Here's the deal:
The AP put out a story that reported the drowning death of a 3 year old at a birthday party. I won't re-write the story or reproduce it here, because the AP specifically forbids that.
The only point worth taking from the article - and they didn't make this point - is that, when you have vulnerable people in the area of dangerous hazards, it's really up to everybody - in particular, the parents of the vulnerable people - to make sure that if a vulnerable one - a child, an intoxicated adult, whatever - doesn't get harmed by the dangerous hazard.
The number one way to prevent cardiac arrests is prevention.
Bob
When you see a cardiac arrest, your brain fights you - "No, this isn't really happening" - and the circumstances fight you - "Dang! in CPR class the manikin didn't weigh very much and wasn't sitting in a deep chair. This blog deals with practical details and presents reports of "saves." Let me have your questions and comments - they will steer the course of this blog. This blog is brought to you by the volunteers at www.slicc.org
Sunday, June 26, 2011
Saw it on TV. Used it to save son's life.
Morris Plains father urges parents to learn CPR
Matt Manochio: (973) 428-6627; mmanochio@njpressmedia.com
MORRIS PLAINS — Arif and Nadia Mahmood didn’t know CPR before their son’s heart stopped.
They’d seen it performed on television before, so when their 20-month-old baby, Sarim, stopped breathing on June 18, they did the best they could — and forunately it worked.
Sarim is genetically predisposed and at high risk for sudden cardiac death because he has what’s known as Long QT Syndrome, an inherited condition that causes disruptions in the heart’s electrical system, said Lauren Woods, senior media relations specialist for NYU Langone Medical Center, where the youngster is a patient.
“It can trigger the heart’s pumping rhythm to go suddenly awry anytime before stopping altogether,” she said.
“My wife started screaming,” Arif Mahmood, a borough resident, said Friday. “He was not moving, he was not breathing.”
Arif Mahmood said he began performing mouth-to-mouth and chest compressions on his son. He said his wife took over for him so he could call 911.
Sarim began breathing, weakly, when police and an ambulance arrived, and he began crying when an oxygen mask was placed over his tiny mouth.
“We had no CPR training,” he admitted.
That, and much else, has changed.
Dr. Steven Fishberger, an NYU Langone pediatric electrophysiologist, on June 20 installed inside little Sarim an implantable cardiac defibrillator, Woods said.
Just like a pacemaker, this ICD device helps prevent a patient from suffering sudden cardiac death, Woods said. It works by monitoring the heart to detect any abnormal rhythms.
If a dangerous arrhythmia is detected, the ICD delivers an electrical shock to restore the heart’s normal rhythm and prevent sudden cardiac death.
Fishberger credited Mahmood and his wife for being able to perform CPR, without knowing it, under pressure.
“To be able to do it under those circumstances is remarkable,” he said Friday.
Fishberger recommended people who think they might have this condition to see a doctor for an electrocardiogram.
He said if people have unexpected fainting spells, or fainting during exercise, they should also be screened for Long QT Syndrome.
Arif said he and his wife knew about the Long QT Syndrome, and that Sarim was taking medicine for it.
Doctors discovered Sarim had trouble hearing after he was born, and this led to further testing which uncovered the Long QT Syndrome. Sarim also wears a cochlear implants to help him hear.
They just didn’t think his heart would stop, even though they knew there was that possibility.
That’s why he’s urging parents not to risk anything when it comes to their child’s condition.
He said he’s grateful for the help NYU gave his son, and the education they gave to him and his wife.
An NYU Langone social worker taught them CPR, and Sarim is doing well. He’s scheduled to return there Monday for his first post-surgery appointment.
Fishberger said he expects Sarim to live an otherwise normal life.
Matt Manochio: (973) 428-6627; mmanochio@njpressmedia.com
MORRIS PLAINS — Arif and Nadia Mahmood didn’t know CPR before their son’s heart stopped.
They’d seen it performed on television before, so when their 20-month-old baby, Sarim, stopped breathing on June 18, they did the best they could — and forunately it worked.
Sarim is genetically predisposed and at high risk for sudden cardiac death because he has what’s known as Long QT Syndrome, an inherited condition that causes disruptions in the heart’s electrical system, said Lauren Woods, senior media relations specialist for NYU Langone Medical Center, where the youngster is a patient.
