CPR 2005 - Critical Concepts

- Pushing Hard and Fast
- Allowing Full Chest Recoil After Each Compression
- Minimizing Interruptions in Chest Compressions
- Avoiding Hyperventilation

CPR 2005

2005 American Heart Association (AHA) Guidelines News Release
http://www.americanheart.org/

9:30 a.m. EST Monday
Nov. 28, 2005

American Heart Association announces updated emergency care guidelines DALLAS, Nov. 28 – New emergency care guidelines include dramatic changes to cardiopulmonary resuscitation (CPR) and emphasis on chest compressions, according to authors of the 2005 American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care.

The guidelines were published online today in Circulation: Journal of the American Heart Association. They provide recommendations for how lay rescuers and emergency healthcare providers should resuscitate victims of cardiovascular emergencies. Topics include CPR, the use of automated external defibrillators (AEDs) and recommendations for advanced cardiovascular life support (ACLS) and pediatric advanced life support (PALS).

The 2005 guidelines emphasize that high-quality CPR, particularly effective chest compressions, contributes significantly to the successful resuscitation of cardiac arrest patients. Studies show that effective chest compressions create more blood flow through the heart to the rest of the body, buying a few minutes until defibrillation can be attempted or the heart can pump blood on its own. The guidelines recommend that rescuers minimize interruptions to chest compressions and suggest that rescuers “push hard and push fast” when giving chest compressions.

“The 2005 guidelines take a ‘back to basics’ approach to resuscitation,” said Robert Hickey, M.D., chair of the American Heart Association’s Emergency Cardiovascular Care programs.

“Since the 2000 guidelines, research has strengthened our emphasis on effective CPR as a critically important step in helping save lives. CPR is easy to learn and do, and the association believes the new guidelines will contribute to more people doing CPR effectively.”

The most significant change to CPR is to the ratio of chest compressions to rescue breaths – from 15 compressions for every two rescue breaths in the 2000 guidelines to 30 compressions for every two rescue breaths in the 2005 guidelines. The 30-to-two ratio is the same for CPR that a single lay rescuer provides to adults, children and infants (excluding newborns). The change resulted from studies showing that blood circulation increases with each chest compression in a series and must be built back up after interruptions. The only exception to the new ratio is when two health care providers give CPR to a child or infant (except newborns), in which case they should provide 15 compressions for every two rescue breaths.

Another guidelines change emphasizing the importance of CPR is the sequence of rhythm analysis and CPR when using AEDs. Previously, when AED pads were applied to the chest, the device analyzed the heart rhythm, delivered a shock if necessary, and analyzed the heart rhythm again to determine whether the shock successfully stopped the abnormal rhythm. The cycle of analysis, shock and re-analysis could be repeated three times before CPR was recommended, resulting in delays of 37 seconds or more. Now, after one shock, the new guidelines recommend that rescuers provide about two minutes of CPR, beginning with chest compressions, before activating the AED to re-analyze the heart rhythm and attempt another shock. Studies have shown that the first AED shock stops the abnormal cardiac arrest rhythm more than 85 percent of the time and that a brief period of chest compressions between shocks can deliver oxygen to the heart, increasing the likelihood of successful defibrillator. The guidelines also recommend that healthcare providers minimize interruptions to chest compressions by doing heart rhythm checks, inserting airway devices, and administering of drugs without delaying CPR.

The new recommendations continue to encourage greater implementation of AED programs in public locations like airports, casinos, sports facilities and businesses. The 2005 guidelines reflect results of the Public Access Defibrillation trial, which reinforced the importance of planned and practiced response to cardiac emergencies by lay rescuers.

The new guidelines recommend that 911 dispatchers be trained to provide CPR instructions by phone and help callers correctly identify cardiac arrest victims. Dispatchers may walk rescuers through compressions-only CPR for most adult victims of cardiac arrest; however, instructions to do compressions and rescue breaths will be given for infants and children or adult victims of asphyxia, caused by near-drowning or other non-cardiac causes. Dispatchers also should be trained to recognize the symptoms of heart attack and other Acute Coronary Syndromes, and advise such patients to chew an aspirin while awaiting EMS.

