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ORLANDO, FL-- As schools are getting back to full in-person learning for the 2021-2022 school year, school sports are also making a comeback. But before your teen gets back to the swing of things, will you get your child the COVID-19 vaccine? A survey from the Kaiser Family Foundation says nearly one in four parents will definitely not. However, doctors say that can spell trouble, especially for student athletes. There are more than eight million high school student athletes in the U.S. “One in 300 will carry a form of cardiovascular disease that predisposes them to have a risk of sudden cardiac arrest,” explained Gul Dadlani, MD, Chief of Pediatric Cardiology at Nemours Children’s Hospital. And having COVID-19 could put them at greater risk including those who never had heart problems before. “COVID can affect the heart and you don’t have to be that symptomatic to have issues within your heart muscles,” continue Dr. Dadlani. A study from The Ohio State University found 15 percent of athletes who had mild symptoms of COVID, or were asymptomatic, showed signs of heart inflammation as they recovered. Overexerting the heart while it’s inflamed can lead to major complications, sudden cardiac arrest, and even death. Watch out for chest pain, shortness of breath, and dizziness after the quarantine period. “Those are always red flags that warrant a follow-up with their pediatrician and/or pediatric cardiologist,” Dr. Dadlani stated. Also, make a graduated return to play. Don’t push yourself to practice or play right after COVID recovery. Check with your doctor to see if the heart inflammation has cleared before returning to play. Another recommendation is to perform a heart EKG on athletes before they even take part in team sports. This screening is typically not included in a sport physical but doing one may find heart abnormalities that can lead to sudden cardiac arrest or even death. Recent research shows a rare side effect of the COVID-19 vaccine is heart inflammation, but CDC officials say the benefits of getting the COVID vaccine still outweighs the risks. SOURCE: Ivanhoe Newswire and Sudden Cardiac Arrest Foundation Posted on 08/10/2021

Where to put AED pads on Adults? AED pad placement is the same for all adults. Where you put AED pads on a woman = where you put AED pads on a man = where you put AED pads on a pregnant woman. It’s all the same! The electrode pad placement might vary from one AED brand to the next, so be sure to check your AED’s owner’s manual for specific electrode pad placement instructions. If you can’t find it there, most AEDs have an image printed directly on the electrode pads that show where they should be placed on a person’s body. Where to put AED pads on Children? There are several additional considerations when it comes to placing AED pads on a child. Read more about the specifics of child defibrillator pad placement with our Pediatric AED Pad Guide. Installing pediatric AED pads Older AED units, such as the ZOLL AED Plus, require responders to remove their pre-installed adult pads and insert a separate and detached set of pediatric pads to treat infants and children. The dedicated pediatric pads have a built-in attenuation mechanism that receives the full amount of energy from the AED unit but reduces the energy to a lower level before delivering the shock to a child. Newer AED models are moving in the direction of using the same set of electrode pads (i.e. universal pads) for adults and pediatric patients. With universal pads, users can press the “Child Button” on the AED, which switches the device between “adult” and “child” mode, to attenuate the energy of the defibrillation shock. One set of electrode pads, capable of serving all patients, no matter their size or age, is a much better option than two separate sets of pads (one for adults and one for children) in several ways: AED Brands that Use One Set of Electrodes for ALL Patients (Adults & Children) https://avive.life/guides/pediatric-electrode-pads/

Check out Avive's vision for the future of sudden cardiac arrest response! Avive unveils its new AED/defibrillator and related connected ecosystem to the public for the first time. Much more than just a smaller, lighter, more portable, and affordable AED - the Avive Connect AED is a connected system of care focused on improving out-of-hospital SCA outcomes in communities across the country! Learn more at www.avive.life This device is currently undergoing FDA review and is not commercially available for sale in the U.S. or UK

