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A recent study conducted by Stanford University’s Medical School and the Lucile Packard Children’s Hospital Stanford found methods that significantly increase survival rates of pediatric patients who experience cardiac arrest while hospitalized. The study focused on the training of the entire code team, rather than just specific individuals who respond to the code.
When a “Code Blue” is called in a hospital, it signifies that there is a patient in cardiac arrest. While these are relatively infrequent events in a pediatric setting, when compared to adult acute care hospitals, they tend to be more stressful for the responders. The goal of the study was to not only improve survival statistics, but also to provide insight as to how each member of the code team responds to a pediatric code call.
Previous studies focused exclusively on the roles that nurses and resident physicians held during resuscitation efforts. The Stanford study looked at the roles of each individual who plays a role on the code team, from doctors to security personnel. Researchers would create simulations in which a code blue call would be signaled in the hospital. Responders were unaware if the code was for an actual patient or a simulation.
When the responders arrived at the simulation, each team member took on a specific role. One individual took charge of the code, while other members provided support to the responders by distributing the necessary medications and equipment. Parents were cared for by a social worker who responded. The area was kept clear of unnecessary personnel by security. Each simulation was recorded for review by the team after each event.
As the training progressed, the team began to see significant improvement in survival rates. The survival rate nationally for pediatric cardiac arrest patients is 40 percent. Researchers saw this rate climb to 60 percent with good neurological results. Results continued to exceed the national average after the hospital added a new cardiac intensive care unit and cancer center.
The hospital has chosen to make this training a permanent part of their resuscitation protocol. Researchers hope other pediatric hospitals will make similar changes to their training to increase the odds of survival nationwide.
Cardiac arrest can happen to anyone at any moment. Protect your loved ones and know CPR and pediatric advanced life support – sign up for a course at Lifesaver Education today!
A recent study conducted by Swedish researchers has discovered that manual CPR is just as effective as CPR delivered by a mechanical device. The study was conducted on patients who suffered cardiac arrest outside the hospital and received transport to the hospital through an ambulance service.
While there are several different factors determining whether or not a patient will survive cardiac arrest, the proper delivery of CPR is key to restarting the circulatory system. It was thought that manual CPR was not as effective as mechanical CPR, due the lengthy pause of compressions in the process. The manual compression delivery was thought to be subpar when delivered while in the ambulance going to the hospital. The theory was that a mechanical device would significantly improve the results of CPR, because it was more consistent and did not deliver a lengthy pause. The mechanical compressions used a suction cup like device to deliver the CPR, and it was set to follow the same guidelines for compression used in manual CPR. Defibrillation was used in conjunction with both types of CPR in the study.
Between 2008 and 2013, both manual and mechanical CPR was tested on over 2,500 patients that suffered a cardiac arrest outside of a hospital, and their four-hour survival rate was recorded. It was an international study that engaged patients being served by ambulances in Sweden, Britain, and Holland. 307 of the patients who received mechanical compressions survived versus 305 of those receiving manual compressions. This was a difference of .01%, and it does not show a significant statistical difference. The study also followed up with both sets of patients six months later in terms of their neurological outcomes. 99% of the mechanical compressions patients were doing well versus 94% of the manual compression patients. This is not considered a large enough difference to prove one method superior to the other.
Learn to save a life today by signing up for a CPR course at Lifesaver Education!
A recent medical study out of Portland, Oregon proves that people should not ignore tell-tale signs of heart problems. The Oregon Sudden Unexpected Death Study focused on men in the 35 to 65 years old age bracket. From 2002 to 2012, they looked into the medical histories of men of these ages who had sudden cardiac arrests while not in the hospital. This study was presented on November 19, 2013 at the American Heart Association’s Scientific Sessions.
Cardiac arrests occur when the heart's electrical system malfunctions, causing the heart to stop suddenly. These events are different from heart attacks, when blood flow is blocked to the heart muscle. People sometimes survive cardiac arrests if bystanders immediately begin CPR and a defibrillator is used to shock the heart back into its normal rhythm.
During the ten year period of the Oregon Sudden Unexpected Death Study, 567 men had fatal cardiac arrests. More than half of these men, 53 percent, had symptoms of heart trouble before the final, fatal attack occurred. Of those experiencing symptoms, 56 percent of those men experienced chest pain, 13 percent experienced shortness of breath and 4 percent felt faint, dizzy and had palpitations. Most of these symptoms, about 80 percent, occurred between an hour and a month before the sudden cardiac event happened. Most of the men in the study did have coronary artery disease. However, only about half of the men were diagnosed with diseased hearts before their deaths.
This study underscores the need for people to take cardiac arrest symptoms seriously. In the United States, over 360,000 people have these issues out of the hospital every year. When people experience cardiac arrests away from a medical center, only about 9.5 percent of them survive. One of the study's lead authors, Dr. Eloi Marijon, stated, "By the time rescuers get there, it’s much too late."
Although for years, doctors have encouraged people experiencing symptoms of heart trouble to go to the emergency room, many people ignore these symptoms. However, this study emphasizes that ignoring serious heart symptoms can have fatal results. Dr. Sumeet Chugh of Cedars-Sinai Heart Institute said, “The lesson is, if you have these kinds of symptoms, please don’t blow them off.”
Lifesaver Education stresses the importance of knowing CPR in case of any emergency – it can happen when you least expect it.
According to a study funded by the American Heart Association and performed at the Department of Cardiology, CPR and Emergency Cardiovascular Care at Surugadai Nihon University Hospital in Tokyo, people who experienced cardiac arrest and received 38 minutes or more of cardio-pulmonary resuscitation (CPR) had improved chances of survival. This study has important implications for good Samaritans, paramedics and other medical personnel attending to people in places where there is no available defibrillator.
In the study, researchers examined patients who experienced cardiac arrests in Japan from 2005 through 2011 using a large data registry. They examined the amount of time between the cardiac event and when CPR was initiated as well as how long CPR was performed. The researchers found that in some cases, even when longer periods of CPR were performed, the body's circulation could still be restored. The ability of the body to pump blood on its own is essential for normal brain function and for survival. The faster the restoration of spontaneous blood circulation returns, the more likely the patient is to survive and retain normal brain function.
People whose spontaneous circulation restarted by 13 minutes after the cardiac event were most likely to fare well a month later. The chances that a patient would survive their cardiac arrest dropped by 5 percent for every 60 seconds of delayed CPR. Continuing CPR for at least 38 minutes offered patients the best chance at surviving a cardiac arrest outside of the hospital and still retaining normal brain function when examined by a physician a month after their cardiac event. The researchers controlled for confounding neurological and other medical conditions that may have played a role in a patient's brain functioning.
This research is important because nearly 80 percent of cardiac arrests occur outside the confines of a hospital. Fewer than 10 percent of people who experience cardiac arrest outside of a hospital survive the event.
Learn CPR today by signing up for a Los Angeles CPR class with Lifesaver Education!
Hospitals house professionals that are skilled in diagnosing, managing, and treating serious conditions. Highly-trained physicians and nurses are responsible for the care of patients on a continuing basis. Although medical facilities strive to provide the best care for patients, studies show that more efficient care is given during on certain days and during particular time periods. As a result, it is crucial to understand which time periods constitute a decline in care and an increase in critical, and even fatal, outcomes.
In the medical community, cardiac arrest is the most critical of conditions possible. Without intervention, and sometimes with proper action, cardiac arrest often directly results in death or serious physical attributes, such as brain damage and/or permanent side effects. Though cardiac survival rates vary between hospital settings, statistics confirm that cardiac arrest outcomes decline during the night hours. Though cardiac arrest outcomes during various times throughout the day have not been studied, children who experience in-hospital cardiac arrest at night have lower survival rates than those who undergo cardiac arrest during the day/evening hours.
One study set "night" hours in hospital settings as 11PM to 6:59AM and measured survival rates by patient discharge (see study here). Any type of arrest in the delivery room was excluded in this study to provide more accurate, thorough results on a widespread basis. The study found that out of 10,541 arrests, 31% occurred throughout the night hours and 69% took place in the day/evening hours. Patient symptoms did not vary significantly based on the time period followed or regarding patient characteristics, such as age, race, sex, etc. Yet, the survival to discharge proportion was significantly lower for those who experienced cardiac arrest during the night.
After taking patient and hospital characteristics into consideration, the ratio for higher death rates for pediatric cardiac arrests that occurred during the night remained the same. Though the reason for the results from this study are not understood, it does confirm the hypothesis that the survival rate for individuals experiencing arrest at night is lower than those who experience cardiac arrest during the evening/daytime.
Cardiac arrest can happen at any moment. Be sure you know how to respond in this life or death situation; sign up for a CPR course with Lifesaver Education.
Researchers have confirmed that variance in an individual's surrounding environment can affect the actions and mindset of those within it. In fact, each year organizations spend millions of dollars on creating the perfect environment to initiate consumer spending, marketing to appropriate clients, and promoting company growth. Even small changes, such as creating warm displays and fast-paced music, can aide in consumer habits.
In order to test this theory, a recent study was performed to measure the effect of an ultra-brief video of compression-only CPR (CO-CPR) on high quality chest compressions performed by viewers (http://www.abstractsonline.com/Plan/ViewAbstract.aspx?sKey=fc0e7ae0-0588-45cc-ac99-8d8e7ca4fe0b&cKey=f690ab4c-049b-4e8a-8116-75e42a2cc176&mKey=951e351e-429c-4b2e-84d0-8da73b00de45). Though the effectiveness of ultra-brief videos on compression-only CPR performed by bystanders is unknown, this study provided useful insight into the immediate reactions of bystanders. In a shopping mall setting, participants who were 18 and older were separated into two groups: Group 1 (the control group) sat idly for 60 seconds, and Group 2 watched an Ultra-Brief Video of CO-CPR. Participants were then taken to an area of the mall where a mannequin simulator was on the ground, and participants were advised to do "what they thought was best." The study was measured based on responsiveness (the time period from when the mannequin was found and when 911 was alerted) and the quality of CPR provided.
Out of 100 participants who varied in characteristics, such as age, gender, and ethnicity, those who viewed the ultra-brief video dialed 911 more frequently and initiated CCs more frequently than those in the control group. Though there was no reported statistical difference in CC depth, there was great variation in response time and the initiation of CCs between the two groups.
Despite the short period of time viewers were given to watch the ultra-brief video, a significant difference in response time and CO-CPR was identified. As a result, researchers found that even short videos can impact the resultant actions of bystanders. Though it is unknown how the viewing of these videos can impact society on a greater level, it is apparent that UBVs provide a hands-off method for widespread intervention and information for viewers and mere bystanders.
Call or enroll online for your CPR Course with Lifesaver Education today.
Hospitals house professionals that are skilled in diagnosing, managing, and treating serious conditions. Highly-trained physicians and nurses are responsible for the care of patients on a continuing basis. Although medical facilities strive to provide the best care for patients, studies show that more efficient care is given during on certain days and during particular time periods. As a result, it is crucial to understand which time periods constitute a decline in care and an increase in critical, and even fatal, outcomes.
