First Aid Training
FIRST AID TRAINING
This is an online first aid training course. There are 4 modules, with a quiz at the end of each module. Upon successful completion of all 4 quizzes, the applicant will receive a certificate of completion from “First Aid for Free”.
answers can be sent to heartandhomearizona@gmail.com
Creator of this training: John Furst
JOHN FURST is an experienced emergency medical technician and qualified first aid and CPR instructor.
Module 1
Why Learn First Aid
Unit 1 Why Learn First Aid
Knowledge of basic first aid can make the difference between life and death. A glance at some statistics from around the world shows why:
Every year, around 735,000 people suffer a heart attack in the USA
Road traffic accidents are one of the top ten causes of death worldwide, in Europe around 30,000 people die from road traffic accidents each year
Sudden cardiac arrest is the leading cause of death, but many people wouldn’t know how to recognize cardiac arrest or commence resuscitation
Finally, we believe first aid is an important life skill. Anyone can give basic first aid. Even if all you do is stay with the victim, this is much better than leaving them alone.
Unit 2 The Aims of First Aid
A simple way to remember the aims of first aid is to think of the “Three Ps”
Preserve Life
Prevent Worsening
Promote Recovery
Preserve Life: Your first aim is to preserve life by carrying out emergency first aid procedures. For example, opening a victim’s airway or performing cardiopulmonary resuscitation (CPR).
Prevent Worsening: For example, asking a victim with a broken limb to stay still and padding around the injury will prevent the fracture from moving and causing further injury or pain.
In addition, this aim includes preventing further injuries. You should attempt to make the area as safe as possible and removing any potential dangers. If removing danger is not possible you should attempt to remove the patient from the danger or call for specialist help.
Promote Recovery: you can promote recovery by arranging prompt emergency medical help. In addition, simple first aid can significantly affect the long-term recovery of an injury. For example, quickly cooling a burn will reduce the risk of long-term scarring and will encourage early healing.
Unit 3 Incident Management
Incident management refers to the skills required to manage the scene of an emergency. First aiders may be ‘first on scene’ at an incident so need to know basic principles of incident management.
Assessment
Your first actions when coming across the scene of an incident should be to:
Check for any dangers to yourself or bystanders
Manage any dangers found (if safe to do so)
Ensure continuing safety of yourself and bystanders
In many first aid situations, help from the emergency services will be required. Call 911 for urgent situations, and call your supervisor for non urgent situations.
Give clear, precise information about:
– The location of the incident
– The number of victims / people involved
– The nature of their injuries
– In some cases, their age
– Any hazards at the incident (e.g: spilt fuel, fire, electricity)
If the area is remote/difficult to access, consider sending someone to meet the emergency services in a known location
Unit 4 Infection Control
it is important to have a good understanding of infection control. Infection control is important for two reasons:
To protect yourself. Remember you are the most important person, if you are not safe, you cannot help others
To protect the victim
When approaching a victim, you first need to put on protective gloves if you will be exposed to blood or bodily fluids.
Why is Infection Control Important?
Various diseases can be transmitted via blood and body fluids including HIV and Hepatitis B & C. The risk of infection can be reduced by following standard infection control precautions.
Infection Control Precautions
Hand Hygiene: Wash your hands with soap and running water whenever possible. Ensure any cuts/open injuries to your hands are covered with waterproof plasters or dressings. Keep nails short if possible.
If soap and running water is not available, alcohol hand gel can be used. However, alcohol hand gel will not clean visibly dirty hands. In addition, some bugs will not be killed by alcohol hand gel.
Personal Protective Equipment (PPE): Always wear disposable latex or nitrile gloves when there is a risk of coming into contact with bodily fluids. However, this is not always practical so, in an emergency, you can improvise and use anything to create a barrier. e.g: a plastic carrier bag
Personal Protective Equipment (PPE) also includes masks, aprons, and safety glasses. The purpose of PPE is to prevent blood and body fluids from reaching the first aider’s skin, mucous membranes, or personal clothing. PPE must create an effective barrier between the exposed first aider and any blood or other body fluids.
Clinical waste: “Clinical waste” is waste which is contaminated with bodily fluids (for example a bloody dressing). This should be disposed of appropriately and not placed in general waste/rubbish. Normally this will involve being sealed in a separate bag and taken for incineration. You should always inform the ambulance crew of any clinical waste so it can be disposed of appropriately. Any used sharps should be placed in a sharps bin
Unit 5 End of Module 1 Quiz
Question 1: In a first aid situation, who is the most important person?
