Rescue & Resuscitation

majo · November 28th, 2005, 04:46 PM

All,

For your information.

the new 2005 resuscitation protocols are out today. I know you all will follow your training till you recieve new guidelines from your agencies etc but thought you would all like to have the information.

The new protocols are written for the benefit of lay people and sudden cardiac arrest and not for drowning situations.

There is a modification to the protocols for people involved with drowning ( it specifies lifeguards, such divers also fit that)

For Adult the BLS is as follows:
"The following changes in the BLS guidelines have been made to reflect the greater importance placed on chest compression, and to attempt to reduce the number and duration of pauses:
1) Make a diagnosis of cardiac arrest if a victim is unresponsive and not breathing normally.
2) Teach rescuers to place their hands in the centre of the chest, rather than to spend more time using the ‘rib margin’ method.
3) Give each rescue breath over 1 sec rather than 2 sec.
4) Use a ratio of compressions to ventilations of 30:2 for all adult victims of sudden cardiac arrest. Use this same ratio for children when attended by a lay rescuer.
5) For an adult victim, omit the initial 2 rescue breaths and give 30 compressions immediately after cardiac arrest is established."
More information can be found on the UK Resuscitation Council, look at http://www.resus.org.uk/pages/guide.htm

http://www.resus.org.uk/pages/bls.pdf this has the pdf of the new protocol and the section on drowning.

I have emailed BSAC for their Views and I am awaiting information from the RLSS UK (i'm a lifeguard trainer) and the Red Cross (trainer again).

When I have more information I will post it, if anyone wants to discuss it further please do so. It has implications for divers due to the general public not being trained in a method that is specificaly directed for us in a drowning situation.

Regards,

Mark

Joe Hesketh · November 28th, 2005, 08:36 PM

Very interesting and thanks for posting this, though I can see some potential conflicts in a diving sense.

The simplifications are all very well 'on the numbers' given that the average lay person is most likely going to have to give BLS on a victim in the street in cardiac arrest.

The current BSAC (and EFR) protocol on distinguishing action required for drowning or injury (1 min CPR then call EMS) as opposed to suspected heart attack (call EMS then start CPR) would in my view be complicated by adopting the new Resus guidelines. Given that the step as to when you call EMS is, in a lot of diving scenarios, irrelevant (there's usually someone available to make the call while someone else starts CPR), the current sequence is then identical (2 rescue breaths followed by CPR at 15:2 ratio). However if the guidlines are adopted, potentially there is now a marked differece which can only add to the complication - ie:

Suspected cardiac arrest: no initial rescue breaths then the new 30:2 ratio with shorter lung ventilation,

vs.

Drowning/Injury: now 5 initial rescue breaths, followed by CPR (though the guidelines don't say whether this is to be at the previous 15:2 ratio and/or whether more emphasis be placed on effective ventilations (ie over 2 seconds to decrease lung resistance).

Any other thoughts welcome.

Joe

majo · November 28th, 2005, 09:03 PM

In the new protocols near the bottom of the pdf, suggest that it will stay as 30:2 for drowning (all due to increast blood flow and pressure as I understand it, saw some of the data about experiements with pig hearts, way above my level), but will be modified.

I see it being

5 initial rescue breaths (to counter hypoxia)
CPR for 1 minuite
Call for Ambulance (if alone)
Continue CPR (30:2)

Mark

Joe Hesketh · November 28th, 2005, 09:48 PM

Quote: (Originally Posted by majo)

In the new protocols near the bottom of the pdf, suggest that it will stay as 30:2 for drowning

It doesn't really say, though by stating what the modifications to the standard sequence are for drowning I guess that means the ratio would stay as 30:2. In that case your predicted new sequence is likely.

