Pursuant to subsection 5.9(2) of the Aeronautics Act, and after taking into account that the exemption is in the public interest and is not likely to affect aviation safety, I hereby exempt Canadian air operators operating under Part VII (Commercial Air Services), Subpart 5 of the Canadian Aviation Regulations (CARs) from clause 705.124(2)(b)(iv)(E) of the CARs and from the requirements set out in the Introduction (6) - Aviation First Aid and Initial Part Eight - Aviation First Aid of the Flight Attendant Training Standard, TP 12296, made pursuant to Paragraph 705.124(1)(b) of the CARs and from Part A - Section 6 - First Aid of the Flight Attendant Manual Standard, TP 12295, made pursuant to Section 705.139 of the CARs subject to the conditions set out below.
Clause 705.124(2)(b)(iv)(E) of the CARs states that an air operator’s training program shall include, in respect of flight attendants, initial and annual training, including first aid training. Clause 705.124(2)(b)(iv)(E) of the CARs is reproduced in Appendix A.
The Flight Attendant Training Standard, TP 12296 and the Flight Attendant Manual Standard, TP 12295 are reproduced in Appendix A.
PURPOSE
The purpose of this exemption is to allow Canadian air operators operating under Part VII (Commercial Air Services), Subpart 5 of the CARs, to exclude a first aid section from their flight attendant training program and flight attendant manual; however, they are required to comply with Part 9 – First Aid of the Aviation Occupation Health and Safety Regulations (AOHSR) (SOR/2011-87), as reproduced in Appendix B.
APPLICATION
This exemption applies to Canadian air operators operating under Part VII (Commercial Air Services), Subpart 5 of the CARs.
CONDITION
This exemption is subject to the following condition:
- Part VII (Commercial Air Services), Subpart 5 air operators shall comply with Part 9 – First Aid of the Aviation Occupation Health and Safety Regulations (AOHSR) (SOR/2011-87), as reproduced in Appendix B.
VALIDITY
This exemption is in effect until the earliest of:
- 23:59 Eastern Daylight Time on May 31, 2013;
- the date on which any condition set out in this exemption is breached; or
- the date on which this exemption is canceled in writing by the Minister where he is of the opinion that it is no longer in the public interest or that it is likely to affect aviation safety.
Dated at Ottawa, Canada on this 22nd day of December 2011, on behalf of the Minister of Transport.
[original signed by Nicole Girard for]
Martin J. Eley
Director General
Civil Aviation
APPENDIX A
Training Program
705.124 (1) Every air operator shall establish and maintain a training program that is
- designed to ensure that each person who receives training acquires the competence to perform the person's assigned duties; and
- approved by the Minister in accordance with the Commercial Air Service Standards and, in respect of flight attendants, in accordance with the Commercial Air Service Standards and the Flight Attendant Training Standard.
(2) An air operator's training program shall include
- for flight crew members:
- company indoctrination training,
- line indoctrination training,
- upgrading training, where applicable, and
- initial and annual training, including
- aircraft type training,
- aircraft servicing and ground handling training,
- emergency procedures training, and
- aircraft surface contamination training;
- for flight attendants:
- aviation indoctrination,
- line indoctrination training,
- in-charge training, where applicable, and
- initial and annual training, including
- safety procedures training,
- aircraft type training,
- emergency procedures training,
- aircraft surface contamination training, and
- first aid training;
- for flight dispatchers:
- initial and annual aircraft type training,
- on-the-job training, and
- aircraft cockpit familiarization training;
- initial and annual aircraft surface contamination training for those operations personnel designated in the Commercial Air Service Standards; and
- any other training required to ensure a safe operation under this Subpart.
(3) An air operator shall
(a) include a detailed syllabus of its training program in its company operations manual;
(b) ensure that adequate facilities and qualified personnel are provided for its training program, in accordance with the Commercial Air Service Standards; and
(c) establish and maintain a safety awareness program concerning the adverse effects of aircraft surface contamination and provide the program to all flight operations personnel who are not required to undergo the training described in paragraph (2) (d).
Flight Attendant Manual
705.139 (1) Every air operator, other than an air operator that is authorized solely for the transport of cargo in its air operator certificate, shall establish and maintain, as part of its company operations manual, a flight attendant manual for the use and guidance of flight attendants in the operation of its aircraft.
(2) A flight attendant manual shall contain the instructions and information necessary to enable flight attendants to perform their duties safely and shall contain the information required by the Flight Attendant Manual Standard.
(3) The Minister shall, where the Flight Attendant Manual Standard is met, approve those parts of a flight attendant manual, and any amendments to those parts, that relate to the safety and emergency information contained in Part A of the Flight Attendant Manual Standard.
(4) An air operator shall provide a copy of its flight attendant manual, including any amendments to that manual, to each of its flight attendants.
(5) Every flight attendant who has been provided with a copy of a flight attendant manual pursuant to subsection (4) shall keep it up to date with the amendments provided and shall ensure that the appropriate parts are accessible when the flight attendant is performing assigned duties on board an aircraft.
TP 12296 - Flight Attendant Training Standard
6. Aviation First Aid
- REGULATORY APPROVAL PROCESS
To obtain regulatory approval of an Aviation First Aid Training Program, or a revision to an approved program, an air operator shall submit the program to the Minister together with written evidence from an “accepted agency” or Health Canada that the program or revision meets the first aid training standard and that the content is technically accurate. Ministerial approval will then be granted and the program or revision can be implemented.
- ACCEPTED AGENCIES
An accepted agency is a first aid organization/agency that has received acceptance from Health Canada for their Aviation First Aid Training Program.
For more information of becoming an “accepted agency” contact
HEALTH CANADA,
Civil Aviation Medicine Division (AARG),
Place de Ville, Tower C, 330 Sparks Street, Ottawa, Ontario,
K1A 0N8.
- INSTRUCTOR QUALIFICATION
Instructors shall be qualified in accordance with CAR 705.124 and the program of the “accepted agency.”
