Resusitation Teaching Visual Aids [Archive]

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PeteM

23-03-2006, 09:37

Guys

I posted this in the middle of another thread but I think it got lost in the noise

With all the changes to basic life support i.e. terms, numbers, recommended methodologies, a lot of the slides we use for teaching are going to have to change.

Is HQ going to make or co-ordinate these changes or should branches be doing it themselves?

I ask as it seems pointless to duplicate effort across the country

Sean Gribben

23-03-2006, 12:01

Well changes get done within the BSAC by volunteers.
Are you volunteering your services? :)

Sean

PeteM

23-03-2006, 12:09

Well changes get done within the BSAC by volunteers.
Are you volunteering your services? :)

I wish I had the time...

Janos

23-03-2006, 12:13

I might be able to have a go. I've hurt my toe so diving's off.

Janos

Andy Botten

23-03-2006, 13:56

I have largely finished ST2
I have 2 small changes then I will submit it.

PeteM

23-03-2006, 16:01

I have largely finished ST2
I have 2 small changes then I will submit it.

OK I have reviewed on the DL stuff, done DT3 and DT9, working on DT2

Where can I put the files to make them accessible? (2Mb each zip)

Also we need a volunteer to go through the Advanced Diver slides

Ben Thompson

23-03-2006, 16:05

Also we need a volunteer to go through the Advanced Diver slides

I can't do them right now, but can do them tonight when I get home.

PeteM

23-03-2006, 16:17

I can't do them right now, but can do them tonight when I get home.

OK looks like we are nearly there. I have emailed Keith to sort out somewhere to put them so all we will need is some peer review once they are available

PeteM

23-03-2006, 17:12

OK looks like we are nearly there. I have emailed Keith to sort out somewhere to put them so all we will need is some peer review once they are available

Keith is going to put them in the forums download area.

Just had a thought. Are there any SDC slides that will need amending? Volunteers?

Janos

23-03-2006, 17:54

Ah sloblocks, I've jut gone through all the slides and updated them. And then I see everyone else's posts.

I've done:

ST2, DT2,3,6,9, and AT4.

I couldn't see anything else that needed changing.

Perhaps we could all upload them and then Sean can compare and contrast so to speak.

Janos

Janos

23-03-2006, 17:55

PS - How do I upload them?

Janos

Janos

23-03-2006, 17:56

PPS - Also, if we're reissuing the powerpoints, maybe we could incorporate all of the Errata at the same time?

Janos

PeteM

23-03-2006, 18:00

PS - How do I upload them?

Janos

Email them to me and I will co-ordinate
pete 'at' melbourne 'dot' me 'dot' uk

My copies of DT3 and DT9 are already here...
http://www.bsacforum.co.uk/downloads/dtp/

Ben Thompson

23-03-2006, 18:08

Hi Pete... I think there might be a typo in the very last slide of DT03...

A near frowning casualty... Well I'd be pretty near frowning if I was a casualty, but shouldn't it be drowning? :)

Janos

23-03-2006, 18:12

Email them to me and I will co-ordinate
pete 'at' melbourne 'dot' me 'dot' uk

Will do, but they're massive!

Janos

Keith Lawrence

23-03-2006, 18:16

Haven't yet worked out a way to give you guys limited FTP access :rolleyes: But myself and a few of the other Sys Admins have full FTP access and can upload for you.

Keith L

JimW

23-03-2006, 18:35

Will do, but they're massive!

Janos

Try and keep the amended files to ONLY the slides you have had to amend.
There is absolutely no need to updload a whole lecture.

Jim

Janos

23-03-2006, 18:37

Try and keep the amended files to ONLY the slides you have had to amend.
There is absolutely no need to updload a whole lecture.

No why didn't I think of that. :confused:

Janos

PeteM

23-03-2006, 18:39

Try and keep the amended files to ONLY the slides you have had to amend.
There is absolutely no need to updload a whole lecture.

Jim

Fine for the computer literate but not so good for those technologically challenged when they have to put them back together to show on a PC

David Walker

23-03-2006, 19:04

Yeah a full replacement would be better.

