Do you have adblock enabled?
If you can read this, either the style sheet didn't load or you have an older browser that doesn't support style sheets. Try clearing your browser cache and refreshing the page.

(USA Today)   Dozens of people perform CPR for over an hour and a half. Recipient survives, mentally intact, and thanks them   (yourlife.usatoday.com) divider line 163
    More: Hero  
•       •       •

18083 clicks; posted to Main » on 03 Mar 2011 at 9:02 PM (4 years ago)   |  Favorite    |   share:  Share on Twitter share via Email Share on Facebook   more»



163 Comments   (+0 »)
   

Archived thread

First | « | 1 | 2 | 3 | 4 | » | Last | Show all
 
X15
2011-03-03 11:38:00 PM  

feckingmorons: You don't have to provide any credentials, this is Fark, but I'll still opine that you don't have a clue.

I'll call the guy in the article and tell him amiodarone didn't work and he needs to report for his dirt nap.


You still have yet to tell me how the AHA is wrong in finding that amiodarone doesn't actually help with survival to hospital discharge.
 
X15
2011-03-03 11:41:08 PM  

rga184: MasterPython: Last time I took first aid they basically said that unless the person drowned and you got to them immediately all you were doing is keeping the organs good for transplant. One time they had a video that said give up after an hour because if it does not work by then it never will.

this guy was an anomaly. they were able to get a breathing tube and IV in him right away to start ACLS. if they hadn't done that, he probably wouldn't have survived.


...

*sigh*
 
2011-03-03 11:43:00 PM  
Good story, these people did the right thing, one thing I don't understand is where were the paramedics? Why did it take an air abulance 96 minutes to travel 35 miles?
 
2011-03-03 11:43:18 PM  

Deedeemarz: Just a cool note about Amiodarone. Some people who take it long term turn blue. Smurf blue. It is really disturbing to see....and it doesn't go away when they quit taking it either.


Ack.

archderm.ama-assn.org
 
2011-03-03 11:46:42 PM  

X15: ...

*sigh*


are you disputing something here?
 
2011-03-03 11:49:45 PM  

X15: feckingmorons: You don't have to provide any credentials, this is Fark, but I'll still opine that you don't have a clue.

I'll call the guy in the article and tell him amiodarone didn't work and he needs to report for his dirt nap.

You still have yet to tell me how the AHA is wrong in finding that amiodarone doesn't actually help with survival to hospital discharge.


Did you read the article, it apparently does.

You do realize the AHA changes it recommendations as the science changes. Heck when I first became a nurse PEA was called EMD!

You could check the literature for yourself for things like:

Altogether more than 434 papers were found using the reported search, from which 23 articles were used to answer the clinical question. No randomized trials have been found in which amiodarone was studied in patients with refractory VF/VT after cardiac surgery. Recommendations on the use of amiodarone in patients with refractory VF/VT in both European and American 2005 Guidelines on Resuscitation are mainly based on expert consensus and are supported by a few randomized trials in patients with out-of-hospital cardiac arrest. We would therefore recommend that amiodarone is the first line drug that should be used in patients with refractory ventricular arrhythmias
Leeuwenburgh BP et al, Interact Cardiovasc Thorac Surg. 2008 Dec;7(6):1148-51. Epub 2008 Sep 16.

Or
Amiodarone has emerged as the leading antiarrhythmic therapy for termination and prevention of ventricular arrhythmia in different clinical settings because of its proven efficacy and safety. In patients with shock refractory out-of-hospital cardiac arrest and hemodynamically destabilizing ventricular arrhythmia, amiodarone is the most effective drug available to assist in resuscitation.


Van Herendael H, Dorian P. Amiodarone for the treatment and prevention of ventricular fibrillation and ventricular tachycardia. Vasc Health Risk Manag. 2010 Aug 9;6:465-72.

Or perhaps
However, only amiodarone is today the drug of choice in VTA pts and also highly effective even in pts with defibrillation-resistant out-of-hospital cardiac arrest (CA). There is a general agreement that bystander first aid, defibrillation and advanced life support is essential for neurologic outcome in pts after cardiac arrest due to VTA.
Trappe HJ. Treating critical supraventricular and ventricular arrhythmias. J Emerg Trauma Shock. 2010 Apr;3(2):143-52.

