Here's an action-provoking thought:

THE POLITE VERSION:

The statistics regarding sudden cardiac arrests and CPR are shocking:

• The odds that you will see one or more sudden cardiac arrests in your lifetime are about one-in-seven;
• When you see a cardiac arrest, the odds are about 85% that the victim will be a family member, a friend, or an aquaintance.

These statistics are even more shocking when you consider the implications of both at the same time: there is a non-trivial probability that you will have to either perform CPR on a family member or friend someday.

Please get trained if your current training is more than two years old - CPR has changed.

________

...and if that hasn't convinced you that you need to get current CPR training, read the blunt version below.

THE BLUNT VERSION:

What's the difference between playing Russian Roulette and not knowing CPR?

Very little, actually:

• If you play Russian Roulette, the odds that you will die or be terribly neurologically damaged are about one in six with every spin of the cylinder of a revolver. If you lose, you die or spend the rest of your life in a care facility. In this case, you are acting irresponsibly, you might suffer tragically, and it's not going to be a walk in the park for those you leave behind.
• If you don't know CPR, it's just like Russian Roulette, but the revolver is pointed at the head of a family member or friend or acquaintance. In this case, a family member or friend dies or spends the rest of their life in a care facility. In this case, you are acting irresponsibly, and your family or friends or acquaintances might suffer tragically.

Please get trained if your current training is more than two years old - CPR has changed.

Studies offer insight into potential CPR standard changes

THE SHORT FORM:

1. There is no advantage in performing full CPR vs compression-only CPR in many sudden cardiac arrest situations.
2. There is a significant benefit to using an AED before the EMS arrives.

THE DETAILS:We need to strengthen the pre-arrival link in the chain of survival if we are to reduce the number of these deaths

By Art Hsieh
EMS1 Editorial Advisor

As the countdown continues toward the fall release of the American Heart Association Guidelines for emergency cardiac care, studies continue to provide insight into potential changes. Two such articles came across my Google Reader that I'd like to share.

The first is titled "CPR with Chest Compression Alone or with Rescue Breathing" and was conducted in both the United States (King and Thurston Counties, Wash.) and the United Kingdom (London).

The researchers wanted to find out if there were any differences in outcome in cardiac arrest based on whether bystanders were instructed to provide mouth to mouth rescue breathing, or if they were instructed to perform only chest compressions.

The results indicate that there were no differences in overall survival to discharge. There were "favorable trends" for performing compression-only CPR for patients who suffered sudden death from a cardiac cause, and there appeared to be an improvement in neurological outcome as well.

The second article looked at the prevalence of public access defibrillation (PAD) and its impact on survival. "Survival After Application of Automatic External Defibrillators Before Arrival of the Emergency Medical System" is based on research being performed with the Resuscitation Outcomes Consortium (ROC), a multicenter, multiregional study group spread across the United States.

In this study, researchers looked at the impact of PAD in patients experiencing out of hospital cardiac arrests (OHCA). They found significant differences in survival to hospital discharge in those patients who had bystander CPR performed but did not receive pre-EMS defibrillation in public areas (9 percent), compared to those who did have an AED applied and a shock delivered (38 percent).

These studies continue to reinforce the notion that EMS must continue to participate in community-based activities that promote an immediate and appropriate bystander response to sudden cardiac arrest.

SCA continues to be our number one killer in the United States. We need to strengthen the pre-arrival link in the chain of survival if we are to reduce the number of these deaths.

About the author

EMS1 Editorial Advisor Art Hsieh, MA, NREMT-P is the Chief Executive Officer and Education Director of the San Francisco Paramedic Association. In the profession since 1982, Art has worked as a line medic and chief officer in both third service and fire-based EMS. He has directed both primary and EMS continuing education programs. A Past President of the National Association of EMS Educators, and a scholarship recipient of the American Society of Association Executives, Art is a published textbook author and has presented at conferences nationwide.

Spruce Creek High football player collapses during practice

[The phenomenon involved in the story below is called Commotio Cordis.

(from wiki) From 1996 to spring 2007, the U.S.A. national Commotio Cordis Registry had 188 cases recorded, with about half occurring during organized sports. (Position Statement on Commotio Cordis". US Lacrosse. Retrieved 2008-10-16.) Almost all (96%) of the victims were male, the mean age of the victims during that period was 14.7 years, and fewer than 1 in 5 survived the incident.

