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Approximately every five years, the CPR training industry undergoes revisions and updates to its protocols. It's important to know what the differences are in the current recommendation year as compared to the one that's currently outdated. We're gonna be talking about those updates, so that you can become more aware of the current recommendations and compare them to the way you were trained in the past. We have several topics but we're gonna start with basic CPR. The CPR recommendations really haven't changed a whole lot. But the re-emphasis is on the rate of compression and the depth of compression. You see the rate of compression before was at least 100 times per minute. But the current recommendation is that it's at least 100 and no more than 120 compressions per minute. The other emphasis is on the depth of compression. Before it said at least 2 inches deep and now we have a ceiling. It's at least 2 inches deep and no more than 2.4 inches deep. We've also re-emphasized the fact that though hands-only CPR is better than no CPR at all, for infants and children who are heavily driven by oxygenation, if you know how to do CPR or are willing to do full CPR, rescue breathing and chest compressions have been shown to be more beneficial than just hands-only CPR, when it comes to infant and child patients. Along with CPR, we should talk about how to access EMS when an emergency situation is recognized. There's been a re-emphasis because of all of the different types of technology, that we are encouraging people now to not necessarily spend as much time looking for landlines when they have a cell phone right in their pocket. Accessing the phone is a great way to speed up the time from recognizing emergency to activation of emergency medical services. It's also important for us to realize that most phones have a speakerphone. So if you can touch the speakerphone button, have the dispatcher actually be able to talk you through the prompts or be there to encourage you through this very intense moment, it's always going to help you to have a better experience as you work through this process. The next subject is a topic that I'm very passionate about, and that's the training regarding CPR. The update currently is re-emphasizing the need for ongoing education and especially that which is sooner than every two years. The current recommendation is that you get re-certified every two years. But what we see is that people are losing their skills sooner than that. So it's important that they have some way of refreshing their skills more often, and maybe even getting re-certified more closely to an annual versus a bi-annual. I'm sure we'll see some recommendations evolving over time with this. But keep it in the back of your mind, that if there's a way to refresh your skills more often, take advantage of it. It's also important that we know how deep we're compressing the chest of the mannequin when we're practicing for real-life CPR. So there's been a push that mannequins ideally will have an intrinsic device that actually will tell you, with some feedback device, when you've reached that 2 to 2.4 inches depth compression. Now related to the metronome, or the pace of the compressions, that can be done either intrinsically in the mannequin or from an external device. The depth of the compression can also be an external device that's laid over the top of the mannequin while you're doing your compressions. Now let's talk about the topic of how people learn and some very interesting science that's come back, when it comes to comparing those who learned via the computer with video-based education and those that were instructor-led in the classroom. See the science shows that people are learning just as equally well in a computer-based or video-based learning environment as they did in a classroom with an instructor who led them through the steps. But what we believe as well is that because they can pace themselves and they can do it at a time and in a location that's most convenient for them, they're usually better learners and absorb the information better. Now probably the biggest change to this update was the introduction of the opioid overdose treatment. This is now implementing naloxone, when is better known as Narcan, by its trade name. You see Narcan, or naloxone, has now become an over the counter medication in many states. It can be delivered or administered through the nasal passages or through the intra-muscular. Now what's great about this is that for those people who are in respiratory or cardiac arrest, as a result of an opioid overdose, this treatment could reverse the effects and help save their life. So that pretty much highlights most of the changes as it relates to CPR. And though I said before, it's not really changes, it's just reiterations, for the most part, in the exception of the opioid overdose. Now let's talk about the First Aid changes that may be affecting you, as you go through this next training. So there's really about five or six topics that I think are even worth discussing in the update list. And those are the topics of bleeding that is out of control or needs help being controlled, the spinal immobilization concept, the tooth avulsion, the hypoglycemia treatment, stroke assessment, and when concussion patients can actually return to play or work. Now in bleeding control, there's three different pieces of that. One is when to use a hemostatic agent, when to use a tourniquet, and then we're not going to actually use the fully occlusive chest dressing when we have a chest wound. These are things that are not really all that new for the most part, in the exception of the chest wound occlusive dressing. But it's being reiterated that if a bleeding issue is not controlled easily or the person's life may be at risk, that we're re-encouraging the use of these hemostatic agents and tourniquet use. When it comes to spinal immobilization, the idea is that we're not really using C collars anymore. We're not trying to fully immobilize. We're trying to minimize the movement of the patient, as we know that it's impossible to fully immobilize anybody. So that's just something to keep in mind. When it comes to tooth avulsion, there's been some other treatment recommendations in what to put teeth into, and one of the most favorite was milk, whole milk, and egg whites. And neither of those are easily stored in a First Aid bag. So we have some recommendations that we'll be coming to, that are a little bit more stable and more portable and will last longer in a First Aid bag. When it comes to hypoglycemia, we're gonna be talking about how, usually after the first dose treatment of giving someone sugar, we now for a diabetic could wait up to 15 minutes before we activate emergency medical services and get them on the way, as we may see a delayed response in giving the person sugar. Remember, it's only when they can safely swallow it themselves, that we do so. But we'll cover that in training. When it comes to the area of concussions, there's been an assessment put in place that when a person has the signs and symptoms of concussion, that they do not return to play or work until they're fully cleared by the healthcare provider. And lastly, on stroke assessment, we'll be showing you the latest recommendations on how we use an easy to learn acronym that helps point us to whether or not a person might be suffering the symptoms of stroke and how to activate emergency services. These updates might not seem all that different. But it's always good to keep them refreshed. And we thought summarizing them might help you look for them when it comes to this update training for you.
