View Full Version : Changes in resuscitation will be announced by the UK Resus Council.
Shambling Shaman
03-11-2010, 14:55
**Please Note This For Information ONLY**
**Please Note This For Information ONLY**
Got an email from Admin@AoFA.org
Highly important changes in resuscitation will be announced by the UK Resus Council in late October. These changes are important and will affect all first aid training and procedures.
this followed a few days ago
When obtaining help, ask for an automated external defibrillator (AED), if one is available.
1. Compress the chest to a depth of 5-6 cm and at a rate of 100-120 per min.
2. Give each rescue breath over 1 second rather than 2.
3. Do not stop to check the victim or discontinue CPR unless the victim starts to show signs of regaining consciousness, such as coughing, opening his eyes, speaking, or moving purposefully AND starts to breathe normally.
4. Teach CPR to laypeople with an emphasis on chest compression, but include ventilation as the standard, particularly for those with a duty of care. In addition, advice has been added on the use of oxygen, and how to manage a victim who regurgitates stomach contents during resuscitation.
hoppinmad
03-11-2010, 15:28
the 2010 changes come out on the 18 of Oct and are availabe here
http://www.resus.org.uk/SiteIndx.htm
I think this is quite important, hence stickied it temporarily.
Shambling Shaman
03-11-2010, 17:50
the 2010 changes come out on the 18 of Oct and are availabe here
http://www.resus.org.uk/SiteIndx.htm
Nice link thanks
Going to make it very tiring to keep up unless there's someone to spell you
Interesting - I never knew about the alternative abdominal thrusts ( I was never sure of using the Heimlich manouevre).
hoppinmad
07-11-2010, 15:55
some video's explaining the resus changes
http://www.cprguidelines.eu/2010/index.php
These changes were introduced in May 2009 to all "professional" first aid providers with the FAW following on by October 2009 and the changes were published in the tri services first aid manual (Red Cross, St. John's, St Andrew's) which has been available since February this year. One of the most significant changes is that the rescue breaths which in the past were required to be effective has now been downgraded and has now become attempted, so even if ineffective the first aider should not waste time in trying to make them effective. Current thinking is that there is enough oxygen retained in the blood to last several hours before a "top up" is required. It is still recommended that people who wish to learn first aid still should update their skills by attending a recognised training course. The new Tri service first aid manual I believe is the best source of information and explanation for the lay person and is a very handy reference to have at home, particularly now as it is written for the lay person and no longer the "professional" first aider who will be getting a professional providers manual early next year it is rumoured. The next expected major change to be introduced sometime in the future is the dropping of the rescue breaths altogether, but when this will come in I have no idea, some speculate early next year but I think this is doubtful, and personally think it will coincide with the next update of the manual due in 3 years time.
It is very important to use what you were taught i.e. don't 'self update' if you have a valid first aid certificate.
Shambling Shaman
25-11-2010, 09:26
It is very important to use what you were taught i.e. don't 'self update' if you have a valid first aid certificate.
That is very true, the thread dose start with **Please Note This For Information ONLY** but i think how you put it is more correct :)
TinkyPete
22-12-2010, 11:02
One thing I have been recently taught about the timing for the compressions is the nursery rhyme "Nelly the elephant" and if you say it at the natural pace which is quite fast that you should get your right compressions, doing for 10 minutes during a recent course certainly made me knackered another reason why they say get or phone for help first!!
Here are a couple of links to help:
http://kids.niehs.nih.gov/lyrics/nellie.htm
http://en.wikipedia.org/wiki/Nellie_the_Elephant
http://www.youtube.com/watch?v=1F3Uhrj9YVI&feature=related
The last being the video try to keep to the timing of the chorus :)
It's amaxing what you hear paramedics sining nowadays :)
what's next Bohemian rhapsody for counting blood pressure? :) or maybe this http://www.youtube.com/watch?v=7movKfyTBII
Hope they don't go the dumbing down way and drop rescue breaths altogether.
Hope they don't go the dumbing down way and drop rescue breaths altogether.
They were talking about doing just that a couple of years ago when I last did a CPR course.
It won't be dumbing down Bod in reality it will in theory make it more efficient, the general concensus is that the blood will retain enough oxygen supply for some time before requiring replenishment. Therefore keeping the blood pumping around the organs can be more beneficial in keeping the body "alive" till a defib is brought in. If you think about it CPR can only (in the overwhelming majority of cases) keep the organs viable for transplant if the defib cannot restart the heart. In all but certain conditions and certain events the likelyhood of restarting the heart with CPR is virtually non existant. At the moment this is all academic as this has not yet been brought in, although it is on the cards for some future date, but no one knows when as yet.
ashes1627
23-12-2010, 13:13
They won't drop rescue breaths altogether, as they are still required for infants, children and a person who has drowned.
http://www.sja.org.uk/sja/first-aid-advice/life-saving-procedures/faqs-to-resuscitation-changes.aspx is worth a read if you wish to know more about the changes.
