SAINT-BERNARD ACADEMY GUIDELINES

National guidelines for first aid

The recommendations presented below are based on studies carried out by ILCOR.


The recommendations we present here are a comprehensive summary of decisions from multiple national scientific publications. These recommendations present the latest evidence on first aid, reviewed by the scientific experts of the International Liaison Committee on Resuscitation (ILCOR) Task Force. They have been designed on the basis of sound scientific research to provide clear guidelines for first aid training and practice.

 

Keys to the guideline development process

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ILCOR


ILCOR is a committee set up in 1992 to provide a forum for liaison between the world's leading resuscitation organizations. Its mission is to develop, with the help of its members, guidelines for resuscitation and first aid. It plays a crucial role in evaluating, discussing and debating the thousands of peer-reviewed publications (ILCOR, n.d.).

To issue its recommendations, ILCOR forms work groups made up of hundreds of researchers and experts who are tasked with identifying and evaluating evidence on specific topics. The mission of the First Aid Task Force is to coordinate international efforts in the field of first aid. It sets objectives for first aid practice, produces an international definition of first aid and collaborates on treatment recommendations. In developing the guidelines, members of the working group evaluate data from thousands of scientific publications and discuss issues to be considered in collaboration with first aid professionals.
 

The CoSTR


To provide an ongoing assessment of scientific evidence, ILCOR calls on experts to analyze existing data relating to the priority themes selected by the First Aid Task Force, and to carry out meta-analyses and syntheses of scientific data. The evidence identified from the systematic evaluation of each priority theme is then analyzed by the Task Force members and compiled into a Consensus on Science with Treatment Recommendations (CoSTR).

The preliminary document of CoSTR statements is first made available for public comment. The writing groups of the ILCOR Task Force then compose the final recommendations, presented in the CoSTR Summary, taking into account the comments received. The official CoSTR summary is then used to define guidelines for first aid training and practice.
 

The PICOST framework


PICOST: Population, Intervention, Comparator, Outcome, Study design, Time frame.

The PICOST framework is used to structure the analysis of evidence and recommendations. It defines the key characteristics of studies and evidence considered in the development of guidelines. 

In order to review, classify and prioritize the evidence collected, CoSTR Task Forces use the PICOST framework to formulate questions that take into account the populations concerned, the interventions performed, comparators in similar circumstances, the results for each patient, the methodology used and the duration of the research. First aid recommendations are made on the basis of the most positive results possible.

 

Summary of the guideline development process

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The composition of the guidelines stems from a process of evaluation, discussion and deliberation of the certainty of the data. The ILCOR First Aid Task Force carries out this process using criteria for recommendation ranking, data analysis, development and evaluation. It then presents their consensus on treatment recommendations, outlining key evidence and identifying priority knowledge gaps for future research.


Types of evidence assessment


The development of first aid guidelines is based on three types of evidence assessment: systematic review, scoping review and evidence update (M. E. Singletary & al., 2020).

Systematic review: This is a process of literature overview based on a targeted search and selection of topics, quality assessment of studies and transparent presentation of results. In the development of first aid recommendations, the specific questions to be studied are formulated according to the PICOST framework. Each item to be studied is determined by a knowledge synthesis unit, an expert systematic reviewer or the Task Force, and ranked according to its importance. The systematic reviews are then published separately.

Scoping review : This second major type of assessment is designed to identify and map available evidence. It therefore serves to identify the extent, range and nature of evidence on a topic or issue. This examination can then lead to a systematic review. In the process of developing recommendations, the Task Force analyzes the identified evidence and determines its value and implications for first aid practice or research. If the scoping review fails to identify evidence to warrant systematic review, the most recent recommendations are reiterated. 

Evidence update : This type of assessment is carried out to identify studies published after the last evidence assessment in order to update previous systematic reviews. This evidence update is carried out by members of the First Aid Task Force, collaborating experts or editorial group members.
 

Transparency and anti-conflict-of-interest policies


ILCOR's evidence evaluation process, as well as the development of guidelines by key bodies, is governed by strict disclosure policies. The aim of these policies is to ensure that ILCOR manages situations of actual and potential conflicts of interest transparently and effectively, in order to preserve public confidence in the integrity of their process and documents (ILCOR, 2017, Article 8). Accordingly, relevant relationships are disclosed in the updated recommendations published in 2020, as well as in all CoSTR publications.

 

In summary

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Saint-Bernard Academy is committed to providing high quality training in accordance with these guidelines, ensuring that our first aid programs are based on rigorous scientific evidence and reflect the international consensus on first aid practice. We are committed to providing our members with reliable knowledge based on the latest recommendations to ensure best practice in emergency care. Ultimately, our commitment to the recommendations outlined in the CoSTR summary ensures the quality and relevance of our training courses.

 

ILCOR. S.d. « About : International Liaison Committee on Resuscitation ». https://ilcor.org/about

ILCOR. 2017. « Internal rules ». https://www.ilcor.org/data/InternalRulesNovember2017.pdf

Singletary, E. M., Zideman, D. A., Bendall, J. C., Berry, D. C., Borra, V., Carlson, J. N., Cassan, P., Chang, W.-T., Charlton, N. P., Djärv, T., Douma, M. J., Epstein, J. L., Hood, N. A., Markenson, D. S., Meyran, D., Orkin, A. M., Sakamoto, T., Swain, J. M. et Woodin, J. A. 2020. « 2020 International Consensus on First Aid Science With Treatment Recommendations ». Circulation. Vol. 142, no. 16, suppl. 1, S284-S334. https://doi.org/10.1161/CIR.0000000000000897

Guidelines - First aid with treatment recommendations