Guest guest Posted November 29, 2005 Report Posted November 29, 2005 The dissemination of this information is of a high priority; the U.K's respected and recognised Resuscitation council has issued new guidelines and we are all going to have to follow them and get everyone we train to do the same; and this is the rub...I am still occasionally coming into conflict with people I am training at the work site who recall the old 5:1 compression/ventilation ratio!! In my brief reading of the new regs the resus council now recommends: A ratio of 30: 2 for adults A ratio of 15: 2 for paeds Adrenaline every 3-5 minutes 2 minutes of CPR after delivery of defibrillation for VF/Pulseless VT or between assessments of pulse for PEA/Asystole. This makes the Algorythmn much simpler to follow. The provision of a second pre-cordial thump in the event of a witnessed and monitored arrest where no defib is immediately available. The use of therapeutic hypothermia for 12-24 hrs for arrest survivors Oh well, best re-schedule the 100 plus guys on the site for some CPR up- date sessions! Regards > > Hi all > What do you think of the new Resus Council guidelines then? > I was having a chat with a mate of mine (yes Tom, I have some) who is a > resus officer and he seemed to think that they made sense. > > Thoughts, chaps? > > Rod > Quote
Guest guest Posted November 29, 2005 Report Posted November 29, 2005 : Thanks for the heads up; most appreciated. Up here in the great white north, we all (Medical staff et all) Heard on the television last night...(yes, Tom we do have T.V.here) that the standards have changed. In fact the news release stated a possibility of a 400% increase in lives saved?...yup my ears still work..... hmmmm? Cant wait for the hardcopy on that one. Bloody polite of the Resus council to inform the providers on this media, wankers! Quite difficult to answer the lay questions when one has no information, 100 guys...try 5000+. Any Changes with first line antiarrthmics or vasopressin, just rumour of one Defib then CPR instead of the 3 shocks back to back? Just like the old days...damn good thing i just recertified a month ago.......where's my wallet AGAIN? Wilf Re: New guidelines > The dissemination of this information is of a high priority; the U.K's > respected and recognised Resuscitation council has issued new > guidelines and we are all going to have to follow them and get everyone > we train to do the same; and this is the rub...I am still occasionally > coming into conflict with people I am training at the work site who > recall the old 5:1 compression/ventilation ratio!! > > In my brief reading of the new regs the resus council now recommends: > > A ratio of 30: 2 for adults > > A ratio of 15: 2 for paeds > > Adrenaline every 3-5 minutes > > 2 minutes of CPR after delivery of defibrillation for VF/Pulseless VT > or between assessments of pulse for PEA/Asystole. This makes the > Algorythmn much simpler to follow. > > The provision of a second pre-cordial thump in the event of a witnessed > and monitored arrest where no defib is immediately available. > > The use of therapeutic hypothermia for 12-24 hrs for arrest survivors > > Oh well, best re-schedule the 100 plus guys on the site for some CPR up- > date sessions! > > Regards > > > >> >> Hi all >> What do you think of the new Resus Council guidelines then? >> I was having a chat with a mate of mine (yes Tom, I have some) who is > a >> resus officer and he seemed to think that they made sense. >> >> Thoughts, chaps? >> >> Rod >> > > > > > > > > Member Information: > > List owner: Ian Sharpe Owner@... > Editor: Ross Boardman Editor@... > > ALL list admin messages (subscriptions & unsubscriptions) should be sent > to the list owner. > > Post message: egroups > > Please visit our website http://www.remotemedics.co.uk > > Regards > > The Remote Medics Team > Quote
Guest guest Posted November 29, 2005 Report Posted November 29, 2005 All the evidence looking at ventilation in CPR is that it isn't helpful and probably does harm (as per AufderHeide et al). In addition, you don't get adequate diastolic pressure for coronary artery perfusion until the 11th or 12th compression so in 15:2, you only get three squirts of blood to the heart for every round of CPR; with 30:2, you'll get 18 good perfusions. It wouldn't surprise me if the next iteration is continuous CPR with a NRB on the patient thoughout (you generate a decent tidal volume with each compression anyway). Also, for those of us who have defibrillated patients from v-fib to persistant asystole (which is probably all of us), the reasoning is that there isn't enough ATP (cellular fuel) in the myocardium for the cardiac cells to begin beating again after defibrillation puts them into asystole. The additional CPR builds up a reserve of ATP so they heart can restart from the electrically induced asystole (which is what defibrillation does--it induces asystole and the heart is supposed to restart on its own). Jonnathan --- cpfmedic <cpfmedic@...