Understanding CPR signage and legislation

Public Pools and Spas Cropped

Hi Team,

In recent times I have been asked by a number of people why they are being told their brand new CPR sign is not compliant to pool safety regulations.

The legislation covering this area is produced below along with a section of the handbook promulgated by Housing and Public Works.

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Building Regulation 2006 ( Current as at 17 August 2015)

13A (2) (e) [ CPR sign must] show information about the procedures for providing first aid, including performing cardiopulmonary resuscitation in the way stated in the document called ‘Guideline 7—cardiopulmonary resuscitation’ published by the Australian Resuscitation Council in February 2006.

Editor’s note— At the commencement of this section, the document could be inspected on the Australian Resuscitation Council’s website at <www.resus.org.au>. [Well actually no it can’t]

Guidelines for pool owners and property agents October 2015 (published by Qld Housing and Public Works)

http://www.hpw.qld.gov.au/SiteCollectionDocuments/GuidelinesForPoolOwnersAndPropertyAgents.pdf

6.4 Cardiopulmonary resuscitation signs

A CPR sign (refer to Appendix D) must be clearly and conspicuously displayed near the pool. Under the Building Regulation 2006, the sign must comply with the Australian Resuscitation Council’s Guideline 7 − cardiopulmonary resuscitation, be at least 300 millimetres by 300 millimetres in size, be made of a durable and weatherproof material and clearly state what to do in an emergency e.g. phone 000, ask for ambulance, stay with injured person, call for help and resuscitation.

Problem:  The regulation calls up a practice that is no longer supported by the Australian Resuscitation Council (ARC)and if you go to the ARC website Guideline 7, as stated in the reg, deals with defibrillation and the CPR Guideline is now number 8 and has been since December 2010.  The main difference between the two is the 2006 version calls for two rescue breaths after a person is found not breathing while the 2010 version goes from not breathing directly to compressions.  The physiological effect is significant hence the change.

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The Dept of Housing and Public Works has advised thus in their guidelines for inspectors (http://www.hpw.qld.gov.au/SiteCollectionDocuments/PoolSafetyInspectorGuideline.pdf ):

“Since the introduction of the pool safety laws, there have been changes to the Australian Resuscitation Council guidelines, reversing the order of giving breaths and compressions during CPR. However, the practice outlined in section 13A of the Building Regulation 2006 is supported by the department and QBCC and is preferred as it provides guidance specific to immersion incidents. (p14)”

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It is somewhat dubious that the Dept of Housing and Public Works and the Queensland Building and Construction Commission are authorities that can make such a statement particularly in that ARC  Guideline 7 (2006) nor Guideline 8(2010) makes any mention of immersion.  In fact immersion or drowning is covered by ARC Guideline 8.2 (2006 [obsolete]) and ARC Guideline 9.3.2 (2014).  The only hint of a caveat in the CPR procedure and a drowning victim comes in ARC Guideline 9.3.2 (2014) where it says that compression only CPR does not meet the ventilation needs of the victim whose poorly oxygenated blood is usually the primary cause of the collapse.

The drafters of the legislation call up the authority of the ARC guidelines 2006 (which are no longer available and were not available then unless a subscription was held)) and then dismiss the authority of the ARC’s best practice guideline 2010?  Calling up a document which is no longer available publicly (and certainly not at the website quoted in the regulation) is against the Government own principles of drafting legislation.  The only chance of obtaining a copy of the ARC Guideline 7 (2006) is from a ARC subscriber who kept their paper version.

So there will be the first aid trainer quite rightly (and by requirement) using the ARC as the authority  and then the trainee confused by the sign at a pool under the regulation which is different.  The one thing that first aid needs is simple straight forward process in CPR for people to feel confident and be willing to have a go.

There have been approaches to the Govt by first aid trainers to resolve this but currently as seen above the confusion stands.  While the argument above might seem pedantic it is important (although any CPR is better than none).  The information above may give you some understanding why an inspector may query a sign or  may give you the chance to talk with some knowledge to a public servant in the pool safety authority or a member of parliament in an attempt to make CPR a simple skill of a confident majority.

As always where there is confusion in legislation there are operators “flogging” “old” signs with no motivation other than financial gain but this time they have legislation their side.

Thanks for reading this epic

Appreciatively,

Eric Wilson

Risk Services Manager

Lutheran Education Queensland

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