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Wasatch EMS Report Febuary 2011

Modern Medicine is the “Religion” that Changes Daily

A community member approached me a few weeks ago. She was concerned about the CPR she saw performed on her neighbor. She thought it “looked different” than what she expected. I spent a great deal of time helping her understand what she saw, the reasons behind why we do what we do, and why it is always changing. Although driven by a sad situation, I think this is a great opportunity to generate something positive and help clarify CPR and why things in medicine seem to change all the time.

The practice of medicine changes daily. We would think that something as amazing as modern medicine and the miracles it can perform would be nearing complete; yet research drives us forward all the time. Many involved in health care treat it as a “religion “-some believe that it has all of the answers, but the research drives change all of the time. In healthcare, what we thought we knew yesterday is different than what we know today.

The medicine surrounding cardiac arrest is no different. At the end of 2010, the American Heart Association changed the rules for Advanced Cardiac Life Support (ACLS). After decades of research, it became clear that the steps we take to manage cardiac arrest patients needed to start with more blood flow to the brain. A person’s brain begins to die about 4 minutes after blood flow stops. The chance of death increases 10% each minute after cardiac arrest. When this happens, we don’t have much time to save someone. Consequently, starting the chest compressions portion of CPR immediately after realizing a patient is in cardiac arrest is the most important part of CPR. In other words, a person trained in CPR needs to begin chest compressions as soon as possible in order to even grant a chance of recovery to the patient.

Although it would be ideal if every patient needing CPR would survive, like on TV, we know that is not reality. Even though the heart is an amazing organ; it will continue to beat even after many other organs fail. It takes a great deal of illness or injury to stop a heart. But if the heart does stop, the body is in a critical situation; one that is really difficult to survive. Modern medicine often cannot save people suffering from cardiac arrest; however, beginning chest compressions immediately is the best way to try.

Two lessons became more apparent from my discussion with the concerned citizen. The first is that “bystander CPR” can be lifesaving, and it is really our only hope in that situation. In order for our loved ones and neighbors to have the best possible chance at survival during cardiac arrest, we need to know how to help them. We, as a community, need to learn CPR. Again, the faster the patient gets blood to flow from the heart to the brain through compressions, the better their chances of survival. Courses are taught through various agencies, including our own ambulance/ EMS services. There are even iPhone apps that can assist in CPR as a reference (see PocketCPR by Bio-Detek, Inc). Although these apps DO NOT SUBSTITUTE for CPR training, anything can help in an emergency.

Some members of our community have begun the process of helping EMS in the endeavor of bystander CPR by getting trained as first responders. The residents of Timberlakes are a shining example of a group who are working diligently to improve the care of their part of this great county.

The second lesson may not be as easy. We need to help identify the causes of cardiac arrest before it happens. Seeing your primary doctor for health checkups is vitally important. All members of this community need to know their health status and there is no better way than to see your doctor. If you have a chronic illness, like diabetes, or family histories of certain disease processes, discuss risks and complications of the conditions with your doctor. Prevention is better than reaction. If you are on a medication, take it only as prescribed.

As always, Wasatch EMS crews are ready to answer the call for emergencies in this county. We merely want to have more members of our community trained in CPR. By doing this, we as citizens of this county will assist in critical situations such as when a friend, loved one, neighbor or visitor experiences a cardiac arrest.

Please, be safe and aware.

BY KRIS KEMP, MD   02/08/2011

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