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CORE Training – From Practice Scenarios to Saving Lives

5 July 2019

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A Hamilton nurse is thankful for her CORE training, after saving a life on her first ever GoodSAM callout – and then doing two more in the same week.

Megan Stowers (30), mother of two who works in critical care, urges other New Zealanders to download the GoodSAM app and make sure their CPR skills are up to scratch.

Her hectic week began on a Monday morning, when as she was getting her kids ready for school a loud siren sound suddenly blared from her phone.

“Instantly my adrenaline kicked in, and I was like what the heck.”

She told her husband the app had informed her someone nearby was having a cardiac arrest, and asked if he could take over getting the kids to school. 

“I was literally in my ugg boots, I’d just had a shower, my hair was dripping wet, and he just said yep, go.”

Megan prioritised getting to the scene as quickly as possible over taking a detour to the medical centre in search of a defibrillator.

The incident was only a few blocks away from her house, so she made it there in good time.

Racing to the door, she knocked on the front door. There was no response, but peering through the door’s stained glass windows she noticed the back door was open. 

Taking off at a run, she dashed round the corner and encountered a new obstacle – a chicken wire fence.

With a life at stake and not a second to lose, Megan launched herself into the air as high as she could and toward the backyard.

“I did not clear it,” she laughs.

“I demolished the fence to the ground. The guys who live there say they can’t wait to rewatch the footage from their security cameras.”

Back on her feet and dusting herself off, Megan composed herself, entered the house and saw a boy in his high school uniform standing in the hallway.

She introduced herself as a first responder, and asked him if somebody in the house needs help. 

“The relief on his face was so clear,” she says.

“He said it’s my Mum, she needs your help.”

After the boy told Megan his mother was in the bathroom, she told him to wait outside on the road until an ambulance arrived and help them find her.

This drama was unfolding to the backdrop of an otherwise normal morning. Two schoolfriends arrived and joined the boy on the road as he waited, and word began to spread around the neighbourhood. 

Megan made her way to the bathroom, where she found a woman collapsed and her husband trying to put her in the recovery position.

“I just switched into emergency mode, and I went to help,” she says.

The husband told Megan his wife had a seizure and fell off the toilet onto the tiled bathroom floor, in a narrow ensuite. He had already performed some CPR.

The woman arrested again shortly after Megan arrived. Flipping the patient onto her back, Megan maintained an airway and did about four chest compressions before the woman groaned, vomited and became responsive.

A positive development – but the crisis was far from over.

“She was blue like I’d never seen before,” Megan says.

“Blue like a smurf, and she was getting duskier and duskier.”

The woman opened her eyes and began complaining she couldn’t breathe. Megan focused from this point on maintaining the airway, reassuring the patient she was doing well and help would arrive soon.

Megan’s phone issued an alert to notify her the ambulance had arrived. The ambulance officer, who Megan knew from previous years spent working in ambulances herself, entered the house and reacted with surprise to see Megan there already.

“She asked me how I know these people, and I said I don’t! I’ve come from the GoodSAM thing,” laughs Megan.

The ambulance officer was more than happy to have help on the scene. Once it became apparent matters were not going to improve, the woman was stretchered out into the ambulance.

Training makes a difference

Megan believes her recent participation in a NZ Resuscitation Council CORE Immediate class helped her remain calm under pressure, and gave her confidence in up to date skills. 

“It helped so much. Every time it helps,” she says.

“You walk out of that class almost wanting someone to arrest so you can practice what you’ve learned. That’s how awesome it is.”

While she enjoys critical thinking in her work, she notes that a lot of people – even experienced nurses – sometimes get nervous about doing practice scenarios in front of other people. 

“It can be a bit scary, but that actually prepares you for the real thing,” she says. 

“Everybody is awkward at first about volunteering for the group stuff, but they put you in that position so strategically and so well that you just do it. The courses help! Whether it’s basic or advanced training, it really helps with your confidence and your capability.”

Megan has years of experience as an emergency nurse and with the ambulance service before that, and she says the CORE courses are valuable for people of all experience levels.

“You get to practice what you would do, and it’s like oh I do know some stuff, but I learned this new angle about it,” she says.

 “Even if there’s stuff you don’t do so well in the practice scenarios, you talk about what happened and it turns into a positive.”

Megan encourages any health administrator considering how best to upskill their workforce to contact the NZ Resuscitation Council and discuss how the CORE programme is relevant to them. 

