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First Aid Update Clinic 2010 CPR Guidelines. Slide Agenda 2 1. Why change? AHA/ILCOR background 2. What has changed? (video demo/Push Hard Push Fast flyer)

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Presentation on theme: "First Aid Update Clinic 2010 CPR Guidelines. Slide Agenda 2 1. Why change? AHA/ILCOR background 2. What has changed? (video demo/Push Hard Push Fast flyer)"— Presentation transcript:

1 First Aid Update Clinic 2010 CPR Guidelines

2 Slide Agenda 2 1. Why change? AHA/ILCOR background 2. What has changed? (video demo/Push Hard Push Fast flyer) 3. Stations: CPR & AED, practice new standards & Must Sees 4. Changes to first aid & awards 5. Teaching first aid awards 6. Stations: First Aid, practice and review first aid test items 7. Workplace Safety & Insurance Board (WSIB) 8. Wrap up – administration, what's next?

3 Slide Clinic objective: To ensure all Instructors and Examiners understand (and can demonstrate) the new resuscitation protocols and the implications for planning, teaching and evaluating the Societys training programs. To ensure all Instructors and Examiners understand (and can demonstrate) the new resuscitation protocols and the implications for planning, teaching and evaluating the Societys training programs. 3

4 Slide Background to changes CPR & first aid science reviewed every 5 years by the American Heart Association (AHA) and the International Liaison Committee on Resuscitation (ILCOR) CPR & first aid science reviewed every 5 years by the American Heart Association (AHA) and the International Liaison Committee on Resuscitation (ILCOR) International panel of medical experts reviews new science and makes treatment recommendations International panel of medical experts reviews new science and makes treatment recommendations National first aid training agencies meet to interpret guidelines and recommendations for course delivery National first aid training agencies meet to interpret guidelines and recommendations for course delivery Provincial regulators review submitted course content from first aid training agencies to meet required legislation Provincial regulators review submitted course content from first aid training agencies to meet required legislation 4

5 Slide Changes at glance Summary of CPR steps Summary of CPR steps 5 YouTube CPR Update YouTube CPR Update

6 Slide What changed? 1. New CPR sequence for cardiac arrest victims 2. No change in CPR sequence for drowning victims 3. Compression only CPR: unwilling or untrained 4. Depth of compression: minimum depths 5. Choking procedures: back blows & abdominal thrusts 6. Jaw thrust: NLS lifeguards attempt jaw thrusts for spinals 7. AED: children and infants 6

7 Slide New CPR sequence CPR sequence: Check the scene, if unresponsive, activate EMS and get AED Check the scene, if unresponsive, activate EMS and get AED Airway check – open airway (head-tilt/chin-lift) Airway check – open airway (head-tilt/chin-lift) Breathing check – use visual cues like chest rise (5 sec.) Breathing check – use visual cues like chest rise (5 sec.) Circulation – perform 30 compressions if not breathing or gasping Circulation – perform 30 compressions if not breathing or gasping 7

8 Slide Depth of compressions Minimum depths of compressions have changed Minimum depths of compressions have changed Adult minimum of 5 cm Adult minimum of 5 cm Child minimum of 5 cm or (1/3 chest diameter) Child minimum of 5 cm or (1/3 chest diameter) Infant minimum of 4 cm or (1/3 chest diameter) Infant minimum of 4 cm or (1/3 chest diameter) Effective chest compressions Effective chest compressions Minimum depths help to ensure essential blood flow during CPR Minimum depths help to ensure essential blood flow during CPR Landmarking Landmarking Emphasis is on centre of chest between the nipples Emphasis is on centre of chest between the nipples 8

9 Slide Drowning victims NO change in rescue steps: NO change in rescue steps: Deliver 2 rescue breaths before starting chest compressions Deliver 2 rescue breaths before starting chest compressions If not successful, start CPR and use AED If not successful, start CPR and use AED Evidence shows drowning victims are in need of urgent replenishment of oxygen compared to a cardiac arrest victim and may respond to a few initial rescue breaths Evidence shows drowning victims are in need of urgent replenishment of oxygen compared to a cardiac arrest victim and may respond to a few initial rescue breaths 9

10 Slide Compression only CPR All trained rescuers should perform CPR with breaths and compressions. Gloves and a mask should be used All trained rescuers should perform CPR with breaths and compressions. Gloves and a mask should be used If an untrained rescuer is unwilling or unable, compression only CPR may be performed If an untrained rescuer is unwilling or unable, compression only CPR may be performed Studies have shown a combination of breaths and compressions is best for children or victims who have an underlying cause of cardiac arrest such as: Studies have shown a combination of breaths and compressions is best for children or victims who have an underlying cause of cardiac arrest such as: Drowning, trauma, drug overdose, etc. Drowning, trauma, drug overdose, etc. 10