The victim
The emergency responders
Yourself
The bystanders
Question 2: Which of these is not an aim of First Aid (remember the “3 P’s”):
Promote Recovery
Protect Wounds
Prevent Deterioration
Preserve Life
Question 3: What is the American Universal Emergency Number:
112
911
191
Question 4: You have to attend a formal first aid course before you can give first aid to a stranger?
True or False
Question 5: You arrive at the scene of a road traffic collision. What should you do first?
Check for Dangers
Call 911
Check for a pulse
Question 6: You should always put on gloves before approaching a victim
True or False (you only need to wear gloves when there is a risk of you being exposed to blood or bodily fluids)
Module 2
The Unconscious Victim
Unit 1 The Primary Survey: DRAB
The primary survey is a quick way to assess a collapsed victim. It can easily be remembered by the letters DRAB.
D: Danger remember YOU are the most important person. If the area is too dangerous then stay back and call the emergency services.Check to see if there are any dangers to yourself or the casualty. Try and make the scene as safe as possible,
R: Response Attempt to wake the person up by shouting loudly in both ears and gently shaking the shoulders.
If you do not get a response, then the person is unconscious. So what exactly does this mean?
Complete or near-complete lack of responsiveness
Unaware of both self and external surroundings
The difference between being asleep and being unconsciousness is that an unconscious person will not wake up.
Being unconsciousness is a medical emergency which requires immediate first aid intervention.
When someone is unconscious, they lose muscle tone. The tongue (a muscle) can block their airway when it loses muscle tone. This is known colloquially as “swallowing your own tongue”.
In addition, loss of control over their stomach muscles can cause stomach contents (vomit) to travel back up to the throat which can also block the airway.
At this stage do not worry about trying to find out why they are unconscious, your immediate aim is to open their airway.
A: Airway The airway is a series of tubes which carries air from your mouth & nose to your lungs. It can become blocked by the tongue and regurgitation of stomach contents. This will stop the victim from breathing and can quickly cause death.
You need to open the airway by tilting the head backwards and lifting the chin with two fingers as demonstrated in the picture below.
B: Breathing Keep your hands on the person’s head & chin. Place your cheek above their mouth and look at their chest. Look, listen and feel for regular breathing for up to 10 seconds.You are assessing for normal breathing. The occasional gasping or snoring sound is not regular breathing and should be treated as no breathing. Once you’ve assessed whether the victim is breathing normally you can perform the appropriate first aid treatment.
Unit 2 The Recovery Position
If a victim is unconscious but breathing normally then you should place them into the recovery position in order to protect their airway.
The recovery position involves rolling the casualty onto their side with their head tilted back. By doing this, the tongue is kept clear of the airway and any vomit is able to drain and not obstruct the casualty’s airway.
The photo below demonstrates an example of the recovery position.
How to Place a Victim into the Recovery Position
1. Kneel by the victim’s waist
2. Place the hand closest to you at a right angle (so it looks like the victim is ‘waving’)
3. Grasp the hand furthest to you, place the back of their hand against their cheek closest to you
4. Lift the leg furthest away from you at the knee and place their foot on the floor
5. Using their knee as a lever, pull the person onto their side
6. Ensure their head is still tilted back and they are on their side
Once the victim is in the recovery position you should call for an ambulance/EMS if this hasn’t already been done. In addition, remember to recheck the victim’s breathing at regular intervals until further medical help arrives.
Suspected neck or back injuries
If you suspect the victim may have sustained a neck or a back injury then moving them could worsen the injury. However, it is vital to maintain the victim’s airway so that they do not suffocate. If the victim’s airway is clear and there is no evidence of vomiting then keeping the victim still is advised until EMS arrive.
However, if you are unable to maintain their airway then the victim will need to be moved carefully into the recovery position. If additional rescuers are available, one person can support the victim’s head to minimize excessive movement.
Once the person has been placed in the recovery position you can start assessing and treating any other injuries which you’ve found.
Unit 3 Introduction to CPR
If the casualty is not breathing, you should immediately call an ambulance/activate EMS and commence cardiopulmonary resuscitation (CPR). We will now look at CPR in more detail.
