positions appropriate for infants and preschoolers.

Give the class the starfish lesson sheet and give each student 5 minutes to prepare a unique 5 minute lesson segment of a parent and tot lesson. Allow time for discussion and comments after every presentation.
Their communication should include instructions that are simple for the kids to understand as well as include explanations of physical principles, common errors and ways to correct for the parents.

Have them each select two criteria from the preschool program to teach the remainder of the class. Have the class act out as best they can and be as realistic as they can as they are acting as parents with children taking a preschool class.





Posted in St Mark James
Monday, 26 December 2011
Last updated: July 13, 2014 at 16:33 pm

Red Cross Swim Kids Program

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The Red Cross swim kids program is one of many safety and instructional programs offered to Canadians through the Red Cross. The Red Cross is most famous for its first aid and CPR courses and first aid re-certification classes. This page will focus solely on the Red Cross Swim Kids program and provide a overview and detailed lesson plan for the course.

7 hours (1.5 hours class; 5.5 hours pool)
Definition: A 10-level program designed to provide solid and manageable skill progressions from one level to the
1. Demonstrate the ability to apply the Red Cross Swim Kids program progressions in a peer teaching environment.
2. Teach the content item and identify the performance criteria for each level of the Red Cross Swim Kids program.
3. Identify effective teaching strategies to meet the needs of the children’s age group characteristics.
4. Identify the program support materials and use for the Red Cross Swim Kids program.
Evaluation Criteria
-Demonstrates ability to plan activities appropriate for the age group and level of Red Cross Swim Kids program
-Demonstrates the ability to apply the Red Cross Swim Kids program progressions in a peer teaching environment
-Identifies how to teach the content item and identifies the performance criteria for each level of the Red Cross Swim Kids program
-Identifies effective teaching strategies to meet the needs of the children’s age group characteristics
-Identifies the program support materials and use for the Red Cross Swim Kids program
Dry Portion (1.5 Hours):
Formations and Placement

Demonstrates ability to plan activities appropriate for the age group and level of Red Cross Swim Kids program

Materials: Flipchart, felts

Time: 30 minutes

Put candidates into four groups. Place four pool floor plans around the room and designate one per group. Each group is given a level and a skill within that level. They must find an area of the pool in which they will teach that skill including the formation they will use and where they will place the instructor. Each group rotates through the posters. They then switch activities and repeat the process. Candidates are encouraged to challenge themselves to use different formations each time. Lead the candidates through a discussion of which formations were successful and which weren’t.

The Four Activities that the candidates will cycle through are as follows:

1. Swim Kids 2
2. Swim Kids 4
3. Swim Kids 6
4. Swim Kids 8
-Demonstrate the ability to apply the Red Cross Swim Kids program progressions in a peer teaching environment.
-Teach the content item and identify the performance criteria for each level of the Red Cross Swim Kids program.
-Identify the program support materials and use for the Red Cross Swim Kids program.
Materials: Red Cross Swim Kids Worksheets, Flipchart, Felts

Time: 30 minutes

Activity: Divide candidates into small groups. Provide each group with a copy of the
worksheets for the Red Cross Swim Kids Program. Assign each group a skill (either swimming or water
safety skill) to follow the progression through the program. Each group will identify the progression steps
including the evaluation criteria of the progression. Present these findings to the class. Allow for ten minutes for group time and five minutes per presentation.
Communication (Empathy):

Identify effective teaching strategies to meet the needs of the children’s age group characteristics.

Materials: Cue Cards with instructor and learner elements, flipchart, felts

Time: 30 minutes

Activity: Have each candidate choose a partner. Designate one partner “instructor” and the other “learner”. Give all the instructors a cue card with a communication element (e.g. towering teacher) and give the learners a cue card with a feeling (e.g. frustrated). Ask the instructors to assign a skill to the learners (e.g. draw a picture of a horse) and allow the instructors and the learners to interact. Post a flipchart with the word “feeling” on one column and the word “empathy” on the other. Brainstorm for ways of showing empathy toward learners. ** You might need to define the word “empathy”! See Empathy task cards – communication in Appendix D

Definition of Empathy: understanding and entering into another’s feelings

Wet Portion (5.5 hours):
Activity: Footsteps

-Demonstrate the ability to apply the Red Cross Swim Kids program progressions in a peer teaching environment.
-Teach the content item and identify the performance criteria for each level of the Red Cross Swim Kids program.