To increase successful resuscitation, new guidelines advise EMS systems to evaluate their current protocols, shorten the response time for cardiac arrest patients, then document the impact of such changes on the number of lives saved.

The guidelines are based on the Consensus on Science and Treatment Recommendations (CoSTR), a.document developed by the International Liaison Committee on Resuscitation. This group includes the American Heart Association and leading international resuscitation councils.

The review of resuscitation literature reflected in CoSTR is the largest ever published. It took more than 36 months and includes input from 380 international experts CoSTR serves as the scientific basis for many countries’ resuscitation treatment guidelines.

CNY 2009 - Duty

During the 2009 Chinese New Year holidays, I was back at my hometown. So helped out SJAM South Area to be on duty. This year the South Area decided to be on standby at the road from Teluk Intan town to Hutan Melintang. The reason, is because there are to many agencies stationed at the same location. This stretch is one of the busiest road.

Anyway let me share with you SJAM South Area Ambulance photos.




So where there any accidents ? Thank God there were none !

Maybe it is because our Malaysian Drivers are being more careful ; )

St. John Frek

St. John Freak

Hi ! This blog is dedicated to SJA FREAKS . It is not an Official Site for St. John Ambulance but a place I wish to share my ideas / experience / opinions of my Life in St. John & my own day to day experience.

This is in response to comments from Tn. Manimaran.

If you have read the above intro about my blog I hope all of you will understand that what I say in this blog is just MY ideas / experience / opinions. I don't get a ringgit writing this blog and the only thing I get is more people maybe disliking me!

If some people feel offended or hurt, I AM SORRY. As readers it is up to "YOU" to choose either to accept what i write here or just ignore this blog. And as a blogger, I too will be responsible when I write things in my blog. For those who leave comments in my blog, you to have to be responsible with what you say.

MAKING A DIFFERENCE

When my own people in my beloved organization turn to me and say "This organization is not good", I remind them don't blame the organization but blame the people in it. I know I can't change everyone or make a difference overnight but I will try doing it. We are an organization with a very long colorful history and many people have high regards, not only that we have a reputation and discipline is the fundamental of the existence of St. John Ambulance.

WHO IS MAKING THE DIFFERENCE?

Some even ask, why you want to still stay in this organization. A great leader, The Late Tn. Guru told me, "Stay and fight this battle!" when i wanted to resign.

I wish to quote the following words:

“The only thing necessary for the triumph of evil is for good men to do nothing”

by Edmund Burke

CHANGE

Like it or not as the world is changing, we to have to change and improve. We need to come back to the right path as I think we have strayed from our original objectives. Day by day volunteerism is dying. I just pray that I will live to see my beloved organization make everyone of us proud being in it. The question is "Is it US , or the ORGANIZATION that need the change?"

I hope some will understand what I am trying to say. I am using SOME because I know everyone will not accept every suggestion/opinions i express it here in my blog.

Thank you

the st. john freak

ICC 2008 - Comments from Tn Manimaran - Camp Commandant ICC

Tn. Manimaran - Camp Commandant ICC said...

Dear Mr. Kevin,

The organizing committee welcomes constructive suggestion and feedback to the International Cadet Camp (ICC) 2009 organized by SJAM-SDE. However, the organizing committee regrets that the comments provided above were either untrue or misleading. As such, we have decided to reply to the allegations made in order to caution all readers and make clarification on issues highlighted by you.

Security of the Campsite
The organizer has taken every measure to ensure the safety of the campers. Steps were taken to safeguard the interest and welfare of the campers. We’re sure you were well aware that the Jabatan Bomba and Jabatan Pertahanan Awam (JPA) were hired to manage the activities planned for the camp. There were policemen stationed at the campsite 24 hours a day throughout the whole camp duration to ensure the safety of the campers. Police patrol and sentry duty by campers were also arranged. A medical bay was set up to provide 24 hours service and was managed by doctors and qualified nurses. Ambulance was stationed at the medical bay at all time for any immediate case transfer if the need arises.

