February 15, 2009
BehindTheMedspeak: Not gasping but dying — Don't delay CPR during a heart attack
Long story short: When a person having a heart attack starts gasping for air, don't wait for them to stop but instead immediately begin CPR.
Here's Eric Nagourney's January 6, 2009 New York Times Science section story on a recent report in the journal Circulation.
Gasping Misunderstood in Heart Attacks
When a heart attack victim gasps for air, bystanders often take it as a sign that they do not need to start giving CPR. But a new study reports that the people who gasp are more likely to survive — especially if they are given chest compressions right away.
Writing in the December 9 issue of Circulation, researchers said health professions needed to do a better job of educating people about the significance of gasping. The study was led by Dr. Bentley J. Bobrow of the Mayo Clinic in Arizona.
There has been some debate about the likelihood of gasping in heart attacks and what it means. Some bystanders who know how to do cardiopulmonary resuscitation do not do so because they do not associate gasping with a heart attack, the study says.
Others realize a heart attack has taken place but think that the gasping means there is no need to begin resuscitation right away. Even emergency medical workers make these mistakes, the study said.
But when the researchers reviewed 1,200 cardiac arrest cases that occurred outside the hospital, they found that the patients were gasping about a third of the time. And as the minutes went by, the gasping went away, as did the chances of saving the patient.
The study found that among those patients given CPR, the survival rate was 39 percent for those who gasped. For those who did not gasp, it was 9 percent. Gaspers did better than nongaspers even when CPR was not given.
Here's the abstract of the scientific paper, published online November 24, 2008 in Circulation.
Gasping During Cardiac Arrest in Humans Is Frequent and Associated With Improved Survival
Background: The incidence and significance of gasping after cardiac arrest in humans are controversial.
Methods and Results: Two approaches were used. The first was a retrospective analysis of consecutive confirmed out-of-hospital cardiac arrests from the Phoenix Fire Department Regional Dispatch Center text files to determine the presence of gasping soon after collapse. The second was a retrospective analysis of 1218 patients with out-of-hospital cardiac arrests in Arizona documented by emergency medical system (EMS) first-care reports to determine the incidence of gasping after arrest in relation to the various EMS arrival times. The primary outcome measure was survival to hospital discharge. An analysis of the Phoenix Fire Department Regional Dispatch Center records of witnessed and unwitnessed out-of-hospital cardiac arrests with attempted resuscitation found that 44 of 113 (39%) of all arrested patients had gasping. An analysis of 1218 EMS-attended, witnessed, out-of-hospital cardiac arrests demonstrated that the presence or absence of gasping correlated with EMS arrival time. Gasping was present in 39 of 119 patients (33%) who arrested after EMS arrival, in 73 of 363 (20%) when EMS arrival was <7 minutes, in 50 of 360 (14%) when EMS arrival time was 7 to 9 minutes, and in 25 of 338 (7%) when EMS arrival time was >9 minutes. Survival to hospital discharge occurred in 54 of 191 patients (28%) who gasped and in 80 of 1027 (8%) who did not (adjusted odds ratio, 3.4; 95% confidence interval, 2.2 to 5.2). Among the 481 patients who received bystander cardiopulmonary resuscitation, survival to hospital discharge occurred among 30 of 77 patients who gasped (39%) versus only 38 of 404 among those who did not gasp (9%) (adjusted odds ratio, 5.1; 95% confidence interval, 2.7 to 9.4).
Conclusions: Gasping or abnormal breathing is common after cardiac arrest but decreases rapidly with time. Gasping is associated with increased survival. These results suggest that the recognition and importance of gasping should be taught to bystanders and emergency medical dispatchers so as not to dissuade them from initiating prompt resuscitation efforts when appropriate.
Keeps your chips whole — through thick or thin.
Hey, that's pretty clever... who wrote it?
No one here, that's for sure.
Grown-ups can unscrew the two halves
to clean it between courses.
Bizarro World Hack: How to turn your iPhone into an iPod touch
I mean, why would anyone in the real world want to do that?
Well, guess what?
Someone asked Rob Pegoraro, the Washington Post's excellent Personal Technology columnist, that very question (no, silly — not why you'd want to, but how to do it) and he was so taken with the query he led off today's "Fast Forward's Help File" feature with it.
The exchange follows.
Q. I'm taking my iPhone on an international trip and don't want to get hit with any roaming charges. How can I shut off the phone but keep WiFi on?
