First aid

CPR - Cardiopulmonary Resuscitation: 30x2 or 15x1?

I recently took a First Aid Course with BCTIO in Christchurch, New Zealand. Something that caught my attention was the instructor's comment that there is no longer the cycle of 15 compressions and 1 breath performed by 2 rescuers. Instead a cycle of 30 compressions for every 2 breaths is performed by 1 rescuer. She commented that she can have 2 rescuers without a problem, but when one tires the other replaces him, following the cycle of 30 compressions for 2 breaths. I confess that I was surprised by this information and contacted a friend in Brazil (the owner of a Consulting and Advisory company in Health and Safety at Work) who confirmed that the same update had occurred in Brazil in 2015. After completing this course, which is a requirement for all construction workers here in New Zealand, I decided to write this article in order to compare the laws of New Zealand and Brazil regarding CPR.

New Zealand follows Standard 6402 – to provide basic life support issued by the NZQA (New Zealand Qualifications Authority) which complies with all requirements and knowledge practices of the current version of the NZRC (New Zealand Resuscitation Council). The article written by Kevin Nation, NZRC Chief Executive on November 30, 2018, reports that when the ILCOR ( International Liaison Committee on Resuscitation) revised the policy in 2017, several important recommendations were made. There was agreement that observers should perform chest compressions for everyone in cardiac arrest. Furthermore, those who are trained, capable and willing to give rescue breaths, should do so in a 30:2 ratio between compressions and breaths.

Brazil follows the CLT-Consolidation of Labor Laws through Law 6.514 / 1977 that approved the Regulatory Norms, through Ordinance 3214/1978, where we cite Regulatory Norm No. 1 General Provisions in the items: 1.5.6.2. The procedures for responses to emergency scenarios must provide for: a) the means and resources necessary for first aid, referral of accident victims and abandonment; and b) the necessary measures for emergency scenarios of great magnitude, when applicable. Additionally, 1.2.2 Compliance with NR does not release organizations from complying with other provisions that, in relation to the matter, are included in construction codes or health regulations of the States or Municipalities, as well as those arising from collective labor agreements. In compliance with item 1.2.2 we have the Decrees of the Fire Departments of each State. I will quote here Decree No. 63,911, OF DECEMBER 10, 2018 Institutes the Fire Safety Regulation of buildings and risk areas in the State of S?o Paulo. It subsequently provides related measures through Technical Instruction No. 17 - Fire Brigade in item 5.6.3 First aid 5.6.3.1 Provide first aid to possible victims, maintaining or restoring their vital functions with Basic Life Support (BLS) and Cardiopulmonary Resuscitation CPR until specialized assistance is obtained. State Decree no. 46,595 / 2014 - Amends the Fire and Panic Safety Regulations in buildings and areas at risk in the State of Minas Gerais through Technical Instruction No. 12 - Fire Brigade in item 5.4 Duties of the fire brigade, 5.4.2 Fire actions emergency: e) first aid, according to specialists in the field of First Aid in Brazil, our references are: PHTLS (Prehospital Trauma Life Support) according to the NAEMT (National Association of Emergency Medical Technicians). This association collaborated with ACS-COT in the development of guidelines for maintaining or terminating CPR in the prehospital setting with the AHA (American Heart Association) which updated the guidelines in 2015 through ILCOR with emphasis on chest compressions for first responders. Untrained persons should provide CPR with their hands only, with or without an attendant's guidance, to adult victims of CPA (Cardiopulmonary Arrest). The rescuer must continue CPR only with compression until the arrival of an Automated External Defibrillator (AED) or rescuers with additional training. All lay-rescuers should, at a minimum, give chest compressions to victims of CPA. In addition, if the trained lay-rescuer can deliver breaths, 30 compressions should be applied for every 2 breaths. The rescuer must continue CPR until the arrival and preparation of an AED for use, or until the Medical Service professionals can assist the victim or the victim begins regains consciousness.

Both New Zealand and Brazil through their specific legislation based on guidelines dictated by international organizations such as the ILCOR and the NAEMT state we should only do the cycle of 30 compressions for 2 breaths through 1 rescuer. The cycle can be continued by another rescuer until the arrival of an AED, SME or terminated if the victim regains consciousness.

Sources: https://www.nzrc.org.nz/; https://www.nzqa.govt.nz/; https://www.ilcor.org/; https://bcito.org.nz/; https://enit.trabalho.gov.br/portal/index.php/seguranca-e-saude-no-trabalho/sst-menu/sst-normatizacao/sst-nr-portugues?view=default; https://www.naemt.org/about-naemt; https://www.corpodebombeiros.sp.gov.br/; https://www.bombeiros.mg.gov.br/; https://www.heart.org/; https // www.facebook.com / WSMsecurity work /; https://www.picklerteam.com/index.php on June 7, 2020.