“It can trigger the heart’s pumping rhythm to go suddenly awry anytime before stopping altogether,” she said.
“My wife started screaming,” Arif Mahmood, a borough resident, said Friday. “He was not moving, he was not breathing.”
Arif Mahmood said he began performing mouth-to-mouth and chest compressions on his son. He said his wife took over for him so he could call 911.
Sarim began breathing, weakly, when police and an ambulance arrived, and he began crying when an oxygen mask was placed over his tiny mouth.
“We had no CPR training,” he admitted.
That, and much else, has changed.
Dr. Steven Fishberger, an NYU Langone pediatric electrophysiologist, on June 20 installed inside little Sarim an implantable cardiac defibrillator, Woods said.
Just like a pacemaker, this ICD device helps prevent a patient from suffering sudden cardiac death, Woods said. It works by monitoring the heart to detect any abnormal rhythms.
If a dangerous arrhythmia is detected, the ICD delivers an electrical shock to restore the heart’s normal rhythm and prevent sudden cardiac death.
Fishberger credited Mahmood and his wife for being able to perform CPR, without knowing it, under pressure.
“To be able to do it under those circumstances is remarkable,” he said Friday.
Fishberger recommended people who think they might have this condition to see a doctor for an electrocardiogram.
He said if people have unexpected fainting spells, or fainting during exercise, they should also be screened for Long QT Syndrome.
Arif said he and his wife knew about the Long QT Syndrome, and that Sarim was taking medicine for it.
Doctors discovered Sarim had trouble hearing after he was born, and this led to further testing which uncovered the Long QT Syndrome. Sarim also wears a cochlear implants to help him hear.
They just didn’t think his heart would stop, even though they knew there was that possibility.
That’s why he’s urging parents not to risk anything when it comes to their child’s condition.
He said he’s grateful for the help NYU gave his son, and the education they gave to him and his wife.
An NYU Langone social worker taught them CPR, and Sarim is doing well. He’s scheduled to return there Monday for his first post-surgery appointment.
Fishberger said he expects Sarim to live an otherwise normal life.
Saturday, June 25, 2011
200,000 patients treated for cardiac arrest annually in US hospitals, Penn study shows
Public release date: 24-Jun-2011
Contact: Holly Auer
holly.auer@uphs.upenn.edu
215-200-2313
University of Pennsylvania School of Medicine
First analysis of national in-hospital cardiac arrest rate underscores need to identify preventable causes, implement best practices in resuscitation care
(PHILADELPHIA) -- More than 200,000 people are treated for cardiac arrest in United States hospitals each year, a rate that may be on the rise. The findings are reported online this week in Critical Care Medicine in a University of Pennsylvania Perelman School of Medicine-led study.
Though cardiac arrest is known to be a chief contributor to in-hospital deaths, no uniform reporting requirements exist across the nation, leaving experts previously unable to calculate its true incidence and study trends in cardiac arrest mortality and best practices in resuscitation care.
The authors, led by Raina M. Merchant, MD, MS, an assistant professor of Emergency Medicine, used three different approaches – involving the American Heart Association's Get With the Guidelines data, a voluntary registry of hospital resuscitation events –to estimate the total number of treated cardiac arrests that take place in United States hospitals each year.
While some of these events occur among terminally ill patients, the authors suggest that many of the cardiac arrests they catalogued may be preventable through better monitoring of patients, quicker response time to administer CPR and defibrillation, and improved adherence to best practices in resuscitation guidelines. Patients who suffer in-hospital cardiac arrests are more than twice as likely to survive than those who arrest in public settings -- 21 percent survive to go home, compared to less than 10 percent of out-of-hospital cardiac arrest patients – but both areas suggest opportunities to improve and standardize care.
"Our study proves that cardiac arrest represents a tremendous problem for hospitals in the United States," Merchant says. "Until now, we could only guess about how many patients were suffering these events. It's impossible to make improvements in something we can't measure. These numbers finally provide us with a roadmap for improving allocation of resources to care for these critically ill patients and further our study of ways to identify patients who are at risk of cardiac arrest in the hospital and improve survival."
