ProTrainings UK Blog

The British Heart Foundation is urging people to forget “mouth-to-mouth” and to concentrate on chest compressions when performing CPR.  ”Hands-only CPR” has previously been supported by the Resuscitation Council (UK).  But it is now being promoted in a new advertising campaign featuring footballer-turned-actor Vinnie Jones.  New polling by the BHF suggests many feel worried about the idea of giving the “kiss of life”.

Watch the video click here This is nothing new in our training and the course is taught the same and full CPR training must still be trained, it is excellent advice to untrained people and as an alternative to full CPR to anyone.  All our courses have always had chest only compression training videos.

The official position of the BHF is now that anyone who does not have CPR training should ignore the kiss of life in favour of hard and fast compressions in the centre of the chest.   A new poll conducted across the UK and involving 2,000 respondents showed nearly half were put off from performing CPR because of a lack of knowledge.

A fifth worried specifically about the thought of the kiss of life or about contracting an infectious disease.  Four in 10 people were worried about being sued if they did something wrong, even though the BHF argues no such case has ever succeeded in Britain.   ”The kiss of life can often be daunting for untrained bystanders who want to help when someone has collapsed with a cardiac arrest,” said Ellen Mason, senior cardiac nurse at the BHF.

She said the kiss of life remained the “gold standard” of CPR, but added if a person had not had training the best option would be to just do chest compressions.

Bee Gees hit  -  The BHF is also suggesting people hum to the Bee Gees hit Stayin’ Alive, to get the tempo of chest compressions right, although others have in recent months questioned whether this is appropriate, suggesting it may lead to compressions which are too shallow.  The new BHF advert features Vinnie Jones in his traditional hardman guise, administering chest compressions to a Bee Gees backbeat after being thrown an unconscious body by his henchmen.

Commenting on the new campaign, he said: “There really shouldn’t be any messing about when it comes to CPR. If you’re worried about the kiss of life just forget it and push hard and fast in the centre of the chest.

“Hands-only CPR should give have-a-go heroes the confidence to step in and help when somebody is in cardiac arrest.”  Ms Mason said everyone should learn what to do: “Thirty thousand people have a cardiac arrest in the UK every single year and half of those are witnessed, but in most cases no-one acts, no-one knows what to do, people panic.  ”If it was us, we would all want our loved ones and ourselves to be saved, wouldn’t we?”

More information http://www.bhf.org.uk/heart-health/life-saving-skills/hands-only-cpr.aspx

We have updated all the first aid manuals and added a fire safety manual.  You can download these for any course that you have taken with us.  We are adding more manuals shortly for all courses. You can access these by clicking the red link in the top right corner of the site once you are logged in.

If you need to find a classroom course by one of our approved instructors then you can see this at www.procourses.co.uk. We have linked this site to all our online site so you can easily find a course or an instructor near to you.

If you cannot find a course, then search by instructor and contact them direct as they can easily add extra courses to meet your needs.  You can even print off maps to the course direct from our site.

If you need a course to be taught at your place of work then again contact the instructors who will be able to help.  When you complete your ProTrainings course you will receive a ProTrainings wall certificate and wallet card in the post after the course and receive weekly refresher emails, reminder and be able to download a free PDF student manual for your course.

The HSE have clarified the point of giving Asprin to someone who is having a heart attack. This advice is directly for first aiders in the workplace but good advise in all sectors.  They state:

Anecdotal information has come to our attention that training on the administration of aspirin on FAW courses appears to be inconsistent. The view of HSE is that the administration of medication by a first aider is not part of a FAW or EFAW training course, but you can assist an individual in taking it. However, the one exception is when training students on first aid for heart attacks, when this subject must be covered. Therefore, for heart attack management, the student must be able to assist a casualty in taking 300 mg of aspirin and to advise them to chew it, not swallow.

If you need any further clarification on this please email us.

We have now added to all our first aid courses new videos to bring them to follow the guidelines of the ERC and UK Resus Council.

The new guidelines we announced a few weeks ago and there are some changes in CPR.  Existing customers can look back and see the new videos to ensure they are up to date.  Unlike other courses with ProTrainings Video E-Learning you are kept up to date for 8 months after you buy the course.