Can't they go on the BSAC main website Keith? There's an instructor section with some slides in already as far as I remember, would be good for all instructors to be able to get the updated versions, not just us on here?

David

judithbodkin

23-03-2006, 19:05

For the SDC'S we are looking at the 02, First Aid & Rescue First Aid
I believe these are the only ones.

Lifesaver & Advanced Lifesaver there isn't any powerpoint presentations
for. I know that some divers have put something together in the Instructor Resorces. These are so out of date it's something 2/ 02.

I'm running a Lifesaver Course in house next month. Causing bit of a headache!!!!

We also ran a 02 Course on the Saturday in house and everything got changed the following week!!!

Keith Lawrence

23-03-2006, 19:13

OK folks, time-out a little on this one :)

Can I request 'Updates Only' slides please, spare a thought for our bandwidth and the many users we still have on dial-up! Sean & Jim are keeping an eye on this from the NDC point-of-view, we'd be delighted to include the updates on the main bsac.org web site when we've all had a look/proof read, our thanks to the members putting in the effort on this.

I'm just trying to sort out the DNS for you, I hope to have an area where Pete and Janos (who seem to be taking the lead) can upload directly to our server.

Thanks all

Keith L

PeteM

23-03-2006, 19:52

Can I request 'Updates Only' slides please, spare a thought for our bandwidth and the many users we still have on dial-up! Sean & Jim are keeping an eye on this from the NDC point-of-view, we'd be delighted to include the updates on the main bsac.org web site when we've all had a look/proof read, our thanks to the members putting in the effort on this.

I disagree with that, I think that there are too many non computer literate people out there and telling them to put this slide in here, this slide in there will just confuse them. I think it safer to do full replacements.

However your the boss

I'm just trying to sort out the DNS for you, I hope to have an area where Pete and Janos (who seem to be taking the lead) can upload directly to our server.

Situation is Janos has done all the changes, I have reviewed and discussed amendments, which I now also have. I am now going through them all to a) correct the recurring problem with bullets changing to pen icons and b) fix the other errors listed in the Errata section.

Can I suggest anyone else working on the main diver training programme hold fire until these changes are up on a web site somewhere then they can review.

We do however still need to consider:

Instructor Manual changes
Exam Changes
SDC Changes

Now with the revisions due with the inclusion of nitrox it is debatable whether the first two are worth the effort

Adrian Kelland

23-03-2006, 20:37

There could be some usefull tips here (http://office.microsoft.com/en-us/assistance/ha011168821033.aspx) that might bring the file sizes down somewhat.

I understand Keith's reasons for requesting updates only, I very much prefer getting the whole lesson file in one go. While there are many users of computers and the internet, the number that can make suitable changes to common Microsoft Office files is far fewer. :(

If the download/bandwith issue is really too big, I wonder if we can make use of peer to peer tools such as BitTorrent or whatever. I have never used them myself, but this might help spread the load. Anyone with experience of these tools?

Adrian

Keith Lawrence

23-03-2006, 21:18

Sean Gribben

23-03-2006, 21:33

Not like us to beat you Keith!
You must have been out the room :p

Sean

PeteM

23-03-2006, 22:53

Blatting whole presentations up there is making it so difficult for everybody :( Without detailed documentation about what's changed it makes it very difficult and time consuming for Jim etc. to work out what has been changed without ploughing through the entire lot manually looking for changes. I can tell you now that we will be asked to provide just the updates, ideally we may want to provide both.

At this stage it makes it far, far easier if you just upload the changes. People have much less to review, we're quite happy to collate the changed slides back into the master copies. We will also be asked specifically "what's changed?", it is normal to provide a detailed list of changes when a new revision is put out, if the whole lot is uploaded then it is a big job reverse engineering that list.

I'm just passing on a request from HQ/NDC, they beat me too it because I was going to ask exactlt the same thing myself!

Cheers

Keith L

Fair enough

The presentations I have are complete. I don't have time for at least a week to decollate them to just the changed slides, I've already spent far longer on this than I really had time to. Guess the whole thing will have to go on hold for a while unless Janos has time to sort it out (and personally having seen the work he has done I feel he has already delivered beyond the call of duty).