“They’re awesome. Even when they’re scary they’re so good. Practical, example based learning – there’s nothing better.”

It feels good to help 

Megan went to work at Hamilton Hospital later that day, though not before helping her husband get the kids to kōhanga.

She had the opportunity to meet the patient and her family later in the week, where she was warmly and tearfully received.

There was more to come! Two further callouts that week saw Megan arriving alongside or shortly after emergency services.

Her intervention wasn’t crucial in these cases, but still serves as evidence that the GoodSAM app is ensuring trained rescuers are on site to help when needed. 

She says the whole experience was deeply rewarding, and encourages health sector colleagues to download and activate the GoodSAM app.

While recognising that the job is already demanding, she says it feels good to give back to the community and a balance can be struck between volunteering outside of work hours and meeting the requirements of family life. 

“It was a crazy week, but it was so good and so worth it being able to help these people. With that first lady, if I hadn’t been there she’d probably have died. It feels amazing to know I was able to help keep that beautiful family together.”


 

2018 Round Up: Resuscitation good news stories

30 November 2018

Resuscitation is always a serious topic, but it can also be a positive one. There have been many stories this year of people surviving heart attacks or cardiac arrests, and community awareness of defibrillation and bystander CPR continues to grow.

Below are some of the best stories we thought are worth highlighting. Let us know if there are others you want to suggest!

Auckland indoor football player Josh Margetts collapsed from a heart attack during training.

It came as a surprise. As his team mate Kareem Osman notes, “you don’t expect a fit 24 year old to go down like that.”

Luckily, Osman is also a registered doctor and knew what to do. Find out what happened next at Newshub.

In other news, Max Montgomery and Andi Traynor were at the beach in Santa Cruz, California, on their first date.

Montgomery, 56, suffered a heart attack, and Traynor performed CPR — their first kiss helping to save his life.

Check out this video of the happy couple talking about the scary moment that eventually led to their romance.

Fast forward to October, and Auckland Mum Lea Tainui was watching her son play softball.

17 year old Oliver suddenly collapsed, suffering a cardiac arrest during his team’s first game of the season.

Umpire Tamati Montgomery saved Oliver by performing CPR until St John ambulance arrived, and paramedics took over with a defibrillator.

Read more on Stuff about the lessons taken to heart by those involved.

Shortly after this, GoodSAM received a welcome profile boost with the story of Brett Palmer.

His heart stopped beating for 14 minutes when he collapsed on a grass berm during his morning walk in Cambridge. 

Local electrician and off-duty St John volunteer Ash Hammond was notified by the app of Mr Palmer’s distress, and raced to the scene.

Joined soon by an ambulance team, they succefully saved Mr Palmer’s life; read on here to learn more about the story.

World Restart a Heart Day received perhaps it’s single greatest publicity boost with a fantastic segment on Duncan Garner’s show.

He interviewed a mother, her son, and her friend, about their experience when the little boy collapsed.

Watch the video here; it’s a great example of bystander CPR in action, and it’s great to know the public were given such good advice about what to do.

Finally, the recently published story of George Scott is a testament to the great work being done by first responders in New Zealand.

Scott suffered a cardiac arrest while driving, causing his car to veer off the road, through a fence and into a paddock. 

36 year old Aran Fairley was driving a few vehicles behind, and sprang into action. 

Using bolt cutters to remove the number 8 wire entangled around Scott’s car, a group of nearby motorists rescued him from the vehicle.

Fairley had learned CPR, and immediately began to perform compressions and rescue breaths before the Fire Brigade turned up. Scott made what was described as a “miraculous” recovery.

It’s great to know people are out there making a difference; no doubt there will be more success stories to come before the year is finished.

Teaching CPR - Compressions and Breaths

30 November 2018

Kevin Nation, Chief Executive, NZRC

With help from Alastair Reith, Communications and Engagement Advisor, NZRC

There is no doubt quality CPR for those in cardiac arrest improves the likelihood of good outcome.

When the International Liaison Committee on Resuscitation (ILCOR) reviewed the science of CPR in 2017, a number of key recommendations were made. There was agreement that bystanders should perform chest compressions for everyone in cardiac arrest, and those who are trained, able and willing to give rescue breaths should do so at a 30:2 ratio of compressions to breaths1.

