The AHA Scores A Bullseye!

I rejoice in the AHA's recommendation that all State Legislatures pass legislation requiring middle and high school students learn CPR in school.

At the same time, I would argue that the legislatures would benefit from additional guidance, and I would urge the AHA to provide some specific guidance to those legislatures in order to maximize the impact an minimize the unintended consequences of this wonderful initiative. I respectfully suggest that the guidance address the following:

Background: SLICC is a presence in the public school system, the parochial school system, and in several private schools in Chatham County and in South Georgia. SLICC has been teaching CPR, AED use, the Heimlich maneuver, and stroke recognition to students ranging from fifth grade through 12th grade for several years. The course takes less than one hour. The students are given a test during the week before the class and they are given the same test during the week following the test. The pre-test tells us where were are starting. The post test tells us how well we did our teaching job. Here is what we have learned:

1. With some exceptions, fifth and sixth grade students are often without the physical strength or emotional maturity to adequately benefit from the experience.
2. Middle school students are quite capable of absorbing the material, but by the eighth grade, it is best to segregate the classes by gender, if you hope to have anything approaching their undivided attention.
3. Toward the end of the hour, the eyes start to glaze over, and the attention wanders. There is no question in my mind that running a longer class would be a waste of everyone's time.
4. Communication is enhanced by using blunt, accurate language and by relating the material to the students' family and friends.
5. There is, in general, a great deal of confusion in most students' minds with respect to the difference between a heart attack, a stroke, and a cardiac arrest.
6. What the students see on TV represents the foundation of their medical education. (Thank you, Hollywood.)

I sincerely hope that all the legislatures do pass the legislation requested. What I fear is that the legislators will write the bills in terms of certificated courses - normally a three and one half hour ordeal. The negatives associated with this are:

1. As Drs. Roppollo, Pepe et al. showed in 2007 (Resuscitation (2007) 74, 276-285)) a thirty minute treatment of CPR and AED use is as good as (CPR) or better than (AED) the traditional certification class. There is no good to be gained by taking three and one-half hours to accomplish what can be covered in a far shorter time.
2. The choking / stroke recognition portion of the course is roughly as important in terms of preventing death and disability as is the CPR and AED segment and could be included without exceeding the normal class length.
3. Scheduling a three and a half hour session for each student will be a significant burden on the individual schools.
4. Certification courses are not without cost: if nothing else, the cost of the card must be paid.
5. Remember that the application of the skills learned by the students will be primarily as Bystanders. Please require that they teach a Bystander course, not a full CPR course. Those students who need certification for employment as baby-sitters, lifeguards, and the like can still take those mandated courses from the AHA or ARC.

Specifically, what I am urging is that the committee that made the "required in the schools" recommendation go one step further. I am asking that the recommendations specify that the course to be taught be a bystander course that includes CPR, AED use, choking emergencies, and stroke recognition. I would further suggest that they develop such a course and make it available to all the schools for no more than the cost of producing, reproducing, and mailing the DVD. I would also urge that the recommendation be expanded to include suggested training cycle definitions that would result in providing courses every year with attendance staggered so that every new student in the school is trained in the year of their entrance and that every student in the school is trained every other year. The students' ability to retain what they learned is not the issue. Rather, as the students mature, they will get different insights from the same material, Further, if history is any guide, the guidelines will continue to evolve through the period a student passes through middle and high school, and they should benefit from that improvement.

I sincerely hope that this initiative succeeds. The volunteers at SLICC would like nothing more than to be able to withdraw from the battle as the school systems take over. We have plenty to do to keep us busy.

Bob Trenkamp

‘Bystander CPR' helps save Mustang woman

By SONYA COLBERG NewsOK.com

Published: 1/18/2011 9:47 AM

He couldn't really say why, but the associate pastor gulped down his lunch at home and then got back to Chisholm Heights Baptist Church within 30 minutes.

In the church gym, church preschool coordinator Martha Rhodes took a lunch break with others who volunteered in the kitchen. They were kidding around, talking about being tired. As if to demonstrate how tired she really was, Rhodes slumped against a friend's shoulder. Everyone laughed at her antics.