Materials: Laminated papers with major progressions and minor progression in the swim kids program

Time: 1 Hour

Activity: With all the students in the water take out a mat and place the laminated forms of all the major progressions (can be in the shape of a foot) on a mat, out of order. Have the students place the progression in the right order. Have the students then demo all the progressions one by one. Discuss the importance of doing the progressions in order and discuss what would happen if you were to skip a progression and how the next progression would go.

Separate the class into the number of groups of major progressions. Give each group a mat and have them put the smaller progressions to that large progression in order. Give them approximately 5 minutes to place the progressions in order. After that give them 5 minutes to prepare a 10 minute presentation on those progressions, as they describe them and demonstrate them to the class. Leave time for questions, comments and concerns after each group presents. The progressions can be taught with one presenter if class has lower level of participants.

Activity: Teaching Experience.

-Demonstrate the ability to apply the Red Cross Swim Kids program progressions in a peer teaching environment.

Materials: Laminated papers with formation, drill and scenario.

Time: 1 Hour

Activity (wet): Give out a laminated sheet with a formation, drill and scenario for each student. They each need to teach the remainder of the class. The class gets a scenario laminated paper which the instructor must cater to (instructor will not know). Allow for time after each instructor for comments, criticism, questions and concerns. Make sure you do this in the order of progressions and use a variety of formations.

Student Criteria can involve the following
-Attention deficit child
-extremely young class, immature
-older, mature class
-crying student
-abusive student
-student does not want to do anything
-angry student.
-no English student.

Ask students for input after each presentation.

Activity: Major Strokes

-Demonstrate the ability to apply the Red Cross Swim Kids program progressions in a peer teaching environment.
-Teach the content item and identify the performance criteria for each level of the Red Cross Swim Kids program.

Materials: Laminated form with stroke errors

Time: 1.5 Hour

Activity (wet): Divide the class into four groups. Give each group a major stroke. Give them each ten minutes to prepare to teach the class, using the appropriate formations, atleast 5 drills for that stroke. They must also identify how they can correct the stroke errors that were handed to them. They must explain what drill can be used to correct that error. They each receive 10 minutes for there presentations with time at the end for questions, comments and concerns. Leave room for input from other groups.

The four major strokes are as follows:
Front Crawl
Back Crawl
Breast Stroke
Elementary Backstroke
Activity: Fitness

Materials: Fitness Sheet

Time: 30 minutes

Activity (wet): Have the class swim a distance endurance swim of 400 meters. Then have them do a fitness drill and have them check there circulation after each interval.
Activity: Lesson Observation

-Identify effective teaching strategies to meet the needs of the children’s age group characteristics.
-Identify the program support materials and use for the Red Cross Swim Kids program.
Materials: Lesson Plans, Behaviour cards

Time: 1 Hour
Show the Sample Lesson Plans to the class. Choose one lesson plan and take the class through the lesson plan in the water using them as the candidates. Role-model effective instructional techniques.

Prior to the lesson, have each instructor candidate review the lesson observation questions (Appendix C).
Once the lesson is over have the candidates complete the questions.
Review the lesson observation questions together.
Have the group identify how these factors (safety supervision, class management, transitions and activity level) contributed to the success of the class.

Give each candidate a behaviour card. A behaviour card can be any type of behaviour that may be
observed in a lesson by a student (fear, authority challenger, boredom, etc.) As you move through each
activity, select one candidate to read his/her behaviour card. Have the candidate identify what strategy or
alternative activity s/he would identify as a potential solution to effectively meet the challenge identified on
the behaviour card. Invite the class to provide alternative options as well. Identify successful strategies.

Posted in St Mark James
Monday, 26 December 2011
Last updated: July 13, 2014 at 16:33 pm

Red Cross Course Planning

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The Red Cross is on the forefront of first aid, CPR, re-certifications and water safety programs. This article focuses on the planning aspects of a water safety instructor (WSI) course. This page includes a overview and detailed outline of the Red Cross WSI Course planning section.

2 hours (class)
Definition: Development of both long-term and short-term lesson plans to ensure that the content is covered during a
lesson set and everyone’s needs are met.
1. Identify why WSIs use lesson plans.
2. Identify the key components of daily and long-term lesson plans.
3. Demonstrate the ability to create effective long-term and daily lesson plans.