When you look at a cardiogram, you see an ongoing cycle of a trigger signal (a P wave) a complex cycle (the QRS complex) in which the large pumps in the heart do the heavy lifting job of pumping the blood to the lungs (the right ventricle pump) and to the rest of the body (the left ventricle pump. The next major feature you see is the recharging of the heart (the T wave) to get ready for the next trigger signal. If a sudden, physical impact to the chest in the area of the heart occurs at a specific portion of the recharging operation, a person can go into sudden cardiac arrest.

The Sudden Cardiac Arrest Foundation is competing in the Pepsi Refresh Everything project this month for a $50,000 grant. You can support them with your vote by going to www.slicc.org/Pepsi/ ]

A football player collapsed during practice at Spruce Creek High School this evening and was taken to a hospital in critical condition, emergency workers said.

The boy was identified by teammates as defensive lineman Jordan Peterson, a senior. He was hit in the chest by another defensive lineman during a drill and fell to the ground in cardiac arrest, according to Port Orange Battalion Cmdr. Bryan Smith.

"Anybody who's hit in the chest can experience cardiac arrest if you're hit at the specific time when your heart beats," Smith said.

Volusia County rescue workers received a 911 call about 5:55 p.m. about an injury at the Port Orange school. The caller said an athletic trainer was performing cardiopulmonary resuscitation on the player, Smith said. With the trainer's help, a coach used an automated external defibrillator donated by Port Orange Fire Rescue to restart the boy's heart, witnesses and officials said.

"That saved that kid's life," Smith said. "No doubt."

Teammate Chauncey Langevin, a running back, said coaches initially thought Jordan just got the wind knocked out of him. But when he didn't get up, one of the coaches began performing CPR and an ambulance arrived. The other Hawks players were told to go inside and hadn't been given any further information, Chauncey said.

Jordan Peterson was doing tackling drills with teammates.

Defensive lineman Shayne Laidler said the two players rolled over after the tackle, and nothing initially seemed out of the ordinary. Then Jordan walked about 10 feet away, went down on one knee and appeared to be catching his breath, Shayne said. One of the coaches asked if he was OK, and Jordan waved him off, then rolled over onto his back, Shayne said.

A few seconds later, a coach walked over and asked if Jordan was all right and got no response.

"He [Jordan] got nailed in the chest and he fell to the ground and wasn't getting back up and one of our coaches had to perform CPR on him," said teammate Patrick Maneti. "They got a pulse and a heart signal on him and when they took him to the hospital he was in cardiac arrest."

Jordan was taken to Halifax Health Medical Center of Port Orange, where he was stabilized, and immediately transferred to Halifax Health Medical Center of Daytona Beach, which handles more serious traumas.

He was in critical condition the entire time, said Mark O'Keefe of EVAC ambulance. A nursing supervisor tonight said Jordan was not listed as a patient, although that could mean he was admitted under another name or his information is being kept private. A spokeswoman for the Volusia County school district, Nancy Wait, said she could not comment on his condition.

The incident happened the same day as a football player collapsed and died during practice at Wekiva High School near Apopka.

Sudden Cardiac Arrest – Is There Hope?

On June 25, 2009, Michael Jackson, well-known as the King of Pop, died of cardiac arrest.

Cardiovascular disease (CVD) is the leading cause of mortality in the U.S. and the majority of CVD deaths are attributable to Sudden Cardiac Arrest (SCA) which claims more than 250,000 lives each year. One person dies of SCA-related events every two minutes. This is equivalent to more 650 deaths each day. Each year, more people die from SCA than from breast cancer, lung cancer, stroke, or AIDS combined. 95% of SCA cases are fatal and two-thirds of SCA events occur in people without any previous indications of heart disease.

According to the American Heart Association (AHA), SCA occurs when electrical impulses in the heart become rapid or chaotic, which causes the heart to suddenly stop beating. The blood supply to the rest of the body ceases and without the blood supply, the oxygen supply is also cut off, resulting in tissue damage and death. Because of its suddenness, cardiac arrest is also called sudden death or sudden cardiac arrest (SCA) or sudden cardiac death.