I don't just pull this stuff from my arse, I actually do know what I am talking about.
 
2011-03-03 11:53:44 PM  

Type40: Good story, these people did the right thing, one thing I don't understand is where were the paramedics? Why did it take an air abulance 96 minutes to travel 35 miles?


[Repeat of disclaimer: I'm not a doctor, paramedic, etc., and this stuff I'm less sure of than what I was writing about before. This is all my understanding, so take it with a grain of salt.]

It didn't!

It's rarely the case for a non-trauma case that they'll get on-scene, dump the guy on a stretcher, dump the stretcher in their ambulance, and go. Instead, I'm pretty sure it's virtually always protocol for the paramedics to resuscitate on-scene. It's way easier to do that while sitting on solid ground than in the back of an ambulance and the decrease in resuscitation efficacy isn't worth it because I think there's very little that the ER could do that the paramedic crew can't. (Unless they, you know, run out of meds.) Way better to get the heart beating then go.

Probably the air ambulance got there after 20 minutes or something and the flight crew spent the next hour helping with the resuscitation.
 
2011-03-03 11:58:24 PM  
Can we not argue about ACLS algorithms any more? (new window)

I know that doctors are all mean, evil, thought-controlling douchebags who sacrificed between 7 and 11 years of their life so they might have a rudimentary understanding of how to give money to insurance companies and hospital administrators while being expected to work more hours than is legal, but amio is a drug which has known physical effects on heart cells. You might similarly find little randomized controlled trial evidence for the use of epinephrine (adrenalin for our friends across the pond) in anaphylaxis, so I guess we should stop using that, too.
 
X15
2011-03-04 12:03:12 AM  

feckingmorons: You do realize the AHA changes it recommendations as the science changes.


So again, tell me why the November 2010 AHA ACLS Guidelines state that there's no empirical evidence that amiodarone leads to a higher rate of survival to hospital discharge.
 
2011-03-04 12:03:24 AM  
Oh, I just thought of a question for you folks who actually do this for real:

When using an AED, while it is analyzing the rhythm, you have to stop CPR because if the patient moves it disturbs the reading. Is this true of manual defibrillators too?

If it isn't true (and a manual defibrillator can read a rhythm while CPR is in progress), do you know why an AED can't?
 
X15
2011-03-04 12:09:10 AM  

rga184: X15: ...

*sigh*

are you disputing something here?


I have to go to bed, but yes.

There's no evidence that ACLS does anything at all for cardiac arrests, none. Only expert opinion.
 
2011-03-04 12:09:46 AM  
One of the better uses of the Hero tag here of late.
 
2011-03-04 12:10:40 AM  

X15: feckingmorons: You do realize the AHA changes it recommendations as the science changes.

So again, tell me why the November 2010 AHA ACLS Guidelines state that there's no empirical evidence that amiodarone leads to a higher rate of survival to hospital discharge.


You're right it does not. I was completely wrong. I'll call the guy first thing in the morning and tell him he needs to pick out a casket because some guy on the internet who thinks he is Marcus Welby said he should be dead.

You know the AHA guidelines are not a law right. Heck you can even use medications off label, I once took an aspirin for chest pain in 1984.

Lawyers and doctors, if you ever need on Fark has plenty of people with their GED in Law and Medicine.
 
2011-03-04 12:11:44 AM  

X15: rga184: X15: ...

*sigh*

are you disputing something here?

I have to go to bed, but yes.

There's no evidence that ACLS does anything at all for cardiac arrests, none. Only expert opinion.


You are really out there. I hope nobody actually lets you touch live patients.
 
2011-03-04 12:13:43 AM  
I ain't no doctor but I would venture the theory that the freezing temperatures probably played a big role in his survival. I've been reading about how lately lowering body temperature following a heart attack or whatnot can significantly increase your survival rate by preserving vital tissues before too much damage is done.
 
2011-03-04 12:15:08 AM  

evaned: Oh, I just thought of a question for you folks who actually do this for real:

When using an AED, while it is analyzing the rhythm, you have to stop CPR because if the patient moves it disturbs the reading. Is this true of manual defibrillators too?

