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First Aid Standards of Care

First Aid/CPR Standards of Care

This page contains a collection of first aid/CPR-related policies/procedures, articles, and video demonstrations that together help to define the standard of care for lifeguards and other safety workers.

2010 ECC Guidelines

Key Changes in CPR and ECC (Taken from Part 1: Executive Summary: 2010 AHA Guidelines for CPR and ECC, S643-S644)

"Look, listen, and feel" eliminated in favor of a quick check for responsiveness and normal breathing. NOTE: The ARC protocol retains the pulse check; the AHA protocol eliminates it.
Compression-Only CPR to be taught to untrained rescuers who witness a sudden collapse.
Chest compressions now proceed breaths (CAB rather than ABC) for sudden cardiac arrest victims. For hypoxic victims, the ABC protocol is retained.
High-quality CPR is emphasized, including chest compressions of appropriate depth, at a rate of at least 100 per minute, with complete chest recoil between compressions and without excessive pauses.
Appropriate compression depth is changes to 1.5 inches for infants, 2 inches for children, and at least 2 inches for adults.
Tasks in resuscitation attempts (e.g., chest compressions, airway management, rescue breathing, AED use, etc.) to be performed concurrently as much as possible by trained rescue teams.

Points of Continued Emphasis in 2010 AHA Guidelines (Taken from Part 1: Executive Summary: 2010 AHA Guidelines for CPR and ECC, S643-S644)

Early recognition of sudden cardiac arrest based on assessing responsiveness and the absence of normal breathing. Training should focus on alerting potential rescuers to unusual presentations of cardiac arrest victims, including gasps and seizure-like signs.
Interruptions in CPR to be minimized. There is no reassessment of the victim once CPR is started.
The importance of the pulse check to be minimized. Detection of a pulse is difficult, and even highly trained healthcare providers often incorrectly assess the presence or absence of a pulse when blood pressure is low or absent. Rescuers should take no more than 10 seconds to determine if a pulse is present. Chest compressions delivered to patients subsequently found not to be in cardiac arrest rarely lead to significant injury. Lay rescuers should not attempt a pulse check and should assume that cardiac arrest is present if an adult suddenly collapses, is unresponsive, and is not breathing (or not breathing normally).

Links to the 2010 ECC Guidelines

Airway Management/Oxygen

First Aid for Choking

Head Tilt Chin Lift

Modified Jaw Thrust

Nasal/Oral Airways

Oxygen Administration

Suctioning

Assessment of Scene/Patient

General/All Inclusive

Principles of Assessment (Brady EMT-B; 1995)

Scene Size-up

Primary (Initial) Assessment/Ongoing Assessment

EMS Activation

Secondary Assessment

Recovery Position

According to 2010 ECC Guidelines: "The recovery position is used for unresponsive adult victims who clearly have normal breathing and effective circulation. This position is designed to maintain a patent airway and reduce the risk of airway obstruction and aspiration. The victim is placed on his or her side with the lower arm in front of the body."

"There are several variations of the recovery position, each with its own advantages. No single position is perfect for all victims.... The position should be stable, near a true lateral position, with the head dependent and with no pressure on the chest to impair breathing.... Studies in normal volunteers... show that extending the lower arm above the head and rolling the head onto the arm, while bending both legs, may be feasible for victims with known or suspected spinal injury...." --Part 4: CPR Overview: 2010 American Heart Association Guidelines for CPR and ECC, S694.

Automated Ext. Defibrillator (AED)

Bandaging/Wound Care

General Bandaging/Wound Care

Bandage Type/Techniques

Adhesive Bandages

Elastic Bandage

ACE Bandage Wrapping How Tos (3M)

Roller Gauze

Triangular/Cravat Bandage

Special Bandaging/Wound Care

Gunshot/Knife Wounds

Impaled Object

Protruding Organs (Abdominal Evisceration)

Severed Body Part

Sucking Chest Wound

Tourniquet

Bleeding/Shock

External Bleeding

Internal Bleeding

Shock (Hypoperfusion)

Treatment

Body Substance Isolation (BSI)

Breathing Devices

Cleanup of Spills

Diseases of Concern

Bloodborne Pathogens
Other Diseases and Infections

Tuberculosis (SafetyIsSimple)

Engineering and Work Practice Controls

Exposure Control Plan

American Safety Council

OSHA Regulations

Bloodborne Pathogens Training

CPR Standards and Skills

Adult/Child CPR

Hands-Only CPR

High-Quality CPR

Health and Safety Institute
The Quest for High-Quality CPR (JEMS)
High-Frequency Chest Compressions (Rate of >120 per Minute) - "High frequency chest compressions... has been studied as a technique for improving resuscitation from cardiac arrest. The sparse human data have demonstrated mixed results.... There is insufficient evidence to recommend the routine use of high-frequency chest compressions for cardiac arrest. However, high-frequency chest compressions may be considered by adequately trained rescue personnel as an alternative." --Part 7: CPR Techniques and Devices: 2010 American Heart Association Guidelines for CPR and ECC, S720. WSG Comment: The frequency of chest compressions should not compromise the quality of CPR in terms of compression depth and full recoil.

Infant CPR