But the laughter turned to gasps of terror.

When they realized she had knocked over her glass of iced tea, they knew she wasn't joking around.

Somebody had the presence of mind to call the main office, where Badgett heard the cry over the speaker phone.

“Call 911! It's Martha, and it's bad!”

Badgett heard enough.

“I just took off running to the gym,” he said.

“By the time I got there, you could see that Martha was white. Her lips were already blue.”

Rhodes' heart had stopped. Some people were scrambling around in fear, and someone had the 53-year-old Rhodes on her knees in the floor.

“Somebody help me lay her out flat!” Badgett yelled. Badgett would have a hand in saving someone that day. This time, it was physically instead of spiritually.

For the first time on a human, Badgett began “bystander CPR,” in which he did chest compressions. He learned cardiopulmonary resuscitation on a mannequin about three decades earlier and got a refresher course about a decade ago.

Hands-only chest compression, without breathing into the victim's mouth, is now recommended by the American Heart Association to help an adult who has suddenly collapsed.

“She was really nonresponsive the whole time,” Badgett said. “I'll be honest. I didn't have much hope at that time.”

He kept doing chest compressions until the Mustang Fire Department and Emergency Medical Services Authority paramedics arrived. EMSA paramedic Kimberly Maze said Rhodes wasn't breathing and had no pulse when they arrived. Probably the difference in Rhodes surviving was continuing the bystander CPR until paramedics were in place to take over, she said.

“In my 13 years with EMSA, this was probably the best bystander CPR that I have ever seen,” Maze said.

Paramedics had to use a defibrillator to electrically shock her heart three to four times before Rhodes showed signs of life. Once she was rushed to the hospital, doctors found three blood clots — in her shoulder, arm and heart — had knocked Rhodes to the edge of death.

“They said people like me are usually found dead,” Rhodes said.

Bystanders are sometimes fearful of mouth-to-mouth contact through regular CPR when they witness cardiac arrest, EMSA spokeswoman Lara O'Leary said. That's one reason the heart association's new recommendations on deep compressions without mouth contact are important. And a study published in the Journal of the American Medical Association shows survival rates were higher in the compression-only group, compared with those people who received no bystander help and those who received conventional CPR.

O'Leary said, just as in the Rhodes' case, EMSA paramedics who are dispatchers will advise callers on what to do: How quickly to push on the chest and other details while EMSA medics are en route.

Without bystander CPR, a sudden cardiac arrest victim's chance of survival decreases 7 to 10 percent per minute, studies have found.

A USA Today study shows Oklahoma City and Tulsa are among the top 12 cities in terms of surviving cardiac arrest. O'Leary said the success rate could rise even more as more Oklahomans learn CPR.

Rhodes said she had been encouraging the church to host free CPR classes. After her experience, the church held a CPR class that attracted about 15 students.

Rhodes said every time her husband, Steve, sees Badgett, he thanks the pastor for saving his wife that day in September. She is well now and plans to stand up at a Mustang City Council meeting tonight to thank Maze and her EMSA partner, Mustang firefighters and her pastor for saving her life.

“Words just fall so far short. Words are just words, and it's a heartfelt thing. I can't begin to thank them enough,” Rhodes said.

Read more: http://newsok.com/bystander-cpr-helps-save-mustang-woman/article/3533173#ixzz1BQMLiGF4

DCTS student’s lessons help to save dad’s life

By SUSAN L. SERBIN
Times Correspondent

FOLCROFT — Youngsters routinely wonder, how am I going to use what I’m being taught in the classroom? One Delaware County Technical School (DCTS) student got a swift and remarkable answer to that question by applying what she learned in a life-saving event.

In early in December, Darlene Dougherty was able to put into action the DCTS slogan, “Real School for the Real World.”

Dougherty, a sophomore at Academy Park High School, attends the DCTS Emergency and Protective Services program at the DCIU Folcroft campus and the Delaware County Training Center taught by instructor Paul Tresca and assistant Rich Caruth. Like many other DCTS students, Dougherty said the hands-on learning approach of the technical school programming appealed to her and brought more meaning to regular classroom disciplines, especially with her career goals in emergency services and law enforcement.