If it isn't true (and a manual defibrillator can read a rhythm while CPR is in progress), do you know why an AED can't?



Hmm, that is an interesting question. While doing CPR someone who can read a monitor can see the rhythm and see the underlying rhythm even with the artifact produced by CPR. You occasionally do stop to check a pulse and look at the monitor for 5 or 10 seconds, or if you have just given a drug and expect a change.

So a manual defibrillator does not actually read the rhythm a person does and we can interpret through that artifact.

That and every few minutes you switch who is doing compressions so you get a few seconds without compressions anyway.
 
2011-03-04 12:16:16 AM  

SmitetheRighteous: I ain't no doctor but I would venture the theory that the freezing temperatures probably played a big role in his survival. I've been reading about how lately lowering body temperature following a heart attack or whatnot can significantly increase your survival rate by preserving vital tissues before too much damage is done.


"Clinical hypothermia". Crazy stuff.
 
2011-03-04 12:18:15 AM  

evaned: Oh, I just thought of a question for you folks who actually do this for real:

When using an AED, while it is analyzing the rhythm, you have to stop CPR because if the patient moves it disturbs the reading. Is this true of manual defibrillators too?

If it isn't true (and a manual defibrillator can read a rhythm while CPR is in progress), do you know why an AED can't?


A manual defibrillator is two things, an EKG and a defibrillator. A trained professional (MD or EMT-P) reads the rhythm and decides whether it is a shockable rhythm or not. If it is shockable, they then manually set the machine to administer the appropriate dose of electricity in the appropriate manner. An EKG will give you funny readings if the patient is being moved, so in ACLS algorithms there is a built-in 'rhythm check' where CPR is briefly and temporarily stopped so the team leader can check the rhythm.
 
2011-03-04 12:20:52 AM  
Lets rename this town:
www.jimpoz.com
 
2011-03-04 12:21:26 AM  

feckingmorons: Hmm, that is an interesting question. While doing CPR someone who can read a monitor can see the rhythm and see the underlying rhythm even with the artifact produced by CPR. You occasionally do stop to check a pulse and look at the monitor for 5 or 10 seconds, or if you have just given a drug and expect a change.


OK, so it's partly a matter of "the AED's algorithms aren't good enough yet" as opposed to something with the hookups or something like that. It'll be interesting to see how long it takes for Zoll or whoever to come out with an AED that doesn't have that limitation; I can't imagine that something like that isn't not too far down the road.
 
2011-03-04 12:27:46 AM  
This article was written to get people used to Obamacare, because you will have to rely on your fellow citizens for healthcare.
 
2011-03-04 12:30:31 AM  

evaned: feckingmorons: Hmm, that is an interesting question. While doing CPR someone who can read a monitor can see the rhythm and see the underlying rhythm even with the artifact produced by CPR. You occasionally do stop to check a pulse and look at the monitor for 5 or 10 seconds, or if you have just given a drug and expect a change.

OK, so it's partly a matter of "the AED's algorithms aren't good enough yet" as opposed to something with the hookups or something like that. It'll be interesting to see how long it takes for Zoll or whoever to come out with an AED that doesn't have that limitation; I can't imagine that something like that isn't not too far down the road.


I'm not touching one while it is thinking about zapping someone, no thank you. I'll be over here with my hands in my lap until it is done.

Live better electrically.
 
2011-03-04 12:39:41 AM  

feckingmorons: I'm not touching one while it is thinking about zapping someone, no thank you. I'll be over here with my hands in my lap until it is done.


Dude, just 'cause it's thinking about it doesn't mean it has to do it yet. ;-)

I'm sure you'd still need to hit the little button to actually deliver it, and you'd have time after it goes "shock advised" before you could even do that.

Heck, if I were working on someone I'd be tempted to continue CPR during the brief window when it's charging. I don't think I actually would, especially for a stranger, but I'd be tempted to.
 
2011-03-04 12:55:38 AM  
Fark: the entire town is now infected with hepatitis B.
 
2011-03-04 12:56:54 AM  
He asked Goodman: "Why didn't you stop?"

It's a question, Goodman says, that he still doesn't have a good answer for.


