Rob.Carr@f81.n129.z1.fidonet.org (Rob Carr) (12/14/89)
ECCC Supplemental Guidelines Review
by Rob Carr, BA, EMT-P
from articles in JAMA Nov. 17, 1989 Vol 262, No. 19
The continuing concern regarding such contagious or potentially contagious
diseases as Neisseria meningitidis, herpes simplex, Heptatis B Virus (HBV),
and Human Immunodeficiency Virus (HIV) and others has prompted the Emergency
Cardiac Care Committee of the American Heart Association to issue
supplimental guidelines for CPR and CPR training. The complete article, as
well as an editorial review, may be found in the above reference. This
article summarizes the new guidelines.
The guidelines are broken up into recommendations for infected and non-
infected rescuers, laypersons, infected instructors and students, and
for those unable to complete a CPR course.
The recommendations amount to common sense with a questionable
condescention to the continuing public hysteria regarding HIV. Rescuers
with contagious diseases or who may have been exposed to same are requested
to use mechanical methods whenever possible. Non-infected rescuers are
simply reminded of their duties and of the various methods of ventilating
a patient that are available to ensure universal precautions are observed.
A special point to note is that masks without valves or filters are to be
considered useless, including the "S" shaped tubes and the old standby, the
handkerchief. By being a rescuer with a duty to respond, a person has
ethical, moral, and legal obligations to the patient, including the
administration of CPR. In other words, you have three basic options.
Perform mouth - to - mouth, always carry protective airway adjuncts, or
quit. (Of course the malpractice option is also available.)
Lay rescuers are given more leaway, to the point that compressions MAY be
begun before ventilations. Theoretical reasons for the effectiveness of
this variation are presented. Ironically, while the attempt here is to
increase the public's willingness to do CPR, perhaps the reverse will
result. This guideline will promote the hysteria and misinformation
which abound today, and may result in the wholesale abandonment of mouth -
to - mouth by the lay rescuer. Lay rescuers are encouraged to continue
providing mouth -to - mouth.
If you are a student or a teacher, there are some additional guidelines.
Anyone who has a short term infectious disease (such as the common cold)
is requested to hold off taking or teaching CPR. Previous methods for
reducing transmission of infectious diseases are to be continued, and where
possible, requests for individual mannikens are to be honored. If a
teacher or student has a chronic infection, participation in a CPR class
is dependant on a personal physician clearing the person for such activity.
If, due to illness or handicap, a person is unable to complete the
performance objectives of the class, no changes in the standard are
permitted. If a person is unable to perform CPR, no CPR card may be
issued, even if it is a condition of employment.
--
Uucp: ...{gatech,ames,rutgers}!ncar!asuvax!stjhmc!129!81!Rob.Carr
Internet: Rob.Carr@f81.n129.z1.fidonet.org