In the medical community, cardiac arrest is the most critical of conditions possible. Without intervention, and sometimes with proper action, cardiac arrest often directly results in death or serious physical attributes, such as brain damage and/or permanent side effects. Though cardiac survival rates vary between hospital settings, statistics confirm that cardiac arrest outcomes decline during the night hours. Though cardiac arrest outcomes during various times throughout the day have not been studied, children who experience in-hospital cardiac arrest at night have lower survival rates than those who undergo cardiac arrest during the day/evening hours.
One study set "night" hours in hospital settings as 11PM to 6:59AM and measured survival rates by patient discharge (http://www.abstractsonline.com/Plan/ViewAbstract.aspx?sKey=1118c690-bf74-4bca-83ac-9c40b15af13b&cKey=74018cc1-966f-4c70-bf70-8894bb3166d6&mKey=951e351e-429c-4b2e-84d0-8da73b00de45). Any type of arrest in the delivery room was excluded in this study to provide more accurate, thorough results on a widespread basis. The study found that out of 10,541 arrests, 31% occurred throughout the night hours and 69% took place in the day/evening hours. Patient symptoms did not vary significantly based on the time period followed or regarding patient characteristics, such as age, race, sex, etc. Yet, the survival to discharge proportion was significantly lower for those who experienced cardiac arrest during the night.
After taking patient and hospital characteristics into consideration, the ratio for higher death rates for pediatric cardiac arrests that occurred during the night remained the same. Though the reason for the results from this study are not understood, it does confirm the hypothesis that the survival rate for individuals experiencing arrest at night is lower than those who experience cardiac arrest during the evening/daytime.
To learn more about cardiac arrest and help save a life, take a Los Angeles CPR class offered by Lifesaver Education .
On Tuesday, November 12, 2013, new guidelines were released by the United State’s top heart organizations. These guidelines are said to be fundamental in restructuring the usage of medications that lower cholesterol levels. Statin medications are prescribed for around one quarter of Americans over the age of 40.
As a result of the new guidelines, individuals who take statin medications will no longer need to lower cholesterol levels to specific number goals that are monitored by blood tested, which has been the standard method for many years. At this point in time, taking the proper dose of a statin medicine would suffice.
The reorganized guidelines list people who require cholesterol treatment into two categories. These include individuals who have extremely high levels of LDL cholesterol and those who are at risk for having higher cholesterol levels as a result of diabetes or having had a heart attack in the past. In general, these are the people who should be prescribed statin medications. Previous to the change of guidelines, however, these individuals would have been told to lower their LDL levels to 70. This is no longer a requirement.
Anyone whose medical history has determined that they are at risk for a heart attack or stroke over the next decade should be taking a statin as their risk sits around at least 7.5 percent. Physicians are being advised to rely on a new risk calculator that takes into consideration factors such as age, blood pressure, cholesterol levels among additional aspects to determine this risk.
Dr. Harlan M. Krumholz, a cardiologist and professor of medicine at Yale University, points out that as a result, one in four American patients over 40 years of age will wonder whether they should continue taking a statin medication.
The new guidelines were created by the American Heart Association and the American College of Cardiology. They are based on a study that took place over four years and include a four step process that determines which patients absolutely need to take statins. It is believed that there may be new candidates for taking the medications as a result in addition to determining that certain individuals will no longer need them.
A heart attack can happen at any moment- be sure you're prepared. Sign up for a CPR course with Lifesaver Education!
Sudden Cardiac Arrest (SCA) is the leading cause of death for people over the age of 40 in the United States and several other countries. SCA occurs when a person’s heart stops beating normally so that blood is not circulated to the rest of the body. The person needs immediate CPR and defibrillation in order to have any chance of survival. In fact, 9 out of 10 people who experience this condition outside the hospital do not survive. Make it your priority to learn CPR this month! BLS classes are offered nearly daily at Lifesaver Education www.LifesaverEd.com and are appropriate for anyone wanting to learn CPR.
For more information on SCA Awareness Month follow this link:
Last year the survival rate for cardiac arrest in Ventura County, California was rated at approximately 14 percent, which surpasses the 10 percent national average and places the county high in the national ranking. The key to this astonishing rate of survival can be found in education. In instances where victims of cardiac arrest were given CPR, their chances of survival improved. Of the total victims in Ventura County, a surprising 44 percent survived, thanks to the timely intervention of skilled bystanders, until electric shock could be administered by emergency personnel.
Another aspect of the relatively high survival rating of complete cardiac arrest victims, is that the emergency system sends them only to the handful of hospitals best equipped to treat them effectively. Such planning greatly reduces the fatalities due to inept or insufficient care. According to city officials, such success relies heavily not only on cooperative planning and resource allocation, but on education of the general public in CPR and efficiently trained EMTs and Paramedic staff. While hospitals use hypothermia therapy, in order to mitigate the cell damage that occurs when the heart completely stops, CPR is still one of the most effective measures to preserve the integrity of the brain and heart tissues after the blood ceases to move through the vascular system.
In the final week of December of 2012, Ryan Sevy--a 32 year-old medical technician in training at the local firefighting academy--experienced an inexplicable cardiac event that would have proven fatal, had it not been for the timely intervention of educated friends. Although he was shocked six times in total and clinically dead for nearly an hour, Sevy was transported to the Los Robles Hospital and Medical Center of nearby Thousand Oaks. Here, the well-trained staff medically induced a stable coma and chilled his blood to 90 degrees, so the damage to his cardiovascular system would be minimized while doctors treated him.
Once he fully recovered, Ryan decided to dedicate his time to the educational programs that saved his life. Currently, he works as a part-time EMT and a community educator in CPR. When he isn't responding to calls, he's teaching CPR to neighbors.
Learn how to save a life. Visit Lifesaver Education to book your CPR class or BLS online class today.
According to a new study published in the online Journal of the American College of Cardiology, people who suffer sudden cardiac arrest while they are at the gym are more likely to survive compared to other indoor places. Researchers say that this is due to a number of factors, including more common access to automated external defibrillators, or AEDs, and early CPR.
Studies have established that a regular exercise program reduces the risk of suffering sudden cardiac arrest. Still, the risk of sudden cardiac arrest is raised somewhat during and right after exercise. For this reason, AEDs are often kept on hand at gyms. Less research has addressed whether sudden cardiac arrest is as frequent at other places where exertion is common, such as dance studios, bowling alleys and recreation centers. AEDs are less likely to be located in those places.
The frequency of sudden cardiac arrest along with treatment and outcomes were studied at standard and alternative types of gyms. Specifically, the study examined 849 cases of sudden cardiac arrest occurring at indoor facilities frequented by the public in Seattle and King County, WA, between 1996 and 2008. Cases were divided into those happening at traditional exercise locations, ones occurring at alternative exercise locations, such as bowling alleys, and those occurring at non-exercise locations, including shopping centers and banks.
Researchers found that 52 cases of sudden cardiac arrest happened at gyms, 84 occurred at alternative exercise locations and 713 happened at other types of indoor facilities. The respective survival rates were 56 percent, 45 percent and 34 percent. With available information from these cases, researchers found that 77 percent happened while exercising but just 18 percent happened after exercise and 4 percent before the physical activity.
In addition, researchers examined the types of exercise associated with sudden cardiac arrest. Basketball, the most common exercise, accounted for 20.5 percent of cases. Next, dancing and strength training each accounted for 11.6 percent. 8.9 percent of cases occurred during treadmill use, 6.3 percent during tennis, 5.4 percent while bowling and 4.5 percent while swimming.
The study shows clearly that AED placement and CPR classes, such as those offered by Lifesaver Ed, are vital at gyms. However, the study found that rates of sudden cardiac death were equally common at alternative exercise locations. As a result, researchers noted that these safeguards should also be on hand at these other places.
The methods for allowing diabetes patients to keep an eye on their blood-sugar levels are continually advancing and students in the Lifesaver Ed online bls courses and CPR Los Angeles classes. Most forms of improvement involve the use of newer and fancier gadgets with more sophisticated programming. However, the latest innovation involves the technology already put in place by mother nature. Dogs who have undergone very specific training possess the ability to smell the breath of a person and determine whether their blood-sugar levels are too high or too low.
These diabetes alert dogs are growing in popularity based partly on the high level of success that specially trained canines have had in working with the blind and hearing impaired. The primary organization training dogs to perform this specialized task is known as Do Canine. Their estimates show that there are 150 dogs that have been trained for this task across the nation. There are annual conferences held that allow owners and trainers to come together and share experiences with one another.
The dog is able to use its extraordinary sense of smell to detect the subtle changes in odor given off by the owner in order to determine the condition of their blood-sugar levels. When the dog smells trouble, they are trained to go into an alert mode that warns the owner of the danger so that they can take action. The alert modes given to the dogs through training typically involve the dog whining, jumping around, pacing, and staring directly into their owner's eyes. In most cases, these dogs can alert owners of the problem much sooner than the average digital monitor, saving many people from the dangers that come with hypoglycemia.
There are limitations to the abilities of the dog, and doctors do not recommend a canine companion as a complete substitution for checking one's blood sugar on a regular basis throughout the day. The training for the dog is no walk in the park either. The entire process takes two years and must begin from the time that the dog is a puppy. The training also requires that the dog experience the exercises with the person who they will be monitoring.
The American Heart Association recently released a report that revealed some rather alarming news. Based on several data sources, the American Heart Association has discovered that the quality level of CPR (cardiopulmonary resuscitation) can vary between Hospitals and EMS units. To exacerbate the matter, the report also made the assessment that the variations could actually mean higher loss of life at certain facilities.
The Association published a statement in its journal that openly called for a renewed and more intense focus on improving CPR techniques, as well as the tracking of CPR results.
The lead author on the statement, Dr. Peter Meaney M.D. was explicit in his expression that the lack of quality that has been revealed at certain institutions is highly unnecessary. According to Dr. Meaney, the advancements that have been made in CPR techniques over recent years have produced the capability to provide a higher level of quality as far as CPR is concerned. The problem is the fact that there is such a wide variation in the way that CPR is being performed from facility to facility, that it creates chasms in which the quality of CPR that is received by patients can be subpar.
Annually, there are more than 500,000 children and adults that suffer cardiac arrest and require CPR, and there is a huge disparity in the survival rates, based on where the CPR was administered. According to the American Heart Association this should not be the case. The way that CPR is performed should be more universal.
There are a number of variables that can make a difference, such as the minimization of interruptions to chest compressions which has an immense impact on the survival rate. The purpose of the chest compression is to compress the heart for the purpose of generating blood flow in order to get oxygen throughout the body, especially to the brain.