Contact: Holly Auer
holly.auer@uphs.upenn.edu
215-200-2313
University of Pennsylvania School of Medicine
First analysis of national in-hospital cardiac arrest rate underscores need to identify preventable causes, implement best practices in resuscitation care
(PHILADELPHIA) -- More than 200,000 people are treated for cardiac arrest in United States hospitals each year, a rate that may be on the rise. The findings are reported online this week in Critical Care Medicine in a University of Pennsylvania Perelman School of Medicine-led study.
Though cardiac arrest is known to be a chief contributor to in-hospital deaths, no uniform reporting requirements exist across the nation, leaving experts previously unable to calculate its true incidence and study trends in cardiac arrest mortality and best practices in resuscitation care.
The authors, led by Raina M. Merchant, MD, MS, an assistant professor of Emergency Medicine, used three different approaches – involving the American Heart Association's Get With the Guidelines data, a voluntary registry of hospital resuscitation events –to estimate the total number of treated cardiac arrests that take place in United States hospitals each year.
While some of these events occur among terminally ill patients, the authors suggest that many of the cardiac arrests they catalogued may be preventable through better monitoring of patients, quicker response time to administer CPR and defibrillation, and improved adherence to best practices in resuscitation guidelines. Patients who suffer in-hospital cardiac arrests are more than twice as likely to survive than those who arrest in public settings -- 21 percent survive to go home, compared to less than 10 percent of out-of-hospital cardiac arrest patients – but both areas suggest opportunities to improve and standardize care.
"Our study proves that cardiac arrest represents a tremendous problem for hospitals in the United States," Merchant says. "Until now, we could only guess about how many patients were suffering these events. It's impossible to make improvements in something we can't measure. These numbers finally provide us with a roadmap for improving allocation of resources to care for these critically ill patients and further our study of ways to identify patients who are at risk of cardiac arrest in the hospital and improve survival."
Wednesday, June 22, 2011
West Pierce: Bystander Saves Boy From Drowning
The man saw that the boy was underwater their apartment complex's pool and pulled him out of the water. He also performed CPR on the boy as crews arrived.
By Patch Staff | Email the author | June 21, 2011
A bystander likely saved an 11-year-old's life today, according to West Pierce Fire & Rescue.
The department reports that shortly before 3 p.m. today, crews responded to reports of a drowning at the Forrest Village Apartments, located at 8300 Phillips Road SW in Lakewood, about a mile outside of University Place.
Firefighters arrived at the apartment complex and found an 11-year-old boy conscious and breathing after being pulled from the pool by a bystander.
The man had been watching the boy and his friend play catch in the shallow end of the pool, when he noticed one of the boys underwater for a length of time. He told his friend to check on him, but the boy couldn’t dive that deep. He dropped everything and dove into the pool, only to find the 11-year-old unconscious and without a pulse.
He started CPR and the boy began to breathe as firefighters and police arrived on scene. Paramedics transported the boy to a local hospital for medical evaluation. Without the quick actions of this bystander, the outcome of this situation would have been very different, according to the fire department.
With today being the first day of summer, the fire department that serves both University Place and Lakewood wants to remind everyone to know their limits when it comes to the water.
Custom-fit life jackets are available for purchase at West Pierce Fire & Rescue for $12. Life jackets will also be sold at the City of Lakewood’s SummerFest event this Saturday from noon to 7 p.m. at Fort Steilacoom Park.
By Patch Staff | Email the author | June 21, 2011
A bystander likely saved an 11-year-old's life today, according to West Pierce Fire & Rescue.
The department reports that shortly before 3 p.m. today, crews responded to reports of a drowning at the Forrest Village Apartments, located at 8300 Phillips Road SW in Lakewood, about a mile outside of University Place.
Firefighters arrived at the apartment complex and found an 11-year-old boy conscious and breathing after being pulled from the pool by a bystander.
The man had been watching the boy and his friend play catch in the shallow end of the pool, when he noticed one of the boys underwater for a length of time. He told his friend to check on him, but the boy couldn’t dive that deep. He dropped everything and dove into the pool, only to find the 11-year-old unconscious and without a pulse.
He started CPR and the boy began to breathe as firefighters and police arrived on scene. Paramedics transported the boy to a local hospital for medical evaluation. Without the quick actions of this bystander, the outcome of this situation would have been very different, according to the fire department.
With today being the first day of summer, the fire department that serves both University Place and Lakewood wants to remind everyone to know their limits when it comes to the water.
