Re: First Aid Req. (LONG)
Bruce E. Cobern (bec@PIPELINE.COM)
Sun, 2 Nov 1997 10:15:58 -0500
At 04:24 PM 10/31/97 -0600, Peter K Kennon wrote:
> Hello Everyone.
>Should The CPR requirement be dropped from first class?
>During the past 10 yrs. the age of first class scouts has been getting
>younger and younger, now the BSA goal is 12-13 yrs old. As the scouts are
>getting younger the advances in understanding and practice of CPR has be
>getting more advanced.
I disagree. The First Class requirement does NOT require the Scout to
perform CPR. It reads:
"Tell the five most common signs of a heart attack. EXPLAIN (emphasis mine)
the steps (procedures) in cardiopulmonary resuscitation (CPR)."
As I would interpret this requirement it is for the Scout to have an
understanding of what CPR is, how it is done, why it is done, and, MOST
IMPORTANTLY, when it is or IS NOT performed. I think we all know that one
of the most important aspects of properly using CPR is that it is important
NOT to administer the CARDIO portion of the process to someone who does not
need it. Thus, the earlier we start communicating the need to be absolutely
certain that a victim has stopped breathing AND that there is no pulse or
heartbeat BEFORE attempting compressions the less likely we are to face a
situation of someone administering compressions to a patient who does not
There is no strength required to determine if a person is breathing. There
is no strength required check a pulse, either at the wrist or neck, and we
can certainly teach the proper ways to do this. There is also no strength
required to administer rescue breathing, the PULMONARY part of CPR, and
something that might actually be the more common need. (Not sure about this
part, just speculating.)
Thus, I'm not sure there is any downside to teaching our Scouts, even those
not physically capable of doing the compressions themselves, how to
recognize someone who, in fact, NEEDS those compressions (or that the victim
DOES NOT need them, which could lead the Scout to prevent some other good
Samaritan from administering them when not needed), even if it means that
this just gives him better information to provide to the person who
eventually attempts the rescue.
Besides, as I have said in either this or other places in the past, IF the
person truly has no heartbeat and NEEDS the compressions there is NO
downside risk to those compressions being improperly performed because if
the "unqualified" person does nothing the victim dies. If he does them
wrong the worst that could happen is that the victim dies. But, the BEST
that could happen is that the patient's life is saved. The only risk I see
here (remember, I qualified it by saying the victim NEEDS the compressions)
is that someone unqualified thinks he is qualified and refuses to turn over
the treatment to someone better qualified. But, I think most Scouts (or
most PEOPLE) who are not professionals in this field would welcome the
opportunity to turn over the treatment to someone else, so I think this is
not a significant problem.
If you were somewhere and had a heart attack and needed CPR, and the ONLY
person who was nearby was someone who was NOT CPR trained, but THOUGHT he
might be able to do something even if though he wasn't trained, would you
prefer for him to stand around and let you die (after calling EMS), or would
you prefer that he attempt CPR anyway, KNOWING that without his attempts you
had NO chance of survival?
> The American Heart Asso. (AHA) Recommends that a
>person administering CPR be at least 16 yrs of age. The reasoning behind
>this is that younger people do not have the strength to adequately
>administer it. As a member of the local Volunteer Fire and Rescue Dept and a
>NREMT-B I have been trained time and time again to administer CPR and have
>done so on many occasions and I personally agree with the guideline.
As to the age requirements, I thought the minimum age at which the agencies
would certify CPR was actually DECREASING. My understanding was that the
ARC always had a higher minimum age than the AHA, or that the AHA had no
minimum age, and that the ARC had recently DROPPED their minimum age, and
that BOTH agencies now only required a physical ability to do the
compressions, and did NOT base their course requirements on age. I have
seen posts somewhere on the net to that effect (I believe) but have no
personal knowledge of the current AHA or ARC age requirements, but I'm sure
there are those on this list who do. :-)
>Also with the
>procedures for first aid changing about every 1-2 yrs. the BSA Handbook is
>already out of date.
I believe that in the last issue of Scouting magazine (Oct.-Nov.) there was
a letter about certain changes in First Aid treatment having been made by
either ARC or other recognized agencies, and the answer was that there were
going to be some changes made to the TREATMENT explanations (not changes in
the requirements, and there is a difference) in subsequent printings of the
various publications, like the handbook and mb pamphlets.
Remember, the requirements are to demonstrate first aid for various
injuries. Merit badge pamphlets have always been GUIDES to meeting
requirements, but have never even been REQUIRED, so I have never believed it
to be the case that the requirements for the rank or badge EVER meant
"Demonstrate first aid for 'X' using the methods in this book." Thus, if
there are new methods they should be taught. Now, keep in mind that there
were times where there has actually been disagreement about the proper
treatment for certain injuries and that the BSA has consciously differed
from ARC as to what the proper treatment is. (I believe that this was the
case for a time with snakebite and whether to cut and suck or not.) In that
case, I believe we need to test on the BSA prescribed treatment, although I
think it is appropriate to discuss the alternatives and which agencies
prescribe which, if it can be done without helplessly confusing the Scouts.
Remember, that in most cases the NEW procedure is merely a BETTER procedure
and, thus, using the OLD procedure would still be effective, even if the NEW
procedure might be more effective.
>The other issue is the people teaching the CPR. Most often they are troop
>guides that have no training at all. Or, a SM or ASM that has had only a
>community CPR class or none at all.
There is NO excuse for ever having anyone train ANY subject who does not
know or understand the subject. However, since the First Class requirement
only requires an understanding of the steps of CPR (a book requirement vs. a
practical requirement, as it were), I see no problem with this requirement
being taught and tested by someone short of a CPR instructor.
>The change that should be made:
>Remove the requirement form 1st class
Disagree - see above
>Change the requirement in First Aid MB to mandate the CPR be taught by a
>Cer. Instructor and the scouts meet current AHA standards. (AHA is usually
>1yr ahead of the Red Cross)
There has been a long debate over whether BSA should require outside
certification. To this date the BSA has felt this is not necessary. It is
required that the Scout "Demonstrate proper technique for performing CPR on
an adult mannequin for at least three minutes." My understanding is that
this is actually LONGER than the demonstration required for certification.
It was when I was last certified, but I could be wrong with the current AHA
or ARC requirements.
Certainly, again, nobody should be counseling a mb who is not qualified to
do so. That included the ability to determine whether the Scout has met ALL
of the requirements for the badge, including the CPR requirement. To this
end, many aquatics mb counselors "farm out" the CPR requirement to "first
aid" type people. However, I do not believe that ONLY CPR instructors are
qualified to determine whether or not the compressions are being properly
administered. If the Scout KNOWS when compressions are and are not required
(the first and MORE IMPORTANT part of the CPR requirement in these mb's)
then, as I said before, the downside risk of improper administration is
Just my opinion. Sorry for the length, but this IS an important topic which
cannot be dealt with in a few words. At least not by me anyway.
Bruce E. Cobern
Terry Howerton Sakima Group, Inc. SCOUTER Magazine Kansas City