ECSI Instructor Update 2021

Emergency Care & Safety Institute
2021 Instructor Update
Copyright © 2021 by Public Safety Group, A Division of Jones & Bartlett Learning. www.psglearning.com.
Objectives
 Upon completion of this presentation, you will be able to:
• Describe new ECSI policy changes to lay responder adult CPR and
AED programs
• Describe science behind CPR, AED, and first aid education changes
per 2020 ILCOR Treatment Recommendations and ECC Guidelines
• Identify modifications being made to ECSI programs and products.
• Describe administrative changes to ECSI programs.
Changes to ECSI Policy
ECSI Policy Changes and COVID-19
 ECSI education centers are now able to issue course
completion cards for the following lay responder adult
CPR/AED programs:
• Compression-only CPR with AED*
• Conventional CPR with compressions, ventilations, and AED
 Education centers have the option to choose which techniques
they will incorporate into their lay responder programs
 Relevant for adult lay responder CPR programs only
• Ventilation is a critical aspect of pediatric training
*ECSI reserves the right to update this policy based on safety factors and local, state or national standards.
Changes to CPR and AED for Trained Lay
Responders
Lay Responder: Emphasis on Dispatchers
 Dispatchers:
• Recognize a cardiac arrest
• Send appropriate responders
• Provide pre-arrival instructions for compression-only CPR
○ This can reduce the response time to zero
• Coach lay responders in the proper rate of compressions using the
caller's phone speaker
• Improve outcomes
Lay Responder: Emphasis on Mobile Technology
 There are some very useful mobile apps available that can:
• Locate the nearest AED
• Locate where the victim is (PulsePoint)
• Remind the user of CPR steps
• Act as a metronome for proper rate of compressions
Lay Responder: Checking the Victim
 Verify scene safety
 If victim is unresponsive:
• Shout for nearby help
• Activate 9-1-1 with your mobile
device
 Simultaneous assessment
• Breathing and responsiveness
 If no breathing or only gasping:

• Begin chest compressions
Lay Responder: Chest Compressions (1 of 2)
 The order is CAB:

• Compressions
• Breathing
• Airway
Lay Responder: Chest Compressions (2 of 2)
 Compression depths:
• Adult: At least 2 inches deep
• Child: About 2 inches deep (or one-
third the AP diameter of the chest)
• Infant: About 1.5 inches deep (or
one-third the AP diameter of the
chest)
 100–120 compressions per minute

 Allow full chest recoil
 Do not lean on the chest
Lay Responder: Pediatric CPR
 Applicable to lay responders and  2020 Guideline updates:
BLS providers • One breath every 2–3 seconds
 Traditional CPR with ventilations (20–30 breaths per minute)
still recommended for pediatric • Can use 1 or 2 hands for
patients compressions in children
• Compression-only CPR is • For infants, two-thumbs
primarily for adults encircling hands is the preferred
• Kids need ventilations! compression technique
Lay Responder: Infant CPR
 Applicable to lay responders and
BLS providers
 Preferred method
• Two-thumbs encircling hands
technique for single- and two-
rescuer CPR
• Compression rate and depth
remains the same
 Alternate method
• Two-finger compressions
Lay Responder: CPR Review
1. Verify scene safety
2. Check for responsiveness and breathing
3. Call or have someone else call 9-1-1 and get an AED
4. Provide 30 chest compressions deep and fast
5. Provide two rescue breaths
6. Repeat cycle of compressions and breaths until an AED is
available or EMS personnel arrive
Lay Responder: Compression-Only CPR
 Lay responder adult CPR/AED
programs only
 Not for infants
• Infants need breaths
 Compressions only
• Hard
• Fast
• Continuous
Lay Responder: AED Use
 No changes to Guidelines
 Adults
• Use adult electrode pads
 Children
• Use pediatric electrode pads if
available
• Use adult electrode pads if no
pediatric electrode pads are
available
Lay Responder: Cardiac/Respiratory Arrest and
Opioid Overdose
 Number of opioid overdoses is still at an alarming rate
 Overdose leads to respiratory and/or cardiac arrest
 Reversible condition if managed appropriately
 If opioid overdose is suspected, naloxone should be
administered after compressions or ventilations have been
started
Changes to CPR and AED for Basic Life Support
(BLS) Providers
BLS Provider: Chain of Survival (1 of 3)
 Links are slightly different for out-of-hospital cardiac arrest
(OHCA) versus in-hospital cardiac arrest (IHCA), recognizing
the importance of preventing cardiac arrest in the hospital
setting
 Chain includes a new sixth link for “recovery”
 Adult IHCA links
Activation of
Early recognition Post-cardiac
emergency High-quality CPR Defibrillation Recovery
and prevention arrest care
response
 Adult OHCA links

