Training on Defibrillators to be included on the EFAW and FAW Syllabus

Changes to Resuscitation Council UK guidelines on cardiopulmonary resuscitation (CPR) in October 2015 mean that HSE will now be revising the Emergency First Aid and First Aid at Work syllabuses.  The revision will require all workplace first aiders to be trained in the use of an automated external defibrillator (AED) from the 31 December 2016, as the Resuscitation Council UK guidelines now state that the management of a casualty requiring CPR is to request an AED.

It is sensible to ensure that EFAW and FAW first aiders are trained in AED use as they are now available within many workplaces and public spaces.  There is good evidence that the early use of an AED has a far more beneficial outcome for the casualty than if that intervention is delayed.

For employers this does not mean you have to purchase a defibrillator for your workplace as the requirement for a defibrillator is still dependent on your needs assessment.  Neither do you have to retrain all your existing first aiders as they will be updated in this skill when they requalify.

For those who deliver EFAW and FAW training the change means that you should ensure that students are trained and assessed on how to use an AED from the 31 December 2016 within the existing timeframe allowed for the delivery of either EFAW or FAW training.  HSE has no objection if training providers wish to adopt this change before the 31 December.

HSE updated stance on Blended Learning

Advice to Employers on the use of Blended Learning* in First Aid Training

Blended learning is an accepted means by which workplace first aid training can be delivered.  It is important that Employers conduct the necessary additional checks (due diligence) to decide if staff should be trained in first aid using this method (a combination of electronic distance based and face to face classroom based instruction).  This means you should make sure:

  • you are satisfied that where first aid training comprises of blended learning, it is as effective as exclusively face to face learning;
  • the individual being trained knows how to use the technology that delivers the training;
  • the training provider has an adequate means of supporting the individual during their training;
  • the training provider has a robust system in place to prevent identity fraud; and,
  • sufficient time is allocated to classroom based learning and assessment of the practical elements of the syllabus.

Employers should also ensure they are complying with Regulation 13 of the Health and Safety Management Regulations 1999, which has a requirement  to ensure adequate time is set aside during the working day to undertake any first aid training employees receive.  HSE Guidance document GEIS3 will be updated to reflect this change.

* Blended learning is a combination of online learning and traditional face-to-face learning. For first aid training, this would be items such as roles and responsibilities and legislation as the online learning and then performing things like CPR and recovery position in the face-to-face time.

Lifesaving Defibrillators Often Behind Locked Doors, Study Finds

Devices that shock heart rhythm back to normal were not available 25 percent of time in emergencies

Powerheart G3 Plus

Public defibrillators can help anyone save the life of someone suffering cardiac arrest, but the devices are often kept behind locked doors, a new study finds.

At issue is the accessibility of devices called automated external defibrillators, or AEDs. They are portable, layperson-friendly versions of the devices doctors use to “shock” the heart out of cardiac arrest.

It’s now routine for paramedics to carry AEDs, and the devices are often available in large venues, such as airports and sports stadiums, as well as schools and private businesses. To live up to their full potential, though, those devices have to be readily available, said study author Timothy Chan, a researcher at the University of Toronto.

However, his team found, that’s often not the case. The researchers looked at the cases of 451 Toronto residents who went into cardiac arrest within 100 meters of an AED — about a football field’s distance. One-quarter of the time, the devices were behind locked doors. “If the AED isn’t accessible, it’s as if it’s not there at all,” Chan said.

The study found that AEDs in schools, office buildings, industrial sites and recreational facilities were most likely to be locked up, particularly at night or on weekends — which is not surprising, Chan noted, since such buildings are not open 24/7. Unfortunately, two-thirds of the cardiac arrests in this study occurred at night or over the weekend, Chan said.

He was to present the findings Sunday at the annual meeting of the American Heart Association, in Orlando, Fla. The data and conclusions should be considered preliminary until published in a peer-reviewed journal. The findings “ring true,” according to Dr. Clifton Callaway, an AHA spokesperson and a professor of emergency medicine at the University of Pittsburgh.

“One of our longstanding concerns is that AEDs are not always in locations that are clearly marked, or that people are aware of,” Callaway said. It makes sense, he added, that AEDs would also frequently be inaccessible — particularly those owned by private businesses. “A lot of businesses would buy these with their employees in mind, and not for the general public to use,” Callaway said.

He said local communities need to come up with “novel ideas” on how to make AEDs broadly available, and make sure that people know where the devices are located. There is work being done, both Callaway and Chan said. The PulsePoint Foundation, for example, has developed a smartphone app that allows users to locate local AEDs. Chan said companies are also working on ways to make AEDs available outdoors, in weatherproof, vandalism-proof containers.

