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God tells me to copy and paste, so you can't stop me. -- Kate

"You know, I could run for governor, but I'm basically a media creation. I've never done anything. I've worked for my dad. I worked in the oil business ..." -- G.W. Bush

I do not feel obliged to believe that the same God who has endowed us with sense, reason, and intellect has intended us to forgo their use. -- Galileo Galilei

Tuesday, November 29, 2005

You know, I just don’t know how I learned anything without the internet.

In the news today is an artricle about American Heart Association changes for performing CPR. So, I looked up “new cpr”on Google so I could find an article that I could easily copy and paste from. (Yahoo news gives me such a hard time.) Among the results was this article from 2003.


The new CPR: flip the patient
By Ben Wyld June 28 2003

Flipping a patient over and performing heart massage on their back could be a better way of restoring blood flow than the standard resuscitation method, according to research that may challenge decades-old orthodoxy.

A study of reverse cardiopulmonary resuscitation (CPR) on six critically ill intensive care patients found significant increases in their blood pressure. The patients' hearts had stopped and they had failed to respond to standard resuscitation

After 45 minutes of standard CPR without response, doctors at New York's Columbia Presbyterian Medical Centre turned the patients on to their stomachs and gave them a further 15 minutes of CPR applied to their backs. They found the systolic blood pressure improved dramatically, compared to that measured in the final 15 minutes of the standard technique. Blood flow through the arteries also increased.

None of the patients survived, but the researchers claim the results demonstrate, for the first time, that CPR applied to the back may have distinct benefits. The technique is already used when patients suffer an arrest while they are face down for surgery. But it has never been directly compared to standard CPR.
. . .

Dr Weisfeldt believes the technique allows for firmer compression of the heart muscle. This is because the spine is less easily damaged than the sternum and ribcage.
Thinking about it, it makes sense that there would be more pressure applied to the heart by doing CPR on the back. The spine is meant to flex so it would be easier to press the spine and put more pressure on the heart easier. The breastbone and the ribs aren’t really supposed to move that much. Seems to me too that as long as they can flip the victim over safely then a weaker person would be able to do the compressions.

Now after finding the above article in the Google results I then found this article on MSNBC from earlier this year. Dr. Gorden Ewy, director of the Sarver Heart Center at the University of Arizona says that there is a better way to do CPR. He’s convinced city of Tucson, Ariz., the fire department and the paramedics that his was the right way to do CPR. Dr. Ewy’s way is to skip the rescue breathing entirely and do 100 chest compressions per minute.
Ewy says the big problem with CPR as it is currently practiced is those breaths to the mouth, which interrupt chest compressions. During that interruption, he says, the critical flow of blood to the brain also gets interrupted.

And more important, surveys show most people won't blow into a stranger's mouth.
. . .

"The paramedics in the field are reporting that it's an easier way to resuscitate code arrests and they are seeing a lot better response from the patients," says Joe Gulotta, deputy chief of the Tucson Fire Department.
And from this article, New CPR method improves results 500%
Dr. Arthur Sanders from the Sarver Heart Center, says "We improved survival from 13% for people receiving ventilation and compression, to 80% survival rate where they were getting continuous chest compressions."
. . .

Richard White from the Southern Arizona Red Cross says, "They are learning [at Red Cross classes] tried and true tested techniques internationaly respected that have been saving lives for more than 50 years."
Funny thing about what Richard White says, it’s completely opposite from information I’ve gotten from various CPR teachers. In fact my last CPR teacher pretty much said “most people stay dead when you do CPR” but it’s better than doing nothing. Look at the statistics, 13% saved the conventional way or 80% saved with the continuous chest compressions. Perhaps it’s time to change things a bit?

I think one of the important things about the new CPR guidelines is that they say it can be taught in about 20 minutes instead of the 4 hour class.
The study found that just five minutes of training on defibrillator use and 20 minutes of instruction in CPR was as effective as the standard four-hour course.
I think the Red Cross will miss some of the money the 4 hour classes brought in but if they can teach more people faster in a way that can be remembered then that’s a good thing. The last CPR class I was in took about 4 hours but only about an hour was used to teach the important part, the CPR. The CPR portion, including using the defibrillator, was taught at the end of the class when everyone was tired and bored. I can’t help but think that more was forgotten that day then was remembered.

Now if they can come up with an automated external defibrillator (AED) that can be used with clothes on. That’s my problem with using it. You have to cut off the top and bra, if you’re working on a woman, to use it correctly. I’m just not comfortable with stripping someone in public, even if it is for a good cause. If there’s ever a need, I hope I can get over it
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