First, you will need to check and verify that the person is unconscious. This can be accomplished by performing the following steps: Loudly ask if they are okay. Shake them gently to determine if they’re rousable. If the individual is not responsive, you must take further action. 1. Unresponsive but Breathing Normally: What You Need to Do Here is what to do if you encounter an unresponsive but breathing person: 1. Call 999 When calling 999, try to stay calm and clearly explain what is going on. In this case, you would tell the 999 dispatcher that you have found an unconscious person and answer their questions clearly and with as much detail as they ask of you. They may ask if you notice any injuries or suspect any trauma. Dispatchers are there to help and support you. You are not alone! 2. Open the Airway of the Victim To open the airway, tilt their head back to ensure there are no blockages, such as the tongue or foreign objects. 3. Check Their Breathing Now that the airway is open, it is time to check and see if the person is breathing using the Look, Listen and Feel process: Look closely at the chest to see noticeable rising and falling of the chest. Place your cheek next to the patient’s airway and listen to see if you can hear them breathing. While your cheek is next to the airway, you should also be able to feel the breaths. 4. Place Them in the Recovery Position If you have established the patient is unconscious but breathing, you need to try to keep the victim safe until help arrives. In this situation, it is best to place the person on their side and to tilt the head back. This helps keep the airway open. This is what is known as the recovery position. 2. Unresponsive And Not Breathing: What to Do What should you do if a person is unconscious and NOT breathing normally? If you have determined that a person is unconscious and unresponsive, and not breathing properly, you must immediately begin CPR to save their life. How to Perform CPR CPR is simple, easy to learn, and will help increase the patient’s chances of survival tremendously. Basic CPR Steps: Call 999 to notify them of the emergency. Put the heel of one hand on the centre of the person’s chest. Put the heel of the other hand on top of the first hand and interlock your fingers together. Position your body directly over the patient’s so that your shoulders are over your interlaced hands, and make sure your arms are straight. Push hard enough to make the chest compress two inches down and push fast to enough to keep a 100-120 beats per minute rhythm. Perform CPR until the ambulance arrives. If an AED is available, use the device to Restart the Heart. With thanks to the original post: https://avive.life/blog/how-to-determine-if-someone-is-unresponsive/

The new 2021 and 2022 course dates for first Aid are now available from our partners Bolton Under Fives Forum (BUFFs) based here in Bolton. Contact Debra Jones by email on boltonunder5@tiscali.co.uk or on telephone number 01204 338210

New guide now available on how to access your course. Good luck!

Resuscitation Council UK Statement on COVID-19 in relation to CPR and resuscitation in first aid and community settings Whenever CPR is carried out, particularly on an unknown victim, there is some risk of cross infection, associated particularly with giving rescue breaths. Normally, this risk is very small and is set against the inevitability that a person in cardiac arrest will die if no assistance is given. The first things to do are shout for help and dial 999. Watch what to do in an emergency. First responders should consult the latest advice on the NHS website ( https://www.gov.uk/government/publications/novel-coronavirus-2019-ncov-interim-guidance-for-first-responders/interim-guidance-for-first-responders-and-others-in-close-contact-with-symptomatic-people-with-potential-2019-ncov). Those laypeople and first responders with a duty of care (workplace first-aiders, sports coaches etc.) that may include CPR should be guided by their employer’s advice. This guidance may change based on increasing experience in the care of patients with COVID-19. Healthcare workers should consult the recommendations from the World Health Organisation and Department of Health and Social Care for further information, and advice by nation is at the conclusion of this statement. Resuscitation Council UK Guidelines 2015 state “If you are untrained or unable to do rescue breaths, give chest compression-only CPR (i.e. continuous compressions at a rate of at least 100–120 min-1)”. Because of the heightened awareness of the possibility that the victim may have COVID-19, Resuscitation Council UK offers this advice: Recognise cardiac arrest by looking for the absence of signs of life and the absence of normal breathing. Do not listen or feel for breathing by placing your ear and cheek close to the patient’s mouth. If you are in any doubt about confirming cardiac arrest, the default position is to start chest compressions until help arrives. Make sure an ambulance is on its way. If COVID 19 is suspected, tell them when you call 999. If there is a perceived risk of infection, rescuers should place a cloth/towel over the victims mouth and nose and attempt compression only CPR and early defibrillation until the ambulance (or advanced care team) arrives. Put hands together in the middle of the chest and push hard and fast. Early use of a defibrillator significantly increases the person’s chances of survival and does not increase risk of infection. If the rescuer has access to any form of personal protective equipment (PPE) this should be worn. After performing compression-only CPR, all rescuers should wash their hands thoroughly with soap and water; alcohol-based hand gel is a convenient alternative. They should also seek advice from the NHS 111 coronavirus advice service or medical adviser. Paediatric advice We are aware that paediatric cardiac arrest is unlikely to be caused by a cardiac problem and is more likely to be a respiratory one, making ventilations crucial to the child’s chances of survival. However, for those not trained in paediatric resuscitation, the most important thing is to act quickly to ensure the child gets the treatment they need in the critical situation. For out-of-hospital cardiac arrest, the importance of calling an ambulance and taking immediate action cannot be stressed highly enough. If a child is not breathing normally and no actions are taken, their heart will stop and full cardiac arrest will occur. Therefore, if there is any doubt about what to do, this statement should be used. It is likely that the child/infant having an out-of-hospital cardiac arrest will be known to you. We accept that doing rescue breaths will increase the risk of transmitting the COVID-19 virus, either to the rescuer or the child/infant. However, this risk is small compared to the risk of taking no action as this will result in certain cardiac arrest and the death of the child.

