“ 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 )

Screen Shot 2019-04-13 at 7.49.13 AM.png

 

 

essay 1:    *** Letter to Tinsley Harrison ***  -  90º  Turn Toward Recovery

essay 2 :    *** Survivor's Tale ***

 

*survivor* webpage

Screen Shot 2019-04-18 at 7.44.35 PM.png


Screen Shot 2019-02-24 at 5.56.20 AM.png


Screen Shot 2018-04-17 at 4.14.24 AM.png

   “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.

Screen Shot 2016-06-23 at 6.06.27 AM.png
Screen Shot 2019-03-02 at 2.30.43 AM.png
Screen Shot 2019-03-02 at 2.31.48 AM.png
Screen Shot 2019-03-02 at 2.32.05 AM.png
Screen Shot 2019-03-02 at 2.32.31 AM.png
Screen Shot 2019-03-02 at 2.31.11 AM.png
Screen Shot 2019-03-02 at 2.31.24 AM.png

*Illustrated History of CPR*

American Heart Association



Screen Shot 2019-03-20 at 10.42.45 PM.png
Screen Shot 2019-03-26 at 7.29.41 AM.png
Screen Shot 2019-04-13 at 6.15.45 PM.png
Screen Shot 2019-03-20 at 10.49.09 PM.png

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

origins of CPR and defibrillation - brief video




Cardiocerebral Resuscitation (CCR) pathway.JPG
Cardiopulmonary Resuscitation Quality  -   Improving Cardiac Resuscitation Oucomes Both Inside and Outside the Hospital  -  Circulation.JPG
Adult Cardiac Arrest Algorithm  -  2018 update - 1.JPG
Adult Cardiac Arrest Algorithm  -  2018 update - 2.JPG
Screen Shot 2019-01-02 at 12.27.34 AM.png

Trouble Beneath The Surface - Sudden Cardiac Arrests in Triathlon Super Athletes - ESPN - 2013 

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

Screen Shot 2019-01-06 at 8.58.41 PM.png

“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

Screen Shot 2019-03-02 at 3.18.02 AM.png
Screen Shot 2019-01-02 at 7.45.47 AM.png
Screen Shot 2019-02-06 at 3.38.18 AM.png
Screen Shot 2019-02-24 at 5.56.40 AM.png
Screen+Shot+2019-04-03+at+8.45.35+PM.jpg

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

Screen Shot 2019-03-02 at 3.00.42 AM.png
Screen Shot 2019-03-02 at 3.02.14 AM.png
Screen Shot 2019-03-02 at 3.01.41 AM.png

Here’s the status quo:

Screen+Shot+2019-02-24+at+5.55.05+AM.jpg

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

Screen+Shot+2019-02-24+at+5.55.28+AM.jpg

Screen Shot 2019-01-04 at 7.16.13 AM.png
Screen Shot 2019-01-04 at 7.16.38 AM.png

_________________________________________________________________________

_________________________________________________________________________

 




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:

CPR+on+beach+-+sequence+from+video.jpg

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

Screen Shot 2019-03-02 at 3.08.31 AM.png
Screen Shot 2019-03-12 at 4.53.38 AM.png






_________________________________________________________________________

 

 

 

Screen Shot 2019-01-04 at 7.18.09 AM.png
Screen Shot 2019-01-04 at 7.18.34 AM.png
Screen Shot 2019-01-04 at 7.19.15 AM.png

 

 

 

 

 

Strategies to increase AED use.jpg