Cardiac arrest is not a heart attack. It is a widespread misconception that SCA is synonymous to a heart attack. In order to educate the public, the AHA and the Sudden Cardiac Arrest Coalition (SCAC) are quick to point out the difference. A heart attack or myocardial infarction occurs when the arterial supply or coronary arteries are compromised or blocked, thus cutting off the blood supply to the heart. And if allowed to continue will eventually lead to infarction or injury to the heart muscles. “The term “massive heart attack” is often wrongly used in the media to describe sudden death.” The SCAC has a beautiful analogy to explain to the general public: “If you think of your heart as a house – SCA would be a problem with the electricity; a heart attack would be a problem with the plumbing.”

Cardiac arrest is not heart failure. In cardiac arrest the electrical failure of the heart is sudden and unexpected, whereas heart failure is progressive but slow, thus allowing time for heart failure patients to eventually be considered as possible heart transplant candidates.

Some people are more at risk for SCA than others.

(1) SCA deaths are more common among women aged 35 to 44 years old compared to men of the same age. Women have also a less chance of recovering from SCA than men.

(2) African Americans have a much higher risk to suffer from SCA-related events than whites and other ethnic groups. They also have less than a 1% chance of surviving, much lower compared to the 5% survival chance in the general population.

(3) Some underlying conditions especially heart problems make people more susceptible to SCA than others. Yet, even healthy individuals without any health problems may suffer from SCA.

There many things that can cause the heart to stop abruptly. Most of the cardiac arrests that lead to sudden death occur when the electrical impulses in the diseased heart become rapid (ventricular tachycardia) or chaotic (ventricular fibrillation) or both. This irregular heart rhythm (arrhythmia) causes the heart to suddenly stop beating. Some cardiac arrests are due to extreme slowing (bradycardia) of the heart.

So what causes the electrical system of the heart to fail?

(1) Cardiovascular disease. According to the AHA, in 90% of adult victims of sudden cardiac death, two or more major coronary arteries are narrowed by fatty buildups. Scarring from a prior heart attack is found in two-thirds of victims.

(2) Electric shock/electrocution. A strong electric shock, e.g. electrocution and lighting strikes can cause the heart to stop. Conversely, it also takes an electric shock to restart the heart.

(3) Respiratory arrest. When people cannot breathe during to choking, suffocation, drowning, or injury, SCA can also occur.

(4) Strenuous physical activity. There are cases of athletes suddenly collapsing during training or competitions. This may be caused by underlying heart abnormalities. Adrenaline released during intense physical activity acts as a triggering mechanism for arrhythmia and sudden death.

(5) Medications. Certain drugs, prescription or illegal, can interfere with heart rhythms. When taken in excessive amounts, certain medications can completely stop the heart. Some of these drugs are: performance-enhancing drugs used in sports, prescription drugs for heart problems, pain, and sleeping disorders especially insomnia, and illegal or “recreation” drugs.

(6) Trauma. A strong sudden blow to the heart during sports competition for example, can cause a condition called Commotio cordis that can trigger ventricular fibrillation and lead to SCA. An injury that damages the heart can also lead to cardiac arrest.

(7) Unknown causes. Unfortunately, a lot of cases of SCA are put down to unknown causes, often in young, healthy people with no apparent heart disease or other risk factors.

How can death from SCA be prevented? Not easy, in fact, 95% of SCA cases are fatal. To have a chance of surviving, victims of SCA must receive life-saving defibrillation within the first 4 to 6 minutes of an attack, when brain and organ damage start to occur.

Following are ways to restart the heart during SCA:

(1) Defibrillators. These are the so-called paddles applied to the chest to deliver an electric shock to make the heart beat again. Defibrillators are only available in emergency services and hospitals and can only be operated by medical professionals.

(2) Automatic External Defibrillators (AEDs) are battery-operated portable defibrillators. Current AEDs are designed to be operable by almost anybody, even without formal medical training. AEDs are now widely available in public places where crowds tend to gather.

(3) Implantable Cardioverter Defibrillators (ICDs) are implanted in patients who have a high risk for cardiac arrest from recurrent, sustained ventricular tachycardia or fibrillation. An ICD automatically reacts to irregular rhythms of the heart and applies an electrical jolt to restore normal heart rhythms. According to the SCAC, ICDs are 98% effective at protecting those at risk for SCA, but only 35 percent of patients who require this device have one. According to a New York Times article “in the last two years the number of patients receiving defibrillators has actually declined, as more doctors and patients decide the risks and uncertainties the devices pose may outweigh their potential benefits.” More recently, the European Society of Cardiology (ESC) issued a statement on driving restrictions for patients implanted with ICDs.