P

Keith Lawrence

23-03-2006, 23:06

Fair enough

The presentations I have are complete. I don't have time for at least a week to decollate them to just the changed slides, I've already spent far longer on this than I really had time to. Guess the whole thing will have to go on hold for a while unless Janos has time to sort it out (and personally having seen the work he has done I feel he has already delivered beyond the call of duty).PPete/Janos etc.

If what you've got is complete presentations then fine - but can you provide a simple .txt list or something saying "I've changed slides 1, 3 and 7"? You know what you've changed, we don't, it just makes it much easier all round if we all know instead of having to work it out :)

Cheers

Keith L

PeteM

24-03-2006, 07:42

Pete/Janos etc.

If what you've got is complete presentations then fine - but can you provide a simple .txt list or something saying "I've changed slides 1, 3 and 7"? You know what you've changed, we don't, it just makes it much easier all round if we all know instead of having to work it out :)

As I said here (http://www.bsacforum.co.uk/forums/showthread.php?p=30801) I've changed a lot more than just the basic life support stuff so I will have to work it out. The actual deleting of unchanged slides is trivial it's the working out that is the problem.

Ben Panter

24-03-2006, 08:44

Pete,

I spotted a piece of software this morning called diff doc which may do what you want automatically (ie. compare two powerpoints and produce a report of the differences):

http://www.document-comparison.com/

There's a free trial, but my computer doesn't have office on it so I can't test it out. Might be worth a look though, especially if it is automatic...

Ben

PS: It asks for an email address, but doesn't do anything with it so ok to use a junk one like me@privacy.net .

Keith Lawrence

24-03-2006, 11:59

Pete/Janos/Adrian...

Thanks for your help guys, you have mail :)

K

PeteM

24-03-2006, 14:36

Right, we have uploaded the amended versions, they are on
http://mul.bsacupdates.org.uk/dtp/

Right click on the file you want and select "Save Target As"

Corrections, comments, suggestions, general abuse on here please and I will try and sort them out

Thanks

Pete

Adrian Kelland

24-03-2006, 15:21

Pete/Janos/Adrian...

Thanks for your help guys, you have mail :)

K
I do?

Hamish

24-03-2006, 21:51

Keith Lawrence

24-03-2006, 23:14

To all concerned, Thanks Guy's.:)

I was about to sit down this weekend and go through my powerpoint slides, but low and behold there they were (with ever so slight adjustments).
It's people like yourselves who make BSAC what it is today. From one very gratefull Instructor.:) :) They aren't the 'official' versions yet Hamish, but we hope that the volunteer effort that's going in will contribute significantly to the final versions.

Cheers

Keith L

PeteM

25-03-2006, 00:18

To all concerned, Thanks Guy's.:)

I was about to sit down this weekend and go through my powerpoint slides, but low and behold there they were (with ever so slight adjustments).
It's people like yourselves who make BSAC what it is today.

From one very gratefull Instructor.:) :)

Hamish they are work in progress - but please add your contribution by downloading and proof reading...

Let us know how you get on

Hamish

29-03-2006, 17:54

They aren't the 'official' versions yet Hamish, but we hope that the volunteer effort that's going in will contribute significantly to the final versions.

Cheers

Keith L

Hi Keith,

It would be nice to know if those in the higher echelons are perhaps reviewing the work being done by the humble members down here and if so perhaps letting us know if we could be wasting time as they alraedy have it under control?

Regards

Hamish

Keith Lawrence

29-03-2006, 18:43

Hi Keith,

It would be nice to know if those in the higher echelons are perhaps reviewing the work being done by the humble members down here and if so perhaps letting us know if we could be wasting time as they alraedy have it under control?I can't answer that. Perhaps you should ask the question of Sean Gribben who responded earlier in this thread, he's on the NDC Steering Group and team leader of the Diver Training Group responsible for this :rolleyes:

Keith L

PeteM

30-03-2006, 13:05

It would be nice to know if those in the higher echelons are perhaps reviewing the work being done by the humble members down here and if so perhaps letting us know if we could be wasting time as they alraedy have it under control?