Every five years the CPR training industry undergoes some revisions and updates to their protocol. It's important to know what those updates are, so you can put into place the current recommendations that have been proven more effective.
The recommendations haven't changed much in this area since 2015. However, there are a few areas of re-emphasis to mention.
The rate of compressions previously was a minimum of 100 per minute. Now, that minimum is the same, but there is now a maximum rate of chest compressions – 120 per minute.
The depth of compressions previously was a minimum of 2 inches deep. That minimum is also the same, but now there's a maximum depth of 2.4 inches.
Another re-emphasis is that hands-only CPR is better than no CPR at all, even as it applies to infants and children, who are more driven by oxygenation than adults. However, when it comes to infants and children, the combination of chest compressions and rescue breaths has shown to be more effective than compressions alone.
This re-emphasis is due to ever-changing technologies and ways in which you can benefit from them, like your cell phone. There's no reason to waste time searching for a landline anymore when you have a mobile phone in your pocket.
You'll save precious time using your cell phone, and you can put it on speaker for a hand's free experience that will allow you to continue helping the patient. This will also allow you to get valuable guidance from dispatch if needed.
The area of re-emphasis in this area has been on education and refreshing your skills more frequently. The current recommendation is recertification every two years, but we've seen that people tend to lose their skills sooner.
If you have access to more frequent skill refreshment opportunities, take advantage of it. And when it comes to recertification, maybe consider doing it every year, instead of every other year, and keep those skills fresher longer.
CPR manikins allow us to hone our CPR skills, but if you're not sure how deep your compressions are, then it's not going to be as instrumental.
Modern manikins have a feedback device that will show you how deep your compressions are, as well as the pace of compressions. And if the manikins you practice on don't have this feedback device, you can always supplement with an external device that lays on top of the manikin.
Let's not forget, getting the right depth and pace of chest compressions is crucial to providing high quality CPR.
There have been some interesting studies comparing computer-based learning with traditional instructor-led classroom learning. The science has shown that video-based computer training is just as effective as classroom learning.
Those who take advantage of computer learning can work at their own pace and at a time and location that suits their lifestyles and schedules. There are also studies that have shown that students who learn this way absorb the material better.
The biggest recent update has been in the area of opioid overdoes treatment, and more specifically the implementation of naloxone (brand name, Narcan).
Narcan is now an over-the-counter medication in many states and can be administered through the nasal passages or by intermuscular injection. For patients in cardiac or respiratory arrest due to an opioid overdoes, the use of naloxone could reverse the effects and save their lives.
There are six topics in the first aid update list worth mentioning:
There is one area of re-emphasis and one update when it comes to bleeding control. First, the re-emphasis.
For bleeding that isn't easy to control, especially if the patient's life is at risk, we're re-encouraging the use of hemostatic agents and tourniquets to help stop the bleeding.
The update: For open chest wounds, we're no longer using fully occlusive chest dressings.
We're no longer using cervical collars, as it's impossible to fully immobilize a patient. Instead, the focus is going to be on minimizing the patient's movement as much as possible.
There has been a new treatment recommendation when it comes to what to put teeth into when they're dislodged. What works best seems to be whole milk or egg whites, but these are not easy to store or preserve in a first aid kit.
The goal was on finding something more stable, more portable, and with a longer shelf life. To that end, there are two new recommendations – coconut water and Hank's Balanced Salt Solution.
After administering the first dose of sugar/glucose treatment, the new recommendation is to wait up to 15 minutes before calling 911 and activating EMS, as there is often a delayed response between administering the treatment and it taking effect.
A new assessment is now in place for when a person shows signs and symptoms of a concussion. The patient will not be able to return to work or play until they are fully cleared by a healthcare provider.
And finally, the latest recommendation on stroke assessment involves the use of an easy-to-remember acronym (that we'll teach you in this course) that will help you determine if a patient's symptoms are indeed stroke-related or not.