Every 5 years the European Resuscitation Council (ERC), the Resuscitation Council (UK) and the International Liaison Committee on Resuscitation (ILCOR) review the latest research and evidence in resuscitation before producing updated guidelines. In 2015 the European Resuscitation Council (ERC) also produced guidelines for first aid for the first time.
Here are the key points:
1. Elevation and indirect pressure points are no longer recommended for the treatment of major external bleeding.
Apply direct pressure to control external bleeding where possible. Do not try to control major external bleeding by the use of proximal pressure points or elevation of an extremity, as there is a lack of evidence supporting the effectiveness of these methods.
2. Sucking chest wounds should be left open to the environment – three sided dressings are no longer recommended.
The most up to date guidance is to leave open chest wounds (sucking chest wounds) uncovered. If absolutely necessary, cover the wound with a non-occlusive (breathable) dressing. Three sided dressings are no longer recommended. Any localised bleeding can be controlled with direct pressure.
3. Oral carbohydrate-electrolyte beverages (sports energy-rehydration drinks) are now recommended for exertion related dehydration.
Specific sports energy-rehydration drinks have proven to be more effective than water as they also replace lost body mineral salts. Acceptable alternatives include water, coconut water, 2% milk or tea with or without carbohydrate electrolyte solution added.
4. Be aware that a seizure may indicate that a person has gone into cardiac arrest.
Immediately following cardiac arrest, blood flow to the brain is reduced to virtually zero which may cause a seizure-like episode that can be confused with an epileptic seizure. First Aiders should be suspicious of cardiac arrest in any casualty presenting with seizures and should know how to recognise agonal gasps — something Life Saving Training has always taught.
5. Haemostatic dressings and tourniquets are to be used when direct pressure cannot control severe bleeding.
Following extensive use and research in combat, there is a wealth of evidence that tourniquets and haemostatic dressings/agents have saved many lives. People in environments where catastrophic blood loss is possible should be trained in the use of tourniquets and haemostatic agents/dressings to stop this type of bleeding.
6. First Aiders should aim to give 15-20g of glucose to conscious casualties showing effects of Hypoglycaemia (low blood sugar).
Treat conscious casualties with hypoglycaemia with glucose tablets equating to 15–20g of glucose. If glucose tablets are not available, use other dietary forms of sugar such as sugary drinks or food.
7. For the treatment of Asthma, first aiders should know how to administer an inhaler and how to use a ‘spacer device’.
In the UK, that includes assisting a casualty to take their own prescribed reliever inhaler and knowing how to recognise and use a spacer device.
8. First Aiders should know how to activate the speaker function on their phone when calling 999.
This helps the First Aider to communicate with the Emergency Medical Dispatcher at the same time as assisting the casualty — something we’ve always advocated.
9. ’Shout for help’ when appropriate.
A First Aider may shout for help at any stage during the initial assessment of a casualty and any subsequent resuscitation attempt — something we’ve often discussed on our courses!
If you have any questions about these updates, would like to book a short refresher or need anything else, get in touch and we’ll be happy to help!