> wrote: > The dissemination of this information is of a high > priority; the U.K's > respected and recognised Resuscitation council has > issued new > guidelines and we are all going to have to follow > them and get everyone > we train to do the same; and this is the rub...I am > still occasionally > coming into conflict with people I am training at > the work site who > recall the old 5:1 compression/ventilation ratio!! > > In my brief reading of the new regs the resus > council now recommends: > > A ratio of 30: 2 for adults > > A ratio of 15: 2 for paeds > > Adrenaline every 3-5 minutes > > 2 minutes of CPR after delivery of defibrillation > for VF/Pulseless VT > or between assessments of pulse for PEA/Asystole. > This makes the > Algorythmn much simpler to follow. > > The provision of a second pre-cordial thump in the > event of a witnessed > and monitored arrest where no defib is immediately > available. > > The use of therapeutic hypothermia for 12-24 hrs for > arrest survivors > > Oh well, best re-schedule the 100 plus guys on the > site for some CPR up- > date sessions! > > Regards > > > > > > > Hi all > > What do you think of the new Resus Council > guidelines then? > > I was having a chat with a mate of mine (yes Tom, > I have some) who is > a > > resus officer and he seemed to think that they > made sense. > > > > Thoughts, chaps? > > > > Rod > > > > > > > Jonnathan Busko MD MPH EMT-P Emergency Services Eastern Maine Medical Center _-__-__-__-__-__-__-__-__-__-_ Primum Non Nocere __________________________________ Music Unlimited Access over 1 million songs. Try it free. http://music./unlimited/ Quote
Guest guest Posted November 30, 2005 Report Posted November 30, 2005 wrote...> > ....Oh well, best re-schedule the 100 plus guys on the site for some CPR > up- > date sessions!.... Interesting to see how people in different spheres of operation are reacting to the changes. It appears to vary amongst the general training community. Some are already adopting and delivering the new guidelines in their teaching methods - whilst some are talking about waiting until the VAS produce the 9th edition before they transfer over or revamp training materials. Another concern that seems to be raising it's head a lot is what mnemonic to use - could DRABCDE still apply? - albeit with adjustments - or can members suggest a likely alternative? Alan Quote
Guest guest Posted November 30, 2005 Report Posted November 30, 2005 Interesting point Alan. There will always be a lag between new research/advice and the issuing of new texts for the lay person but I can't see from a legal or professional point of view how anyone could continue teaching the old recommendations. Just my opinion. Regards > > wrote...> > > ....Oh well, best re-schedule the 100 plus guys on the site for some CPR > > up- > > date sessions!.... > > Interesting to see how people in different spheres of operation are reacting > to the changes. It appears to vary amongst the general training community. > Some are already adopting and delivering the new guidelines in their > teaching methods - whilst some are talking about waiting until the VAS > produce the 9th edition before they transfer over or revamp training > materials. Another concern that seems to be raising it's head a lot is what > mnemonic to use - could DRABCDE still apply? - albeit with adjustments - or > can members suggest a likely alternative? > > Alan > Quote
Guest guest Posted November 30, 2005 Report Posted November 30, 2005 I agree that there will always be a period between release of information and update of training materials (phone call to one of the VAS suggested that there is yet to be a tripartite meeting/agreement and that 9th edition of FA manual might not come out until middle of next year!) Agree also that latest techniques should be adopted and taught - just concerned that revision and issue of handouts etc without a standardised format such as the VAS FA Manual to base info on, will result in even more confusion at a later stage when any training materials attended to at this point will inevitably have to be adjusted yet again! There is an " out -clause " for those so inclined methinks in the second last paragraph of the Resus Council Guidelines Introduction - " It will take time for courses and training materials to be updated and ............The publication of new treatment recommendations does not imply that current clinical care is