11 Slide Choking procedures Alternating techniques Alternating techniques More than one technique may be needed in removing a severe obstruction. Use back blows, abdominal thrusts, chest thrusts More than one technique may be needed in removing a severe obstruction. Use back blows, abdominal thrusts, chest thrusts Conscious choking (adult, child) Conscious choking (adult, child) Perform alternating back blows and abdominal thrusts Perform alternating back blows and abdominal thrusts 5 back blows 5 back blows - Bend victim over, near parallel to the ground - Support victim with one arm across their chest - With other arm apply 5 back blows, between the shoulder blades 5 abdominal thrusts (chest thrusts for pregnant or obese) 5 abdominal thrusts (chest thrusts for pregnant or obese) 11

12 Slide Jaw thrust A technique used to open the airway: A technique used to open the airway: Used on spinal victims to help minimize head/neck movement Used on spinal victims to help minimize head/neck movement Grasp jaw on both sides of the face where it forms an angle close to the ears. Using both hands, move the jaw forward (upward) without tilting the head back. Grasp jaw on both sides of the face where it forms an angle close to the ears. Using both hands, move the jaw forward (upward) without tilting the head back. Used by NLS lifeguards (NLS curriculum) Used by NLS lifeguards (NLS curriculum) Instructed in NLS courses in management of spinal victims Instructed in NLS courses in management of spinal victims Jaw thrust is attempted and if unsuccessful use the head-tilt/chin-lift Jaw thrust is attempted and if unsuccessful use the head-tilt/chin-lift 12

13 Slide AED units Automated External Defibrillator (AED) Device that measures electrical activity of the heart. The use of an AED along with CPR can dramatically increase survival rates for sudden cardiac arrest Used to provide a lifesaving shock when needed A heart that is fibrillating or twitching cannot beat effectively. When a shock is provided the heart is defibrillated A heart that is fibrillating or twitching cannot beat effectively. When a shock is provided the heart is defibrillated Apply an AED as soon as possible to an unresponsive, non-breathing victim. Turn on unit and follow voice prompts. Apply an AED as soon as possible to an unresponsive, non-breathing victim. Turn on unit and follow voice prompts. 13

14 Slide AED pad placement 14 Adult: Adult: Follow directions for pad placement. One pad on upper right side of chest. Other pad to the lower left side of chest Follow directions for pad placement. One pad on upper right side of chest. Other pad to the lower left side of chest Children: Children: Look for a child key or switch or child pads Look for a child key or switch or child pads Adult pads may be used if no child pads Adult pads may be used if no child pads If child is small, place one pad on centre of chest, the other on back, so not touching If child is small, place one pad on centre of chest, the other on back, so not touching

15 Slide AED shock/no shock 15 Turn on AED. Unit will either advise a shock or no-shock Turn on AED. Unit will either advise a shock or no-shock If shock is advised: say aloud Stand Clear, push the shock button, continue CPR (2 min.) If shock is advised: say aloud Stand Clear, push the shock button, continue CPR (2 min.) If no shock is advised: continue CPR (2 min.) If no shock is advised: continue CPR (2 min.) After 2 min. the AED unit re- analyzes for shock or no shock After 2 min. the AED unit re- analyzes for shock or no shock Continue sequence of shock/no shock until victim recovers or EMS arrives. Continue sequence of shock/no shock until victim recovers or EMS arrives.

16 Slide AED use: infants Infants: guidelines have expanded the use of AEDs for infants BUT Infants: guidelines have expanded the use of AEDs for infants BUT AED use on infants is very uncommon AED use on infants is very uncommon A manual defibrillator, which is more advanced, is preferred versus an AED for use on an infant A manual defibrillator, which is more advanced, is preferred versus an AED for use on an infant Infants typically have healthy hearts, meaning a breathing problem is usually the cause of heart failure versus an underlying heart condition Infants typically have healthy hearts, meaning a breathing problem is usually the cause of heart failure versus an underlying heart condition AED training will focus on adult and child use AED training will focus on adult and child use The use of an AED on infants is knowledge- based and not evaluated The use of an AED on infants is knowledge- based and not evaluated 16