Hi Hamish

Sorry for the delay in answering, been out of circulation most of the week.

I am discussing with NDC and they are involved. The plan is once I have incorporated all changes (so far all from you;) ) they will have a look. So if my life sorts itself out enough to give me some breathing space, hopefully we should be able to pass stuff to them early next week

Cheers

Pete

Janos

30-03-2006, 14:03

As an aside. Keith: Is it worth having a link at the top of this page (http://www.bsac.org/techserv/irc/dtpcor.shtml) to the new guidelines?

Janos

Hamish

30-03-2006, 21:44

Hi Pete,

Did you lift the latest updates from here? http://www.btinternet.com/~hamish.torunski/Resus_revision.htm as I said it was better to place them there as then it did'nt clogg up your email with big files.

Hamish

PeteM

31-03-2006, 13:46

Andy Botten

31-03-2006, 14:00

I have just had a quick look at the instructor notes for ST2
The references to CPR need to be swapped to BLS

2 person CPR no longer exists one person does both actions swaping every couple of minutes - I have not checked the slides to ensure the picture of 2 person CPR has been removed/replaced by one person.

Also the landing to the boat section needs to have the 1 minute of RB then dekit without any further RB

Well done & thanks

Hamish

31-03-2006, 23:39

Andy,

It's good to get feedback on work in progress, but perhaps you have not seen the latest updates, also please bear with me as I have to disagree with your interpretation of the BS-AC guidelines for the following reasons:

The references to CPR need to be swapped to BLS

An extract from the 2005 International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science with Treatment Recommendations:- Cardiopulmonary resuscitation (CPR) is a combination of rescue breathing and chest compressions delivered to victims thought to be in cardiac arrest.
If you would also like to read the Resuscitation Council (UK) guidelines here: http://www.resus.org.uk/pages/bls.pdf you will see that Basic Life Support (BLS) refers to RB + CC as CPR and also CC alone as CPR. CPR IMOH is the manipulation of the heart by external means and that is what we would be doing? It therefore remains that where RB and CC are used within the scope of BLS we will still refer to it as CPR.(also see 2 person CPR)

Also the landing to the boat section needs to have the 1 minute of RB then dekit without any further RB

The latest updated ST2 powerpoint does have continue RB 1 minute then de-kit, the update has just not been put into the folder as yet.

2 person CPR no longer exists one person does both actions swaping every couple of minutes - I have not checked the slides to ensure the picture of 2 person CPR has been removed/replaced by one person.

The BS-AC BLS Sequence states:If there is more than one rescuer present, another should take over CPR every 1-2 min to prevent fatigue. Ensure the minimum of delay during the changeover of rescuers.

It does not state that only one rescuer should operate at a time, my interpretation is that where there are 2 rescuers one will carry out the RB whilst the other is engaged in CC (CPR) and that they should change over every 1 to 2 minutes. Please remember that it is the person carrying out CC that will tire quickly not the RB. The RB is in fact resting between the breaths which take on average 8-10 seconds and the CC, whereas the CC member is using physical exertion for a period of aproximately 30-35 seconds.

Please also note ‘CPR’ is used throughout every document, including the BS-AC bulletin when dealing with either Chest Compressions alone or where these are combined with Rescue Breathing.

This is of course my opinion and everyone is entitled to theirs, we will have to wait until the NDC reviews any submissions to get a definitive answer.
Or does anyone have the definitive answer?:confused:

Regards

Hamish

David Walker

01-04-2006, 01:33

The BS-AC BLS Sequence states:If there is more than one rescuer present, another should take over CPR every 1-2 min to prevent fatigue. Ensure the minimum of delay during the changeover of rescuers.

It does not state that only one rescuer should operate at a time, my interpretation is that where there are 2 rescuers one will carry out the RB whilst the other is engaged in CC (CPR) and that they should change over every 1 to 2 minutes. Please remember that it is the person carrying out CC that will tire quickly not the RB. The RB is in fact resting between the breaths which take on average 8-10 seconds and the CC, whereas the CC member is using physical exertion for a period of aproximately 30-35 seconds.