Precaution in food preparation
The Health Department of Daerah Gombak was requested to check on the hygiene and preparation of all meals served. We understand that food samplings were taken from every meal by the Health Department as a control in the event of any complaint on food poisoning. We received no report on this issue.

Quality of drinking water
We went as far as looking into the quality of the drinking water used by participants. A Reverse Osmosis water filtering system was actually installed to supply water to the kitchen. Vitabillion water was distributed to participants as well. We believe the Milo that you were drinking were not only nutritious but were certainly cleaner than the water you can get from most homes.

Dengue Prevention
Fogging was done before the opening of camp to ensure no occurrence of dengue cases.

Female campers
Upon receiving feedback that female campers should be allowed to sleep in their tents instead of the dormitory, the organizing committee immediately responded by giving ALL STATES both options mentioned. However, NONE of the accompanying officers reverted that their female campers would want the tent sleeping arrangement. We sure hope the respective accompanying officers would have conveyed this option to the campers concerned and it was a collective decision made between the campers and their respective accompanying officers. We are surprised now that you chose to differ from your earlier decision.

As accompanying officers, you were given the privilege of sleeping in the dormitory. However, when you asked if you could sleep in the tent, we gave immediate approval. On the registration day, Camp Secretary asked about your preference but no answer was given. We assumed you were happy with the sleeping arrangements made.

Tents
Again, the organizing committee was quick to rectify the “close proximity” pitching of tents mentioned and not left the matter unresolved. Campers were asked to re-pitch their tents if the space is too close. Memories to be refreshed, camp secretariat has requested all accompanying officers to reply on the number of tents, type of tents that the respective states will bring for the camp purpose. From our record, most states (including Perak state) confirmed that it is X number of tents and it’s a 4 to a tent arrangement. No rules being set on the number of campers for each tent.

Quality of Food
Meals provided… Let us all agree that this is a camp. “Food is not good, food is not enough”- these are common remarks given in any camp. The organizing committee immediately took corrective measures when we noticed food served were not sufficient on the very first day. The caterer was told to add in additional serving for all meals provided. Kindly bear in mind that all campers were given unlimited serving each time meals were served. The menus decided were not only given much consideration but were also studied, advised and approved by nutritionists. Having 4 hard boil eggs was not in the menu but since there was leftover, the caterer at his discretion had the leftover eggs cooked as an additional dish on top of what we had planned.

Delay in Opening Ceremony
The delay of the opening ceremony was beyond our control. When our guest of honour was held back by his parliamentary duty, we were on the verge to move on with the opening programme. However, the repeated assurance by his staff on his arrival leaves us with no choice but to respect his wishes. As for long speeches by politicians, we cannot say much but urge you to show the same courtesy you would have extended to any invited guests to your home,.

Steps to minimize inconvenience caused by rain
We cannot resist Mother Nature. In a seven days camp, having some rain is nothing so unusual. Some tents had “minor” flooding problem. Again, the organizing committee immediately took action and had the campers involved relocated to a safer and dry place. Plastic bags were given to ALL campers (not only those in the tents flooded) as a precautionary measure to ensure campers having clean and dry clothing and protecting other personal belongings too.

Jungle Trekking
Let us emphasize that as organizer, the safety of campers is our utmost priority. We engaged experienced trainers and rangers to assist us in the “rugged” activities conducted. With their advice, all measures were taken to ensure safety of campers is not compromised and also to prevent any unforeseen incidents from happening.

The decision whether to abort the jungle trekking rested with the ranger and not the organizer. They are the experts, if any instruction to stop any activities deemed “unsafe” is called upon, organizing committee will not hesitate to STOP. We need to clarify that activities committee didn’t asked for any of the activities to be continued (referring to the jungle trekking activity) despite being advised otherwise.

All campers were given a checklist of things required to bring for the camp. Proposed activities / programs for the camp were also mentioned. Zooming in, all those equipments mentioned by your goodself were mentioned in the checklist. Accompanying officers would have brief and given sound advice to their respective campers prior to the camp. (Note: We shall not expound on the roles and duties of an accompanying officer).