Custom-fit life jackets are available for purchase at West Pierce Fire & Rescue for $12. Life jackets will also be sold at the City of Lakewood’s SummerFest event this Saturday from noon to 7 p.m. at Fort Steilacoom Park.
Monday, June 20, 2011
Pause between CPR, defibrillation can be deadly
ANDRÉ PICARD
PUBLIC HEALTH REPORTER— From Tuesday's Globe and Mail
Published Monday, Jun. 20, 2011 4:00PM EDT
Last updated Monday, Jun. 20, 2011 4:43PM EDT
The research, published in Tuesday’s edition of the medical journal Circulation, indicates that minimizing the brief period it takes to move from cardiopulmonary resuscitation to administering an electric shock with a defibrillator is a key predictor for survival.
“If your preshock pause is over 20 seconds, the chances of surviving to reach a hospital, be treated and be discharged are 53 per cent less than if the pause is less than 10 seconds,” said Sheldon Cheskes, medical director of the Sunnybrook Osler Centre for Prehospital Care in Brampton, Ont., and lead author of the study. “Those seconds matter.”
He said he hopes the findings will encourage paramedics to move more quickly. In particular, he said, using defibrillators in manual mode halves the delay. Dr. Cheskes said that manufacturers of lifesaving equipment also need to update software to ensure that the time required to analyze a patient’s heart rhythm and charge the defibrillator before delivering a shock is minimal.
The new study is based on data from 815 people who suffered out-of-hospital cardiac arrest between 2005 and 2007 across Canada and the United States. Their average age was 64, and 80 per cent were men.
All of the people included in the research suffered either ventricular fibrillation (abnormal heart rhythm) or pulseless ventricular tachycardia (no effective cardiac output), conditions that can be reversed with an electric shock. They were treated promptly – paramedics arrived, on average, in less than six minutes – and received CPR and defibrillation. The patients received at least one shock but required, on average, five jolts to restart their heart.
Dr. Cheskes and his colleagues in the research group known as the Resuscitation Outcomes Consortium found the time that passed between stopping CPR and defibrillation ranged from 0 to 107 seconds. The median time required for the transition was 22 seconds.
The researchers found that when the pause was less than 20 seconds, 32.6 per cent of patients survived; between 20 and 39 seconds, the survival rate was 31.9 per cent. But when the pause exceeded 40 seconds, the survival rate fell to 20.3 per cent.
“If you minimize interruptions, you maximize survival,” Dr. Cheskes said. He stressed, however, that the study focused on just one element in a chain of events that needs to occur when a person suffers cardiac arrest.
“We looked at the work of paramedics but don’t forget that without bystander CPR – people doing CPR before the paramedics arrive – very few people survive,” Dr. Cheskes said. “Any delay in blood flow to the brain is detrimental for survival.”
In 2010, new CPR guidelines were published that urge people to push hard and fast – at least 100 compressions a minute. While assisting with breathing (mouth-to-mouth in common parlance) is still important, it is considered secondary because it discouraged many people from intervening.
In addition to chest compressions, people are urged to call 911 and ask for another bystander to locate a public access defibrillator. PADs are automated and will not “shock” a patient unless there is no heart rhythm.
In the new study, in 52 per cent of cases, a bystander performed CPR before paramedics arrived, but a PAD was used in fewer than 1 per cent of cases.
PUBLIC HEALTH REPORTER— From Tuesday's Globe and Mail
Published Monday, Jun. 20, 2011 4:00PM EDT
Last updated Monday, Jun. 20, 2011 4:43PM EDT
The research, published in Tuesday’s edition of the medical journal Circulation, indicates that minimizing the brief period it takes to move from cardiopulmonary resuscitation to administering an electric shock with a defibrillator is a key predictor for survival.
“If your preshock pause is over 20 seconds, the chances of surviving to reach a hospital, be treated and be discharged are 53 per cent less than if the pause is less than 10 seconds,” said Sheldon Cheskes, medical director of the Sunnybrook Osler Centre for Prehospital Care in Brampton, Ont., and lead author of the study. “Those seconds matter.”
He said he hopes the findings will encourage paramedics to move more quickly. In particular, he said, using defibrillators in manual mode halves the delay. Dr. Cheskes said that manufacturers of lifesaving equipment also need to update software to ensure that the time required to analyze a patient’s heart rhythm and charge the defibrillator before delivering a shock is minimal.
