“ 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 )
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.
American Heart Association
Control of Heart Action by Electrical and Mechanical Means - Paul Zoll and Arthur Linenthal - 1966
Historical Development of Cardiac Pacemakers - Paul Zoll - 1972
origins of CPR and defibrillation - brief video
“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.”
” Prometheus, teacher in every art, brought the fire that hath proved to mortals a means to mighty ends.”
Here’s the status quo:
Here’s an initial goal - currently achievable when ideal process is in place:
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
** 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
2015 American Heart Association Guidelines Update for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care
EDECMO.org [ Emergency Department Extracorporeal Membrane Oxygenation ] ... ECLS: Extracorporeal Life Support
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 - 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
AutoPulse Resuscitation System - Zoll CPR machine
Dr. Levi Watkins - Dead at 70 - Baltimore Sun - April, 2015
* Tony Soprano* - James Gandolfini - Dead at 51 - TMZ - 6/19/13
Jim Paratore - TMZ Founder - Dies at 58 - 5/29/12
Tim Russert: From a Prominent Death - at 58 - , Some Painful Truths - NYT article - 6/24/08