[CENTER]When obtaining help, ask for an automated external defibrillator (AED), if one is available.
i don't understand this bit.
when you phone an ambulance you talk to professionals and they should know what kit they will need!
pete
hoppinmad
23-12-2010, 15:42
Hi Pete,
During your primary survey.Danger, Response, Shout for help, Airway, check Breathing for not more than ten seconds..if not breathing normally..then go/or sent for help and get the nearest AED if one is available...a lot of large stores shopping centers etc have AED's AED's can be used by anyone [better if trainned] and will basically tell you what to do in terms of pad placement etc
The early use of a AED is the only hope of any chance of survival
If you look at the link i posted earlier all the information you need is there
Hope this helps
regards
Stu
cbkernow
23-12-2010, 16:32
it seems its the breathes that put some people off doing anything, so we tend to emphasise (I teach Scout leader "First Response" courses, a very basic course that all leaders need to go through) that doing SOMETHING is better than nothing, so if the casualty has vomited, has facial injuries or may have suffered from posioning etc, just do the compressions, but don't just do nothing!
Bothwell_Craig
23-12-2010, 16:57
Compression only CPR is still a viable option, particularly for witnessed Cardiac Arrest. The blood that would have been circulating prior to the collapse will be oxygenated already. I have made the decision to undertake compression only CPR before due to the circumstances and not having my usual kit available at hand.
The changes to the Resus Council Guidelines this year have been the biggest anti climax known to the First Aid providers world!
They won't drop rescue breaths altogether, as they are still required for infants, children and a person who has drowned.
As I said in my post ashes there are some circumstances where the heart can be restarted by cpr such as drowning, trauma (severe blow to the sternum), electrocution. But the overwhelming majority of a casualty collapsing with heart stoppage or inconsistant rythm is disease or medical condition and rescue breath/no rescue breath will have little to no significance. I can assure you that rescue breaths will dissappear, it's not if but when is the question. But as has been pointed out until these changes are announced you should continue with how you have been trained ie 30 compression to 2 attempted rescue breaths, compression at a rate of 100 per minute to a depth of 1/3 body depth.
Peter T what was meant was when calling for people around you for assistance to bring an AED, when you call 999 they will automatically have oxygen, bag valve and mask, plus AED with them on arrival.
Prioritising CPR thrusts over EAR breaths makes sense but an experienced person should give the breaths where possible. I would irrespective of the current protocols and always for children.
People give up too easily. My daughters friend drowned and 'died' - no pulse, cyanosis after several minutes under water. CPR was given by first aiders and friends. The doctor who arrived examined her and pronounced her dead and started his saying condolences to the mother who had just arrived. Wife and friends continued resusciation and a bare couple of minutes later she started up.
Is there any change to "Airway" by the way? If you are not going to give rescue breaths anyway will the airway be checked? IF the victim choked then his blood will be more de-oxygenated that some one whose heart stopped due to disease. Such a person may have a healthy heart and be one of the 10% who might have lived...
Still check and open the airway just in case a heart rythm does restart. Unfortunately it is true in some cases people do give up too early, and please remember that full CPR breaths and compressions is very hard to physically do for real so in some extreme cases it's where the first aider cannot physically continue, so where there is more than one of you it cuts the effort required in half. As I say this is the wisdom of the top think tank on such matters so the info is valid but as I say it's a matter of time as to when they decide it is time to roll it out for public consumption as it were.
cbkernow
25-12-2010, 21:31
you should be checking the airway as part of the initial assessment so shouldn't need to specifically open it if you're performing CPR without breathes.
If there is no phone or no one to get the phone, and after ascertaining the casualty is not responsive and not breathing, when you have returned from raising help, you should proceed with CPR immediately on return.
I hate this update, I really do. I wish they'd stop constantly changing them. It will be interesting to see whether the research shows better outcomes given the new guidelines for arrests in the community. Time will tell.
You can perfuse the body all you like by giving heart massage, but if you're not oxygenating that blood through giving breathes, it's not going to help much. There are some quite misleading things being said in this thread - the body certainly doesn't have hours of reserves of oxygen, it has a few minutes. Once these have been used, you can pump that heart all you like - it's not going to do anything or save a life. There is a theory that performing compressions will also incidentally push air in and out of the lungs, and so some ventilation will be performed - it's going to be pretty minimal. I would always attempt to ventilate as well as give compressions.
With children, cardiac arrest is almost always caused by a respiratory arrest. Ventilate a kiddie soon enough and they should come back. Primary cardiac arrest in children is very rare, and is usually only seen on the Paediatric Intensive Care Unit. Again, you should always try to blow air into their lungs during CPR.
Bothwell_Craig
26-12-2010, 15:16
I hate this update, I really do. I wish they'd stop constantly changing them. It will be interesting to see whether the research shows better outcomes given the new guidelines for arrests in the community. Time will tell.