How does CPR work?
All the cells in your body require oxygen to survive. They also require a good supply of nutrients and the rapid removal of waste products. Oxygen and nutrients are carried around the body in your blood, which is pumped by your heart.
In your lungs, oxygen enters your bloodstream and carbon dioxide (a waste product) is removed in a process known as gas exchange.
A “cardiac arrest” is when your heart stops beating. This is not the same as a “heart attack”, although a heart attack may lead to a cardiac arrest. There are numerous causes of cardiac arrests, including:
A disturbance in the heart rhythm (arrhythmia)
Drugs/poisoning
Heart disease / a heart attack
Traumatic injury / blood loss
Anaphylaxis
Breathing problems – eg Choking / Asthma attack
If a cardiac arrest occurs, blood will stop circulating around the body. Breathing will also cease as well, though it may not stop completely for several minutes.
Without a supply of oxygen, the cells in the body start to die. Brain cells are incredibly sensitive, after about 4 – 5 minutes of no oxygen brain cells will begin dying leading to brain damage and death.
The purpose of CPR is to keep oxygenated blood flowing through the body to keep the vital organs alive. CPR itself will not restart someone’s heart, it just keeps them alive until a defibrillator arrives. A defibrillator is a device which delivers an electrical shock to the heart to restart it.
Unit 4 The Chain of Survival
Victims of a cardiac arrest require prompt CPR and early use of a defibrillator in order to give them the best chance of survival. These steps make up a chain known as The Chain of Survival.The ‘links’ of the chain are as follows:
Early recognition and call for help
Early contact should be made to the emergency services after a cardiac arrest is recognized. In addition, serious conditions which may lead to a cardiac arrest (e.g: a heart attack) should be recognized and emergency medical help called for promptly.
Early CPR Cardiopulmonary resuscitation (CPR) should be commenced immediately after a cardiac arrest has occurred (ie, the patient has stopped breathing). Anyone can perform CPR, and ideally, there should be no interruption in CPR before the ambulance arrives.
Early Defibrillation A defibrillator is an electrical device which delivers a shock to the heart in an attempt to correct any abnormal electrical activity which has caused the cardiac arrest.
Post-resuscitation care Appropriate advanced post-resuscitation care in a hospital is essential to improving long-term survival for the patient. This care should be accessed as quickly as possible after the cardiac arrest has occurred.
Unit 5 Performing Adult CPR
CPR should be commenced as soon as possible once EMS has been activated. You do not need to check for a pulse, as this wastes valuable time. If a public defibrillator (AED) is available, then it should be sent for immediately.
Untrained and lay rescuers are now advised to perform chest compression only (“Hands Only”) CPR
Performing Chest Compressions
Once you’ve found a victim isn’t breathing normally, you should start CPR by administering 30 chest compressions. Chest compressions are the most important component of high-quality CPR.
To perform high-quality chest compressions, follow these steps:
Kneel by the side of the victim
Place the heel of one hand in the center of the victim’s chest
Place the heel of your other hand on top of the first hand
Interlock the fingers of your hands and ensure that pressure is not applied to the victim’s ribs. Do not apply any pressure over the upper abdomen or the bottom end of the sternum
Position yourself vertically above the victim’s chest and, with your arms straight, press down on the sternum approximately 5 – 6 cm
After each compression, release all the pressure on the chest without losing contact
between your hands and the sternum
Repeat at a rate of 100 – 120 chest compressions per minute
Each compression and release should take an equal amount of time
If trained, you can attempt two rescue breaths after every 30 chest compressions.
Tilt the victims’s head backwards, make a seal over their mouth and blow in for approximately one second. Do not over inflate the victim’s lungs as this could cause vomiting.
If you are not performing rescue breaths then continue with chest compressions (this is known as ‘hands-only CPR’) alone.
When to Stop CPR
Only stop CPR if:
The casualty shows signs of life: coughing, breathing etc.
You are asked to stop by a healthcare professional (ambulance crew etc.)