The new study is based on data from 815 people who suffered out-of-hospital cardiac arrest between 2005 and 2007 across Canada and the United States. Their average age was 64, and 80 per cent were men.
All of the people included in the research suffered either ventricular fibrillation (abnormal heart rhythm) or pulseless ventricular tachycardia (no effective cardiac output), conditions that can be reversed with an electric shock. They were treated promptly – paramedics arrived, on average, in less than six minutes – and received CPR and defibrillation. The patients received at least one shock but required, on average, five jolts to restart their heart.
Dr. Cheskes and his colleagues in the research group known as the Resuscitation Outcomes Consortium found the time that passed between stopping CPR and defibrillation ranged from 0 to 107 seconds. The median time required for the transition was 22 seconds.
The researchers found that when the pause was less than 20 seconds, 32.6 per cent of patients survived; between 20 and 39 seconds, the survival rate was 31.9 per cent. But when the pause exceeded 40 seconds, the survival rate fell to 20.3 per cent.
“If you minimize interruptions, you maximize survival,” Dr. Cheskes said. He stressed, however, that the study focused on just one element in a chain of events that needs to occur when a person suffers cardiac arrest.
“We looked at the work of paramedics but don’t forget that without bystander CPR – people doing CPR before the paramedics arrive – very few people survive,” Dr. Cheskes said. “Any delay in blood flow to the brain is detrimental for survival.”
In 2010, new CPR guidelines were published that urge people to push hard and fast – at least 100 compressions a minute. While assisting with breathing (mouth-to-mouth in common parlance) is still important, it is considered secondary because it discouraged many people from intervening.
In addition to chest compressions, people are urged to call 911 and ask for another bystander to locate a public access defibrillator. PADs are automated and will not “shock” a patient unless there is no heart rhythm.
In the new study, in 52 per cent of cases, a bystander performed CPR before paramedics arrived, but a PAD was used in fewer than 1 per cent of cases.
Time matters - it's really important
Contact: Tagni McRae
tagni.mcrae@heart.org
214-706-1396
American Heart Association
Shorter pause in CPR before defibrillator use improves cardiac arrest survival
A shorter pause in CPR just before a defibrillator delivered an electric shock to a cardiac arrest victim's heart significantly increased survival, according to a study in Circulation: Journal of the American Heart Association.
Researchers found the odds of surviving until hospital discharge were significantly lower for patients whose rescuers paused CPR for 20 seconds or more before delivering a shock (the pre-shock pause), and for patients whose rescuers paused CPR before and after defibrillation (the peri-shock pause) for 40 seconds or more, compared to patients with a pre-shock pause of less than 10 seconds and a peri-shock pause of less than 20 seconds.
"We found that if the interval between ending CPR and delivering a shock was over 20 seconds, the chance of a patient surviving was 53 percent less than if that interval was less than 10 seconds," said Sheldon Cheskes, M.D., principal investigator of the study and assistant professor of emergency medicine at the University of Toronto. "Interestingly there was no significant association between the time from delivering a shock to restarting CPR, known as the post-shock pause, and survival to discharge. This led us to believe that a primary driver for survival was related to the pre-shock pause interval."
The team also found that patients with peri-shock pauses of more than 40 seconds had a 45 percent decrease in survival when compared to those who had peri-shock pauses of less than 20 seconds.
Based on previous studies, American Heart Association resuscitation guidelines advise minimizing interruptions to chest compressions to 10 seconds or less. However, previous studies didn't measure how such pauses in CPR affected survival to hospital discharge.
According to this study, emergency medical services (EMS) in the United States treat nearly 300,000 cardiac arrest cases a year that occur outside the hospital. Less than 8 percent survive.
Cheskes and colleagues used data gathered by the Resuscitation Outcomes Consortium (ROC), a group of 11 U. S. and Canadian Emergency Medical Services that carry out research studies related to cardiac arrest resuscitation and life-threatening traumatic injury.
Between Dec. 1, 2005, and June 30, 2007, 815 patients suffered a cardiac arrest and were included in the study. They were treated by EMS paramedics in Toronto and Ottawa, Ontario; Vancouver, B.C.; Seattle/King County, Wash. and Pittsburgh, Pa. The patients were treated with either an automated external defibrillator (AED) or a manual defibrillator.