either unsafe or ineffective " . Here's hoping that professionalism prevails! I remember when an instructor was adamantly lecturing that first aiders were no longer trained to check for a pulse - and then follow this up 3 hrs later by studiously verifying each delegate's ability to locate and monitor pulse sites as part of secondary survey! If only they had clarified the circumstances and reasoning to support the former - confused faces all round! Regards Alan Re: New guidelines > Interesting point Alan. > > There will always be a lag between new research/advice and the > issuing of new texts for the lay person but I can't see from a legal > or professional point of view how anyone could continue teaching the > old recommendations. Just my opinion. > > Regards > > > >> >> wrote...> >> > ....Oh well, best re-schedule the 100 plus guys on the site for > some CPR >> > up- >> > date sessions!.... >> >> Interesting to see how people in different spheres of operation are > reacting >> to the changes. It appears to vary amongst the general training > community. >> Some are already adopting and delivering the new guidelines in > their >> teaching methods - whilst some are talking about waiting until the > VAS >> produce the 9th edition before they transfer over or revamp > training >> materials. Another concern that seems to be raising it's head a > lot is what >> mnemonic to use - could DRABCDE still apply? - albeit with > adjustments - or >> can members suggest a likely alternative? >> >> Alan >> > > > > > > > > Member Information: > > List owner: Ian Sharpe Owner@... > Editor: Ross Boardman Editor@... > > ALL list admin messages (subscriptions & unsubscriptions) should be sent > to the list owner. > > Post message: egroups > > Please visit our website http://www.remotemedics.co.uk > > Regards > > The Remote Medics Team > Quote
Guest guest Posted November 30, 2005 Report Posted November 30, 2005 All, Note that here in the good old U-S-eh... it was cited yesterday by one of the authors of the new stuff, that while the new guidelines are out NOW, " instructors will get their updated curiculum information after the first of the year " - go figure. Sure makes us feel like promoting CPR classes when we can't actually know what to teach. It certainly would cost me all my students until then if I had classes scheduled - brilliant! Best, Steve Wilf Mackie <w.mackie@...> wrote: : Thanks for the heads up; most appreciated. Up here in the great white north, we all (Medical staff et all) Heard on the television last night...(yes, Tom we do have T.V.here) that the standards have changed. In fact the news release stated a possibility of a 400% increase in lives saved?...yup my ears still work..... hmmmm? Cant wait for the hardcopy on that one. Bloody polite of the Resus council to inform the providers on this media, wankers! Quite difficult to answer the lay questions when one has no information, 100 guys...try 5000+. Any Changes with first line antiarrthmics or vasopressin, just rumour of one Defib then CPR instead of the 3 shocks back to back? Just like the old days...damn good thing i just recertified a month ago.......where's my wallet AGAIN? Wilf Re: New guidelines > The dissemination of this information is of a high priority; the U.K's > respected and recognised Resuscitation council has issued new > guidelines and we are all going to have to follow them and get everyone > we train to do the same; and this is the rub...I am still occasionally > coming into conflict with people I am training at the work site who > recall the old 5:1 compression/ventilation ratio!! > > In my brief reading of the new regs the resus council now recommends: > > A ratio of 30: 2 for adults > > A ratio of 15: 2 for paeds > > Adrenaline every 3-5 minutes > > 2 minutes of CPR after delivery of defibrillation for VF/Pulseless VT > or between assessments of pulse for PEA/Asystole. This makes the > Algorythmn much simpler to follow. > > The provision of a second pre-cordial thump in the event of a witnessed > and monitored arrest where no defib is immediately available. > > The use of therapeutic hypothermia for 12-24 hrs for arrest survivors > > Oh well, best re-schedule the 100 plus guys on the site for some CPR up- > date sessions! > > Regards > > > >> >> Hi all >> What do you think of the new Resus Council guidelines then? >> I was having a chat with a mate of mine (yes Tom, I have some) who is > a >> resus officer and he seemed to think that they made sense. >> >> Thoughts, chaps? >> >> Rod >> > > > > > > > > Member Information: > > List owner: Ian Sharpe Owner@... > Editor: Ross Boardman Editor@... > > ALL list admin messages (subscriptions & unsubscriptions) should be sent > to the list owner. > > Post message: egroups > > Please visit our website http://www.remotemedics.co.uk > > Regards > > The Remote Medics Team > Quote
