New first-aid guidelines update treatment for minor, major emergencies

Cleaning with soap and water might seem like the best way to disinfect a cut, but new research calls for scrapping the soap and rinsing for five minutes with clean, running tap water instead.
The change to this widely adopted practice is one of many updates included in the new Canadian first aid and CPR guidelines.

Updated every five years, the first aid and CPR guidelines are agreed upon by the Canadian Guidelines Consensus Task Force, which is composed of Canadian Red Cross, Heart and Stroke Foundation, St. John Ambulance, Canadian Ski Patrol and Lifesaving Society. The updated guidelines include the most recent research from the international scientific community and distill findings into best practices for first responders and first aid providers. At times, some of these changes appear to be subtle, but they represent real, substantive improvements to addressing various minor and major emergencies.

"We are in the business of saving lives," says David Sculthorpe, CEO of the Heart and Stroke Foundation. "The Canadian first aid and CPR guidelines are based on the newest techniques and approaches to increase survival rates. Our goal is to empower Canadians to be ready, willing and able to act in the event of a medical emergency."

An estimated 70,000 heart attacks and up to 40,000 cardiac arrests happen in Canada each year. Lost-time accidents regularly occur in Canadian workplaces, and countless others take place every day in our homes and communities.

The Canadian guidelines impact how Canadians administer CPR and first aid and include revisions ranging from treating minor cuts and abrasions to addressing major emergencies such as concussions and cardiac arrest. Here are some key learnings and updates:

• Adults experiencing chest pain should chew one adult or two low-dose aspirins while waiting for emergency medical assistance to arrive (unless they have an allergy or bleeding disorder).

• In the case of severe allergic reaction, the new guidelines recommend that first aid providers should help administer a second dose of epinephrine if there are no signs of improvement after the first dose. Some studies have shown that it is most effective to administer the second dose within five to 10 minutes of the first if symptoms have not stopped progressing.

• When someone experiences a blow to the head they should stop activity immediately whether sport related or in the workplace, and seek medical aid (even if they aren't showing signs of a concussion).

• The routine use of cervical collars is no longer recommended as they can cause complications and discomfort for the injured person. Instead, in suspected cervical spine injury, the new guidelines recommend manually supporting the head in position, limiting angular movement, until more advanced care arrives.

Coming face-to-face with a workplace emergency can be overwhelming, depending on what kind of first aid is needed. A recent survey of 1,000 Canadians conducted by Nielsen Consumer Insights and commissioned by Canadian Red Cross found employees feel substantially more confident responding to various minor incidents, with 80 per cent to 87 per cent reporting feeling confident in dealing with nosebleeds, minor wounds or bleeding.

When the nature of the emergency is more serious, confidence drops considerably. The survey found that many Canadian employees did not feel confident in their ability to assist with a range of more serious medical emergencies:
• heart attack or cardiac emergency (50 per cent)
• anaphylaxis shock/severe allergic reaction (48 per cent)
• concussion (47 per cent)
• stroke (42 per cent)
• psychotic episode (33 per cent).