- EQUIPMENT AND PROCEDURES CRITERIA
Training program content and delivery shall be consistent with the amount and type of equipment carried on the air operator’s aircraft and the air operator procedures that have been published.
- VALIDITY PERIOD
First Aid Training is valid for three years from the month in which the course was completed.
Initial Part Eight - Aviation First Aid
8.1 In-flight Emergency Scene Management (Including Universal Precautions)
Training Objective:
The crew member will be able to define/demonstrate the principles of first aid and emergency scene management required to effectively handle an in-flight medical emergency situation.
Scope:
Principles of First Aid
Principles of Safety When Giving First Aid
Knowledge of First Aid Equipment and Materials
Principles of Emergency Scene Management
Scene Survey
Primary Survey
Secondary Survey
Ongoing Casualty Care
Suspected Death
8.1A Principles of First Aid
8.1A.1 Name the objectives of first aid.
8.1A.2 List the priorities of first aid.
8.1B Principles of Safety When Giving First Aid
8.1B.1 Describe how first aid training promotes safety consciousness in a flight attendant.
8.1B.2 State the reasons for universal precautions.
8.1B.3 Describe the use, care, removal and disposal of gloves used for first aid.
8.1B.4 Describe the use, care, decontamination and disposal of personal protective equipment available onboard.
8.1B.5 State the disposal procedures for:
- Body fluids; and
- Contaminated first aid materials.
8.1C Knowledge of First Aid Equipment and Materials
8.1C.1 Describe the onboard location of first aid materials and conditions for use:
- First aid kit;
- Medical kit; and
- Improvised materials carried on the aircraft.
8.1D Principles of Emergency Scene Management
8.1D.1 Define emergency scene management.
8.1D.2 List the steps of emergency scene management.
8.1D.3 Name possible sources of help and describe how they may assist in an in-flight emergency situation, e.g.:
- Passengers;
- Crew members; and
- Medical personnel onboard.
8.1D.4 State the authorities that must be notified of an in-flight emergency, e.g.:
- In-charge flight attendant; and
- Captain who will advise the ground advanced life-support system.
8.1D.5 Describe the process for completing and submitting information to be reported on administrative forms following an in-flight emergency, e.g.:
- Medical kit;
- First aid kit; and
- Name and address of doctor in attendance or anyone providing assistance
8.1D.6 State the air operator's procedures for in-flight passenger control when dealing with a first aid emergency.
8.1D.7 Describe the effect of the aircraft environment on an in-flight emergency situation, e.g.:
- Cabin configuration of aircraft;
- Number of flight attendants onboard;
- Turbulence;
- Distance to ground life-support system;
- Cabin altitude; and
- Movement of the casualty while onboard.
8.1E Scene Survey
8.1E.1 Define the term history and describe its use.
8.1E.2 Define the term mechanism of injury and describe its use.
8.1E.3 Define the terms signs and symptoms and describe their uses.
8.1F Primary Survey
8.1F.1 Define the term primary survey.
8.1F.2 Demonstrate, on a simulated conscious casualty with suspected head/spinal injuries, the sequential steps of a scene survey followed by a primary survey.
8.1F.3 Demonstrate, on a simulated unconscious casualty without suspected injuries, the sequential steps of scene survey followed by a primary survey.
8.1G Secondary Survey
8.1G.1 Describe the steps of the secondary survey.
8.1G.2 List the vital signs used in aviation first aid.
8.1G.3 State why it is important to monitor and note the changes in the casualty's level of consciousness.
8.1G.4 State the responses used for assessing the levels of consciousness.
8.1G.5 State how a medical alert device can assist in assessing a casualty's condition.
8.1G.6 Describe effective breathing for a healthy adult casualty at rest.
8.1G.7 State the characteristics of the pulse for a healthy adult at rest.
8.1G.8 Demonstrate, on a simulated casualty, how to perform a secondary survey (including assessment of the vital signs).
8.1H Ongoing Casualty Care
8.1H.1 Describe ongoing casualty care.
8.1I Suspected Death
8.1I.1 Describe the procedures to be followed in the case of suspected death.
8.2 Shock, Unconsciousness and Fainting
Training Objective:
The crew member will be able to define/demonstrate the first aid for shock, unconsciousness, and fainting required to effectively handle an in-flight emergency situation.
Scope:
Shock
First Aid for Shock
First Aid for Unconsciousness
Fainting
First Aid for Fainting
8.2A Shock
8.2A.1 Define the term shock.
8.2A.2 List the most common signs and symptoms of shock.
8.2A.3 List the major causes of shock.
8.2B First Aid for Shock
8.2B.1 State how to prevent shock from becoming worse.
8.2B.2 Identify the position used to alleviate shock.
8.2C First Aid for Unconsciousness
8.2C.1 Define the term unconsciousness.
8.2C.2 Describe the first aid for an unconscious casualty.
8.2D Fainting
8.2D.1 Define the term fainting.
8.2D.2 Name the most common causes of fainting.
8.2D.3 Describe the signs and symptoms of an impending faint.
8.2E First Aid for Fainting
8.2E.1 Describe the first aid for person who:
- Feels faint; and
- Has fainted.
8.3 Artificial Respiration - Adult
Training Objective:
The crew member will be able to define/demonstrate the artificial respiration on an adult required to effectively handle an in-flight emergency situation.
Scope:
Respiratory System
Respiratory Emergencies
Mouth-to-Mouth Method of Artificial Respiration
Mouth-to-Mouth Method of Artificial Respiration - Casualty with a Suspected
Head/Spinal Injury
Ongoing Casualty Care - Restored Breathing
8.3A Respiratory System
8.3A.1 Define the respiratory system.
8.3A.2 Define the term respiration.
8.3A.3 Name and locate on an anatomical diagram the three major parts of the airway.
8.3B Respiratory Emergencies
8.3B.1 List the major causes of breathing emergencies in adults.
8.3B.2 List the major signs of breathing emergencies (include chest injuries).