Activation of
Advanced Post-cardiac
emergency High-quality CPR Defibrillation Recovery
resuscitation arrest care
response
 Pediatric IHCA links
Activation of
Early recognition Advanced Post-cardiac
emergency High-quality CPR Recovery
and prevention resuscitation arrest care
response
 Pediatric OHCA links

Activation of
Advanced Post-cardiac
Prevention emergency High-quality CPR Recovery
resuscitation arrest care
response
BLS Provider: CPR Steps
1. Verify scene safety
2. Recognize cardiac arrest
3. Activate emergency response (or additional resources)
4. Provide 30 high-quality chest compressions
5. Provide two rescue breaths
6. Continue cycles of chest compressions and breaths until the
patient begins to move, you are replaced, or you become too
fatigued to continue
BLS Provider: High-Quality Compressions (1 of 3)
 Rate
• 100–120 compressions/min
 Depth
• Adult: 2 to 2.4 inches
• Child: One-third AP diameter
(2 inches)
• Infant: One-third AP diameter
(1.5 inches)
 Full chest recoil
 Minimal interruptions
• Less than 10 seconds
 Use a feedback device if

available
 Chest compression fraction is the number of minutes of actual
compressions over the number of minutes of duration of
cardiac arrest
 Achieve a CCF of at least 60%, with a goal of 80%
BLS Provider: Asynchronous Ventilations
 Some EMS systems may choose to provide continuous chest
compressions prior to an advanced airway being inserted. In
this case, it is reasonable to provide 1 breath every 6 seconds
(10 breaths/minute), which are asynchronous of the
compressions.
BLS Provider: Pediatric CPR
 Traditional CPR with ventilations  2020 Guideline updates:
still recommended for pediatric • One breath every 2–3 seconds
patients (20–30 breaths per minute)
• Compression-only CPR is • Can use 1 or 2 hands for
primarily for adults compressions in children
• Kids need ventilations! • For infants, two-thumbs
encircling hands is the preferred
compression technique
BLS Provider: Infant CPR
 Preferred method
• Two-thumbs encircling hands
technique for single- and two-
rescuer CPR
• Compression rate and depth
remains the same
 Alternate method
• Two-finger compressions
BLS Provider: AED Use
 No changes
 Adults
• Use standard electrode pads
 Children and infants

• Use pediatric electrode pads if
available
• Use standard electrode pads if
no pediatric electrode pads are
available
Changes to First Aid
First Aid: Positioning the Victim
 On the victim’s back
• CPR-ready
 Recovery position
• Keeps the airway clear
• Spinal motion restriction
First Aid: Obstructed Airway
 Back blows for adults and
children:
• Provide five back blows and
then five abdominal thrusts (or
chest thrusts if large or
pregnant)
• Continue until obstruction is
dislodged or victim becomes
unresponsive
First Aid: Pressure and Hemostatic Dressings
 Apply direct manual pressure
 Apply hemostatic dressing, if
available
 Apply pressure dressing after
bleeding is controlled
First Aid: Tourniquets
 Apply a manufactured tourniquet  Tourniquet application:
as soon as possible • 2–3 inches above the wound
 If a tourniquet is not available or • Not over a joint
fails to stop bleeding, apply
direct manual pressure with a
hemostatic dressing
 If a tourniquet and a hemostatic
dressing are not available or fail
to stop bleeding, apply an
improvised tourniquet
First Aid: Aspirin
 Give aspirin for adults with
nontraumatic chest pain unless
allergic or previously advised not
to by a health care provider
First Aid: Glucose
 For adults with suspected hypoglycemia, give oral glucose
 For children with suspected hypoglycemia that are unwilling or
unable to swallow glucose, apply granulated sugar and water
under the tongue
 Seek additional professional care if symptoms worsen or do
not resolve within 10 minutes
 Do not give glucose to individuals who are not awake or not
able to swallow
First Aid: Anaphylaxis
 Administer one dose of
epinephrine via prescribed
autoinjector
 Call 9-1-1
 If symptoms are not relieved
after initial dose, provide a
second dose
First Aid: Presyncope
 Have the person sit or lie down
 Once sitting or lying, use PCMs to avoid syncope
• Lower-body PCMs preferable to upper-body and abdominal PCMs
• Do not use PCMs when symptoms of heart attack or stroke
accompany presyncopy
 If no improvement or if symptoms worsen or reoccur, call 9-1-1
First Aid: Heatstroke and Exertional Hyperthermia
 Move person from hot environment, remove excess clothing,
limit exertion, and call 9-1-1
 Initiate whole-body water immersion
• Water 34°F–79°F, until core body temperature is less than 102°F
• Do not immerse the person’s head
 When water immersion is not available, initiate other forms of
active cooling
• Ice packs, cool shower, cooling vests, evaporative cooling, fanning, or
combination of these techniques
 Limited evidence to make a recommendation at this time
First Aid: Simple Concussion
First Aid: Manual Spine Stabilization and Cervical
Spinal Motion Restriction
 Manual spine stabilization  Cervical spinal motion restriction
• Insufficient evidence for or • Suggest against use of cervical
against manual cervical spine collars by lay responders
stabilization
First Aid: Avulsed Permanent Tooth
 If cannot be replanted, store tooth in one of the following:
• Hank’s Balanced Salt Solution
• Oral rehydration salt solutions
• Cling film
 If above are not available, store tooth in one of the following:
• Any form of cow’s milk
• The person’s saliva
 Seek dental care as soon as possible
ECSI Product Releases and Administrative Updates
ECSI: 2021 Product Releases
 Quarter 1:  Quarter 2:
• Standard First Aid, CPR, and • Advanced First Aid, CPR, and
AED, Eighth Edition AED, Eighth Edition
• Basic Life Support (BLS) for the • Bloodborne and Airborne
Health Care Provider, Sixth Pathogens, Sixth Edition
Edition • CPR and AED, Eighth Edition
• First Aid, CPR, and AED Guide,
Eighth Edition
ECSI: Student Manuals
 More user friendly