Anyone who has been trained in CPR learns the same thing: once you start CPR, you don't stop. No matter how long it's been, you keep going until either the paramedics show up to take over, or you are physically unable to continue. Clearly, this was a lesson the people of Goodhue took to heart (forgive the pun). I've heard it said that the "best" place to have a heart attack is the floor of the Bellagio, but clearly for this man it was on the sidewalk in Goodhue.

If there is any being out there capable of bestowing blessings, let it bless the good people of Goodhue, Minnesota.
 
2011-03-04 01:01:04 AM  
Go and learn how to do CPR properly.

All of you reading this, go!

Then one day, you too might be part of saving somebodies life, instead of standing by watching them die.
 
2011-03-04 01:01:19 AM  

Begoggle: This article was written to get people used to Obamacare, because you will have to rely on your fellow citizens for healthcare.


I was going to comment on how nice this story is compared to the crap I see in the Politics tab every day, and how it made my day that there are people that will do their damndest to save others.

And then you came along.

I hope you're happy.

/these guys are still heroes and I still have the warm fuzzies
//I hope I never have to do CPR
 
2011-03-04 01:26:00 AM  
FTA: What makes the incident even more striking was that it took place in rural Goodhue, pop. about 900, a town without a traffic light.

Why is this striking?
 
2011-03-04 01:40:19 AM  
As a Paramedic, and not reading the rest of the comments...



MasterPython 2011-03-03 09:30:20 PM
Great Justice: Honestly, don't they have a portable machine for this yet? I see those defibrillators in a lot of places, why can't we build an automatic air mask combined with a chest compressor band, and have them available for emergencies?


could be comming soon.Link (new window)


I had the opportunity to be in a test study for this thing.

In my humble opinion and the rest of my co-workers...

IT IS A PIECE OF CRAP!!!

Too heavy, batteries run out, and the opinion of the AHA is that it (and other machines) are not as effective as chest compressions.

By the way, the testing was cancelled early because of the above and the company that made it blamed the Medics.
 
2011-03-04 01:44:31 AM  

feckingmorons: Great Justice: Honestly, don't they have a portable machine for this yet? I see those defibrillators in a lot of places, why can't we build an automatic air mask combined with a chest compressor band, and have them available for emergencies?

It is called a thumper, they exist and many ambulances have them. They are not as easy to use as a defibrillator as they have to be connected to oxygen, the patient has to be intubated, and it really takes 2 people to put the patient on the thumper but once the patient is on the thumper it requires only one person to attend the patient. They are not inexpensive and they require more training than an automatic defibrillator.


We have LUCAS here. Lightweight, easily portable, no requirements of being intubated, and as easy to operate as a lifepak.
 
2011-03-04 02:05:59 AM  
Dammit, it's dusty in here.
 
2011-03-04 02:28:43 AM  

jingks: FTA: What makes the incident even more striking was that it took place in rural Goodhue, pop. about 900, a town without a traffic light.

Why is this striking?


Maybe that there were that many people at the scene qualified to perform CPR
 
2011-03-04 03:31:10 AM  

MasterPython: Great Justice: Honestly, don't they have a portable machine for this yet? I see those defibrillators in a lot of places, why can't we build an automatic air mask combined with a chest compressor band, and have them available for emergencies?

could be comming soon.Link (new window)


There are already devices like this available, but they are increadibly expensive, they are difficult to use and take a long time to put on, the battery life sucks, and most of them are one-time-use. Look up the Zoll Auto-Pulse.
 
2011-03-04 03:54:41 AM  

Kesherz: Great Justice: Honestly, don't they have a portable machine for this yet? I see those defibrillators in a lot of places, why can't we build an automatic air mask combined with a chest compressor band, and have them available for emergencies?

A machine for this would be incredibly cumbersome. Now, for respirations, you can use an ambu bag. But a compressor band won't work. First off, have you seen the size of most people nowadays? Just getting the band on someone would take too long. Or, potentially crush the first responders if you roll the patient over too far. :P

Just from my own experience... damn, this guy was lucky. Not only to have so many CPR trained people around at the time, but being that close to Mayo Clinic.

And, for reference, amiodarone is typically administered as a drip, not an injection. These folks were pulling every trick in the book to get his hard re-started, and they're lucky they were able to get him ambu-bagged and then intubated so quickly. That alone saved his brain.

