Post by LSDeep on Jan 15, 2006 19:08:16 GMT -5
Changes are coming to DAN courses: New first aid and CPR guidelines are released
Making sure that rescuers are prepared to provide care in an emergency is the goal of every first aid program, and DAN’s training programs are no exception. Since 1991, DAN has offered training in oxygen first aid and now offers multiple dive-specific programs to help divers be prepared to lend aid to their fellow divers.
While DAN’s programs address concerns such as decompression illness or jellyfish stings, they are built on a foundation of basic life support that includes airway management, breathing and circulation.
DAN teaches cardiopulmonary resuscitation (CPR) only in the Basic Life Support for Dive Professionals course, but basic life support techniques appear in all DAN courses.
The first aid training community is focused on simplifying training to ensure that bystanders respond quickly and appropriately. Recently, the American Heart Association and the International Liaison Committee on Resuscitation (ILCOR) released a new set of science-based guideline changes to basic life support. These changes are designed to help first responders be more confident when they encounter an emergency. These changes should also make the response and care given more effective.
The guideline changes apply to general CPR and first aid. In some cases, DAN may implement these recommendations as advised; or DAN may choose to modify them to be appropriate to dive-specific circumstances.
For example, while the new guidelines support the use of bag-valve masks and flow-restricted oxygen-powered ventilators to deliver oxygen for nonbreathing persons, supporting DAN’s Advanced Oxygen program, the guidelines for first aid care neither support or recommend against oxygen for a person who has been injured.
However, DAN recommends the delivery of oxygen first aid for a breathing person injured in a dive accident who shows signs and symptoms of decompression illness, a specific situation not addressed by the new guidelines.
DAN Instructors and Providers should feel confident that the programs they are using and the materials they have for DAN programs are still appropriate for providing care for injured divers. These new guidelines simply find ways to improve upon the care provided.
DAN Medical and Training staff will review these new guidelines and every DAN course to determine how best to implement these changes. DAN Instructors should continue to teach DAN courses as they are written. However, if DAN Instructors choose to address the changes discussed above with their students and include them as part of their courses, they may do so at their discretion.
DAN will revise all of its training programs in 2006 to accommodate and reflect these changes. These major changes are:
Chest Compressions: Rescuers are now advised to “push hard and push fast” when delivering chest compressions during CPR.
Rescuers should deliver these compressions at a rate of 100 compressions per minute – almost two each second. This emphasis on the quality of the chest compressions is new, although the rate had been in place since 2000.
You should allow the chest to recoil completely after each compression, and your compression and release times should be the same. When delivering compressions, you should also work to minimize interruptions.
Compression to Ventilation Ratio: In all cases with a single rescuer, rescuers should deliver 30 chest compressions followed by two breaths. This applies to adults, children and infants. Until now, the recommendation was 15 compressions to two breaths on an adult and 5:1 on a child or infant.
When two rescuers are performing CPR on an adult, the rescuers should also use a 30:2 ratio. When two rescuers are providing care for a child or an infant, they should use a 15:2 ratio.
Signs of Circulation: Do not check for signs of circulation. After delivering two rescue breaths during the initial assessment, immediately begin chest compressions. Assume a person who has stopped breathing is also in full arrest. The only exceptions to this are when caring for children and for professional rescuers.
Rescue Breaths: Each rescue breath should be delivered over 1 second: previously, the recommendation was 1 to 2 seconds. Each breath should make the chest rise, and rescuers should be able to see that rise. Rescuers should also avoid giving breaths that are too large or too forceful.
DAN has also determined that rescue breathing is important when caring for injured divers and swimmers. As such, Rescue Breathing will remain in DAN courses as a standalone skill. The AHA still recommends a check for signs of circulation and rescue breathing for professional rescuers. DAN courses represent a step above basic lay provider training.
AED Use: When using an AED to care for a person who shows no signs of circulation, rescuers should deliver a single shock and then provide CPR for approximately two minutes. The rescuers should begin with chest compressions following the shock and complete about 5 cycles of compressions and ventilations.
This new recommendation will require AED devices to be reprogrammed by the manufacturers. Until this change has been made, rescuers should allow the AED unit to operate as normal.
The 2005 guidelines also reaffirmed the 2003 statement recommending using AEDs on children older than 1 year of age. The recommendation also states that the AED device should, ideally, be able to deliver a “child energy dose.”
However, if the AED available is only able to deliver an adult dosage, it can still be used. When you witness the sudden collapse of a child, you should use the AED immediately. If the collapse was not witnessed, you should provide 5 cycles of CPR prior to using the AED.
Other changes to Lay Rescuer CPR that will affect DAN courses are:
* The jaw thrust is no longer recommended. Use the head-tilt chin-lift for all victims.
* Take 5 to 10 seconds to check for NORMAL breathing in an unresponsive adult. You should never take more than 10 seconds.
* Take a normal breath, not a deep one, when delivering rescue breaths.
