Overview Why new CPR Guidelines. 2005 CPR Guideline changes. Automatic External Defibrillation. Types of AEDs, and local suppliers.
Why new Guidelines?!!! • The new CPR and AED guidelines are the result of years of study and debate carried out by ILCOR, the International Liaison Committee on Resuscitation. • ILCOR was formed in 1992 to provide a forum for liaison between principal resuscitation organizations worldwide.
Why new Guidelines?!!! • ILCOR comprises representative organizations from the USA, Europe, Australia, New Zealand, South Africa, …and the Heart and Stroke Foundation of Canada. • The objectives of ILCOR include; providing a forum for discussion of resuscitation issues, and fostering scientific research and reviewing scientific data. • Therefore, new CPR guidelines are not arbitrary creations of the Red Cross, St. John Ambulance etc.
Why new Guidelines?!!! • ILCOR produced the first set of international CPR guidelines in 2000. With an evidence based review of resuscitation science, these CPR guidelines were updated in 2005. We will see a fresh review every five years. • With this process, CPR and Emergency Cardiac Care is standardized across a large part of the world, and amongst training agencies such as the Red Cross, St. John Ambulance, Heart and Stroke, etc.
What does this mean for you?? • New CPR levels for employers/agencies. • New Guidelines for responders.
CPR Levels…what should you ask for ??? • Level A- For both lay rescuers and the workplace, it covers one rescuer CPR and choking maneuvers for adults only. (Not suited to Fire Departments). • Level B-For families, child care workers, etc. It covers one rescuer CPR and choking maneuvers for adults, children and infants, and includes an introduction to AED.
CPR Levels…what should you ask for ??? • Level C- For police, firefighters or other first responders who are trained to the Standard First Aid level or lower. It covers adult, child and infant CPR and choking maneuvers, two rescuer CPR, and an introduction to AEDs. • Level HCP- For police, firefighters or other first responders who are trained to the First Responder level or higher. It covers everything in Level C, plus incorporates pulse checks, use of bag-valve-mask, and jaw thrust.
New CPR Guideline Changes… Specifics • The focus is on simplification, and better retention of the skills. • For those taking Level A,B or C CPR, the rescuer begins CPR if the victim is unconscious, not moving and not breathing. (No pulse check!). Those trained to the “First Responder” level or above will still check for a pulse. • Increased emphasis on the process of CPR: “push hard and push fast” at a rate of 100 compressions per/min. • Allow full chest recoil.
New CPR Guideline Changes… Specifics • No land marking on the chest. Simply place the heel of one hand in the “middle of the chest”. • Single rescuers of an infant, child and adult will use a compression to ventilation ratio of 30:2 • If you find an unresponsive adult and you are alone, leave them to go call 911. If you find an unresponsive child or infant, do five cycles (two minutes) of CPR first before going to call 911.
New CPR Guideline Changes… Specifics • Those trained to a Standard First aid level or below will use a full head tilt-chin lift to open the airway, even with possible spinal injuries. The jaw thrust is reserved for those trained as First Responders and above. • Actively suggest to a person suspected of having a heart attack that they take ASA (Asprin). • Increased emphasis on how to use an automatic External Defibrillator (AED) if available.
Importance of Automatic External Defibrillation • In Canada, 35,000 to 45,000 people die of sudden cardiac arrest each year. • A comprehensive US Fire Administration study showed the leading cause of line of duty death in firefighters was sudden cardiac arrest (44%). • Prompt CPR and early access to defibrillation in the pre-hospital setting is the treatment of choice for sudden cardiac arrest. • For every one minute delay in defibrillation, survival rate of a cardiac arrest victim decreases 7-10%. After 12 minutes, the survival rate of adults is less than 5%.
What is an AED • An AED is a device containing sophisticated electronics used to identify cardiac rhythms, and to deliver a shock to correct abnormal electrical activity in the heart. An AED will only advise the individual to deliver a shock if the heart is in a rhythm which can be corrected by defibrillation.
Recommendation for AED Use • The Canadian Heart and Stroke Foundation, and ILCOR, have recommended the use of AEDs by trained lay, and professional responders, to increase survival rates in patients with cardiac arrest. • The Foundation urges anyone in close contact with those at high risk of cardiac arrest, such as firefighters, to become trained in the use of AEDs.
Just how easy is it to Use ? After the AED arrives… • Open and turn on the AED. • Remove clothing or objects from the person’s chest • Ensure the chest is dry and free of hair so the pads can stick. • Follow the diagrams for pad placement on the person. • Follow the automated prompts. • If the AED prompts you to give a shock, stand clear and say “I’m clear, your clear, everbody’s clear” and press the shock button.
New Technology in AEDs • Defirillators today employ biphasic waveforms. This means instead of sending electrical current through the heart in only one direction (monophasic), the current now also reverses and passes back through the heart a second time. • Biphasic devices achieve higher first shock success rates than monophasic AEDS. • Biphasice AEDs do this using less energy and less current, ultimately better for the heart.
AED Program If you are going to place a defibrillator in service, you should have a maintenance program in place. Such a program includes: • Routine readiness checks on the batteries and pads, and self tests. • Scheduled equipment maintenance. • Regular training of likely users. • Performance measures (track outcomes, time to shock,etc.)
Factors in purchasing an AED • Cost of the AED. • Cost of the AED trainer which matches your AED. • Cost of disposable pads. • Availability of a replacement unit in a timely fashion. • Customer service (locally available?, 24/7??) • Is the unit easy to use? • Compatibility with surrounding departments and/or local EMS.
Factors in purchasing an AEDHint, hint…. • Ambulance Services branch is rumored to have decided to make a group purchase of the Philips Heart Start MRx for every ambulance in the province.
Local Suppliers Carrying AEDs • Green Star Medical carries the Philips HeartStart FRx and HeartStart FR2+. • Brent Fairweather (Laerdal Dealer) also sells Philips products. • Safety Source Ltd. carries ZOLL AED Plus. • VMC carries Medtronic LIFEPAK 1000. All AED models function in a very similar manner
Ball Park Prices Recently obtained quotes on one AED… • Medtronic LIFEPAK 1000 $3600.00 • ZOLL AED Plus Defib $1800.00 • Philips HeartStart FRx $2475.00 • Philips HeartStart FR2+ $4341.00
Thank you for your time! AED DEMO