I participated in the Emergency First Response Instructor Trainer course today. One of the most important things that came out during the course are new emergency care guidelines as sacntioned by the 2010 consensus.
The 2010 guidelines represent the most extensive research into emergency cardiac care to date. In general, no great change from Guidelines 2005 and further reinforce emphasis on providing effective chest cokmpression with minimal interruptions. The reason for this is because studies have shown the importance of providing fast, effective chest compression as a critical aspect in treating a patient who has suffered cardiac arrest.
Most practices, such as compression to ventilation ratio of 30:2, have not changed. Compression-only CPr continues as a recommendation for untrained individuals. However, the recommendation remains for the trained lay rescuer to perform compressions and ventilations. A summary of changes in administering CPR and AED's for both ERC was delivered to the participants. The application of the new guidelines will be published by EFR in the next issue of The Responder.
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| It looks like the old ABCD's are loosing some importance. This list was provided as a guideline for performing demostrations. |
The changes made can be sumarized as follows:
1. When obtaining help, ask for someone to call for an ambulance AND to bring an AED. The reason for this change is that more AED's are being placed in public places making them more accessible. (ERC)
2. "Look, Listen and Feel" has been removed to minimize delay in chest compressions. (AHA)
3. Begin CPR by providing 30 chest compressions, then open the airway and give two breaths. If drowning is suspected beging CPR by providing rescue breaths. (ERC)
4. Adult chest must be compressed to a depth of at least 5 cm (old guideline was 4 - 5 cm). Rate is the same: 100 compressions per minute (ERC)
5. Compress infant chest to approximately 4 cm and child chest to approx 5cm at a rate of 100 - 120 compressions per minute (ERC) or to one third of the diameter of the chest (AHA)
6. To minimize interruptions in chest compressions, AED's can be switched on and patches applied WHILE performing CPR. (ERC - AHA)
For detailed references see the full AHA Guidelines for CPR and ECC and the ILCOR CoSTR document in the Journal of Circulation and view the ERC Guidelines 2010
