I have opined for many years on this board that in-water rescue breathing is a mostly futile ( though well-intentioned ) effort that actually works against the chances for successful resucitation ( I say "mostly" because there are circumstances where several initial breaths would be indicated; eg: a witnessed drowning with quick recovery ).
There is growing case-history in the field to support the new "cardio-cerebral" method of emergency resucitation; consider:
CPR alternative
By Nate Legue
ROCKFORD REGISTER STAR
Click here for more information about Nate Legue
ROCKFORD Howard Erickson cant remember how fast he ran the annual Turkey Trot last Thanksgiving.
The 59-year-old jogger cant remember much at all from that day.
Thats because when the Beloit, Wis., man finished the 5K race at Reuben Aldeen Park and turned to see the clock, he dropped dead.
It wasnt a full-blown coronary that felled him, but the electrical disturbance in his ticker was enough to bring down the robust former Rock County sheriff.
He survived because several doctors were nearby to give first aid and Rockford firefighters rushed to the scene from a station less than a mile away. Forgoing traditional CPR, they resuscitated Erickson with a different method, a protocol that is saving three to seven times more coronary victims than CPR, according to medical studies.
Thankfully for Erickson, some local paramedics and medical directors are among the first emergency responders in the country to switch to the new protocol, dubbed continuous chest compression or cardiocerebral resuscitation. But the method still has not gained wide acceptance in the medical community because it means abandoning mouth-to-mouth resuscitation in favor of nonstop chest thrusts and re-examining 40 years of conventional wisdom about first aid guidelines for heart attacks.
Dr. Robert Harner, a Rockford cardiologist, and Dr. John Underwood, SwedishAmerican Hospitals emergency medical director, prompted a 13-month study of the method with the Rockford and Byron fire departments. By using only continuous chest compression and automatic external defibrillators, they found that 28 percent of heart attack victims lived and 82 percent of those survivors suffered little or no ill effects to brain function. Under normal CPR protocol, which also uses AEDs, the local medical community saved only about 3.7 percent of its heart attack victims, a standard survival rate, said Bob Vertiz, training coordinator for emergency medical services at the Rockford Fire Department.
Because of the improved survival rates weve been seeing in the field, weve put all our faith in this new method, Vertiz said.
With evidence from tests like Rockfords study popping up in medical journals, emergency responders in almost two dozen regions, including major metropolitan areas like Kansas City, Mo., are launching their own trials. The biggest proponent of the method, Dr. Gordon Ewy, a university medical professor, is advocating for it statewide in Arizona.
What makes continuous chest compression effective? When a persons heart stops, it leaves between six and nine minutes worth of oxygen in the bloodstream. That oxygen can be circulated with rapid chest thrusts and keep the brain alive. When paramedics or bystanders stop to blow air into the victims mouth, it interrupts the flow and starves the brain for 10, 20 and even 30 seconds enough time to do damage during cardiac arrest.
We feel breaths are detrimental, Underwood said. I think they do more harm than good. If we can get people to stop doing them, we can see an increase in survival rates.
Erickson credits the resuscitation method for his very life. Six days after his Thanksgiving heart episode, the retired police officer checked out of the hospital. Three weeks later he was back to work as a marketing director for a travel bus company.
Im just as good as I was before, Erickson said. I can certainly tell you what they did worked.
In addition to rapid chest thrusts, paramedics used an AED to shock Ericksons heart three times during his collapse. While medical experts agree that AEDs improve survival, the electrical devices are still not widespread even with state laws requiring them in many public places. And continuous chest compression is simple. It can be taught to a bystander over the phone by a 911 dispatcher. In fact, since 2000, dispatchers have been doing just that when callers say they cant do CPR.
The problem is that many bystanders dont do CPR, sometimes because theyre panicked and afraid to mess up or sometimes because they dont want to kiss a complete stranger.
And many experts are reticent to endorse the experimental method because it could do harm to some patients who need mouth-to-mouth. While continuous chest compression works well on adult heart attack patients, it could hurt drowning or drug overdose victims who have exhausted bloodstream oxygen and need air.
Still, many physicians who subscribe to the rapid compression method are agitating for a change in training guidelines for first responders and laypeople. The American Heart Association allows for emergency personnel to use high-frequency chest compressions but says there is insufficient evidence to recommend for or against its use, according to the guidelines it published last year.
What theyre saying is, You guys are telling us that what weve been doing for 40 years is wrong. Youve got to really prove it to us, said Dr. Michael Kellum, a Janesville, Wis., physician who spearheaded a similar study supporting cardiocerebral resuscitation. Youll see over the next year or two more people report this (in medical journals), and the experts will say, Now we have enough data to say this is the way we should do it.
Staff writer Nate Legue can be reached at 815-987-1346 or nlegue@rrstar.com.
By the numbers
3.67 Percent of local patients who survive a cardiac arrest
2 to 5 Percent of heart attack survivors considered normal by emergency responders
28 Percent of patients who survived cardiac arrests in 13-month study of continuous chest compression by Rockford and Byron firefighters
82 Percent of those survivors who suffered little or no brain damage
48 Percent of heart attack survivors found in a similar study in Walworth and Rock counties in Wisconsin
Sources: Rockford Fire Department, American Journal of Medicine
So I ask you - is it not time for a complete review of diving rescue / resuscitation in light of this new information?