Have a look at our online first aid e-learning courses You can see all our sites from this link including Manual Handling Online and Infection Control Online

We have added another e-learning course called First Aid Plus.  This course is aimed at people who want more first aid subjects covered. We will be adding more videos to this one as they are available.

We will be updating the videos on all our sites to the 2010 ERC guidelines in a few weeks.

First Aid Plus – First aid video training online

On Monday 18th October the rules that govern Resuscitation changed.  We are currently updating our videos and they will be live shortly. The changes are as follows:

Adult basic life support

The following changes in the basic life support (BLS) guidelines have been made to reflect the importance placed on chest compression, particularly good quality compressions, and to attempt to reduce the number and duration of pauses during chest compression:

• When obtaining help, ask for an automated external defibrillator (AED), if one is available.
• Compress the chest to a depth of 5-6 cm and at a rate of 100-120 min.
• Do not stop to check the victim or discontinue CPR unless the victim starts to show signs of regaining consciousness, such as coughing, opening his eyes, speaking, or moving purposefully AND starts to breathe normally.
• Teach CPR to laypeople with an emphasis on chest compression, but include ventilation as the standard, particularly for those with a duty of care.

The use of Automated External Defibrillators

There are no major changes to the sequence of actions for AED users in Guidelines 2010. The following changes are aimed mainly at increasing the use of AEDs along with clarification on when to stop CPR:

• An AED can be used safely and effectively without previous training; its use should not be restricted to trained rescuers. Training should however be encouraged to help improve the time to shock delivery and correct pad placement
• Short video/computer self-instruction courses, with minimal or no instructor coaching, combined with hands-on practice can be considered as an effective alternative to instructor-led BLS and AED courses. Such courses should be validated to ensure that they achieve equivalent outcomes to instructor-led courses (ProTrainings video e-learning systems)
• When using an AED minimise interruptions in chest compression. Do not stop to check the victim or discontinue CPR unless the victim starts to show signs of regaining consciousness, such as coughing, opening his eyes, speaking, or moving purposefully AND starts to breathe normally.

Pre-hospital cardiac arrest

A pre-hospital chapter has been included for the first time in the RC(UK) Guidelines. The chapter covers the following resuscitation topics of specific relevance to the pre- hospital emergency medical services (EMS):

• Telephone-advised cardiopulmonary resuscitation (CPR)
• CPR versus defibrillation first
• Pre-hospital airway management
• Rules for stopping resuscitation.

Paediatric basic life support

Changes in paediatric life support guidelines have been made partly in response to new scientific evidence, and partly to simplify them in order to assist teaching and retention. As in the past, there remains a paucity of good-quality evidence specifically on paediatric resuscitation, and some conclusions have had to be drawn from experimental work or extrapolated from adult data.

Although ventilation remains a very important component of CPR in asphyxial arrest, rescuers who are unable or unwilling to provide this should be encouraged to perform at least compression-only CPR. A child is far more likely to be harmed if bystanders do nothing at all.

Chest compressions are frequently too shallow, so there has been a subtle, but important, change in the instruction on chest compressions from ‘approximately one third’ to ‘at least one third’ of the AP diameter of the chest. The mean one-third compression depths for infants and children are 4 and 5 cm respectively. In order to be consistent with the adult BLS guidelines the recommended compression rate is now 100 – 120 min.

Compression-only CPR

Studies have shown that compression-only CPR may be as effective as combined ventilation and compression in the first few minutes after non-asphyxial arrest. However, chest compression combined with rescue breaths is the method of choice for CPR by trained lay rescuers and professionals and should be the basis for lay-rescuer education. Lay rescuers who are unable or unwilling to provide rescue breaths, should be encouraged to give chest compressions alone. When advising untrained laypeople by telephone, ambulance dispatchers should give instruction on compression-only CPR.

Resuscitation of children and victims of drowning

Both ventilation and compression are important for victims of cardiac arrest when the oxygen stores become depleted: about 2 – 4 min after collapse from ventricular fibrillation (VF), and immediately after collapse for victims of asphyxial arrest. Previous guidelines tried to take into account the difference in causation, and recommended that victims of identifiable asphyxia (drowning; trauma; intoxication) and children should receive 1 min of CPR before the lone rescuer left the victim to get help. But most cases of sudden cardiac arrest out of hospital occur in adults and are of cardiac origin due to VF (even though many of these will have changed to a non-shockable rhythm by the time of the first rhythm analysis). These additional recommendations, therefore, added to the complexity of the guidelines whilst applying to only a minority of victims.