Other findings from the study:
The length of the post-shock pause showed no significant survival difference between the two groups.
AEDs were used to treat 40 percent of the cardiac arrests; 20 percent received shocks from a manual defibrillator.
Patients treated with AEDs had pre-shock pause times nearly double those treated in the manual mode, a median of 18 seconds versus 10 seconds. This likely resulted from the time required for an AED to analyze the patient's rhythm as well as the time required to charge it prior to delivering a shock.
The study findings could prompt EMS providers and defibrillator manufacturers to adopt changes likely to increase the number of successful cardiac arrest resuscitations, researchers said. These include:
Paramedics should minimize all CPR interruptions; preferably defibrillate patients in manual mode to limit the pre-shock pause to an "optimal time" of five seconds.
Manufacturers should modify defibrillator software to quicken the assessment of a patient's heart rhythm, and allow devices to deliver more timely shocks while in AED mode. "If these changes occur, I think you have at least the potential to see a greater number of patients surviving cardiac arrest," Cheskes said.
Although the study was not a randomized controlled trial, researchers said their findings confirm those of other smaller observational studies and that it would be very difficult to perform a randomized controlled trial given the evidence to date. Furthermore, higher rates of bystander witnessed cardiac arrest and bystander-provided CPR occurred in the study group which may have resulted in a selection bias. Although the study controlled for a large number of resuscitation variables, the potential for other components of CPR such as compression rate and depth may have also confounded the findings.
###
Study co-authors and funding sources are listed on the manuscript.
Statements and conclusions of study authors published in American Heart Association scientific journals are solely those of the study authors and do not necessarily reflect the association's policy or position. The association makes no representation or guarantee as to their accuracy or reliability. The association receives funding primarily from individuals; foundations and corporations (including pharmaceutical, device manufacturers and other companies) also make donations and fund specific association programs and events. The association has strict policies to prevent these relationships from influencing the science content. Revenues from pharmaceutical and device corporations are available at www.americanheart.org/corporatefunding.
NR11 – 1088 (Circ/Cheskes)
Additional resources:
Information about CPR, including guidelines and training, is located at www.heart.org/cpr.
Information about cardiac arrest can be found at www.heart.org/cardiacarrest.
Downloadable stock footage, animation and our image gallery are located at www.heart.org/news under Multimedia.
tagni.mcrae@heart.org
214-706-1396
American Heart Association
Shorter pause in CPR before defibrillator use improves cardiac arrest survival
A shorter pause in CPR just before a defibrillator delivered an electric shock to a cardiac arrest victim's heart significantly increased survival, according to a study in Circulation: Journal of the American Heart Association.
Researchers found the odds of surviving until hospital discharge were significantly lower for patients whose rescuers paused CPR for 20 seconds or more before delivering a shock (the pre-shock pause), and for patients whose rescuers paused CPR before and after defibrillation (the peri-shock pause) for 40 seconds or more, compared to patients with a pre-shock pause of less than 10 seconds and a peri-shock pause of less than 20 seconds.
"We found that if the interval between ending CPR and delivering a shock was over 20 seconds, the chance of a patient surviving was 53 percent less than if that interval was less than 10 seconds," said Sheldon Cheskes, M.D., principal investigator of the study and assistant professor of emergency medicine at the University of Toronto. "Interestingly there was no significant association between the time from delivering a shock to restarting CPR, known as the post-shock pause, and survival to discharge. This led us to believe that a primary driver for survival was related to the pre-shock pause interval."
The team also found that patients with peri-shock pauses of more than 40 seconds had a 45 percent decrease in survival when compared to those who had peri-shock pauses of less than 20 seconds.
Based on previous studies, American Heart Association resuscitation guidelines advise minimizing interruptions to chest compressions to 10 seconds or less. However, previous studies didn't measure how such pauses in CPR affected survival to hospital discharge.
According to this study, emergency medical services (EMS) in the United States treat nearly 300,000 cardiac arrest cases a year that occur outside the hospital. Less than 8 percent survive.
Cheskes and colleagues used data gathered by the Resuscitation Outcomes Consortium (ROC), a group of 11 U. S. and Canadian Emergency Medical Services that carry out research studies related to cardiac arrest resuscitation and life-threatening traumatic injury.
