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However consider the significance of proceeding immediately to airway maintenance and breathing checks. The template indicates airway inspection while the casualty is still on their back, using only optimal head tilt and thumb/fingers lifting the chin into jaw thrust position.
This has served two purposes - reduced time in establishing airways management and reduced the memory retention requirement for the student, in other words has eliminated what is now considered to be an unnecessary step.
The next major change is from the '5 quick full breaths' to a recommendation of '2 effective breaths'
'Five quick full breaths' has on too many occassions resulted in the rescuer overinflating with subsequent vomiting or regurgitation.
The recommended '2 effective breaths' are to be delivered at a steady rate taking 1-1.5 secs for each inflation.
This is more likely to produce a tidal volume in the region of 500-800 ml instead of the undesirable 8-1200 ml with the five breath method.
Next comes pulse assessment with 10 seconds being assigned this task. Most professional will agree this is totally inadequate as most lay rescuers will take up to 30seconds or more in assessing the carotid pulse.Therefore pulse check is discontinued.
While this has been left in because of its integral importance to BLS the teaching of carotid palpation is recommended to be down-staged in teaching in favour of more direct signs and symptoms.
The other major recommendation now sees recognition of a standard across the board rate of compressions at 100 bpm to achieve an effective 60 bpm. Again it is recognised that the effective rate in most cases rapidly degenerates, particularly with the non-professional rescuer. ILCOR data indicates there should be no expectation of effective rate to be continued beyond about 4.22 minutes.
The overall effect of this template is to reduce time to start of effective procedures in event of an arrest and to provide an easier remembered operation for the lay student.
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