Revised guidelines for first aid

The American Red Cross and American Heart Association today announced changes to guidelines for administering first aid. Among the revisions are updated recommendations for the treatment of snake bites, anaphylaxis (shock), jellyfish stings and severe bleeding. The First Aid Guidelines are being published in Circulation: Journal of the American Heart Association.

Volunteer experts from more than 30 national and international organizations joined the Red Cross and the American Heart Association in reviewing 38 separate first aid questions. Experts analyzed the science behind them and worked to reach consensus on the treatment recommendations. Last revised in 2005, these recommendations form the recognized scientific basis for most first aid training around the world.  

"It is vital that the first aid community come to consensus and speak in a clear voice on these life and death issues," said David Markenson, M.D., first aid science advisor to the American Red Cross. "We are proud to help set the standard for first aid training around the globe."

"Prompt and effective first aid can save lives and prevent many medical situations from worsening, so it's important that everyone learn about the changes the American Heart Association and American Red Cross have made to the first aid guidelines," said Jeff Ferguson, M.D., American Heart Association volunteer co-chair of the first aid guidelines writing group.

In looking at the treatment of jellyfish stings, the revised guidelines reaffirm the recommendation to use vinegar to treat the sting. The vinegar neutralizes the venom and may prevent it from spreading. After the vinegar deactivates the venom, immersing the area in hot water for about 20 minutes is effective for reducing pain. The treatment for snake bites has been amended slightly to recommend applying a pressure immobilization bandage to any venomous snake bite, with pressure being applied around the entire length of the bitten extremity.

Under the revised guidelines for treating anaphylaxis, if symptoms persist after a few minutes of giving the patient an epinephrine injection from a prescribed auto-injector and medical help is delayed, the first aid provider can give a second epinephrine injection from a prescribed auto-injector. The guidelines also recommend that the general public not routinely use hemostatic agents (substances used to help stop bleeding) to control bleeding because of significant variability in effectiveness and the potential for adverse effects. Tourniquets and hemostatic agents should be considered alternatives for professional rescuers when direct pressure is not possible or fails to control bleeding.

The expert panel also reaffirmed some key first aid recommendations, including use of aspirin when helping someone experiencing persistent chest pain or discomfort associated with a cardiac emergency. Bystanders should call 9-1-1 and activate the emergency medical services (EMS) system for anyone with chest discomfort. While waiting for EMS personnel to arrive, the person being treated may be advised to chew two low dose baby aspirin or one adult (non-enteric-coated) aspirin, if they are not allergic to aspirin or have had a stroke or recent bleeding.