Only weeks after she was one of 40 students in the class receiving CPR/AED certification, Dougherty was at home in Folcroft, ready to run an errand with her dad, Joe. She looked out the window and saw him on the ground next to his truck.

“I was the only one home who could handle this. I jumped over a table and down 13 steps,” said Dougherty, noting her little brother, grandmother as well as mother returning home all added to a sense of chaos she had to overcome.

Dougherty ran outside, calling 911 on the way, and yelled to a neighbor for help. She instructed the neighbor to hold her father’s head to prevent any further head or spinal injury while she performed “textbook CPR,” according to Tresca’s recounting of the incident.

Paramedics arrived within minutes, taking over CPR and administering an AED (Automated External Defibrillator), bringing Joe Dougherty back to life. The Doughertys learned later kidney stones had created the crisis.

“My teachers really taught me something that I could use. It’s so different when you are in class for two hours and studying what you like,” said Dougherty.

At the January DCIU Board Meeting, Dougherty was recognized as well as the teaching mastery of Tresca and Caruth. While Tresca expressed appreciation for the recognition, he said it was like “giving an award to Albert Einstein’s geometry teacher.

“There’s a lot to be said about Darlene. She was a firecracker since the first day of class. On this occasion, she did everything right,” said Tresca, clearly proud of his student’s accomplishment. Admiration between teacher and student was mutual.

The DCTS website (www.delcotech.org) describes each program available to students. Skills needed for the Emergency and Protective Services course include critical thinking, judgment and decision-making, problem solving and a high degree of motivation and self discipline.

Dougherty gave those attributes a true-to-life face, saying, “I would have given the same care to anyone, but it was my dad. I had to stay calm, do what I was taught and make no mistakes.

“What she did was unbelievable. But I have to thank Paul (Tresca) a lot for doing what he does in the class,” said Joe Dougherty, a retired corrections officer.

Although only 16, Darlene Dougherty has a clear view of what she wants to achieve in the future. She will further study EMT courses at DCTS, join the U. S. Marines for a stint, and then become a police officer.

“Darlene wanted me to stay in law enforcement, but it was time for me to retire,” said her dad, who now has the luxury of watching his daughter fulfill her ambitions.

Middletown High's teamwork saves a life

Trained staff take quick action

Kenny Tillman-Myrie, left, and his friend, Shaquille Greene, visit during basketball practice at Middle-town High School in Middletown. The boys were together when Kenny when had his heart attack.CHET GORDON/Times Herald-Record

By Stephen Sacco

Times Herald-Record

Published: 2:00 AM - 12/26/10

There might not be anything sweeter to a 17-year-old than a free class period right before a holiday. This was true for Kenny Tillman-Myrie on Oct. 29 until his heart stopped working and he collapsed on the cold floor of a Middletown classroom.

Kenny's a little on the skinny side; he's a bit shy too, but he has an athletic build developed from his years of devotion to basketball. He also has a wining smile, the kind that could charm just about anybody.

When Kenny walked into Scott Cantara's classroom for a free period Oct. 29, he was laughing and joking with his best friend, Shaquille Green. They talked about Halloween, coming up on Sunday, and, of course, about basketball.

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Defibrillators getting simpler to use

It's no accident that a defibrillator was on hand Oct. 29 and that Middletown High School personnel were trained to use it, says Jim Parker, senior director for health and safety for the American Cross of Greater New York.

The American Red Cross has been focusing its efforts on outreach and education to get automatic defibrillators in schools and other public places and to teach people how to use them to save lives, he said. In New York it's the law that there must be a defibrillator at sporting events.

Parker says the good news is that technology for these devices has rapidly improved. While chances of responding to a life-threatening incident successfully greatly improve with training, the new defibrillators are easier to use than in years past and most will give you instructions so you can use them even if you aren't trained.

The machine used on Kenny at Middletown High School automatically assessed his conditions within seconds.