17 Slide Stations: CPR & AED Practice stations: NEW test items & Must Sees Practice stations: NEW test items & Must Sees Station 1: One-rescuer CPR: adult, child & infant Station 1: One-rescuer CPR: adult, child & infant Station 2: Two-rescuer CPR & AED: adult & child Station 2: Two-rescuer CPR & AED: adult & child Station 3: Choking, conscious to unconscious Station 3: Choking, conscious to unconscious Questions & answers Questions & answers Group feedback, comments Group feedback, comments 17

18 Slide Changes to first aid awards Emergency First Aid (8 hrs.) Emergency First Aid (8 hrs.) Test item 11c external bleeding: Test item 11c external bleeding: - Elevation removed NEW Test item 12 Wounds: NEW Test item 12 Wounds: - 12a: Abdominal injury - 12b: Burn injury - 12c: Facial injury One-rescuer CPR: test item 6 One-rescuer CPR: test item 6 - with AED Protocol (adult/child) Standard First Aid (16 hrs.) Standard First Aid (16 hrs.) Two-rescuer CPR: test item 1 Two-rescuer CPR: test item 1 - with AED Protocol (adult/child) 18 AED protocol Must See items in: AED protocol Must See items in: CPR A-B-C CPR A-B-C CPR-HCP CPR-HCP EFA EFA SFA SFA

19 Slide Changes to first aid Bleeding: Bleeding: Rest and direct pressure. Elevation has been removed as a Must See. Evidence shows direct pressure is the most effective means to initially stop bleeding Rest and direct pressure. Elevation has been removed as a Must See. Evidence shows direct pressure is the most effective means to initially stop bleeding Auto-injector Auto-injector New EpiPen. Pull off blue cap and apply to outer thigh for 10 seconds. After use, the auto-injector will extend over the needle tip to further prevent injury when handled New EpiPen. Pull off blue cap and apply to outer thigh for 10 seconds. After use, the auto-injector will extend over the needle tip to further prevent injury when handled 19

20 Slide Changes to first aid Heat-related emergencies: Sport drinks (electrolyte drinks) can be used for treatment of heat exhaustion Sport drinks (electrolyte drinks) can be used for treatment of heat exhaustion For victims with suspected heat stroke, immersion in cold water is preferable if possible For victims with suspected heat stroke, immersion in cold water is preferable if possible Angina/heart attack: Continued emphasis on use of ASA. The use of ASA was referenced in previous guidelines and is found in Canadian First Aid Manual, p. 34 Continued emphasis on use of ASA. The use of ASA was referenced in previous guidelines and is found in Canadian First Aid Manual, p. 34 If victim has no heart medication, suggest taking ASA (1 regular tablet or 2 child low- dose tablets). Ask if they have ASA allergy, or advised not to take ASA from a doctor. If victim has no heart medication, suggest taking ASA (1 regular tablet or 2 child low- dose tablets). Ask if they have ASA allergy, or advised not to take ASA from a doctor. 20

21 Slide CPR-HCP: changes CPR-HCP: health care providers (HCP) who frequently respond to emergencies CPR-HCP: health care providers (HCP) who frequently respond to emergencies Few changes overall: Few changes overall: Team response is emphasized, allowing responders to delegate roles as team members arrive on the scene Team response is emphasized, allowing responders to delegate roles as team members arrive on the scene Use of AED on infants permissible, manual defibrillator preferred Use of AED on infants permissible, manual defibrillator preferred Cricoid pressure removed as knowledge item. A technique that is difficult to teach and apply Cricoid pressure removed as knowledge item. A technique that is difficult to teach and apply 21

22 Slide Agenda – whats next 22 1. 1. Why change? AHA/ILCOR background 2. 2. What has changed? (video demo/Push Hard Push Fast flyer) 3. 3. Stations: CPR & AED 4. 4. Changes to first aid awards 5. Teaching first aid awards 6. Stations: first aid practice and review 7. Workplace Safety & Insurance Board (WSIB) 8. Wrap up – administration, what's next?

23 Slide Teaching first aid Brainstorm: how do the new standards and content affect how you plan and teach your first aid courses. Consider any of the following: Lesson planning, course length, combined courses Lesson planning, course length, combined courses Lifesaving Instructor schools (assignments, evaluation, etc.) Lifesaving Instructor schools (assignments, evaluation, etc.) What new resources do you need What new resources do you need List minimum first aid equipment for teaching EFA or SFA List minimum first aid equipment for teaching EFA or SFA Evaluation criteria, what has been added Evaluation criteria, what has been added Differences among revised first aid test sheets Differences among revised first aid test sheets Additional resources: First Aid Instructor CD (updated) First Aid Instructor CD (updated) Bronze Medals Instructor CD (new) Bronze Medals Instructor CD (new) 23

