Revisions to CPR-Related
Courses

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Background Information for Red Cross Instructors and Organizations Providing Red Cross CPR Courses.

Listed below is a summary of changes integrated into Red Cross courses that include CPR (Summer 2001).

The American Red Cross divides CPR and first aid courses into three primary categories: lay responder, lay responder with a duty to act and professional rescuer. We are initially focusing on revisions affecting lay responders with a duty to act and professional rescuers. A summary of revisions affecting lay responders will be released at a later time.

In courses where successful participants receive course completion certificates with a validity period, the courses fall into the categories of lay responder with a duty to act and professional rescuer. Red Cross courses in these categories include the following:

Lay Responder with a Duty to Act

    • Workplace Training: Standard First Aid
    • Workplace Training: Standard First Aid with AED
    • Workplace Training: Adult CPR
    • Workplace Training: Adult CPR/AED
    • Workplace Training: First Aid
    • Community First Aid & Safety
    • Responding to Emergencies

Professional Rescuer

    • Lifeguard Training
    • CPR for the Professional Rescuer
    • Emergency Response

Summary of Changes to Courses for Lay Responders with a Duty to Act and Professional Rescuers

Overall, Red Cross CPR courses will continue to emphasize the importance of skills training and include an even greater emphasis on the use of Automated External Defibrillators (AEDs). Listed below are the main concepts of the changes that will be integrated into Red Cross courses for the lay responder with a duty to act and the professional rescuer.

Lay Responder with a Duty to Act

Rescue Breaths

  • Instructs responders to give breaths to adult, child and infant victims in such a way that ensures the delivery of the most effective breaths and to reduce the risk of gastric inflation during rescue breathing. As an example, for an adult—
    • Each breath should be slow, gentle and last about 2 seconds.
    • The responder should pause and take a breath between breaths given to the victim.
  • Face shields should be used instead of direct mouth–to–mouth contact only until mouth–to–mask or bag–valve–masks are available.

Pulse Check

  • Instructs responders to check for signs of circulation. The signs of circulation include—
    • Normal breathing.
    • Coughing or movement in response to rescue breaths.
    • A pulse.
  • Instructs responders that if after the initial two slow, gentle, rescue breaths, the victim does not show signs of circulation, the responder should begin CPR.
  • Emphasizes that a responder should look, listen and feel for no more than 10 seconds.

Chest Compressions

  • Instructs responders to—
    • Perform CPR at a ratio of 15 compressions to 2 breaths for 1 and 2 responders.
    • Perform chest compressions at a rate of approximately 100 compressions per minute for an adult or child victim who shows no signs of circulation.
    • Perform chest compressions at a rate of at least 100 compressions per minute for an infant victim who shows no signs of circulation.
  • Clarifies that this is the rate, not the actual number of compressions done in a minute.
  • Provides instruction on 2–responder CPR for all Red Cross courses that teach CPR when a course completion certificate is awarded to successful participants.

Full CPR versus Compressions Only or Breaths Only

  • Emphasizes that responders should perform both rescue breaths and chest compressions during CPR with exceptions made only in the following situations:
    • Responders who are unwilling to give rescue breaths are instructed to begin chest compressions.
    • Responders who are unwilling to perform chest compressions are instructed to begin rescue breaths.

Unconscious Choking Victim
Instructs responders to—

  • Call 9–1–1 or the local emergency number (or have someone else call) and begin CPR for an unresponsive or unconscious choking victim.
  • Continue performing CPR even if there appears to be an airway obstruction in the unresponsive victim.
  • Each time the airway is positioned to give rescue breaths, look for an object in the back of the throat. Attempt to remove an object only if you see it in the mouth.

Note: The chest compressions of CPR basically equate to chest thrusts. The science indicates that chest thrusts are as effective as, and potentially more effective than, abdominal thrusts. This technique is currently taught in Red Cross courses for an unconscious choking victim who is noticeably pregnant. This revision results in a simplification in training. The same basic skill of chest compressions/chest thrusts and rescue breaths can be applied to victims who have no pulse and unresponsive victims with a foreign–body airway obstruction.