8.3B.3 State the time period when brain damage may result from lack of oxygen.
8.3C Mouth-to-Mouth Method of Artificial Respiration
8.3C.1 Define the term artificial respiration.
8.3C.2 State why direct methods of AR can sustain a casualty's life.
8.3C.3 State the rate and force of ventilations for an adult.
8.3C.4 State when, where, and for how long, the pulse is checked and rechecked during AR for an adult.
8.3C.5 Demonstrate, on an adult manikin or on a simulated casualty, mouth-to-mouth artificial respiration for a minimum of one minute or 12 to 15 consecutive ventilations, using the head-tilt chin-lift method to open the airway and a facemask with an oxygen port and a one-way valve.
8.3C.6 Demonstrate, on an adult manikin or on a simulated casualty, with the assistance of passengers, the technique for ventilations prior to moving a casualty and every 15 seconds thereafter until the casualty is positioned.
8.3C.7 Name the complications that may occur when giving AR.
8.3C.8 State the most common causes of gastric distention and vomiting during AR.
8.3C.9 State how to minimize the risk of gastric distention.
8.3C.10 Demonstrate on an adult manikin or a simulated casualty how to deal with vomiting during AR.
8.3D Mouth-to-Mouth Method of Artificial Respiration - Casualty with a Suspected Head/Spinal Injury
8.3D.1 State when the jaw thrust without head tilt would be used.
8.3D.2 Demonstrate, on an adult manikin or on a simulated casualty, how to give mouth-to-mouth AR, using the jaw thrust without head-tilt.
8.3D.3 Describe how to take the radial pulse.
8.3E Ongoing Casualty Care - Restored Breathing
8.3E.1 State when and why the recovery position is used.
8.3E.2 State locations(s) in the aircraft for the recovery position.
8.3E.3 Demonstrate, on an adult manikin or on a simulated casualty, ongoing casualty care following successful AR (recovery position).
8.4 Artificial Respiration - Child and Infant
Training Objective:
The crew member will be able to define/demonstrate artificial respiration on a child or infant required to effectively handle an in-flight emergency situation.
Scope:
Mouth-to-Mouth Artificial Respiration on a Child
Mouth-to-Mouth-and-Nose Artificial Respiration on an Infant
8.4A Mouth-to-Mouth Artificial Respiration on a Child
8.4A.1 Define the term "child" as it applies to first aid (and CPR, if included) in training program.
8.4A.2 State the differences in the rate and force of ventilations between an adult and a child.
8.4B Mouth-to-Mouth-and-Nose Artificial Respiration on an Infant
8.4B.1 Define the term "infant" as it applies to first aid and CPR, if included in training program.
8.4B.2 State when and where the brachial pulse is taken and rechecked during mouth-to-mouth-and-nose artificial respiration.
8.4B.3 State the rate and the force of ventilations for an infant.
8.4B.4 Demonstrate, on an infant manikin, the mouth-to-mouth-and-nose method of artificial respiration for a minimum of one minute or 20 consecutive ventilations, using the head-tilt chin-lift method to open the airway.
8.5 Choking - Adult, Child and Infant
Training Objective:
The crew member will be able to define/demonstrate the chocking procedures for adult, child and infant required to effectively handle an in-flight emergency situation.
Scope:
Breathing Emergencies
Choking
First Aid for a Choking Adult and Child
First Aid for a Choking Infant
Ongoing Casualty Care for Choking
8.5A Breathing Emergencies
8.5A.1 State the causes of choking in an adult, child and infant.
8.5A.2 State the safety measures to prevent choking on foreign objects in an in-flight situation.
8.5B Choking
8.5B.1 Define partial and complete airway obstruction:
- Adult;
- Child; and
- Infant.
8.5B.2 Describe the signs of choking:
- General signs;
- Partial airway obstruction:
- Good air exchange
- Poor air exchange
- Complete airway obstruction.
8.5C First Aid for a Choking Adult and Child
8.5C.1 Describe the first aid for a conscious choking adult and child casualty with a partial airway obstruction.
8.5C.2 Describe the two methods by which a conscious choking adult or child casualty can assist him/herself:
- Markedly obese or pregnant casualty; and
- Other casualties.
8.5C.3 Demonstrate on a simulated adult or child casualty, the first aid for a choking casualty with a complete airway obstruction:
- Conscious;
- Becomes unconscious; and
- Found unconscious.
8.5C.4 State the instances when chest thrusts should be used on an adult casualty.
8.5C.5 Demonstrate on a simulated female in the advanced stages of pregnancy, or a markedly obese casualty, with a complete airway obstruction the first aid for choking using chest thrusts:
- Conscious;
- Who becomes unconscious; and
- Found unconscious.
8.5D First Aid for a Choking Infant
8.5D.1 Demonstrate, on an infant manikin, the first aid for a complete airway obstruction when an infant is:
- Conscious;
- Becomes unconscious; and
- Found unconscious.
8.5D.2 Describe the first aid for a conscious, choking infant who has a partial airway obstruction:
- Foreign object; and
- Croup.
8.5E Ongoing Casualty Care for Choking
8.5E.1 Describe the ongoing casualty care until handover for a casualty who received first aid for a complete airway obstruction:
- Adult;
- Child; and
- Infant.
8.6 Cardiovascular Emergencies
Training Objective:
The crew member will be able to define/demonstrate the first aid for cardiovascular emergencies required to effectively handle an in-flight emergency situation.
Scope:
Cardiovascular Disease
Risk Factors of Cardiovascular Disease
Preventive Health Measures
Principles of First Aid for Cardiovascular Emergencies
Angina/Heart Attack
Stroke/TIA
8.6A Cardiovascular Disease
8.6A.1 Describe in simple terms the following cardiovascular disorders:
- High blood pressure (hypertension);
- Narrowing of the arteries (arteriosclerosis);
- Angina (pectoris);
- Heart attack (myocardial infarction);
- Cardiac arrest; and
- Stroke/TIA.