8.6 What happens if staff need to renew their paediatric first aid (PFA) certificates? If PFA certificate requalification training is prevented for reasons associated directly with coronavirus (COVID-19), or by complying with related government advice, the validity of current certificates can be extended by up to 3 months. This applies to certificates expiring on or after 16 March 2020. If, exceptionally requalification training is still unavailable, a further extension is possible to no later than 30 September 2020. If asked to do so, providers should be able to explain why the first aider hasn’t been able to requalify and demonstrate what steps have taken to access the training. Employers or certificate holders must do their best to arrange requalification training at the earliest opportunity. Taken from:

Investigators believe theirs are the first published data showing high numbers of at-home cardiac arrests amid the pandemic. By Shelley Wood May 01, 2020 Chilling numbers out of northern Italy point to a 58% increase in the number of out-of-hospital cardiac arrests (OHCAs) in the first 40 days of the COVID-19 pandemic there, as compared with the same period last year. This spike in arrests appeared to follow the geographic time course of the outbreak, such that the percent increase in OHCA was steepest in the two provinces that experienced the earliest cases of COVID-19 and had the highest number of cumulative cases per 100,000 people, Simone Savastano, MD (Fondazione IRCCS Policlinico San Matteo, Pavia, Italy), senior author on the study, told TCTMD. For the province of Lodi, the increase in OHCA was 187%, and for Cremona, it was 143%. In Pavia and Mantova, where the epidemic hit later and fewer people were infected per capita, the increases in cardiac arrest were 24% and 18%, respectively. “When the COVID epidemic started, we noticed an important reduction in STEMI and so some of us thought that maybe cardiac arrest can also be reduced, so we questioned our database and very quickly we had a terrible answer,” Savastano said. “It was exactly the contrary: out-of-hospital cardiac arrests were increasing day by day, and they went hand in hand with the COVID-19 trend.” The dramatic drop in acute MIs during the COVID-19 epidemic has emerged as a devastating side story, with cardiologists and researchers increasingly convinced that hospital avoidance by patients terrified of the contagion has helped to drive the numbers down. And while some of these “missing STEMIs” are arriving to the hospital late, with dire complications from that delay, there are growing fears that many patients are arresting and dying at home, the cause of death impossible to disentangle from COVID-19. Savastano believes their Lombardy data, published as a research letter in the New England Journal of Medicine, is the first to provide a snapshot of cardiac arrest numbers in a region hit hard, and hit early, by the COVID-19 pandemic. Cardiac Arrest Also a Killer in COVID-19 The research letter draws on data from the Lombardia Cardiac Arrest Registry, first launched in 2015, as well as daily reports of new COVID-19 cases from the National Department of Civil Protection and the emergency medical system’s electronic database that tracks symptoms and cardiac deaths. COVID-19 positivity was inferred from symptoms suggestive of infection prior to the arrest (fever lasting ≥ 3 days before OHCA, plus cough, dyspnea, or both) or on the basis SARS-CoV-2-positive pharyngeal swabs obtained either prior to the arrest or after death. All emergency response personnel were instructed to ask about patient symptoms prior to arrival and don protective equipment before administering care. In all, there were 362 OHCAs between February 20 and March 31, 2020, as compared with 229 in over the same period in 2019. Among the 2020 patients, 103 had confirmed or suspected COVID-19. While it’s impossible to differentiate between arrests directly caused by complications of COVID-19 versus those resulting indirectly, as a result of hospital avoidance, the authors estimate that COVID-19 accounts for 77.4% of the increase in cases of out-of-hospital cardiac arrest observed in these four Italian provinces. In COVID-19 patients, Savastano speculated to TCTMD that “hypoxia, pulmonary embolism, or mechanical complication of MI may have played a role.” Overall, the proportion of cardiac arrests due to medical causes (as opposed to causes like trauma, drowning, or electrocution) was 6.5% higher than in 2019, out-of-hospital arrests were 7.3% higher, unwitnessed arrests were 11.3% higher, and median time to emergency medical services (EMS) arrival was 3 minutes longer. In patients for whom EMS attempted resuscitation, deaths were almost 15% higher than during the same 40-day period in 2019. Tragically, the proportion of patients receiving bystander CPR was 15.6% lower than in 2019. Overall mortality was nearly 89%, up from 77% in 2019. More Lessons From Lombardy To TCTMD, Savastano stressed that cardiac symptoms and the risk of cardiac arrest in COVID-19 patients need to be on the radar of physicians and hospital systems now facing down this pandemic in other parts of the world, emphasizing also that advice to stay home does not extend to patients with fast-evolving symptoms. “If I can make a suggestion to our colleagues, I would say that COVID patients are very hard to take care of at home,” he advised. “Our hospital system was very burdened by the epidemic, so we tried to leave patients at home and to prescribe drugs at home; probably, sometimes, we didn’t pay the right attention to symptoms. Regretfully, we now know the progression of respiratory distress is very, very quick, so it's quite difficult to decide which patients can be left at home and which need to be taken to the hospital. “We have to be very careful to pay attention to symptoms and also to instruct the patient to be very careful with their symptoms and to activate the emergency response system quickly” if they need it, particularly in the case of chest pain or other symptoms related to the heart, Savastano said. Sources Baldi E, Sechi GM, Mare C, et al. Out-of-hospital cardiac arrest during the COVID-19 outbreak in Italy. N Engl J Med. 2020;Epub ahead of print. https://www.tctmd.com/news/terrible-spike-cardiac-arrest-deaths-during-lombardys-covid-19-surge Disclosures Savastano reports no relevant conflicts of interest.

