The UK Resuscitation Council guidelines are updated roughly every five years. Utilizing the latest developments in research, technology and education to help improve survival rates in out of hospital cardiac arrests (OHCA). It’s always useful to know about any changes since the last update in 2015.

Useful Statistics

  • Most cardiac arrests (72%) occur in the home or a workplace (15%)
  • Half of all out of hospital cardiac arrests (OHCA) are witnessed by a bystander
  • 8 out of 10 OHCA are due to a cardiac cause
  • Public access defibrillator use is reported as being used in less than 1 in 10 OHCA
  • The average ambulance response time is 6.9 minutes
  • The initial rhythm is shockable in approximately 1 in 4 OHCA (22-25%)
  • AEDs increase the chances of survival by two to four-fold
  • A return of spontaneous circulation (ROSC) is achieved in approximately 30% of attempted resuscitations
  • When resuscitation is attempted. Just fewer than one in ten (9%) 

Adult Cardio Pulmonary Resuscitation (CPR)


The adult CPR protocol remains the same as when reviewed in 2015. The protocol is to dial 999 / 112 then deliver 30 chest compressions, followed by 2 rescue breaths. Then to continue this process until qualified medical assistance tells you to stop, or if the casualty shows signs of recovery.

Those unwilling or unable to deliver rescue breaths should deliver high quality chest compressions only. This also applied to bystanders who feel at risk of CO-VID19 and are unwilling to deliver rescue breaths through fear of contracting the virus. 

Helpful hint -  The depth of compression is 5 - 6 cm at a rate of 100-120 per minute

Paediatric Resuscitation Guidelines


The paediatric CPR algorithm largely remains the same with a few small exceptions. The child age group is now defined as being 1 - 18 years of age. This mainly affects the CPR protocol and would require the combination of chest compressions and rescue breaths unless the casualty is 18 years or older. 

The reason for this change is that most children and young adults will suffer a cardiac arrest from a pulmonary cause, and will require rescue breaths in order to deliver life saving oxygen into their bodies. 

Did you know - The infant age group is considered to be from birth to one year in age

Another key point is when to use an Automated External Defibrillator (AED) in children and infants. The protocol of using paediatric pads with an attenuator in children below 8 years of age remains the same. However if the pads are unavailable it is recommended to use the standard AED pads for all age groups. The risk of damage to the child / infant is outweighed by their chances of survival without defibrillation.

Did you know - The specialist paediatric pads reduce the energy delivered to between 50 - 75 J

Summary of Paediatric CPR Protocol


The below CPR protocol for infants and children remains the same as when reviewed in 2015:
  1. Deliver 5 initial breaths
  2. 30 chest compressions (5 cm child / 4 cm infant)
  3. 2 rescue breaths
  4. Continue 30:2 until qualified assistance takes over or the child / infant shows signs of recovery
The first aider / bystander can decide whether to use one or two hands (interlocked) when delivering chest compressions to a child. Preferably use a two-thumb encircling technique for infants. Single rescuers may alternatively use the two finger technique.

Finally


The guidelines encourage active participation in out of hospital resuscitation. It is always far better to attempt some sort of resuscitation rather than none at all. Even when the correct protocol / ratio cannot be remembered. For example those trained only in Adult CPR could apply the same technique to a child whilst awaiting the arrival of the emergency services.


Photo by Michel E on Unsplash