Today’s correspondent wonders what my:
… take on the following would be?
On 19th March the Australian Resuscitation Council released the following statement on their website (https://resus.org.au/ accessed 26 March 2020):.
COVID-19 Impact on First Aid and Resuscitation Training
The ARC recommends that the teaching of routine first aid and resuscitation courses should be postponed until the current COVID-19 pandemic has abated and expert consensus opinion is that there is no longer an unnecessary risk involved in participating in a course.
The ARC recommends that the requirement for resuscitation training and re-certification be considered in the light of the current concerns.
The ARC will be regularly reviewing this recommendation.
Yesterday the First Aid Industry Reference Committee, as part of the SkillsIQ (the Skills Service Organisation) released the following advice to RTOs
First Aid Industry Reference Committee recommendations in regard to delivery of First Aid training impacted by the COVID-19 pandemic
Many RTOs have raised concerns about the ongoing delivery of First Aid training during COVID-19. RTOs must comply with State and Federal Health Authority directions. RTOs should perform a risk assessment, when deciding whether or not to continue to provide First Aid training, taking into account the following:
- State, Territory and Federal Health Authorities advice (health.gov.au)
- The Australian Resuscitation Council’s recommendations and guidelines (resus.org.au)
- SafeWork Australia’s advice (safeworkaustralia.gov.au)
- ASQA’s advice (asqa.gov.au).
Specific concerns have also been raised about the transmission of the virus while performing ventilations on mannikins. The potential for transmission of the virus is significantly reduced if proper infection control procedures are followed, which involves excluding anyone who shows symptoms of the virus. The Assessment Requirements are clearly stated, and the performance of compressions and breaths must be demonstrated on a mannikin in order to make a determination of competency. It cannot be a demonstration of compressions only.
A reasonable adjustment may apply where a student states they will not put their mouth on the mannikin during breaths (even with a barrier device in place), in which case the student is required to demonstrate all aspects of giving breaths (i.e. head tilt and blowing to the side of the mannikin) while not actually blowing into the mouth of the mannikin. This reasonable adjustment is to only apply at this time of the COVID-19 pandemic and only if the student requests exemption (i.e. on an exception basis only).
Further information may be found as follows:
- The First Aid Companion Volumeon page 11 clearly states that reasonable adjustment can be made to the assessment procedures, and RTO’s should ensure that ‘the integrity of the Unit of Competency and/or qualification is upheld’.
- In the case of ventilations used while performing CPR, the ARC guidelines found at ANZCOR Guideline 5 – Breathingare specific in the need to provide ventilations as well as the control of transmissible diseases during CPR.
- RTOs should comply with the Australian Guidelines for the Prevention and Control of Infection in Healthcare (2019)and support the use of resuscitation barriers and other PPEs as required.
My take is that they are not inconsistent positions. ARC says ‘don’t do first aid training at all’ and the First Aid Industry Reference Committee says ‘if you are doing first aid training this is what you have to do’. They do say trainers have to comply with ‘State, Territory and Federal Health Authorities advice’ and given directions to limit numbers and unnecessary groups that may confirm the ARCs advice.
I don’t understand why the Committee says that only those that ask should be allowed, or ‘required to demonstrate all aspects of giving breaths (i.e. head tilt and blowing to the side of the mannikin) while not actually blowing into the mouth of the mannikin’. That would seem like a reasonable adjustment to apply to everyone.
The ARC are saying ‘don’t do first aid training at all’; the Committee are saying, in effect if you are going to still do training, to sign people off you need to do ‘this’. Anyone thinking of doing training would need to consider all of that –
ARC says ‘don’t do it’; federal and state directions may have specifically prohibited first aid training but they put up lots of barriers – social isolation so people can’t work together so how do I demonstrate practical skills like bandaging or stable side position? I have to consider CPR and comply with Committee’s recommendation. Taking all that into account what’s the sensible thing to do?
I would suggest any sensible RTO would follow the ARC recommendation and stop first aid training during the current crisis.
I was booked in with the ANMF to update ALS. The ANMF have quite sensibly cancelled the ALS course and refunded the course fees. This is the responsible thing to do.
The ARC is not a regulator. CPR training has always been conducted with hygiene and in such a way as to preventing transmission of anything. The positions are inconsistent. The ERC has produced advice that is much more sensible, both about training and the emergency implementation of CPR. The reason that the ARC has just said “no training” and have not mentioned anything about altering the implementation of actual CPR is that a. they have a strong ideological objection to suggesting “compression-only” CPR (particularly in SCA) as; as good as or better than traditional CPR (a position understood by the science since 2006) and b. they are a voluntary body with no Government legislative authority or representation and lack the capacity to sit down and provide helpful, consistent and balanced opinion. In General Practice (as with industry) accreditation and registration bodies are still demanding compliance with training requirements to perform jobs and enter sites..
I agree that the ARC are not a regulator however they are the only well informed body in Australia that provides updated guidelines on BLS and ALS. However, I concur as per the American Heart Foundation that the provision of applying 2 breaths is a nonsense in particular when you are creating a level of negative pressure for air to enter when you are performing cardiac compressions. Interesting debate