(4) Cardiopulmonary resuscitation (CPR) works by attempting to maintain the blood flow to the heart and the brain until more effective defibrillation can be performed. About 80% of SCA cases happen at home, just like in the case of Michael Jackson. Therefore, CPR needs to be performed by bystanders, family members, and people, even without medical training. Unfortunately, only a third of out-of-hospital SCA victims receive bystander CPR and many die before the arrival of emergency services. Immediate effective bystander CPR can double or even triple a victim’s dismal survival chances. A 2008 survey by the AHA revealed that 80% of respondents said they were willing and able to do something to help if they witnessed a medical emergency. However, only a few (12%-20%) are confident that they would know when it is appropriate to perform CPR or use an AED.

So, what could have caused Michael Jackson’s cardiac arrest? Some of the possible causes based on Jackson’s personal and medical history (Source: heartwire) include:

(1) Overdose of prescription medications. Expectedly this is the most popular theory but without a toxicology report, this remains speculative. It seems that Jackson was on prescription painkillers and two that may possibly be implicated in his death are Demerol (meperidine) and Oxycontin (oxycodone). Dr Douglas Zipes of Indiana University Medical School, Indianapolis tells heartwire: “It’s really where I would go, but it’s all very speculative at this point. We know that depending on the type of painkillers, they can depress respiration. The initial stories are that he gradually slowed his respiratory rate and stopped breathing. That can create hypoxia, which can produce ventricular fibrillation.” The use of Diprivan for his insomnia has also been implicated. Without an official toxicology report, all these however, remain as speculations.

(2) Complications from lupus. It is not a well-known fact, but Jackson seemed to have been suffering from lupus, an inflammatory disease that can also affect the heart and lead to a heart block.

(3) Other heart diseases. A heart attack has also been speculated but the singer did not have a history of heart disease and no other heart conditions were detected during the most recent routine physical exam.

(4) Stress. It cannot be denied that Jackson was under too much stress. He was having major financial problems and he was busy preparing for an international concert tour about to start in two weeks.

It is without doubt that SCA is a major and deadly health concern. Advocacy groups including the American Heart Association and the Sudden Cardiac Arrest Coalition are actively involved in bringing this issue to the forefront. There are even those who advocate the routine placement of AEDs in the homes of patients who are at high risk.

Yet SCA mortality remains high even in the setting of bystander CPR and AEDs. WE have a long way to go!

Post Published: 07 September 2010
Author: admin
Found in section: Hot News

Drowning - Why?

Teen dies following causeway swimming accident on Saturday

By JEFF LYSIAK, jlysiak@breezenewspapers.com

POSTED: August 23, 2010

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A swimming accident off the Sanibel Causeway over the weekend claimed the life of a 15-year-old Immokalee resident.

According to a Lee County Sheriff's Office incident report, Robert Anzualda, Jr. had been swimming with family and friends on Saturday afternoon near the causeway's "C" span before strong currents pulled the boy underneath the waters of San Carlos Bay.

Dep. Jeff Barrack arrived at the scene around 3 p.m., finding Anzualda at the water's edge not breathing and unresponsive. He immediately began performing CPR on the youngster. Anzualda responded "by expelling water from his mouth and attempting to breathe."

Barrack continued CPR on Anzualda before being joined by LCSO Marine Units 1 and 2, with Cpl. J. Tolley and Cpl. J. Reagan assisting the rescue effort.

"During CPR, Robert's breathing was labored and had a faint pulse," Barrack's report states, noting that Lee County EMS Medic Units 5 and 15 arrived and took over medical treatment of Anzualda, a student at Collier High School in Naples.

Members of the Sanibel Police Department and Lee County Fire Department also responded to the incident.

Lee County EMS Medic Unit 15 transported Anzualda to HealthPark Medical Center in Fort Myers. The teenager died several hours later at the hospital's Pediatric Intensive Care Unit, according to Lee Memorial Health Systems spokeswoman Karen Krieger.

No additional information was available.

[What do you think caused the death? What could have been done to prevent it?]

From the Sudden Cardiac Arrest Foundation...