Guest guest Posted November 30, 2005 Report Posted November 30, 2005 Alan, as a trainer in one of the VAS, I can confirm that the meeting of our medical directors is scheduled for January. The timetable was set earlier this year and basically will be for trainer and member update training from about April and go-live on public training in August 2006. The updates will be a new impression of the 8th Edition manual rather than a new edition and so the date it hits the shelves will be dependant on stock levels of the old impression but hopefully will be around April/May. Going on past form, new impressions of the manual are usually identified by a different colour spot on the front cover (the current one is green). Best Wishes Tom Crellin Re: Re: New guidelines I agree that there will always be a period between release of information and update of training materials (phone call to one of the VAS suggested that there is yet to be a tripartite meeting/agreement and that 9th edition of FA manual might not come out until middle of next year!) Agree also that latest techniques should be adopted and taught - just concerned that revision and issue of handouts etc without a standardised format such as the VAS FA Manual to base info on, will result in even more confusion at a later stage when any training materials attended to at this point will inevitably have to be adjusted yet again! There is an " out -clause " for those so inclined methinks in the second last paragraph of the Resus Council Guidelines Introduction - " It will take time for courses and training materials to be updated and ............The publication of new treatment recommendations does not imply that current clinical care is either unsafe or ineffective " . Here's hoping that professionalism prevails! I remember when an instructor was adamantly lecturing that first aiders were no longer trained to check for a pulse - and then follow this up 3 hrs later by studiously verifying each delegate's ability to locate and monitor pulse sites as part of secondary survey! If only they had clarified the circumstances and reasoning to support the former - confused faces all round! Regards Alan Re: New guidelines > Interesting point Alan. > > There will always be a lag between new research/advice and the > issuing of new texts for the lay person but I can't see from a legal > or professional point of view how anyone could continue teaching the > old recommendations. Just my opinion. > > Regards > > > >> >> wrote...> >> > ....Oh well, best re-schedule the 100 plus guys on the site for > some CPR >> > up- >> > date sessions!.... >> >> Interesting to see how people in different spheres of operation are > reacting >> to the changes. It appears to vary amongst the general training > community. >> Some are already adopting and delivering the new guidelines in > their >> teaching methods - whilst some are talking about waiting until the > VAS >> produce the 9th edition before they transfer over or revamp > training >> materials. Another concern that seems to be raising it's head a > lot is what >> mnemonic to use - could DRABCDE still apply? - albeit with > adjustments - or >> can members suggest a likely alternative? >> >> Alan >> > > > > > > > > Member Information: > > List owner: Ian Sharpe Owner@... > Editor: Ross Boardman Editor@... > > ALL list admin messages (subscriptions & unsubscriptions) should be sent > to the list owner. > > Post message: egroups > > Please visit our website http://www.remotemedics.co.uk > > Regards > > The Remote Medics Team > Quote
Guest guest Posted November 30, 2005 Report Posted November 30, 2005 Tom, Many thanks for the info. (One of the reasons that I joined this invaluable site in the first place) and I will look out for the revised & updated edition on the bookshelves. Once again, thanks for the update. To all - As concerns my last e-mail - on reading again I think I should clarify that " they " in the last sentence refers to the instructor concerned and not anyone else! Alan Re: New guidelines > > >> Interesting point Alan. >> >> There will always be a lag between new research/advice and the >> issuing of new texts for the lay person but I can't see from a legal >> or professional point of view how anyone could continue teaching the >> old recommendations. Just my opinion. >> >> Regards >> >> >> >>> >>> wrote...