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PocketCPR

PocketCPR | Heart and Vascular Health | Scoop.it

PocketCPR for iPhone:
• Actively utilizes the accelerometer hardware in the iPhone for real-time coaching and actual feedback on CPR while you are learning and practicing.
• Measures the actual depth and rate of your compressions and lets you know if you need to push faster or slower, and whether you should push harder or softer. The patented algorithm also measures the recoil or release of each compression to help ensure full decompression during CPR. A Perfusion Performance Indicator (PPI) graphical display "fills" as compression quality is optimal and remains optimal, providing the user an indication that all the elements of excellent, high quality compressions have been achieved.

Seth Bilazarian, MD's insight:

I have now used this app with three consecutive cardiac arrest patients.  I found the feedback it provides both for the rate of compression AND the depth of compression AND the rate of compression release to be a valuable tool to aid in effective chest compressions.  

There's also a CPR guide with step by step instructions for first responders.

It's free.  Sponsored by Zoll.

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'Thankful forever': Runner revived after suffering heart attack in Thanksgiving race counts his blessings

'Thankful forever': Runner revived after suffering heart attack in Thanksgiving race counts his blessings | Heart and Vascular Health | Scoop.it

On this chilly morning he was among nearly 10,000 pumped-up people running the Feaster Five Road Race in Andover. He ran with his daughter Paige, a student at the University of West Virginia.

“I was really excited,” said the 52-year-old North Andover resident. “It was the third time I had run the Feaster Five. I was with my daughter, who was home from college (University of West Virginia). I just remember being so happy.”

With about 150 yards to go in the 5K race, Dewhirst turned right onto York Street, a pain-in-the-neck hill near the end the course.

“I really wanted to give it my all and finish strong,” said Dewhirst. “I started charging up the hill. I was about three-quarters of the way up when I started feeling light-headed, like I was going to pass out.”

That’s the last thing Dewhirst remembered of his run. He collapsed on the street. He had suffered a heart attack.whirst was revived and whisked him off to Lawrence General Hospital.

Seth Bilazarian, MD's insight:

"“He had no pulse, no heartbeat,” “Our medical team, along with a few runners in the area, responded right away and performed CPR and with an AED and brought Alan back to life. He is lucky he went down in a road race versus in his back yard or walking up his stairs. It’s proof again that running in a road race can actually save your life.”
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Great story by Bill Burt ( @BurtTalksSports ) of Eagle Tribune showing the fantastic life saving results when the chain of survival is in place for rapid CPR (within seconds), rapid defibrilation with an AED (within minutes) then transport to a first rate hospital for heart attack care with angioplasty and stenting (Lawrence General Hospital). Patient returns to a productive life thanks to all the participants which have led to his complete recovery.
Take note of the importance of recognizing early warning signs.  "Dewhirst, ... does recall some issues over the last six months in which he was a little more tired than normal or his heat was “racing” and he needing to stop and breathe." This story turned out great but earlier recognition would have been less dramatic and allot safer.

 

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Mobile App: Pocket First Aid & CPR from AHA

Get Pocket First Aid & CPR from the American Heart Association on the App Store. See screenshots and ratings, and read customer reviews.
Seth Bilazarian, MD's insight:

An app that could save a life.

Screen shots on emergency first aid and CPR.

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Chest compressions: Yes or no?

Chest compressions: Yes or no? | Heart and Vascular Health | Scoop.it

It's supposed to be a foregone conclusion (right?), but one debate at AHA 2012 provided convincing arguments against chest compressions. This could be a major paradigm shift: To compress or not to compress?

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The most provocative presentation at AHA 2012 (#AHA12) was presented by Dr. Gust Barty who made a convincing argument that we should at least study whether the use of chest compressions in cardiac arrests is better than prompt use of a defibrillator and no compression at all. He sighted data from Piacenza Italy where this practice is being used. Survival in this community is 34% at 1 year after cardiac arrest. This is in direct opposition to the current recommendations of AHA that chest compression should be done immediately and with minimal interruptions.
I summarize the major arguments Dr Barty makes in my blog.

