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(The Atlantic)   A look at the increasing popularity in CPR shows the overall issue of "medical creep," which also explains the whole rise in chiropractic "care"   (theatlantic.com) divider line 57
    More: Interesting, CPR, defibrillators, elective surgery, Stephen Jay Gould, surgical team, mesothelioma, permanent brain  
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5285 clicks; posted to Main » on 05 Nov 2013 at 12:13 PM (37 weeks ago)   |  Favorite    |   share:  Share on Twitter share via Email Share on Facebook   more»



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2013-11-05 04:51:45 PM

Mose: kendelrio: Mose: Russ1642: kittyhas1000legs: Some chiropractors are alright. They just need to be the "I'll help your back feel better" kind, instead of the "this will cure your allergies, asthma, arthritis, and diabeetus" kind.

I'll help your back feel better by applying high risk violent rotations to your neck.

Full disclosure, my wife is a DPT- the biggest problem is not what they're doing is unsafe, it's just that a lot of it is not effective long term.  That's why you often hear people saying how they have to visit their chiropractor every so often, when they have the option to go see chiropractic's science/reality based older sibling, physical therapy, and address the cause of the pain/problem rather than just the symptoms.

Chiropractors just like the business model of come see me once a month for the rest of your life, we have your card on file as far as I can see.

Sort of like getting you oil changed in your car?

/Maintenance, how do it work?

No.  Not at all like getting the oil changed in your car, actually.  A better analogy is this: you have an oil seal leak somewhere and you're burning oil.  You can go to the mechanic once a month who adds a quart of oil with each visit and charges an hour of labor, or you can go to the mechanic that replaces the faulty gasket.  Chiropractic vs. PT.


Much better analogy.
 
2013-11-05 04:54:41 PM

11Casey: Mose: Russ1642: kittyhas1000legs: Some chiropractors are alright. They just need to be the "I'll help your back feel better" kind, instead of the "this will cure your allergies, asthma, arthritis, and diabeetus" kind.

I'll help your back feel better by applying high risk violent rotations to your neck.

Full disclosure, my wife is a DPT- the biggest problem is not what they're doing is unsafe, it's just that a lot of it is not effective long term.  That's why you often hear people saying how they have to visit their chiropractor every so often, when they have the option to go see chiropractic's science/reality based older sibling, physical therapy, and address the cause of the pain/problem rather than just the symptoms.

Chiropractors just like the business model of come see me once a month for the rest of your life, we have your card on file as far as I can see.

Just like those damn dentists.... making you come in for a cleaning every 6 months.  Because we all know that schedule is evidence-based, yet no one ever comments about that...


Funny thing about that schedule, it coincided with a time in which dentists discovered that visits were going down due to people taking better care of their teeth, and thus less drill n fill was necessary. It is odd that no one ever questions this.
 
2013-11-05 05:41:48 PM
Xetal:
I work in a hospital and end up doing compressions once every 4 or 6 weeks.  I've had plenty of people survive... but it is a highly controlled situation (hospital ER or ICU), and surviving sometimes isn't a good thing depending on how long they've been down and the amount of damage to their brain from lack of oxygen.

You get some situations where the factor causing their heart to stop is temporary (like an O.D.) and can be negated/controlled by drugs until it passes.  A lot of others are just not savable.  I don't know the percentage of survivors off the top of my head, but I'd guess 10 or maybe 20%, with half of those having major brain damage.


For my experience, think ski hill -- Typically takes about 10 to 12 minutes from arriving on scene to get an unconscious victim on a back-board (more if they're wrapped around a tree) and some more minutes to the waiting ambulance (the ambulance guys are great -- when you call a code, they get there fast). From there it's about 13 to 14 minutes to an ER if no idiots obstruct the ambulance. Most victims with no pulse are either heart attacks or have hit a tree or other fixed obstacle at speed.

/If you ski, wear a helmet -- it'll give you a chance of keeping the porridge in the same bowl.
//Still won't save you if you hit a tree or lift tower at 40mph.
///The padding on those towers? Purely ornamental so far as I can tell -- you *really* don't want to hit one at speed. It *will* kill you.
(Trees are just as bad -- even small ones. This past season, saw a guy hit one that couldn't have been more than 3 inches across. He wasn't even going that fast. We lost vitals 7 minutes and 40 seconds in, just as we were loading him into the toboggan -- he was at the ambulance in under 2 minutes later. Autopsy said he died of head and chest injuries. He was not wearing a helmet.)
 
2013-11-05 10:49:09 PM

jgilb: InfamousG: My life was saved from misery by a chiropractor. Saying all chiropractors are ineffective is akin to saying all MDs are pill pushers.

Some DCs get better results than others due to skill, technique, and proper evaluation of issues.

Educate yourself on what a chiropractor does (and doesn't) do rather than blather on with an opinion you heard from some guy that had never actually been to one.

Thank you. I was forming my view of chiropractors based off of scientific studies that proved how ineffective they were, but with your anecdotal evidence, I may have to reformulate my opinion.


Ah yes, I'm sure you have read many objective studies on the topic.
 
2013-11-05 11:12:07 PM
I've done CPR countless times, on patients ranging from a few months old to 90+ years old.  Younger people DO seem to have a better viability rate (i.e. - leaving the hospital under their own power, no ill side effects).  Unfortunately, because everybody expects CPR to be done, it gets done.  The article touched upon this - just because it CAN be done doesn't mean it SHOULD be done.  There have been a LOT more people who left the hospital with varying degrees of brain damage, the majority of those being pretty much catatonic for the remainder of their lives.
To quote Pet Sematary, Sometimes, dead is better.
 
2013-11-06 12:09:50 AM

guttermedic: I've done CPR countless times, on patients ranging from a few months old to 90+ years old.  Younger people DO seem to have a better viability rate (i.e. - leaving the hospital under their own power, no ill side effects).  Unfortunately, because everybody expects CPR to be done, it gets done.  The article touched upon this - just because it CAN be done doesn't mean it SHOULD be done.  There have been a LOT more people who left the hospital with varying degrees of brain damage, the majority of those being pretty much catatonic for the remainder of their lives.
To quote Pet Sematary, Sometimes, dead is better.


Yeah, and as I said above, who are we to make that decision? There are people who would prefer brain damage to death and vice versa. There are people with what I consider to be a lousy quality of life living in nursing homes (so getting a DNR order is hassle-free) that are full codes, while extremely vibrant people choose DNR. Failing clear and legal documentation stating the patient's wishes, I don't know how a medical provider can ethically operate in any way but under the assumption that the patient wants to be alive.

No one should get to decide whether somebody else's life is worth living.
 
2013-11-06 01:10:49 PM

lizyrd: No one should get to decide whether somebody else's life is worth living.


THIS.

In the absence of clearly defined and legally defensible documentation of wishes by that patient, it is not your decision to make without clear and unmistakable signs of death present, or evidence of futile effort.
 
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