Archive - Aug 2011

Archive - Aug 2011

August 30th

Studies: Increasing Complications for Pacemakers and ICDs

NEW YORK– Implantation of cardiac implantable electrophysiological devices (CIED) is associated with increasing rates of complications and mortality, according to results of 3 studies published in the August 23rd online Journal of the American College of Cardiology.

There have been dramatic increases in the implantation of these devices, largely due to the expanded indications and the aging of the general population. Previous studies have suggested that the complication rates associated with implantation of these devices may be increasing, too.

Infection rates have clearly increased, according to a report from Dr. Arnold J. Greenspon from Thomas Jefferson University Hospital, Philadelphia, Pennsylvania and colleagues. They analyzed the historical trends for CIED infection in the United States between 1993 and 2008 using data from the Nationwide Inpatient Sample.

World’s Largest Cardiac Arrest Trial Shows Longer Period of Initial CPR by Paramedics and Firefighters Provides No Benefit

 A study involving nearly 10,000 cardiac arrest patients from 10 North American regions has shown that extending the period of initial cardiopulmonary resuscitation (CPR) by paramedics and firefighters from one to three minutes provides no benefit. The study, led by Dr. Ian Stiell of the Ottawa Hospital Research Institute (OHRI), the University of Ottawa (uOttawa) and the Resuscitation Outcomes Consortium (ROC), resolves a worldwide controversy about cardiac arrest care. It is the largest randomized cardiac arrest trial in the world, published in the New England Journal of Medicine.

August 29th

Report on AED Failures: A Reminder that Maintenance is Vital

WASHINGTON-- More than 1,000 cardiac arrest deaths over 15 years are connected to the failure of automated external defibrillators (AEDs); battery failure accounted for almost one-quarter of the failures. The study was published online last week in Annals of Emergency Medicine ("Analysis of Automated External Defibrillator Device Failures Reported to the Food and Drug Administration" http://bit.ly/ox6YYr).

"Survival from cardiac arrest depends on the reliable operation of AEDs," said lead study author Lawrence DeLuca, MD, EdD, of the University of Arizona Department of Emergency Medicine in Tucson. "AEDs can truly be lifesavers but only if they are in good working order and people are willing to use them."

Hygienist's CPR saves heart-attack victim after wreck

By Terry Evans
tevans [at] star-telegram [dot] com

Star-Telegram / Ron T. Ennis

Dental hygienist Julie Watson looks over debris outside the dental clinic where she works on Bryant Irvin Road. Watson is credited with saving the life of a heart-attack victim who slammed his car into the clinic.

FORT WORTH — A dental hygienist is credited with saving a heart-attack victim's life after the car he was driving slammed through the wall of the dentist's office where she works.

Julie Watson performed CPR and used an automatic defibrillator on the man after he was pulled from his vehicle and placed on the ground outside Dr. Gary Pointer's dental clinic on Bryant Irvin Road.

There's a large problem with 'presenting rhythm' statistics.

Here's the deal...

When you have a sudden cardiac arrest, your heart has already progressed from a perfusing rhythm to a non-perfusing rhythm.

i.e., your heart is not pumping blood to your brain, and you are clinically dead.

The tracking systems report the "initial rhythm" as whatever the rhythm was when the first person with an AED or Cardiac Monitor got their gear wired to the patient.

If the rhythm was "shockable" and the device was an AED, we know that it was one of two or more well-known rhythms.

If the rhythm was described in terms of the specific rhythm, the device used was a cardiac monitor.

The officially recorded presenting rhythm is reported as "shockable" if an AED fired a blast and as whatever the paramedic on scene saw if the EMTs were the first on the scene and attached a heart monitor.

August 27th

Patients With ICDs Live Longer, However Pacing is Crucial

Adverse effects of right ventricular pacing on the survival of ICD (implantable cardioverter-defibrillator) patients are long term, researchers from the Minneapolis Heart Institute at Abbott Northwestern Hospital explained, however, CRT (cardiac resynchronization therapy) lessens the impact.

The scientists presented their findings at the European Society of Cardiology (ESC) Congress August 28 in Paris, France. Lead author Robert G. Hauser, MD, said: "We were pleased to discover that the average patient, despite having severe left ventricular dysfunction, lived nine years after ICD implantation, which are the best results that we are aware of."

August 24th

Some really interesting items in the CARES report

In no particular order, here are some punctuation marks from the CARES data for the past 4+ years.

By way of background, there are two significant categories of heart rhythm: shockable and un-shockable. The first chance we have of learning what a cardiac arrest victim's heart rhythm is occurs when an AED or cardiac monitor is first attached to the victim.

The length of time that passes between the victim's death and the attachment of a monitor / AED is extremely important because there is frequently a progression from one rhythm to another over time when someone arrests. For example, a victim might begin in a shockable rhythm when they died, and with the passage of a few minutes, they might have transitioned into an un-shockable rhythm.

Missing and Rusty Links...in the Chain of Survival

There's a nice, tidy guide to maximizing resuscitation success when someone has a sudden cardiac arrest: (1) immediately recognize the arrest for what it is and activate the 911 emergency response network; (2) immediately begin chest compressions; (3) promptly defibrillate the victim; (4) get the victim under Advanced Life Support care; and (5) provide early post-resuscitative care. It's called the Chain of Survival.

In some parts of the real world, however, there are a surprising number of rusty or missing links. What goes wrong?

August 22nd

It's important to know where to find AEDs on Airplanes, Trains, and other public places.

Train Passengers Perform CPR After Man Collapses at West Newton Station
After a man collapsed on the platform in West Newton, Commuter Rail passengers stepped in to help out.
By Melanie Graham

It was an exciting commute for a few passengers on the Framingham/Worcester Commuter Rail line this morning.

David Perry, an Ashland resident, as well as Framingham resident Dean Bonis, helped perform CPR on a man at the West Newton station after the man collapsed and went into cardiac arrest.

"I knew I had the training and I knew what to do," Perry told Newton Patch.

Newton Fire Chief Paul Chagnon told Newton Patch this morning that the man was reported to be "awake and alert" in the hospital.

As the train pulled into the West Newton stop around 8 a.m., Perry and Bonis explained that someone ran onto their cars asking if there was a doctor available, as a man had just collapsed on the platform.

August 17th

PA Rep. Mike Vereb Legislation Protects Student Athletes Against Sudden Cardiac Arrest

PA Rep. Mike Vereb Legislation Protects Student Athletes Against SCA

Urging public awareness before the start of the fall school sports season, Rep. Mike Vereb (R-Montgomery) today held a press conference to discuss his legislation, House Bill 1610, to educate and safeguard student athletes against sudden cardiac arrest (SCA). SCA is the leading cause of death in young athletes. In fact, according to news reports, approximately one out of every 180 students is at high risk for sudden cardiac death.

“Sudden cardiac arrest strikes quickly and unexpectedly,” Vereb said. “Parents and coaches need to be aware of the warning signs. Too often news reports contain stories of student athletes who die during a game or practice as a result of an unknown heart condition. Awareness is the first step toward prevention.”

Vereb’s legislation ensures that appropriate measures are taken when a student athlete shows symptoms of cardiac distress. Specifically, his legislation stipulates that:

Mission & Vision

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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