Summary of First 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 Click on the “expand” button to enlarge the slides Click on the “files” button to download the presentation This presentation will be available on demand and as a podcast for the next 3 months

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