According to the AHA, the solution is dichotomous. First, an emphasis must be placed on performing proper and updated techniques, such as the techniques taught in the Lifesaver Education CPR Classes in Los Angeles. Second, health care providers must start collecting accurate data that can reflect the type and quality of CPR that is being provided throughout the nation.
A recent health scare for former President George W. Bush has brought heart awareness into the spotlight. In early August, President Bush had to undergo heart surgery due to a blocked artery in his heart. He had to have a stent inserted in order to reinforce his artery and promote proper blood flow. The president's problem is one that many Americans face and is typically resolved through an angioplasty procedure. Through the insertion of a catheter in a vein in the groin or wrist, a wire is used as a guide to place the stent in the blocked artery. From that point, a balloon is used to clear the blockage and the stent is placed to effectively strengthen a weakened artery. Additional treatment options may include releasing medication from the stent itself in order to avoid future blockages. Other medications and aspirin, as well as lifestyle changes are often recommended as well.
President George W. Bush took the world by surprise with his hidden heart condition. As an fit man who has engaged in physical activities ranging from cycling to golfing and daily workouts, no one would have expected the younger President Bush to experience heart problems at age 67. It was on a routine doctor's visit that his blockage was diagnosed. A day later, he was in surgery to resolve the issue before there were serious consequences.
President Bush's story is a wake-up call for everyone. Those who appear to be physically fit, eat right, and make wise, lifestyle choices could fall prey to hidden heart conditions. Heart problems can be genetic or result from viral infections, such as the recent health crisis involving Randy Travis. People need to pay attention to their bodies and be proactive. In addition to choosing a heart healthy diet, taking CPR classes and taking part in activities that promote cardiovascular fitness, regular doctor's visits are key in identifying any underlying concerns. This especially holds true for individuals who fall into the age bracket between their forties and sixties. Heart conditions can affect those who have never experienced a problem, remain active, and maintain an ideal weight.
Visiting a doctor after experiencing chest pain can be a life-saving decision, particularly for anyone who is at greater risk of suffering a heart attack. This is the conclusion of a research study that was recently published by the American Heart Association.
The research was conducted in the Canadian province of Ontario and involved more than 50,000 adults, slightly more than half of whom were men. Those in the study had either been previously diagnosed with heart disease or suffered from diabetes, or had gone to an emergency room due to chest pain. This is the first study to demonstrate the importance of following up treatment for suspected heart trouble with additional medical care.
Among the "high risk" patients who had been evaluated in an emergency room for chest pain, 75 percent visited a physician within a month of the initial evaluation. The vast majority of these patients were seen by primary care doctors, and fewer than 20 percent were evaluated by a heart specialists. Those who were seen by cardiologists were 21 percent less likely to suffer a heart attack or to die for any reason. This percentage was three times the improved health rate of individuals who visited a primary care physician, apparently because those treated by cardiologists received more tests and enhanced medical procedures. The 25 percent of the patients who did not seek health care of any kind after their visit to the emergency room had the greatest chance of suffering a heart attack or of dying.
There are different reasons why individuals would not seek health care under the circumstances, including the simple belief that it was not required. Another factor may be an insufficient system of referring patients for such care. In the U.S., which does not have universal health care for those under the age of 65, the costs involved may discourage individuals from seeking health care.
Chest pain is the most common reason for visitations to emergency rooms in the U.S. It can result from a number of conditions, including digestive disorders and even anxiety. However, heart trouble is an underlying factor in most cases of prolonged chest pain, which is why those who suffer from it should seek medical attention. Lifesaver Education can help teach what to do in the event of a cardiovascular emergency with their CPR Los Angeles classes and online bls courses.
In an abstract presented at the American Academy of Allergy, Asthma, & Immunology (AAAAI) 2013 Annual Meeting, researchers presented a paper showing that 75 percent of patients experiencing anaphylaxis did not receive epinephrine properly before cardiac arrest. In a recent Medscape article, doctors noted that in spite of the sharp decline in deaths from anaphylaxis, which is a life-threatening allergic reaction, epinephrine use continues to be extremely low for a variety of reasons.
Dr. Ya Sophia Xu of McMaster University (Hamilton, Ontario) conducted the retrospective study on 80 deaths in Ontario, Canada. The data come from both the Ontario Coroner’s Database as well as unpublished deaths listed with Anaphylaxis Canada. The study looked at deaths occurring from 1986 to 2011.
The positive news was that pediatric deaths declined markedly. While there were 11 anaphylaxis deaths from 1986 to 2000, no children died between 2004 and 2011. Out of the 80 deaths reported, only 25 percent received epinephrine prior to cardiac arrest. Dr. Xu noted that this may indicate more information is needed by patients and first responders about using autoinjectors, along with indications and administration techniques of epinephrine.
Patients at risk for anaphylaxis need to be taught to always carry an autoinjector and its proper use. Only 11 percent of those who died had an autoinjector with them at the time of the anaphylaxis attack.
Medical professionals also need to ensure their patients have a current prescription for autoinjectors. Of the 47 people who had a known or suspected allergy to the potentially fatal allergen, 18 only had been given a prescription for an autoinjector, and only nine people had it with them.
It is critical that medical and first responder staff review administration protocols and check regularly to ensure they have unexpired epinephrine. At least eight people who died either received expired epinephrine or had epinephrine administered incorrectly.
Researchers called for improved education of patients and medical personnel on the importance of epinephrine as a first-line drug in anaphylaxis, despite concerns about side effects. Administering this drug correctly and as soon as possible during anaphylaxis can save lives.To learn more about measures to take during a life threatening event, visit Lifesaver Education to book your CPR Los Angeles class.
There is no doubt that cardiac arrest is a major concern. With over 300,000 out-of-hospital cardiac arrests per year, each and every community needs to take a good look at the paths they can take to ensure the safety of their citizens. AED's or Automated External Defibrillators have been used for over a decade to save many lives and have been steadily gaining more and more popularity.
Many public, private and government facilities carry this type of device. The requirements vary widely by state, ranging anywhere from being placed in public areas to be used by anyone to being kept secure for use only by trained or emergency personnel. For instance, California requires every health studio to acquire an AED with the exception of hotels whereas Alabama does not require specific placement, but allocates funds for AED programs and purchases. Many states simply provide laws about who can operate and use an AED machine. Missouri declares that only emergency personnel or personnel who have received certification from the American Red Cross or American Heart Association may use an AED. In Minnesota they include a comment that makes non-professional users exempt from civil liability. AED's are extremely simple to use. The simplicity of the device and whether or not training is needed can be argued either way.
The Federal Drug Administration (FDA) has put AED's under immense pressure recently due to technical malfunctions, design flaws and/or component errors. These types of failures were the result of hundreds of deaths between 2004 and 2009. Almost every AED manufacturer has experienced a recall of their product over the years. This does not mean, nor is it trying to portray that AED's are a deadly device. They have by far saved more lives than not and will continue to do so.
Like many products that become increasingly affordable with age, AED's are no exception, having dropped in price to a third of what they cost five to ten years ago. Hopefully every citizen can look forward to seeing an AED at their local gym, day care or grocery storoe. To learn more about how to operate an AED machine, visit Lifesaver Education to enroll in their Heartsaver CPR Los Angeles course.
You may think that the safest place to have a heart attack is in a hospital, but a recent study published in the Journal of the American Heart Association suggests otherwise. This new research shows that patients who suffer a specific kind of heart attack while in the hospital for another health problem have a much lower survival rate than do patients who come to the emergency room with the same kind of heart attack.
The University of North Carolina study evaluated survival rates among patients who suffered an ST elevation myocardial infarction (STEMI), a common cause of heart attack. The researchers found that the survival rate for patients who presented to the emergency room with classic signs of a heart attack, including chest pain, was very high, at 96%. In contrast, only 60% of patients who experienced a STEMI while hospitalized for another condition survived.
While various explanations for the researchers' findings are possible, there are two that are likely contributing to the wide discrepancy in survival rates. First of all, hospitalized inpatients are, in general, more advanced in age and more critically ill than outpatients before the heart attack occurs. When these patients experience a STEMI, they are already compromised by their previous illness, which can impact their ability to recover.
Additionally, the signs of a STEMI are different in inpatients than they are in patients who come to the emergency room for heart attack. Outpatients often experience chest pain, nausea, pain in the arms, and other classic heart attack symptoms. Emergency room personnel are highly trained to recognize these signs, as heart attack is a common condition seen in Western medicine. Therefore, STEMI is quickly recognized and may be treated in as little as 45 minutes, allowing the health of the heart muscle to be preserved and the patient to have an excellent chance of recovering. Inpatients, on the other hand, may not experience chest pain or classic heart attack symptoms, and any signs they do display may be attributed by hospital personnel to the patient's primary disease process. Personnel tend to be slower to recognize STEMI in these patients, and as such, more damage to the heart may occur before treatment is initiated.
Further research is warranted to find better ways to detect STEMI in hospitalized patients and ensure that all heart attack victims have a good prognosis in the future. To learn more about what to do in the event of a cardiac arrest, visit Lifesaver Education to book a CPR class Los Angeles or an online BLS course.
In a frightening study, it was discovered by researchers at Rice University in Houston that there is a direct link between cardiac arrests in individuals not in hospitals and high levels of pollution and ozone. This study has sprung more training in the area of CPR at areas that are considered to be at risk.
Rice University's own Statisticians Loren Raun and Katherine Ensor discussed their findings at the American Association for the Advancement of Science conference, which was held in Boston, on February 17, 2013. They shared information on their research, which was published in the American Heart Association journal known as “Circulation.”
It was revealed that the American Lung Association considers Houston as number eight on the list of those cities in the United States with the highest ozone problem. With that being said, the Rice researchers then explored the possibility of exposure to high levels of ozone leading to cardiac arrest. As a result, they studied a collection of eight years’ worth of data regarding air quality monitors and over 11,000 out of hospital cardiac arrest incidents that were recorded by Houston’s Emergency Medical Services. Their results showed that there is in fact a positive correlation between out of hospital cardiac arrests and exposure to ozone.
In addition, the research revealed that, with a daily increase of particulate matter of as little as six micrograms, the risk for individuals to suffer cardiac arrest rises by 4.6 percent. This has more impact on those who already have pre-existing health conditions. The risks were found to be higher for men, individuals over the age of 65 and African Americans.
Also for the study, the cardiac arrests were labeled as instances where EMS workers performed CPR. The researchers noted that more than 90 percent of the individuals studied died. The majority of the deaths – 55 percent – took place during the hotter summer months.
Other substances, including nitrogen dioxide, sulfur dioxide and carbon monoxide, where studied, but none of them were found to be concurrent with out of hospital cardiac arrest. To learn more about what steps to take during a cardiac arrest, visit Lifesaver Education to find your nearest Los Angeles CPR class or online BLS course.