Prices for the devices have gone down significantly, too. Some people have even purchased the machine for their home when a family member is at risk.

"I think there is a heightened awareness about the benefits of (having a defibrillator on hand)," Parker said. "And the science of assisting somebody (with the device) has been constantly improved."

Steve Sacco

He and Shaquille had distinguished themselves on the varsity team at Middletown High School.

There was some trouble for Kenny early in life with a foster family. That was behind him. Kenny has called his aunt Loraine Myrie "Mom" since he was five years old. Myrie took Kenny and his sister, Tara, and adopted and raised them both.

Tara is in college at Utica. Kenny is looking at college. He wanted to play college basketball. He wanted that bad.

Kenny was already being looked at by some college coaches, say Middletown coaches Jim Kelly and James Smith. A good student, Kenny had hopes of using basketball to help pay for college.

Life to Kenny on Oct. 29 was looking up. But walking into Cantara's classroom is the last thing he remembers about that day.

The next thing he remembers is waking up blurry eyed the next day in Westchester Medical Center with his aunt and girlfriend looking down at him, he says.

His life had changed forever in little more than an instant. "I thought it was a dream," he said.

He only had only seconds

"(Kenny) just fell back in his chair," said Shaquille about that day in October. "At first we thought he was joking or just laughing too hard." He wasn't.

Kenny's heart seized up and it wasn't pumping blood to his vital organs. He was most likely in this condition for half a minute. Seconds longer and the result might have been brain damage or death.

After Kenny hit the floor, school staff acted swiftly, according to an internal timeline provided by the school. Nurses Wendy Manis, Linda Blosser and Shelley Burr were called to the classroom. Security monitor James "Duke" Kimble ran to get the automatic defibrillator.

Manis listened to Kenny's breathing. Something was very wrong. The high school's security team members — Sam Barone, Nelson Reed, classroom teacher William Donohue and School Resource Officer Kevin Weymer — arrived to assist.

They put the paddles of the defibrillator on Kenny. The machine assessed his heart rhythm. He needed a shock. Blosser pushed the button. Manis performed chess compression while Donohue provided breathing for three cycles of CPR. The EMTs arrived and took Kenny to the Horton campus of Orange Regional Medical Center before he was flown to Westchester.

News spread throughout the school. "I couldn't believe it," said Laura Brissing, Kenny's guidance counselor. Healthy 17-year-old athletes don't go into cardiac arrest. Do they?

What just happened?

As far as Loraine Myrie is concerned, Kenny's being alive today is nothing short of a miracle.

The school was tremendously supportive, she said. Assistant Principal Carl Pabon drove Myrie to Westchester Medical Center after the incident.

Clinically, Kenny didn't die. "Death is not a reversible diagnosis," said Dr. Mathew Pinto, a pediatric cardiac specialist who treated Kenny when he arrived at Westchester.

But he beat the odds. An adolescent going into cardiac arrests outside of a hospital has a 9 percent chance of surviving, says Pinto. Inside the hospital the chances of survival increase to just 27 percent.

Kenny not only survived, but also suffered no brain damage. This wouldn't have been the case if the school staff hadn't responded so quickly, Pinto said.

Kenny can't play competitive basketball again. He can shoot a few hoops. But he can't play to win.

The doctors still can't tell him what's wrong but they opened Kenny's chest at Westchester to install an internal defibrillator.

Pinto says the most likely answer is genetic but it will take some time until testing can prove this conclusively. It's likely Kenny has some type of cardiac dysrhythmia, also known as arrhythmia, meaning the electric activity of his heart is abnormal.

That's what the internal defibrillator is for; to shock the heart back into a regular beat. But it's too risky to play competitive sports when wires are attached to your heart, Pinto said. Goodbye, basketball.

'A purpose for this young man'

Sam Barone, a past fire chief in Middletown, has used a defibrillator before, but never on somebody so young, he said.

Barone, like many of the people who responded to Kenny's emergency, had the necessary training. The American Red Cross is currently looking at awarding medals to the people involved with the incident who received their CPR training with the Red Cross, according to Ken Eastwood, school superintendent.

