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August 15, 2017

BehindTheMedspeak: Some CPR is better than no CPR

Ekg brugada

It wasn't all that long ago that the American Heart Association (AHA) — as a rule late to the evidence-based medical party — finally came around to what anesthesiologists have known for years: no one can perform effective rescue breathing.

The organization's current CPR guidelines are dramatically different from those that prevailed for many years.

Among the biggest changes is the recognition that mouth–to–mouth breathing during CPR is now optional.

When I posted here to that effect 12 years ago I got all kinds of flak from both professionals and laypeople saying I was flat-out wrong.

Guess not.

As Dr. Robert O'Connor of Christiana Care Health System in Newark, New Jersey, one of the authors of the guidelines, told USA Today, "Some CPR is better than no CPR."

O'Connor went on to note that "until emergency medical responders arrive, chest compressions alone can often be just as effective in saving a life."

Note: proper chest compressions — strong and powerful, at a rate of 100/minute — cannot be continued for more than a minute or two by a single individual without some loss of effectiveness.

Good CPR will make you sweat and tire you out after that amount of time — trust me, I've been there and done that many, many times.

In the meantime, while you're resting and taking a break, increase venous return — and the likelihood of CPR being successful — by simply picking up the unconscious person's feet and holding them about two or three feet above the ground.

This will provide an autotransfusion of about two units of blood to the central circulation and heart, increasing perfusion and the likelihood of recovery without permanent brain damage.

No, it may not help — but it will not hurt.

Primum non nocere, remember, is what we're all about here.

August 15, 2017 at 12:01 PM | Permalink | Comments (4)

"The Big Snit"

Richard Condie's Oscar-nominated 1985 short film.

August 15, 2017 at 10:01 AM | Permalink | Comments (1)

Crescent Moon Earrings


Noor Fares's signature 18-karat-gold earrings in the shape of crescent moons, with vivid gemstones: diamond, pearl, ruby, carnelian, emerald, citrine, lapis lazuli, cat's eye, sapphire.

"It's a nod to Nirvana," said Fares. "The nine sacred gemstones cited within Hindu astrology that each correspond to a planet and are believed to absorb and transmit energy."


August 15, 2017 at 08:01 AM | Permalink | Comments (0)

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