> >>> > ....Oh well, best re-schedule the 100 plus guys on the site for >> some CPR >>> > up- >>> > date sessions!.... >>> >>> Interesting to see how people in different spheres of operation are >> reacting >>> to the changes. It appears to vary amongst the general training >> community. >>> Some are already adopting and delivering the new guidelines in >> their >>> teaching methods - whilst some are talking about waiting until the >> VAS >>> produce the 9th edition before they transfer over or revamp >> training >>> materials. Another concern that seems to be raising it's head a >> lot is what >>> mnemonic to use - could DRABCDE still apply? - albeit with >> adjustments - or >>> can members suggest a likely alternative? >>> >>> Alan >>> >> >> >> >> >> >> >> >> Member Information: >> >> List owner: Ian Sharpe Owner@... >> Editor: Ross Boardman Editor@... >> >> ALL list admin messages (subscriptions & unsubscriptions) should be sent >> to the list owner. >> >> Post message: egroups >> >> Please visit our website http://www.remotemedics.co.uk >> >> Regards >> >> The Remote Medics Team >> Quote
Guest guest Posted December 1, 2005 Report Posted December 1, 2005 Hi Rod and all, Had one of my sparkies visit this morning with a newspapaer cutting from the Daily Express detailing the changes so I thought aha ... I'l be dead clever and go straight to remote medics and post something ..... and was beaten to it ... oh well .... Have had a quick read through this morning and seems pretty good so far and makes sense. It certainly seems to mirror some of the recent mumblings and makes more of a comparison to the AHA guidelines also. Havent had chance to go through the ALS stuff yet. Will read further and add comments as responses come in as I hope they will. Tim C (gripping tightly to my desk as we roll uuuupp and dowwwn ... uuuuuup and dowwwwwwn) >From: " Rod Eglin " <rod@...> >Reply- >< > >Subject: New guidelines >Date: Tue, 29 Nov 2005 13:06:52 -0000 > >Hi all >What do you think of the new Resus Council guidelines then? >I was having a chat with a mate of mine (yes Tom, I have some) who is a >resus officer and he seemed to think that they made sense. > >Thoughts, chaps? > >Rod > Quote
Guest guest Posted December 1, 2005 Report Posted December 1, 2005 Alan With regards to DRABCDE, what is starting to slowly spread through the British military (and I have even come across it in the civilian world) is MARCH. Massive haemorrhage, Airway, Circulation, Head injury. The massive haemorrhage bit is when the " claret " is painting the ceiling i.e. if you go down the ABC route, they will be dead by the time you get to C, because there is none left! Mark Re: Re: New guidelines > wrote...> >> ....Oh well, best re-schedule the 100 plus guys on the site for some CPR >> up- >> date sessions!.... > > Interesting to see how people in different spheres of operation are > reacting > to the changes. It appears to vary amongst the general training > community. > Some are already adopting and delivering the new guidelines in their > teaching methods - whilst some are talking about waiting until the VAS > produce the 9th edition before they transfer over or revamp training > materials. Another concern that seems to be raising it's head a lot is > what > mnemonic to use - could DRABCDE still apply? - albeit with adjustments - > or > can members suggest a likely alternative? > > Alan > > > > > > Member Information: > > List owner: Ian Sharpe Owner@... > Editor: Ross Boardman Editor@... > > ALL list admin messages (subscriptions & unsubscriptions) should be sent > to the list owner. > > Post message: egroups > > Please visit our website http://www.remotemedics.co.uk > > Regards > > The Remote Medics Team > Quote
Guest guest Posted December 2, 2005 Report Posted December 2, 2005 HI guys, with reference to MARCH this really is point of injury when the bullets are flying sort of thing and relies a lot on buddy buddy and self tourniquet.It definatly has a place in the civilian role but is primarily a battlefield measure where casevac,blood products and adequate fluids are not readily available.The R in MARCH is Respirations <10/>29 rpm and is again designed for very fast triage by the guys on the ground hope thats clarified things cheers Mark Mark <tintin@...> wrote: Alan With regards to DRABCDE, what is starting to slowly spread through the British military (and I have even come across it in the civilian world) is MARCH. Massive haemorrhage, Airway, Circulation, Head injury. The massive haemorrhage bit is when the " claret " is painting the ceiling i.e. if you go down the ABC route, they will be dead by the time you get to C, because there is none left! Mark Re: Re: New guidelines > wrote...