Overview
Why
new CPR Guidelines.
 2005 CPR Guideline changes.
Automatic External Defibrillation.
Types of AEDs, and local
suppliers.
Why new Guidelines?!!!

The new CPR and AED guidelines
are the result of years of study and
debate carried out by ILCOR, the
International Liaison Committee on
Resuscitation.
 ILCOR was formed in 1992 to provide
a forum for liaison between principal
resuscitation organizations worldwide.
Why new Guidelines?!!!

ILCOR comprises representative organizations
from the USA, Europe, Australia, New Zealand,
South Africa, …and the Heart and Stroke
Foundation of Canada.
 The objectives of ILCOR include; providing a
forum for discussion of resuscitation issues, and
fostering scientific research and reviewing
scientific data.
 Therefore, new CPR guidelines are not arbitrary
creations of the Red Cross, St. John Ambulance
etc.
Why new Guidelines?!!!

ILCOR produced the first set of international
CPR guidelines in 2000. With an evidence
based review of resuscitation science, these
CPR guidelines were updated in 2005. We will
see a fresh review every five years.
 With this process, CPR and Emergency Cardiac
Care is standardized across a large part of the
world, and amongst training agencies such as
the Red Cross, St. John Ambulance, Heart and
Stroke, etc.
What does this mean for you??
 New
CPR levels for
employers/agencies.
 New Guidelines for responders.
CPR Levels…what should you ask
for ???
 Level A-
For both lay rescuers and the
workplace, it covers one rescuer CPR and
choking maneuvers for adults only. (Not
suited to Fire Departments).
 Level B- For families, child care
workers, etc. It covers one rescuer CPR
and choking maneuvers for adults,
children and infants, and includes an
introduction to AED.
CPR Levels…what should you ask
for ???

Level C- For police, firefighters or other first
responders who are trained to the Standard First
Aid level or lower. It covers adult, child and infant
CPR and choking maneuvers, two rescuer CPR,
and an introduction to AEDs.
 Level HCP- For police, firefighters or other first
responders who are trained to the First
Responder level or higher. It covers everything
in Level C, plus incorporates pulse checks, use
of bag-valve-mask, and jaw thrust.
New CPR Guideline Changes…
Specifics

The focus is on simplification, and better
retention of the skills.
 For those taking Level A,B or C CPR, the
rescuer begins CPR if the victim is unconscious,
not moving and not breathing. (No pulse check!).
Those trained to the “First Responder” level or
above will still check for a pulse.
 Increased emphasis on the process of CPR:
“push hard and push fast” at a rate of 100
compressions per/min.
 Allow full chest recoil.
New CPR Guideline Changes…
Specifics
 No
land marking on the chest. Simply
place the heel of one hand in the “middle
of the chest”.
 Single rescuers of an infant, child and
adult will use a compression to ventilation
ratio of 30:2
 If you find an unresponsive adult and you
are alone, leave them to go call 911. If you
find an unresponsive child or infant, do five
cycles (two minutes) of CPR first before
going to call 911.
New CPR Guideline Changes…
Specifics

Those trained to a Standard First aid level or
below will use a full head tilt-chin lift to open the
airway, even with possible spinal injuries. The
jaw thrust is reserved for those trained as First
Responders and above.
 Actively suggest to a person suspected of
having a heart attack that they take ASA
(Asprin).
 Increased emphasis on how to use an automatic
External Defibrillator (AED) if available.
Importance of Automatic External
Defibrillation

In Canada, 35,000 to 45,000 people die of
sudden cardiac arrest each year.
 A comprehensive US Fire Administration study
showed the leading cause of line of duty death
in firefighters was sudden cardiac arrest (44%).
 Prompt CPR and early access to defibrillation in
the pre-hospital setting is the treatment of choice
for sudden cardiac arrest.
 For every one minute delay in defibrillation,
survival rate of a cardiac arrest victim decreases
7-10%. After 12 minutes, the survival rate of
adults is less than 5%.
What is an AED
 An AED
is a device containing
sophisticated electronics used to identify
cardiac rhythms, and to deliver a shock to
correct abnormal electrical activity in the
heart. An AED will only advise the
individual to deliver a shock if the heart is
in a rhythm which can be corrected by
defibrillation.
Recommendation for AED Use
 The
Canadian Heart and Stroke
Foundation, and ILCOR, have
recommended the use of AEDs by trained
lay, and professional responders, to
increase survival rates in patients with
cardiac arrest.
 The Foundation urges anyone in close
contact with those at high risk of cardiac
arrest, such as firefighters, to become
trained in the use of AEDs.
Just how easy is it to Use ?
After the AED arrives…
 Open and turn on the AED.
 Remove clothing or objects from the person’s
chest
 Ensure the chest is dry and free of hair so the
pads can stick.
 Follow the diagrams for pad placement on the
person.
 Follow the automated prompts.
 If the AED prompts you to give a shock, stand
clear and say “I’m clear, your clear, everbody’s
clear” and press the shock button.
New Technology in AEDs
 Defirillators
today employ biphasic
waveforms. This means instead of sending
electrical current through the heart in only
one direction (monophasic), the current
now also reverses and passes back
through the heart a second time.
 Biphasic devices achieve higher first
shock success rates than monophasic
AEDS.
 Biphasice AEDs do this using less energy
and less current, ultimately better for the
heart.
AED Program
If you are going to place a defibrillator in
service, you should have a maintenance
program in place. Such a program
includes:
 Routine readiness checks on the batteries
and pads, and self tests.
 Scheduled equipment maintenance.
 Regular training of likely users.
 Performance measures (track outcomes,
time to shock,etc.)
Factors in purchasing an AED







Cost of the AED.
Cost of the AED trainer which matches your
AED.
Cost of disposable pads.
Availability of a replacement unit in a timely
fashion.
Customer service (locally available?, 24/7??)
Is the unit easy to use?
Compatibility with surrounding departments
and/or local EMS.
Factors in purchasing an AED
Hint, hint….
Ambulance
Services branch is
rumored to have decided to make
a group purchase of the Philips
Heart Start MRx for every
ambulance in the province.
Local Suppliers Carrying AEDs
 Green
Star Medical carries the Philips
HeartStart FRx and HeartStart FR2+.
 Brent Fairweather (Laerdal Dealer) also
sells Philips products.
 Safety Source Ltd. carries ZOLL AED
Plus.
 VMC carries Medtronic LIFEPAK 1000.
All AED models function in a very similar
manner
Ball Park Prices
Recently obtained quotes on one
AED…
 Medtronic LIFEPAK 1000
$3600.00
 ZOLL AED Plus Defib
$1800.00
 Philips HeartStart FRx
$2475.00
 Philips HeartStart FR2+ $4341.00
Thank you for your time!
AED DEMO