Cardiopulmonary resuscitation has been used for decades by first responders and Good Samaritans with mixed results. Clinical studies as cited in an article published by the Journal for Emergency Medical Services have shown that administering proper chest compressions increases the survival rate for those suffering from cardiac arrest. Studies demonstrate that the most important factors in CPR are chest compression depth, rate, and fraction (pauses when compressions are not being performed). These factors and the survival rates associated with them played a part in the 2008 change in protocol from ABC to CAB.
The recommended depth for chest compressions is at least 2 inches. Studies have shown this depth is rarely achieved. Even when performed by trained professionals in hospital settings, the depth of 1.5 inches is only reached 72% of the time. The cited studies have shown that a depth of 2 inches or deeper results in better perfusion of blood, resulting in lower carbon dioxide levels.
Other factors contributing to higher success rates are the rate at which chest compressions are administered and the pauses, or fraction, between rounds. The AHA-recommended rate is 100 to 120 compressions per minute. It is also recommended that the pauses should be 10 seconds or less. Studies have proven that a higher rate with fewer interruptions directly affected the patient's chances of survival. Pauses lasting longer than 10 seconds caused a drop in blood perfusion, the depth of the compressions became shallower, and the survival rate decreased. It was found that the longer the pause, the more difficult it became for the rescuer to regain the depth and speed necessary for adequate CPR. A graph accompanying the article showed that deeper and faster compressions resulted in a higher number of patient's being admitted to hospitals alive.
The JEMS article cited over a dozen studies conducted over the span of five years and suggested that the quality of chest compressions was more important then defibrillation and that the rates during CPR were suboptimal. This, and the survival rates associated with it, is why the compression-only approach was suggested in 2008 for both professionals and bystanders who witness a cardiac arrest. To learn more about CPR classes Los Angeles, visit Lifesaver Education to book a CPR training course.
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In February of this year a nurse at a retirement center made the national news when she refused to perform CPR on an 87-year-old woman that collapsed in the dining room. She did, however, call 911. The nurse spoke with the 911 operator for seven minutes while awaiting the arrival of the emergency help. The nurse reiterated the policy of the facility that stated she was only allowed to call 911, stay with the dying woman but not preform CPR. In this particular case, the family stated their relative would not have wanted intervention.
The facility did not have a do-not-resuscitate order (DNR) for this resident. The nurse reportedly was working as an administrator, not a nurse. Does this matter? A licensed nurse must always have a current CPR certification. Is this an appropriate policy for a facility full of elderly residents? Or, did the resident sign some form that relieved the facility of this responsibility?
Registered nurses are certified in nursing school to perform CPR before they are licensed, and they are held to a standard of care. The Board of Nursing in California has revoked nurse’s licenses when they did not perform CPR on a patient who did not have a DNR order. It is quite clear that a nurse working in a healthcare facility must begin CPR if the patient is not breathing nor has a pulse.
As this incident received a great deal of coverage on the news, many independent living facilities are reviewing their policies regarding this very situation. At this time the consensus seems to be, if an RN is working in the facility, then they must be allowed to perform CPR if there is no DNR order.
A facility that employs nursing staff should discuss with each new resident their wishes concerning CPR, and either initiates a DNR order or proper documentation that expresses the client’s wishes should be signed. This means the nursing staff must have a way to know which patients have a DNR order or do not want CPR.
If a residential facility does not employee nursing staff, then they can hardly be required to have anyone available to perform CPR in an emergency. To learn more about this event as well as how to perform CPR and other lifesaving measures, visit Lifesaver Education and sign up for CPR Classes Los Angeles or BLS online courses.
A recent study is suggesting that advanced airway management may not be helpful to emergency medical personnel in resuscitating patients who have had a cardiac arrest outside of a hospital.
The study, published in the Journal of the American Medical Association, found that an older technique worked better than a more modern one. It followed 649,359 cardiac arrest patients in Japan and compared their outcomes using three methods. The methods were endotracheal intubation, supraglottic airway devices, and the older ambu-bag technique.
Dr. Kohei Hasegawa, the chief author of the study, and colleagues found that patients treated by the first two techniques had worse, not better, outcomes than those using the older ambu-bag technique. The patients treated with the first two techniques scored significantly worse in neurological testing.
According to the study authors, "Our observations contradict the assumption that aggressive airway intervention is associated with improved outcomes and provide an opportunity to reconsider the approach to pre-hospital airway management in this population."
The researchers have been speculating as to why there is such a difference in outcomes among the three techniques. One theory is that the time being spent inserting airway devices could be harming efforts to perform CPR. Another theory is that endotracheal tubes can be difficult to insert correctly. Blood supply to the brain or heart can be interfered with if too much air is pushed into the lungs. This might provide too much oxygen and actually be toxic to the body.
Due to some of the limitations of the study, researchers feel that the best approach from here is a randomized clinical trial. Such a trial could shed further light on if the study's findings are accurate and if so, what specifically it is about the various techniques that leads to poorer outcomes for cardiac arrest patients. To learn more about the older airway management techniques as well as what to do in the event of a life threatening emergency, visit Lifesaver Education to sign up for Los Angeles CPR courses and EKG Certification Classes.
Previously, the consensus among authorities was that pediatric CPR beyond 20 minutes was a futile effort, with standard of care allowing cessation of CPR after those 20 minutes. However, that common knowledge may soon be up for revision. A new study conducted by Dr. Renee Matos at the University of Pittsburgh School of Medicine showed that of 3,419 children involved in the study that required CPR, 28% of these children survived to be discharged from the hospital. Of these children surviving CPR until hospital discharge, 16.6% percent received CPR lasting longer than 35 minutes. Of the children receiving CPR longer than 20 minutes, 60% of these children had a favorable neurological outcome, meaning that no significant and irreversible damage to the central nervous system due to lack of blood flow that could cause decreased survival occurred.
Previous but recent studies had shown that longer CPR could be beneficial for children. However, these studies were also limited or flawed, either due to their retrospective nature or because only one hospital or medical center was involved. Matos and colleagues attempted to overcome some of these limitations through a multi-center retrospective study, using the American Heart Association's Get With the Guidelines-Resuscitation (GWTG-R) registry as eligibility criteria. Not only did this increase the number of patients involved, but also the broadness of hospitals involved; 328 hospitals were involved in the study, from the United States and Canada. The study found that with prolonged CPR, the total number of patients surviving after CPR between 16 to 35 minutes of CPR was 17.8%, with the survival rate increasing to almost 44% between 1 to 15 minutes.
In addition, the study also found that patients in the Surgical Cardiac category fared best with prolonged CPR, with a 25% survival to hospital discharge. Children involved in trauma fared the worst, with only 8% surviving to hospital discharge. Despite the findings from Matos, the clear evidence still remained that survival drops off drastically after the first several minutes of CPR. Still, these new findings may bring about discussion about current CPR guidelines for children, including the CPR Los Angeles classes at Lifesaver Education, as well as BLS online classes.
A recent study has found that the use of a certain type of CPR training kit can help prepare parents to do the right thing in an emergency. The research, which was done at Stanford University in California, involved 117 parents, all of whom had children in high-risk cardiovascular situations. These parents were given the training kit after their children were discharged from the hospital and told to make use of it at home. They were then interviewed by telephone at one, three and six month intervals to see how much knowledge they had retained.
At the end of the final series of interviews, it was determined that 80 percent of the parents knew that calling 911 was the first and most important step in helping an unconscious child. An even greater percentage knew to watch the chest rise and fall to make sure ventilation was occurring during CPR breathing.
It should be pointed out that there are a few problems with this study, such as the fact that there was no control group to compare to. It was also noted that the parents who already had some knowledge of CPR were more likely to take part in the survey, which means that the findings are somewhat skewed. That said, researchers still think the kit, which is called CPR Anytime and includes a baby mannequin for practice purposes, is a great thing. The nurses at Lucile Packard Children's Hospital at Stanford found that giving the kit to parents lessened the amount of time that they needed to spend educating the parents themselves, making them more available to help other patients. It was also found that handing out the kit to parents continued to spread CPR awareness, as many of them shared the instructional materials with friends and family.
The Lucile Packard Children's Hospital is now giving the kit to all parents of high-risk children at no additional charge. To learn more about this program as well as other measures to take during a life threatening emergency, visit Lifesaver Education to book your CPR Los Acourngeles class or ACLS online course.
Survival rate among pediatric patients who experience cardiac arrest has improved in recent years, according to research by Dr. Saket Girotra and his colleagues at the University of Iowa Hospitals and Clinics. Even better, the improvement in survival rate does not come with a worsening in neurological outcomes.
When adjusted for risk, the survival to discharge rate improved each year from 14.3 percent in 2000 to a rate of 43.4 percent in 2009. During the same time period, there was virtually no change in the number of survivors who experienced significant neurological disability.
Reasons for the higher survival rate are currently unknown. Dr. Giortra suggests that the improvement may be linked to more emphasis that clinical guidelines have placed on resuscitation over the past ten years. Another possibility for the increase may be the result of quality improvement efforts within hospitals. More research will need to be conducted in an effort to determine which hospital-specific quality improvement measures may have contributed to such a sharp improvement in survival rates.
Researchers evaluated data from the 1,031 children, who were patients at 12 hospitals that reported in-patient cardiac arrest from 2001 to 2009. The study's authors indicate that greater use of minimally invasive techniques to treat congenital heart disease, better patient management after surgery, and advances in management of pediatric patients during cardiac surgery with reduced ischemia time may have contributed to the favorable trend in patient survival rates. However, an increase in the severity of non-cardiac illnesses among pediatric patients may have led to an increase in the proportion of cardiac arrest incidents that were related to non-shockable rhythms. Survival to discharge rates also improved over the examined period.
The authors commented that limitations of the study include lack of information on resuscitation values, hospital characteristics, treatment delivered, and the fact that researchers were only able to study unadjusted rates of neurological disability due to the small sample size and lack of data.
Hospitals that were the subject of the study and participated in the Get With The Guidelines Registry may also differ from other medical centers; therefore the results cannot be generalized.
To learn more about this study as well as what to do in the event of cardiac arrest, visit Lifesaver Education to book ACLS classes Los Angeles or EKG Certification classes.
Senior women, who have heart disease, could possibly be an increased risk for developing mental changes that experts believe may be the beginning stages of a form of dementia. According to a recent study, researchers believe that vascular dementia, a form of mental decline, occurs when there is a problem with the blood circulation to the brain.
There is a study that is published in JAMA Neurology. The study followed 1,450 women and men who were in their 70s and 80s at the time. All of the subjects lived in Rochester, Minnesota. The researchers administered tests that measured the participants’ brain function every 15 months.
Four years into the study, 348 subjects experienced some type of mild cognitive impairment (MCI). Trouble making decisions, going through a neighborhood that one is familiar with, finding the right words to say and memory loss are some of the signs of MCI. Ninety-four of the people developed a form of MCI that is linked to vascular dementia. This form of dementia does not cause memory loss, but it can interfere with visual-spatial relations, reasoning and decision making.
