Resuscitation Guideline 2015 – Resuscitation Council UK and European Resuscitation Council Guideline – Basic Life Support – the Changes Hot off the Press!
Today the 15th October 2015 the Resuscitation Council UK and European Resuscitation Council guidelines 2015 are introduced. The European Resuscitation guidelines were published at 6am and the UK guidelines at 11am.
Unlike 2005 and 2010, today there are very few changes. All morning the team at Guardian Angels Training have examined the Resuscitation Guideline 2015 and have produced an overview of the changes in BLUE text.
As a quality training provider we can confirm the Resuscitation Guideline 2015 will be included in all regulated First Aid and Basic Life Support courses with immediate effect. This will ensure that our customers receive compliant, safe and evidenced based training courses.
You will find the original Resuscitation Guideline 2015 here:
Overview of the Changes:
Safety – emphasis is on the rescuer, casualty and bystander safety.
No change here from the 2010 guideline.
Response – Check the victim for a response. Gently shake his shoulders and ask loudly: “Are you all right?
No main change here for the process of checking of a response, however the sentence “Shout for help” has been removed from the Resuscitation Guideline 2015.
Airway – The 2015 guideline emphasises that the method of airway opening for Lay Rescuers should remain as “head tilt and chin lift”.
No significant change.
Breathing – “Look, Listen and Feel for NORMAL Breathing for no more than 10 seconds”. The 2015 guideline still includes the vital point of being caution of Agonal Breathing and always erring on the side of caution. “If you have any doubt whether breathing is normal, act as if it is they are not breathing normally and prepare to start CPR.”
The Resuscitation Guideline 2015 does also include a new section on “seizure-like episodes” as a result of reduced blood flow to the brain. In some cases the catastrophic reduction of oxygen can be confused with a seizure so rescuers “should be suspicious of cardiac arrest in any patient presenting with seizures and carefully assess whether the victim is breathing normally.”
What is also interesting is that previous guidelines have discussed what to do if the casualty was, and was not breathing normally. The 2015 guidelines just examine what to do if the casualty is not breathing normally.
Dial 999 and Send for an AED – The guidelines continue to clarify how the emergency services should be contacted and how to obtain an AED.
The Resuscitation Guideline 2015 have an added section on teaching rescuers to “activate the speaker phone” to aid communications with the emergency services. Moreover, the 2015 guideline also confirm that a lone rescuer should not leave a casualty to retrieve an AED, however, if help is available they should be sent for an AED if available. The 2015 guidelines have confirm that AED can be safely used by those with minimal or no training; “AEDs are safe and effective when used by laypeople, including if they have had minimal or no training”.
Circulation – “Start chest compressions”. The 2015 guideline primarily examines the effective use of chest compressions with minimal delay or interruption. The position, rate and ratio remain unchanged; “place the heel of your hand in the centre of the chest with the other hand on top”, “chest compressions are performed at a rate of 100 – 120 min”, should be combined with rescue breaths using a ratio of 30 chest compressions to 2 breaths respectively.
The Resuscitation Guideline 2015 confirm that compressions that are too shallow are more harmful than compressions that are too deep and therefore training should continue to prioritise achieving adequate compression depth of approximately “5 cm but not more than 6 cm in the average sized adult”. There is also emphasis on allowing “full recoil of the chest” to allow for better blood flow to improve the effectiveness of CPR. Rescuers should therefore take care to avoid leaning forward after each chest compression.
Rescuers fatigue when performing effective CPR. The 2015 guidelines confirm that they “should change over approximately every two minutes to prevent a decrease in compression quality”.
Rescue breaths – are delivered over 1 second. The importance of not using forceful or rapid breaths is mentioned.
Earlier guidelines mention two breaths should take no more than 5 seconds, however the 2015 guideline mentions “the maximum interruption in chest compression to give two breaths should not exceed 10 seconds”. This involves opening the airway, providing two breaths over 1 second respectively and commencing chest compressions.
The Resuscitation Guideline 2015 also mentions in addition the mouth-to-mouth ventilations, mouth-to-nose and mouth-to-tracheostomy. There is further mention of the use of a barrier device with the aim of reducing the amount of bacterial transference. It is important to note, that their effectiveness in clinical practice is unknown. If rescuers use a barrier device, care should be taken to avoid unnecessary interruptions in CPR.
Compression only CPR – trained rescuers should perform chest compressions and rescue breaths.
The Resuscitation Guideline 2010 brought significant confusion amongst some national training providers who advocated that First Aiders and those who were trained should provide Compression Only CPR. This was absolutely WRONG and uncompliant with the Resuscitation Council UK 2010 guideline. The 2015 remains unchanged with the view, that those rescuers trained and able should provide chest compressions and rescue breaths as this may provide additional benefits to the casualty. ONLY if rescuers are not trained or unable to give rescue breaths should they do compression-only CPR.
Use of an AED – typically the use of an AED has been a separate section in the guidelines.
The 2015 guidelines feature AED within the Basic Life Support protocol. This is confirmation of the importance of Public Access Defibrillators available in the UK. The 2015 guidelines confirm that “AEDs are safe and effective when used by laypeople, including if they have had minimal or no training. Rescuers should concentrate on following the (AED) voice prompts”
The Clinical Training Team at Guardian Angels Training hope that our customers have gained some insight into the changes to resuscitation practice in the UK. If you require any further information then please do contact any member of the team who will be happy to help.
The full Resuscitation Guideline 2015 and downloaded PDF Resuscitation Posters are available here: https://www.resus.org.uk/resuscitation-guidelines/