Dangerous CPR
The New York Times is reporting that emergency medical techs may sometimes worsen heart attack victims' chances by administering CPR too quickly. Apparently, an awful lot of them do this, because adminsitering more than one breath every five seconds actually lowers the chances of recovery.
CPR....interesting:
CPR has become a bureauracy unto itself. The protocols change year to year to year. I have personally taken at least 15 such CPR courses.
Every year they keep changing the process. Its not that new research doesn't mandate new ideas but that CPR has become something seemingly magical that requires continuous education. Is this a good thing. Yes, if it saves lives. Whether the person is having a heart attack or no, CPR is constrained to fast action.
My prediction: One day every student will learn CPR in high school or before.
Its actually quite simple.
Oops,
The key line in the NY Times article is:
"What we aim for is a Goldilocks approach," i.e. that every resuscitator will give the appropriate number of breathes per minute."
Hello, Dr. Lady, the patient is bloody dying of a flipping heart attack....Oxygen helps..Okay ?
Out-of hospital CPR for heart attacks is usually ineffective, which is evident even in this study where they point out that all the patients died. To say it's somehow related to the fact that the paramedics administered too many breaths is a joke. It's like saying the Titanic sank because the crewmen didn't bail fast enough.
CPR is good for drowning victims, and the airway management part is great for choking victims, but for heart attacks the key is defibrillation ASAP. Those units are getting smaller and cheaper, and they're almost foolproof. Honestly, the authors of this study should have taken the money it took to do this and scattered a few more AED's around the mall.
Bottom line- if you have a heart attack at home and lose your pulse, you're toast unless you're defibrillated and a pulse is restored in less than five to ten minutes. Even if you make it to the hospital, there's a good chance you'll have significant brain damage as a result. CPR without a defibrillator is better than nothing, but not by much.
Now, having said that, my father-in-law had an MI at the ripe old age of 54, at the Dallas-Ft. Worth Airport. Dropped right in front of the ticket counter. However, the airport has its own paramedics and an AED. Furthermore, there was an anesthesiologist behind him in the line who always happened to carry intubation equipment around, just in case!!!! He was defibrillated and intubated in less than three minutes and is back to his usual self. Doesn't even realize how close he got to the Pearly Gates- or maybe doesn't want to talk about it.
I do not disagree that delivering ventilations too rapidly is not as effective. However, I don't think they should have published an article in the New York Times after studying only one department with only 13 patients.
I also think that someone will be making a killing (no pun intended) off a device that emits a beep every five seconds. ;)
I had too long an opinion on this article, so I just wrote it up as an entry:
http://www.seadoc.net/sd/archives/individual/2004/04/20040406-cpr_taking_a_deadly_turn.php