Heart health did seem to have an effect on the subjects’ risk of developing mental changes. Researchers took high blood pressure, diabetes, lack of exercise, family history and stroke into consideration. They still found that people who have heart failure, coronary heart disease and atrial fibrillation were twice as likely to develop MCI without memory loss.
This correlation was very strong in women. Women who had heart problems were three times as likely to develop MCI as women who did not have any heart problems.
According to the researchers, the first step should be exercising and eating a healthy diet to prevent heart disease from developing. People who already have heart disease should see their doctor regularly so that they can keep their cholesterol, diabetes and blood pressure under control. That will improve brain and heart health.
Rosebud Roberts, a physician and epidemiology professor, has stated that if people can reduce the risk of the illnesses that lead to heart disease, then they will be able to reduce the risk of developing mild cognitive impairment. This in turn will reduce the risk of dementia.
To learn more about this study and many others, visit Los Angeles CPR class leader, Lifesaver Education or book an ACLS online class.
Many of us have been taught the basics of CPR and so we believe that the proper procedure involves alternating chest compressions with blowing breaths into the victim. However, a new Japanese study suggests that a simpler procedure, using chest compressions alone, may yield greater survival rates. This CPR technique is called Hands-Only CPR.
The study appeared in the American Heart Association's Journal (called Circulation) and it claims that chest compressions alone yield more survivors with satisfactory brain function versus using compressions and breathing combined.
If bystanders witness someone experiencing a sudden cardiac event, they should immediately begin chest compressions, without pausing to offer rescue breathing. If an automated external defibrillator (AED) is accessible, the bystander should use it to administer a shock to the victim. AEDs are often mounted in easily accessible locations in public buildings such as schools and gyms.
The study involved 1,376 sudden cardiac events that occurred in Japan during the years 2005 to 2009. All of these cardiac events involved bystanders who administered some form of CPR as well as a shock by an AED device. Some bystanders performed compression-only CPR while others performed chest compressions combined with rescue breathing. Approximately 35% of the cardiac arrest victims received compression-only CPR while the other roughly 65% of victims received compressions as well as rescue breaths.
The study compared the health status of these two groups of victims one month after their cardiac event. Their findings revealed that nearly half of the compression-only group was alive while only 40 percent of the compression and rescue breathing group was alive. The study also looked at the brain function of survivors. In the compression-only groups of victims, 40.7% had good brain function one month after their cardiac event. However, in the traditional CPR group, only 32.9% of victims retained good brain function.
With these study results favoring the use of chest-compression only CPR, it should make the process of teaching and learning this life-saving technique easier for everyone involved.
The American Heart Association still recommends administering traditional CPR to children. To learn more about this study as well as what to do during a life threatening emergency, visit Lifesaver Education and schedule a BLS online course or EKG Certification classes.
New research shows that a person can reduce their risk of myocardial infarction if they consume large quantities of berries in their diets regularly. A diet rich in anthocyanins, found in blueberries and strawberries, can lower myocardial infarction risks in women. The research confirmed the dietary benefits of berries in lowering MI risks.
Anthocyanins are flavonoids found in blueberries and strawberries. Scientists recently confirmed that the flavonoids decrease heart attack risks in young and middle age women. Women who ate over three servings of fruits rich in flavanoids per week were able to lower their MI risks by 34 percent when compared to women who didn’t consume berries. Women in the study who ate the most berries saw approximately 32 percent reduction in heart attack risks.
In the Nurses’ Health Study, 93,600 women were asked to complete a questionnaire every four years. Since 1991, the women were monitored as a part of the study. The questionnaire asked participants to record basic information about their lifestyle and diets. In the group, 405 reported myocardial infarction activity. The median age for the women included in the group was 48.9. After adjustments were made for physical activity, alcohol consumption and other dietary habits, the research showed significant improvements in cardiovascular health with a diet rich in antioxidants. Berry supplements and their effectiveness were not evaluated as a part of the research. Scientists have not determined whether or not similar heart health benefits can be derived from berry supplements.
Research also found that women who consumed large quantities of berries and foods rich in antioxidants were also less likely to engage in certain activities. The study showed that women who had more than three servings of berries per week were less likely to consume fewer alcoholic beverages. Women who receive the recommended amount of antioxidants were more likely to be physically active. They also consumed higher amounts of fiber and had lower amounts of fat in their diets.
The phytonutrients and rich antioxidant properties found in berries have been previously studied for their health benefits. The flavonoids contained in berries and eggplants promote heart health in young and middle age women. In younger women, flavonoids were shown to be most beneficial in lowering coronary heart disease among young women. To learn more about this study and other lifesaving measures, visit Lifesaver Education to book your CPR Los Angeles class or EKG Certification Classes online.
Research has consistently shown a high degree of correlation between secondary-intervention drug strategies and favorable lifestyle changes upon recurrent acute coronary disease. Medical regulatory bodies have taken note of this correlation and have established an 85 percent threshold of regimen adherence for all ACD patients in the UK.
Unfortunately, continual evidence of poor adherence, in the form of recurrent hospital visits for further myocardial infractions and other cardiovascular ailments, has prompted an additional study into prevention-regimen compliance. This observational study displayed an adherence-failure rate much higher than the standards set by regulatory agencies.
Examining the results, methods and limitations of the study can give insight into the future of ACD treatment plans. With some luck, future regulatory agencies, general practitioners and patients can benefit from the considerations and recommendations provided.
The research was performed in an observational manner within a single medical facility over the course of 9 months. Exactly 100 patients, 61 males and 39 females, were observed during the study. Patients were chosen based on hospital admission for myocardial infraction or other symptoms of coronary heart disease. This requirement resulted in a mean patient age of 65. Subject choice was not biased based on individual drug effectiveness. Data was collected concerning drug prescriptions, smoking history and cardiovascular health. Subject data was not collated to determine any relationship between drug administration and patient cardiovascular health risk.
The data illustrated a sharp divide between medical standards and actual adherence. Whereas regulatory bodies sought an 85 percent rate of adherence, upwards of 70 percent of patients were missing key prescriptions from their treatment plans. Antiplatelet aggregation drugs, lipid regulators and beta blockers were among the most lacking. The standards for effective control of blood lipid profiles, cholesterol and resting heart rate were not met among the testing group.
While the findings display a pronounced divide between medical standards and actual practice, the limits of this particular research deserve mentioning. The relatively small sample size and center-specific investigation reduce the applicability of the research. As such, confounding factors related to locale may play a part in skewing data. To learn more about this study as well as what to during a major cardiovascular event, visit Lifesaver Education to sign up for one of their Los Angeles CPR classes or to book an ACLS online course.
The cells that form the inside of the heart have for the first time been shown to be a major source of the cells found in coronary arteries. Scientists have also identified the pathway by which these inner heart cells are transformed into artery cells. These discoveries were made by scientists at the Albert Einstein College of Medicine, which is one of the schools of Yeshiva University, located in New York City.
Dr. Bingrou Wu and his colleagues reported their findings after research that was conducted using mice embryos. Dr. Wu explained that the research has helped in the understanding of how biological structures are formed during embryonic development. However, he noted that there is still "a long way to go" in terms of the practical application of what has been learned.
Endocardial cells comprise the inner layer of the heart. Endothelial cells, on the other hand, line the arteries that are vital to the functioning of the heart. The new research has shown that endocardial cells use what's known as vascular endothelial growth factor signaling to become endothelial cells. It had previously been suspected that the arteries and the veins of the heart had a common source. However, medical researchers had been unable to identify the specific mechanism by which heart vessels formed. Dr. Wu attributed this failure to methodological limitations.
The latest research work employed genetic mapping, imaging and such functional studies as gene knockout. These methods made it possible for Dr. Wu and his colleagues to determine that endocardial cells found in the ventricles of the heart develop by forming networks of cells through the process of angiogenesis. Experiments further showed that endocardial cells contribute little to the development of coronary veins prior to their transformation.
This new research suggests that the manner in which heart arteries and veins develop is largely related to groups of endothelial cells that are found at different locations and different periods of time during embryonic development. The findings of this research could be of vital importance when looking for ways to regenerate coronary arteries, which in turn could in turn be of great significance in treating heart disease. To learn more about this study as well as lifesaving measures during a cardiac event, visist Lifesaver Education to register for a CPR Los Angeles class or ACLS online course.
The majority of research regarding exercise and its effects on a person’s lifespan has been an attempt to understand how exercise decreases a person’s mortality risk. But, a recent study published in PLoS Medicine on November 6, 2012 indicated that a little bit of exercise may go a long way to lengthening lives, instead of just decreasing the risk of sudden death.
Steven C. Moore, PhD, from the Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, Maryland and his colleagues combined 6 companion studies that included 654,827 participants in the age range of 21 to 90. Dr. Moore specifically focused on the duration of physical activity performed during the participants’ leisure time and their life expectancy.
Moore and his colleagues found that those who were middle aged and exercised by briskly walking for just 75 minutes a week lived almost two years longer than those who did not, even if they were overweight. If they engaged in more rigorous exercise (such as swimming or aerobics) and did so more frequently, their life expectancy increased by 3 to 4.5 years. Interestingly, a small amount of exercise still extended the lifespan of the participants despite their body mass index (BMI). Those who had little to no physical activity and higher BMIs had a shorter lifespan and an increased risk of death, than those with lower BMIs and the same amount of physical activity.
However, the participants reported on their own amount of physical activity during their free time meaning the numbers could be skewed by the participants. The study also did not take into consideration the participants’ diet or current health conditions because it was observational only.
The study has been praised as a worthwhile endeavor by Geoffrey Godbey, PhD, professor emeritus of recreation, park, and tourism management at Penn State University, University Park, Pennsylvania. Dr. Godbey also noted that the large number of participants and the fact that the physical activity took place during leisure hours were important strengths of this study. To learn more about this study as well as what to do in the event of an emergency, visit Lifesaver Education to book your CPR Los Angeles class or EKG Certification classes.
A recent study published in the New England Journal of Medicine on October 25, 2012 found that the type of neighborhood in which an individual lived had a huge impact on whether or not a bystander would initiate CPR on an individual should they need it. Someone who lived in a low-income neighborhood that was predominantly black or Latino was less likely to receive CPR than someone who lived in a high-income neighborhood that was predominantly white, or integrated.
In the study, twenty nine American cities were surveyed by Dr. Comilla Sasson and her colleagues from the University Of Colorado School Of Medicine, Aurora campus. The numbers she found were astounding. The possibility of receiving CPR by a bystander was 50 percent greater in a predominantly white high-income neighborhood than in a predominantly black or Latino low-income neighborhood. The statistics were very similar for white and integrated low-income neighborhoods.
Sasson found that there were several reasons for this. The main reason was the lack of education about CPR among residents in low-income neighborhoods. Residents were unable to afford CPR classes or certification, which can cost up to $75.00, and still afford to put food on their family’s table or pay their bills.