For the record, campers commented that it was overall an enjoyable camp. Some even commented the activity (martial arts) conducted by Wing Chun Association was fun and interesting. (referring to comments posted via internet or verbal comments received).

Meeting held with the accompanying officers was at the canteen. It was because campers were not utilizing the venue at that time and meeting was expected to end before supper. Comments given were campers should have been silent knowing well that there’s an on going meeting.

For the convenience of the campers, the organizer strived to provide additional facilities at the campsite i.e. internet and mini mart. However, the “officer mess” mentioned by your goodself is not part of the ICC facilities (meaning not opened to campers). It was only meant for senior officers to meet and have fellowship in a more relax manner. Please take note that none of the camp budget was allocated to this “officer mess”. All officers were required to purchase their own drinks.

Funding
The organizing committee has decided on RM160 as the registration fee. With much effort taken, we were confident of getting sponsorship to help minimize the fee imposed. However, monetary sponsorships received were minimal and only mineral water (350 cartons), buns and mugs (given out as souvenirs) were under sponsors. Despite the discouraging response, the organizer did not raise the registration fees. We believe ultimately it is to encourage more members to participate and for them to have an enjoyable and memorable camping experience.

During the course of planning, many campsites were given due consideration. The organizing committee has visited and surveyed all the campsites. After taking many factors into consideration, Templer Park was chosen as the best choice. Indeed this campsite can accommodate more than 500 campers. In fact, the total number of campers participated is within the capacity of the campsite.

One of the camp objectives is to foster better relationship among members of the same organization from all over Malaysia and other countries. Thus, sitting in their respective groups will definitely achieve this objective. After all, there is no restriction on the meal seating arrangement.

National Review

Readers’ attention is brought to the National Review issue.

It was not the intention of the organizer to host this camp in the same week as the National Review. In fact the decision to organize this camp was made more than a year ago and its preparation were at the advanced stage when the organizer learnt of the National Review being held.

Efforts were put in place to ensure these two events can run concurrently without one being disrupted by the other. A briefing was called the night before the actual event. The camp commandant briefed all campers on the arrangement and itinery for the National Review and City Tour. 7.00 am was the meeting time and not the leaving time as mentioned by you.

The logistic of moving 1,000 campers and 25 buses is a real no-easy task. However, with the coordination of ‘tour leaders’ and committees, all members managed to arrived safely at Dataran Merdeka as scheduled. Decision to hire 25 buses was made based on the total number of registered members. The non “full capacity” was due to campers being absent or campers leaving the campsite for unavoidable reasons. To travel in their respective groups will also allow better monitoring and coordination.

Wearing of T shirt
In the briefing, it was also mentioned that all officers were allowed to put on their Ceremonial Uniform for the event. As for the campers, they were required to be in Camp T-shirt for easy identification and safety reasons. Decision to allow international campers to be in their uniform was decided based on National Headquarters’ (NHQ) request. Having said that, ICC participants were there as “observers” and not part of the review. NHQ was aware of campers wearing the camp T-shirt and no objection was brought up.

In fact the organizing committee members were aware of the possible complications of running these two big events so close in time. They had worked closely with officers from NHQ and attended several meetings with NHQ on the organizing of National Review to keep each other well briefed. This is to ensure better coordination and smooth running of the event. Upon arrival at Dataran Merdeka, many national officers directed campers and accompanying officers to their respective seating area. Even organizing committee assisted in this task.

The good effort put up by the special branch of Bukit Aman should not go unmentioned. With over a thousand participants from the National Review and our campers in a crowded shopping centre, the possibility of one of us being pick-pocketed or robbed or encountered any unpleasant experience is high. While everyone is enjoying themselves in Time Square, special branch officer were present and on the look out to prevent any untoward incidents happening. We were happy none had happened.

We appreciate constructive feedback but we will not tolerate comments made out of bad faith. We trust the above explanation will erase any misconceptions that readers would have formed. And to you Kevin, we will expect no less than an apology.


