December 2015 - Parks & Recreation - 25

Heat stroke: Persons suffering a
heat-related illness with a change
in mental status, such as confusion,
sleepiness, vision disturbances and
seizures, are likely to be suffering
from heat stroke. Responders should
immediately apply rapid active cooling measures and call 911.
Hypoglycemia: Early treatment of
hypoglycemia (low blood sugar)
while the person is still awake and
able to follow instructions can prevent progression to more serious
hypoglycemia that would require
advanced treatment. To avoid giving too much or too little sugar, the
new guidelines recommend use of
glucose tablets (15-20 gm) that can
be purchased at a retail pharmacy.
Glucose tablets have been shown to
be more effective at resolving symptoms of hypoglycemia than dietary
forms of sugar. If glucose tablets are
not available, food sources such as
sucrose candies, fruit leather strips
or orange juice can still be used, in
that order of preference.
Anaphylaxis: Under the revised
guidelines for treating anaphylaxis
(severe allergic reaction), if symptoms
persist beyond the initial dose and
arrival of advanced care will exceed
5-10 minutes, the first-aid provider
may give a second epinephrine injection from a prescribed auto-injector.
Recognition of stroke: Approximately 800,000 Americans have a
stroke each year, leaving them at risk
for long-term disability. Early recognition of stroke through the use of
a stroke assessment system (i.e., the
Face, Arms, Speech and Time, or
FAST, assessment tool) decreases
the interval between the time that
the incident occurs and the time it

takes for that person to arrive at a
hospital and receive specific treatment. This faster time to treatment
may reduce the damage and disability from a stroke.
Use of aspirin with heart attacks:
The updated guidelines clarify that
aspirin should be used only when
helping someone suspected of having a heart attack, characterized by
symptoms such as chest pain accompanied by nausea, sweating and pain
in the arm and back. If the first-aid
provider is unclear on whether this
is a heart attack or simply someone
experiencing
non-cardiac-related
chest pain or discomfort, then aspirin should not be given. Additionally, the updated guidelines emphasize
that there is no need to distinguish
between enteric (coated, time-release
tablets) versus non-enteric coated aspirin as long as the aspirin is chewed
before being swallowed.
CPR Updates Highlight
Importance of Taking Action
The latest CPR guidelines highlight
how quick action, proper training,
use of technology and coordinated
efforts can increase survival from cardiac arrest. More than 326,000 people experience cardiac arrest outside
of a hospital each year and about 90
percent of them die.
The 2015 guidelines say high-quality CPR training will help responders act confidently and provide better CPR to cardiac arrest victims.
Additionally, research shows resuscitation skills can decline within a
few months - far before the twoyear current evaluation standard.
Conducting regular in-service CPR
training will help ensure that employees deliver the highest quality of
emergency cardiovascular care.

The American Heart Association
cites the following as key points from
the 2015 guidelines update:
Untrained bystanders: If they haven't done so already, lifeguards and
other trained responders should encourage bystanders to call 911.
Trained lay responders: Trained
responders should simultaneously
perform steps in an effort to reduce
the time to the first chest compression. While the guidelines encourage use of hands-only CPR (CPR
without rescue breaths) for untrained
responders, they continue to recommend that trained lay responders
conduct CPR with breaths.
Compression rate and depth:
For adults, upper limits of recommended rate and compression depth
have been added based on new data
suggesting that excessive compression rates and depth are less effective. The key points for rescuers to
remember are to perform chest compressions at a rate of 100 to 120 per
minute and to a depth of at least 2
inches, avoiding excessive depths
greater than 2.4 inches. Rescuers
should also avoid being too shallow
with compressions to achieve the best
possible outcomes.
Proper and robust training around
these updated guidelines will give
your staff the technical edge needed
to ensure the safety and health of all
patrons if or when a medical emergency should occur. For more information about first-aid training, visit
www.redcross.org/ux/take-a-class.
Jonathan Epstein is a paramedic and Senior
Director of Science and Content
Development for the American Red Cross
(jonathan.epstein@redcross.org).

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December 2015 - Parks & Recreation

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