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At HRS12, this data was presented. Abstract says: Piacenza, Italy has recorded 2,730 OOH-CAs in 12 years. Mean age of was 73.6 +/- 14.8 years and men represented 59.5%. OOH-CA was treated by EMS in 2668 and by Progetto Vita in 62. The 12 year all cause survival rate is 4% when OOH-CA is treated by EMS and 34% when treated by PV, log rank p<0.001. Independent predictors of survival were age (p=0.008) and Progetto Vita intervention (p=0.034). Age was related to shorter survival by every year of age by 6% (95% CI: 1-10%). Progetto Vita was protective with HR = 0.62 (95% CI: 0.39-0.95). There were no differences in survival when adjusted for location of arrest, intervention time and the presence of a shockable rhythm at first ECG. Limitations of this study include the small numbers treated by Progetto Vita and non-randomized populations. Conclusions: Long-term survival is better for OOH-CA when only an AED is used, and CPR is avoided, compared to the traditional EMS response. It is time for a randomized trial of CPR vs. No-CPR.

(www.hrsonline.org/content/.../1/.../2012LBCT_Saturday.pdf )

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Patients in Cardiac Arrest Report Conscious Awareness

Patients in Cardiac Arrest Report Conscious Awareness | Heart and Vascular Health | Scoop.it
Nearly 40% of 140 cardiac arrest survivors claimed memories from when they were in cardiac arrest.

Awareness during anesthesia has been well described, but what about during cardiac arrest? Researchers performed a 4-year multicenter observational study involving a qualitative and quantitative interview of 140 post-cardiac arrest patients in the hospital (52) and after discharge (90).

Overall, 39% of patients believed they had memories from the time they were in cardiac arrest. Using a validated near-death-experience scale, 9% of patients reported such experiences, but only two patients claimed explicit recall of actual events related to their resuscitations. No other patient had memories related to any medical procedure, pain, or experience.

Seth Bilazarian, MD's insight:

Comments by Dr. Kristi Koenig - This is the first study to quantify awareness during cardiac arrest. This study's results might be biased, because there was no consistency in the timing of interviews, and some patients did not complete the interview. Whether these memories “formed” during arrest or later or represent some other psychological phenomenon is not known. Nevertheless, the bottom line is to be careful what you say during resuscitations — you never know if patients can hear you! 

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What's CPR? Should I allow it? Advance Care Planning Decisions

What's CPR? Should I allow it? Advance Care Planning Decisions | Heart and Vascular Health | Scoop.it

A series of videos designed to educate and empower patients about advance care planning and their choices for medical care. Video decision tools effectively communicate and inform patients about their options for care. 

These videos are designed to shed light on the reality of aggressive end-of-life treatments, which are often portrayed on television as being more successful than they are.

Seth Bilazarian, MD's insight:

This is a well done video about CPR and can help patients make advance planning decsions.  The video does a good job introducing this complex subject and might help stuimulate a conversation between patients & their physicians . Many of my pateints choose a DNR (Do Not Recussitae) status because they believe that this will prevent the use of indefinite duration of life support if their medical circumstances are futile. These decisions are about whethtr tyo start these efforts not about when to stop them.

 

Most physicians and hospitals have a policy to NOT offer immediate, potentuially life saving angioplasty in the setting of a heart attack to patietns who have chosen to be DNR.  See my blog http://www.theheart.org/columns/private-practice/treating-the-acute-mi-patient-with-stemi-and-labeled-dnr.do

 

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Compression Only CPR - British Style

Compression Only CPR - British Style | Heart and Vascular Health | Scoop.it
Our vision is of a world in which people do not die prematurely of heart disease. We'll achieve this through pioneering research, vital prevention activity a...
Seth Bilazarian, MD's insight:

The British Heart Foundation twist on hands only CPR to the tune of their own Bee Gees singing Staying Alive.

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Anyone Can Save A Life

Anyone Can Save A Life | Heart and Vascular Health | Scoop.it

Anyone Can Save A Life is a first-of-its-kind emergency response program for after-school practices and events.

 

Key Take Away: My community has done a great job acquiring Automatic External Defibrillators (AED) for schools, churches and public places.  HOWEVER, these devices will not be life saving unless people know where the nearest AED is and how to use it.  This is a great program to get schools to create confident and rapid use in the setting of Sudden Cardiac Arrest (SCA).  By implementing Anyone Can Save A Life, the school community is ‘heart safe’–equipped and prepared to respond to life-threatening emergencies that may take place during after-school athletic and activity practices and events.

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