Recovery Position

  • Instructs responders to turn the adult or child victim to the opposite side after 30 minutes or until there are signs of loss of circulation to the lower arm.

AED Use in Children

  • Clarifies that the use of an AED is not recommended for an infant or child less than 8 years old and who weighs less than 55 pounds.
  • Clarifies that for an infant or child less than 8 years old and who weighs less than 55 pounds who is in cardiac arrest, the initial priorities continue to be support of the airway, oxygenation and ventilation.

Jaw–Thrust Maneuver to Open the Airway

  • Demonstrates a technique to apply a jaw–thrust maneuver to an adult or child victim.

Sequence for a Responder Who is Alone

  • Instructs responders to Call First, that is, call 9–1–1 or the local emergency number before providing care for—
    • An adult victim or child 8–years–old or older.
    • An infant or child known to be at a high risk for heart problems.
  • Instructs responder to provide 1 minute of care, then Call Fast for—
    • An unconscious victim less than 8–years–old.
    • Submersion or near drowning.
    • Arrest associated with trauma.
    • Drug overdoses.

Professional Rescuer

Rescue Breaths

  • Instructs rescuers to give breaths to adult, child and infant victims in such a way that ensures the delivery of the most effective breaths and to reduce the risk of gastric inflation during rescue breathing. As an example, for an adult—
    • Each breath should be slow, gentle and last about 2 seconds.
    • The rescuer should pause and take a breath between breaths to the victim.
  • A face shield should be used instead of direct mouth–to–mouth contact until a mouth–to–mask or bag–valve–mask is available.

Mouth–to–Mask or Bag–Valve–Mask Breathing with Supplemental Oxygen

  • Instructs rescuers to use only the force necessary to cause the chest to clearly rise for adult, child and infant victims.

Pulse Check

  • Instructs rescuers to check for signs of circulation. The signs of circulation include—
    • A pulse.
    • Coughing or movement in response to rescue breaths.
    • Normal breathing.
  • Instructs rescuers that if after the initial two slow, gentle, rescue breaths, the victim does not show signs of circulation, the rescuer should begin CPR.
  • Emphasizes that a rescuer should look, listen and feel for no more than 10 seconds.

Chest Compressions

  • Instructs rescuers to—
    • Perform CPR on an adult victim at a ratio of 15 compressions to 2 breaths for 1 or 2 rescuers.
    • Perform chest compressions at a rate of approximately 100 compressions per minute for an adult or child victim who has no pulse.
    • Perform chest compressions at a rate of at least 100 compressions per minute for an infant victim who has no pulse.
  • Clarifies that this is the rate, not the actual number of compressions done in a minute.

Infant Chest Compressions for 2 Rescuers

  • Instructs rescuers to use a technique where—
    • One rescuer encircles the infant's chest with his or her hands and compresses the chest with his or her thumbs.
    • The second rescuer provides ventilations.

Recovery Position

  • Instructs rescuers to turn the adult or child victim to the opposite side after 30 minutes or until there are signs of loss of circulation to the lower arm.

AED Use in Children

  • Clarifies that the use of an AED is not recommended for an infant or child less than 8 years old and who weighs less than 55 pounds.
  • Clarifies that for an infant or child less than 8 years old and who weighs less than 55 pounds who is in cardiac arrest, the initial priorities continue to be support of the airway, oxygenation and ventilation.

Jaw–Thrust Maneuver to Open the Airway

  • Instructs rescuers in a technique to apply a jaw–thrust maneuver to an adult, child or infant victim.

Sequence for a Rescuer Who is Alone

  • Instructs rescuers to Call First, that is, call 9–1–1 or the local emergency number before providing care for—
    • An adult victim or child 8–years–old or older.
    • An infant or child known to be at a high risk for heart problems.
  • Instructs rescuers to provide 1 minute of care, then Call Fast for—
    • An unconscious victim less than 8–years–old.
    • Submersion or near drowning.
    • Arrest associated with trauma.
    • Drug overdoses.

 



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