Recent discussions

  • Carl Gwinnutt

    As someone who lives by the coast and trains local lifeboat personnel they have recognised that those who suffer a cardiac arrest 'out at sea' can be divided into 2 main groups which I find quite interesting. The first is the 'youngsters' who are most likely to have drowned and have a hypoxic arrest. I have taught the crew that ventilation in this group with additional oxygen (they have facemark with the ability to add oxygen) is important and may in some cases be all that is required. Furthermore, trying to do quality CPR in a RIB is very difficult (see below). The second group are the older generation who frequently have co-morbidities and are more likely to have a primary cardiac cause of their arrest. In this group, the key thing is for them to start chest compressions as a primary procedure and get the person to the nearest AED. The crew have a map of all the AEDs along the coastline they cover and normally this only takes a few minutes, but is weather dependant. If this is delayed by more than a few minutes, they may then decide to add rescue breaths with supplementary oxygen. Doing CPR is very difficult but I decided to let them work out what they feel is the best position for the victim to make this as easy as possible, and they decided that they would lift the victim's legs up and place them on the side of the RIB! This of course may actually be beneficial and help with venous return. Food for thought..........
    In following article:
    CAB or ABC in drowning: Basic Life Support Systematic Review
  • Haldun Akoglu

    I think ventilation first approach is well known and accepted in public and repeatedly reinforced in movies and series. Moving towards CAB would actually mean a change from common knowledge for lay person education. For professionals, CAB should be thought as the only approach.
    In following article:
    CAB or ABC in drowning: Basic Life Support Systematic Review
  • Gerard Meijer

    I have a 5 year old granddaughter who attends a private school and very interested in the resuscitation information she has been taught. Full marks to the school swimming trainers who have included the processes in their swimming safety briefs. I shall be seeking to take her training in the safety domain by involving her in the Royal Life Saving programme. her mother has board her joining Little Nippers at the Southbank pool facility. These little minds are so curious and take up skills like sponges.
    In following article:
    Inclusion of infants, children, and adolescents in Public Access Defibrillation programs.
  • Gerard Meijer

    Is there any organisation which is examining the 'retention' aspects of CPR abilities? It would be easy to do in house within organisations I would venture to propose. Training retention of any knowledge is good but how good is it and what makes it better? It is not possible to be quite as regulatory as the national paramedic training which mandates regular reviews - which is why their personnel are so good at it.
    In following article:
    Faculty Development Approaches for Life Support Courses: A Scoping Review
  • Gerard Meijer

    Dear Leonard May I beg to differ on being too late to increase competence. It would seem that the incentive to become more efficient/effective is heightened by the pandemic. As a first aid trainer with SES I have noted a more intense interest in the CPR component. My wish-list includes having the compression measuring device available.
    In following article:
    Faculty Development Approaches for Life Support Courses: A Scoping Review
  • Gerard Meijer

    Is there a pre-ventilation action to clear the airway of any oropharyngeal 'foreign body' eg water, in the case of drowning by putting the casualty briefly on their side to allow whatever is there to 'drain' out? To ventilate extraneous water, bile or any liquid down into the bronchial system sound counterproductive.
    In following article:
    CAB or ABC in drowning: Basic Life Support Systematic Review
  • Shinichiro Ohshimo

    Congratulations on the completion of the Scoping Review! I highly appreciate your Scoping Review. I think this Scoping Review includes an important finding for the training of CPR instructors. One question I have is whether the teaching skills of instructors differ depending on their job title. If there are certain professions that are better suited for teaching, this may provide hints for other professions to improve their skills.
    In following article:
    Faculty Development Approaches for Life Support Courses: A Scoping Review
  • Shinichiro Ohshimo

    Congratulations on the completion of the Systematic Review! I appreciate your excellent work. I think this SR is a new recommendation on the order of resuscitation in drowning. One concern is that the cause of drowning may be a mixture of airway obstruction and non-respiratory causes such as fatal arrhythmia. Is it possible to make the same recommendation for drowning and cardiopulmonary arrest due to fatal arrhythmia?
    In following article:
    CAB or ABC in drowning: Basic Life Support Systematic Review
  • David Symes

    It would seem and feel right to continue the uniform approach of compression first for lay public or non specifically trained professionals. There is evidence that this group may be reluctant to undertake ventilation, especially if no barrier equipment is available,, thus prolonging the time before resuscitative efforts are commenced. The accepted ABC approach for those appropriately trained and equipped remains I believe the optimum response for this group.
    In following article:
    CAB or ABC in drowning: Basic Life Support Systematic Review
  • Scott Ruddle

    I agree that whether chest compressions come first or the resuscitation is started with ventilations likely makes little difference as shown by the manikin study. (The delay to set up ventilation equipment may change the time to first ventilation.) It would make instructing the procedure to lay rescuers easier if there was just one procedure advocated, CAB order of approach. However, education that drowning is a hypoxic event should be reinforced. Ventilations, preferably with supplemental oxygen, should be encouraged. Explain that compression only CPR may be less effective in this circumstance, since it does not address the hypoxia. Explain that ROSC can frequently occur without defibrillation since reversing the hypoxia corrects the lack of cardiac output.
    In following article:
    CAB or ABC in drowning: Basic Life Support Systematic Review
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