WebExpo Presentation on the Guideline Changes

Summary of
First Aid/CPR/AED
Guidelines Changes
David Markenson, MD, FAAP, EMT-P
Jonathan Epstein, MEMS, NREMT-P
March 3, 2011
• 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
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
– Rescue breaths remain
important for infants and
children and others with
respiratory emergencies
• 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
– 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
• Networking Lounge: 2 pm ET
• Experts: Dr. Eunice Singletary and Dr. Andrew MacPherson