I'm 99% certain that the rules on two-person CPR are intended to mean that one person does both CC & AV, then another does both CC & AV. As I remember its not just to do with getting tired, but because of problems coordinating two people doing it together which apparently presented problems in the past. Worth checking with the resus council guidelines though.

Edit: by the way, i've never seen CC referred to as CPR before (other than generalising when the distrinction is not important) which may be where the confusion is arising?

David

Hamish

02-04-2006, 17:49

I'm 99% certain that the rules on two-person CPR are intended to mean that one person does both CC & AV, then another does both CC & AV. As I remember its not just to do with getting tired, but because of problems coordinating two people doing it together which apparently presented problems in the past. Worth checking with the resus council guidelines though.

Edit: by the way, i've never seen CC referred to as CPR before (other than generalising when the distrinction is not important) which may be where the confusion is arising?

David

Hi David,

It's good to see people are taking an interest in this subject as for all divers it a fundemetal change in teaching. That is one of the reasons I have read and re-read the "Resuscitation Council (UK) RESUSCITATION GUIDELINES 2005" and the "BS-AC Basic Life Support Guidelines 2006". This is to try and ensure that those rewrites I have put forward for discussion follow the guidelines. Now your reply has got me to re-read them through again (not a bad thing).

Having done so I believe the entry which covers the subject of 2 person CPR which comes from the Resuscitation Council (the BS-AC does not mention it) guidelines is as follows:

"Finally, there is recognition that delivering chest compressions is tiring.
It is now recommended that, where more than one rescuer is present, another should take over the compressions (with a minimum of delay) about every 2 min to prevent fatigue and maintain the quality of performance."

As you can see the relation is due to the person carrying out the CC tiring, nowhere in either document does it relate to 1 person delivering both RB and CC alone where 2 are available. I therefore stand (or fall) by my interpretation of the guidelines that where there are 2 people available for Basic Lfe support where CPR, incorperating CC + RB is employed, that they would alternate between RB and CC every 2 minutes or as required by the person carrying out the CC. This ensures the minimum of delay as the RB can ready themself to take over the CC on request as was previously employed under the old teaching.
The delay in contiuation of the BLS sequence when carried out by one person is quite dramatic, the person has to reposition each time to change from CC to RB, this I believe wastes valuable time.

The fact is if it was me who was deciding the process for 2 rescuers I would have the Rescue Breather on completion of there last breath to position themself on the opposite side of the casualty, then on the 15th compression by the person delivering CC take over and deliver the second group of 15 CC therefore allowing the other rescuer time to position themself for the continuation of RB.

This would give the minimum of break in the Basic Life Support sequence.

It's a can of worms as they say.

Regards

Hamish.

David Walker

02-04-2006, 18:15

Its a difficult one, i've found where the confusion is arising.

See http://www.patient.co.uk/showdoc/40002005/

This is the 2000 standards and specifically:
"Two person CPR is less tiring than single person CPR. However, it is important that both rescuers are proficient and practised in the technique. Therefore it is recommended that this technique is only used by trained healthcare providers and those lay persons who are members of trained teams, such as first aid and rescue organisations."

The new 2005 standards say this:
"Finally, there is recognition that delivering chest compressions is tiring. It is now recommended that, where more than one rescuer is present, another should take over the compressions (with a minimum of delay) about every 2 min to prevent fatigue and maintain the quality of performance."

Based on the 2000 standards, and the fact that the 2005 standards don't explicitly say either way, i'd be inclined to stick with the 2000 standard interpretation and say that it should always (usually) be one-person CPR, but swapping over each person doing both AV and CC every two minutes, rather than one doing AV and one doing CC, and then swapping.

David

Andy Botten

03-04-2006, 13:09

Resus council 2005 BLS: last para in section 6A is quite explicit.

If there is more than one rescuer present, another should take over CPR about every 2 min to prevent fatigue. Ensure the minimum of delay during the changeover of rescuers.

CPR is as was stated earlier RB & CC
Therefore, only one person at a time.