Many people were also afraid to perform CPR because they thought they might be putting themselves in danger. The fear of being robbed made people apprehensive to get involved at all, let alone perform CPR. The possibility of being sued was also a major reason for apprehension as was the idea of performing mouth-to-mouth resuscitation because of the possible health risk.
In an effort to ease these fears, Sasson and the American Heart Association as well as the American Red Cross provided free hands-only CPR training in low-income neighborhoods through organizations that were already successful in these areas. Hands-only CPR alleviates the need for mouth-to-mouth resuscitation, which means less people will be apprehensive about using it. Educating as many people as possible through CPR classes Los Angeles and BLS online courses offered by Lifesaver Education means more people will know what to do should the need arise, which can greatly increase a person’s chances of receiving CPR.
A recent study published in Lancet found that patients who are treated in hospitals which make efforts at resuscitation for a longer time are more likely to survive cardiac arrest than patients treated in hospitals whose resuscitation efforts stop sooner.
The study, sponsored by the American Heart Association, looked at the medical records of 64,339 patients from 453 different hospitals. The researchers focused only on patients who had suffered a cardiac arrest while in the hospital. Analysis confirmed the results of earlier studies; patients who revived generally did so early in the resuscitation process. However, the study also showed that patients who did not revive right away had a higher survival rate at hospitals that tend to spend a longer average time on resuscitation efforts. In fact, patients at the hospitals with the highest average time, 25 minutes, had a 12% better chance of resuscitation than patients at hospitals whose average resuscitation attempts lasted 16 minutes, the lowest average found in the survey.
The study also showed that the patients who took longer to resuscitate did not show more damage to neurological functions than the patients who revived quickly.
Physicians are often wary of making lengthy attempts at cardiac resuscitation because the outcome is often poor. It’s estimated that of every five patients who suffer a cardiac arrest while hospitalized, only one will survive to be discharged.
Currently, the American Heart Association does not offer guidelines on how long resuscitation attempts should last, due to the lack of scientific data on what signs medical personnel should look for to determine whether or not resuscitation still has a chance of success. To learn more about how to perform CPR, visit Lifesaver Education to book CPR classes Los Angeles as well as ACLS online classes.
Emergency Dispatch centers frequently receive calls about possible heart attacks, but a new study shows that the majority of those calls come from female patients. Dr. Jonathan D. Newman from Columbia University Medical Center in New York conducted a study, which was later reported in The American Journal of Cardiology. The initial study found that among 184 sufferers of heart attacks, women were more likely to call 911. Fifty-seven percent of women called, and only 28 percent of men called.
The findings are based on 476 patients who were transported to the Columbia ER from a different center or directly arrived to the ER from their own home. Of the 476 patients, 39 percent of them were actually diagnosed with a heart attack. The other 61 percent were diagnosed with unstable angina. To further breakdown the statistics, only 15 percent of women and 13 percent of men of the 292 patients with unstable angina actually called 911. The study didn't include how the remainder of patients reached medical care. It is most probable they took either the subway or a taxicab. Dr. Newman also mentioned that he is unsure of the exact reason why women typically call 911 more than men.
Women usually experience heart attack symptoms more than men. However, women are also more likely to experience no symptoms of a heart attack. Based on that last comment, researchers would assume that men would call 911 more often than women would call 911 for heart attack symptoms. The one thing that Dr. Newman's team found was that the study had a large demographic of younger women. In other words, young women called 911 more than young men. Again, there is no real reason why young women call 911 more frequently. One theory is that young women are more frightened by chest discomfort, whereas older women may find the pain as a part of their aging. The study was localized in the New York region, so the findings may not be accurate of all Americans. To learn more about the proper steps to take during a cardiac episode, book a Los Angeles CPR class with Lifesaver Education or find a BLS online course.
Officials in Suffolk County, New York, are reporting that the use of Narcan by EMTs has prevented 23 fatal drug overdoses in the first 10 weeks of the program.
Narcan, or naloxone hydrochloride, is an antidote to the effects of opiates such as heroin and morphine. When administered as a nasal spray by an EMT, Narcan counteracts the potentially deadly effects of an opiate overdose. Time is an important factor in treating drug overdoses; the body begins to shut down and emergency personnel may not have enough time to transport the patient to the hospital for treatment. With Narcan, the EMTs can counteract the opiate effects to stabilize the patient for transport.
Dr. Scott Coyne, medical director of the Suffolk police department, was enthusiastic about the program's success. "We have had phenomenal success with intranasal administration of this medication," he said.
Bob Delagi, the EMS council director explained that the health department has wanted Narcan available to EMTs since 2009, but since it was only available as an injectable drug only EMTs with advanced certifications could administer it. Now that Narcan is available as an intranasal spray, the state is funding training in its use for basic-level EMTs. In May of 2012 the program was approved, and to date 1083 of the county's 5000 registered EMTs have been trained; this includes nearly 400 police officers.
The Narcan program comes at a fortunate time, as Suffolk County has seen a drastic rise in opiate-related fatalities. Opiates contributed to 119 deaths in 2010, but in 2011 that number increased to 217. The county has reported 53 opiate-related deaths in just the first quarter of 2012.
Medical researchers have reported very few serious side effects from Narcan use. Emergency response teams around the country are using Narcan to prevent overdose deaths in increasing numbers. To learn more about lifesaving measures you can take in the event of an emergency, visit Lifesaver Education to book Los Angeles CPR classes or an online CPR training course.
Approximately 30-45 percent of people who have myocardial infarctions (MI) have STEMI, which means a ST elevation in their cardiac rhythm. The treatment for a patient presenting with a heart attack with STEMI would typically be a clot buster medication to quickly restore blood to the heart muscle.
A recent myocardial infarction study in France, by Dr. Nicholas Danchin, concluded that two different trends were occurring. He found a decrease in the death rate over the past fifteen years for those with recognized risk factors due to better prevention strategies. This decline in mortality was especially true for older patients. He concluded that senior patients, who are considered prime MI candidates, are receiving better primary care treatment and faster treatment if such an event occurs. The unsettling finding in this study was the increased number of women under the age of 60 years who smoke and suffered a myocardial infarction with STEMI. This number increased 7 percent from 1995 to 2010. Most of the women did not have the typical risk factors for developing heart disease, except for smoking. Smoking rates for women in this group increased 36 percent from 1995 to 2010. Obesity rates in this time frame also increased 8 percent.
The study found that the overall average age for those that suffered an MI with STEMI decreased from 66.2 years to 63.3 years. The decrease in the number of women under the age of 60 having an MI is believed to have caused the change. These women did not have the standard risk factors, such as hypercholesterolemia, diabetes or hypertension.
Women under the age of 60 represent about 7 percent to 8 percent of all myocardial infarctions. At the current time, 25 percent of the women who suffer an MI are under age 60. In addition, myocardial infarctions for women under the age of 50 have also increased 7 percent.
The conclusion reached by Dr. Danchin is that smoking is more damaging than obesity. Often women choose not to stop smoking because they are concerned about weight gain, but the doctor states it would behoove them to weigh a bit more and stop smoking to prevent a myocardial infarction. To learn more about this study as well as what to do during a major heart event, book local Los Angeles CPR classes with Lifesaver Eduction, who also offers PALS Online certification classes.
A recent observational study looked the correlation between current antipsychotic use among the elderly population and hospitalization for acute coronary syndrome (ACS). Contrary to findings from earlier studies, the Dutch-based investigation found no such link. Furthermore, its data suggests that antipsychotic use by older people might actually have a protective effect on the heart.
ACS is the most common cause of death in the 60-plus age group. Antipsychotic use among this group is also high. These two facts led to earlier speculations that there is a link between antipsychotics and ACS. In 2005, the United States Food and Drug Administration warned that antipsychotic use among older people might increase the probability of death from ACS although no direct correlation was ever proven.
The case for an indirect correlation can perhaps be argued. For example, a correlation was found between antipsychotic use and ACS risk factors, including diabetes and elevated concentrations of antiphospholipid and plasma lipid levels (i.e., hyperlipidemia). Antipsychotics have also been linked to factors often seen in unhealthy lifestyles: obesity, physical inactivity, and smoking. The indirect nature of these correlations, coupled with the unexpected results of The Netherlands’ study, suggests that definitive connections between antipsychotics and ACS remain elusive.
One of the strengths of The Netherlands’ study is its inclusion of a cohort of elderly de novo antipsychotic users. Study results are further supported by its use of a large, community-based population: experimental group (n= 2,803); cohort group (n=26,157); and, control group (n=11,024).
The study is not without its shortcomings, however. Inherent in the observational model is the likelihood that all associated variables are not excluded. The negative association noted between antipsychotic drugs and ACS in the experimental group could be due to factors other the drug itself. It is conceivable, for example, that non-referral rate is high among elderly people who take antipsychotics and who also have ACS. As always, one should be cautious when making inferences about causation. Further study is warranted before results of The Netherlands’ study can be considered conclusive. To learn more about this study as well as what to do in the event of a heart attack, book your closest Los Angeles CPR or BLS online class with Lifesaver Education.
In a small study conducted by the American Heart Association, young adult volunteers in good health who were exposed to ozone for two hours experienced certain physiological changes related to cardiovascular problems.
Those who participated in the study showed evidence of a possible reduction in their ability to dissolve blood clots blocking arteries, alterations in the system controlling the heart’s rhythm and vascular inflammation. However, these changes were found to be both temporary and reversible.
Note that ground-level ozone develops when pollutants from power plants, vehicles, industry, consumer products and chemical solvents react where sunlight is present. Recently, epidemiology studies also reported a relationship between acute ozone exposure and fatalities. However, little has been discovered as to what the underlying causes of this phenomenon might be.
Those who participated in the study experienced two controlled exposures, one with clean air and the other with air polluted by ozone, approximately two weeks apart. In both situations, the participants engaged in periods of stationary cycling followed by matching periods of rest.
No participant reported any physical symptoms or harmful effects when the study was conducted, but following ozone inhalation, tests revealed significant changes that were ozone-induced when compared with their exposure to clean air.
By visiting the Environmental Protection Agency’s (EPA’s) website, www.airnow.gov, you can learn how to reduce your exposure to ozone. In addition, the American Heart Association supports the EPA’s guidelines for limiting the activity of the elderly and those with heart disease, diabetes, pulmonary disease, and specific cardiovascular risk factors.
Being exposed to ozone, as well as airborne particles that reach the lungs could be a major factor in the 2 million acute air pollution fatalities across the globe every year, as estimated by the World health Organization (WHO). The Environmental Protection Agency (EPA) estimates that the yearly toll in the United States is 40,000-50,000 deaths. To learn more about this study and what to do in the event of a heart attack, visit Lifesaver Education to find CPR classes Los Angeles or a BLS online course.
Daily aspirin therapy can minimize the risk of heart attack, according to the Mayo Foundation for Medical Education and Research. Doctors may suggest aspirin therapy for people who have had a heart attack, stroke, coronary bypass surgery, a coronary stent or chest pain caused by angina. Aspirin therapy is sometimes recommended for middle-aged people who have diabetes or a high risk of heart attack.