8.6B Risk Factors of Cardiovascular Disease
8.6B.1 Define the term risk factor as it applies to cardiovascular disease.
8.6B.2 List the risk factors of cardiovascular disease that can be controlled.
8.6B.3 List the risk factors of cardiovascular disease that cannot be controlled.
8.6C Preventive Health Measures
8.6C.1Describe healthy life-style habits that can help reduce the risk of cardiovascular disease.
8.6D Principles of First Aid for Cardiovascular Emergencies
8.6D.1 List the first aid measures which are a priority for all cardiovascular emergencies.
8.6D.2 State why it is important to get medical help promptly.
8.6E Angina/Heart Attack
8.6E.1 State the cause for angina/heart attack.
8.6E.2 List the signs and symptoms of angina/heart attack.
8.6E.3 State the first aid for angina/heart attack:
8.6E.4 List the rights to be observed when assisting the conscious casualty to take his/her medication.
8.6F Stroke/TIA
8.6F.1 State the most common causes of a stroke (cerebrovascular accident - CVA).
8.6F.2 List the signs and symptoms of a stroke.
8.6F.3 Describe the first aid for a stroke.
8.6F.4 Define the term Transient Ischemic Attack (TIA) and describe the first aid.
8.7 Wounds and Bleeding
Training Objective:
The crew member will be able to define/demonstrate the first aid for wounds and bleeding required to effectively handle an in-flight emergency situation.
Scope:
Wounds
Types of Bleeding
Contamination and Infection
Dressings, Bandages and Slings
First Aid for Wounds with External Bleeding
First Aid for Wounds with Embedded Objects
Internal Bleeding
Bleeding from the Nose
8.7A Wounds
8.7A.1 Define the term wound.
8.7A.2 Describe the types of minor soft tissue injuries.
8.7B Types of Bleeding
8.7B.1 Describe the difference between venous and arterial bleeding.
8.7B.2 Define the terms external bleeding and internal bleeding.
8.7B.3 List the signs and symptoms of severe bleeding.
8.7B.4 State how bleeding may be recognized:
- External bleeding; and
- Internal bleeding:
- Causes;
- Characteristics; and
- Signs of internal bleeding.
8.7C Contamination and Infection
8.7C.1 Name measures to prevent further contamination and infection of wounds.
8.7C.2 State how to clean a minor wound.
8.7D Dressings, Bandages and Slings
8.7D.1 Describe the characteristics of dressings, bandages and slings, and state their uses.
8.7E First Aid for Wounds with External Bleeding
8.7E.1 Describe the first aid principles for wounds with severe external bleeding.
8.7E.2 Describe the signs and the effects of inadequate distal circulation to the extremities:
- Skin temperature;
- Color; and
- Pulse.
8.7E.3 Demonstrate, on a simulated casualty, the techniques to control severe external bleeding.
8.7E.4 Demonstrate, on a simulated casualty, how to improve impaired distal circulation when a limb has been bandaged.
8.7E.5 Demonstrate, on a simulated casualty, how to check for and monitor distal circulation.
8.7F First Aid for Wounds with Embedded Objects
8.7F.1 Describe the first aid for a wound with an embedded object.
8.7F.2 Demonstrate, on a simulated casualty, the techniques for the control of bleeding from a wound with a short embedded foreign object in the lower leg.
8.7G Internal Bleeding
8.7G.1 Describe the first aid for a casualty with suspected internal bleeding.
8.7H Bleeding from the Nose
8.7H.1 Describe the techniques to control bleeding from the nose by positioning, pressure and time.
8.8 Fractures, Dislocations and Sprains
Training Objective:
The crew member will be able to define/demonstrate the first aid for fractures, dislocations and sprains required to effectively handle an in-flight emergency situation.
Scope:
Bone and Joint Injuries
First Aid for Bone and Joint Injuries
Muscle Strain
8.8A Bone and Joint Injuries
8.8A.1 Define two classifications of fractures.
8.8A.2 Define two types of joint injuries.
8.8A.3 List the signs and symptoms of a/an:
- Open fracture;
- Closed fracture/sprain; and
- Dislocation.
8.8B First Aid for Bone and Joint Injuries
8.8B.1 State the general rules of first aid for bone and joint injuries (f.a. principles the same).
8.8B.2 Describe the characteristics of a good splint.
8.8B.3 Describe how to support and immobilize the following bone and joint injuries of the upper limb:
- A fracture of the collarbone using two triangular bandages;
- Support and immobilization of a dislocated shoulder using padding, three triangular bandages and the application of cold;
- An open fracture of the upper arm when the elbow can be bent, using padding and triangular bandages; and
- A closed fracture of the wrist using an improvised or a commercial splint and triangular bandages.
8.8B.4 Demonstrate, on a simulated casualty, how to support and immobilize a closed fracture of the forearm using an improvised or a commercial splint and triangular bandages.
8.8B.5 List the factors that increase the seriousness of a femur (hip) fracture.
8.8B.6 Describe how to support and immobilize the following bone and joint injuries of the lower limbs:
- A closed fracture of the upper leg using a long, padded (improvised) splint and a body splint;
- A closed fracture of the knee, when the knee cannot be straightened, using two padded (improvised) splints, padding and triangular bandages; and
- An open fracture of the lower leg using dressings, protective padding, six triangular bandages and the good leg as a body splint.
8.8B.7 Demonstrate, on a simulated casualty, how to support and immobilize a sprained ankle using a pillow splint or a blanket splint triangular bandages and the application of cold.
8.8C Muscle Strain
8.8C.1 Define the term muscle strain.
8.8C.2 Name the causes of muscle strain.
8.8C.3 State the first aid for muscle strain.
8.9 Burns
Training Objective:
The crew member will be able to define/demonstrate the first aid for burns required to effectively handle an in-flight emergency situation.
Scope:
Burns
First Aid for Burns
8.9A Burns
8.9A.1 State the classifications of burns by mechanism of injury/causes and give an example of each.
