Bob Trenkamp's blog

Bob Trenkamp's blog

How many households where both adults can perform a 2" chest compression on their spouse?

In the USA there are about 1,000 cardiac arrests each day. About 70% occur in a private residence. Two-thirds of the victims are male.

In a sample of 50 couples, the result was the same as the prior examination with 30 couples: the percentage of households where each adult could perform a single two-inch compression on their spouse was zero.

Does this mean you shouldn't try? NOT AT ALL!

But it does suggest an alternate strategy: Have a personal AED at home and take it with you when you travel!

This works so much better than the suggestion that both spouses should alter their diets to get to where both weigh about 25% more than the other!

Bob

A SUBTLE ADVANTAGE FOR DRIVERLESS CARS

Driverless cars will be actively sold before the end of this decade.

Recent evidence shows that the accident rate with a driverless car is far less than with a human at the wheel.

One consequence is that, if the "driver" is wearing a device such as iBeat, the car can re-route and head for the closest ER when that passenger / driver is recently clinically dead.

Sure beats calling an ambulance.

Bob

AED vs. CPR

The difference between performing CPR and using an AED

  1. An AED is a device that examines the victim's heart rhythm and advises the rescuer as to whether to administer a shock or to resume chest compression. The AED either delivers the shock when you press the button or it delivers the shock automatically.
  2. CPR pushes oxygen-bearing blood to the heart muscle and brain. The preservation of these two organs determine the degree you can function if resuscitated. CPR also delays the transition from a shockable rhythm to a non-shockable rhythm.

Which is better?

CPR Realities

Your ability to perform CPR has nothing to do with strength - it is determined by your weight, your weight distribution, the stiffness of the victim's chest, and the method of chest compression - manual (with then hands) or heel ( with the heel of the foot.)

Use of heel compression quadruples the number of people that can perform 2 inch compressions for ten minutes.

When the people who are most likely to have the opportunity to perform chest compression, it it likely that they wil most likeiy be able to do so with Heel Compressions,

Write with questions to bobt [at] slicc [dot] org

best

bob

What are the most serious problems with CPR?

FROM 10,000 feet:
1. We're not focusing on training the people who most need to be trained. The people most likely to need to perform CPR are about the same age as - and live alone with - the victim.
2. The technique most commonly taught is something that the vast majority cannot perform for ten minutes.
3. Many of the people who will be called upon to perform CPR weigh too little to perform 2" chest compression on a chest of average stiffness.
4. Even with free instruction, many people who need to know won't take the time to learn.

THE DETAILS:

Mary Newman Rocks!

Check out the Fox News report on the parade at ECCU
http://fox5sandiego.com/2015/12/10/1200-marchers-encourage-people-to-lea...

Bob

It works

The Short Version
An elderly male suffered a cardiac arrest at a meeting. Another elderly male began to perform manual CPR but quickly tired and was unable to continue. The other person present - who had recently read an interview with one of the authors of an article in the American Journal of Emergency Medicine regarding Heel Compression CPR began to perform Heel CPR. The victim's heart was restarted before the arrival of EMS.

That's the whole point of Heel CPR - when you cannot get down on the ground or you have a problem pressing hard enough on the chest to get adequate compression depth, consider an alternative: Heel CPR. Go to www.slicc.org/ClassVideo and click on the Adult CPR video.

Background

Some things most bystanders don’t know about CPR…and why you need an AED in your home.

A heart attack is not the same thing as a cardiac arrest. Heart attack victims normally are able to talk and many are in pain. Cardiac arrest victims are non-responsive, clinically dead, and are not breathing normally – even though they might be gasping.

CPR is not used on heart attack victims. CPR is only used on SCA victims.

CPR does not re-start hearts – It tries to keep the heart muscle and brain alive, and it delays the transition from a shockable rhythm to a non-shockable one. This transition drops your chance of survival seven-fold. It takes an AED to re-start the heart, and sooner is a lot better!

Eighty-five percent of all cardiac arrests occur in a private residence. The witness, if there is one, is usually about the same age as the victim. Heel Compression quadruples the number of people who can perform guideline-compliant chest compression ("GC3’s") for ten minutes.

Why it is so important to begin chest compression immediately and not stop

Often newspapers and magazines make a statement that implies that the probability of surviving a cardiac arrest is a x% per minute declining ramp. This, it turns out, is an oversimplification.

In many cases it's more accurate to think of it as three steps of decreasing survival probability:

The starting point is just before the arrest, and your chance of living through the day is essentially 100%.
The first step down is frequently a drop down to ~28% chance of surviving.
The second step down drops your chance of surviving to a little less than 5%
The third step down drops that number to 0%.

The Importance Of Beginning Chest Compressions As Early As Possible

One doesn't have to read much about CPR for Cardiac Arrest victims to encounter the assertion that the probability of survival decreases about 10 percent per minute. Sometime other numbers are used.

This, it turns out, is an oversimplification.

One common sequence seen in sudden cardiac arrests is:
1. Normal sinus rhythm[doesn't need to be treated], followed by...
2. Supraventricular tachycardia [a shockable rhythm], followed by...
3. Ventricular fibrillation [a shockable rhythm], followed by...
4. Asystole [a non-shockable rhythm]

From Chan, McNally et al (DOI: 10.1161/CIRCULATIONAHA.114.009711) we know that 27.9% of victims in shockable rhythms survive and 4.4% of victims in non-shockable rhythms survive.

Because you as a bystander do not have a heart monitor, you cannot know what the victim's rhythm is. But you do know that chest compression can delay the transition from a shockable rhythm to an unshockable rhythm.

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The mission of the Sudden Cardiac Arrest (SCA) Foundation is to prevent death and disability from sudden cardiac arrest. The vision of the SCA Foundation is to increase awareness about sudden cardiac arrest and influence attitudinal and behavioral changes that will reduce mortality and morbidity from SCA.

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