You can perfuse the body all you like by giving heart massage, but if you're not oxygenating that blood through giving breathes, it's not going to help much. There are some quite misleading things being said in this thread - the body certainly doesn't have hours of reserves of oxygen, it has a few minutes. Once these have been used, you can pump that heart all you like - it's not going to do anything or save a life. There is a theory that performing compressions will also incidentally push air in and out of the lungs, and so some ventilation will be performed - it's going to be pretty minimal. I would always attempt to ventilate as well as give compressions.
With children, cardiac arrest is almost always caused by a respiratory arrest. Ventilate a kiddie soon enough and they should come back. Primary cardiac arrest in children is very rare, and is usually only seen on the Paediatric Intensive Care Unit. Again, you should always try to blow air into their lungs during CPR.
Ronnie
Three studies in recent years now support compression only CPR.
A Japanese study which featured in the Lancet concentrated on cardiac collapse in children which, as you pointed out, do not present with pulseless collapse for the same reasons as adults. Where the cause of collapse was cardiac then the study showed that mouth to mouth respiration made no difference to survival rates. None. Nada. Zilch.
For other child causes such as asthma attack and choking, mouth to mouth did improve survival rates better than chest compressions alone.
However two large scale, independent studies in the New England Journal of Medicine showed that compressions alone were just as good as compression plus ventilation.
The reality is that without early access to a defib the chance of survival beyond admission to hospital is negligible anyway.
The other reality is that many people do not undertake CPR of collapses because they do not want to perform ventilations. Personally the “if you are willing and able to perform [rescue breaths]” line is a winner for me and means that rescue breaths still have their place in the protocols.
I have had to perform CPR many times. I normally have a pocket face shield in my wallet and a face mask on my belt when operational. In my personal vehicle I have a Defib, BVM, O2, OP Airways….I’m sure you get the picture.
If I drop and the choice is get CPR minus breaths or no CPR then I know which one I’d choose.
Compression only CPR is a viable option. If you don't feel that you can give breaths be that because of facial trauma or lack of self protection then do chest only compressions. It can still buy time for a defib to get to your locus.
Craig
Excellent and well considered post, Craig.
I have to admit that my background is in Paediatric critical care, which is probably why I was so dubious of compression only resuscitation. So, I'm very interested in the New England Journal studies. I can only assume that this efficacy is due to incidental ventilation secondary to the compressions?
That being said, I've always ventilated as well as given compressions and will continue to do so.
Scots_Charles_River
27-12-2010, 22:41
Don't give up ............
http://www.nydailynews.com/news/world/2010/12/26/2010-12-26_ill_elderly_woman_in_brazil _wakes_up_in_coffin_two_days_a fter_doctors_pronounce_.html?r =news
Yes do not give up.
I once gave CPR to a sailor who collapsed after a yacht race. I was talking to him when he collapsed and was first on scene. A surgeon was a second behind. I gave CPR. The ambulance arrived after 20 minutes and after the second defib there was a loud bang and flash from the machine!
So much for technology. . One of the paramedics gave breaths and I resumed compressions ( I was a senior marine SAR crew then so I guess she was happy to let me do compressions). However he was still connected to the ECG which still worked and I could see the result of each of my compressions - big spikes in the line - and the surgeon felt for the femoral (groin) pulse which was also strong.
Although I had done actual CPR before until then I did not truly appreciate that when you are giving CPR you really are that persons heartbeat and lungs.
And you are circulating oxygenated blood to the body.
What this thread does not address is the effect on yourself of them dying. In SAR unlike most RTAs there is a big emotional investment or commitment by first responder -rescuers. There is elation when all goes well but if it doesn't it can be very hard on rescuers. Some of my fellow crew have never gone out again and some water police crew have had PTSD. There is a "could I have done more/been faster?" side to the story that can be tough.
So be kind to yourself, use all you know and do the best you can.
Perry was my crew mate and with friends we had just finished a race together.
Minotaur
09-02-2011, 09:45
They have major league tested these changes. They work. Many pigs did not do well :)
They are not that big a change either, but I found them harder to remember and put into practice.
Ref them dying, look up the stats. Not sure on the changes, but it something like 1 in 20 survive. The big reason to do it, is you do not know what wrong with them.
Never done it myself, but have comforted a few people. It can be a bit of a shock to suddenly realise you have done it.
bigbeewee
17-02-2011, 13:36
If you are determined and prepared to commence CPR including AV you really need one of these.
I've dealt with three cardiac emergencies in remote areas in the last couple of months. The common factor with all was BLS (CPR) caused regurgitation of the casualties dinner/breakfast.
I'm used to bodily excretions but mouth to mouth is virtually impossible to continue in these situations and you certainly won't get any ready volunteers to spell you.
The another factor is people will step up and do compressions, and the nelly the elephant advice is all you need to get a complete non first aider up and running with adequate compressions
If you start, you won't want to stop but its tiring stuff and sharing the workload helps
http://www.spservices.co.uk/advanced_search_result.php?key words=key+ring+shield&stype=q&search_in_description=1&osCsid=2oj4o98kjd7cem0ni840612 c04&image2.x=7&image2.y=9
or one of these
http://www.spservices.co.uk/product_info.php?products_id=4 448