By the numbers...

It's all about 

• the size of the risk and what you know.
• The largest killer in this country
• the largest disabler in this country
• what you can do about them.

Two factors determine the size of a risk: 

1. How likely is it that the thing you're concerned about will happen?
2. And if it happens, how large is the loss?

• "one chance in a million that you'll lose a leg" is not a big risk.
• "a 50 / 50 chance that you'll lose a penny" is not a big risk.

How big a risk is a ten percent chance that you'll see a family member or friend die of a cardiac arrest and not know exactly what to do about it? 

Each of us will see - at least once in our lifetime - a family member or friend or someone we know die of a cardiac arrest. And whether that person gets brought back with their brain intact will be significantly determined by whether you know what to do and do it quickly.

Your odds of seeing a stranger arrest are ten times smaller - unless you watch a lot of TV. In real life, seventy percent of all arrests happen in the home.

That's why it's it's terribly important to your survival that those you are frequently around know how to recognize when you have had a sudden cardiac arrest and when you have had a stroke...and what to do about it. 

To get those around you to get trained often requires that you first get trained.

Why don't you do something about that now? Once you've watched those clips, make sure those people you spend time with do, too.

Bob

I will unavoidably not be able to attend ECCU this year, so I've written down what I wanted to share with people there. The focus is on what we can do to fix CPR.

You can access my notes at http://www.slicc.org/ECCU_Info.pdf

Bob

SLICC passes 10,000 trained mark!

As SLICC entered it's eighth year in April, its roster of trained bystanders had reached 10,254.

Our latest annual report is at http://www.slicc.org/AR2014

After having demonstrated at the AHA Resuscitation Science Symposium that most rescuers are not capable of delivering manual Guideline-Compliant Chest Compressions ("GC3's") for the average time from a cardiac arrest until the ambulance crew is "hands-on" at the victim, and recognizing that nearly seventy percent of all cardiac arrests occur in the home, we have advocated pedal compressions for those who cannot get down on the floor, for those who have problems with their hands / wrists / arms, for those who find they do not weigh enough to perform GC3's, and for those rescuers who are just too tired to continue with manual compressions.

Our class video runs about forty minutes and covers Bystander CPR, AED use, choking emergencies, and stroke recognition.

We are actively looking for people to use our materials to teach bystanders in all areas of the USA.

Contact bobt@slicc.org if you are interested.

Bob

The Recommendation of a Book.

Thanks to Doctors Gillinov and Nissin of the Cleveland Clinic, we have a book titled Heart 411 (Three Rivers Press). It is a well-organized, comprehensive, 500+ page treasure trove of information.

The book contains an interesting chapter on how a woman's heart is different and similar to a man's.

Similarities?
The primary symptom of coronary heart disease is chest pain for both sexes. Also the principal strategies for prevention and treatment apply to both men and women: healthy lifestyle, medicine, angioplasty, and surgery.

Differences?

1. Since 1984, more women than men have died from coronary heart disease each year. Prevalence is dropping in men but rising in women.
2. For men, a heart attack is the first sign of heart disease. For women, the first sign is more commonly angina - a discomfort or fullness in the chest that generally occurs with exercise or stress and is relieved with rest.
3. About 25% of all heart attacks occur without chest pain - more commonly in women than in men. Shortness of breath is often the clue in the absence of chest pain, as are indigestion, nausea, vomiting, sweating, fatigue, and weakness.
4. Women tend to wait longer than men before seeking treatment, and they are more likely to go to their doctor's office than to the Emergency Department.
5. Eighty percent of women (vs. fifty percent of men) report having experienced early warning symptoms one month or more before a heart attack. The early warning signs for women include unusual fatigue (72%), sleep disturbance (48%), shortness of breath (42%), indigestion (39%), anxiety (36%), and chest discomfort (30%)
6. The standard exercise cardiac stress test is less reliable in women (more false positives) and fewer catheterizations for chest pain reveal blockages, thus raising the risk and lowering the benefit of these important procedures.
7. Young women - less than fifty years old - have twice the risk of dying in the hospital following admission for a heart problem than do men.
8. Men have heart attacks at an earlier age than women.

And what's all this doing in a blog usually dedicated to Cardiac Arrest and CPR? While most heart attacks are not fatal - i.e., don't trigger a cardiac arrest - some of them do.

What I didn't know about CPR

I've seen four different ways to perform CPR with your hands in the past weeks.

1. Lock your arms straight, get your shoulders over the hands, and rock from the hips. So far, no surprise.
2. Perform #1 but use your abs to accelerate your shoulders downward.
3. Perform #1 but start with your arms slightly bent and straighten them as you start the downward push.
4. Perform 1, 2, and 3 simultaneously.

For those who lack the physical training and endurance to perform alternatives 2, 3, & 4, you'll have to stick with alternative #1.

A fifth alternative - not available to those performing CPR as part of their employment - is to perform pedal compressions. It's the only way I know of where the average person at home - where two-thirds of all cardiac arrests occur - can perform chest compressions from the time they witness an arrest to the time the ambulance crew is "hands on" at the victim of a cardiac arrest. See how to perform Pedal CPR  I'm a paramedic. I've gotten a lot of CPR experience over the past decade, and I am absolutely positive that I can perform pedal compressions on someone for the ten-minute average period from the moment I see someone collapse and the time that help is "hands on." 

I hope this is something that you never need to know.

did you ever stop to think about how?

One of the recommendations one hears in CPR class sessions is "Get the victim on their back on a hard, flat surface."

Recognizing that two thirds of all arrests in the U.S.A. occur in the home, you are going to fit into one of the categories below.

1. I can physically pick up my spouse and place him or her on his or her back on a hard, flat surface, and my spouse can do the same for me.
2. I am the only adult in my home.
3. One of us can pick up the other and get him or her onto his or her back on a hard, flat surface.
4. Neither one of us can do that.

OK. Those of you who fell into group 1 or 2 can skip the rest of this. Those who are in groups 3 or 4 really need to watch www.slicc.org/2014CV_AdultCPR.mov. I can painfully testify that my 113 pound wife can get my 185 pound body out of a recliner or out of a bed and onto the floor without a problem.

If you are interested in the entire video, go to www.slicc.org and click on "For past trainees" in the left column. The Intro and the Adult CPR segments are the only 2014 videos, but the entire 2012 video is up there, as well. SLICC's instructional videos assume that you will be a "lone rescuer."

Here's a tip that can save someone's life...

How many things can you think of that you did better the first time you did them than the second?

Not a lot, right?

Here's the point: You have a rediculously high chance of seeing someone you know have a cardiac arrest, and getting it right the first time is important.

So you and your spouse need to take turns pretending that the other just had a cardiac arrest and acting out what you would do.

What would you do?

Hopefully, you would...

1. Determine that it's safe to help - there's no high voltage power line on top of the person, right?
2. Check to see that the person is truly unresponsive and not breathing normally.
3. Call 911 while walking to the door to unlock it. 
4. And don't let 911 hijack the call - and tell them (a) where you are, (b) what's wrong, (c) what you are doing about it, and (d) what you need. If you don't take charge of the call, they will keep you on the phone longer than you can afford to ignore the victim.
5. Get the victim on their back on a hard, flat surface and start chest compressions - at least two inches deep, and at least at a rate of 100 - 120 per minute.
6. Don't even think of breathing for that adult - they won't need it for the first 5-10 minutes, and interrupting the compressions, really reduces their chance of surviving.

It will be soooo much easier to get it right if you have practiced. Seriously.

See www.slicc.org if you have questions.

Best,

Bob