A. This is a good idea, considering voice calling can run well over a dollar a minute overseas — even for calls that you let go straight to voice mail. International data access is still more expensive, and AT&T Wireless's "Data Global" add-ons — starting at $24.99 a month for 20 megabytes — are no bargain either.
Fortunately, the iPhone's software blocks data usage on non-AT&T networks. To verify that yours still has this setting, tap the Settings application's General heading and then its Network heading; on that screen, the "Data Roaming" switch should be off.
To block voice calls too, the simplest remedy is to remove your iPhone's SIM (subscriber identity module) card. Take one end of a small paper clip and poke it into the small hole next to the headphone jack, and a plastic carriage holding this small card in place will pop out. Tuck the card away where you won't lose it, and your iPhone will only be able to speak WiFi.
Third Eye [Not Blind] Video Camera
"Smaller than a golf ball" (how'd they know I'm microcephalic? But I digress) begins the copy for this stylish new entrant into the wearable videocam space.
Don this puppy and the music you'll be hearing will take you wayyyyy back.
From the website:
Third Eye Video Camera
Smaller than a golf ball, this ultralight spherical video camera attaches to a headband, providing a third eye while biking, hiking, or during other activities.
The rechargeable battery provides up to 2 1/2 hours of continuous operation from an eight-hour charge using the included USB cable.
The camera can also be set to record images and video when it detects movement, preserving battery life. Includes headband.
The camera's sensor captures images at 320 x 240 resolution at 30 fps (the built-in microphone records audio).
Up to 1,200 still images and six hours of video can be saved onto the included 8GB micro SD memory card.
Images and video are downloaded to your PC via USB cable (requires PC running Windows with USB 2.0).
It can also be connected to a TV for viewing images and video using the included cable.
Say 'Hi' to Alberto Arroyo, 'Mayor of Central Park' — And wish him 'Happy Birthday' (he's 93 today)
Colleen Ambrose, a New York City jogger who met Arroyo 15 years ago, plans to celebrate by pushing him around the Central Park Reservoir track (he had a stroke last August which disabled him) with a balloon tied to his wheelchair.
"Afterwards, he expects to spend a couple of hours greeting well-wishers at the South Gate House," wrote Charles Wilson in today's New York Times Sports section; the article follows.
The caption for the photo up top: "Alberto Arroyo, who will be 93 on Sunday, had a stroke in August. Central Park joggers joined forces, and take him to a park in his wheelchair."
Above, Arroyo at the reservoir in 2005.
From the website:
The versatile Convert-A-Bench is designed to let you flip the seat to create a strong 29"-high table.
Put two together to create a full-size picnic table with room for six adults.
Made of all-weather maintenance-free resin
and vinyl that never needs painting.
Great for the patio, deck, by the pool, in the yard or even indoors.
Features durable arm rests and legs, assembly hardware, and measures 58" long, with 15"-wide seat and 15"-high seat back.
Helpful Hints from joeeze — Printer paper hacks
Last night in my hotel room, while I watched my printer's paper supply dwindle as it spit out endless pages of some article, I scolded myself for not bringing an extra pack of paper.
I mean, I remembered to bring extra ink cartridges, so what's so hard about throwing in some paper as well?
I realized that the article was gonna need more paper than was in the tray, and found myself trying to solve the problem with what was in the room.
I espied a yellow legal pad and tore off a few sheets, then inserted them in the paper tray behind the regular paper: voila, the printer printed on them without a hiccup — and the text is even easier to read than on the regular white paper.
I tore off a few more sheets and got the whole article without having to wait until this morning to get more paper.
So that's hack #1.
#2 is to go down to a hotel's business center and remove paper from their printer for your own use.
I just did that.
Hack #3 is to use the reverse side of paper/documents you already have – assuming you don't have to do anything official with them.
Sure, all this is obvious — but maybe not so much so when you're exhausted or disoriented by time zone changes and whatnot.
A lot of technology for $3.25.
From the website:
Swivel lights can be pointed in any direction to illuminate a hallway, top step, doorway or any area needing extra “spot” lighting.
Light swivels a full 360 degrees so you can aim the beam exactly where you want.
Automatically turns on when room darkens and turns off when no longer needed.
Super-bright LED light means no bulbs to replace.
Plug into any outlet.
Four for $12.98.