Most folks I see come to my ER... well, aren't so lucky. It's a rural area, so they've usually been down a long time before the ambulance even gets to them, making our efforts basically for naught. Once in a while though, we (and the patient) get lucky.


In ACLS amiodarone is given as an IV injection for pulseless arrest. The first dose is 300mg and the second is 150mg. Where they deviated from this is when they called the cardiologist and got permission to double the second dose.
 
2011-03-04 04:09:44 AM  

evaned: feckingmorons: I'm not touching one while it is thinking about zapping someone, no thank you. I'll be over here with my hands in my lap until it is done.

Dude, just 'cause it's thinking about it doesn't mean it has to do it yet. ;-)

I'm sure you'd still need to hit the little button to actually deliver it, and you'd have time after it goes "shock advised" before you could even do that.

Heck, if I were working on someone I'd be tempted to continue CPR during the brief window when it's charging. I don't think I actually would, especially for a stranger, but I'd be tempted to.


We were actually taught in my paramedic class to do this. It takes way too long to do the rhythm check, charge, shock, and resume compressions, so we were taught to do compressions while charging, then stop when the defibrillator operator says "clear," then immediately back on the chest as soon as the shock is given.
 
2011-03-04 06:17:50 AM  

Notabunny: Thank you, subby.

I've had a pretty crapass day, and that made me smile.

Here, this is for you.


can't drink :(

/pituitary hematoma
 
2011-03-04 07:19:51 AM  

Raptor Jesus: VvonderJesus: I hope I never have to perform CPR, but it's better to know it and not need it, than need it and not know it.

As someone who has, on someone I loved, let me tell you it's one of the most heartbreaking and difficult things you may ever have to do.

/I love you, Shayna. I miss you baby.


Ouch, dude. Your post made my heart hurt more than reading TFA. I'm so, so sorry. That must have been awful.
 
X15
2011-03-04 07:50:16 AM  

feckingmorons: X15: feckingmorons: You do realize the AHA changes it recommendations as the science changes.

So again, tell me why the November 2010 AHA ACLS Guidelines state that there's no empirical evidence that amiodarone leads to a higher rate of survival to hospital discharge.

You're right it does not. I was completely wrong. I'll call the guy first thing in the morning and tell him he needs to pick out a casket because some guy on the internet who thinks he is Marcus Welby said he should be dead.


One case where it is reported that a dose of amiodarone works, after the patient had already been pumped full of a cocktail of other drugs, and been shocked a bunch of times does not trump empirical studies.

Repeat after me:

Correlation does not equal causation
Correlation does not equal causation
Correlation does not equal causation
 
2011-03-04 07:57:20 AM  
It's nice to hear a story where people know what they are doing, and it all works out well in the end, despite the odds.

Thanks Subby.
 
2011-03-04 08:03:42 AM  
And the guy sues for broken rib?
 
2011-03-04 08:09:10 AM  

X15: Repeat after me:

Correlation does not equal causation
Correlation does not equal causation
Correlation does not equal causation


Did you just use "correlation" to describe a phenononon dealing with the human body. (Points and laughs.)

Oh wait, you are serious! Let me laugh harder.

I have to model the cognitive process in humans. It's as hard as modeling weather. Sure there are equations to describe what's going on, but those equations are high order differentials. You could have a meter on every nerve in the body, and still not be able to predict what it's going to do more that a few milliseconds out.

And I deal in the cognitive world, where I can (at least attempt to) repeat conditions over and over on a large cross sampling.

And how good have these "clinical studies?" How many "safe" drugs have been pulled from the market over the past few years? How many effective drugs were pulled, only to be cleared on further study? Medicine is not a frigging science. It's an art. That's why doctors are paid like artists or sports stars. What they do is a combination of science, drawing on experience, and a ton of gut instinct.

So unless you have a frigging "M.D." in your title, STFU.
 
X15
2011-03-04 08:37:46 AM  

Evil Twin Skippy: Medicine is not a frigging science. It's an art. That's why doctors are paid like artists or sports stars. What they do is a combination of science, drawing on experience, and a ton of gut instinct.


I prefer my medicine to have actually been proven to, you know, work. If I wanted faith healing I'd go with homeopathy.
 
