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Tuesday, November 2, 2010

Aspirin

A recent AARP bulletin published new guidelines for daily aspirin.

Here is a section of their article:

"The aspirin-a-day controversy erupted publicly in March when a 10-year study of nearly 30,000 adults ages 50 to 75 without known heart disease found that a daily aspirin didn’t offer any discernible protection. The group taking aspirin had cardiovascular disease at the same rate as those taking a placebo. Moreover, the study—published in the Journal of the American Medical Association—reported that taking a daily aspirin (100 mg) almost doubled the risk of dangerous internal bleeding.

"The panel also recommended that people over 80 not take aspirin at all because of bleeding risk.

"For the first time, the panel also broke down its advice by gender, recommending against daily aspirin use in women under 55 and men under 45.

"Is it right for you?

"So, should you take a daily aspirin or not? The answer is not quite as simple as doctors previously thought. Aspirin, they say, can still be a lifesaving drug, but it’s not for everyone.

"For reasons researchers don’t fully understand, aspirin seems to provide different benefits for men and women.

"In men, aspirin can prevent heart attacks but seems to have no effect on strokes, says Michael LeFevre, M.D., a member of the task force that wrote the new guidelines and a professor of family medicine at the University of Missouri. Conversely, he says, aspirin appears to help women avoid strokes but not heart attacks.

"The new recommendations suggest that aspirin will be most beneficial to:

  • "men between 45 and 79 who have a high risk for heart attacks;
  • "women between 55 and 79 who are at high risk for strokes."

The full article can be found at http://www.aarp.org/health/drugs-supplements/info-04-2010/can_an_aspirin_do_more_harm_than_good.html?cmp=NLC-WBLTR-TEST-10810-F1-71&USEG_ID=4529196825

Bob

I just heard a new excuse

I thought I had heard of all the reasons given by people for not being willing to learn CPR. But Christine Lind - SLICC's Director of Skidaway Operations - shared one with me yesterday that still has my head shaking.

The person had told Christine that they didn't want to learn CPR because they didn't want to someday have the responsibility for whether a person lived or died.

What the person was missing is an understanding of the purpose of CPR: it keeps the heart and brain alive so that when the ambulance gets there, the people with the drugs and electricity can try to restart the heart. Refusing to perform CPR means that the victim's chance of recovering remain about one-in-twenty. Refusing to perform CPR also means that if the ambulance crew is able to restart the heart, the odds that the victim will have significant neurological damage will be significantly higher.

CPR is a win-win act: if you perform CPR, you have preserved the playing field for the paramedics who arrive in the ambulance. If the patient survives with major brain function intact, you were part of a team that saved a life; if the patient doesn't survive, it wasn't your fault: you preserved the playing field, but not all cardiac arrest victims can be saved.

CPR by itself doesn't save a life...it's one link in the chain of survival. Refusal to perform CPR doesn't remove a person from having the responsibility for whether a victim lives or dies. Just the opposite is true: refusal to perform CPR is a conscious decision that assures that the outcome will be worse than it might have been.

Bob