Rescue Breathing on the surface

[northen diver]

You are also wrong. The compression-ventilation ratio is not the same for one and two person rescues.

The following quote was copied from the American Heart Association's guidelines for CPR:
" A compression-ventilation ratio of 30:2 is recommended and further validation of this guideline is needed (Class IIa). In infants and children (see Part 11: "Pediatric Basic Life Support"), 2 rescuers should use a ratio of 15:2 (Class IIb)."

The following quote came from the same source and refers to CPR being provided by non-professionals:
"
[SIZE=-1]Compression-Only CPR[/SIZE]
The outcome of chest compressions without ventilations is significantly better than the outcome of no CPR for adult cardiac arrest. In surveys healthcare providers as well as lay rescuers were reluctant to perform mouth-to-mouth ventilation for unknown victims of cardiac arrest.
In observational studies of adults with cardiac arrest treated by lay rescuers, survival rates were better with chest compressions only than with no CPR but were best with compressions and ventilation (LOE 3; 4). Some animal studies (LOE 6) and extrapolation from clinical evidence suggest that rescue breathing is not essential during the first 5 minutes of adult CPR for VF SCA. If the airway is open, occasional gasps and passive chest recoil may provide some air exchange. In addition, a low minute ventilation may be all that is necessary to maintain a normal ventilation-perfusion ratio during CPR. Laypersons should be encouraged to do compression-only CPR if they are unable or unwilling to provide rescue breaths (Class IIa), although the best method of CPR is compressions coordinated with ventilations."



Here's a link to the whole document:

http://circ.ahajournals.org/content/vol112/24_suppl/


The bits I copied are from part 4 Adult Basic Life Support.

You have some old materail. I didnt mention infants due to we were talking about a SCUBA rescue class and I havent seen an infant diving as of yet

BLS Healthcare Provider​

2006 Study Guide​

Source: HCP AHA Text and St David Healthcare Partnership​

Basic Life Support for​

Healthcare Providers​

Many of the changes in BLS recommended

in 2005 are designed to simplify CPR
recommendations (including eliminating
differences in technique for different ages
when possible), increase the number and
quality of chest compressions delivered,
and increase the number of uninterrupted
chest compressions.
A universal compression-to-ventilation ratio
of 30 to 2 is recommended for lone rescuers
for victims of all ages (except newborns).
This 30:2 compression-to-ventilation
ratio also applies to healthcare providers​

performing 2-rescuer CPR for

adult victims​

until an advanced airway (eg, endotracheal​

tube, esophageal-tracheal combitube​

[Combitube], or laryngeal mask airway

[LMA]) is in place. Once an advanced

airway is in place, 2 rescuers should no
longer provide cycles of CPR with pauses​

in compressions to give rescue breaths



​

 

[northen diver]

Go back and read. 1) I said I am not a Life guard Instructor and as you pointed out in your next post, the Lifeguard Instructor teaches in water ventillations. (maybe) 2) Dive Instructors are not automatically re newed in CPR when not teaching CPR classes like Medic First Aid or EFR. An instructor does not get a new CPR cert for teaching Rescue Diver or a DM class. There is no requirement for an instructor or DM/Dive Con to be current 3) Nobody says Rescue Breathing is a waste of time? I said be trained to do it if need be. Take an Advanced class. Each case will be different. If I am 50 feet from a boat messing around with gear and breathing is a wast of time. And by the way, if you have a Lay responder card that says you are not qualified to do rescue breathing only and you screw around "trying" what are the consequences?

don O

Didnt someone say:
If the person's heart is not beating, no oxygen will be circulated so rescue breaths would be a waste of time in the water.

 

[ffhamm]

You have some old materail. [

in 2005 are designed to simplify CPR
recommendations (including eliminating

A universal compression-to-ventilation ratio
of 30 to 2 is recommended for lone rescuers
for victims of all ages (except newborns).
This 30:2 compression-to-ventilation
[

until an advanced airway (eg, endotracheal

tube, esophageal-tracheal combitube

[Combitube], or laryngeal mask airway
[LMA]) is in place. Once an advanced
airway is in place, 2 rescuers should no
longer provide cycles of CPR with pauses​

in compressions to give rescue breaths

​

[/COLOR][/SIZE][/FONT]

​

2005 AHA standards are the latest at this time. AHA guidelines are based on science and studies of pt outcomes. After a guideline is released, it takes a while to track trends and make appropriate changes.

Remember: Most people that have questions about this are "layperson' level certified. Layperson cpr does not include rescue breaths *only* anymore.

The reason rescue breaths are still recommended in rescue diver classes, is we assume the patient is apnic due to asphyxiation and there is the possibility that they still have a pulse. Remember also, there are potential causes that are NOT drowning. Use you training and do what you were taught. You will provide the highest level of care you are capable of.

No reason to make CPR harder than it has to be. 30 (hard and fast, 100 per minute):2 (slow breaths that cause rise of chest) is good. Follow AHA (or whoever taught your class) guidelines after the pt is removed from the water. A layperson will not be intubating a pt, so we probably don't need to be discusssing continuous compressions.

Jeff (AHA instructor)​

 

[donooo]

Also, the instructors dont need to keep taking CPR classes over and over just to teach it. As long as you teach twice a year, your instructor card is good.

That is not the way it is with the ARC. Just being an Instructor does not meet your requirements for being certified. If you need certification you must TAKE a class. Now what you are saying may be true for EFR or Medic First Aid but I have chosen to not go that way. I am sure that being a DAN BLSpro instructor does not meet a CPR requirement. In fact being both a DM and a DiveConn I have no requirements to be current. I feel that all dive professionals should be trained and current at the Pro level, maybe even the students in the Rescue classes.