Some people are concerned about the health risks associated with daily maintenance doses of aspirin. They usually cite easy bleeding, blood clotting disorders and bleeding stomach ulcers. While these conditions may increase the risk of bleeding, aspirin therapy does not cause these conditions.
Recent research conducted by Dr. Jeffrey S. Berger and his colleagues at New York University found that low-dose aspirin on a maintenance plan does not significantly impact bleeding or adverse heart problems. Funded by AstraZeneca, the research analyzed 136 separate studies involving nearly 290,000 heart patients who were managed with medicine or stents.
The study participants included patients with acute coronary syndrome, a group of symptoms associated with the obstruction of coronary arteries. The medical management group received thrombolytic drugs to dissolve blood clots, or in some cases mixed therapies, along with aspirin. Low-dose aspirin was defined as 75 to 149 milligrams and high-dose aspirin was 150 to 325 milligrams. The stent group received clopidogrel, an anti-platelet agent, and aspirin. In this group of study participants, low-dose aspirin was defined as 75 to 159 milligrams and the high-dose was 160 to 325 milligrams.
Researchers analyzed major bleeding, heart attack and death at intervals of one, six and twelve months. With a lone exception in the medical management group, the researchers found no significant differences in any clinical outcomes based on aspirin dose.
Dr. Sanjit Jolly, a cardiologist at McMaster University in Ontario, Canada, urged caution when interpreting the research results. Jolly, who was involved with one of the trials, said only two randomized trials looked at long-term aspirin therapy. He also noted that United States cardiologists lean toward higher aspirin doses, while European doctors favor a low-dose approach. These geographic differences in prescription patterns places limits on observational studies.
Nevertheless, Jolly believes low-dose aspirin therapy can be reasonable in clinical settings. As the research shows, low-dose aspirin can be as effective as higher doses for people with acute coronary syndrome. Since aspirin can interact with certain drugs and dietary supplements, it is important for people to discuss their needs with a doctor before starting daily aspirin maintenance. To learn more about this study, as well as what to do in the event of a heart attack, visit Lifesaver Education to book your BLS online class or local Los Angeles CPR Classes.
A group of researchers in Switzerland have developed a promising new algorithm that uses patient levels of the cardiac protein troponin T to determine the probability of acute myocardial infarction. The Swiss researchers initially used the algorithm to assist in the evaluation of 436 patients who were selected randomly from emergency room patients who reported experiencing severe chest pain, and they followed up by randomly choosing an additional 436 patients to validate the results.
During the three year study, patient levels of troponin T were tested twice using an assay, once to get a baseline reading and again after an hour had passed. The study found that higher levels of troponin T had a very strong correlation to the occurrence of an acute myocardial infarction (AMI), whereas patients with very low levels of the cardiac protein were accurately diagnosed as not having experienced an AMI. Use of the algorithm on both the initial test group and the validation group resulted in more than 75% of patients receiving an accurate AMI diagnosis in about an hour.
One of the major findings of this study was the ability to successfully rule out myocardial infarction for groups with troponin T levels below 12 ng/L whose levels did not fluctuate more than 3 ng/L within an hour. Further validation of this finding could result in shorter hospital stays and fewer tests for patients in this group.
Conversely, patients with troponin T levels above 52 ng/L whose levels changed 5ng/L or more in the initial hour after baseline testing fell into the group that could be definitively diagnosed as having experienced a myocardial infarction. This finding could result in reduced testing time and expedited treatments for patients in this high troponin T group, hopefully leading to improved outcomes over time.
Although more research is needed to validate the results of this cardiac study, the findings represent a tremendously positive development in the attempt to establish new ways to quickly convert diagnostic data received from cardiac patients into more rapid and effective treatments. To learn more about this study and learn what to do during a myocardial infarction, visit Lifesaver Education to sign up for your closest CPR Los Angeles class or online BLS classes.
An increasing number of physicians treat cardiac arrest with mild therapeutic hypothermia, also known as MTH. The therapy protects cardiac, cerebral and neurological function. Some medical researchers believe that the therapy provides greater benefit to cardiac arrest patients suffering from ventricular fibrillation. Practitioners induce MTH using external cooling devices, which drops the patient’s core temperature to 32 to34 degrees Celsius (89.6 to 93.2 degrees Fahrenheit) for a period of 24 hours. Prior to treatment, patients receive a muscle relaxant that diminishes shivering and a sedative if conscious. During mild therapeutic hypothermia, patients also receive ventilation and close monitoring by medical staff.
Besides implementing MTH as part of a treatment regimen for cardiac arrest patients, surgeons commonly cool patient’s bodies during bypass surgery or traumatic brain injury. The cerebral protective effects also benefit stroke victims and allow physicians more time for initiating treatment. When cooled, the body requires less energy and oxygen. Mild therapeutic hypothermia also interferes with the chemical processes that contribute to cellular destruction and cerebral edema. By stabilizing the chemical transmissions emitted and received by delicate neurological tissue, patients have less risk of developing seizure activity.
Research varies from one study to the next concerning the benefits of mild therapeutic hypothermia. Some data indicates that in the case of cardiac arrest secondary to ventricular fibrillation, up to 66 percent of the patients had better neurological outcomes. Only 8 percent of patients undergoing hypothermia after cardiac arrest caused by other types of abnormal rhythms had favorable outcomes. Researchers have not conducted extensive studies comparing the outcomes of cardiac patients receiving MTH compared to cardiac patients not receiving the treatment. Following patients for two or more years after hypothermic treatment also indicates the process increases the likelihood of long term survival.
Some believe that a lack of education and training might contribute to the hesitation physicians have toward accepting and using therapeutic hypothermia. The treatment is also not without possible hazardous side effects. Decreasing body temperatures slows overall circulation, which encourages factors causing abnormal blood clotting. The process also diminishes the body’s natural immune system making patients more susceptible to infection. The sedation required for patient comfort may cover seizure activity. Continual patient monitoring throughout the treatment process alerts medical teams when additional interventions become necessary.
To learn more about what measures can be taken in the event of a cardiact arrest, visit Lifesaver Education to find convenient Los Angeles CPR classes or online cpr training.
Cardiac arrest is a medical emergency that has become a cause for concern. It is estimated that nearly 300,000 people in the United States die each year from cardiac arrest. Advances in medical technology have greatly improved a person’s chance of survival. In the past, a person who went into cardiac arrest only had about a two to five percent chance of surviving. Immediate chest compressions, timely defibrillation and delayed endotracheal tubation are just a few of the many things that have increased a person’s chance of surviving.
Post-resuscitation care is critical to the survival of patients who have gone into cardiac arrest. Once the patient’s circulation has been restored, it is important for health care providers to consider a coronary angiography and mild therapeutic hypothermia. A coronary angiography should be performed immediately on patients whose arrest is considered to be cardiac in origin. An angiography can identify blocked arteries and unstable lesions. If blocked arteries or lesions are found in the patient, doctors will immediately need to perform percutaneous coronary artery intervention.
Patients who are successfully resuscitated but remain comatose should be cooled to 24-32 degrees Celsius for a minimum of 24 hours. Both percutaneous coronary artery intervention and mild therapeutic hypothermia can increase the patient’s chance of survival by 50-60 percent. Eighty to 90 percent of survivors will have normal neurological function.
There was a study done that confirmed the survival rate of cardiac arrest patients who were given aggressive post-resuscitation care. The study followed 248 patients who had suffered cardiac arrest. The results of the study were that 56 percent of the patients were alive five years after they had gone into cardiac arrest. Furthermore, 93 percent of the patients who survived had favorable neurological function. The findings of this study also prove that aggressive post-resuscitation care does not jeopardize a person’s independence or cognitive function.
To learn more about this study and what to do in the event of a cardiac emergency, visit Lifesaver Education to book your Los Angeles CPR class or online BLS course.
Every year, thousands of people visit hospital emergency rooms with symptoms suggestive of Acute Coronary Syndrome, or ACS – in other words, a heart attack. Although nearly three-quarters of those presenting with the typical symptoms of a heart attack do not in fact have ACS, ruling out the condition can be difficulty.
A recent study reported in Medscape examined the typical symptoms associated with ACS in order to determine when a diagnosis of heart attack could likely be ruled out. The location and nature of the pain reported by patients in emergency rooms can offer essential information that leads to the diagnosis, or elimination of a diagnosis of ACS.
ACS is part of a spectrum of cardiac diseases that include various forms of angina and myocardial infarction. Although the classic symptoms of ACS – chest pains, nausea, difficulty breathing – are well known, these symptoms can also be caused by a spectrum of other diseases and circumstances.
Along with diagnostic tools such as the EKG, or electrocardiogram, cardiac enzyme testing and assessing individual and family risk factors, recent studies have explored the nature of cardiac symptoms themselves, examining the type and location of chest pain and other factors associated with chest discomfort as an indicator of ACS.
While pain that radiates to the left arm and, particularly to the right arm, suggests an increased likelihood of ACS, other types of chest discomfort can help to rule it out. Sharp pains, or pain associated with a particular position, appear to be associated with a decreased probability of a heart attack. Pleuritic pain, or pain associated with forceful breathing, and pain that can be induced by palpating the area, also suggest a lower risk of ACS, as does pain that is not linked to exertion, such as exercise or lifting objects.
Cardiac specialists point out that these diagnostic tools only offer probability, not certainty. But the combination of standard testing for Acute Coronary Syndrome and an evaluation of the nature of a patient’s chest discomfort can help doctors to rule out or confirm a diagnosis of ACS. To learn more about lifesaving measures in the event of a heart attack, visit Lifesaver Education or sign up for EKG certification classes.
Epinephrine is a hormone that regulates the flight or fight response in the nervous system. It is also a standard medication that is given to cardiac arrest patients. Even though it was previously thought that epinephrine increases the survival rate of cardiac arrest patients, a recent study has contradicted that belief. Researchers in Japan conducted a study that involved 417,888 patients who were over the age of 18. The mean age of the participants was 72. The data for the study was collected between the years of 2005 and 2008.
The study found that the chances of spontaneous circulation were much higher in the patients who were given epinephrine. However, the study also found that the patients who were given epinephrine were less likely to survive one month after their cardiac arrest. Furthermore, the researchers also found that the epinephrine worsened the patients’ neurological outcome.
Health experts believe that epinephrine works by increasing the coronary and aortic pressure. The results of this study suggest that epinephrine may be bringing patients out of cardiac arrest at the expense of other organs in the body. The researchers of the study concluded by saying that epinephrine offers short-term advantages, but may have long-term negative effects on survival and neurological outcome. This study is one of the few that has measured the potential negative effects of epinephrine.