You become too exhausted to continue
The situation suddenly becomes too dangerous
Ideally, you should only carry out CPR for 2 minutes before swapping with someone else. This is to ensure that the chest compressions remain effective
Unit 6 Common CPR Mistakes
High-quality CPR is vital to ensure a victim of cardiac arrest has the best possible chance of survival. CPR is a practical skill, and surprisingly easy to make mistakes when performing. You should avoid performing these common CPR mistakes:
Inadequate chest compression depth
Chest compressions need to be at least 5cm (2inches) deep in order to be effective. A common mistake made during CPR is performing shallow, ineffective chest compressions. Often people underestimate the force required in order to compress an adult victim’s chest. In addition, some people are worried about causing harm to the victim (for example, rib fractures).
Shallow chest compressions will not provide enough force to pump blood around the victim’s body. Therefore the brain will be starved of vital oxygen and a defibrillator is less likely to work when it is deployed.
It is common for ribs to be broken during CPR. One study found the prevalence of rib fractures in adult victims who received CPR was over 80. The rescuer may feel ribs break when they deliver chest compressions. This can be an unpleasant experience for the rescuer, but it is important to continue to deliver high-quality chest compressions.
Too slow or too fast chest compressions
Chest compressions should be given at a speed of around 100 – 120 a minute. Slow chest compressions are less likely to be effective, and fast chest compressions may not be deep enough in order to push blood around the body.
Leaning on the victim’s chest
Each chest compression should involve compressing the chest to a minimum of 5cm, followed by a full release of the chest wall. This is important to allow the heart to fill with blood. A common mistake
new rescuers make is to ‘lean’ on the victim’s chest, especially when they become tired. This means there is not a complete release of the chest wall after each compression, reducing the effectiveness of the CPR.
Over-inflating the victim’s lungs
If trained and willing, rescue breaths can be performed in order to provide oxygen to a victim. However, it is important not to over-inflate the victim’s lungs. Over inflating the lungs will cause air to enter the stomach and increase the risk of the victim vomiting and blocking their airway. Therefore, each rescue breath should only last approximately one second
Unit 7 End of Module 2 Quiz
Question 1: What does the term “unconsciousness” mean?
A person does not wake up and is not aware of themselves or their surroundings
A person is speaking but not making sense
A person appears to be sleeping
A person is not breathing
Question 2: What is the first thing you should do if you find someone collapsed?
Check for a pulse
Check for danger
Look for blood
Call 911
Question 3: What does DRAB stand for?
During, Response, Airway, Bleeding
Danger, Response, Airway, Breathing
Danger, Return, Air, Breathing
Question 4: How should you open someone’s airway?
Turn their head to the side
Raise their legs higher then the level of their head
Tilt the head back and lift the chin
Sit them up
Question 5: If an unconscious victim is breathing, they must be rolled into the recovery position.
True or False
Question 6: What does “CPR” stand for?
Cardiopulmonary Resuscitation
Cardiopothy Rescue
Cranial Pulonary Return
Module 3
Bleeding and Shock
Unit 1 The Circulatory System
Let’s start off this module by briefly looking at how blood moves around our body through the circulatory system.
The heart is a muscular pump responsible for pushing blood around the body. Blood travels in arteries, veins, and capillaries. Its purpose is to transport Oxygen and nutrients around the body and to remove waste products such as Carbon Dioxide. An average adult has around 10 pints of blood in their body.
The Different Types of Blood Vessels
The three types of blood vessels will cause different types of bleeding from a victim.
Arteries: Carry blood under high pressure away from the heart. Blood is likely to spurt out of a wound.
Veins: Carry blood under low pressure back to the heart. Blood will flow steadily from the wound
Capillaries: Carry blood to the individual cells and tissues, very small and very low pressures. Blood will ooze from the wound.
Types of Wound
There are various different types of wound that a victim may sustain.
Laceration: Tearing of the skin & tissue
Contusion: A bruise
Abrasion: Graze – loss of the superficial layer of skin
Incision: A straight clean wound
Puncture: Caused by a sharp object which may still be in the wound (foreign / embedded object)
Unit 2 Dealing with Major Bleeding
Major bleeding is life-threatening and requires urgent first aid intervention to prevent further blood loss and the development of shock.
First Aid Steps for Major Bleeding
Expose injury and elevate above level of the heart
If there are no foreign objects, apply firm direct pressure over the wound
If there is an object, apply pressure around the foreign object
Call for emergency medical help (911)
A useful mnemonic to help you remember the first aid steps for major bleeding is ‘PEEP‘.