Manimaran a/l V. Munisamy
Camp Commandant,
International Cadet Camp

Thursday, February 26, 2009 7:21:00 PM

SJAM Penang EMAS & their New Ambulance

SJAM Penang HQ

On Saturday 21 Feb 2009, I was in Penang. While in Penang, thought would pay a visit to EMAS Base. The main reason going to Penang is to attend the BLS (Basic Life Support) Course organised by SJAM Penang the following day. 3 other members joined me, so I thought it will be good to expose them to the service rendered by the dedicated SJAM members in Penang.

A day before our trip, SJAM Penang received another new ambulance. The new ambulance will be used to expend their EMAS Service. (For more news visit: http://www.sjamemas.org.my/news.htm )

Our tour guide was Mr. Gan Hoo Kok, he drove us to the base and shared with us the humble begining of EMAS.

A second hand Ford Transit which was purchased by SJAM Penang and
now used to transport members for duties

At the EMAS base, which is situated at Poliklinik Bayan Baru, we met volunteers and full time staff of EMAS. We were given a tour of the EMAS base and their operations.

EMAS Ambulance

Inside EMAS Ambulance

One of the 2 units EMAS Bikes

According to Gan Hoo Kok, members and officers are welcomed to be a part of the EMAS team. Those interested can visit their website http://www.sjamemas.org.my/ .

Newspaper article about our SJAM member (Part 2)

Check out this video!

http://thestaronline.tv/v/2909

Courtesy of the STAR Newspaper

Newspaper article about our SJAM member

Here is another article about our SJAM member from Pahang in The Star Newspaper 15.02.2009. Read full article at : http://thestar.com.my/news/story.asp?file=/2009/2/15/education/3245219&sec=education

According to her, there will be more articles about how she and a bunch of young Malaysians spent their Valentine's Day courtesy of The Star Newspaper.

I wish to take this opportunity to congratulate her!

Read extract of the article courtesy of The Star newspaper

Elena See Yoke Theng, 22

This Pahang girl is currently studying statistics in Universiti Malaya and claims she loves it.

“I love numbers, anything to do with numbers is fine with me,” says the bubbly lass. “I wanted to be a Maths teacher when I was a kid.”

A loyal supporter of Table for Two, Elena applied to be one of the participants in 2007 but did not succeed. Well, her entry won her a place in this year’s event.

Her dream is to travel around the world to meet new people, but right now, she misses her home in Kuantan, sunrise and sunsets at the Teluk Chempedak and Cherating beaches, and the smell of the ocean.

Topping her list of most exciting things she has ever done was to help deliver someone’s baby in an ambulance when she volunteered with St John Ambulance of Malaysia.

“It was the holidays and I was doing my highway duty then. This lady just came up and said she was having a baby. We didn’t expect to have to deliver the baby enroute to the hospital!” she says.

Division Level Training

The year has started and with a blink of the eye it is Feb 2009! Some schools have started their recruitment exercise and some haven't due to instructions from school to only start in March 2009.

What ever are your plans, my advice is priority should be given in planning out your division level activity especially your First Aid & Home Nursing Training.

What is Division Level Training?
Training can be anything such as First Aid, Home Nursing, Foot Drill, etc.

You will be thinking, well same old stuff, nothing new.

YES. Nothing new, it is the same old training but we can always change the method we teach or shall I say share the knowledge with the members. For me 3 important instruments to ensure proper training is provided in the most effective and fun way is :-

TRAINER / INSTRUCTOR
To be able to provide an effective training, Divisional Instructors must ensure they have the correct knowledge and skill. Apart from that he/she must have the up-to-date knowledge on the method and syllabus which will be examined during the Annual Examination / Re-Certification.

SYLLABUS
Get the correct syllabus from your respective ASO/SSO (Training) - First Aid and Home Nursing. When you conduct the class make sure you do not get all the members together. Divide them into their respective years of joining and attending their Exam. Example : First Year (New Members) are grouped together to give them extra attention as they are new in our organisation.

EQUIPMENT
I believe this is the most important part in the effective and fun training. It is time for us to change, that is boring class room-white/black board- writing notes etc.

Members should be allowed to do plenty of hands-on to enable them to be familiar with equipments such as stretchers, splints, triangular bandages, etc.

Next time let me share what are the sutable equipments you need for your division training.