Updated CPR and First Aid Guidelines

On October 15, 2015 the International Liaison Committee on Resuscitation (ILCOR) released updated CPR and First Aid Guidelines. To comply with these new recommendations and ILCOR, First Aid instructors must complete an instructor update course by the end of 2016. instructors can continue to teach and certify using the 2010 materials until December 31, 2016.

On January 1, 2017, any instructor or instructor trainer who has not yet completed the class covering these changes in treatment recommendations will not be authorized to issue ASHI First Aid certification cards.

Evergreen Safety Council has a couple of these classes already slated for February 11 and March 21, in Kirkland, WA.

Here is a brief overview of a few of these changes that have been incorporated in the ASHI/HSI training:

• In the area of education they found that the use of a CPR feedback device (like the Loop) is very effective for improving CPR skills and if one is not available, use a device such as a metronome to improve adherence to recommendations for chest compressions (which is now 100 to 120 per minute).
  
• Findings show that most CPR compressions are too shallow and it is more effective to compress deeper rather than shallower. The recommendation is a depth of at least 2 inches and not deeper than 2.4 inches.
  
• Pediatric CPR compression rates are also 100 to 120 per minute and they are recommending deeper compressions of at least 1/3 the anterior-posterior diameter of the chest for those aged one month to the onset of puberty.
  
• On burns it is now recommended that thermal burns are cooled with cool or cold potable water for at least 10 minutes. If water is not available a clean cool compress can be used to loosely cover the burn. (Care should be taken to monitor for hypothermia when cooling large burns.) Also with burns it is NOT recommended to use natural remedies, however if you are in a wilderness setting honey could be used on a burn.
  
• They are now recommending that following a dental avulsion, it is essential to seek rapid assistance with  re-implantation of the tooth. if you cannot get to a dentist soon put the tooth in milk or clean water if milk is not available.
  
• The anaphylaxis emergencies have been updated to state that if a person with anaphylaxis does not respond to the initial does of epinephrine and the arrival of EMS exceeds 5 to 10 minutes a repeat dose of epinephrine may be considered.
  
• There have been a couple of new additions to the concussion area which are if:
  
  
  • Any person with a head injury that has resulted in a change in level of consciousness or has progressive development of signs or symptoms of a concussion should be evaluated by a medical professional as soon as possible, and
    
  • Using any mechanical machinery, driving, cycling, or continuing to participate in sports after a head injury should be deferred until they are assessed by a medical professional.
    
  • Bleeding control has also been updated to include training in tourniquets. According to the guidelines because the rate of complications is low and the rate of hemostasis is high, first aid providers may consider the use of a tourniquet when standard first aid hemorrhage control does not control severe external limb bleeding. It is reasonable for first aid providers to be trained in the proper application of tourniquets, both manufactured and improvised. In addition, hemostatic dressings may be considered by first aid providers when standard bleeding control is not effective for severe or life threatening bleeding.

Remember that the new science and treatment recommendations do not imply that emergency care or instruction involving the use of earlier science and 2010 treatment recommendation is unsafe.

Contributed by Eric Tofte, Director of Training Evergreen Safety Council