8.9A.2 State the factors that determine the seriousness of a burn.
8.9A.3 State the classification of burns by degree and state their signs and symptoms.
8.9A.4 State the complications that may result from a burn.
8.9B First Aid for Burns
8.9B.1 State the first aid procedures for a burn caused by:
- Heat;
- Chemicals:
- Liquid
- Dry
- Electrical current; and
- Radiation:
- Sun
- Radioactivity
8.9B.2 State the instances when medical help is required for a casualty who has been burned.
8.10 Head/Spinal Injuries
Training Objective:
The crew member will be able to define/demonstrate the first aid for head/spinal injuries required to effectively handle miscellaneous conditions in an in-flight emergency situation.
Scope:
Head/Spinal Injuries
First Aid for Head/Spinal Injuries
8.10A Head/Spinal Injuries
8.10A.1 Describe how to recognize the three types of head/spinal injuries by:
- History/mechanism of injury; and
- Signs and symptoms.
8.10A.2 Name the injuries that are most commonly associated with head/spinal injuries.
8.10B First Aid for Head/Spinal Injuries
8.10B.1 Describe the first aid for a scalp wound with an underlying fracture of the skull.
8.10B.2 State the principles of first aid for a head/spinal injury.
8.10B.3 Describe the precautions necessary when moving a casualty with a suspected spinal injury within the limitations of an aircraft configuration.
8.10B.4 State the dangers of improper handling of a casualty with head/spinal injuries.
8.10B.5 State why it is important to get immediate medical help for a casualty with head/spinal injuries.
8.11 Asthma, Allergies and Poisons
Training Objective:
The crew member will be able to define/demonstrate the first aid for asthma, allergies and poisons required to effectively handle an in-flight emergency situation.
Scope:
Severe Asthma
Severe Allergic Reactions
Poisoning
First Aid for Poisoning by Ingestion
8.11A Severe Asthma
8.11A.1 Define the term asthma and state its causes.
8.11A.2 State the signs and symptoms of a severe asthmatic attack.
8.11A.3 Describe the first aid for a severe asthmatic attack.
8.11B Severe Allergic Reactions
8.11B.1 State the routes of entry by which allergens are introduced into the body.
8.11B.2 Define the term allergic reaction and describe the signs and symptoms.
8.11B.3 Describe the first aid for an allergic reaction.
8.11B.4 Explain the use of the Epi-pen and the Ana-kit.
8.11C Poisoning
8.11C.1 Define the term poison.
8.11C.2 State the facts that help to determine the history of a poisoning emergency.
8.11C.3 List the signs and symptoms of poisoning by ingestion.
8.11D First Aid for Poisoning by Ingestion
8.11D.1 State the first aid for a conscious and unconscious casualty when a poison has been ingested.
8.12 Medical Conditions
Training Objective:
The crew member will be able to define/demonstrate the first aid for medical conditions required to effectively handle an in-flight emergency situation.
Scope:
Diabetic Emergencies
Epilepsy
Convulsions in Children
Acute Abdominal Distress
First Aid for Acute Abdominal Distress
8.12A Diabetic Emergencies
8.12A.1 Define the types of diabetic emergencies.
8.12A.2 State how the history of an incident helps to identify a diabetic emergency:
- Conscious casualty; and
- Unconscious casualty.
8.12A.3 List the signs and symptoms of a diabetic emergency:
- Diabetic coma; and
- Insulin shock.
8.12A.4 State the first aid for a diabetic emergency.
8.12B Epilepsy
8.12B.1 Define the term epilepsy.
8.12B.2 List the signs and symptoms of an epileptic seizure.
8.12B.3 State the first aid for an epileptic seizure.
8.12C Convulsions in Children
8.12C.1 State a common cause of convulsions in children.
8.12C.2 List the signs and symptoms of an epileptic seizure.
8.12C.3 State the first aid for fever convulsions in children.
8.12D Acute Abdominal Distress
8.12D.1 Define the term acute abdominal distress (acute abdomen), e.g., appendicitis.
8.12D.2 Describe the signs and symptoms of an acute abdomen.
8.12E First Aid for Acute Abdominal Distress
8.12E.1 Describe the first aid for acute abdominal distress:
- Call for medical assistance;
- Give nothing by mouth;
- Place casualty in the position of most comfort; and
- Give first aid for shock.
8.13 Altitude Related Conditions
Training Objective:
The crew member will be able to define/demonstrate the first aid for altitude related conditions required to effectively handle an in-flight emergency situation.
Scope:
Earache and Sinusitis
First Aid for Earache and Sinusitis
Hyperventilation Syndrome
First Aid for Hyperventilation
Motion Sickness
First Aid for Motion Sickness
8.13A Earache and Sinusitis
8.13A.1 State the signs and symptoms of an ear infection:
- Pain, increasing during descent of aircraft;
- Dizziness;
- Loss of hearing; and
- Possible discharge.
8.13A.2 State the signs and symptoms of a sinusitis:
- Headache;
- Pain increasing during descent of aircraft;
- Possible discharge; and
- Dizziness.
8.13B First Aid for Earache and Sinusitis
8.13B.1 Describe the first aid for an earache:
- Assist in taking prescribed medication; and
- Dispose of discharge in an appropriate manner.
8.13B.2 Describe the first aid for sinusitis:
- Assist in taking prescribed medication; and
- Dispose of discharge in an appropriate manner.
8.13C Hyperventilation Syndrome
8.13C.1 State the signs and symptoms of hyperventilation:
- Marked anxiety;
- Dyspnea; and
- Dizziness and light-headedness.
8.13D First Aid for Hyperventilation
8.13D.1 Describe the first aid for hyperventilation:
- Try to talk the passenger into slowing his or her respiration rate;
- Have the passenger breathe into an oxygen mask operating at low flow (Note: Giving oxygen to someone with hyperventilation will not make the condition worse); and
- Recommend that the passenger consult a physician.
