CPR123 Newsletter, September 30, 2011

The following articles and news releases have been selected by the editorial team at CPR123. They have broad applications to Emergency Care professionals in relation to career pursuits, changes in the industry and, sometimes, plain old curiosity.

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Shocking need for defibrilators

ST John Ambulance wants to see more automated external defibrillators (AEDs) machines, which can shock the heart back into action after a cardiac arrest, in businesses, shops, leisure facilities and workplaces across the county.

They are urging employers to get a defibrillator, along with the training to use it, to protect their workforce and local community. In the UK, one person suffers a heart attack every two minutes and as many as one in three will die before they reach hospital.

For each minute that passes without defibrillation, the chances of survival fall by up to 10 per cent. Survival rates increase by more than 50 per cent if a defibrillator is used within the first four minutes. Thirteen per cent of workplace casualties are cardiac arrest victims.*

To encourage more businesses and organisations to install defibrillators, St John Ambulance is offering a special package in Bedfordshire of a Philips Heart Start defibrillator and on-site training in how to use it for up to eight people for just £1,295 plus VAT.

A defibrillator can be the difference between a life lost and a life saved.

Sue Skoyles, regional training manager for St John Ambulance in the East of England, said: “Every year, thousands of people die of cardiac arrest when first aid could give them the chance to live. Our own research shows that currently 72 per cent of businesses don’t have access to a defibrillator despite 66 per cent of employees believing that employers should reasonably be expected to keep one.

“This is a fantastic package offering all you need to have a defibrillator on site with confidently trained staff and we’d like to see more lives saved in the county because organisations have defibrillators available.”

St John Ambulance strongly recommends employees attend training on the use of defibrillators so that their first experience with the machine is not in a life-and-death situation. Ninety five per cent of employees agree that training would make them feel more comfortable using an AED on a cardiac arrest victim.

“The latest guidance on CPR states that anyone can use an AED without training,” added Sue. “The machines are now so simple to use that access is the most important thing. It means that anyone, trained or untrained, can be the difference between a life lost and a life saved in an emergency.’ Read the entire article here.

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Life changes greatly lower frequency of heart attacks

Each year, more than 1 million Americans experience a heart attack, meaning a heart attack occurs about once every 30 seconds. CNN recently produced a program “Dr. Sanjay Gupta Reports: The Last Heart Attack” that has a lot of people talking.

Following the odyssey of former President Bill Clinton and two everyday Americans, Dr. Gupta introduced viewers to the work of Dr. Arthur Agatston whose method of screening for coronary calcium is considered one of the best predictors of heart disease. Viewers also saw the work of Dr. Dean Ornish and Dr. Caldwell B. Esselstyn, whose diet and lifestyle-based programs have shown recognized medical effectiveness at preventing and even reversing heart disease.

“Heart disease could be as rare as malaria in our country if we put into practice what we already know,” Ornish said. The program brings us excellent information about what we need to do about stopping heart attacks but hangs on a gigantic “if” in the middle of Ornish’s statement.

What we know is that medical checkups using the best testing methods available must be combined with successful lifestyle improvement. We know the formula. According to the American Heart Association, “Although people with a family history of heart disease are at higher risk, you can take steps to dramatically reduce your risk. Create an action plan to keep your heart healthy by tackling these to-dos: get active, control cholesterol, eat better, manage blood pressure, maintain a healthy weight, control blood sugar and stop smoking.” What they are recommending is all about behavioral change.

The work of Dr.Ornish has been widely accepted as medically legitimate for years, yet it’s always qualified by mentioning that the probability of Americans adopting the lifestyle recommended is remote. Becoming a complete vegetarian, exercising regularly, practicing stress management skills and increasing social and emotional support is a tall order to say the least. Yet it works. Gupta’s report is telling us that change is possible, now we have to discover how.

Here are some suggestions for the behavioral side of preventing that potential heart attack:

• Know your current state of health in detail. Don’t put off that checkup or blood-work. Make a commitment to yourself to get it done.
• Envision what you want your health to be like.
• Ask yourself, “What has to change in my life for me to live that vision?” This creates a solid foundation for you to create the plan that you will follow to make your vision a reality.
• Develop a wellness plan that has a series of small steps, which over time lead to large lifestyle changes.
• Gather support for your plan. Share your vision and plan with the people you know who will be positive and encouraging.
• Track your behavior. Avoid self-deception by writing down or entering on a phone app your progress.
• Acknowledge and celebrate every success along the way to a better life.

Read the entire article here.
Michael Arloski, Ph.D., PCC, CWP, is CEO of Real Balance Global Wellness Services LLC. and Dean of the Wellness Coach Training Institute. He can be reached at (970) 568-4700, email at michael@realbalance.com or visit www.realbalance.com.

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Restarting a heart

A large study, with results published in the New England Journal of Medicine, has confirmed that paramedics should go ahead and use their defibrillators right away – there’s no benefit to performing additional CPR first.

But of course, it isn’t always paramedics who make the first choices about how to treat a patient. It’s often laypeople who are the only available help in those first crucial minutes. They should do cardio-pulmonary resuscitation as soon as possible and until the paramedics or first responders arrive.

But while CPR can prevent damage and keep the blood flowing, the heart of a cardiac arrest patient will need to be shocked back into a normal rhythm or the patient won’t recover. And as the study makes clear, the sooner that happens, the better. Emergency services can be expected to arrive in about nine minutes in Ottawa, but every minute that passes before defibrillation decreases the chances it will work.