November 28th, 2005, 04:46 PM	#1 (permalink)
majo(Offline) New Member Join Date: Nov 2005 Location: Littleport, Cambridgeshire, UK Posts: 16	Resuscitation All, For your information. the new 2005 resuscitation protocols are out today. I know you all will follow your training till you recieve new guidelines from your agencies etc but thought you would all like to have the information. The new protocols are written for the benefit of lay people and sudden cardiac arrest and not for drowning situations. There is a modification to the protocols for people involved with drowning ( it specifies lifeguards, such divers also fit that) For Adult the BLS is as follows: "The following changes in the BLS guidelines have been made to reflect the greater importance placed on chest compression, and to attempt to reduce the number and duration of pauses: 1) Make a diagnosis of cardiac arrest if a victim is unresponsive and not breathing normally. 2) Teach rescuers to place their hands in the centre of the chest, rather than to spend more time using the ‘rib margin’ method. 3) Give each rescue breath over 1 sec rather than 2 sec. 4) Use a ratio of compressions to ventilations of 30:2 for all adult victims of sudden cardiac arrest. Use this same ratio for children when attended by a lay rescuer. 5) For an adult victim, omit the initial 2 rescue breaths and give 30 compressions immediately after cardiac arrest is established." More information can be found on the UK Resuscitation Council, look at http://www.resus.org.uk/pages/guide.htm http://www.resus.org.uk/pages/bls.pdf this has the pdf of the new protocol and the section on drowning. I have emailed BSAC for their Views and I am awaiting information from the RLSS UK (i'm a lifeguard trainer) and the Red Cross (trainer again). When I have more information I will post it, if anyone wants to discuss it further please do so. It has implications for divers due to the general public not being trained in a method that is specificaly directed for us in a drowning situation. Regards, Mark Last edited by majo; November 28th, 2005 at 05:36 PM. Reason: Change Title

November 28th, 2005, 08:36 PM	#2 (permalink)
Joe Hesketh(Offline) New Member Join Date: Nov 2005 Location: London, UK Posts: 657	Very interesting and thanks for posting this, though I can see some potential conflicts in a diving sense. The simplifications are all very well 'on the numbers' given that the average lay person is most likely going to have to give BLS on a victim in the street in cardiac arrest. The current BSAC (and EFR) protocol on distinguishing action required for drowning or injury (1 min CPR then call EMS) as opposed to suspected heart attack (call EMS then start CPR) would in my view be complicated by adopting the new Resus guidelines. Given that the step as to when you call EMS is, in a lot of diving scenarios, irrelevant (there's usually someone available to make the call while someone else starts CPR), the current sequence is then identical (2 rescue breaths followed by CPR at 15:2 ratio). However if the guidlines are adopted, potentially there is now a marked differece which can only add to the complication - ie: Suspected cardiac arrest: no initial rescue breaths then the new 30:2 ratio with shorter lung ventilation, vs. Drowning/Injury: now 5 initial rescue breaths, followed by CPR (though the guidelines don't say whether this is to be at the previous 15:2 ratio and/or whether more emphasis be placed on effective ventilations (ie over 2 seconds to decrease lung resistance). Any other thoughts welcome. Joe

November 28th, 2005, 09:03 PM	#3 (permalink)
majo(Offline) New Member Join Date: Nov 2005 Location: Littleport, Cambridgeshire, UK Posts: 16	In the new protocols near the bottom of the pdf, suggest that it will stay as 30:2 for drowning (all due to increast blood flow and pressure as I understand it, saw some of the data about experiements with pig hearts, way above my level), but will be modified. I see it being 5 initial rescue breaths (to counter hypoxia) CPR for 1 minuite Call for Ambulance (if alone) Continue CPR (30:2) Mark

November 28th, 2005, 09:48 PM	#4 (permalink)
Joe Hesketh(Offline) New Member Join Date: Nov 2005 Location: London, UK Posts: 657	Quote: (Originally Posted by majo) In the new protocols near the bottom of the pdf, suggest that it will stay as 30:2 for drowning It doesn't really say, though by stating what the modifications to the standard sequence are for drowning I guess that means the ratio would stay as 30:2. In that case your predicted new sequence is likely.