24 Slide First aid stations Practice stations: (review test items & Must Sees) with reference to the Canadian First Aid Manual and First Aid Award Guide Practice stations: (review test items & Must Sees) with reference to the Canadian First Aid Manual and First Aid Award Guide Station 1: External bleeding EFA item 11c and Facial injury item 12c Station 1: External bleeding EFA item 11c and Facial injury item 12c Station 2: Bone or joint injury SFA item 4 Station 2: Bone or joint injury SFA item 4 Station 3: Assessment item 5 and Unconscious victim EFA item 12 Station 3: Assessment item 5 and Unconscious victim EFA item 12 Questions & answers Questions & answers Group feedback, comments Group feedback, comments 24

25 Slide WSIB: overview Workplace Safety & Insurance Board (WSIB) www.wsib.on.ca Workplace Safety & Insurance Board (WSIB) www.wsib.on.cawww.wsib.on.ca WSIB (Ontario government, Ministry of Labour) tasked to reduce workplace injuries and to raise awareness of workplace safety. WSIB (Ontario government, Ministry of Labour) tasked to reduce workplace injuries and to raise awareness of workplace safety. Employers pay WSIB (required by law) to manage claims during a workplace accident. WSIB helps employees with their medical needs to get back to work. In return employers are not sued. Employers pay WSIB (required by law) to manage claims during a workplace accident. WSIB helps employees with their medical needs to get back to work. In return employers are not sued. WSIB is empowered with enforcement to ensure compliance for safe work environments for employees. First aid training is a requirement for worksites. Regulation 1101. WSIB is empowered with enforcement to ensure compliance for safe work environments for employees. First aid training is a requirement for worksites. Regulation 1101. Enforcement of EFA and SFA training criteria falls under WSIB. All course providers, approved by WSIB, must follow training criteria such as course content, minimum times, etc. Enforcement of EFA and SFA training criteria falls under WSIB. All course providers, approved by WSIB, must follow training criteria such as course content, minimum times, etc. 25

26 Slide Summary: lets review New CPR sequence New CPR sequence Drowning victims: 2 breaths Drowning victims: 2 breaths Compression-only CPR knowledge Compression-only CPR knowledge AED use on infants knowledge AED use on infants knowledge Jaw thrusts (NLS lifeguards) Jaw thrusts (NLS lifeguards) Choking procedures (5&5) Choking procedures (5&5) Minimum depths (5cm, 4cm, 1/3) Minimum depths (5cm, 4cm, 1/3) New Must See: AED protocol New Must See: AED protocol 26 New test items in EFA & SFA New test items in EFA & SFA Elevation removed from (RED) Elevation removed from (RED) New auto-injector (EpiPen) New auto-injector (EpiPen) Heat-related injury Heat-related injury ASA use ASA use Teaching First Aid Teaching First Aid First Aid Stations First Aid Stations WSIB overview

27 Slide Wrap up - administration Complete Aquatic Master Sheet Complete Aquatic Master Sheet First Aid Update, tracked on find a member First Aid Update, tracked on find a member Instructors may teach new standards after successfully completing update Instructors may teach new standards after successfully completing update Check with employer when new content is implemented at worksite Check with employer when new content is implemented at worksite 3 credits earned for successful completion 3 credits earned for successful completion Upon recertifying your Lifesaving Instructor an Emergency First Aid Instructor award will also be issued ($7.00) Upon recertifying your Lifesaving Instructor an Emergency First Aid Instructor award will also be issued ($7.00) Resources at Societys website: www.lifesavingsociety.com Resources at Societys website: www.lifesavingsociety.com Revised first aid test items and test sheets Revised first aid test items and test sheets PowerPoint slides – First Aid Update PowerPoint slides – First Aid Update Notes for conductors – First Aid Update Notes for conductors – First Aid Update Push Hard Push Fast – flyer Push Hard Push Fast – flyer Lifesaving Society YouTube channel Lifesaving Society YouTube channel 27

28 Slide Wrap up – clinic conductors Conductors: First Aid Update Conductors: First Aid Update After successful completion, the following examiners and trainers may also deliver the First Aid Update Provincial Trainers Provincial Trainers First Aid Instructor Trainers First Aid Instructor Trainers NLS Instructor Trainers NLS Instructor Trainers Lifesaving Instructor Trainers Lifesaving Instructor Trainers First Aid Examiners First Aid Examiners NLS Examiners NLS Examiners 28

29 Slide Wrap up 29 Final questions, comments? Final questions, comments?

30 First Aid Update Clinic 2010 CPR Guidelines Thank you & goodbye


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