But more innovation is needed, according to Chan. One possibility, he said, would be to bring banks on board and have AEDs available in ATM lobbies. In Japan, Chan noted, there are AED vending machines.

AEDs can be used to restore a normal heart rhythm in some cases of cardiac arrest. Most often, cardiac arrest occurs when the heart’s main pumping chamber stops contracting and begins to quiver chaotically — depriving the body of blood and oxygen. Without prompt treatment, it’s fatal within minutes.

Each year in the United States, about 360,000 people suffer cardiac arrest outside of a hospital, according to the AHA. Less than 10 percent of those people survive. The odds of survival do improve, however, if bystanders perform chest compressions or use an AED while waiting for paramedics to arrive.

Chan said it’s not clear how AED availability might have affected the survival of patients in his study. Callaway also pointed out that increasing AED availability is just one piece of the picture. The public also needs to know that the devices exist, and be comfortable using them.

Local CPR courses now include AED training, Chan said. But even without training, he added, anyone can use an AED: The devices automatically analyze the heart’s rhythm, then deliver a shock only if it’s appropriate.

Chan pointed to a widely reported study of “mock” cardiac arrests, where researchers found that untrained sixth-graders used AEDs almost as well as medical professionals did.

More information

The American Heart Association has more on cardiac arrest.

SOURCES: Timothy Chan, Ph.D., research chair, novel optimization and analytics in health, University of Toronto; Clifton Callaway, M.D., Ph.D., professor, emergency medicine, University of Pittsburgh Medical Center; Nov. 8, 2015, presentation, American Heart Association annual meeting, Orlando, Fla.


No driving licence without first aid training? New parliamentary bill could

New parliament bill seeks to force new drivers to obtain life-saving skills before qualifying for full license. An MP is seeking to introduce a new bill in parliament that would make first aid training a mandatory requirement before receiving a driving licence.
The Driving Licence (Mandatory First Aid Training) Bill has been presented to the House of Commons by Will Quince, Conservative MP for Colchester.

The bill, backed by the British Red Cross and St John’s Ambulance, calls for new drivers to undergo a four-hour practical first-aid course before they can be granted a licence.

So often there isn’t time for an ambulance to arrive, knowledge of first aid can be absolutely critical

Will Quince, MP

Quince says that if added to the statute book, his bill could reduce road deaths in the UK and increase knowledge among the population of important life-saving skills.

He bases this claim on a recent survey conducted on behalf of St John Ambulance, which found that 59% of respondents didn’t feel confident enough to save a life, while 24%, if they found themselves at the scene of a road traffic collision, wouldn’t take any action until an ambulance arrived.

If introduced, this legislation wouldn’t be unique: a number of countries – including Germany, Switzerland, Czech Republic and Austria – have similar laws in place. Switzerland, for example, requires new drivers to prove that they have had at least 10 hours of first-aid training in order to qualify for their driving theory test.

When presenting his bill, Quince said: “A review of road traffic in Europe cited by the World Health Organisation claims that 50% of deaths from road collisions occurred within a few minutes of the crash.

“So often there isn’t time for an ambulance to arrive, knowledge of first aid can be absolutely critical. Immediate initiation of CPR, for example, can double or even quadruple survival from cardiac arrest.

“But the sad reality is that in Britain the knowledge of first aid is patchy. Through no fault of their own, people do not feel confident enough to intervene and provide first aid in crash and accident situations.”

First Aid and Defibrillator Training for Devro plc

Mike and Duncan recently delivered a 1 day Emergency First Aid at Work (EFAW) and Automated External Defibrillator (AED) course for Devro plc in London. The feedback from the staff involved included comments of how easy it was to use the defibrillator, especially from people who had never used it before and had no previous training.

Devro have recognised the need for a defibrillator at both their London and Glasgow sites for a few years now. They have received defibrillator training from Abacus Training for a couple of years. Devro London decided that they wished to expand on this and train as many of their London based staff in basic first aid as well.

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Half of people not confident about administering CPR, survey finds

About half of people in Scotland do not feel confident administering CPR if needed in an emergency, a survey has found.

Fear of causing an injury (22%) and lack of skills (19%) were the top reasons, closely followed by being put off by visible vomit or blood (19%) and indications the person is a drug user (16%).

A fear of being sued (8%) or catching a disease (10%) were also cited in the out-of-hospital cardiac arrest (OHCA) report by the Open University for the Scottish Government.

The study was set up to explore ways of improving people’s understanding and knowledge of emergency CPR.

It states that survival rates from OHCA in Scotland currently stand at 5% and those who receive CPR from a bystander before professionals arrive are “far more likely to survive to hospital discharge than those who do not”.

