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New First Aid Guidelines

     New First Aid guidelines have just been introduced into First Aid Programs.  These treatment recommendation guidelines come from the National First Aid Science Advisory Board that was put together to review and evaluate the scientific literature on first aid. The goals of the National First Aid Science Advisory Board are to reduce morbidity and mortality due to emergency events and to analyze the scientific evidence that answers the following questions:

• What are the most common emergency conditions that lead to significant morbidity and mortality?
   
• In which of these emergency conditions can morbidity or mortality be reduced by the intervention of a first aid provider?
   
• How strong is the scientific evidence that interventions performed by a first aid provider are safe, effective, and feasible?

First Aid Recommendations were made for:

In 2005, Updates Were Made For First Aid:
Medical Emergencies:
• Oxygen Administration
• Asthma Inhalers
• Epinephrine Auto injectors
• Recovery Position

  Injury Emergencies:
• Cervical Spine Injuries & Stabilization
• Severe Bleeding Treatment Protocol
• Wound and Abrasions
• Wound Irrigation
• Use of Antibiotic Ointment
• Thermal Burns
• Cooling Procedure & Burn Blister Treatment
• Musculoskeletal Injuries (Fracture, Sprains, and Contusions)
• Dental Injuries

  Environmental Injuries:
• Hypothermia
• Frostbite
• Poisoning
• Water Irrigation
• Ingested Poisons



In 2010, Updates Were Made For First Aid:
• Supplementary oxygen administration Professionals
• Epinephrine and anaphylaxis
• Aspirin administration for chest discomfort (new)
• Tourniquets and bleeding control
• Hemostatic agents (new)
• Snakebites
• Jellyfish stings (new)
• Heat emergencies






Reference:

Markenson, D et al. (2010) Part 17: First Aid: 2010 American Heart Association and American Red Cross Guidelines for First Aid. Circulation. 122;S934-S946

Resource: First Aid Science Advisory Board Evidence Evaluation Conference, hosted by the American Heart Association and the American Red Cross in Dallas, Texas, January 23-24, 2005. (Circulation, 2005;112:III-115-III-125.)

 

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New CPR Guidelines

     New Cardiopulmonary Resuscitation guidelines have just been introduced into First Aid & CPR Programs.  The guidelines are based on evidence evaluation from the 2010 International Consensus Conference on Cardiopulmonary Resuscitation  and Emergency Cardiovascular Care Science with Treatment Recommendations. These guidelines supersede the past 2005 guidelines. The new Perri-Med First Aid and CPR program has launched and we are updated to provide it. During the evidence evaluation process the ILCOR (International Liaison Committee on Resuscitation) task force weighed the scientific evidence and developed consensus statements on the interpretation of the scientific findings. Recommendations were published in ILCOR 2010 CPR Consensus which were then taken to make these guidelines.  Because of researchers, ILCOR, Canadian Heart and Stroke Foundation, American Heart and Stroke and the careful deliberation of theses guidelines and recommendations BVD can now bring you these new changes with hopes of increasing the level of training and retention of the skills through these new program changes.

CPR Guidelines Past and Present:

In 2005, Updates Were Made For CPR:
• Separate courses for Health Care Professionals
• Separate courses for Work Places, general public, & First Responders
• New CPR Ratios
• New Equipment introduced to the program
• New compression technique and Positioning
• New concentrations while doing CPR
• New Chain of Survival concentration
• New way of Classifying Adult, Children & Infants
• New protocol for when to call 911
• New recommendation of how long to check for breathing
• New depth of compression numbers
• New protocol for switching during 2 person CPR



In 2010, Updates Were Made For Lay Responder CPR:
• The simplified universal adult BLS algorithm has been created: C-A-B
• Refinements have been made to recommendations for immediate recognition and activation of the emergency response system based on signs of unresponsiveness, as well as initiation of CPR if the victim is unresponsive with no breathing or no normal breathing (ie, victim is only gasping).
• “Look, listen, and feel for breathing” has been removed from the algorithm.
• Continued emphasis has been placed on high-quality CPR (with chest compressions of adequate rate and depth, allowing complete chest recoil after each compression, minimizing interruptions in compressions, and avoiding excessive ventilation).
• There has been a change in the recommended sequence for the lone rescuer to initiate chest compressions before giving rescue breaths (C-A-B rather than A-B-C). The lone rescuer should begin CPR with 30 compressions rather than 2 ventilations to reduce delay to first compression.
• Compression rate should be at least 100/min (rather than “approximately” 100/min)
• Compression depth for adults has been changed from the range of 1½ to 2 inches to at least 2 inches (5 cm).



In 2010, Updates Were Made For Health Care Provider CPR:
• Because cardiac arrest victims may present with a short period of seizure-like activity or agonal gasps that may confuse potential rescuers, dispatchers should be specifically trained to identify these presentations of cardiac arrest to improve cardiac arrest recognition.
• Dispatchers should instruct untrained lay rescuers to provide Hands-Only CPR for adults with sudden cardiac arrest.
• Refinements have been made to recommendations for immediate recognition and activation of the emergency response system once the healthcare provider identifies the adult victim who is unresponsive with no breathing or no normal breathing (ie, only gasping). The healthcare provider briefly checks for no breathing or no normal breathing (ie, no breathing or only gasping) when the provider checks responsiveness. The provider then activates the emergency response system and retrieves the AED (or sends someone to do so). The healthcare provider should not spend more than 10 seconds checking for a pulse, and if a pulse is not definitely felt within 10 seconds, should begin CPR and use the AED when available.
• Increased emphasis has been placed on high-quality CPR (compressions of adequate rate and depth, allowing complete chest recoil between compressions, minimizing interruptions in compressions, and avoiding excessive ventilation).
• Look, listen, and feel for breathing” has been removed from the algorithm.
• Use of cricoid pressure during ventilations is generally not recommended.
• Rescuers should initiate chest compressions before giving rescue breaths (C-A-B rather than A-B-C). Beginning CPR with 30 compressions rather than 2 ventilations leads to a shorter delay to first compression.
• Compression rate is modified to at least 100/min from approximately 100/min.



In 2010 Updates Were Made For Automated External Defibrillation:
• Integration of AEDs into the Chain of Survival system for public places
• Consideration of AED use in hospitals
• AEDs can now be used in infants if a manual defibrillator is not available
• Shock first versus CPR first in cardiac arrest
• 1-shock protocol versus 3-shock sequence for VF
• Biphasic and monophasic waveforms
• Escalating versus fixed doses for second and subsequent shocks
• Electrode placement
• External defibrillation with implantable cardioverter-defibrillator
• Synchronized cardioversion



  Reference:

Resource: 2005 First Aid Science Advisory Board Evidence Evaluation Conference, hosted by the American Heart Association and the American Red Cross in Dallas, Texas, January 23-24, 2005. (Circulation, 2005;112:III-115-III-125.)

Highlights of the 2010 AHA Guidelines for CPR and ECC, American Heart Association

Field JM, Hazinski MF, Sayre M, et al. Part 1: Executive Summary of 2010 AHA Guidelines for CPR and ECC. Circulation. In press.

Hazinski MF, Nolan JP, Billi JE, et al. Part 1: Executive Summary: 2010 International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science With Treatment Recommendations. Circulation. In press.

Resource: 2005 American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Care, Part 4: Adult Basin Life Support, Circulation. 1005:112(suppl IV):IV-19-IV-34