In water ventilations is not a waste of time. I never said it was. It is a tool and may be necessary. Proper training is necessary.

You people that keep bringing up chest compression only need to read the first line / paragraph of every article again. It is "better then nothing" and "if the responder will not provide rescue breaths" is common to all of those articles.

don O

 

[freediver]

If I could please clarify on some misinformation.
1) The American Red Cross DOES NOT teach in-water rescue breathing in the lifeguard program and has not since 1994.
2) In reference to the O2 admin statement.... this is not a required portion of the lifeguard training course; it remains an optional component.
3) The American Red Cross instructor that teaches at least one class per year is reauthorized for a two-year calendar period, however, they do not receive a basic level participation card for this teaching. An instructor, in order to maintain CPR certification, must take the appropriate level CPR class just like everyone else.
4) Although extremely limited, research has shown that in-water resuscitation is effective in improving outcome of drowning victims.

 

[bubba105]

From someone who has done CPR, probably, 500 times in my 25 years with the FDNY, the people banging heads on this thread are the people I want around if I fail in the water. These are the people who are going to DO SOMETHING. Who cares what one agency or another says. Is rescue breathing in the water going to help? Probaly not, but, who cares, it couldn't hurt, do something. Tell you the truth, if I found no heart beat on initial examination, I would probably include a cardiac thump. Will it help, who knows, the alternative is death. Heart beats don't just magically come back, CPR/rescue breathing is the time to pull out all the stops. BTW, 500 tries, 2 saves, but, 2 beats none.

http://www.redcross.org/article/0,1072,0_332_4975,00.html

 

[northen diver]

If I could please clarify on some misinformation.
1) The American Red Cross DOES NOT teach in-water rescue breathing in the lifeguard program and has not since 1994.
2) In reference to the O2 admin statement.... this is not a required portion of the lifeguard training course; it remains an optional component.
3) The American Red Cross instructor that teaches at least one class per year is reauthorized for a two-year calendar period, however, they do not receive a basic level participation card for this teaching. An instructor, in order to maintain CPR certification, must take the appropriate level CPR class just like everyone else.
4) Although extremely limited, research has shown that in-water resuscitation is effective in improving outcome of drowning victims.

**SIGN** while banging my head on the table.......
1. ARC does teach deep water rescue breathing. NOT in the poolside training, in the waterfront portion. They also teach mask and fins usage and water line searches. Its all in section 10 of the NEW instructor manual for waterfront training. Also in Lesson 5 in the RESCUE BREATHING part of the poolside training. It used to be a cross over training for all YMCA employeed lifeguards that were trained by the ARC because the Y's had that in thier training and had the O2 bottles on thier decks. As of this year its MANDATORY for the ARC lifegaurding classes.
2. O2 was optional in the poolside training, but now its mandatory as of end of this year.
3. Used to teach one class a year, its now two classes a year for the NON-Lay responder.

4. I agree. Even if its only a small percentage.

 

[northen diver]

2005 AHA standards are the latest at this time. AHA guidelines are based on science and studies of pt outcomes. After a guideline is released, it takes a while to track trends and make appropriate changes.

Remember: Most people that have questions about this are "layperson' level certified. Layperson cpr does not include rescue breaths *only* anymore.

The reason rescue breaths are still recommended in rescue diver classes, is we assume the patient is apnic due to asphyxiation and there is the possibility that they still have a pulse. Remember also, there are potential causes that are NOT drowning. Use you training and do what you were taught. You will provide the highest level of care you are capable of.

No reason to make CPR harder than it has to be. 30 (hard and fast, 100 per minute):2 (slow breaths that cause rise of chest) is good. Follow AHA (or whoever taught your class) guidelines after the pt is removed from the water. A layperson will not be intubating a pt, so we probably don't need to be discusssing continuous compressions.

Jeff (AHA instructor)

Jeff- The AHA changed thier compression ratio's sometime in 2005. I am not sure what month it was. I had seen a report posted dated 2005 with different ratio from what is being taught now by the AHA and I had thought that maybe it was an older recommended ratio. Your last name isnt by chance Brosius?

 

[Tom Winters]

CPR is tough enough to do on dry, flat land. Fuggedaboudit in the water. If it's a requirement for your rescue or dm class, just do it. If you have to deal with it real-life, get the victim on shore or on a boat as quickly, and safely, as you can. Then take it from there.

 

[freediver]

**SIGN** while banging my head on the table.......
1. ARC does teach deep water rescue breathing. NOT in the poolside training, in the waterfront portion. They also teach mask and fins usage and water line searches. Its all in section 10 of the NEW instructor manual for waterfront training. Also in Lesson 5 in the RESCUE BREATHING part of the poolside training. It used to be a cross over training for all YMCA employeed lifeguards that were trained by the ARC because the Y's had that in thier training and had the O2 bottles on thier decks. As of this year its MANDATORY for the ARC lifegaurding classes.
2. O2 was optional in the poolside training, but now its mandatory as of end of this year.
3. Used to teach one class a year, its now two classes a year for the NON-Lay responder.

4. I agree. Even if its only a small percentage.

northen diver, I must ask, are you an American Red Cross authorized lifeguard instructor? Could you share your source of information? While mask and fins usage along with deep and shallow water line searches are taught, in-water rescue breathing is not. It is not in pool lifeguard training, waterfront nor waterpark training.
AED is a required component in lifeguard training, O2 admin is not.
Also, per ARC instructor manual, "To be reauthorized as a Lifeguarding instructor, you must teach or co-teach at least one of the following within the authorization period:
1) Lifeguarding (including CPR/AED for the PR)
2)Shallow water attendant (including CPR/AED for the PR).
Again, I would love to know your source.