ILCOR recognises there are some potential benefits to teaching compression-only CPR. It is simple to learn, and easy to direct someone to do. However, it must also be emphasised that there are significant potential benefits to combining compressions and ventilations for those in asphyxia arrest (commonly seen in infants and children), or in settings where ambulance response time is prolonged.

New Zealand Resuscitation Council (NZRC) guidelines for CPR in New Zealand reflect these scientific principles and values, but what does this mean for the messaging in formal training sessions?

Compression-only CPR is best seen as the first step in a series of resuscitation steps, and as a minimum standard for bystander involvement. It is often used in promotional material and campaigns because of its simplicity of teaching, and as a way to maximise bystander involvement.

Best practice is always determined in part by local context. New Zealand’s bystander participation rates (estimated at around 60%) are reportedly relatively high compared to other areas of the world, but that doesn’t mean we can’t do better.

New Zealand is an island nation, with a long coastline and strong cultural ties to the water. As the summer months roll in, many will be swimming, surfing or just taking their families to the beach to relax. The dark side of this pastime is a tragically high drowning rate – 92 preventable fatal drownings and 148 hospitalisations in 2017 alone2. There is clear scientific consensus that those who drown are likely to benefit from combining rescue breaths with chest compression, and an over-emphasis on compression-only CPR in public messaging risks confusion.

It is reasonable that promotional campaigns advocate simplicity. However, for formal training sessions, the NZRC believes teaching ventilations is important. Learners should have the opportunity to practice compressions and ventilations on manikins and receive formative feedback. The benefits of breaths to those in cardiac arrest outweigh the simplicity of teaching compressions alone.

It is easy for those training in conventional CPR to dissuade learners from giving rescue breaths. Statements in teaching such as “you don’t have to give the breaths if you don’t want to” or “the rescue breaths are not important” are discouraging. Learners should be encouraged and empowered to give combinations of compressions and breaths when they can, as the best thing they can do for those in need. If a bystander is unable to bring themselves to perform rescue breathing, they should be encouraged to at least do chest compressions.

The goal is to save lives and improve outcomes from cardiac arrest. Increasing bystander participation is a key strategy to achieving this. While any CPR is better than none, the NZRC would encourage those trained in CPR to strive to do what’s best for those they help.

References

  1. Olasveengen TM, de Caen AR, Mancini ME, Maconochie IK, Aickin R, Atkins DL, et al. . 2017 International consensus on cardiopulmonary resuscitation and emergency cardiovascular care science with treatment recommendations summary. Resuscitation (2017) 121:201–4
  2. Water Safety New Zealand, Drowning Prevention Report, 2017

 

Oceania Pacific Islands Map iStock

Introducing the South Pacific Resuscitation Certificate

1 November 2018

We are pleased to announce the development of a new resuscitation training option for our friends and colleagues in the Pacific Islands. Full course details can be found here.

The South Pacific Resuscitation Certificate can be conducted in the South Pacific region (outside New Zealand and Australia) by NZRC CORE Advanced instructors, using the guidelines set by the New Zealand Resuscitation Council. 

Certification is issued by the CORE Advanced instructor, and we’d expect that the content will be adapted for the local environment. South Pacific Resuscitation Certificate course material can be purchased through the NZRC office.

The New Zealand Resuscitation Council expects instructors will adapt the content of the South Pacific Resuscitation Certificate course to make it relevant to the skill level of learners and the resourcing available in the local environment. The New Zealand Resuscitation Council has not checked or verified the content, and cannot accept responsibility concerning the completeness of an individual course.

The New Zealand Resuscitation Council does not recognise the South Pacific Resuscitation Certificate as equivalent to CORE certification and individual registration bodies or employers should evaluate the content (acquired from the certifying instructor) for the purposes of professional or workplace credentialing.

This is an exciting new opportunity for the further development of training in the region and we invite the directors of these courses to report back on content and participant feedback.

We look forward to continuing strong ties between the New Zealand resuscitation community and our Pacific neighbours.


Update for NLS Instructors

31 October 2018

We are pleased to inform you that a newly designed NLS instructor certificate has been prepared, and will be issued to those who acknowledge the Code of Conduct.

In July 2017 the New Zealand Resuscitation Council approved a new Code of Conduct.  All New Zealand Resuscitation Council instructors are expected to uphold the code.  We ask all NLS instructors who have not already signed the code to do so now.  Once this has been done we will send you the new NLS instructor certificate.  Please click here to read and acknowledge the new code. 