8.13E Motion Sickness
8.13E.1 List the signs and symptoms of motion sickness:
- Nausea and vomiting;
- Dizziness;
- Pale, clammy skin; and
- Fainting.
8.13F First Aid for Motion Sickness
8.13F.1 Describe the first aid for motion sickness:
- Assist in taking medication;
- Provide fresh air;
- Recline the passenger's seat;
- Place a cool, damp cloth over the passenger's eyes;
- Dispose of any vomitus in an appropriate manner; and
- Clean and deodorize area as required.
8.14 Eye Injuries
Training Objective:
The crew member will be able to define/demonstrate the first aid for eye injuries required to effectively handle an in-flight emergency situation.
Scope:
First Aid for Foreign Objects in the Eye
First Aid for Burns to the Eye
8.14A First Aid for Foreign Objects in the Eye
8.14A.1 Describe the first aid when a foreign object is adhered to or embedded in the eye.
8.14A.2 List situations when no attempt should be made to remove a foreign object from the eye.
8.14A.3 State the procedures and precautions for the removal of a loose particle from:
- The surface of the eyeball;
- Under the upper eyelid; and
- Under the lower eyelid.
8.14B First Aid for Burns to the Eye
8.14B.1 State the first aid for burns to the eye resulting from:
- Chemicals
- Liquid
- Dry
- Intense light sources
8.15 Childbirth and Miscarriage
Training Objective:
The crew member will be able to define/demonstrate the first aid for childbirth and miscarriage required to effectively handle an in-flight emergency situation.
Scope:
Childbirth
Preparing for an Emergency Delivery
Emergency Delivery
Miscarriage
First Aid for Miscarriage
8.15A Childbirth
8.15A.1 Define the term labour.
8.15A.2 List the signs that indicate the beginning of labour.
8.15A.3 State the signs of imminent delivery.
8.15B Preparing for an Emergency Delivery
8.15B.1 List the materials that will assist a crew member in an emergency delivery.
8.15B.2 State how to prepare the expectant mother for an emergency delivery.
8.15C Emergency Delivery
8.15C.1 Describe the role of the crew member in an emergency delivery:
- Normal delivery;
- Delivery with complications:
- Umbilical cord;
- Placenta; and
- Haemorrhage.
8.15C.2 State how to care for the newborn baby.
8.15C.3 State how to care for the placenta and the umbilical cord following delivery.
8.15C.4 Describe how to care for the mother following delivery until medical aid is obtained.
8.15D Miscarriage
8.15D.1 Define the term miscarriage.
8.15D.2 List the signs and symptoms of miscarriage.
8.15E First Aid for Miscarriage
8.15E.1 State the first aid for a woman who has had a miscarriage.
8.16 Frostbite/Hypothermia
Training Objective:
The crew member will be able to define/demonstrate the first aid for frostbite/hypothermia required to effectively handle an in-flight emergency situation.
Scope:
Cold Injuries
First Aid for Cold Injuries
8.16A Cold Injuries
8.16A.1 Name the signs and symptoms of:
- Superficial frostbite; and
- Deep frostbite.
8.16A.2 List signs and symptoms of the progressive stages of hypothermia.
8.16A.3 Name the signs of a frozen casualty.
8.16B First Aid for Cold Injuries
8.16B.1 State the first aid for:
- Superficial frostbite;
- Deep frostbite; and
- Hypothermia.
8.16B.2 State the minimum time for pulse assessment in a casualty with severe hypothermia.
8.17 Heat Illness
Training Objective:
The crew member will be able to define/demonstrate the first aid for heat illnesses required to effectively handle an in-flight emergency situation.
Scope:
Heat Illness
First Aid for Heat Illness
8.17A Heat Illness
8.17A.1 State the conditions that cause heat illnesses.
8.17A.2 List the safety measures to prevent heat illnesses.
8.17A.3 List the signs and symptoms of:
- Heat exhaustion; and
- Heatstroke:
- Classic heatstroke; and
- Exertional heatstroke.
8.17B First Aid for Heat Illness
8.17B.1 State the first aid for:
- Heat exhaustion; and
- Heatstroke.
8.18 CPR - Adult, Child and Infant
Training Objective:
The crew member will be able to define/demonstrate CPR for an adult, child and infant as required to effectively handle an in-flight emergency situation.
Scope:
Cardiac Arrest
CPR - Adult, Child and Infant
8.18A Cardiac Arrest
8.18A.1 List the common causes of cardiac arrest.
8.18A.2 State the signs of cardiac arrests.
8.18B CPR - Adult, Child and Infant
8.18B.1 Define the terms adult, child and infant as they apply to CPR.
8.18B.2 State the first aid for cardiac arrest.
8.18B.3 Describe one rescuer CPR for adult, child and infant casualties:
- When to start/when to stop;
- Techniques;
- Sequencing; and
- Timings.
8.18B.4 Demonstrate, on an adult manikin, one-rescuer CPR for a minimum of one minute or four continuous cycles of 15 compressions and two ventilations in accordance with the guidelines of the Heart and Stroke Foundation of Canada.
8.18B.5 Demonstrate, on a child manikin, one-rescuer CPR for a minimum of one minute or ten continuous cycles of five compressions and one ventilation in accordance with the guidelines of the Heart and Stroke Foundation of Canada.
8.18B.6 Demonstrate, on an infant manikin, one-rescuer CPR for a minimum of one minute or ten continuous cycles of five compressions and one ventilation in accordance with the guidelines of the Heart and Stroke Foundation of Canada.
8.18B.7 Demonstrate, on an appropriate manikin, one rescuer CPR for and adult, child and infant in combination with oxygen administration.
8.19 Toothache
Training Objective:
The crew member will be able to define/demonstrate the first aid for a toothache to effectively handle an in-flight emergency situation.
Scope:
Toothache
First Aid for a Toothache
8.19A Toothache
8.19.A.1 List the signs and symptoms of a toothache:
- Pain;
- Swelling; and
- Localized heat
Note: Often associated with sinusitis - referred pain.
