You may not be aware, but every 5 years the European Resuscitation Council (ERC), the Resuscitation Council (UK) and the International Liaison Committee on Resuscitation (ILCOR) review the latest research and evidence in resuscitation, and then release updated guidelines. In addition to this, for the first time in history, this year the European Resuscitation Council (ERC) have also produced guidelines for first aiders. The guidelines and new changes can sometimes be a little confusing so we have put it into plain English for you.
The good news is that you don’t need to do anything different to what we have already taught you, you will be updated on the changes at your next refresher course. If you do have any concerns though, we would be more than happy to deliver an annual update session to your team or as always, we are on the end of the phone!!!
Please read below for a no jargon explanation of the recent changes….
Our awarding body, Nuco Training Ltd has informed us of the following changes / updates….
What is First Aid
Priorities of First Aid now includes Alleviate suffering
There must be more emphasis on asking the bystander to go and find and bring an AED back to you if one is available. However, if you are on your own, then you must call the emergency services yourself. Stay with the casualty when making this call if possible. Activate the speaker function on the phone to aid communication with the ambulance service and commence CPR without delay.
The ‘Shout for help’ has been removed from the Primary Survey. However, both ourselves and Nuco Training Ltd believe you should still shout for help if you are on your own.
Immediately following a cardiac arrest blood flow to the brain is reduced to virtually zero, which may cause seizure-like episodes that may be confused with epilepsy. You should be suspicious of cardiac arrest with any casualty that presents seizure like symptoms and carefully assess whether they are breathing normally.
Heart attack treatment
For heart attack management, the First Aider must be able to assist a casualty in taking up to 150 – 300 mg of chewable aspirin and to advise them to chew it rather than swallow it whole, providing you are confident that the casualty is not allergic to it. As always, you aren’t allowed to keep drugs of any kind in your first aid kit. If you have members of staff with known heart conditions, its advisable to have aspirin on site somewhere.
The sternum should not be pressed more than 6cms and you should allow the chest to recoil completely after each compression, do not lean on the chest. It is rare for CPR alone to restart the heart. Unless you are certain the casualty has recovered, continue with CPR. Signs the casualty has recovered include: Waking up, Moving, Opening eyes, and normal breathing. Be prepared to restart CPR immediately if the casualty deteriorates.
Do not interrupt compressions by more than 10 seconds to deliver two breaths. Return your hands without delay to the correct position on the sternum and give a further 30 chest compressions.
If you have access to an AED
As soon as the AED arrives, switch it on and attach the electrode pads on the casualty’s chest. Follow the voice prompts. If more than one rescuer is present, CPR should be continued whilst the electrode pads are being attached to the chest.
Chain of survival
Early Defibrillation within 3–5 minutes of cardiac arrest can produce survival rates as high as 50–70%. Each minute of delay to defibrillation reduces the probability of survival to hospital discharge by 10%.
Sprains and Strains
We will be replacing RICE with PRICE
- Protect the injured area from further injury by using a support or (in the case of an ankle injury) wearing shoes that enclose and support the feet, such as lace-ups
- Rest by stopping the activity that caused the injury and rest the injured joint or muscle. Avoid activity for the first 48 to 72 hours after the injury was afflicted
- Ice for the first 48 to 72 hours after the injury, apply ice wrapped in a damp towel to the injured area for 15 to 20 minutes every two to three hours during the day. Do not leave the ice on whilst sleeping, and do not allow the ice to touch the skin directly, because it could cause a cold burn.
- Compress or bandage the injured area to limit any swelling and movement that could damage it further. Use a simple elastic bandage or elasticated tubular bandage. It should be wrapped snuggly around the affected area, but not so tightly that it restricts blood flow. Remove the bandage before going to sleep.
- Elevate by keeping the injured area raised and supported to help reduce swelling
Head and spinal injuries
Monitoring now includes Responsiveness but excludes a Pulse check. We are now teaching that holding a cold compress against the head injury (Concussion) is acceptable.
Adrenaline is the gold standard in the treatment of anaphylaxis, and its administration should not be delayed. In a First Aid situation, Adrenalin will normally be delivered by an auto-injector. If available, an injection of adrenaline should be given as soon as possible. If after 5 -15 minutes the casualty still feels unwell, a second injection should be given. This should be given in the opposite thigh. A second dose may also be required if the symptoms reoccur. When treating a potential anaphylaxis casualty, it should be noted that there are NO contraindications for the use of adrenaline.
If you have a known diabetic, offer them 15-20gms of glucose in the form of glucose tablets otherwise stick to the usual sugary drink and food. Again, these shouldn’t be kept in the first aid kit!!!