Many children do not receive resuscitation because potential rescuers fear causing harm. This fear is unfounded; it is far better to use the adult BLS sequence for resuscitation of a child than to do nothing. For ease of teaching and retention, laypeople

should be taught to use the adult sequence for children who are not responsive and not breathing normally, with the single modification that the chest should be compressed by one third of its depth. However, the following minor modifications to the adult sequence will make it even more suitable for use in children:

• Give 5 initial rescue breaths before starting chest compressions (adult BLS sequence of actions 5B).
• If you are on your own, perform CPR for 1 min before going for help.
• Compress the chest by one third of its depth. Use two fingers for an infant under 1 year; use one or two hands for a child over 1 year as needed to achieve an adequate depth of compression.

The same modifications of five initial breaths, and 1 min of CPR by the lone rescuer before getting help, may improve outcome for victims of drowning. This modification should be taught only to those who have a specific duty of care to potential drowning victims (e.g. lifeguards). If supplemental oxygen is available, and can be brought to the victim and used without interruption in CPR (e.g., by attaching to a resuscitation face mask), it may be of benefit.

Drowning is easily identified. It can be difficult, on the other hand, for a layperson to recognise when trauma or intoxication has caused cardiorespiratory arrest. If either cause is suspected the victim should be managed according to the standard BLS protocol.

Bag-mask ventilation

Considerable practice and skill are required to use a bag and mask for ventilation. The lone rescuer has to be able to open the airway with a jaw thrust whilst simultaneously holding the mask to the victim’s face. It is a technique that is appropriate only for lay rescuers who work in highly specialised areas, such as where there is a risk of cyanide poisoning or exposure to other toxic agents. There are other specific circumstances in which non-healthcare providers receive extended training in first aid, which could include training, and retraining, in the use of bag-mask ventilation. The same strict training that applies to healthcare professionals should be followed and the two-person technique is preferable.

Mouth-to-tracheostomy ventilation

Mouth-to-tracheostomy ventilation may be used for a victim with a tracheostomy tube or tracheal stoma who requires rescue breathing.

Mouth-to-nose ventilation

Mouth-to-nose ventilation is an effective alternative to mouth-to-mouth ventilation. It may be considered if the victim’s mouth is seriously injured or cannot be opened, if the rescuer is assisting a victim in the water, or if a mouth-to-mouth seal is difficult to achieve.

Agonal gasps

Agonal gasps are present in up to 40% of cardiac arrest victims.10 Therefore laypeople should be taught to begin CPR if the victim is unconscious (unresponsive) and not breathing normally. It should be emphasised during training that agonal gasps occur commonly in the first few minutes after sudden cardiac arrest; they are an indication for starting CPR immediately and should not be confused with normal breathing.

More details to follow shortly or download the following:

UK Resus 2010 Teaching

UK Resus summary 2010

First Aid Instructors advice

We have now launched a new online course that is available as a online or a blended course with one of our national instructor/evaluators. This course is ideal for nurses, Doctors as well as anyone who wants to learn basic life support for Adult, Infant and Child.

For more information see www.probls.co.uk

We are launching a new course and instructor finder at www.blendedcpr.eu where you can find local instructors and courses in your area.   We are adding more of our national instructors to the system and we will post an update shortly when complete.

You will see all the new classroom courses that our approved instructors can offer. All ProTrainings courses are taught by approved instructors and you will always receive a wall certificate and wallet card with a unique student number that you can check on www.blendedcpr.eu or any of our online First Aid, Blood Bourne Pathogens and Manual Handling video based e-learnign sites.

If you are one of our Pro Trainings Instructor or ITG Instructor Training Instructors and you do not show up or you are another instructor/Sales person and you want to be listed email keith@protrainings.eu

The next of our European courses just went live at www.probloodbourne.co.uk.  This course covers the European and UK guidelines and is a good course for everyone to be aware with particularly people in the following sectors:

This list is not the only workplaces where a risk is present. Anyone at anytime could be at risk in their day to day life. For more information and to register go to the Blood Bourne Pathogens Training Site at www.probloodbourne.co.uk