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2010 Guidelines

2010 Guidelines. Instructor Update. Welcome !. This class will provide you with information about the recently released changes in emergency medical care and how those changes affect your authorization as an ASHI or MEDIC First Aid Instructor. Purpose of Class.

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2010 Guidelines

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  1. 2010 Guidelines Instructor Update

  2. Welcome ! • This class will provide you with information about the recently released changes in emergency medical care and how those changes affect your authorization as an ASHI or MEDIC First Aid Instructor.

  3. Purpose of Class • Highlight the major changes in science, treatment recommendations, and guidelines. • Provide helpful guidance to you for the transition to new materials.

  4. Learning Objectives • Identify the four central publications for changes in the 2010 science, treatment recommendations, and guidelines. • Identify the scheduled release dates for updated training programs. • Describe the significant changes affecting ASHI and MEDIC First Aid training programs. • Describe the rationale for the changes being made.

  5. Who is HSI?

  6. About HSI • The Health & Safety Institute (HSI) unites the recognition and expertise of: • American Safety & Health Institute • MEDIC FIRST AID International • 24-7 EMS • 24-7 Fire • First Safety Institute • HSI is the largest privately held emergency care training organization in the world.

  7. Proven Track Record • In business for more than 30 years. • In more than 100 countries. • Over 16,000 training centers approved. • Over 200,000 Instructors authorized. • More than 19 million providers certified.

  8. Training Structure • HSI develops and markets proprietary training programs, products, and services to approved Training Centers. • Instructors are authorized by Training Centers to certify course participants who successfully complete a training program.

  9. Approved for Use • HSI’s basic and professional level programs are endorsed, accepted, approved, or meet the requirements of more than 1800 Federal and state regulatory agencies and occupational licensing boards.

  10. 2010 ILCOR Conference • HSI participated in the 2010 International Committee on Resuscitation (ILCOR) International Conference on CPR and ECC Science with Treatment Recommendations.

  11. International First Aid Advisory Board • HSI representatives were members of the 2005 National and 2010 International First Aid Advisory Board founded by the AHA and ARC. • HSI representatives contributed to both the 2005 and 2010 Consensus on First Aid Science and Treatment Recommendations.

  12. Integrating 2010 Science, Treatment Recommendations, and Guidelines

  13. Where do guidelines come from? Multi-year process involving resuscitation experts from around the world Results in the following publications: 2010 Science and Treatment Recommendations ILCOR International Consensus on CPR and ECC AHA and ARC International Consensus on First Aid 2010 Training Guidelines 2010 AHA Guidelines for CPR and ECC 2010 AHA and ARC Guidelines for First Aid

  14. 2010 Guidelines The science and guidelines were published in the journal Circulation on October 18th, 2010 They are both freely available at www.hsi.com/2010guidelines

  15. New Program Development • In order to integrate the 2010 guidelines, time is required to make systematic and organized changes to our products. • We are currently revising all of our emergency care training materials. • New training materials will be released throughout 2011.

  16. Source References • 2010 International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science With Treatment Recommendations • 2010 American Heart Association and American Red Cross International Consensus on First Aid Science With Treatment Recommendations • 2010 American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care • 2010 American Heart Association and American Red Cross Guidelines for First Aid

  17. Interim Training Materials • We have created interim training materials that allow Instructors to immediately start incorporating some of the most significant changes into current (2005) training materials. • The interim materials are only intended to be used until the new training programs are made available. • Use of the interim materials is an option and not a requirement. Instructors can continue to use the current (2005) materials as designed.

  18. Using (2005) Materials • The release of new science and treatment recommendations do not imply that emergency care or instruction involving the use of previous recommendations science and treatment recommendations is unsafe.

  19. Support for Current Materials • You may continue to purchase and teach using current (2005) training materials until the new programs are available. • Support for the current materials will continue until December 31, 2011, or until the inventory of the materials is depleted.

  20. Planned 2nd Quarter 2011 Release • ASHI • CPR and AED • Basic First Aid • CPR, AED, and Basic First Aid Combination • CPR Pro • MEDIC First Aid • CarePlus CPR and AED • BasicPlus CPR, AED, and First Aid

  21. Planned 3rd Quarter 2011 Release • ASHI • Advanced Cardiac Life Support (ACLS) * • Bloodborne and Airborne Pathogens • MEDIC First Aid • PediatricPlus CPR, AED, and First Aid for Children, Adults, and Infants • CPR and AED Child/Infant Supplement • Bloodborne and Airborne Pathogens *Release date is dependent on third party production.

  22. Planned 4th Quarter 2011 Release • ASHI • Pediatric Advanced Life Support (PALS)* • Child and Babysitting Safety Course (CABS) *Release date is dependent on third party production.

  23. Update Requirements

  24. Need to Know • Every Instructor needs to understand the guideline changes that affect the program(s) he or she is authorized to teach. • In the following pages we have organized the most significant guideline changes by area and training level. • For each identified change, the lesson provides the 2005 guideline for reference, the updated 2010 guideline, and the reason for the change.

  25. Lay and Healthcare Providers • Some of the lessons cover lay providers and some cover healthcare providers. • Even though an Instructor may only teach a single provider level, the comparison information from the other level may be valuable for understanding and ability to answer student questions.

  26. ACLS and PALS • Specific information regarding the changes in our advanced training programs, ASHI ACLS and ASHI PALS is not included in this presentation. • The information is provided in the HSI 2010 Updated Training Guidelines Supplement found in the document section of the online Instructor Portal.

