EFR change?

[rsingler]

There are actually two courses offered by the American Heart Association:
CPR
CPR - Healthcare Provider

 

[boulderjohn]

I taught first aid merit badge at a Boy Scout camp a half century ago. That was before CPR. That course was much more complex and inclusive of information than a modern first aid course. And I was a tough teacher. Boy, was I tough. You had to be really good to earn that merit badge.

I write that today with great embarrassment.

Modern first aid theory has recognized an important fact--if you overload people with information and they then go through a period of inactivity, when it comes time for them to act in a real emergency, they freeze. They have too much information from too long ago spinning about their heads, and they walk away from intervening, too afraid to step in and make the kind of mistake that would cause them to fail the class taught by a jerk like me.

Modern first aid theory has recognized that pretty much any attempt by a well-intentioned first aider will help, so they want to inspire people to step in and do something rather than sit back and tremble as they try to remember trivia. The classes have been shortened in content so that people will remember the important stuff rather than try to retrieve it from an avalanche of stuff they really will never need to know. The educational theory phrase for this is "less is more"--if you focus on learning fewer individual items, you will remember more than if you are overwhelmed with information.

So, yes, at all levels there is a difference between what is taught to potential first aiders and professionals.

 

[rsingler]

I'm just glad we're not teaching "back press-arm lift" for "artificial respiration" for scuba anymore.

John, you and I's jes' plain old!
But what's that expression that I'm sure to bastardize?
I'll take old age and craftiness over youth and strength any day! (or something like that...)
And we're still humping tanks.

 

[TMHeimer]

John, Thanks for the good explanation. It kind of fits with my observations in the courses I've taken. While the two EFR courses were mostly taken by divers looking to take Rescue course, the two I took from an outside organization were obviously not. Some of the students there were just there because it was a requirement of their employer. As well, none of the 4 times I took CPR was there any real test, other than just doing what the instructor told you to do, and collecting a first responder "certificate" of sorts.
Perhaps those taking EFR and intending to do rescue and go Pro would be more responsible, and at least review the manual now and again (as do I), perhaps not. I review a page of my original 2006 EFR manual most days....I assume it's pretty much all valid, though a little more detailed than today's version. To be honest, I really do this so I would hopefully be prepared to act if my wife or other loved one was in trouble. I would guess that taking a CPR course every 2 years for an evening because it is a dive shop requirement for staff means very little, should an incident occur 4 months after the course.
Another pitfall for "civilians" is that unlike medical pros, the chances of needing to do CPR in real life are close to nil--I'm 64 and still have only seen it done on TV. Whereas, the pro is doing it for real regularly and must always be up to snuff, therefor can have many details on the tip of their tongue.
So, I do agree completely with your explanation of why the difference between civilian courses and pro ones.

Unimportant, but it still leaves me curious as to why it took until so recently for the powers that be to realize that compressions only, and no breaths is best for the civilian to remember.

rsingler, Don't worry, I was always referring to non water-related CPR procedures.

 

[Rred]

In the 60's every Boy Scout knew about tourniquets. Then somewhere along the way, civilian first aid said never ever ever even think about them, they cause loss of limbs. And that went on until fairly recently, maybe five or ten years ago. Then someone figured out that, gee, we've got these mass casualty incidents where people are bleeding out....funny thing, the military has been using the forbidden tourniquets to address that problem, and they've got the documentation to prove it works. Gee.

So tourniquets are being taught again. The great wheel turns.

Same thing with CPR. When I was first taught CPR it was for high angle (climbing rope, actually) rescue. If a climber takes a hard fall, that can stop their clock. "But you can't perform CPR on someone hanging on a rope!" Well, it ain't optimal...ain't optimal with a dive buddy in the water, either. Still, there's a reason why football coaches still know what a "Hail Mary" pass is for.

Too much litigious nonsense and frankly, "non-science" from the AMA and some other frankly commercial sources out there. Too little real first aid training going on out there. I'm sure the time I was supposed to spend memorizing the Kings of England in middle school was much more valuably spent. (Ahuh.)

 

[TMHeimer]

In the 60's every Boy Scout knew about tourniquets. Then somewhere along the way, civilian first aid said never ever ever even think about them, they cause loss of limbs. And that went on until fairly recently, maybe five or ten years ago. Then someone figured out that, gee, we've got these mass casualty incidents where people are bleeding out....funny thing, the military has been using the forbidden tourniquets to address that problem, and they've got the documentation to prove it works. Gee.

So tourniquets are being taught again. The great wheel turns.

Same thing with CPR. When I was first taught CPR it was for high angle (climbing rope, actually) rescue. If a climber takes a hard fall, that can stop their clock. "But you can't perform CPR on someone hanging on a rope!" Well, it ain't optimal...ain't optimal with a dive buddy in the water, either. Still, there's a reason why football coaches still know what a "Hail Mary" pass is for.

Too much litigious nonsense and frankly, "non-science" from the AMA and some other frankly commercial sources out there. Too little real first aid training going on out there. I'm sure the time I was supposed to spend memorizing the Kings of England in middle school was much more valuably spent. (Ahuh.)

That's pretty much the way I see it.

 

[Reelman1]

Current Red Cross protocol is 30 compressions / 2 rescue breaths per cycle (optimum rate of 100 compressions per minute), with 5 cycles taking approx. two minutes to complete.This is optimum...the big change in the past few years has been to start with compressions instead of breaths, except in the case of infants...of course, as mentioned above, protocol is different for drowning/in water rescue...

 

[saxman242]

I completed the Red Cross CPR/First Aid/AED course yesterday in preparations for taking the rescue class in a month. They taught CPR with rescue breaths as well as without. They basically said "it's better to do with, but if you can't/aren't willing to provide breaths, by all means provide CPR without as it's still way better than nothing."

 

[TMHeimer]

I completed the Red Cross CPR/First Aid/AED course yesterday in preparations for taking the rescue class in a month. They taught CPR with rescue breaths as well as without. They basically said "it's better to do with, but if you can't/aren't willing to provide breaths, by all means provide CPR without as it's still way better than nothing."

Here's a different approach--"it's better with than without, but each is good". Possibly something else that could've been figured out and decided in 1958, or at least with 1990 computer data?

 

[saxman242]

Here's a different approach--"it's better with than without, but each is good". Possibly something else that could've been figured out and decided in 1958, or at least with 1990 computer data?

What they seemed to be getting at was that yes, you should do rescue breaths if you can. If you can't, you can still do a lot of good by just doing chest compressions. I suspect that there have been times when people didn't do CPR because they weren't able/didn't feel comfortable giving rescue breaths, such as someone with severe facial injuries, with a helmet stuck on, etc, and felt that if they couldn't do rescue breaths it was a moot point..