CPR Protocol

[Twocubdad]

Saw an interesting video on Continuous Chest Compression CPR.

http://ahsc.arizona.edu/node/730

 

Sent this to my troop first aid instructor (a RN). She said she has been trained on this protocol for months now.

 

Is there such thing as an "official BSA" version of CPR? If this is the latest/greatest but BSA takes time to update the literature, is there a problem teaching this method to Scouts?

 

There is no certification for this protocol (which is one of its advantages) so it wouldn't be appropriate for thing like BSA lifeguard where certification is required. But is it okay for First Class or First Aid MB requirements?

 

[Roadkill Patrol]

I heard during my re-cert class in April that the chest compression only is for the layman (non-certified) and is better than doing nothing. By focusing on chest compressions, ordinary people don't have to remember the ratios of chest compressions to breaths.

 

I am certified for CPR for the Health Professional which is different than normal CPR certification. There are different certifications for different groups.

 

I would think that for any requirement where it states "demonstrate CPR", it should be both the chest compressions and breathing.

[Stosh]

I have current American Heart Association certification and was surprised that it was compression only.

 

I used to be a AHA certified instructor and what is being taught the public today is far different than it was 20-30 years ago. I was also surprised to "learn" that compressions started before checking to see if the person is breathing and/or has a pulse. I guess I'm not really ready to break a person's ribs unless it is required.

 

CPR is no longer viewed as Cardio-Pulimnary Recessitation, but a technique for life-saving technique authorized by either the American Red Cross or American Heart Association. If they teaching no breaths, then the demonstrations for the requirement need to be exactly what is accepted by either of these two agencies. No more, no less. When it comes to justification for your actions, what is taught is the only criteria law enforcement, insurance companies and the courts recognize. What one thinks or believes is irrelevant.

 

Stosh

[5yearscouter]

what I understand is that the Continuous Chest Compressions has shown higher success rates than the regular CPR. In cases of drowning and with children they still recommend the traditional CPR to get more oxygen into their systems.

 

Interestingly enough My neighbor/friend who is a Cardiac care Nurse Practitioner taught my oldest's den his Readyman in 2006 or 7 and taught them that if in doubt do the CCC, but this is how to do the CPR as well. She had just been to a big conference on the benefits and comparision of CPR and CCC and came away with the info that the Continuous Chest Compressions should be the standard that is taught for the highest level of success.

 

Not too long after that, I saw in the paper that the local fire dept uses on the CCC with higher success rates as well.

 

I think BSA needs to reevaluate the first class req and first aid MB and include both CPR techniques and CCC with info on when to use each. like I said with infants and childrens and cases of drowning I was told CPR was still preferred, but that may have also changed.

 

[Eagle92]

May I interject ?

 

I'm a current AHA Basic Life Support Instructor, so I teach both the healthcare pro version, Basic Life Support,, and the non- healthcare pro versions. I say non-healthcare pro versions because there are several version of CPR and there are differences. And that is where the confusion is coming from. I can't go into details now, but I'll post more tonite. But suffice to say depending upon what type of instruction and certification, depends upon the number of compressions, breaths, and how to go about it.

 

Trust me you, if think it's hard keeping the new procedures straight for your cert, try having to know ALL the different variations of CPR for the different specialties.

 

Two things to remember: CIRCULATION, AIRWAYS, BREATHING and 30 COMPRESSIONS TO 2 BREATHS FOR 1 MAN CPR!

 

More later.

 

[Eagle92]

Ok a few quick comments. And all caps and bolds are emphasis

 

1) Full fledged CPR with 30 compressions to 2 breaths IS the preferred method.

 

2) IF you do not have a barrier/mask to do CPR, AND you are uncomfortable doing mouth to mouth on the victim AND it is an adult, Compression Only CPR is better than nothing.

 

HOWEVER if it is a YOUTH, you need to do mouth to mouth as it is more likely respiratory and not cardiac.

 

WHAT IS INTERESTING is that some of the research showed that for drownings you still want to do the old 15:2 compression to breaths ratio AND do mouth to mouth no matter what. BUT currently that is not taught. Maybe next time.

 

More later.

