Resuscitation Council (UK) Guidelines 2015
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 and then release updated guidelines. In addition to this, for the very first time, the European Resuscitation Council (ERC) have also produced guidelines for first aid these include new advice on bleeding and other vital updates.
Resuscitation Council (UK) 2015 Guidelines –
There are a few changes to highlight here:
1. ‘Shouting for help’ is no longer a step to be taught on its own. The guidelines now state that the first aider should ‘ask someone to call 999/112’ after checking for normal breathing.
2. The new guidance also emphasises that people should use the speaker function on their phones so they can have hands free guidance from the emergency services whilst administering First Aid.
3. The new guidance highlights that seizure like episodes should not be confused with a sign of life. Seizure like episodes can occur following a cardiac arrest due to reduced blood flow to the brain. If the person does not appear to be breathing start CPR immediately. The guidelines also reinforces the importance of recognising Agonal Gasps and starting CPR if the casualty is not breathing normally.
European Resuscitation Council (ERC)
The ERC first aid guidelines are based on a worldwide expert consensus of best practice following an international evidence-based review from the ERC and ILCOR, making them an extremely important addition to first aid practice in Europe.
Key changes listed below:
Control of Bleeding:
• Elevation is no longer recommended for the treatment of bleeding as there is no evidence that this does actually reduce bleeding.
• Indirect pressure is not recommended as again there is no evidence that this helps control serious bleeding – direct pressure is recommended.
• Haemostatic dressings and tourniquets are to be used in catastrophic bleeding when direct pressure does not control blood loss. There will need to be specific training to use these and this should be included in specific First Aid courses where the Health and Safety Assessment shows a risk of catastrophic bleeding.
• Sucking chest wounds should now be left open to the environment and not covered with a dressing – the three sided dressing is no longer recommended as this has been shown to increase the risk of occlusion. Direct pressure should be used to control localised bleeding.
Treatment for Asthma – First aiders should all be trained in the various methods of administering an Asthma inhaler including spacer devices.
Treatment for Hypoglycaemia – first aiders to give 15-20 g of glucose or tablets for adult casualties.
Treatment for Heat Exhaustion – Oral Carbohydrate-electrolyte beverages (sports energy-rehydration drinks) 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 salts. Evidence also suggests that semi-skimmed milk and tea can also be as effective as water
Treatment for Burns – Burns should be cooled as soon as possible with water for a minimum of 10 minutes. There is no change here to the advice that First Aid for Life has always given, but it is good to have this clarified and documented.
For further information please go to: https://www.resus.org.uk/resuscitation-guidelines/
Should we still be using the Burn Gels?
Paul
Dear Paul, thank you for your message. Burn gel should not be used for large burns as it can precipitate over cooling and lead to hypothermia. Water is the best option for burns, however if you are somewhere where you don’t have access to copious amounts of cool running water, or if the person will not tolerate >10 minutes under cool running water, then burn gels are the next best option. Ideally the burn should be cooled for at least 10 minutes before applying the burn gel. I hope that helps
Why is a dressing sealed on three sides (ideally a plastic card / credit card) no longer suitable for a sucking chest wound? I understand there may be occasions that a dressing becomes fully sealed but this shouldn’t happen with a plastic card – plus the likelihood of the patient dying if left uncovered must be greater? And what about infection?
This just doesn’t make sense to me.
Dear Alan, please refer to the latest European guidelines 2 years ago, where this was fully explained and updated. There is a greater risk of occlusion using the dressing than not. It is now advised to leave the wound open, unless you have a manufactured Russell chest seal with valve. I hope that helps. Best wishes Emma
I see here that research shows elevation is advantageous
http://www.alliedacademies.org/articles/the-effect-of-limb-elevation-on-bleeding-control-in-a-human-venous-hemorrhage-model-9491.html
Thank goodness common sense has prevailed. Thank you so much for sharing
1. CPR and Serious Bleeding. If a casualty has gone into cardiac arrest and has serious arterial bleeding. At what point to you attempt to stop bleeding after CPR, this is specific scenario is if you are alone. The thinking being you are attempting to pump the heart while the patient is seriously bleeding.
2. For many years we were taught to seal (occlusives) sucking chest wound, but now we leave it exposed to the environment? What if you have a specific non- occlusive dressing.
Dear Paul, thank you for your comments. The advice is that if it is a catastrophic bleed, this takes priority over CPR. From experience, there is no point at all trying to resuscitate someone when they are bleeding out within in 3 or 4 minutes.
If you have a specific non-occlusive Russel chest dressing then please use it.
Very best wishes
Emma
Having an argument I am training new guidlines to remove 11am bandage and control bleeding then apply a new bandage and not to apply 2nd bandage befor removing
Where in the guidelines dose it say that first aid treatment for bleeding is to apply a bandage and if bleeding continues removed apply pressure and then a new bandage?
If the bleeding hasn’t stopped, then it is likely that there isn’t sufficient pressure on the source of the bleeding. Hence the advice to remove the dressing and re investigate the source of the bleeding to apply direct pressure to the wound.