Evaluation Criteria
-Identifies the key components of daily and long term lesson plans
-Demonstrates ability to effectively develop and revise a long-term lesson plan
-Demonstrates ability to develop an effective daily lesson plan for any Red Cross Swim Preschool, Red Cross Swim Kids, and Aqua Adults and teens class
Long-Term Planning

-Demonstrate the ability to create effective long-term and daily lesson plans, flipchart, felts
-Identify why WSI’s use lesson plans.

Materials: Travel brochures,

Time: 30 minutes

Gather some brochures of various destinations from a travel agent. Assign groups of candidates to different trips and give them a brochure. Put up the “Planning a Trip” overhead (Appendix B). Have candidates work in groups to answer the questions. Quickly review them as a group. Using a white board or flip chart, map out one of the destinations into a 10 day grid. What things are they going to do each day (no details, just the items)? As you are mapping out the plan, be sure to point out that they may want to do some things or everything more than once so plan for that as well. Point out that to plan a trip, you need to have in mind the length of time gone, what you will take, what you will do, goals, etc. This is the same as lesson planning. Identify the purpose of long term lesson plans: a determination of the skills to be covered, focusing on what day and what skill not how the skills will be covered.

Ensure the long-term lesson plans include the following details:
-when to introduce each new skill/water safety item/stroke/fitness activity,
-a review and practice of skill/water safety item/stroke/fitness activity,
-an introduction of all skill/water safety item/stroke/fitness activity by the fourth or fifth lesson, identifies that skill/water safety item/stroke/fitness activity are repeated a minimum of three times in a lesson set,
-the instructor should begin with those skills which were developed in the previous levels,
-similar skills are linked together,
-and water safety and swimming are covered everyday,

etc. As a group, create a long-term lesson plan using the worksheet for Red Cross Swim Kids 6.
Short-Term Planning

-Identify the key components of daily and long-term lesson plans.
-Demonstrate the ability to create effective long-term and daily lesson plans.
Materials: Flipchart, felts

Time: 30 minutes

Identify that the long-term lesson plan is to determine the “what”; a shortterm
lesson plan is to clarify the “how”. It is also the tool where the individual needs of your swimmers can
be written down. Look at the long-term plan for the trip that was planned above. Let’s take a close look at
Day 4. We want to plan that day in detail – creating a short-term plan. A short-term lesson plan should
include: date, time, level, lesson day, skills listed, methods used, progressions, formations used (minimum of three), safety supervision concerns, equipment and back up. Together, create a brief plan for Day 4 of the trip. Now, as a whole group, create a short-term lesson plan for Day 4 of your Red Cross Swim Kids 6 class by using the long-term lesson plan you designed as a group.
Short-Term Plan for Different Age Groups

-Identify the key components of daily and long-term lesson plans.
-Demonstrate the ability to create effective long-term and daily lesson plans.

Materials: Flipchart, Felts

Time: 30 minutes

Break class into three groups. Assign each group
a topic of Preschool, Adult or Multi-Level. Have them create a short-term plan for Day 3 of a pre-determined
level in the Red Cross Swim Program. Have them prepare their plan on a flipchart and present to the class.
Discuss how the plans differed according to the different age or levels that they were teaching.

Self Evaluation

-Identify why WSIs use lesson plans.

Materials: Paper, felts, Flipchart.

Time: 30 minutes

Have candidates draw a self-portrait. Put the questions listed below on an overhead
or flipchart and have them evaluate how they did. How does this apply to lessons? What should they be
doing when they are teaching their lessons? Point out that they need to be evaluating their lessons at the
end of each day. What went well, what didn’t, what needs to be done again or differently? All of these things
are important to ensure that they teach the best lesson possible.
Self Evaluation Questions
1. Did I give myself two eyes? A nose? A mouth?
2. Was my hair too straight or too curly in the picture or just right?
3. Did I remember to include all distinguishing characteristics – the things that make me special?
4. What could I have done differently to make the portrait look more like me?
5. Is there anything that I could try the next time I try to draw a picture of myself?

Posted in St Mark James
Monday, 26 December 2011
Last updated: July 13, 2014 at 16:33 pm

Instructor Emergency Response Skills

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2 hours (class)
Definition: Items that are taught, practiced, and evaluated to ensure the WSI candidates can respond in an
1. Successfully demonstrate performance criteria on the required IER skills (WSIT Manual, Appendix F3).

Evaluation Criteria
-Demonstrates the performance criteria for the Instructor Response Skills.