[Cambridgeskip]

My side of the Atlantic the British Heart Foundation is plugging the continuous compressions route. The reason being mostly that a lot of men in particular are out off trying anything by the thought of giving the breaths hence BHF reckon that something is better than nothing.

 

There is also the point that doing the breaths wrong can result in the diaphragm being popped out the wrong way which unless you are already on the operating table is basically instant death. But the odds of actually doing that are miniscule.

 

Over all though it is better to do the compressions and breaths at a rate of 30:2 (although with a child you start with the breaths and with an adult start with the compressions)

[Eagle92]

Ok back and have a bit of time. Bit of irony, I need to go to bed early 'cause I have to go to work early and set up for... Basic Life Support Class.

 

 

OK, here's the AHA deal. there are three types of courses: Community, WorkPLACE, and healthcare provider.

 

COMMUNITY HAS 3 types of classes and does not give you a certification. It's basically for those who just want to know CPR. I hate to say this, but although I can teach it, I haven't and haven't even looked at the new course books. Again no cards are issued, and I do not know if testing is involved.

 

First type is Family & Friends CPR and it covers Compression CPR, Adult CPR and Infant/Child CPR, and AED use. Again it short, sweet, and too the point.

 

Second is the Infant CPR Anytime and as the name suggests, it deals with only infants. SO COMPRESSION ONLY CPR IS NOT AN OPTION! ( again all caps and bold are emphasis, not shouting).

 

Last is Family & Friends CPR Anytime , and it teaches ADULT Compression only CPR, Child CPR, choking, and AED use.

 

If scouts needed an intro to CPR. The Friends and Family CPR is one I'd recommend since it covers most situations. Me personally I would not do the community stuff because A)I do not have easy access to the materials and B) one of the WORKPLACE ones is a better for for Scouts IMHO.

 

Now WORKPLACE has 5 courses: Heartsaver CPR AED, Heartsaver First Aid, Heartsaver First Aid CPR AED, Heartsaver Pediatric First Aid, and Heartsaver Blood Born Pathogens. These courses provide certification and if memory serves a written and skill test is required. Sorry I only teach 2 of these classes a year, and both classes are in the same week. Next time I teach one of these will be next week, so it has been a while.

 

AN ASIDE: if anyoneis going for BSA LIfeguard, NONE OF THESE CLASSES COUNT as BSA Lifeguards need the Health Care Provider level courses. (again emphasis0.

 

Heartsaver CPR AED, covers adult and infant child CPR and AED use. It goes over ADULT Compression Only CPR, standard 30 compression : 2 Breaths Adult CPR, and 30:2 Infant/Child CPR. While it does provide certification, again it does not count towards BSA Lifeguard.

 

Heartsaver First Aid only covers first aid situations, no CPR/AED Use. And if memory serves, it also handles pediatric emergencies.

 

Heartsaver First Aid CPR AED combines the two courses above. THIS IS THE COURSE THAT I RECOMMEND FOR SCOUTS (emphasis) as it essentially covers First Aid MB requirements. HOWEVER me as a First Aid MBC and NOT as an AHA Instructor, I would spend a lot more time, probably double to triple depending upon group size, the amount of time that this course requires so that the scouts have a lot more hands on expereince than the course calls for.

 

The last two Heartsaver Pediatric First Aid, and Heartsaver Blood Born Pathogens are ones I don't teach so I really don't know much about.

 

Lastly is the Healthcare Provider set of which I teach Basic Life Support. THIS IS THE CPR CLASS BSA LIFEGUARDS NEED TO GET AND MAINTAIN LIFEGUARD CERTIFICATION!!!!! ( emphasis again)

 

This is where it gets kinda interesting. The Book covers the following:

 

ADULT Compression Only CPR

One Man Adult CPR with pulse check

One Man Adult CPR with Advance Airway with pulse check

One Man Child CPR with pulse check

One Man Infant CPR with pulse check

Two Man Adult CPR with Ambu bag with pulse check

Two man Child CPR with pulse check

Two Man Infant CPR with pulse check

AED Use

 

What goes on in the class and is emphasized is the following though:

 

One Man Adult CPR with pulse check

One Man Child CPR with pulse check

One Man Infant CPR with pulse check

Two Man Adult CPR with Ambu bag with pulse check

Two man Child CPR with pulse check

Two Man Infant CPR with pulse check

AED use

 

Hopefully this helps clarify why AHA has so many "differnt" ways of doing CPR. It's based upon the course you take.