For those who completed the instructor course prior to 2018 your new Instructor certificate will be dated 1 January 2018 to acknowledge that it’s this year you have signed the new code.

Just a reminder that in July 2019 we will be auditing NLS Instructors.  We want NLS Instructors to be teaching at least 3 courses between July 2018 and June 2019 and demonstrating networking and professional development.

We get the teaching information from the participant sheets the Course director completes and sends back to us within a week of the NLS provider course.

The participant sheets can be downloaded here.

For those that attended the NZRC conference this year we will have captured this as a professional development activity. If you have done something that meets the standards described here, you could send us that information now and we will update our records, otherwise we will be asking for this when we do the audit in July next year.

Remember too we are also keen to hear how the courses are going from your participants perspective. We will be sending you reports that let you know how you are going as a teacher but the  way we get this information is from the course feedback forms.  Please ensure you are using the most up-to-date colour feedback forms which are included in all NLS packs.

We only require the participant sheets and the feedback sheets to be returned to us.

NLS Instructor course dates for 2019 have been confirmed and are on our website  at https://www.nzrc.org.nz/training/nls-instructor-course


New ILCOR CoSTR Released

24 October 2018

A new CoSTR is available for review on the website of the International Liaison Committee on Resuscitation. It's title is Methods of Glucose Administration in First Aid for Hypoglycemia.

This CoSTR is a draft version prepared by ILCOR, with the purpose of allowing the public to comment. The comments will be considered by ILCOR. The next version will be labelled “draft" to comply with copyright rules of journals.

Please take a look, and we encourage you to offer your perspective.


Council celebrates 21 years of saving lives

9 March 2018

At its next conference, the New Zealand Resuscitation Council will mark 21 years of improving outcomes for New Zealanders in immediate need of life-saving treatment from emergencies such as cardiac arrest, choking and drowning. Read the full release or see the NZ Resus 2018 - Media Kit.

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Emergency Care Instructor Programme Review

9 February 2018

The New Zealand Resuscitation Council and The Skills Organisation share a vision that a person who collapses, or requires other first aid interventions, shall receive best practice treatment and care. We believe that by reviewing the Emergency Care Instructor programme, we can improve outcomes for people in need.

Find out more about the Emergency Care Instructor Programme Review.


Rachel Allan joins the NZ Resus teamRachel Allan

7 February 2018 

The New Zealand Resuscitation Council has welcomed Rachel Allan as its new Office Administrator. Her background includes working in not-for-profit health and social service organisations, most recently with the New Zealand Orthopaedic Association.

Rachel will be your first port of call when you contact the Council, and we're delighted to benefit from her extensive experience in support and office management roles. 


Kevin Nation named Chief Executive Kevin Nation

20 December 2017 

Kevin Nation has been appointed to the permanent role of Chief Executive of the New Zealand Resuscitation Council. This will take effect on 8 January 2018. Kevin has served the Council for more than ten years, more recently as Acting General Manager, and the Council is delighted to finally formalise Kevin’s role. Read more.... 


Restart a Heart Day 2017

12 October 2017

Restart a Heart Day 2017_IG

Monday 16 October is Restart a Heart Day, a worldwide day to raise public awareness about how to help improve survival from cardiac arrest before emergency services arrive. 

This year’s Restart a Heart Day sees New Zealand taking part for the first time, and the focus is on CPR and AEDs. New Zealand Resuscitation Council member organisations St John, Wellington Free Ambulance, Fire and Emergency New Zealand, and the Heart Foundation are all supporting Restart a Heart Day, as is the Health Promotion Agency. Find out more.


Schools urged to plan for cardiac arrest

12 September 2017 AEDs in School fact sheet

The Ministry of Education and New Zealand Resuscitation Council have partnered to develop AEDs in schools, a guidance document for school boards and leaders.

AEDs in schools raises awareness that sudden cardiac arrest may happen to anyone, and it may occur on school grounds or during school activities. Schools are encouraged to prepare for such an emergency and consider the value of an onsite automated external defibrillator (AED). AEDs in schools poses questions such as ‘Should my school purchase an AED?’, ‘Do staff and students know how to do first aid, CPR and use an AED?’, and ‘Do we have a clear and simple plan to access the AED?’ Read more....