Between Dec. 1, 2005, and June 30, 2007, 815 patients suffered a cardiac arrest and were included in the study. They were treated by EMS paramedics in Toronto and Ottawa, Ontario; Vancouver, B.C.; Seattle/King County, Wash. and Pittsburgh, Pa. The patients were treated with either an automated external defibrillator (AED) or a manual defibrillator.
Other findings from the study:
The length of the post-shock pause showed no significant survival difference between the two groups.
AEDs were used to treat 40 percent of the cardiac arrests; 20 percent received shocks from a manual defibrillator.
Patients treated with AEDs had pre-shock pause times nearly double those treated in the manual mode, a median of 18 seconds versus 10 seconds. This likely resulted from the time required for an AED to analyze the patient's rhythm as well as the time required to charge it prior to delivering a shock.
The study findings could prompt EMS providers and defibrillator manufacturers to adopt changes likely to increase the number of successful cardiac arrest resuscitations, researchers said. These include:
Paramedics should minimize all CPR interruptions; preferably defibrillate patients in manual mode to limit the pre-shock pause to an "optimal time" of five seconds.
Manufacturers should modify defibrillator software to quicken the assessment of a patient's heart rhythm, and allow devices to deliver more timely shocks while in AED mode. "If these changes occur, I think you have at least the potential to see a greater number of patients surviving cardiac arrest," Cheskes said.
Although the study was not a randomized controlled trial, researchers said their findings confirm those of other smaller observational studies and that it would be very difficult to perform a randomized controlled trial given the evidence to date. Furthermore, higher rates of bystander witnessed cardiac arrest and bystander-provided CPR occurred in the study group which may have resulted in a selection bias. Although the study controlled for a large number of resuscitation variables, the potential for other components of CPR such as compression rate and depth may have also confounded the findings.
###
Study co-authors and funding sources are listed on the manuscript.
Statements and conclusions of study authors published in American Heart Association scientific journals are solely those of the study authors and do not necessarily reflect the association's policy or position. The association makes no representation or guarantee as to their accuracy or reliability. The association receives funding primarily from individuals; foundations and corporations (including pharmaceutical, device manufacturers and other companies) also make donations and fund specific association programs and events. The association has strict policies to prevent these relationships from influencing the science content. Revenues from pharmaceutical and device corporations are available at www.americanheart.org/corporatefunding.
NR11 – 1088 (Circ/Cheskes)
Additional resources:
Information about CPR, including guidelines and training, is located at www.heart.org/cpr.
Information about cardiac arrest can be found at www.heart.org/cardiacarrest.
Downloadable stock footage, animation and our image gallery are located at www.heart.org/news under Multimedia.
Sunday, June 19, 2011
Where the hell was the AED?
TONY Guerra had just smashed through the windows of his burning house and delivered his wife to safety when he made the most awful realisation. His young daughter Brittany was still trapped inside.
The 43-year-old builder burst back into the blazing house in a brave but doomed bid to save his 10-year-old daughter, who had an intellectual disability. She died in the fire, and while Mr Guerra made it back out to the front garden he suffered a fatal heart attack there.
Brittany's mother, Kylie Guerra, 38, survived the blaze in Melbourne Road, Sorrento, early yesterday and was taken to Frankston Hospital suffering shock and smoke inhalation. Last night she was reunited with the couple's other, younger daughter, who had been staying with her grandmother
Read more: http://www.theage.com.au/victoria/father-dies-in-doomed-rescue-bid-20110619-1ga7l.html#ixzz1PlNn0mUO
The 43-year-old builder burst back into the blazing house in a brave but doomed bid to save his 10-year-old daughter, who had an intellectual disability. She died in the fire, and while Mr Guerra made it back out to the front garden he suffered a fatal heart attack there.
Brittany's mother, Kylie Guerra, 38, survived the blaze in Melbourne Road, Sorrento, early yesterday and was taken to Frankston Hospital suffering shock and smoke inhalation. Last night she was reunited with the couple's other, younger daughter, who had been staying with her grandmother
Read more: http://www.theage.com.au/victoria/father-dies-in-doomed-rescue-bid-20110619-1ga7l.html#ixzz1PlNn0mUO
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