cardiocerebral
“ When it is seventy five below zero, a man must not fail in his first attempt to build a fire – that is, if his feet are wet. ” - Jack London, To Build a Fire - full text
( metaphor … re: delivery of resuscitative efforts in sudden cardiac arrest )
essay 1: *** Letter to Tinsley Harrison *** - 90º Turn Toward Recovery
essay 2 : *** Survivor's Tale ***
*survivor* webpage
CQI for CPR - Providing Real-Time Performance Feedback During CPR - June 2019 - PDF slideshow
CQI for CPR - Providing Real-Time Performance Feedback During CPR - Keynote version - June 2019 - when opened, this ~400 MB presentation should download for viewing in Keynote … on Mac OS or Mac iOS on iPad or iPhone.
Real-time feedback systems for cardiopulmonary resuscitation: time for a paradigm shift - Journal of Thoracic Disease - 2017
*** Rate, depth, chest recoil and hand position are frequently suboptimal during CPR in both in and out-of hospital by both lay and professional rescuers. ***
Among the new tools to improve the quality of CPR, real-time feedback systems have been largely studied during the last decade. These systems permit the real-time analysis of CPR.
Their use has been primary focused on the improvement during CPR performance with the goal of reducing the gap between high quality standard CPR parameters, described by the guidelines, and real-life performance by rescuers.
Sudden Cardiac Arrest: Suddenly, a Person Becomes a Patient … Now What? - Update on Treatment Guidelines for SCA - December 2016 presentation - PDF slideshow
“Here we are, Hephaestus, at the very limits of the Earth, on these desolate, untrodden Scythian paths. Now it’s your job to do what Father has ordered to be done to this terrible rebel. Use these unbreakable steel chains and shackle him to this high peak. He stole the very blossom of your craft, the blazing flame, the spark of every art and gave it to the mortals.”
Greek text <- … Prometheus Bound … -> English translation
CHORUS: Whoever feels no pity for you, Prometheus, must be made of stone and he must have a heart of steel. I had no need to witness your pain, but now that I did, my heart breaks for you.
PROMETHEUS: Yes, I am a pitiful sight to my friends.
CHORUS: You haven’t, by any chance, committed a further offense?
PROMETHEUS: Yes, I’ve made it so that humans cannot foresee their own death.
CHORUS: What sort of medicine did you use for this?
PROMETHEUS: I have filled their hearts with blind hopes.
CHORUS: That is a great gift you have given them, Prometheus.
PROMETHEUS: And even more than that, I have given them the gift of fire.
CHORUS: So those ephemeral creatures now possess the bright-faced fire?
PROMETHEUS: Yes and with it they will learn many crafts.
Defibrillator / monitor (see here) - defibrillator providing *real-time performance feedback* for CPR providers
AED for public access (see here) - AED providing *real-time performance feedback* for CPR providers
AED for public access (see here) - AED providing *real-time performance feedback* for CPR providers
The AED available at the gym provided real-time CPR quality performance feedback as CPR was done. An accelerometer and timer in the AED provided constant assessment of depth and rate of CPR compressions, with ongoing voice feedback from the AED - to assist the CPR provider with maintenance of proper rate (107/min) and depth (4.7cm) of chest compressions.
Control of Heart Action by Electrical and Mechanical Means - Paul Zoll and Arthur Linenthal - 1966
Historical Development of Cardiac Pacemakers - Paul Zoll - 1972
*To Rescue the Heart - remembering the work of Paul M. Zoll, MD*
origins of CPR and defibrillation - brief video
source: The Pharos - Spring 2021
Trouble Beneath The Surface - Sudden Cardiac Arrests in Triathlon Super Athletes - ESPN - 2013
Austin man dies in Alcatraz Triathlon - KXAN news video - 2013
“Ross Ehlinger fit the template of a typical triathlete in many ways. A successful 46-year-old trial lawyer from Austin, Texas, and married father of three, he was a lifelong athlete who took his fitness goals seriously but wanted to enjoy reaching them.”
ross ehlinger video
How family tragedy helped shape Longhorns QB Sam Ehlinger - The Dallas Morning News - 2018
” Prometheus, teacher in every art, brought the fire that hath proved to mortals a means to mighty ends.”
