Life Support Programme Summary of Changes to RLSS UK Life Support Programme Qualified deliverers The Life Support awards can be taught and assessed by: Lifesaving Instructor (and higher) Pool or Beach Trainer Assessor (and higher) NWSMP Instructor Resources available Instructor: Life Support Programme Instructor Guide (new) Life Support Manual (new) Life Support Presentation and Notes (new) Life Support 3 Presentation and Notes (new) Candidate: Life Support Manual (new) Award Assessment Form Update information The Life Support Manual The Life Support Manual has had a significant re-write and re-design. In addition to being fully updated to the new CPR guidelines, this manual now also includes basic use of an AED at community level. Due to the scale of the re-write of the manual it is not possible to outline all of the changes to the manual in this document. RLSS UK recommends that all Instructors have access to this manual. PowerPoint Presentations Presentations have been produced for the Life Support and Life Support 3 awards for the first time. The presentations follow the sequence of teaching recommended in the new Life Support Programme Instructor Guide, and contain photos and videos of all of the key skills. To run the PowerPoint presentations you will need Microsoft PowerPoint 2007 or later, you will need to ensure your computer has completed the Office updates. Videos are embedded into the PowerPoint presentations to make it easier for you to download and use. Page1
Life Support Programme Instructor Guide (including assessment matrices) This new guide brings the administration requirements, and the assessment matrices for the Life Support Awards together in one useful guide, and for the first time a delivery guide to the awards is included (for guidance only). The content of the assessment matrices has been reviewed to implement the Resuscitation Council UK (RCUK) 2015 Guidelines (and guidance from RLSS UK Medical Advisors), improve formatting, reduce repetition, and reduce the volume of paperwork required by the assessor. Many of the changes made improve the clarity of the text but do not change the technical content. However, in some instances the technical content has been updated, and these changes are summarised in the table on the following page. Additional Information In addition to the RCUK 2015 updates, the Society is investigating how it can improve first aid training within the community focused awards and workshops. To support research into how the Life Support and Life Support 3 Awards are being used, the first aid elements of these awards (bleeding and shock) have been separated into an optional assessment. Instructors and candidates will now be able to choose if they want/need to include the first aid element. It is anticipated that this change will: Support research into how the Life Support and Life Support 3 Awards are being used Reduce repetition where candidates cover bleeding and shock in both their Life Support and aquatic awards (such as Survive & Save awards) Make the delivery of Life Support awards in the community easier, focussing on CPR skills Make the delivery of Instructor Courses which include a Life Support 3 assessment easier to manage Instructors will continue to be required to hold a Life Support 3 Award (with or without the first aid element) to demonstrate ongoing competency in CPR. Other RLSS UK qualifications will also continue to be considered as meeting this requirement (such as NPLQ). Page2
Award & Assessment number LS: 1,2 LS3: 1,2,4,5 LS: 1,2 LS3: 1,2,4,5 LS: 3 LS: 4 LS3: 8 LS3: 4,5 Summary of technical changes to the Life Support and Life Support 3 Assessment Matrices Old text New text Rational Shout/call for help Text removed Shout for help removed following RCUK 2015 guidelines Make an emergency call to alert Summon help from the emergency Request for an AED added the ambulance service services and ask for an AED if available following RCUK 2015 guidelines Answer 4-6 questions on the Answer 4 questions on life support from Text updated to allow for new following topics the questions provided assessment questions (which are provided), and the movement of bleeding and shock into assessment 4 None (new optional assessment) After 1 minute - send or go for help (following CPR for 1 minute) Demonstrate knowledge and understanding of basic first aid On a simulated casualty demonstrate how to manage bleeding on the casualty s arm using a wound dressing On a simulated casualty demonstrate how to treat a casualty for shock Summon the emergency services and ask if an AED is available (following checking for normal breathing) LS3: 4,5 None Explain how your actions would differ if you were alone LS3: 7 Answer 7-10 questions on the following topics Key LS: Life Support LS3: Life Support 3 Answer 3 questions from column A, and 3 questions from column B of questions provided New optional assessment See previous page for further explanation Emergency call (and AED request) now earlier in the sequence to better reflect the RCUK guidance Also see below To assess the candidate s understanding of when to call 999 Text updated to allow for new assessment questions (which are provided), and the movement of bleeding and shock into assessment 8 Page3
Below are all the changes RLSS UK and IQL UK have made to publications following CPR and First Aid guidelines. Please ensure you follow the syllabus for the awards/qualifications you teach. Some topics below may not appear in the syllabus you are following. Changes to CPR 1. Call for help has been removed from the CPR process -There is no need to call for help when finding the casualty does not respond. 2. Telephone CPR has been introduced -The guidelines for 2015 highlight the critical importance of the interactions between the emergency medical dispatcher, the bystander who provides CPR and the timely deployment of an automated external defibrillator (AED). The emergency medical dispatcher plays an important role in the early diagnosis of cardiac arrest, the provision of dispatcher-assisted CPR (also known as telephone CPR), and the location and dispatch of an AED. 3. Information has been included on seizure-like episodes being an indication of cardiac arrest -Immediately following cardiac arrest blood flow to the brain is reduced to virtually zero, which may cause seizure-like episodes that may be confused with epilepsy. Bystanders and emergency medical dispatchers should be suspicious of cardiac arrest in any patient presenting with seizures and carefully assess whether the victim is breathing normally. 4. AED can be used on infants Resuscitation Council UK have confirmed you are able to use an AED on an infant (under one year of age) and it should be used as you would on children. 5. New CPR flow chart A new CPR flow chart has been produced which is very simple to remember and understand. 6. Guidance for Fluid in Airways has been included - In some situations (particularly in casualty s rescued from the water), massive amounts of foam caused by admixing moving air with water are seen coming out of the mouth of the casualty. Do not try and attempt to remove the foam as it will keep coming. Continue with rescue breaths and compressions. Page4