Our online training course in Paediatric First Aid meets these requirements if you are an existing student who has completed our FAW or EPFA course in the last three years and needs to during this COVID crises up-skill due to no PFA staff availability. Training will only be valid during the crises. After restrictions are removed students will just need to attend a 1 day practical session to hold full PFA status. Email paul@paulkenny.co.uk for more details. 6.2 Paediatric First Aid The changes: The requirement for at least one person who has a full paediatric first aid (PFA) certificate to be on the premises at all times when children are present remains in place where there are children below the age of 24 months. Paragraph 3.25 and Annex A of the EYFS set out more detail. However, if children are aged 2-5 within a setting, providers must use their ‘best endeavours’ to ensure one person with a full PFA certificate is on-site when children are present. If after using best endeavours they are still unable to secure a member of staff with full PFA to be on site then they must carry out a written risk assessment and ensure that someone with a current First Aid at Work or emergency PFA certification is on site at all times children are on premises. ‘Best endeavours’ means to identify and take all the steps possible within your power, which could, if successful, ensure there is a paediatric first aider on site when a setting is open, as per the usual EYFS requirement on PFA. Please note this does not apply for childminders as they must already have a full PFA certificate. New entrants (levels 2 and 3) will not need to hold a Paediatric First Aid (PFA) certificate within their first 3 months in order to be counted in staff: child ratios, during the COVID-19 outbreak. Additionally, if PFA certificate requalification training is prevented for reasons associated directly with COVID-19, or by complying with related government advice, the validity of current certificates can be extended by up to 3 months. This applies to certificates expiring on or after 16 March 2020. Providers remain responsible for ensuring all children in their care are kept safe at all times. What this means in practice: For providers with children below the age of 24 months in their care, the requirements around PFA remain the same as in the current EYFS framework, with the exception that during the COVID-19 outbreak new entrants do not need to have a PFA certificate to be counted in ratios. This is in recognition of the greater risk factors for babies and young children in this age bracket, including choking risks and different cardiopulmonary resuscitation (CPR) procedures for those aged 0-1 as set out by the NHS. For providers who have children aged 2-5 in their care they must use ‘best endeavours’ to have one person with full PFA, as set out in the EYFS, onsite. By best endeavours we mean providers must be able to demonstrate they have identified and taken all the steps possible to appoint a suitable person. This should include liaising with their local authority to find a suitable person, this could include identifying and looking to appoint: a person with a PFA certificate and Disclosure and Barring Service (DBS) check from a local provider who has closed; or a registered local childminder with a PFA certificate and DBS check who is approved to work on non-domestic premises Looking to secure full PFA training for staff that includes the specific risk factors and techniques required for the care of young children including but not limited to choking, seizures, and issues related to sleeping. Annex A of the EYFS statutory framework sets out the criteria for effective PFA training. After these actions have been carried out and if it is still not possible for someone with a full PFA certificate to be on site at all times children are present, providers must undertake the following actions in order to remain open: Carry out a written risk assessment to consider and mitigate the likely occurrence of a serious incident. Ensure at least one person with a current First Aid at Work or emergency PFA certification is on site at all times children are on premises and must accompany children on outings. Paragraph 3.65 in the EYFS continues to apply and outings should only be undertaken if it is safe to do so. Providers must take account of any Govt advice in relation to the COVID-19 outbreak. The written risk assessment should take into account all relevant factors with the aim of enabling the setting to ensure they can provide the safe care needed by children of critical workers and vulnerable children during COVID-19 outbreak, including: The number of children on the premises The staff to child ratios The types of activities undertaken with the children on the premises The likely need for first aid based on the needs of the children attending the premises First aider knowledge among staff on the premises: and The mitigations available to reduce the risk of such an incident Providers will need to keep the written risk assessment available in the setting throughout the COVID-19 breakout. This does not need to be sent anywhere but must be available on request. Providers could help members of staff who have a First Aid at Work or emergency PFA certificate to help bridge the gap between their current qualification and full PFA by looking to secure online training to cover elements required for the care of young children. HSE provides guidance on choosing a first aid training provider. As set out in HSE guidance, any training in relation to paediatric CPR and choking should be in line with the Resuscitation Council’s guidance and NHS England guidance.

