For first aid classes during the pandemic, it's pool-noodle mannequins to the rescue

It wasn't even close to pool noodle season when Christopher Chan and other St. John Ambulance volunteers cleared out the shelves of some local dollar stores.

"I think there was a lot of strange faces looking at us," said the learning and development officer for the B.C. branch of the charity, which offers first aid courses.

COVID-19 and the physical distancing that comes with it means that first aid training classes can no longer have students partner up to practise some of their skills on each other. But the charity, which is facing a financial crunch because of cancelled classes and events earlier in the pandemic, can't afford to buy more expensive full-body mannequins as stand-ins.

That's leading instructors to get creative. They're attaching pool noodles to torso-only mannequins traditionally used to teach CPR to serve as limbs.

'It's going to get the job done'

Each appendage was created out of two pieces of pool noodles, which were inserted into pantyhose to allow for bending at the "joints." The instructors stuffed socks into gloves and taped them to the end of the noodles to serve as hands.

"The students can still do the bandaging and everything else they need to do with arms and legs and so forth, or put the person into a three-quarter prone or recovery position," Chan said. "[It's] not going to look pretty or look super real life, but it's going to get the job done. Objective is going to be met."

Across the country, first aid classes have been resuming over the last few weeks, and it isn't just the mannequins that look different. Classes now have fewer people, with individual spaces taped off on the floor. Students wear masks and extensive cleaning procedures are in place. Courses also have online components now to limit the amount of time students need to be in classrooms.

Shawn McLaren, St. John Ambulance's chief learning officer, said pool noodles aren't the only workaround instructors have found.

"Some are using coveralls and stuffing them with shirts and with hoses to give them weight," he said.

What's being taught is also shifting in the pandemic world. St. John Ambulance's first aid classes already had an emphasis on personal protective equipment, but that's been strengthened. Even the basics have been adjusted.

"Before if you've taken your course, part of your ABCs is to look, listen and feel for breathing, so you're really up close to the person's mouth and nose. We can't quite do that now," Chan said. 

"So instead of using all your senses, we probably now have to just rely more on our visual senses. Do we see that chest up and moving up and down? Do we see that they look like they're breathing or not?"

Different approaches to first aid during pandemic

Even before the COVID-19 pandemic, first aid experts had concerns about mouth-to-mouth resuscitation, especially on strangers. 

St. John Ambulance's recommendation is to use plastic "pocket masks" to provide a barrier when possible, or to focus on compression-only CPR. But now even performing compressions is a concern for some.

"In the COVID world, we are asking, if you have something, a tissue, a piece of paper towel, any type of cloth, just cover their face, so that ... as you're doing a compression, we don't get any of those respiratory droplets kicking up," said Lyle Karasiuk, national volunteer chair for the Canadian Council for First Aid Education of the Canadian Red Cross.

"There are some recent studies that might suggest there is limited respiratory vapour. But out of an abundance of caution, and I think giving people that assurance that they probably are a little bit safer, we've recommended and will continue to recommend to do that."

First aid guidelines are created by the International Liaison Committee on Resuscitation (ILCOR), which includes first aid organizations from around the world. Groups within each country take those and can adapt to their own situations.

That's exactly what St. John Ambulance in Canada has done in this case. The organization has decided not to recommend covering a person's face after its medical experts conducted a review of COVID-specific recommendations. 

"We felt it would be a detriment to the recovery of the casualty rate if they are starting to breathe on their own, or if they are gasping the extra barrier between them and the air is not healthy for their recovery," McLaren said.

WorkSafeBC, which oversees workers' health and safety in the province, says employers also need to be aware of new COVID-19 guidelines. It has developed new worksite-specific recommendations and requirements, including upgrading emergency kits with more PPE.

It says all these adjusted guidelines need to be taken into account by employers, especially those required to have first aid attendants on the job site, and develop precautions specific to their workplaces.

Most first aid certifications set to expire during the pandemic have been extended. Organizations say they are trying to ensure anyone who needs to get re-certified for work has priority.