7. You must ensure an unconscious casualty is breathing before you put them into the recovery position - An unconscious casualty whose airway is clear, and who you are sure is breathing normally, should be turned into the recovery position (unless the casualty is suffering from suspected spinal injuries). It is important to ensure that breathing really is normal and not a return of agonal gasps. 8. Agonal breathing is now known as agonal gasps Agonal gasps is the correct term to be used. 9. The initial assessment of a casualty can be done in rapid succession - The initial assessment of danger; response; airway; breathing; 999 can be carried out in rapid succession, to ensure that CPR is started and an AED is available as soon as possible. 10. You should continue with CPR and/or AED until The casualty is definitely waking up There are 3 reason you would stop CPR: If a health professional tells you to stop (such as a paramedic or doctor) If you become exhausted If the casualty is definitely waking up, moving, opening eyes and breathing normally 11. AED - To encourage an AED to be brought to the scene and used, our text at the end of all CPR instructions now says If an AED arrives Switch it on and use. 12. New AED flowchart Changes to First Aid 13. Recognising choking - There is now a very clear difference when recognising a casualty who is choking: A casualty with a partial airway obstruction will be able to speak, cough and breathe but will be distressed A casualty where their airway is completely obstructed will be unable to speak, have a weakening cough and will be struggling or unable to breathe 14. The aims of First Aid now include alleviate suffering- The revised sequence is; Preserve life, alleviate suffering, prevent the situation getting worse, and promote recovery. 15. Recovery position- Where recovery position is mentioned as treatment in any injury or illness, it will now read: If you are sure the casualty is breathing normally place them in the recovery position This is to be sure that the casualty is breathing normally. Page5
16. The treatment for shock no longer refers to recovery position The priority is to treat for shock, even if the casualty is unconscious 17. The treatment for Asthma now includes: Encourage and assist them to use their prescribed medication (reliever inhaler) If they have a spacer device assist them to put it together and use it with the inhaler The inhaler should be used again if the attack does not ease 18. Treatment for anaphylactic shock- This now includes details about an auto injector and common examples of an auto injector, for example Epi-pen and Jext. This is to give a candidate an understanding of what an auto injector may look like and how it may be used. 19. The treatment for external bleeding does not include elevation- This has been omitted following direct reflection of the First Aid guidelines. 20. Guidance for severe bleeding- The following text has been added: The treatment for severe bleeding, or bleeding that is not controlled by direct pressure, consider applying a haemostatic dressing, only if you have been trained in their use. If the bleeding remains severe, consider using a tourniquet, again ONLY if you have been trained in their safe use. Trainers and Instructors should not include training on either of these subjects within our courses. RLSS UK and IQL UK are reviewing the option to add these subjects into our qualifications in the future. 21. The treatment for a varicose vein bleed- We have removed mention of elevation. Treatment is now, apply direct pressure for at least 10 minutes or until bleeding stops. 22. Treatment for amputation bleed- Is now the same as external bleeding. 23. Treatment for burns- States the use of cool running water, rather than cold water and included is a warning of causing hypothermia. 24. Managing a casualty who has regurgitated their stomach contents with spinal injuries The method has been simplified - The same principles for managing regurgitation of stomach contents apply: Carry out management of regurgitation in the normal way taking care to minimise any head and neck movement More than one person is ideal and they can assist with the roll of the casualty The priority is preventing the stomach contents blocking the airway There are no photographs of the log roll in the manual. 25. Explanation of concussion has been improved Text now reads Concussion is where a casualty may have an altered level of consciousness, be disorientated, be confused, have a lack of ability to remember or briefly go unconscious after a blow or other injury to the head. 26. Treatment for chest injuries - No longer includes a 3 sided dressing - It is important not to cover open chest wounds with an occlusive (airtight) dressing, as this may allow pressure to build up inside the chest and interfere with lung function (tension pneumothorax). 27. Chemical eye injury Guidance has been added: Wash the eye with a continuous flow of cool water until emergency services arrive, tilting the head to ensure water runs away from the good eye Where possible give the details of the chemical to the emergency services (these can be found on the bottle, container or product/safety data sheet) Page6
28. Treatment for a dental injury - Now includes placing a tooth in egg white or saline as alternatives to the use of milk. 29. Treatment for a Major seizure - Now includes a check to ensure they are breathing after a seizure - Remember you should be suspicious of cardiac arrest in any casualty presenting with seizures, and you must assess the casualty for normal breathing once the seizures have ended. 30. Treatment for hypothermia - Now includes guidance for remote circumstances - In remote circumstances, or if the casualty is wet, put them in a plastic bag up to their neck (this develops a localised warm environment) and cover their head to prevent further heat loss. 31. Secondary survey Text now includes the importance of returning to the primary survey whilst carrying out a secondary survey. It is important to return to the primary survey and check for normal breathing frequently and treat appropriately. Page7