Activity: IER Experiences

Materials: Pen, Paper,

Time (wet): 40 minutes

Activity: Give candidates 10 minutes to get into groups of at least three and come up with an IER experience they have had within the last couple of years, one per person. Have them present what happened and what action they took and what they would do differently the next time. Have the class input there comments and discuss how to reduce or prevent this situation from happening again. Use these examples as the base for the pool scenarios. Have them answers the following questions.

What was the scenario?
How was it dealt with?
Was there anything you would have done differently?
Activity: Suggested Sample Instructional Emergency Response Scenarios

Materials: Have cue cards with the following scenarios written on them

Time (wet): 80 minutes

Activity: Role Playing. Assign roles of instructor, candidates and parents,etc. After each presentation Discuss and evaluate the performance. What if anything could have been done differently? Have the class pick up the discussion.

Role Playing
1. Assign roles of instructor, candidates, parents, etc.
2. Act out roles as described in the situations.
3. Discuss and evaluate performance.
Instructor #1 Teach surface support to a Red Cross Swim Kids 4 class.
Group #1 You are a Red Cross Swim Kids 4 class. One of you gets a mouthful of water,
panics and grabs the person next to you.
Instructor #2 Teach shallow dive to a Red Cross Swim Kids 8 class.
Group #2 You are a Red Cross Swim Kids 8 class. One of you gets a cramp in your calf.
Instructor #3 Teach foot first surface dives to a Red Cross Swim Kids 10 class.
Group #3 You are a Red Cross Swim Kids 10 class. One of you simulates a
submerged victim.
Instructor #4 Teach front and side rolls to a Red Cross Swim Kids 5 class.
Group #4 You are a Red Cross Swim Kids 5 class. One of you has mastered movement
underwater and is swimming quickly toward one wall. You hit the wall and your
nose starts to bleed.
Instructor #5 Teach front stride dive to a Red Cross Swim Kids 6 class.
Group #5 You are a Red Cross Swim Kids 6 class. One of you will dislocate your shoulder
on entry.
Instructor #6 Teach submersion to a Red Cross Swim Basics (Adult) class.
Group #6 You are a Red Cross Swim Basics (Adult) class. One of you swallows your gum
while submerging and starts to choke.
Instructor #7 Teach stride entry to a Red Cross Swim Kids 7 class.
Group #7 You are a Red Cross Swim Kids 7 class. After a couple of entries, one of you will
twist an ankle while doing a stride entry.
Instructor #8 Your Red Cross Swim Kids 10 class is swimming the 500m endurance swim.
Candidates are in a single loop formation.
Group #8 You are swimming your 500m distance swim, and one swimmer
hyperventilates and goes unconscious, non-breathing.
Instructor #9 You are reviewing Red Cross Swim Kids 5 dolphin dives (in preparation
for kneeling dives) in the shallow end.
Group #9 You are reviewing dolphin dives. One swimmer dives too deep and hits head.
Assistant Water Safety Instructor Course and Water Safety Instructor Course Facilitator Guide
























Posted in St Mark James
Monday, 26 December 2011
Last updated: July 13, 2014 at 16:33 pm

Red Cross Evaluation Made Simple

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In terms of waters safety, first aid and CPR programs the Canadian Red Cross is easily the leader in all three of those categories. This page will focus on the water safety aspects, specifically, the evaluation component of a water safety instructor (WSI) course. This page includes a outline and detailed information pertaining to Red Cross evaluation made simple.

2 hours (class)
Definition: The incorporation of progressive learning and an individualized approach to instruction designed to help swimmers improve each time they enter the water safely and have fun. In other words, evaluation is ongoing.

1. Define and demonstrate how to evaluate performance using continuous evaluation and the 3x rule for content item completion.
2. Provide feedback/final evaluation in written form to participants of the Red Cross Swim program using the Red Cross Swim program evaluation products.
3. Identify the importance of evaluating according to Red Cross performance criteria.
4. Evaluate progressively and determine the final result.
5. Identify specified use of all Red Cross Swim program recognition products.

Evaluation Criteria
-Defines and demonstrates how to evaluate performance of swimmers using continuous evaluation and the 3X rule for content item completion in a peer-teaching environment
-Identifies the importance of evaluating according to Red Cross performance criteria
-Identifies how to evaluate progressively and determine the final result
-Identifies specified use of all Red Cross Swim program recognition products.

Filling out a Worksheet

Materials: Mock class list. Worksheets.