 

 

 

[Eagle92]

Oh almost forgot

 

A)Only differnce between the Heartsaver CPR and BLS is 1) no pulse check for heartsaver 2) Advanced airways are in the book, and 3) two man CPR is taught.

 

B) Some background on Adult Compression Only CPR.

 

Every 5 years, there is an international conference on CPR where research is examined, reviewed, new procedures come out etc. That's why in 2011 all the new stuff came out: their was a conference in 2010.

 

Now back in 2005, it was my understanding that some Norwegians were doing studies on something their 911 folks were doing: telling folks how to do CPR over the phone without breaths. As 'Skip mentioned, a lot of folks balk at the idea of mouth-to-mouth on someone they don't know. So folks were doing just compression. Now the studies were not ready for the 2005 conference, so ADULT Compression Only CPR did come about.

 

BUT in 2007, or possibly 2008, the result were published and it was found that compression only CPR can indeed save lives, and is better than doing nothing. These results were deemed so important, that AHA created an addendum that was added to their already printed CPR books about ADULT Compression Only between revisions.

 

But please, please, PLEASE (caps for begging) remember that breath ARE needed for infant/child CPR, even if you have to give them mouth-to-mouth and mouth-to-mouth and Nose CPR. It's more likely to be a respiratory issue than a cardiac one, hence the reason for still doing breaths without a barrier for kids.

 

 

'Skip,

 

BHF has you doing breaths first for infants and child still? On this side of the pond, it's been been simplified to Compressions, Airway, Breathing (CAB) for everything.

[Wëlënakwsu]

To address the original question of BSA policy...

Traditional CPR Technique Still Official

 

see:

http://www.scouting.org/scoutsource/HealthandSafety/Alerts/CPR.aspx

[Eagle92]

BEST...... ADULT COMPRESSION ONLY CPR... VIDEO... EVER! (AND YES I'M SHOUTING)

 

 

 

And yes that it Dr. Ken Jeong, MD in the video.

 

The BLS version of CPR mentions hands only CPR in the book, but doesn't cover it in the class. So my department found this video and downloaded to go over the ADULT Compression Only CPR, as there seems to be a lot of confusion about it.

 

I'm just glad the didn't use the other song with 100 beats per minute, Queen's Another One Bites the Dust.(This message has been edited by Eagle92)

[suzisk8]

Our Pack leadership recently went through CPR training and I couldn't believe the changes that occurred since I got my Health Care provider three years ago (I let it lapse, I have been ill, not in the nursing program yet). That night my fiance came across this cool YouTube video.

http://www.youtube.com/watch?v=ILxjxfB4zNk

[Twocubdad]

josryan -- seems like that notice has been on Scouting.com for at least a year (the copyright notice on the page says 2010, if you can go by that).

 

BSA is not what you would consider an early adopter.

 

 

[Eagle92]

I actually contacted someone from national, and here's why it takes time if memory serves.

 

1) new changes come out from the conference in October 2010 by the various publications like CIRCULATION and HEART.

 

2) On the CPR side of things, AHA comes up with the procedures to be used in the USA that other orgs use. ARC actually does not do CPR regs, they do the First Aid ones.

 

3) Anywhere from April 2011 to December 2011, depending upon what type of CPR or advanced CPR you are doing, the new books, courses, etc come out. for example BLS came out in April 2011, but the Neonatal Resuscitation (an advanced course) came out in Nov/Dec 2011.

 

4) Once the new policies and procedures are wrote up by the parent org, BSA works with ARC in this matter, then ARC starts working on upgrading the BSA's program.

 

5) once the new BSA program is created, it takes time to get the info out.

 

 

I think that's one reason why BSA now wants certified instructors as MBCs now for first aid.

[qwazse]

2C,

 

Thanks for bringing up the topic. I need to recert my 1st Aid and CPR to complete my BSA Guard recert, so E92's details are very helpful. I now know what to look for.

 

Question: how much beyond BLS are the wi

Depress first aid courses?