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By now most first aiders will have been taught the 2005 guidelines. If you haven’t then some of this rationale may be useful to you.  It may also be useful if you are a first aid trainer and need to qualify some of the changes.

ILCOR (The International Liaison Committee on Resuscitation) meet every five years or so and share research from all the Resuscitation Councils throughout the world including The Resuscitation Council (U.K.). It is from this research that new guidelines are issued and I will summarise them here, together with their rationale as I understand them.

First off all the main message that seems to come through is the need to simplify information so that it is retained longer. One of the ways they (ILCOR) have done this is to take out some of the 'exceptions', for example the only time you would now 'work for one minute if alone' is in the case of a child or drowning victim; the rationale behind this is that drowning is easily identified. In all other cases you should leave your casualty if they are not breathing and call for an ambulance. It is also worth mentioning here about agonal breathing since apparently lots of 'rescuers' believe a casualty to be breathing when in fact they are not.

AGONAL BREATHING
This is a term used to describe 'gasps' of breath by a casualty with SCA (Sudden Cardiac Arrest). This happens in up to 40% of victims for a few minutes after SCA and is often confused with 'normal' or 'noisy' breathing. It is however a sign that CPR should be initiated immediately (once an ambulance has been called). For this reason, if you are in any doubt about if your casualty is breathing or not, assume not.

THE IMPORTANCE OF 'QUALITY' CHEST COMPRESSIONS
Research shows that when a person collapses with SCA their lungs are, at that time, oxygenated. The priority now is to get some of that oxygenated blood to the brain and heart and so this is the reason why we now start the CPR process with chest compressions; the number is now 30 not 15 as before.

NON-VENTILATED CPR
Research has shown that a person in need of CPR who only receives chest compressions and NOT rescue breaths still has a chance of survival, even though inflations COMBINED with chest compressions would be preferable. If you are unable to give rescue breaths (badly injured or contaminated face, for example) or unwilling for other reasons then continuous chest compressions will still give the casualty a better chance of survival rather than nothing.

PAEDIATRIC BLS (Basic Life Support) has also been simplified to come in line with the adult guidelines. Having said that ILCOR go on to say that child/ baby resuscitation can be made more suitable if you start with five breaths. They then go on to give further guidelines if you are a 'healthcare professional with a duty to respond to paediatric emergencies'.

Alan Whitlock
Author - First Aid Explained

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