Sudden Cardiac Death and Arrhythmias - Arrhythmia & Electrophysiology Review - 2018
Sudden cardiac death (SCD) and arrhythmia represent a major worldwide public health problem, accounting for 15–20 % of all deaths.
*** The majority of events occur in patients without traditional risk factors for sudden cardiac death. ***
The majority of cardiac arrests occur outside of hospital, with poor outcomes. Survival to admission may be as low as 8% and survival to discharge as low as 3% for out-of-hospital cardiac arrest.
Early resuscitation and defibrillation remains the key to survival, yet its implementation and the access to public defibrillators remains poor, resulting in overall poor survival to patients discharged from hospital.
Here’s the status quo:
Here’s an initial goal - currently achievable when ideal process is in place:
_________________________________________________________________________
_________________________________________________________________________
Linking myofilaments to sudden cardiac death: recent advances - The Journal of Physiology - 2017
The Influence of Scenario-Based Training and Real-Time Audiovisual Feedback on Out-of-Hospital Cardiopulmonary Resuscitation Quality and Survival From Out-of-Hospital Cardiac Arrest - Annals of Emergency Medicine - 2013
A performance improvement-based resuscitation program reduces arrest incidence and increases survival from in-hospital cardiac arrest - Resuscitation - 2015
American Heart Association - Hands-only CPR
British Heart Foundation - Hands-only CPR
High Quality CPR
** My Favorite Save ** - Sudden Cardiac Arrest -> Therapeutic Hypothermia (TTM)
Targeted Temperature Management - brief videos: how it's done
CPR *Quality* Improves CPR *Outcomes* - Consensus Statement from the American Heart Association
Duration of Cardiac Arrest Resuscitation: Deciding When to “Call the Code” - Circulation - April 2016
Cardio Cerebral Resuscitation: Is it better than CPR? - 2009 article
The Cardiocerebral Resuscitation protocol for treatment of out-of-hospital primary cardiac arrest - 2012 article
Resuscitation Research: Cardiocerebral Resuscitation
2015 American Heart Association Guidelines Update for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care
Post–Cardiac Arrest Care - 2015 American Heart Association Guidelines
EDECMO.org [ Emergency Department Extracorporeal Membrane Oxygenation ] ... ECLS: Extracorporeal Life Support
*about the EDECMO project*
EDECMO - audio and video podcasts
Managing cardiac arrest with refractory ventricular fibrillation in the emergency department: conventional CPR vs. ECMO - Resuscitation - April, 2015
Crushing the Nihilism of Cardiac Arrest - ECMO for SCA patients - June 9, 2017 audio podcast - U. Minnesota Cardiovascular Division - Demetri Yannopoulos, M.D.
Defibrillation for Ventricular Fibrillation - a Shocking Update - September 2017 JACC
Help-A-Heart CPR - immediate, high quality CPR makes all the difference
Scenes from an actual event:
Their 'First Kiss' Came When He Collapsed and She Performed CPR. Now They're Teaching Others to Save Lives - TIME - 8/29/18 - sudden cardiac arrest and CPR in the field (on the beach)
Love story starts with a CPR kiss - NBC Nightly News - 8/30/18 - video of SCA and CPR in the field
*** EDECMO Crash Episode *** – Demetris Yannopoulos on ECPR - the Minneapolis Way - video podcast on ECMO treatment of patients presenting with Sudden Cardiac Arrest - *Grand Rounds* - 3/7/18
X-Series CPR - real-time performance feedback for clinician- delivered CPR - Zoll video: improving quality of CPR as it is delivered to the patient
Powerheart G5 AED:
.