First Aid response COVID-19 considerations: Everyone should treat themselves as a possible path for sharing the virus and should consider other people as a possible risk too. Protecting yourself or the ill/injured person can be done by good hand hygiene, wearing masks, or better yet, working from a reasonable distance. The ill/ injured person can also be source for first aid. For example, they could put direct pressure on their bleeding injury, cool their burn, or take their own temperature, allowing the first aid responder to stay 2 meters apart in many situations. Other people who are less at risk or already exposed to the ill/injured person and can also be given directions by the first aid responder. Assessing breathing can be done from a distance by asking them a question, and observing chest rise/fall, both which avoid being exposed to their exhalations. If there are no signs of life or regular breathing, compression only CPR is reasonable. Ideally breaths are administered with the use of a mask with one-way valve or bag-valve-mask device. Example: Laerdal Pocket Mask with Valve and Filter from Amazon for £12.84 better than a face shield because of the oneway valve. If the person is breathing, place a cloth mask on the person while you assess or treat them if it doesn’t make breathing more difficult for injured/ ill person to protect yourself from their exhalations. Any life-threats found should be addressed in this stage along with notifying emergency services. A detailed or focused assessment follows life-threatening issues are dealt with and includes a head-to-toe physical check and an interview of the person to identify all first aid issues which can give more background to advanced care. COVID-19 Considerations The following are factors to consider if a person is exhibiting signs of COVID-19 A person who is sweaty Fever(>100.4F/37.8C) Age over 50 depending on underlying health conditions like heart/ lung disease, diabetes, or is immunocompromised Coughing Asking if the person might have taken anything specific to COVID-19 to prevent it or help could also identify potential poisoning situations. People with significant medical history should be considered at risk, these might include recent surgeries, cancer treatment, or diabetes. This information is very valuable to the call taker at emergency services or a tele-health provider to help you make the best decisions on where to go for advanced care.

Today the HSE released a new poster for the correct way to remove Single use gloves after use. Download from the main COVID-19 page