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The body’s tissues require a continuous supply of oxygenated blood to function properly. When tissues are deprived of oxygen they become hypoxic. When tissues are deprived of blood supply they become ischaemic.
Ischaemia will cause tissues to become hypoxic. The most common causes of ischaemia and/or hypoxia are shock (where circulation is inadequate to meet the body’s needs), hypoxaemia (low blood oxygen concentration) and cardiac arrest (where the heart stops pumping blood into circulation).
Resuscitation is the general term used to denote the process by which a rescuer attempts to reverse the development of ischaemia and/or hypoxia. Cardiopulmonary resuscitation (CPR) is the cyclic combination of a series of chest compressions, manual airway opening and rescue breaths.
Please see Training.
Please see Training.
If you have lost your CORE or NLS certificate, please contact your provider first. If they are unable to help you, we may be able to issue you a replacement for a fee.
CORE Advanced has those elements found in advanced cardiac life support (ACLS) courses but is the New Zealand Resuscitation Council's course. CORE is the standard of resuscitation training recognised by many of New Zealand's medical colleges and required by most District Health Boards. To find out which level might be right for you, see our Rescuer Framework.
The New Zealand Resuscitation Council and Australian Resuscitation Council recognise the certification provided from the courses of each council as equivalent for the purposes of professional/workplace credentialing. While there are some differences, these differences are minor and have no impact on the quality or outcomes of resuscitation in practice.
No provision for recognising other resuscitation courses exist at this time. Determining qualification equivalence is frequently a professional concern, and individuals and organisations can use our Rescuer Framework to help assess equivalence with CORE.
It is within the Medical Council's Policy for New Zealand and Australian Graduates that Trainee Interns in their first postgraduate year hold an Advanced Cardiac Life Support certificate that is less than 12 months old and commensurate to the skills and knowledge of CORE Advanced.
The New Zealand Resuscitation Council does not have a mandate to set training requirements. Training requirements are set by colleges, professional bodies and employers. Our training programmes are frequently used by such bodies to set professional standards but this is not mandated by us.
Our Rescuer Framework suggest resuscitation training provided by us which might be suitable for different rescuers.
Yes. The New Zealand Resuscitation Council and Australian Resuscitation Council recognise the certification provided from each council's course as equivalent for the purposes of professional or workplace credentialing. Although each council's courses teach slightly different material to reflect differences in national resuscitation guidelines, the differences are minor and have no impact on the quality or outcomes of resuscitation in practice.
This arrangement applies only to CORE Provider courses. No other courses are currently recognised for cross-crediting purposes.
We do not set the requirements for First Aid and do not offer First Aid training. However, we do offer the Emergency Care Assessment for providers who wish to demonstrate that they teach resuscitation and first aid following our resuscitation guidelines.
For most resuscitation councils internationally, the focus of training and education is regarding the management of cardiac arrest (for example with ALS, BLS and ACLS courses), while training related to the management of severe trauma is left largely to other bodies.
In New Zealand, the rate of trauma related morbidity and mortality is very high – especially road trauma related. For this reason the NZRC continues to include introductory education related to the early management of severe trauma in the CORE programme. For those exposed more regularly to the management of severe trauma, the depth of knowledge and breadth of skills required will significantly exceed that covered in this manual and in the CORE programme. Attendance of trauma related courses - such as EMST or ATLS - is recommended.
In the case of cardiac arrest, standard guidelines for giving IV amiodarone, diluted, may not be feasible. A practical approach in the case of cardiac arrest is to administer a 300mg bolus, undiluted, as a push followed by a large flush. See Guideline 11.5 (Guidelines).
Currently the evidence that supports using vasopressors during cardiac arrest management is not strong. The key to a successful outcome from cardiac arrest is quality CPR, early defibrillation, and a systems approach to overall management. While early administration of (IM) adrenaline into a large muscle is the mainstay of anaphylaxis treatment, it is not recommended during cardiac arrest management.
Current guidelines promote rescue breathing as routine in resuscitation events, and the New Zealand Resuscitation Council advocates the use of rescue breathing. Rescuers should be trained to provide rescue breathing as part of the DRS ABCD whereby the ratio of compressions to rescue breaths is 30:2. Rescue breathing is particularly important in drownings. See Guideline 5 (Guidelines).
'Cough CPR' refers to a person coughing repeatedly and vigorously when they think they are having a heart attack and are alone. It has wrongly been suggested as a way to prolong responsiveness until help arrives.
There is no evidence for cough CPR and it has no place in first aid.
Where heart attack is suspected, the priority is to call an ambulance. Heart attack can lead to cardiac arrest and is a medical emergency. For more on first aid management for heart attack, see Guideline 9.2.1 (Guidelines).
We don't recommend the use of abdominal thrusts for treating choking. Wherever possible, we encourage the rescuer to attempt back blows and chest thrusts in preference to abdominal thrusts, as abdominal thrusts have the potential to lead to life-threatening complications. Medical attention should always be sought after an event involving Foreign Body Airway Obstruction where there remains concern that foreign material is still in the airway or injury has occurred. See Guideline 4 (Guidelines).
Where an adult or child is unresponsive and not breathing normally, an automatic external defibrillator (AED) should be used to assess whether a shock can be delivered. In most situations, a shock may be the victim’s only chance of survival following cardiac arrest.
For children between 1 and 8 years of age, use child electrodes if these are available. For children under 1 year of age, there is no scientific data to support the use or non-use of AEDs in children under 1 year of age. Find out more about AEDs in Guideline 7 (see Guidelines).
It is important that you and your next of kin’s wishes are taken into account as much as possible but, in some clinical situations resuscitation is not in the patient’s best interest. In these situations, the decision to continue resuscitation is usually made by a health professional.
The legal means whereby New Zealanders can have others make decisions regarding their welfare is through Enduring Power of Attorney (EOP). There are criteria for EOP to be initiated and limitations on the type of decisions that the person appointed to act with EOP can make. For instance, the person with EOP cannot refuse consent to standard or life-saving medical treatment for the patient.
In New Zealand hospitals, family are usually allowed to be present. Our recommendation is that family members of adults and children undergoing cardiac or trauma resuscitation should be given the option to be present – ideally with a hospital-assigned support person – and that each hospital should have a Family Presence policy and staff education.
Legal, cultural, religious and other concerns should be factored into the decision as to whether family might be present during in-hospital resuscitation efforts. You can find out more in Guideline 10.5 (see Guidelines).
We don’t have anything particular to Maori. Our guidelines are generally about how scientific evidence on resuscitation can be applied to the New Zealand environment, and do not apply a particular cultural lens.
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