The survey of more than 1,000 people found 77% think everyone should be CPR trained but just 52% are.

Of those trained, 44% did so over five years ago and just 28% within the last year.

The majority of respondents who were CPR-trained received it because it was a requirement of their employment or was offered to them through voluntary work.

The study found that the older a person is, the less likely or willing they were to be CPR-trained.

The report said: “These findings are particularly relevant considering that most OHCA happen in the homes of older people.”

Employment was also an influential factor identified among people who had CPR training.

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Resus Council Guidelines 2015

DSC_0077_smThe 15th October was the date that the 2015 Resus Council guidelines were updated. This happens every 5 years, so will be due again in 2020. There were quite a number of changes made in 2010. There appear to be very few changes in the 2015 guidelines.

The first thing to pick up appears to be that there is no emphasised shout for help as part of the response check.

There is no change to the airway section, with jaw thrust still being something that is not recommended for first aiders.

The breathing check has very little change to it, although it does go straight in to what to do if the casualty is not breathing, no mention is made of what to do with a breathing casualty.

After finding a casualty with no breathing, emphasis is placed on sending for an AED (Automated External Defibrillator) and calling for professional help (999/112). If an AED is available, it is recommended that someone should be sent to fetch the defibrillator, if it is a lone rescuer, they should start CPR. It is suggested to use the speaker-phone if calling from a mobile phone, so that the rescuer has both hands available to them.

When moving on to compressions, the wording has changed slightly, the depth of compression is still 5-6cm, but no more than 6cm. There is also emphasis placed on full recoil of the chest to allow the heart to refill with blood.

Those that are trained in CPR/BLS should perform breaths/ventilations if it is safe and they are able to do so. Compressions only CPR should be performed by those that are not trained or, if for some reason, you are unable to do the breaths/ventilations.

The full 2015 Resuscitation Guidelines and posters are available here.


What is diabetes?

Diabetes is a condition where the body does not produce enough insulin or the insulin that is produced is not being used effectively. Insulin is a hormone that is produced by the pancreas and is required to help control the glucose level in the blood. If the insulin is not working correctly then the level of glucose in the body will go up. As insulin is required to allow the glucose to the enter the cells of the body, the cells do not receive enough glucose and become starved.


Current statistics suggest that there are in excess of 3 million people who are diagnosed as diabetic. It is also estimated that there are at least 1 million more people who have diabetes, but do not know it. The number of people diagnosed as diabetic is higher now than in previous years.


Generally it is recognised that there are 2 main types of diabetes. Type 1 and type 2 diabetes.

Type 1 diabetes is a lot less common than type 2 and usually develops in children and young adults. It is currently thought that type 1 diabetes occurs as a result of the body’s immune system destroying the insulin producing cells. This results in them not be able to make insulin and the blood glucose level rising.

Type 2 diabetes is more common middle-age to old age and typically develops over the age of around 40. Although certain ethnics backgrounds are biologically more prone to diabetes at an earlier age. Typically people who are overweight are more likely to develop type 2 diabetes as the body has too much fat and more glucose is produced when it is not needed.

How can you ‘spot it’?

Typically someone who should be checked for diabetes would be someone who has any of the following symptoms:

  • increased thirst
  • passing more urine, particularly at night
  • unexplained/unexpected weightloss
  • blurred vision
  • those diagnosed with glaucoma
  • slow healing of wounds
  • extreme tiredness

People often ignore many of these signs and symptoms as being part of the natural ageing process. These symptoms tend to happen gradually over time, the person puts it down to ageing and does not get a diagnosis.

Undiagnosed diabetes, in the long term can cause heart problems, eye problems and kidney problems amongst other things.

The tale of the dog behind the ‘kiss of life’ discovery – BBC News


There are about 30,000 cardiac arrests every year in the UK and ten times that number in the US. It is one of the most common ways to die.

It is also one of the most common scenarios in which a bystander can save a life through CPR or cardiopulmonary resuscitation, the technique used to keep blood and oxygen pumping round the body until emergency help arrives.

This ‘kiss of life’ has an intriguing history stretching back over 100 years to when electricity was first being installed in domestic homes and, in part, it owes its discovery to the fate of an unnamed lab dog.

Throughout the early 1900s an electrical revolution hit America, and homes became populated with electrical appliances – everything from light bulbs to refrigerators.

But, on the down side, electrocution was a major risk to people working on the newly-installed power lines. Many died of cardiac arrests. As a result, external defibrillators had been invented to shock the heart back into rhythm without opening the chest – but they were too big and cumbersome to use outside of hospitals.