Regards,
DSD
There is growing case-history in the field to support the new "cardio-cerebral" method of emergency resucitation; consider:
CPR alternative
By Nate Legue
ROCKFORD REGISTER STAR
Click here for more information about Nate Legue
ROCKFORD Howard Erickson cant remember how fast he ran the annual Turkey Trot last Thanksgiving.
The 59-year-old jogger cant remember much at all from that day.
Thats because when the Beloit, Wis., man finished the 5K race at Reuben Aldeen Park and turned to see the clock, he dropped dead.
It wasnt a full-blown coronary that felled him, but the electrical disturbance in his ticker was enough to bring down the robust former Rock County sheriff.
He survived because several doctors were nearby to give first aid and Rockford firefighters rushed to the scene from a station less than a mile away. Forgoing traditional CPR, they resuscitated Erickson with a different method, a protocol that is saving three to seven times more coronary victims than CPR, according to medical studies.
Thankfully for Erickson, some local paramedics and medical directors are among the first emergency responders in the country to switch to the new protocol, dubbed continuous chest compression or cardiocerebral resuscitation. But the method still has not gained wide acceptance in the medical community because it means abandoning mouth-to-mouth resuscitation in favor of nonstop chest thrusts and re-examining 40 years of conventional wisdom about first aid guidelines for heart attacks.
Dr. Robert Harner, a Rockford cardiologist, and Dr. John Underwood, SwedishAmerican Hospitals emergency medical director, prompted a 13-month study of the method with the Rockford and Byron fire departments. By using only continuous chest compression and automatic external defibrillators, they found that 28 percent of heart attack victims lived and 82 percent of those survivors suffered little or no ill effects to brain function. Under normal CPR protocol, which also uses AEDs, the local medical community saved only about 3.7 percent of its heart attack victims, a standard survival rate, said Bob Vertiz, training coordinator for emergency medical services at the Rockford Fire Department.
Because of the improved survival rates weve been seeing in the field, weve put all our faith in this new method, Vertiz said.
With evidence from tests like Rockfords study popping up in medical journals, emergency responders in almost two dozen regions, including major metropolitan areas like Kansas City, Mo., are launching their own trials. The biggest proponent of the method, Dr. Gordon Ewy, a university medical professor, is advocating for it statewide in Arizona.
What makes continuous chest compression effective? When a persons heart stops, it leaves between six and nine minutes worth of oxygen in the bloodstream. That oxygen can be circulated with rapid chest thrusts and keep the brain alive. When paramedics or bystanders stop to blow air into the victims mouth, it interrupts the flow and starves the brain for 10, 20 and even 30 seconds enough time to do damage during cardiac arrest.
We feel breaths are detrimental, Underwood said. I think they do more harm than good. If we can get people to stop doing them, we can see an increase in survival rates.
Erickson credits the resuscitation method for his very life. Six days after his Thanksgiving heart episode, the retired police officer checked out of the hospital. Three weeks later he was back to work as a marketing director for a travel bus company.
Im just as good as I was before, Erickson said. I can certainly tell you what they did worked.
In addition to rapid chest thrusts, paramedics used an AED to shock Ericksons heart three times during his collapse. While medical experts agree that AEDs improve survival, the electrical devices are still not widespread even with state laws requiring them in many public places. And continuous chest compression is simple. It can be taught to a bystander over the phone by a 911 dispatcher. In fact, since 2000, dispatchers have been doing just that when callers say they cant do CPR.
The problem is that many bystanders dont do CPR, sometimes because theyre panicked and afraid to mess up or sometimes because they dont want to kiss a complete stranger.
And many experts are reticent to endorse the experimental method because it could do harm to some patients who need mouth-to-mouth. While continuous chest compression works well on adult heart attack patients, it could hurt drowning or drug overdose victims who have exhausted bloodstream oxygen and need air.
Still, many physicians who subscribe to the rapid compression method are agitating for a change in training guidelines for first responders and laypeople. The American Heart Association allows for emergency personnel to use high-frequency chest compressions but says there is insufficient evidence to recommend for or against its use, according to the guidelines it published last year.
What theyre saying is, You guys are telling us that what weve been doing for 40 years is wrong. Youve got to really prove it to us, said Dr. Michael Kellum, a Janesville, Wis., physician who spearheaded a similar study supporting cardiocerebral resuscitation. Youll see over the next year or two more people report this (in medical journals), and the experts will say, Now we have enough data to say this is the way we should do it.
Staff writer Nate Legue can be reached at 815-987-1346 or nlegue@rrstar.com.
By the numbers
3.67 Percent of local patients who survive a cardiac arrest
2 to 5 Percent of heart attack survivors considered normal by emergency responders
28 Percent of patients who survived cardiac arrests in 13-month study of continuous chest compression by Rockford and Byron firefighters
82 Percent of those survivors who suffered little or no brain damage
48 Percent of heart attack survivors found in a similar study in Walworth and Rock counties in Wisconsin
Sources: Rockford Fire Department, American Journal of Medicine
So I ask you - is it not time for a complete review of diving rescue / resuscitation in light of this new information?
Regards,
DSD