* For children, use 1 or 2 hands depending on the size of the child.
Making sure that rescuers are prepared to provide care in an emergency is the goal of every first aid program, and DAN’s training programs are no exception. Since 1991, DAN has offered training in oxygen first aid and now offers multiple dive-specific programs to help divers be prepared to lend aid to their fellow divers.
While DAN’s programs address concerns such as decompression illness or jellyfish stings, they are built on a foundation of basic life support that includes airway management, breathing and circulation.
DAN teaches cardiopulmonary resuscitation (CPR) only in the Basic Life Support for Dive Professionals course, but basic life support techniques appear in all DAN courses.
The first aid training community is focused on simplifying training to ensure that bystanders respond quickly and appropriately. Recently, the American Heart Association and the International Liaison Committee on Resuscitation (ILCOR) released a new set of science-based guideline changes to basic life support. These changes are designed to help first responders be more confident when they encounter an emergency. These changes should also make the response and care given more effective.
The guideline changes apply to general CPR and first aid. In some cases, DAN may implement these recommendations as advised; or DAN may choose to modify them to be appropriate to dive-specific circumstances.
For example, while the new guidelines support the use of bag-valve masks and flow-restricted oxygen-powered ventilators to deliver oxygen for nonbreathing persons, supporting DAN’s Advanced Oxygen program, the guidelines for first aid care neither support or recommend against oxygen for a person who has been injured.
However, DAN recommends the delivery of oxygen first aid for a breathing person injured in a dive accident who shows signs and symptoms of decompression illness, a specific situation not addressed by the new guidelines.
DAN Instructors and Providers should feel confident that the programs they are using and the materials they have for DAN programs are still appropriate for providing care for injured divers. These new guidelines simply find ways to improve upon the care provided.
DAN Medical and Training staff will review these new guidelines and every DAN course to determine how best to implement these changes. DAN Instructors should continue to teach DAN courses as they are written. However, if DAN Instructors choose to address the changes discussed above with their students and include them as part of their courses, they may do so at their discretion.
DAN will revise all of its training programs in 2006 to accommodate and reflect these changes. These major changes are:
Chest Compressions: Rescuers are now advised to “push hard and push fast” when delivering chest compressions during CPR.
Rescuers should deliver these compressions at a rate of 100 compressions per minute – almost two each second. This emphasis on the quality of the chest compressions is new, although the rate had been in place since 2000.
You should allow the chest to recoil completely after each compression, and your compression and release times should be the same. When delivering compressions, you should also work to minimize interruptions.
Compression to Ventilation Ratio: In all cases with a single rescuer, rescuers should deliver 30 chest compressions followed by two breaths. This applies to adults, children and infants. Until now, the recommendation was 15 compressions to two breaths on an adult and 5:1 on a child or infant.
When two rescuers are performing CPR on an adult, the rescuers should also use a 30:2 ratio. When two rescuers are providing care for a child or an infant, they should use a 15:2 ratio.
Signs of Circulation: Do not check for signs of circulation. After delivering two rescue breaths during the initial assessment, immediately begin chest compressions. Assume a person who has stopped breathing is also in full arrest. The only exceptions to this are when caring for children and for professional rescuers.
Rescue Breaths: Each rescue breath should be delivered over 1 second: previously, the recommendation was 1 to 2 seconds. Each breath should make the chest rise, and rescuers should be able to see that rise. Rescuers should also avoid giving breaths that are too large or too forceful.
DAN has also determined that rescue breathing is important when caring for injured divers and swimmers. As such, Rescue Breathing will remain in DAN courses as a standalone skill. The AHA still recommends a check for signs of circulation and rescue breathing for professional rescuers. DAN courses represent a step above basic lay provider training.
AED Use: When using an AED to care for a person who shows no signs of circulation, rescuers should deliver a single shock and then provide CPR for approximately two minutes. The rescuers should begin with chest compressions following the shock and complete about 5 cycles of compressions and ventilations.
This new recommendation will require AED devices to be reprogrammed by the manufacturers. Until this change has been made, rescuers should allow the AED unit to operate as normal.
The 2005 guidelines also reaffirmed the 2003 statement recommending using AEDs on children older than 1 year of age. The recommendation also states that the AED device should, ideally, be able to deliver a “child energy dose.”
However, if the AED available is only able to deliver an adult dosage, it can still be used. When you witness the sudden collapse of a child, you should use the AED immediately. If the collapse was not witnessed, you should provide 5 cycles of CPR prior to using the AED.
Other changes to Lay Rescuer CPR that will affect DAN courses are:
* The jaw thrust is no longer recommended. Use the head-tilt chin-lift for all victims.
* Take 5 to 10 seconds to check for NORMAL breathing in an unresponsive adult. You should never take more than 10 seconds.
* Take a normal breath, not a deep one, when delivering rescue breaths.
* For children, use 1 or 2 hands depending on the size of the child.