Facts and Figures about SCA

• The precise incidence of SCA is unknown because available epidemiological databases do not record deaths due to sudden cardiac arrests. Therefore estimates are based on surrogate data. Efforts are underway to establish a better way to capture accurate data.

• Each year in the U.S., 400,000 to 460,000 people die of unexpected sudden cardiac death in an emergency department or before reaching a hospital. (Circulation 2001;104:2158-63)

• The age-adjusted sudden cardiac death rate is higher among men than women. (MMWR Feb 15, 2002 51(06):123-6).

• Blacks have the highest age-adjusted rate of sudden cardiac death, followed by whites. (MMWR Feb 15, 2002 51(06):123-6).

• States with a high proportion of sudden cardiac deaths, in descending order, include: Wisconsin, Idaho, Utah, Colorado, Oregon, Connecticut, Rhode Island, South Dakota, Montana and Vermont. Hawaii has the lowest age-adjusted sudden cardiac death rate; Mississippi has the highest. (MMWR Feb 15, 2002 51(06):123-6).

• About two-thirds of unexpected cardiac deaths occur without prior indication of heart disease. (J Am Coll Cardiol 2004;44:1268-3008-13)

• About 60 percent of unexpected cardiac deaths are treated by emergency medical services (EMS). (JAMA 2002;288:3008-13)

• EMS treats about 100,000 to 250,000 cardiac arrests in the U.S. annually. (JAMA 2002;288:3008-13; Ann Emerg Med 1999;34:517-25)

• Of the cardiac arrests treated by EMS, 20 to 38 percent are found in ventricular fibrillation (VF) or ventricular tachycardia (VT) (21,000 to 91,000 cases), rhythms that can be treated with defibrillators. (Ann Emerg Med 1999;34:517-25)

• The incidence of VF is decreasing over time. (Ann Emerg Med 1999;34:517-25, Resuscitation 2004:63(1):17-24; Resuscitation 2005;67(1):51-4)

• Fifty-seven percent of adults in the U.S. say they have undergone training in cardiopulmonary resuscitation (CPR), most often due to work or school requirements. Most say they would be willing to use CPR to help a stranger. Most say they would be willing to use an automated external defibrillator (AED). Eleven percent say they have used CPR in an actual emergency. (Resuscitation 2000)

• The incidence of lay responder defibrillation was 2.05 percent in 2002. (American Heart Association)

• The incidence of SCA in children is unknown. Estimates vary widely. Research among high school athletes suggests the incidence ranges from 0.28 to 1.0 death per 100,000 high school athletes nationwide (J Am Coll Cardiol 1998:32:1881-4).

• The average survival SCA survival rate is 6-7%. (Prehosp Emerg Care 1997; 1(1):45-57.)

Brothers Perform CPR, Save Golfer

Gus Franzetta Has Heart Attack On Last Hole At Uniontown Golf Course

Joseph Heckel, Web Producer

UNIONTOWN, Pa. -- Golfer Guz Franzetta said he loves walking the fairways while playing a round or two of golf at local courses, and thanks to two quick-thinking brothers, he'll be able to keep swinging.

Franzetta told Channel 4 Action News' Andrew Stockey that he suffered a heart attack while on the final hole at Duck Hollow Golf Club in Uniontown on Aug. 15.

"I don't remember swinging a club at all. I don't remember playing a single hole," said Franzetta, of Pittsburgh.

But business associate and friend Jim Sampson said he witnessed it all.

"I heard Gus drop, and as I turned to help, I looked at his face and I said, 'Boys, we need to help him,'" said Sampson.

Fortunately for Franzetta, Sampson's sons Eric and Ben both knew CPR.

"We just began working. My brother cleared the airways," said Eric Sampson.

But it appeared Franzetta was almost beyond the point of saving.

"My brother checked his pulse. He had no pulse," said Eric Sampson.

Ben Sampson admitted that he was scared, but maintained his focus.

"The adrenaline and just reaction … I had to keep going. I wasn't going to let him go," said Ben Sampson.

The brothers were able to revive Franzetta before paramedics arrived.

"If there could be a positive way to look at it, the right people were in the right place at the right time. My brother and I know CPR. There was a nurse nearby and retired paramedics," said Ben Sampson.

"I played this past Saturday with other friends of mine and they thanked God it wasn't them that I was playing with when I went down because they probably not have known what to do," said Franzetta.