  27. CPR and AED

  28. Emphasis on High-Quality CPR 2005 Guidelines “… blood flow is optimized by using the recommended chest compression force and duration and maintaining a chest compression rate of approximately 100 compressions per minute. These guidelines recommend that all rescuers minimize interruption of chest compressions … CPR instruction should emphasize the importance of allowing complete chest recoil between compressions.” (Circulation. 2005; 112: IV19-IV34)

  29. Emphasis on High-Quality CPR 2010 Guidelines “To provide effective chest compressions, push hard and push fast. … compress the adult chest at a rate of at least 100 compressions per minute with a compression depth of at least 2 inches/5 cm. … allow complete recoil of the chest after each compression, to allow the heart to fill completely before the next compression. … minimize the frequency and duration of interruptions in compressions to maximize the number of compressions delivered per minute. (Berg, et al. Circulation. 2010;122;S685-S705)

  30. Highlights • This is a re-emphasis from 2005. • For effective compressions: • Push fast • Push hard • Allow chest to fully recoil • Minimize any interruptions • Applies to both lay and healthcare providers.

  31. Rationale For Change • High-quality chest compressions within CPR continues to be a critical focal point. • Well-performed compressions increase the likelihood of survival.

  32. Compression Hand Position 2005 Guidelines “The rescuer should compress the lower half of the victim’s sternum in the center (middle) of the chest, between the nipples. The rescuer should place the heel of the hand on the sternum in the center (middle) of the chest between the nipples and then place the heel of the second hand on top of the first so that the hands are overlapped and parallel.” (Circulation. 2005; 112: IV19-IV34)

  33. Compression Hand Position 2010 Guidelines “The rescuer should place the heel of one hand on the center (middle) of the victim’s chest (which is the lower half of the sternum) and the heel of the other hand on top of the first so that the hands are overlapped and parallel.” (Berg, et al. Circulation. 2010;122;S685-S705)

  34. Highlights • Hands in center of the chest. • Lower half of breastbone • Second hand on top of the first. • Not on lowest part of breastbone. • Applies to both lay and healthcare providers.

  35. Rationale For Change • Use of the nipple line as a landmark for hand placement was found to be unreliable.

  36. Compression Rate 2005 Guidelines “There is insufficient evidence from human studies to identify a single optimal chest compression rate. Animal and human studies support a chest compression rate of >80 compressions per minute to achieve optimal forward blood flow during CPR. We recommend a compression rate of about 100 compressions per minute.” (Circulation. 2005; 112: IV19-IV34)

  37. Compression Rate 2010 Guidelines “It is reasonable for laypersons and healthcare providers to compress the adult chest at a rate of at least 100 compressions per minute with a compression depth of at least 2 inches (5 cm.)” (Berg, et al. Circulation. 2010;122;S685-S705)

  38. Highlights • “At least” 100 times per minute. • It is okay to be a little faster. • Applies to both lay and healthcare providers.

  39. Rationale For Change • It has been found that higher survival rates are associated with an increase in the number of compressions provided per minute.

  40. Child/Infant Compression Rate 2005 Guidelines “Push fast; push at a rate of approximately 100 compressions per minute.” (Circulation. 2005; 112: IV156-IV166)

  41. Child/Infant Compression Rate 2010 Guidelines “Push fast; push at a rate of at least 100 compressions per minute.” (Berg, et al. Circulation. 2010;122;S862-S875)

  42. Highlights • Rescuers tend to compress slower. • “At least” 100 compressions per minute. • It is okay to be a little faster. • Applies to both lay and healthcare providers.

  43. Rationale For Change • It has been found that higher survival rates are associated with an increase in the number of compressions provided per minute.

  44. Compression Depth 2005 Guidelines “Depress the sternum approximately 1 ½ to 2 inches (approximately 4 to 5 cm) and then allow the chest to return to its normal position.” (Circulation. 2005; 112: IV19-IV34)

  45. Compression Depth 2010 Guidelines “It is reasonable for laypersons and healthcareproviders to compress the adult chest at a rate of at least 100 compressions per minute with a compression depth of at least 2 inches/5 cm.” (Berg, et al. Circulation. 2010;122;S685-S705)

  46. Highlights • “At least” 2 inches on an adult. • It is okay to compress a little deeper. • Not enough information to define upper limit. • Applies to both lay and healthcare providers.

  47. Rationale For Change • Research indicates the tendency for CPR providers to not compress deep enough, even with the emphasis to "push hard."

  48. Child/Infant Compression Depth 2005 Guidelines “‘Push hard’: push with sufficient force to depress the chest approximately one third to one half the anterior-posterior diameter of the chest.” (Circulation. 2005; 112: IV156-IV166)

  49. Child/Infant Compression Depth 2010 Guidelines “Chest compressions of appropriate rate and depth. ‘Push fast’: push at a rate of at least 100 compressions per minute. ‘Push hard’: push with sufficient force to depress at least one third the anterior-posterior (AP) diameter of the chest or approximately 1 ½ inches (4 cm) in infants and 2 inches (5 cm) in children.” (Berg, et al. Circulation. 2010;122;S862-S875)

  50. Highlights • “At least” 1/3 of the anterior/posterior diameter of chest. • About 2 inches for children and about 1 ½ inches for infants. • It is okay to compress a little deeper • Applies to both lay and healthcare providers.

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