X15
2011-03-04 08:57:50 AM  
Let's make something clear:

Amiodarone appears to work, because it does produce higher rates of Return Of Spontaneous Circulation, e.g. a "save". But it does not actually lead to higher rates of that person being discharged from the hospital alive. It only leaves their family with a temporary false sense of hope and a horrendous medical bill.
 
2011-03-04 08:58:12 AM  
I did CPR on an accident victim for over 30 minutes on Labor Day 2009...No one ever tells you how much it takes out of you. These guys done good.
 
2011-03-04 09:19:46 AM  

X15: Evil Twin Skippy: Medicine is not a frigging science. It's an art. That's why doctors are paid like artists or sports stars. What they do is a combination of science, drawing on experience, and a ton of gut instinct.

I prefer my medicine to have actually been proven to, you know, work. If I wanted faith healing I'd go with homeopathy.


You better stick to faith healing then. Everything beyond that requires working with an approximation of an unknown.

Chaos theory, my friend. Treatments can only be proven if you can control all of the variables. Patients don't generally show up in the ER straight out of a cloning vat, after being hit by a ball-peen hammer in the exact spot in the head. (And even then, there's a chance the outcome could be different even if you executed the same procedure flawlessly.)
 
2011-03-04 09:52:39 AM  
After reading the article I want to see a pic of Tammy Ryan. There has to be a reason the men in her life are having heart attacks!
 
2011-03-04 10:07:59 AM  

Great Justice: Honestly, don't they have a portable machine for this yet? I see those defibrillators in a lot of places, why can't we build an automatic air mask combined with a chest compressor band, and have them available for emergencies?


They do. It's called a Lucas and it costs $15K. The ambulance service I volunteer with has them, but it's only part of the ALS protocol (stupid, but not much we can do about it) so a paramedic has to put it on.

It won't ventilate, but it does proper compressions. I had a call a few weeks ago where we had to put one on. It makes it A LOT easier, because you can spend your time ventilating, suctioning, and (if you're a paramedic) intubating/pushing drugs.

We're the only ambulance service in the county that has them, though, because of their extreme cost.
 
2011-03-04 10:12:48 AM  

Kesherz: Just from my own experience... damn, this guy was lucky. Not only to have so many CPR trained people around at the time, but being that close to Mayo Clinic.


Indeed, a skilled faculty can make all the difference. An uncle of mine had a heart attack a few years ago, had no health insurance so he insisted on being taken to the shiatty Miracle Whip Clinic a couple towns over. They told him to stop being such a pussy and sent him home with a couple aspirin.
 
2011-03-04 10:31:10 AM  

Great Justice: Honestly, don't they have a portable machine for this yet? I see those defibrillators in a lot of places, why can't we build an automatic air mask combined with a chest compressor band, and have them available for emergencies?


They do exist, minus the air mask (which isn't actually that important anyway). But they are not very portable. They are attached to a what is essentially a stretcher and have a large band that goes across the patient's chest. The device compresses the entire upper torso which provides more blood flow than simple chest compressions. Plus, this is pretty new tech so it is still probably to expensive compared to an AED (Automated External Defibrillator), which can be had for a few grand, and only in use in a handful of places at the moment.

I also there is a CPR coaching app for the iPhone that uses the motions sensors in the device to monitor the rate and depth of typical chest compressions. Most people, even trained professionals, don't press deep enough or at a fast enough rate so having a coach can really improve the effectiveness of CPR.

/
 
2011-03-04 10:34:01 AM  

MasterPython: Great Justice: Honestly, don't they have a portable machine for this yet? I see those defibrillators in a lot of places, why can't we build an automatic air mask combined with a chest compressor band, and have them available for emergencies?

could be comming soon.Link (new window)


That's the one.
 
Displayed 50 of 163 comments

First | « | 1 | 2 | 3 | 4 | » | Last | Show all



This thread is archived, and closed to new comments.

Continue Farking
Submit a Link »
Advertisement
On Twitter





In Other Media


  1. Links are submitted by members of the Fark community.

  2. When community members submit a link, they also write a custom headline for the story.

  3. Other Farkers comment on the links. This is the number of comments. Click here to read them.

  4. Click here to submit a link.

Report