First Aid - CPR and the current protocols

[Shakey]

Have noticed that a previous post with regards to first aid and CPR has attracted many views and comments, I thought I'd post the current 'official' procedures for dealing with a casualty.

Before you read this, the usual legal disclaimers apply. This is for informational purposes only. You really should undertake a first aid course, I'm only describing the order of the procedures to remind those already proficient, not how to do the procedures. The protocols for CPR changed again a couple of years back, this is the current version. I hate the fact I have to cover my back when offering information that might save a life, but that's life nowadays. It's not my fault if this doesn't work.

The following is taken from a handbook approved by the Health and Safety Executive revised May 2004.

++++++++++++++++++++++++++++++++

If the casualty is not breathing or is only making occasional gasps or weak attempts at breathing ASSESS THE CAUSE then follow the basic life support action plan:

ALCOHOL / DRUGS / DROWNING / INFANT / CHILD / CHOKING / TRAUMA.

Give two rescue breaths

Check for signs of circulation (eg. movement, coughing, twitching)

If signs of circulation present continue artificial ventilation (AV). After one minute go for help. Upon return recheck airway and continue AV checking for circulation every minute. If circulation has stopped commence CPR.

If signs of circulation not present commence Artificial Ventilation and External Chest Compressions (aka CPR) for ONE MINUTE. Then go for help. Upon return re-check airway and continue CPR until help arrives.



IF YOU SUSPECT HEART FAILURE

*** GO FOR HELP ***

Upon return, recheck airway, give two rescue breaths, check for signs of circulation.

If circulation present continue AV and check circulation every minute.

If no circulation commence CPR until signs of life or help arrives.

All this looks a lot better and easier to understand when depicted in a flow chart, if you're serious about first aid then you need to read an up to date book on the subject. Note that first aiders aren't supposed to try to find the pulse anymore!

Hope you can remember this but never have to use it.

 

[Peppermint]

Re: The go for help thing

is the bit that people on our course couldn't get their head around. It seemed a bit of a cop out to many but it does make sense. Trauma cases do get worse/weaker as time goes on and need more resources. So a quick fix and then get the pro's does work for me.

For yotties this needs to read *Call for help* as the *going* might be tricky

All of the usual disclaimers apply.

 

[[3889]]

Re: The go for help thing

This has always been a bone of contention.When I taught 1st aid the policy was 1 set of rescue breaths and compressions then get help even with cardiac arrest.
CPR will never start a heart but will oxygenate a casualty and possibly prevent brain damage.Cases where a casualty has revived after heart compression are a result of failure to detect a weak pulse. If you are on a mountain top a 2 hour trip for asistance is useless, better to give cpr and hope someone comes along. On a boat with vhf a mayday is the best option. Although Shakey is right in what the manual says I was advised by an A&E consultant that a judgement has to be made for the circumstances.

 

[dralex]

Re: The go for help thing

All good advice. Nice one Shakey. I think Hianddry is right about using some commone sense in each situation regarding going for help. CPR will only slow the decline resulting from lack of oxygen, not halt it or reverse it. CPR therefore has a finite time for which it is useful ie until the underlying physiology has gone beyond the point of salvage. I was lucky in my recent esperience because the primary cause was respiratory failure with a strong heart which was reluctant to stop.

The key thing is to have a bit of training, then if confronted by a situation, have a go- there's nothing to lose.

 

[wooslehunter]

Re: The go for help thing

One thing that seems to change regularly is the rates.

The current thinking is 15:2 - 15 compressions and then 2 breaths. Also I'm glad to see that there is now a check for "signs of circulation" rather than a pulse check. Many people fail to get a pulse from a person that's fully alive. BUT if you do start CC then be prepared to continue until relieved or told to stop by a competant authority.

 

[Peppermint]

Re: There\'s the nub

Have a go. I'm told that lots of capable 1st aiders "bottle out" when it comes to the crunch. It's a shock when you realise it's time to use the training isn't it?

 

[aitchw]

Re: There\'s the nub

There's always an element of fear of getting it wrong as well. Lack of self-confidence could be a major reason why they 'bottle out'.

 

[Benbow]

Re: There\'s the nub

IMHE the value of real life experience is extraordinary. Not sure how we can go about acquiring this experience, but there is no doubt that the first time I was faced with a medical emergency which I knew in theory how to handle, I was totally useless. It is a real shock when you are faced with a totally unexpected and scary situation. The 2nd time I was able to do something useful, but even then looking back it is surprising how numb my brain was, and I actually cannot remember periods of time during the horribly prolonged time I was the only person able to help a seriously injured pedestrian, and a strangely quiet driver. For all my 1st aid training I was able to do only 3 things - call for help, keep them still & comfortable and watch their breathing & circulation. There hasn't been a 3rd time of similar seriousness, but I hope to be more useful if there is a next time.

 

[dralex]

Re: There\'s the nub

SO you did everything right.