31% is not too shabby

The 2013 statistical update from the USA CDC showed significant 2000-2009 improvement in age-adjusted death rate from CVD.

Wow!

A long way to go, but 30.9% is real progress. Recent achievements in door to thrombolytic time interval for strokes bodes well for next year's statistical update.

Now, if we can only make faster progress on Bystander involvement in out-of-hospital sudden cardiac arrests.

Bob

MICR still paying off

Cardiac Arrest Survival Rates Triple For Ariz. FD

STAFF EXPLORER NEWSPAPER
THE EXPLORER (TUCSON, ARIZONA)
CREATED: DECEMBER 11, 2012

Survival rates have more than tripled for cardiac arrest patients in the Northwest Fire District (NWFD) as a result of a new treatment protocol and a close partnership with the University of Arizona Medical Center.

(see article at http://www.firehouse.com/news/10840863/cardiac-arrest-survival-rates-triple-for-ariz-fd)

Essentially, the overall survival rate has gone from 4.9% to 14.6% for all arrests and from 11.1% to 37.5% for witnessed arrests.

This builds on the MICR work Bobrow et al. published in JAMA in March 2008. 

http://jama.jamanetwork.com/article.aspx?articleid=181606

The enabler was a focus on the issues, minimization of interruptions, and postponing or eliminating intubation. The JAMA article announced a similar percentage gain: "Among the 886 patients in the 2 metropolitan cities, survival-to-hospital discharge increased from 1.8% (4/218) before MICR training to 5.4% (36/668) after MICR training (odds ratio [OR], 3.0; 95% confidence interval [CI], 1.1-8.9). In the subgroup of 174 patients with witnessed cardiac arrest and ventricular fibrillation, survival increased from 4.7% (2/43) before MICR training to 17.6% (23/131) after MICR training (OR, 8.6; 95% CI, 1.8-42.0)." That's more than a three-fold improvement in just shy of three years. 

The more than three-fold improvement just reported was reached within 8 months of the implementation of MICR principles.

Has your EMS implemented MICR?

Another piece of the compelling case...

see:

http://circ.ahajournals.org/content/126/24/2844.full.pdf+html

The results of a Japanese study was published in today's issue of circulation.

The study showed that there is a significant advantage to the victim of an out-of-hospital sudden cardiac arrest when the rescuers use compression-only CPR.

Be safe.

Are you a gambler?

If you see an out-of-hospital sudden cardiac arrest happen - and there's a 14% chance that you will at least once in your lifetime - and if we're not trained, that person will likely stay dead or be brought back with brain damage, just because you wouldn't spend a few hours every two years learning what to do when you see a cardiac arrest happen. There's more than an 80% chance that that victim will be a family member, a friend, or an acquaintance.

What you're really saying when you don't get trained is that you're willing to take an 11% chance that the family member, friend, or acquaintance you see die will stay dead.

Can you live with that?


...From the JournalGazette.net

It's remarkable that he made it back with that long a delay before defibrillation.

Published: December 6, 2012 3:00 a.m.

Hands-only CPR, and lucky timing, saved his life

Frank Gray

Tuesday night, Patrick Carpenter finally got to see the hat that saved his life.
Well, to say that a hat saved his life might be a bit of an exaggeration, but it was a tiny part of a series of events that allows Carpenter to say he is alive today.
On Oct. 13, Carpenter and his wife, Amy, who had gone to South Bend to see the Notre Dame-Stanford game, stopped off at a nearby bookstore.
At the same time, Reenae Lane, her son, Matthew, and her significant other, Gary Davis, were about to leave the bookstore when Lane spied a peculiar hat with ear flaps and asked her son if he liked it.

Matthew looked at the hat and hemmed and hawed for a bit.

Nearby, Carpenter, from Churubusco, complained to his wife that he was suddenly feeling shaky. Moments later he went into cardiac arrest and collapsed.
You can argue that it was fate, chance or Matthew’s hemming and hawing that made the difference, but the fact is that Lane, a nurse at Parkview Hospital, and Davis, an emergency room physician in DeKalb County, who could have been on the sidewalk outside, were in just the right spot at just the right time when Carpenter collapsed.

It quickly became clear that Carpenter had no pulse, so the two started hands-only CPR (just chest compressions) while someone called 911.

About five minutes later, two state troopers, who had been directing traffic, came into the bookstore to escape the rain, saw what was happening and took over.

Carpenter got CPR for about 12 minutes before an ambulance took him to the hospital.

Today Carpenter, who is 47, fit, has 7 percent body fat and owns four fitness centers, is alive and well. His heart is fine, and no one has any idea why he suddenly went into cardiac arrest.