8.19B First Aid for a Toothache
8.19B.1 Describe the first aid for a toothache:
- Call for medical assistance; and
- Give first aid for shock.
8.19B.2 Describe the care for a knocked out tooth:
- Do not handle the tooth by the root; and
- Gently replace the tooth into the socket.
If the casualty refuses to have the tooth replaced: - Place the tooth in moistened gauze or a cup of water; and
- Seek medical aid as soon as possible.
TP 12295 - Flight Attendant Manual Standard
Part A - Section 6 - First Aid
- The First Aid section shall include components 6A.0 to 6A.10 or the air operator may have these components in a separate document, provided the document is:
- referenced in the Flight Attendant Manual,
- issued to each flight attendant,
- readily available for reference during flight, and
- approved by Transport Canada
6A.0 Medical Emergencies
- Procedures regarding management of in-flight medical emergency (e.g. Emergency Scene Management)
6A.1 Signs, Symptoms and Management of:
- Inflight medical emergency scene management
- Shock, unconsciousness and fainting
- Artificial respiration - Adult, Child and Infant
- Choking - Adult, Child and Infant
- Cardiovascular emergencies
- Wounds and bleeding
- Fractures, dislocations and sprains
- Head/Spinal injuries
- Burns
- Asthma, allergies and poisons
- Medical Conditions
- Altitude related conditions
6A.2 Time of Useful Consciousness
- Description
- Time frames
- Flight Attendants to be seated during critical phases of flight even when a medical emergency may be in progress onboard
6A.4 Flight Attendant Responsibilities
- Specific air operator policies and procedures regarding such items as administration of medication, use of equipment, calling for a physician, notification of the flight deck, etc.
- Provide necessary information required to ensure that appropriate medical assistance is available upon arrival
- Procedures regarding prevention of cabin crew injury (e.g. syringes, needles)
- Hygienic protocol to ensure the safety of cabin crew (e.g. latex gloves, face masks)
6A.6 Carriage of Passengers With Contagious Diseases
- Procedures
- Equipment
- Precautions
- Procedures
6A.8 Other First Aid Equipment
- Equipment
- Use
- Precautions
6A.9 Aircraft First Aid Kit(s) and Emergency Medical Kits
- Contents
- Use
6A.10 Reporting Medical Incidents
- Procedures
APPENDIX B
Aviation Occupational Health and Safety Regulations
PART 9
FIRST AID
Interpretation
9.1 The following definitions apply in this Part.
“first aid attendant” means an employee who has, in the last three years, successfully completed basic first aid training, standard first aid training or first aid training for flight attendants. (secouriste)
“health unit” means a facility that is under the charge of a physician or a person who is registered as a registered nurse under the laws of a province and that, if it is under the control of the employer, meets the minimum requirements of a first aid room described in Part XVI of the Canada Occupational Health and Safety Regulations. (service de santé)
“incapacitated” means unable to perform assigned duties in the course of employment due to illness or injury. (incapacité)
“medical treatment facility” means a hospital, medical clinic or physician’s office, at which emergency medical treatment can be dispensed. (installation de traitement médical)
General
9.2 (1) Every employer shall establish and keep up-to-date written instructions for the rendering of first aid to an employee who is incapacitated.
(2) The employer shall make the instructions readily available for examination by employees.
First Aid Attendants
9.3 If there are three or more employees on board an aircraft, at least one of whom is not a flight crew member, one of them shall be a first aid attendant.
9.4 A first aid attendant shall
- have access to a first aid kit;
- render first aid to employees who are incapacitated;
- if required, accompany an incapacitated employee to a health unit or a medical treatment facility and render first aid in transit;
- in providing care as a first aid attendant, have precedence over anyone not trained in first aid; and
- be responsible for providing care for an incapacitated employee until the treatment is complete or the employee is under the care of an equally or more qualified caregiver.
Training Requirements
9.5 (1) If the time required to reach a health unit or a medical treatment facility is two hours or less, the first aid attendant shall have successfully completed a basic first aid course, the elements of which are set out in section 1 of Schedule 1 to this Part, or a first aid course for flight attendants, the elements of which are set out in section 3 of that Schedule.
(2) If the time required to reach a health unit or a medical treatment facility is more than two hours, the first aid attendant shall have successfully completed a standard first aid course, the elements of which are set out in section 2 of Schedule 1 to this Part, or a first aid course for flight attendants, the elements of which are set out in section 3 of that Schedule.
(3) The employer shall determine, in consultation with the policy committee or, if there is no policy committee, the work place committee or the health and safety representative, the elective lesson elements, if any, of the flight attendant first aid training required on any particular flight, taking into account the likelihood of their use.
(4) First aid attendant training courses shall be given by a person who has received the appropriate training from an organization approved by the Minister in accordance with section 9.6.
(5) Basic and standard first aid certificates, basic and standard first aid certifications and first aid certifications for flight attendants are valid for a maximum of three years starting on their date of issue.
Teaching First Aid
9.6 (1) An organization that wants to obtain the approval of the Minister for offering courses or instructional courses in first aid must apply for it in writing to the Minister.
(2) The application shall be accompanied by a description of the proposed courses.
(3) If an application is for approval for offering a course or an instructional course in specialized first aid, including first aid training for flight attendants, it shall be accompanied by a report from the employer, prepared in consultation with the policy committee or, if there is no policy committee, the work place committee or the health and safety representative, that identifies the first aid training requirements.
(4) The Minister shall approve an application by an organization to offer courses or instructional courses in basic and standard first aid if the organization’s training program contains the applicable elements set out in Schedule 1 to this Part.
(5) The Minister shall approve an application by an organization to offer courses or instructional courses in specialized first aid, including first aid training for flight attendants, if the organization’s training program is appropriate for the work place, having regard to the training requirements identified in the report referred to in subsection (3).