"It's all worth it when you see Kenny walking around," Barone said.

On Dec. 14 Kenny turned 18. It's taken him some time to digest everything that happened since Oct. 29.

Shortly before his birthday he was sitting in the guidance office at school with Pabon, Brissing and a newspaper reporter. Kenny says he was brought to tears over not being able to play basketball anymore. He says this quickly, as if pulling off a bandage rapidly so it won't hurt.

"There's a purpose for this young man beyond basketball," said Pabon with complete confidence. "This (incident) proves it."

Kenny steals a look at Pabon, and then looks back at the floor. Then he looks back up, and there it is: Kenny's winning smile, impossible to resist.

ssacco@th-record.com

__________

Blogger's Note #1: in 1980 (AMA - American Medical Association) and 1981(ABA - American Bar Association) the following definition of death was approved.

The uniform determination of death. The National Conference of Commissioners on Uniform State Laws in 1980 formulated the Uniform Determination of Death Act. It states that: "An individual who has sustained either (1) irreversible cessation of circulatory and respiratory functions, or (2) irreversible cessation of all functions of the entire brain, including the brain stem is dead. A determination of death must be made in accordance with accepted medical standards."

This means that someone whose heart isn't pumping blood and who is not breathing is dead. That person will most likely stay dead unless CPR is begun immediately. Using the definition of death approved by the AMA and the ABA, death is reversible. It happens every day in the U.S.A.

High school hockey player in stable condition after accident

[This is most likely a case of commotio cordis - the conversion of a normal heart rhythm to a chaotic one in which the pumping of blood is stopped when a sharp blow to the chest in the area of the heart triggers a chaotic heart motion. This is possible during a fairly small portion of the heart's electrical activity. Hundreds of people die from this event in the U.S.A. every year.]

A 15-year-old Milford High hockey player is in critical but stable condition today after getting hit in the chest by a puck and collapsing on the ice Monday night, the Worcester Telegram & Gazette is reporting.

Tyler Symes' heart stopped after he was hit by the puck at the New England Sports Center in Marlborough, but a team trainer and a bystander quickly helped administer CPR and revived him before medical support arrived.

To learn more, watch the news clip below.

Locals save life at football game

[Clarifying comments in bold, enclosed within []'s]

From the Panola Watchman http://panolawatchman.com/locals-save-life...e-p14476-94.htm

In the midst of the game between Carthage and Brownwood last Friday night, fans responded to a medical emergency in the stands.

On Friday evening during the second quarter of the state semi-final 3A football game, a Carthage coach’s father fell over in the stands with an apparent heart attack. [more likely in cardiac arrest caused by a heart attack] What happened after was a whirlwind of life-saving action.

Romie, Milton Caver’s wife, yelled for help and Carthage fans responded. She also called her son Brian, who was a coach down on the field. Sue Spann, a 32-year RN, sitting just in front of the Caver’s turned when she heard her name being called by a Kathy Lister, who was several rows up. Spann turned and saw the pale, gray, ashiness in Mr. Caver’s face. By the time she was able to turn and render aid, another woman had answered the call, Yvonne Brown, LVN.

While they were assessing the patient who had neither pulse nor heartbeat,[i.e., in cardiac arrest] Mr. Caver had been laid flat on the bench. Brown then began chest compressions and Spann began respirations. All the while, paramedic Dwight Taylor and Dr. Keith Keeling were overseeing the two performing CPR.

“Of course, by that time, many people had called 911 and Dallas paramedics were on their way,” said Spann, “But Mr. Caver still was unresponsive.”

A third person, a man who has not been identified, jumped into relieve Spann and Brown as they tired.

Soon stadium staff brought their AED machine. Caver was shocked twice but was still unresponsive, said Brown., so they resumed CPR. [The fact that the AED shocked him twice means that his heart had a shockable rhythm. They resumed chest compressions because the AED instructed them to do so. When you are using an AED, it is your boss.] Brown said that CPR keeps blood flowing through the body until, hopefully, the patience [s/b 'patient'] regains a heartbeat and pulse.