AutoPulse Resuscitation System - Zoll CPR machine - video
ZOLL - Air Zermatt AutoPulse video (full version - 9 min.)
_________________________________________________________________________
STRYKER - LUCAS 3 chest compression system - link to website
Incredibly Important Wrinkles to Titrated Vasopressors during CPR in Cardiac Arrest - info and April 2019 EMCrit audio podcast
Targeted CPR: Active Cardiopulmonary Resuscitation - 2019 video presentation
Vince Guaraldi - dead at 47 - Los Angeles Times - 2/6/76 … see: wiki
“I don’t think I’m a great piano player,” the San Francisco-born Guaraldi reportedly said in 1958. “But I would like to be able to have people like me, to play pretty tunes and to reach the audience.” He first recorded with Cal Tjader in the ‘50s and later with Brazil’s Bola Sete, and Guaraldi also won a Grammy for best original jazz composition for 1962’s “Cast Your Fate to the Wind.” But he’s indelibly linked with the Peanuts gang, having performed the music for all their specials until his death at just 47 in 1976.
Dr. Levi Watkins - Dead at 70 - Baltimore Sun - April, 2015
“Watkins died Saturday morning after suffering a massive heart attack … Levi died on his feet giving a speech to medical student recruits at Hopkins, which was one of his passions.” (ref.)
Levi Watkins, 70, Dies - NYT obit - 4/16/15
* Tony Soprano* - James Gandolfini - Dead at 51 - TMZ - 6/19/13
Guy Babylon - dead at 52 - The Baltimore Sun - 9/14/09
Allen Toussaint - dead at 77 - 11/10/15
Frank Sutton - dead at 50 - 1974
Nick Saban, Sr. - dead at 46 - Bleacher Report - 12/28/17
Tim Russert: From a Prominent Death - at 58 - , Some Painful Truths - NYT article - 6/24/08
Mr. Russert’s fate underlines some painful truths.
A doctor’s care is not a protective bubble, and cardiology is not the exact science that many people wish it to be.
A person’s risk of a heart attack can only be estimated, and although drugs, diet and exercise may lower that risk, they cannot eliminate it entirely.
True, the death rate from heart disease has declined, but it is still the leading cause of death in the United States, killing 650,000 people a year.
About 300,000 die suddenly, and about half, like Mr. Russert, have no symptoms.
The larger-than-life comedic star John Candy died suddenly of a heart attack on March 4, 1994, at the age of 43.
At the time of his death, he was living near Durango, Mexico, while filming Wagons East, a Western comedy co-starring the comedian Richard Lewis.
full article - NYT - Nov. 1, 2022
FACED WITH LIFE OR DEATH ON SET - at 63 - : WHEN SECONDS COUNT ... one summer afternoon in Hoover, Alabama - 8/3/17 - IATSE Local 479 newsletter
*Lord Wedgwood Charity*
“ In 2001, Lord Wedgwood - International Ambassador for Wedgwood China and Waterford Crystal, as well as a member of the British House of Lords - suffered a major heart attack while playing golf in Birmingham, Alabama, but an AED helped save his life.
“Following his recovery, Lord Wedgwood was inspired to give back to the community and formed the Lord Wedgwood Charity with Birmingham-based business leaders to help place Automatic External Defibrillators (AEDs) in high schools and community gathering places. “
… mission: To fight sudden cardiac arrest
Salute to Piers Wedgwood (video)
Coach Nick Saban interviewed at 2016 Lord Wedgwood Charity event - 20 min. video
What are sudden cardiac arrest and sudden cardiac death ? -Cleveland Clinic - 4 min. video
FOR WITNESSED, SHOCKABLE RHYTHMS: PATIENT SURVIVAL WITHOUT REAL-TIME CPR FEEDBACK 26% / WITH REAL-TIME CPR FEEDBACK 56%
…………………………………………… CO ( during CPR) = HR (compression rate) X SV (depth of compression) ……………………………………………