Time: 25 minutes

Objectives: Provide feedback/final evaluation in written form to participants of the Red Cross Swim program using the Red Cross Swim program evaluation products.
Define and demonstrate how to evaluate performance using continuous evaluation and the 3x rule for content item completion.
Create a mock class listing various skills that a class can and can not do. Hand out the worksheets to the candidates and have them fill it out. Review an accurate version with the rest of the class. Ask class if they have any questions comments or concerns.

Key points.

  • Go over reverse side of the sheet to cover standards
  • 3X rule of evaluation still applies

 Evaluation Made Simple

Materials: EMS task cards. (below)

Time: 25 minutes

Objective: Evaluate progressively and determine the final result.

Introduce candidates to the “Evaluation Made Simple” (EMS) section (WSI Manual page 7.3-7.4) in their manuals. Review each question and how each question should be thought through and decided upon.

Discuss different situations in which the EMS section may need to be used fully. Hand out EMS Task Cards (Written below) and have candidates answer each of the cards with a decision as to what they would do. Have them read the back of the card for immediate feedback.


Parent / WSI
“My child has missed two lessons? What are you going to do for my child?”
Parent / WSI
“My child was brilliant throughout the session, you even said so! Why did s/he not complete the level? I didn’t see this coming, and you never warned me.”
Parent / WSI
“My child’s skills are obviously not as strong as the other five kids in his class, and it’s week 7 of a 10-week
session…what should we do to ensure s/he completes the level?”
Parent / WSI
“I see that in your class there is a child with special needs. It seems as though my child is not receiving enough attention because of this child.”
Parent / WSI
“I have been observing the class you are teaching and feel as though you are not making it challenging enough because it is a multi-level class.”
WSI / Child
It is the last day of classes. You have given a little girl an incomplete. As you hand her the card, tears stream down her face as she hands you a small gift and says “This is for you teacher.”
Adult Candidate / WSI
An adult learner has just completed Red Cross Swim Basics and is asking you what program to register in next.
Teen Candidate / WSI
One of your teen candidates is exhibiting signs of infatuation with you. The candidate takes it one step further and asks you out on a date. How would you deal with this situation?

Activity: Recognition Products

Objective: Identify the importance of evaluating according to Red Cross performance criteria.

Identify specified use of all Red Cross Swim program recognition products.

Materials: Flipcharts, Felts.

Time: 25 minutes

Break class into three groups and give them one of the following items to focus on:

  • One group will focus on Progress cards
  • One group will focus on Worksheets
  • One group will focus on Journals

Have the groups brainstorm onto a flipchart what should be included in criteria from a parent’s point of view. Have them present to the class after 10 minutes of brainstorming. Discuss the following criteria listed below if it has not been discussed yet.


Progress cards

  • Must be legible and directed to the swimmer. Include specific comments as to why a child received a complete or incomplete.
  • Ensure correct spelling. Clearly indicate which level the child should pursue next.
  • Ensure the date and the instructor’s name is on the card.
  • Comments include: a positive constructive comment, specific activities to work on, specific activities done well and a personal comment, e.g., you listened well in class.

Assistant Water Safety Instructor Course and Water Safety Instructor Course Facilitator Guide


  • Parents are permitted to view worksheets.
  • Update each child’s progress after each lesson.
  • Ensure worksheets are legible.


  • Used to track progress in the Red Cross Swim Basics program
  • Used to track progress in the Red Cross Swim Strokes program
  • Used to track participation in the Red Cross Swim Sports program
  • Has tools for participants to track fitness
  • Instructors sign and date participation
  • Brainstorm a list of creative, positive, words that can be used as encouragement for candidates.
  • Discuss techniques for communicating with parents on Day 1, throughout lesson, mid-session, and on the last day.

Activity: What level?

Materials: 15 Flipcharts, felts

Time: 40 minutes

Objective: Identify the importance of evaluating according to Red Cross performance criteria.

Place the Flipcharts spread out throughout the classroom and write one of the preschool and swim kids levels on each of the flipcharts. Divide the class into four groups and have them go around, while only working from memory, and fill in the criteria they think belongs in that class. Give each group 1 minute at each level before making them rotate to the next one. Discuss what they put on each level and how close they were to the actual level criteria. Have them look at there worksheets and see. Ask the class why knowing this information would be useful?

-Last minute lesson
-Evaluations / screenings.

Also ask the class how useful the worksheets and other course materials?

-so we wouldn’t’t evaluate the students poorly.



December 2011
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