P: Position – position the victim in a safe / comfortable position
E: Elevate limbs
E: Expose & examine the injury. Check for any embedded or foreign objects such as pieces of glass.
P: Pressure – apply direct pressure over the injury to control blood loss
Do not apply a tourniquet unless specifically trained to do so. Do not attempt to wash out a major wound – your aim is to control the bleeding as quickly as possible. Watch for signs and symptoms of shock (next unit)
Unit 3 Puncture Wounds
A puncture wound occurs when an object pierces the skin and enters into a tissue of the body. This creates an open wound which is painful and may be bleeding. Punctures may occur due to any sharp objects such as glass, scissors, knives, pins, nails, wood splinters and sharp stones.
The object may remain embedded in the wound or may have passed clean through the body part involved.
Do not remove the object unless it is very small (for example a small splinter)
Stop the bleeding by applying pressure around the wound – take care not to dislodge the object
If possible, elevate the limb to prevent further blood loss
Seek urgent medical attention
It is important to keep the object as still as possible to prevent further injury to the deeper structures below the skin. Whilst it is tempting sometimes to attempt to remove the object, this can actually worsen the situation by causing further bleeding and tissue damage. Removal of embedded objects should only be carried out by a medical professional.
Unit 4 Shock
What is shock?
A lack of oxygen and essential nutrients reaching the tissues
Shock is a medical emergency which can be caused by severe blood loss. The casualty does not receive enough oxygen and other essential nutrients due to the loss of blood.
Remember that blood is the major transport mechanism in the body for oxygen and vital nutrients. If you’ve lost half your blood volume (on the floor in a puddle) then that blood isn’t available to transport oxygen and nutrients to your important organs.
Medical shock is not the same as emotional shock
Many people are confused about what shock actually means. The mass media use the term ‘shock’ to refer to people who have been emotionally affected by a traumatic incident. However – this is not the same as medical shock. Medical shock is a life threatening medical emergency. There are various different causes of shock, major blood loss will cause hypovolemic shock. Hypovolemic means low blood volume.
How to recognise shock
Signs & symptoms of shock include:
Pale, cold and clammy skin
Confusion
Drowsiness (reducing level of consciousness)
Fast, weak pulse
Fast, shallow breathing
If a casualty has lost a lot of blood, you should be actively looking for signs and symptoms of shock.
First aid treatment for shock
If you suspect a casualty is suffering from shock then you should:
Control any external blood loss (think PEEP from the last unit)
Lie the casualty down and raise their legs if possible
Cover the casualty with a coat or blanket to keep them warm
Call for emergency medical help
Do not give the casualty anything to eat or drink! Stay with them until medical help arrives. If the casualty becomes unconscious / unresponsive then you should place them into the recovery position. If they stop breathing normally then commence CPR.
The key skill for a first aider is being able to recognise shock developing early and call for prompt medical assistance.
Unit 5 Minor Wounds
Nearly all of us will have suffered a minor wound at some point in our lives. There are some simple first aid steps you can take if someone has suffered a minor wound:
Wash your hands and wear gloves
Clean the wound thoroughly with antiseptic wipes or clean running water
Cover the wound using a clean dressing (plaster, non-adherent pad etc.).
Caution: Do not remove any embedded objects (e.g: glass) – seek medical advice if there are any objects in a wound.
Most minor wounds will heal with time and these simple first aid steps. However, sometimes they can become infected. You should watch out for signs and symptoms of an infected wound:
Increasing pain
Area around the wound become red, swollen and warm to touch
The wound starts producing discharge / pus
The casualty develops a temperature / fever
Below is an example of an infected minor wound (click on the photo to enlarge). You can clearly see the area around the wound has become red and swollen. The wound is also producing a yellow discharge.
Unit 6 End of Module 3 Quiz
Question 1: How much blood does the average adult have?
17 pints
10 pints
20 pints
8 pints
Question 2: What is a contusion
A laceration
A puncture wound
A bruise
A scrape
Question 3: Elevating a limb can slow down bleeding.
True or False
Question 4: You should remove an object from a wound to hep stop the bleeding.
True or False
Question 5: Direct Pressure is the bet method of stopping bleeding
True or False
Module 4
Burns and Scalds
Unit 1 Classification of Burns
Burn injuries can be classified by their type and depth. The size of burns is expressed as a percentage of total body area.
