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Australian Resuscitation Council releases new guidelines relating to basic life support and CPR

Posted by | January 01, 1970 | General | No Comments

The Australian Resuscitation Council has released new guidelines dated December 2010 relating to basic life support and CPR. There are significant changes to the traditional DRABCD which has now been replaced with DRSABCD. A key change is the prompt to send for help and the commencement of compressions before providing two rescue breaths to a non-responsive/non-breathing casualty.

A major review has been undertaken of Priorities in an Emergency, Unconsciousness, Breathing and the commencement of Compressions.

Steps in resuscitation are now referred to as’ DRS ABCD’ – check for Danger – check for Response – ‘S’ has been added for Send for help – ‘A’ directs rescuers to open the Airway – ‘B’ directs rescuers to check Breathing but no need to deliver two rescue breaths – ‘C’ directs rescuers to perform 30 Compressions to victims who are unresponsive and not breathing normally, followed by 2 breaths – ‘D’ directs rescuers to attach an AED as soon as it is available • The major change is that in the victim who is unresponsive and not breathing normally, CPR commences with chest compressions rather than rescue breaths. • If unwilling / unable to perform rescue breathing, then perform compression only.

The new ARC Basic Life Support Flowchart

ARC Basic Life Support flow chart Dec 2010.JPG

 

Risk Response + Rescue has been monitoring the changes closely and will be amending training, assessment and life support protocols to reflect the new guidelines.

A summary of the major changes to Basic Life Support Guidelines dated December 2010 are;

GUIDELINE 2 – Priorities in an Emergency • Focus changed to cover a range of emergency situations not just cardiac arrest and includes collapsed and injured victims.

GUIDELINE 3 – Unconsciousness • Focus now on the breathing unconscious victim (the non breathing unconscious victim will now call under Guideline 8: CPR)

GUIDELINE 4 – Airway • Minor error in FBAO flowchart corrected

GUIDELINE 5 – Breathing • References to signs of life removed as these are open to interpretation and feedback from member organisations suggests that the term ‘signs of life’ is confusing. • Focus on unresponsive and not breathing normally as the indicators for resuscitation.

GUIDELINE 6 – Compressions • References to signs of life removed as these are open to interpretation and feedback from member organisations suggests that the term ‘signs of life’ is confusing. • Focus on unresponsive and not breathing normally as the indicators for resuscitation. • If unwilling / unable to perform rescue breathing, then perform compression only CPR. • Pulse check downgraded for health care professionals as it is an unreliable indicator of the need for resuscitation. • New focus on maintenance of CPR quality including recommendations to change rescuers every 2 minutes to decrease rescuer fatigue and maintain depth and rate of compressions. • New section on use of prompt devices in clinical use as a part of an overall strategy to improve quality of CPR. NEW GUIDELINE

GUIDELINE 7 – AED Use In BLS • This is a new guideline recognising the role of AEDs as part of BLS in both out of hospital and in hospital environments. • Clear recommendations that training in AED use should be part of BLS education.

GUIDELINE 8 – CPR Changes as per airway, breathing, compressions and AED guidelines • Increase emphasis on bystander CPR as life saving intervention. • Compression: rescue breathing ratio remains at 30:2 • Steps in resuscitation are now DRS ABCD – check for Danger – check for Response – ‘S’ has been added for Send for help – ‘A’ directs rescuers to open the Airway – ‘B’ directs rescuers to check Breathing but no need to deliver two rescue breaths – ‘C’ directs rescuers to perform 30 Compressions to victims who are unresponsive and not breathing normally, followed by 2 breaths – ‘D’ directs rescuers to attach an AED as soon as it is available • The major change is that in the victim who is unresponsive and not breathing normally, CPR commences with chest compressions rather than rescue breaths. • If unwilling / unable to perform rescue breathing, then perform compression only

CPR. BLS FLOWCHART • Highlights ‘Send for help’ • Enables compression only CPR if unwilling / unable to perform rescue breathing. • in victims who are unresponsive and not breathing normally, CPR commences with chest compressions rather than rescue breaths.

GUIDELINE 10.1 – CPR Training • Regardless of the recency of CPR training or re-training, any attempt at resuscitation is better than no attempt and should be encouraged • Duration of CPR courses has not been determined. • Prompt / feedback devices can be used in training as an overall strategy to improve quality of CPR. • The optimal interval for retraining has not been established, but need for refresher training for individuals who are not performing resuscitation on a regular basis is recognised. • Recommendation that individuals trained in CPR should refresh their CPR skills at least annually (opposed to undertake assessment annually).

GUIDELINE 10.2 – CPR Instructor Competencies

DELETE GUIDELINE 10.3 – Cross Infection Risks & Manikin Disinfection • No major changes

GUIDELINE 10.5 – Legal And Ethical Issues • Is undergoing a major re-write and will be released in 2011.

The majority of Guidelines in Sections 11 – Adult Advanced Life Support,
12 – Paediatric Advanced Life Support , and 13 – Neonatal Guidelines
have been updated to December 2010.

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