In the 1950s, the Edison Electric Institute in the US decided to sponsor researchers to investigate the effects of electrical currents on the heart.

Enter Guy Knickerbocker, a fastidious, 29-year-old graduate working under electrical engineer William Kouwenhoven in one of the labs at Johns Hopkins University in Maryland. They were trying to improve the external defibrillator, which Kouwenhoven had invented a few years earlier.

In 1958, before the ethical treatment of animals became a serious consideration, their experiments involved testing on laboratory dogs.

Knickerbocker, now 86 years old, remembers working with a colleague one day when, suddenly, one of the dogs went into cardiac arrest, or ventricle fibrillation (VF). Thanks to a unnamed dog, Knickerbocker and his colleagues discovered how to slow down the dying process in the 1950s. Normally when this happened, they would use a defibrillator to shock the dog’s heart back into rhythm – but that day they were in the lab on the 12th floor and the equipment was on the fifth floor. The notoriously slow lifts in the building meant they would never get the defibrillator to the dog in time.

“There is very little chance of survival after cardiac arrest that goes on longer than five minutes,” says Knickerbocker. Knickerbocker had a brainwave. Only a few weeks earlier he had observed that just the pressure of the defibrillator paddles on the dog’s chest caused a change in blood pressure. Did this change in pressure mean that the blood was moving around the body?

He took a chance: “We started to pump the dog’s chest because it seemed to be the right thing to do.”

Knickerbocker raced along the stairs to the fifth floor to get the defibrillator while his colleagues pressed the dog’s chest for 20 minutes – four times longer than any previous successful attempt. When he arrived back with the defibrillator and administered two shocks, the dog sprang back to life.

The importance of their discovery cannot be overstated; the experiment established beyond doubt that rhythmic pressing of the chest could sustain life. Knickerbocker says: “We had found a way to slow down the dying process, and give people time to receive defibrillation”. Knickerbocker excitedly shared his discovery with cardiac surgeon, Dr Jim Jude, who worked in the next-door lab.

Dr Jude immediately realised its potential, and along with Kouwenhoven, set about working out exactly where to push, how often, and how much force to apply – and found they could extend a dog’s life for more than an hour.

“I didn’t believe the chest compression technique would ever translate to humans, and neither did a lot of my colleagues,” he says today.

This included the head of surgery at Johns Hopkins at that time who wanted the team to provide a lot of evidence before he let them publish their findings. However Dr Jude was convinced the dog-saving technique could work on people.

The chest compression technique, he realised, could be used to simulate up to 40% of normal cardiac activity. The only problem was that there was no-one to test it on.

A little over a year later, a 35-year-old woman, who was admitted for a gall bladder operation at Johns Hopkins, reacted badly to the anaesthetic and went into cardiac arrest.

Dr Jude immediately began applying rhythmic, manual pressure to her chest. Within two minutes her heart started again and she went on to have the operation and make a full recovery. This led Kouwenhoven, Jude and Knickerbocker to publish their discovery in a paper in 1960. “Anyone, anywhere, can now initiate cardiac resuscitative procedures,” the authors concluded. “All that is needed are two hands.”

In collaboration with another research group who were looking at ventilation techniques, they developed modern CPR. Now it is taught across the world and in some countries it is also taught in schools. The American Heart Association estimates that CPR provided immediately after sudden cardiac arrest can double or triple a victim’s chance of survival.

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Low Blood Pressure

Low blood pressure is also known as hypotension. This is when your blood pressure goes below 90/60 (90 over 60). This does not always mean there is a problem, people with low blood pressure tend to live longer than those with high blood pressure.

Low blood pressure does not usually give any symptoms and is often discovered during routine examinations or whilst a person is undergoing checks for other things. However very low blood pressure can sometimes cause dizziness and even fainting.

Other illnesses or conditions can be the cause of low blood pressure. If a person is feeling dizziness they should consult with their GP so that they can investigate this further. Taking certain medications can be cause of low blood pressure, such as those taken for high blood pressure, heart disease and depression. It can also come from some over the counter medications or herbals medications.

Postural hypotension is a condition where a person can get low blood pressure when changing their body position, such as getting out of bed quickly or getting up from the sofa quickly. This can make the person feel lightheaded or dizzy. This condition is quite common in teenagers and older people. If you experience this you should discuss this with your GP. At times, we can all get a small drop in blood pressure, this is nothing to be concerned about, larger drops in blood pressure could be described in postural hypotension.

If a person suffers from low blood pressure, they should ensure they drink plenty of fluids, especially if they are suffering from diarrhoea and vomiting. If you suffer postural hypotension, you should ensure that you get up more slowly in the morning or when you get up from the sofa.