(6) Subject to subsections (7) and (8), a letter of approval from the Minister is valid for a period of five years starting on the date of issue.
(7) The Minister may cancel the approval of an organization under subsection (4) if the organization’s training program no longer contains the applicable elements set out in Schedule 1 to this Part.
(8) The Minister may cancel the approval of an organization under subsection (5) if the organization’s training program is no longer appropriate for the work place.
First Aid Kits
9.7 (1) Every first aid kit shall be
- readily accessible;
- inspected regularly and its contents maintained in a clean, dry and serviceable condition; and
- clearly identified by a conspicuous sign.
(2) Prescription drugs or other medications not included in Schedule 2 to this Part shall not be stored in first aid kits or with additional first aid supplies and equipment listed in Schedule 3 to this Part.
First Aid Supplies and Equipment
9.8 (1) If there are five or fewer employees working on board an aircraft at any time, the employer shall provide one first aid kit.
(2) If there are from six to 19 employees working on board an aircraft at any time, the employer shall provide two first aid kits.
(3) If there are 20 or more employees working on board an aircraft at any time, the employer shall provide three first aid kits.
(4) If there is no flight attendant working on board an aircraft, the first aid kits shall be of type “A”, the contents of which are set out in Schedule 2 to this Part.
(5) If there is at least one flight attendant working on board an aircraft, the first aid kits shall be of type “B”, the contents of which are set out in Schedule 2 to this Part.
(6) If there are three or more employees working on board an aircraft, the employer shall provide the additional supplies and equipment set out in column 1 of Schedule 3 to this Part in the applicable quantities set out in column 2.
(7) If there are 200 seats or more on board an aircraft, there shall be an additional type “B” first aid kit for each 200 seats.
Transportation
9.9 (1) The employer shall provide an ambulance service or other suitable means of transporting an incapacitated employee to a health unit or medical treatment facility.
(2) An incapacitated employee shall be relieved of all duties and transported to a health unit or medical treatment facility as soon as possible.
Communication of Information
9.10 The employer shall ensure that the following information is readily available to every employee:
- information regarding first aid to be rendered for any incapacity; and
- information regarding transportation procedures for incapacitated employees.
Records
9.11 (1) A means of recording first aid that has been rendered shall be readily available to an employee on board an aircraft.
(2) An employee who renders first aid shall
- enter in a first aid record the following information:
- the full name of the incapacitated employee,
- the date, time and location of the occurrence of the incapacity,
- the date and time that the incapacity was reported to them,
- a brief description of the incapacity,
- a brief description of the first aid rendered,
- a brief description of arrangements made for the treatment or transportation of the incapacitated employee, and
- the names of any witnesses, if applicable; and
- sign the first aid record beneath the information entered in accordance with paragraph (a).
(3) A copy of each first aid record shall be given to the employer at the first opportunity following the recording of the information.
(4) The employer shall keep the copy of the first aid record containing information entered under subsection (2) for two years starting on the date of that entry.
(5) Persons with access to first aid records shall keep the information contained in the records confidential except as required for the purpose of meeting reporting obligations under Part 10.
(6) On receiving a written request from a provincial workers’ compensation authority or a physician, the employer shall provide an employee with a copy of any first aid record pertaining to the employee’s treatment.
(7) The employer shall maintain a record of the expiry dates of first aid certificates and first aid certifications for first aid attendants and shall make the record readily available to them.
SCHEDULE 1
(Sections 9.5 and 9.6)
SUBJECTS TO BE INCLUDED IN THE COURSES
1. Basic first aid:
- the provision of basic first aid and the first aid attendant’s role and obligations in relation to basic first aid;
- emergency scene management;
- cardiopulmonary resuscitation (Level A: 1 rescuer, adult casualty);
- medical emergencies;
- shock, unconsciousness and fainting;
- anti-contamination procedures; and
- wounds and bleeding.
2. Standard first aid:
- the provision of standard first aid and the first aid attendant’s role and obligations in relation to standard first aid;
- emergency scene management;
- cardiopulmonary resuscitation (Level A: 1 rescuer, adult casualty);
- medical emergencies;
- shock, unconsciousness and fainting;
- anti-contamination procedures;
- wounds and bleeding;
- fractures and their immobilization;
- chest injuries;
- head and spinal injuries;
- muscle, ligament and joint injuries;
- burns;
- eye injuries;
- pelvic, genital and abdominal injuries;
- movement and transportation of casualty;
- environmental illnesses and injuries;
- toxicological emergencies; and
- evacuation and transportation of casualties.
3. First aid for flight attendants:
- (a) compulsory lessons:
- principles of rendering first aid and in-flight medical emergency scene management (including universal precautions),
- shock, unconsciousness and fainting,
- artificial respiration – adult,
- artificial respiration – child and infant,
- choking – adult, child and infant,
- cardiovascular emergencies,
- wounds and bleeding,
- fractures, dislocations and sprains,
- head and spinal injuries,
- burns,
- asthma, allergies and poisons,
- other medical conditions,
- altitude-related conditions, and
- eye injuries; and
- (b) elective lessons:
- emergency childbirth and miscarriage,
- frostbite and hypothermia,
- heat illnesses,
- cardiopulmonary resuscitation – adult, child and infant, and
- toothache.
TESTING METHODOLOGY
4. Practical evaluation: evaluation points and criteria.
5. Written evaluation: example and marking scheme.
INSTRUCTOR QUALIFICATIONS
6. Training program:
- course content;
- length of the program; and
- evaluation process.
7. Recertification procedures:
- recertification schedule;
- instructor quality assurance procedures; and
- instructor’s guide.
OTHER ELEMENTS
8. Student reference material: current volume to be submitted for review.
9. Lesson plans:
- lesson contents; and
- lesson teaching outline.
10. Audio-visual aids.
11. First aid certificate, if applicable: example to be submitted for authentication.
12. Cardiopulmonary resuscitation certificate, if applicable: example to be submitted for authentication.- Date de modification :