> >> ....Oh well, best re-schedule the 100 plus guys on the site for some CPR >> up- >> date sessions!.... > > Interesting to see how people in different spheres of operation are > reacting > to the changes. It appears to vary amongst the general training > community. > Some are already adopting and delivering the new guidelines in their > teaching methods - whilst some are talking about waiting until the VAS > produce the 9th edition before they transfer over or revamp training > materials. Another concern that seems to be raising it's head a lot is > what > mnemonic to use - could DRABCDE still apply? - albeit with adjustments - > or > can members suggest a likely alternative? > > Alan > > > > > > Member Information: > > List owner: Ian Sharpe Owner@... > Editor: Ross Boardman Editor@... > > ALL list admin messages (subscriptions & unsubscriptions) should be sent > to the list owner. > > Post message: egroups > > Please visit our website http://www.remotemedics.co.uk > > Regards > > The Remote Medics Team > Quote
Guest guest Posted December 2, 2005 Report Posted December 2, 2005 Hi all. I'm a South African paramedic. We see these cases every day. don't trie and complicate things. Stick to ABC. It only takes a few seconds anyway! Re: Re: New guidelines > wrote...> >> ....Oh well, best re-schedule the 100 plus guys on the site for some CPR >> up- >> date sessions!.... > > Interesting to see how people in different spheres of operation are > reacting > to the changes. It appears to vary amongst the general training > community. > Some are already adopting and delivering the new guidelines in their > teaching methods - whilst some are talking about waiting until the VAS > produce the 9th edition before they transfer over or revamp training > materials. Another concern that seems to be raising it's head a lot is > what > mnemonic to use - could DRABCDE still apply? - albeit with adjustments - > or > can members suggest a likely alternative? > > Alan > > > > > > Member Information: > > List owner: Ian Sharpe Owner@... > Editor: Ross Boardman Editor@... > > ALL list admin messages (subscriptions & unsubscriptions) should be sent > to the list owner. > > Post message: egroups > > Please visit our website http://www.remotemedics.co.uk > > Regards > > The Remote Medics Team > Quote
Guest guest Posted December 4, 2005 Report Posted December 4, 2005 Hi Folks I am sure that many on this list will be aware of the old saying " if it ain't broke, don't fix it " , it's just been fixed!!! Just got home from a weekends instructor update course on how the British military are going to run the Battlefield Advanced Trauma Life Support course (very impressed and some interesting ideas) and what I thought would be the pneumonic MARCH is now CABC etc (this will be the standard for the British military). The C stands for Catastrophic haemorrhage (i.e. the claret is painting the ceiling). As the other Mark quite rightly points out this is a point of injury problem with buddy buddy etc, where as in " Medic Buhemba " position I agree to stick to the ABCs because by the time our colleague arrives on scene, the casualty would already be dead due to blood loss. Mark PS: Cheers Mark about the " R " in MARCH. It was a long day and only realised what I had forgotten after I sent the email Re: Re: New guidelines > > > > wrote...> > >> ....Oh well, best re-schedule the 100 plus guys on the site for some > CPR > >> up- > >> date sessions!.... > > > > Interesting to see how people in different spheres of operation are > > reacting > > to the changes. It appears to vary amongst the general training > > community. > > Some are already adopting and delivering the new guidelines in their > > teaching methods - whilst some are talking about waiting until the VAS > > produce the 9th edition before they transfer over or revamp training > > materials. Another concern that seems to be raising it's head a lot is > > what > > mnemonic to use - could DRABCDE still apply? - albeit with > adjustments - > > or > > can members suggest a likely alternative? > > > > Alan > > > > > > > > > > > > Member Information: > > > > List owner: Ian Sharpe Owner@... > > Editor: Ross Boardman Editor@... > > > > ALL list admin messages (subscriptions & unsubscriptions) should be > sent > > to the list owner. > > > > Post message: egroups > > > > Please visit our website http://www.remotemedics.co.uk > > > > Regards > > > > The Remote Medics Team > > Quote
Guest guest Posted October 7, 2006 Report Posted October 7, 2006 ALL OF YOU MUST HAVE NOTICED THE NEW GUIDELINES FOR POSTING. A.NOW ,POWER POINT PRESENTATIONS AND PICTORIAL MESSAGES ARE ALLOWED. & B.FOR DISCUSSIONS,ALL OF YOU ARE INVITED TO JOIN "POSITIVE THINKING AND MEDITATION" COMMUNITY AT 'ORKUT' BY USING THE FOLLOWING LINK: http://www.orkut.com/Community.aspx?cmm=15674676 Mukul Chaudhri http://mukulchaudhri.blogspot.com Quote
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