 Updated content
 More compact
 New design
ECSI: Instructor Resources
 ECSI Instructor Resources
• Available for download
• No more CDs or DVDs
• Revised lesson plans, course
outlines, PowerPoints
 Videos
• Revised to meet 2020 ILCOR
Guidelines
ECSI: Online Courses
 Interactive alternative to
traditional classroom training
 Multiple courses
• First Aid, CPR, and AED
• CPR and AED
• BLS for the Health Care
Provider
• Bloodborne and Airborne
Pathogens
 Skills check
ECSI: Course Completion Cards
 Course completion card for all
courses
• Digital
• Can be emailed to students or
printed and handed out
• Still free with manuals for initial
training
ECSI: Initial and Refresher Training
 Three in-person training options:
• Student manual
• eBook
• Field Guide
 All three options include course

completion card
 Can be used for initial
or refresher training
ECSI: Instructor Cards
 New Instructor Cards

• Electronic files
ECSI: Course Exams
 Optional written exams for lay
responder courses
• End-of-course group activity
alternative
 Health care professionals still

take formal exams
• Info@ECSInstitute.org
ECSI: Contact Us
• 1-800-716-7264
 By phone:
 By email:
 Thank you for participating in the 2021 ECSI Instructor
Wrap-Up
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Emergency Care & Safety Institute

2021 Instructor Update

 ECSI education centers are now able to issue course

 Verify scene safety

 If no breathing or only gasping:

 The order is CAB:

 100–120 compressions per minute

 Applicable to lay responders and  2020 Guideline updates:

 Applicable to lay responders and

1. Verify scene safety

 Lay responder adult CPR/AED

 Links are slightly different for out-of-hospital cardiac arrest

 Adult IHCA links

 Adult OHCA links

 Pediatric IHCA links

 Pediatric OHCA links

1. Verify scene safety

 Full chest recoil

 Use a feedback device if

 Chest compression fraction is the number of minutes of actual

 Some EMS systems may choose to provide continuous chest

 Traditional CPR with ventilations  2020 Guideline updates:

 Children and infants

 On the victim’s back

 Back blows for adults and

 Apply direct manual pressure

 Apply a manufactured tourniquet  Tourniquet application:

 Give aspirin for adults with

 For adults with suspected hypoglycemia, give oral glucose

 Administer one dose of

 Have the person sit or lie down

 Move person from hot environment, remove excess clothing,

 If cannot be replanted, store tooth in one of the following:

 More user friendly

 ECSI Instructor Resources

 Course completion card for all

 Three in-person training options:

 All three options include course

 New Instructor Cards

 Optional written exams for lay

 Health care professionals still

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