Just about the time Brown, Spann, and the third good Samaritan were beginning to tire, Dallas paramedics arrived and took over, since they had much more technical equipment.

By the time they were relieved, Brian Caver had arrived from the field and was holding and comforting his mother. Brown said that she began praying. “I remember praying it would work out, and they would have their Christmas together.”

Brian told this reporter later that as he and his mother watched they thought he was beyond help and they had lost him. “I could only comfort my mom. We knew he was dead. We lost him, even when they took him to the hospital. I had no hope at all,” said Brian.

Since the Cavers were sitting on the top row, paramedics were able to lift him on his board over the back of the stands to get to the ambulance.

Brown said that later she had heard Caver had regained his pulse and heartbeat in the ambulance.

Brian added that while in the ambulance they got his dad‘s heartbeat going even though it was only one beat every 10 to 12 seconds. All in all they shocked him about 20 times. He was taken to Methodist Charlton Hospital, but within the hour was air-lifted to the main Methodist Medical Center in Dallas. There he received two stents in the “widow maker” artery [left anterior descending coronary artery].

Brian said that they were at the right place at the perfect time. “No doubt the good Lord put dad in the exact seat surrounding him by those wonderful people so they could all work together to save his life. And I thank them.

“If this had happened anywhere else, we would have lost him. And if I had been scouting for the possible next game, I would not have been there for my mother. The Good Lord blessed him.”

Milton Caver was in Critical Care until Dec. 16 and was moved to a room Dec. 17, where he was expected to go home later in the day to go home to Linden. Gary, Milton’s younger son is with his father, mother, and Brian now. “He is walking fine now, and the doctor said his heart itself was fine, but he is sore from the compressions that saved his life,” added Brian. by Elaine P.McPherson

Quick-thinking busboy saves woman's life with CPR

Patron in her 80s starts choking; Wilson High senior, 18, responds

Brett Hambright

Reading Eagle

Nathan Cruz is one busboy you better be sure to tip well.

The Wilson High School senior clears tables, greets customers and, oh yeah, saves lives in a pinch.

Halfway into his Saturday night shift at Circle S Ranch House restaurant along Penn Avenue in Spring Township, Cruz heard a hysterical woman in the dining room.

"I was about to bus a table when I heard a woman screaming, 'My mom is choking,' " Cruz, 18, recalled Sunday. "She was hysterical."

The woman's mother was choking on food.

The choking victim, who Cruz said was in her 80s, was short of breath and turning blue when he sprang into action. He prepared to do the Heimlich maneuver when the woman lost consciousness.

Cruz, a junior firefighter with the Western Berks Fire Department and an emergency medical technician trainee, knew to get the woman on her back and start chest compressions.

"It just happened so fast - I just acted," Cruz said. "I was nervous because she was out."

Another patron, who is a nurse, stood by while Cruz administered cardiopulmonary resuscitation.

Within a couple minutes, the lodged food - a piece of roast beef - came out of the woman's mouth.

A few more resuscitative breaths from Cruz, and the woman was awake and alert.

Spring Township police and a supervisor with Western Berks EMS said Cruz might have saved the woman's life.

"It certainly seems like he made a difference," said Bill Baldwin, a Western Berks supervisor who was dispatched to the restaurant.

When a person loses consciousness, Baldwin said, time is precious.

"You have four minutes, and then brain cells start dying," he said.

The woman was taken by ambulance to Reading Hospital and is believed to be doing fine, according to Baldwin.

Her name wasn't available Sunday. Police, medics and restaurant officials weren't sure who she was.

She also was a stranger to Cruz. Still, the teen said his actions were no big deal.

"I'm not looking for a pat on the back," he said. "I was just doing what I was taught."

Cruz is trained in basic life support care and is taking EMT classes.

Oh, and he made sure that the table was cleared off, too.

"Afterwards, it was right back to work," he said. "It was pretty overwhelming. But I pulled it together."

Contact Brett Hambright: 610-371-5022 or bhambright@readingeagle.com.