A new order for CPR, spelled C-A-B

[crowplus]

FYI.

http://www.newsroom.heart.org/index.php?s=43&item=1139

"The 2010 AHA Guidelines for CPR and ECC update the 2005 guidelines.

When administering CPR, immediate chest compressions should be done first.
Untrained lay people are urged to administer Hands-Only CPR (chest compressions only).

DALLAS, Oct. 18, 2010 — The American Heart Association is re-arranging the ABCs of cardiopulmonary resuscitation (CPR) in its 2010 American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care, published in Circulation: Journal of the American Heart Association.

Recommending that chest compressions be the first step for lay and professional rescuers to revive victims of sudden cardiac arrest, the association said the A-B-Cs (Airway-Breathing-Compressions) of CPR should now be changed to C-A-B (Compressions-Airway-Breathing).

“For more than 40 years, CPR training has emphasized the ABCs of CPR, which instructed people to open a victim’s airway by tilting their head back, pinching the nose and breathing into the victim’s mouth, and only then giving chest compressions,” said Michael Sayre, M.D., co-author of the guidelines and chairman of the American Heart Association’s Emergency Cardiovascular Care (ECC) Committee. “This approach was causing significant delays in starting chest compressions, which are essential for keeping oxygen-rich blood circulating through the body. Changing the sequence from A-B-C to C-A-B for adults and children allows all rescuers to begin chest compressions right away.”

In previous guidelines, the association recommended looking, listening and feeling for normal breathing before starting CPR. Now, compressions should be started immediately on anyone who is unresponsive and not breathing normally."

[airsix]

D.A.N. has stated that while this applies to the administration of CPR by lay persons, it should not be applied in cases of diver rescue which must be assumed to include elements of drowning. CPR administered to divers should include rescue breathing.

While this change is important with regards to lay rescuers providing emergency care in the event of a collapse on the street, it will not affect the care of an unconscious diver. Loss of consciousness with cardiac arrest in water must always be assumed to include elements of drowning. For this reason, full CPR is still recommended. Therefore, DAN Education does not plan to change any DAN courses to feature Hands-OnlyTM CPR. For the most part, the proposed changes do not translate to the diving environment. (emphasis added by airsix)

[Grateful Diver]

D.A.N. has stated that while this applies to the administration of CPR by lay persons, it should not be applied in cases of diver rescue which must be assumed to include elements of drowning. CPR administered to divers should include rescue breathing.

While this change is important with regards to lay rescuers providing emergency care in the event of a collapse on the street, it will not affect the care of an unconscious diver. Loss of consciousness with cardiac arrest in water must always be assumed to include elements of drowning. For this reason, full CPR is still recommended. Therefore, DAN Education does not plan to change any DAN courses to feature Hands-OnlyTM CPR. For the most part, the proposed changes do not translate to the diving environment. (emphasis added by airsix)

As in most things scuba diving, it depends ...

Rescue breathing is of limited value if the heart's not moving ... and for that reason, in-water rescue breathing may not be the best approach. In cases where the application of rescue breaths delays getting the diver to a stable enough platform to perform chest compressions, it may do more harm than good. So in cases where a diver can be quickly moved to a shore, dock or boat, you're better off delaying rescue breaths until the diver is moved to a place where chest compressions can be started as quickly as possible. At that point, yes, rescue breathing should be performed.

If getting the diver out of the water quickly is not an option, then in-water rescue breaths should be applied ...

... Bob (Grateful Diver)

[ljjames]

+1 for what bob said.

get them to shore/boat/dock ASAP, this involves getting them out of their kit and using their buoyancy to get them up and out of water as much as possilbe . Try swimming a fully geared diver in to shore from the can buoy at cove 2. now try it with just their exposure suit. Try it with you in full gear and then with just snorkeling gear. You'll likely find that with nice big fins, two wetsuit or drysuit clad divers move pretty darn quick.

there has been commentary that a backplate would make a good solid platform for compressions and harness makes good drag points, but i know for sure having tank, regs, weight belt, etc.. will slow things down. its gonna be kind of hard in an emergency to separate the system and in reality, the majority of divers globally still dive a jacket BCD.

the instructor i did all my advanced training with used to say something along the lines of "don't dive with anyone you can't get out of the water by yourself, and if you can't get them out of water yourself, take a third buddy". I used to think he was just being a bit of an ass (plus he almost failed me in my rescue class cause it was very hard for me to carry a 6'2" 200+lb up above the higher hight tide mark) but now that i've got a bit of maturity to look back on the situation, I realize he had a good point. For the most part i dive with guys who are bigger than me. i had to learn different techniques for getting them out of the water, and yes, one of those techniques is just have a 3 person team

For those who have not already taken a rescue class (that these days combines a first responder class) get ON it!

[airsix]

Bob/Laura, thanks for adding that. I didn't mention anything about in-water CPR because frankly I don't even think of it as an option. I assumed "get them to shore/boat ASAP" was a given.

[Zen Diver]

Just to clarify a bit, for those trained, ventilations and compressions still go together, but the order is changed. Start with compressions, then ventilation. In the case of drowning, patients need ventilation, but they've found that struggling with airway first delays compresions. The good news is it only delays by ~18 seconds. So, for diving incidents, compressions, then ventilations while calling 911 & sending someone for an AED if available.



Valerie
RN, BSN, CEN
DAN/EFR Instructor
American Heart Association Training Faculty
Advanced Cardiac Life Support Instructor
Basic Life Support Instructor
Pediatric Advanced Life Support Instructor

www.jellyfisheducation.com

[Rockfish]

I wonder how many of that are Rescue trained practice those skills?

I know that it has been a long time since I have.

Some of us do practice other dive skills maybe rescue skills should be included.

Just an idea.

I think that I will be practicing some of those rescue skills more often now myself.

Mike

[ArcticDiver]

Just to clarify a bit, for those trained, ventilations and compressions still go together, but the order is changed. Start with compressions, then ventilation. In the case of drowning, patients need ventilation, but they've found that struggling with airway first delays compresions. The good news is it only delays by ~18 seconds. So, for diving incidents, compressions, then ventilations while calling 911 & sending someone for an AED if available.



Valerie
RN, BSN, CEN
DAN/EFR Instructor
American Heart Association Training Faculty
Advanced Cardiac Life Support Instructor
Basic Life Support Instructor
Pediatric Advanced Life Support Instructor

http://www.jellyfisheducation.com

Ped sequence changed too?