HTH

Hamish

03-04-2006, 22:10

Hi David, Andy,

Perhaps we should consult the oracle, you are both correct in what you have stated in your post i.e.

1)
This is the 2000 standards and specifically:
"Two person CPR is less tiring than single person CPR. However, it is important that both rescuers are proficient and practised in the technique. Therefore it is recommended that this technique is only used by trained healthcare providers and those lay persons who are members of trained teams, such as first aid and rescue organisations."

2)
Section 6A: If there is more than one rescuer present, another should take over CPR about every 2 min to prevent fatigue. Ensure the minimum of delay during the changeover of rescuers.

But please consider the following:

In relation to:
1) BS-AC Sports Divers, Dive Leaders etc are considered to be lay persons who are members of trained teams in relation to diver rescue, we train BS-AC divers to carry out CPR as a team as well as individuals. Therefore we should and would continue to train our divers in this technique.
2) The Resuscitation Council document is based on the “2005 International Consensus on Cardiopulmonary Resuscitation (CPR) and Emergency Cardiovascular Care (ECC) Science With Treatment Recommendations”, and in the Resuscitation Council document introduction it states that, “This section contains the guidelines for out-of-hospital, single rescuer, adult basic life support (BLS).

And Page 3 paragraph 4 states:
“Finally, there is recognition that delivering chest compressions is tiring. It is now recommended that, where more than one rescuer is present, another should take over the compressions (with a minimum of delay) about every 2 min to prevent fatigue and maintain the quality of performance.”

The actual “2005 International Consensus on Cardiopulmonary Resuscitation (CPR) and Emergency Cardiovascular Care (ECC) Science With Treatment Recommendations”, states:
Page 13
Treatment Recommendation
It is reasonable for lay rescuers and healthcare providers to perform chest compressions for adults at a rate of at least 100 compressions per minute and to compress the sternum by at least 4 to 5 cm (11⁄2 to 2 inches). Rescuers should allow complete recoil of the chest after each compression. When feasible, rescuers should frequently alternate “compressor” duties, regardless of whether they feel fatigued, to ensure that fatigue does not interfere with delivery of adequate chest compressions.
It is reasonable to use a duty cycle (ie, ratio between compression and release) of 50%. Etc etc

I would interpret this to mean exactly that, that where there are trained teams of lay rescuers i.e. more than one, then one person can carry out the compressions whilst the other carry’s out the rescue breathing, but the compressor should ensure that they do not compromise the procedure by becoming fatigued.

I the light of the above I feel that my interpretation of the procedures for the moment will not change, but that is not to say I am right only that my view has not changed. As we all know it is not for me to decide on the final procedures, but the NDC’s, so we will just have to wait and see what the final outcome is.

It would be nice if someone from the NDC would comment on this particular point as it would then assist the people trying to get some training updates together, but it looks like they are all keeping a low profile or are they watching and waiting?

Regards

Hamish.

andy.cleverdon

20-04-2006, 01:18

Hamish

22-04-2006, 00:40

As a state registered paramedic and a resuscitation training officer the idea is that one person does the whole procedure or algorithm, for 1-2 minutes and then completely rests whilst the other person takes over, there is data and research that has proved that this method allows the rescuers to perform better and for longer than just changing roles every 2 mins.

Hi Andy,

Thanks for your input, but I feel you have not looked at it from a divers rescue scenario. You have to bear in mind that it is more than likely in this situation that diver administered Oxygen Administration will be used and that the time taken to reposition yourself to administer this would be detrimental to the successful administration of Basic life Support.

We are not talking about the type of situation that paramedic's normally find themselves in, with their equipment available, nor is it the situation lay persons are trained for on a first aid course (they are not trained to administer O2).

This is a situation to which a diver or divers would find themselves having to deal with until such time as a qualified person arrived to take control. This entails utilising the equipment available i.e. O2 kit which would normally consists of RB using a constant flow pocket mask and CC's.

I therefore still advocate 1 person giving RB whilst the other gave CC, with a changeover designed to prevent one or the other becoming exhausted.

Regards

Hamish