|Does anyone think it's odd about Jimenez||rollo tommassi|
Dec 9, 2003 8:19 AM
|being buried yesterday? I don't mean to be 'mean', but no autopsy, no medical tests, nothing to look at cause of death? Just get him in the ground asap.....
I feel very badly for the family, I know they've been through a lot over the past two years, and now it's just terrible.
But still, a heart attack? In a clinic? No one there to do CPR?
|Read yesterday's thread on this...||wspokes|
Dec 9, 2003 8:52 AM
|I don't really think it was too strange. I am sure if you did an autopsy you would find heart failure. Depression has a horrible effect on the human body over time including elevated blood pressure which leads to multiple system problems, it really can affect the heart over time as well. It is very sad it occured.
Regarding CPR. I don't know of too many psychiatric clinics that keep a defibrillator on hand and CPR is pretty ineffective without the ability to defib or immediate medical attention to help. Here's a sad fact...
Medical researchers estimate the survival rate for out-of-hospital CPR to be between 1 and 3 percent.
|CPR thought||rollo tommassi|
Dec 9, 2003 9:03 AM
|sorry to post on someting already discussed!
at any rate, having gone thru CPR training, the philosophy behind CPR is to keep blood flow to the brain/vital organs, until such time as a defib or EMT is on scene. If CPR is so ineffective (3% survival rate?) why try?
I've seen three CPR efforts in my life, each one of them was a survivor - EMTs' on scene in less than 20 minutes average. So, your 'sad fact' depresses me...
|Yup...CPR is a last ditch effort...not a panacea||ColnagoFE|
Dec 9, 2003 9:31 AM
|When I took my last CPR recert the EMT that was giving the class said that people worry way too much about the completely "proper" way to administer CPR (ie. # of breaths, compressions, placement). He said that anyone who truly needs CPR is pretty much already dead and you MIGHT be able to get things working again, but not to be too depressed if the patient dies because at that point they are in really bad shape. Having access to a defibrulator might improve your odds a bit, but to have your heart stop beating there has to be some major problem to begin with.|
|Sounds like..........||Len J|
Dec 9, 2003 9:55 AM
|rather than get depressed about the 97% who don't make it, we should realize that CPR has saved 3% that would have died if no-one was there to administer CPR.
I wonder how many people that 3% is annually?
Your point is well taken, how bad off is someone who's heart stops?
Dec 9, 2003 10:07 AM
|I like your view of being happy to have saved 3%...other than be depressed. The other catch to all this is...if a young person has a heart attack the likelihood of him coming back is really rare because he heart hasn't had time to overcompensate for decreased blood flows and hasn't developed any good collateral circulation as opposed to 50s/60s+ whose hearts have been somewhat compromised and the heart developes those tiny little veins springing off to carry blood around the occluded parts.
Interesting stuff though! I just know that the psych units around here aren't set up for major Code situations so when someone goes down and out...time for the EMTs.
|You are totally right! (nm)||rollo tommassi|
Dec 9, 2003 11:18 AM
|Can't remember the last time someone told me that. LOL nm||Len J|
Dec 9, 2003 11:58 AM
|CPR will likely change in the near future.||desertmd|
Dec 9, 2003 12:54 PM
|There is movement afoot here in Arizona to change CPR such that people would not administer breaths, but rather just do chest compressions. It appears that circulation is the most important thing (next to fast arrival of defibrillator or ambulance). As for mortality after "coding", well it is pretty high (though not 97%) - it depends on whose numbers you look at, and the age group, and comorbidities. Sudden cardiac death is most often due to arrthymia (ventricular tachycardia or fibrillation) - which of course has lots of causes. I've seen people recover from codes (just had an 84 year old with a bad heart do just fine - who survived to discharge). The key seems to be early and effective chest compressions - especially given the time it will take to defibrillate (those automatic defibrillators take a long time to diagnose rhythms and then to shock if necessary). I suspect that when changes to the CPR protocol are made, more people will survive because bystanders will be less afraid to get involved (mouth to mouth keeps lots of people away), and the protocol will be simpler. This CPR protocol is already in use in some countries in Europe, which has shown greater chance of survival without stopping to provide respirations.
As for Jimenez, well, the family may have refused autopsy or any further intervention - and for all we know he may have been a "Do Not Resuscitate" person at the time of his terminal event.
|I've heard that too||rollo tommassi|
Dec 10, 2003 10:04 AM
|our CPR seminar here (Chicago) did focus more on the compressions more than on the M-t-M; they cautioned not to do M-t-M unless you had a Microsheild. The one nurse actually used a very funny analogy for chest compression: "it's more like using a plunger on the toilet. You want to move the blood inside not start breathing..."
Good point about Jimenez re no resuscitate; the dirty secret about my original post was doubting the truth of a heart attack at all, and that it may have been a suicide.