Types of burn
Scald – caused by a hot liquid
Friction – caused by rough surfaces, e.g: carpet
Radiation/sunburn
Electrical – will have an entry burn and an exit burn
Chemical
Dry – touching hot objects, e.g: a cooker.
Depths of burn
Superficial (1st degree) – this is when only the top layer of skin has been damaged. These are the most minor burns. Often the only sign is a reddening of the skin. Minor sunburn falls into this category of burns.
Partial thickness (2nd degree) – these burns cause blisters in the skin due to the damaged tissue releasing fluid.
Full thickness (3rd degree) – this is the most serious type of burn. In a full thickness burn, every layer of the skin has been affected and the underlying bone, muscle or fat may have also been damaged.
Assessment of burn size
Correctly estimating the size of the burn is important. Burn area is measured as a percentage of total body surface area.
There are two techniques which can be used:
Palm of hand: roughly speaking, the palm of the victim’s hand will be approximately 1% of their body surface area
Rule of nines (see image)
Burns in the region of 10% of body area are serious and may produce severe shock.
Unit 2 Treatment of Burns
Minor burns are incredibly common household injuries. Our homes are full of items which can cause burns – hair straighteners, kettles, toasters, electric heaters. The list is endless. Generally, burns are caused by touching something hot which damages the skin. However, they can also be caused by radiation (for example, from the sun), chemicals, electricity and friction. As well heat, burns can also be caused by the extreme cold – these are known as freeze or ice burns.
First aid for a minor burn
Step 1: Immediately run the burn under cold running water for a minimum of 10 minutes. If running cold water is not available then improvise! You can use other non-toxic liquids such as drinks. Your aim is to cool the burn.
Step 2: Expose the affected area and if possible remove anything that could be constricted (watches, jewelry etc.). Do not remove clothing sticking to the burn, instead cool through the clothing.
Step 3: After cooling the burn, cover with a non-fluffy dressing/covering to prevent infection. If you have access to a first aid kit, use a non-fluffy sterile dressing. If not then improvise with whatever is available (plastic bag, kitchen cling film, teatowel etc.). Be careful not to constrict the burn!
Step 4: Seek medical advice for anything except the most minor of burns. Call an ambulance if serious or if the burn is near the face/neck.
What not to do
Do not try to remove clothing sticking to a burn, instead cool through the clothing
Do not apply toothpaste / butter / creams to a burn. Running water is the most effective cooling method.
Exception: “Aftersun” lotion is useful for sunburn
Do not burst any blisters
Do not stop cooling before 10 minutes is up!
Chemical burns
There are a wide variety of chemicals and substances which can cause chemical burns. These can range from household chemicals such as bleach, cleaning products, pesticides to strong industrial chemicals used in the workplace. Chemical burns can be incredibly serious as the chemical will keep damaging the skin and tissue until it is removed.
Step 1: Check for any dangers to yourself. The chemicals that caused the casualty’s injuries could also pose a danger to you. Try to establish what caused the burn and how safe the chemicals are. If you are in an enclosed area, move the casualty outside or open windows to prevent the build up of fumes. Wear disposable gloves.
Step 2: Cool the burn with copious running water for at least 15 – 20 minutes. Ensure that you do not come into contact with the water used to cool the burn as it may contain the harmful chemical.
Step 3: If any clothing has come into contact with the chemical, it should be removed providing it isn’t sticking to the burn. Try to identify the chemical involved and its container.
Step 4: Cover the burn with a sterile, non-fluffy first aid dressing. If no dressing is available, then improvise. Good items to use include cling-film and plastic bags.
If the burn is serious, the casualty shows signs of shock or the casualty becomes drowsy/looses consciousness then call an emergency ambulance immediately. If a large chemical spill has occurred then also ensure the fire brigade and police have also been informed.
If you become exposed to the chemical involved then you should seek medical advice immediately.
Unit 3 End of Module 4 Quiz
Question 1: You should cool a burn for at least ____ minutes
14
8
10
15
Question 2: Why should you cover a burn after cooling it?
To warm it back up
To prevent infection
To keep it from the air
Question 3: Clingfilm is a good item to use to cover a burn
True or False
Question 4: A Major Burn can cause a casualty to go into medical shock.
True or False
Question 5: Sunburn is a type of radiation burn
True or False
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