Summary ofFirst Aid/CPR/AED Guidelines Changes

David Markenson, MD, FAAP, EMT-P

Jonathan Epstein, MEMS, NREMT-P March 3, 2011

Housekeeping

• Questions will be answered during live chat at 2 pm ET in the Networking Lounge

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ECC Revisions Overview

• Every 5 years experts from around the world review first aid and emergency care procedures

• The goal is to determine if any new discoveries affect the way care is delivered

• Guidelines and program materials are updated accordingly

Red Cross Scientific Advisory Council

• Multi-disciplinary panel comprised of more than 30 volunteer professionals

• The goal of the Council is to assure that Red Cross courses, training materials and products utilize the latest scientific and technical information available

CPR: The Big Picture . . .

– Emphasis on quickly getting to compressions for anyone in cardiac arrest

– Rescue breaths remain important for infants and children and others with respiratory emergencies

By-standers

• Hands-Only CPR

– For witnessed sudden collapse of any person

– Step of opening the airway eliminated

– Check for responsiveness, call 9-1-1, and quickly look for breathing. If no breathing, give continuous chest compressions. Push hard and fast in the middle of the chest.

Workplace Responders (OSHA-compliant)

• Full CPR: Adults

– Initial 2 rescue breaths eliminated

• Full CPR: Children and Infants

– Retain 2 initial rescue breaths with the exception of a witnessed sudden collapse in which case you would skip the 2 initial rescue breaths

Professional Rescuers

• Full CPR

– Emphasis on quickly checking for breathing and a pulse

– Rescue breathing skill retained

– For adults, initial 2 ventilations (rescue breaths) eliminated

Workplace and Professional Rescuers

• CPR Technique

– For children, use 2 hands and compress the chest about 2 inches

– For infants, compress the chest about 1½ inches

Workplace and Professional Responders

• AEDs

– AED protocols remain the same

– Use an AED as soon as possible

Professional Rescuers

• Giving Ventilations/Using a BVM

– This should only be done as a 2-person skill

First Aid: Medical Emergencies

• Epi– A second dose of an epinephrine auto-injector should be given

if signals of anaphylaxis persist after a few minutes and advanced medical care is delayed

• Positioning– Simplified approach to positioning a person who is

unconscious, but breathing. Generally, the person should not be moved from a face-up position

• Shock– It’s best to leave the person lying flat and not elevate the legs

First Aid: Environmental Emergencies

• Heatstroke– Rapid cooling for heat stroke by cold water immersion is

preferred method with carbohydrate-electrolyte solutions recommended for rehydration

• Frostbite– Care for minor frostbite can be as simple as rewarming by

skin-to-skin contact; with warm water immersion recommended for more serious frostbite

First Aid: Environmental Emergencies

• Bites– Care for any venomous snake bite is now the same

and includes a pressure immobilization bandage

– Irrigation of animal or human bites with large amounts of clean water or saline can minimize the risk of infection

– Use vinegar to prevent further envenomations followed by hot water immersion for reducing pain. If hot water is not available, pack with sand

First Aid: Injuries

• Bleeding– Direct pressure continues to be the most effective method

of control

• Tourniquets– Can be used as a last resort if direct pressure fails, is not

possible or where response from EMS is delayed

• Topical hemostatic agents– Can be considered at the professional rescuer level if

direct pressure and tourniquets are not possible

First Aid: Injuries

• Spinal injuries– Manually support the head and neck in the position found

without movement or alignment with the body, except in the case of compromised airway

• Muscle/bone/joint injuries– Use RICE (Rest, Immobilize, Cold and Elevate).

Angulated fractures should not be straightened

Live Chat: Ask the Experts

Participate in a live chat about the science changes with Red Cross experts who helped craft the new guidelines.

•Networking Lounge: 2 pm ET

•Experts: Dr. Eunice Singletary and Dr. Andrew MacPherson