“ 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

( Re: delivery of resuscitative efforts in sudden cardiac arrest )

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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.

 

Sudden Cardiac Arrest: Suddenly, a Person Becomes a Patient … Now What? - Update on Treatment Guidelines for SCA - December 2016 presentation - PDF slideshow

 

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   “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.”


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 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.

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*Illustrated History of CPR*

American Heart Association



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*To Rescue the Heart - remembering the work of Paul M. Zoll, MD*

origins of CPR and defibrillation - brief video




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Cardiopulmonary Resuscitation Quality  -   Improving Cardiac Resuscitation Oucomes Both Inside and Outside the Hospital  -  Circulation.JPG
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Trouble Beneath The Surface - Sudden Cardiac Arrests in Triathlon Super Athletes - ESPN - 2013 

Austin man dies in Alcatraz Triathlon - KXAN news video - 2013

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“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

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” Prometheus, teacher in every art, brought the fire that hath proved to mortals a means to mighty ends.”

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Here’s the status quo:

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Here’s an initial goal - currently achievable when ideal process is in place:

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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.


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:

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Their 'First Kiss' Came When He Collapsed and She Performed CPR. Now They're Teaching Others to Save Lives  -  TIME  -  8/29/18 - video of sudden cardiac arrest and CPR in the field (on the beach)




 

  *** 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

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AutoPulse Resuscitation System - Zoll CPR machine - video

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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

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Guy Babylon - dead at 52 - The Baltimore Sun - 9/14/09

Nick Saban, Sr. - 46 - Bleacher Report - 12/28/17

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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

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*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

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FOR WITNESSED, SHOCKABLE RHYTHMS: PATIENT SURVIVAL WITHOUT REAL-TIME CPR FEEDBACK 26% / WITH REAL-TIME CPR FEEDBACK 56%

FOR WITNESSED, SHOCKABLE RHYTHMS: PATIENT SURVIVAL WITHOUT REAL-TIME CPR FEEDBACK 26% / WITH REAL-TIME CPR FEEDBACK 56%

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…………………………………………… CO ( during CPR) = HR (compression rate) X SV (depth of compression) ……………………………………………

…………………………………………… CO ( during CPR) = HR (compression rate) X SV (depth of compression) ……………………………………………

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