So the ideal response to a cardiac arrest goes something like this: Bystander One starts CPR while Bystander Two calls 911 and gets the nearest Automated External Defibrillator (AED) and applies it. While training helps to increase confidence and minimize delays, the computerized machines are simple enough for anyone to use; they analyse the patient’s heart rhythm to determine whether a shock is advisable, and then direct the user.

The City of Ottawa has already done an impressive job in making sure the public has access to defibrillators, seeding the city with 400 public-access machines in places such as libraries, pools and community centres, while 90 others, in places like office buildings, are registered with the city. Registration helps because 911 operators can tell bystanders where to find the nearest defibrillator.

Public-access defibrillators have already saved 46 lives in this city and any sizable workplace or community organization should consider buying and registering one. But defibrillators can only save lives if Ottawans know where and how to find one and remember that they are there to be used. Read the entire article here.

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AED Failures Linked to Cardiac Arrest Deaths

John Commins, for HealthLeaders Media

Dead batteries, bad connections, and other malfunctions of automated external defibrillators have been linked to more than 1,000 cardiac arrest deaths over the last 15 years, a study has found.

The study — Analysis of Automated External Defibrillator Device Failures Reported to the Food and Drug Administration – blamed dead batteries for nearly one quarter of the AED failures.

“Survival from cardiac arrest depends on the reliable operation of AEDs,” lead study author Lawrence DeLuca, MD, said in the study, which was published online in Annals of Emergency Medicine. “AEDs can truly be lifesavers but only if they are in good working order and people are willing to use them.”

DeLuca’s team analyzed reports to the FDA about all adverse events connected to AEDs between January 1993 and October 2008. Of the 40,787 AED-related events reported to the FDA, 1,150 of the events were linked to fatalities. Forty-five percent of the failures occurred during the attempt to charge and deliver a shock to the person in cardiac arrest.

Problems with pads and connectors accounted for 24% of the failures and battery power problems accounted for 23% of the failures.

Odds of surviving cardiac arrest decline by 7% to 10% per minute of delay in defibrillation. AEDs have become common in public places such as airports and offices, but bystanders are reluctant to use them. An Annals of Emergency Medicine study published earlier this year found that less than half of people in public places reported being willing to use an AED and more than half were unable to recognize one. http://www.healthleadersmedia.com/page-1/QUA-270375/AED-Failures-Linked-to-Cardiac-Arrest-Deaths##http://www.healthleadersmedia.com/page-1/QUA-270375/AED-Failures-Linked-to-Cardiac-Arrest-Deaths##

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CDC: Why Do Half of Teen Americans Consume Sugary Drinks?

By IBTimes Staff Reporter

Half of the U.S. population age two or older indulges in sugary drinks on any given day, new research finds.

The CDC report, “Consumption of Sugar Drinks in the United States, 2005-2008,” was issued Wednesday. In 2010, U.S. dietary guidelines recommended limiting the intake of both foods and beverages with added sugars.

The American Heart Association (AHA) recommends drinking no more than 450 calories a week of sugar-sweetened drinks, which is less than three 12-ounce colas.

In a survey, health officials asked a sample representative of the U.S. population to tell what they ate and drank during a 24-hour period, including those who drink sugary drinks and those who do not.

“Men drink more than women, and teens and young adults drink the most,” says Cynthia L. Ogden, PhD. Ogden is an epidemiologist at the CDC’s National Center for Health Statistics.

The results also showed how far consumer habits must change to help fight the nation’s obesity epidemic, with nearly two-thirds of Americans either overweight or obese.

CDC researchers interviewed 17,000 Americans about their diets.

Overall, the average male in the survey consumed 175 calories in a day from drinks containing added sugar, while the typical female consumed 94 calories from such drinks.

Boys aged 12 to 19 consumed 273 calories a day from sugar-sweetened drinks, or the equivalent of about two 12-ounce cans of carbonated cola – more than any other group.

Men aged 20 to 39 consumed 252 calories a day from beverages containing added sugar, the second-highest amount.

Among the other findings:

• Boys age 2 to 19 drink the most, with 70% drinking sugary drinks on any given day.
• Adult women, overall, drank less, with 40% drinking sugary drinks on any given day.
• Teen boys averaged 273 calories a day from sugary drinks; teen girls, 171. Men 20 to 39 averaged 252 calories a day. Women in that age range averaged 138 calories.
• Five percent of the population drinks at least 567 calories from sugary drinks a day. That is more than four 12-ounce colas.
• Low-income people take in more calories from sugary drinks as a percentage of daily calories than those with higher income.
• Non-Hispanic black and Mexican-American adults have a higher percentage of calories from sugary drinks than do white adults.
• Ogden said that ”over half, 52 percent, of sugar drinks are consumed at home.” and that people would be more likely to drink them at restaurants.

Sugary drink intake in the U.S. has increased over the last 30 years, and sugared beverages have been linked with weight gain, obesity, poor diet, and, in adults, type 2 diabetes, according to the study.

“We’re concerned about sugary drinks because they are the only foods and beverages that have directly been linked to obesity … Reducing their consumption is the perfect place to start to reduce the epidemic,” Michael Jacobson, executive director of the nonprofit Center for Science in the Public Interest (CSPI) that is spearheading the campaign, told Reuters.

Ogden looked at data from the 2005 to 2008 National Health and Nutrition Examination Survey (NHANES.)

Sugary drinks as defined for the analysis included fruit drinks, sodas, energy drinks, sports drinks, and sweetened bottled waters. Diet drinks, 100 percent fruit juice, sweetened teas, and flavored milks were not classified as sugary drinks in the study.

The American Heart Association (AHA) recommends drinking no more than 450 calories a week of sugar-sweetened drinks, which is less than three 12-ounce colas. Read the entire article here.

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