Tuesday night, at Shorty’s Steakhouse in Garrett, Carpenter, who says he has no recollection of that day, finally got to meet Davis and Lane – and to see that funky hat.

“What do you say to the guy who saved your life other than thank you, several times,” said Carpenter, who had a medium-rare filet.

So, all in all, it’s a nice story with a happy ending, and the kid got his hat.
But there’s a lesson to be learned here, too. Lane says that a person who goes into cardiac arrest outside of a hospital or emergency room has about a 1 percent chance of survival. That’s because all too often people stand around doing nothing, and in the five minutes it takes for an ambulance to arrive, a person can be brain dead.

That 1 percent survival rate might be a bit of an exaggeration. Carpenter himself says he has heard it’s more like 10 percent. Different people will give you different answers.

Having someone nearby who knows how to give CPR, though, using just simple chest compressions, can dramatically increase a person’s odds of surviving cardiac arrest.

Carpenter is proof.

Training people is the trick, and in Fort Wayne, efforts to train people haven’t gone well.

For the past four years, the city has been offering the public free instruction in basic CPR, holding about three large sessions a year.

The city actually has the capacity to train several hundred people a day during those sessions, but response hasn’t been good. Since the program started in October 2008, only 1,685 people have received the training, a disappointing level, says Heather Van Wagner, who helps promote the program.

When new training sessions start next year, it might be worthwhile to attend.

Saving someone’s life isn’t that complicated.

This is the way it's supposed to happen, most of the time.

Player, 14, saved by coach's CPR training, automated external defibrillator

By Associated Press

Knoxville Central High School freshman Hunter Helton had sudden cardiac arrest during a conditioning practice Monday.

According to The Knoxville News Sentinel (http://bit.ly/SClyvb), coach Jon Higgins, -- a former University of Tennessee player -- performed the rescue protocol on Hunter and used the AED to stabilize his heartbeat. The youth is a cousin to Colorado Rockies first baseman Todd Helton, a former UT standout. Todd Helton also played prep ball at Central High School.

Hunter's father said the boy had no history of heart problems.

"He's had poison ivy and braces -- that's all," Ronnie Helton said. "He's always been a healthy, normal kid."

But thinking back to Monday evening and what doctors told him, Ronnie Helton still gets emotional.

"He flatlined three times," he said, choking back tears.

Hunter woke up at East Tennessee Children's Hospital, remembering only a burning in his chest before he passed out.

"I didn't know anything," he said.

Hospital officials said 600 to 1,000 of the 350,000 sudden cardiac deaths in the U.S. each year occur in children or adolescents, which averages out to 10-15 student deaths in Tennessee each year. If an AED is used within 3-5 minutes after a person's heart stops pumping, the result could save a person's life.

"The heart doctor told us if it hadn't been for the coach and the AED, he wouldn't have made it," said Ronnie Helton.

On Tuesday afternoon, Hunter was sitting up in bed, joking with friends and family members.

"I just want to thank my coaches," Hunter said. "They saved my life."

The youth was scheduled to be transferred to Vanderbilt University Medical Center in Nashville on Wednesday to undergo further testing.

------

Information from: The Knoxville News Sentinel, http://www.knoxnews.com

Check out this save!

The LA Times carried a story about an attorney who arrested and was saved by his staff members. See
http://www.latimes.com/news/local/la-me-1007-lopez-cpr-20121007,0,83773.column

Each of us as more than a ten percent chance of seeing - at least once in our lifetime - a family member, a friend, or an associate die of a cardiac arrest. When that happens, the victim is clinically dead, and will almost certainly stay dead unless someone sees that person die, calls 911, begins CPR, and - if one is available - promptly defibrillates the victim's heart with an AED.

When one of the possible outcomes of an event (for example, a cardiac arrest) is, in your mind, truly unacceptable, you need to view the odds of that happening as being 100% and prepare to deal with it when the arrest happens.

Not sure what to do when you see someone have a cardiac arrest? Go to www.slicc.org and click on "For Past Trainees" in the left-hand column. It's a big download, so don't click multiple times - that will just slow down the download process.

Bob

There is a positive note to this tragedy

High school football player dies after collapsing during game
WYFF Greenville
Rouse was given CPR and shocked with a defibrillator before the ambulance arrived to take him to the hospital. Players and coaches from both sides prayed as medical personnel tended to Rouse. Hartsville was hosting Crestwood. 

________________

Ten years ago it would have been very difficult to find an AED on the sidelines at a high school athletic contest. It's tragic that this student died, but AEDs do not bring back every victim. Immediate activation of 911, immediate CPR, and prompt defibrillation are essential to survival after a sudden cardiac arrest. The victim's odds of getting out of the hospital with major brain functions intact are far, far higher when you follow the chain of survival.

Bob