Even though the results of this study may cause medical professionals to question the use of epinephrine in medicine, there are a couple of things that people should take note of about this study. First, the patients’ care prior to being admitted to the hospital was not studied. Secondly, many experts have stated that a randomized, controlled study will produce more accurate results. Furthermore, it is best to carry out several studies before making any adjustments in an established protocol. For more information on this study and other lifesaving techniques, book your CPR Los Angeles class or online BLS class with Lifesaver Education.
Dr. Sripal Bangalore, a lead investigator at New York University Medical Center, informed theheart.org that a recent study found that patients under the age of 35, both men and women, who go to a hospital with STEMI, ST-segment myocardial infarction, symptoms are not treated the same as older patients. There is concern that this may result in higher hospital mortality rates for younger men and women.
Bangalore indicated that physicians are more likely to look for other reasons for chest pain in the younger patients due to several factors. Those patients generally do not have a history of traditional risk factors such as hypertension or diabetes and, in addition, STEMI is not common in younger people. This results in delayed treatment for those patients. However, they are more likely to receive rehabilitation and other health recommendations than older patients are upon discharge. He does note that the mortality rate for younger patients with STEMI is 63 percent lower than for older patients.
Another aspect of the study related to young, postmenopausal women admitted to hospitals with chest pains. The study shows that these young women have a higher in hospital mortality rate than men and older women. It suggests that the reason may be that young women delay going to the hospital with chest pains because they do not believe it to be heart related. In addition, many physicians do not aggressively treat STEMI in young women because many of them believe that it is a disease of men and postmenopausal women.
Physicians should consider six quality-of-care measures for patients with STEMI. The study indicated that patients under the age of 35 were 32 percent less likely than those aged 36 to 45 to receive all of those measures. Researchers noted that patients under 35 receive poor quality of care and; therefore, are at a higher risk of hospital mortality. Bangalore expressed concern and stated that “...these young kids shouldn’t be dying.” To learn more about optimal heart care, as well as what to do in a life threatening emergency, visit Lifesaver Education to find your closest CPR Los Angeles class or an online BLS Class.
Ventura County, California has a 14% survival rate after cardiac arrest as compared to Los Angeles County with only an 8% survival rate. This isn’t something that would be expected, since hospitals are closer to each other in Los Angeles County and so patients should be getting there quicker and have better survival rates. The reason for this difference may be the way that the Ventura County Emergency Medical Services are providing CPR. They are very strictly focused on minimizing interruptions in chest compressions when doing CPR on a cardiac arrest victim. They even manage to intubate, when necessary, without stopping CPR. When defibrillating a person, the goal is to only stop chest compressions for about 2 seconds. This continuous CPR is likely what is making the significant difference in survival rates. When CPR compressions are stopped, the blood stops circulating and it takes several compressions to get it started again. The blood circulation is what brings oxygen to the heart and brain to keep them alive while resuscitating a person. Minimizing interruptions in chest compressions is one of the key American Heart Association recommended components of CPR. More and more studies are showing why this is so important with results of higher survival rates.
Since starting compressions on a victim of cardiac arrest right away and continuing them without interruption is so important, the more people who know how to do compressions, the more victims will survive. Ventura County also has an innovative approach for this. Each ambulance is equipped with a training manikin. Emergency personnel are instructed to train at least one community person to do Hands Only CPR every day. That’s 27 ambulances times 365 or 9,855 people trained each year. or at least that is the goal. It really adds up. Recently, one of the men, who had been trained one week earlier to do CPR, was working out at his gym when person collapsed. The man was able to do compressions and save the life of another person. He was so grateful for the training that he had received that he donated money to put more manikins on more ambulances. CPR really does make a difference. Learn CPR today by finding your closest Los Angeles CPR class or visit Lifesaver Education to learn more about online CPR training.
Last week, for National CPR & AED Awareness Week (June 1-7), the American Heart Association launched a Hands Only CPR campaign. Only about 32% of people who suffer a cardiac arrest receive CPR prior to EMS arrival. Simply pressing on a patient’s chest, using an appropriate technique, can double or triple a patient’s chance of survival. In an effort to train more people to do this life saving CPR, American Heart Association has unveiled a new state-of-the-art mobile CPR training unit that will be traveling across the country and stopping in at least 24 cities during the next three years to teach Americans how to perform CPR. They are using the disco beat of the appropriately named song “Stayin’ Alive” by the Bee Gees to teach the proper rate for pressing on the chest. West Coast stops include:
• Sacramento, CA September 20-22
• San Francisco, CA September 25-27
• Los Angeles, CA October 1-3
• San Diego, CA October 5-8
Since West Coast stops are not coming until fall of 2012, if you would like to learn this life saving technique now, you may go to the American Heart Association homepage to see a video demo at www.heart.org/HandsOnlyCPR. You can also sign up for a class at Lifesaver Education by visiting us at www.LifesaverEd.com. Don’t delay. Learn how to save a life!
Each year, millions of runners complete in either a marathon or half marathon. Runners usually train for years before attempting to complete any type of race. Not only does training help improve an athlete's performance, but it also helps reduce the risk of injury. Even though the chances of having a heart attack are low for an experienced runner, it is still a possibility. Running can be very dangerous for a person who has a preexisting heart condition. There have been cases reported of people who have died running a marathon because they suddenly went into cardiac arrest.
Cardiac arrest is a situation that can result in death within a matter of minutes. That is why it is important for everyone to get trained in CPR. CPR, which is short for cardiopulmonary resuscitation, is a technique that involves pushing down on the victim’s chest to keep blood moving throughout the body. Most studies suggest that if CPR is administered immediately, it can double a person’s chances of surviving.
CPR has been taught ever since the 1960s. Traditionally, it involves doing chest compressions and blowing air into the victim’s mouth. The CPR guidelines changed in 2008, and Hands Only CPR was announced. The mouth to mouth part was removed in cardiac arrest outside a healthcare setting, when a barrier device was not available. Many people are uneasy about putting their mouth on a stranger, which is one of the reasons that the guidelines were changed. Additionally, there has also been evidence to suggest that CPR may be as effective or more effective without the mouth to mouth breathing. So, the most important thing to know is how to press on a person’s chest.
Again, one of the strongest predictors of the chance of a person surviving cardiac arrest is whether CPR is administered immediately by bystanders. It is always wise to be prepared for the unexpected. Learning CPR is one of the best things that people can do to prepare for an unforeseen event. To learn more about lifesaving techniques, find your closest Los Angeles CPR classes or online CPR training courses by visiting Lifesaver Education.
Have you been wanting to learn how to do CPR, but can never find the time or a CPR class that works with your schedule? American Heart Association (AHA) recognizes that this is a common problem, but being able to do CPR is vitally important in order to save people who have heart attacks. AHA has designed two kits, one for adult CPR training called “Family and Friends CPR Anytime” and another for infants called “Family and Friends Infant CPR Anytime.” The kits are designed so that people can learn CPR in the comfort of their own home. It also is designed so that you can share the kit with your family, neighbors, relatives, babysitters, or anyone else who wants to learn CPR. Another advantage of the CPR Anytime kits is that when people attend a traditional class, they tend to forget what they have learned after a couple of months. However, with a kit, they can just pop the DVD into a player, inflate the manikin, and review whenever they have 22 minutes.
Each kit includes an inflatable manikin, a 22-minute DVD (in English and Spanish), and a reference guide. Kits are available through Lifesaver Education or online. If you order online, make sure to order the latest version with 2010 guidelines. The kit’s box is in full color, not just shades of blue. Each CPR Anytime Kit is $45 from Lifesaver Education
Sudden cardiac arrest occurs when an abnormality in the heart causes it to stop pumping blood, which prevents blood from flowing to all other areas of the body. This condition is fatal without immediate medical assistance. Symptoms of sudden cardiac arrest include the absence of a pulse, a lack of breathing, collapse and no consciousness. Signs that sometimes appear before this condition occurs include dizziness, heart palpitations, fatigue and chest pain. Factors that increase the risk of sudden cardiac arrest include coronary artery disease, obesity, heavy drinking, high cholesterol, smoking, previous heart attacks and high blood pressure.
Treatments for sudden cardiac arrest include cardiopulmonary resuscitation (CPR) and defibrillation. CPR helps by keeping blood flowing to the other major organs in the body. Anyone with the proper training can perform CPR and chest compressions on someone suffering from sudden cardiac arrest. Defibrillators, which deliver electrical shocks to the heart, are used by emergency medical personnel. Public-use defibrillators can be used by people who have undergone training, such as staff at health clubs, malls and senior citizen centers.
The American Heart Association (AHA) states that 88 percent of the 383,000 cases of sudden cardiac arrest that occur each year outside of a hospital happen at home. The survival rate for those who experience this condition is less than eight percent. Administering CPR and chest compressions immediately can double or triple a person’s chance of surviving this life-threatening condition, according to the AHA.
Online tools, such as the Save-A-Life Simulator, can help make people more aware of what they should do if someone around them has sudden cardiac arrest. The simulator walks users through a hypothetical situation in which a person in a public place collapses. Users go through a series of questions designed to test their knowledge of what to do in this type of situation. It serves as a valuable tool for people who aren’t familiar with sudden cardiac arrest or CPR.
To learn more information about CPR and defibrillation, including what to do in the event of a sudden cardiac arrest, visit Lifesaver Education’s Los Angeles CPR classes or online CPR courses.
When a patient has a heart attack and is taken to the hospital, the first minutes can be a matter of life and death. Advanced life support is one of the most important skills of the hospital’s emergency team. In fact, most medical facilities require doctors and nurses to freshen their skills every two years to make sure they are up to date on the latest techniques and have adequate practice. However, researchers are now saying that waiting two years for retraining may be too long.
Advanced Life Support
The minutes immediately following a heart attack are crucial. People finding a heart attack victim should call 911 and be guided to administer chest compressions until emergency crews arrive. When the patient arrives at the hospital, the medical team can do even more, continuing the compressions, clearing any obstruction from the airway, administering medication and restarting the heart with a defibrillator.
Need to Retrain
The commonly accepted standard is for doctors and nurses to take advanced life support training every two years. However, researchers who recently looked at 11 medical studies have determined that two years is too long. The studies examined how well doctors performed on advanced life support tests. They discovered that test results started to drop half a year to a year after the most recent training. Doctors and nurses should look for CPR Los Angeles classes or BLS training online both offered by Lifesaver Education.
Medical Centers Respond
Many hospitals are exploring ways to keep their medical teams’ life support skills fresh. It is common to have doctors and nurses periodically practice their skills on mannequins; some hospitals schedule drills in which an emergency team is called to respond to a patient having a heart attack only to find it’s a mannequin. The team continues carrying out its response and the hospital evaluates its performance.
What’s Still Needed
The researchers who looked at 11 studies found that while they showed doctors’ skills deteriorate after six months, the studies themselves were lacking. Medical experts say more research is needed into particular ways to train medical personnel in advanced life support. Having such specific recommendations will facilitate changing the protocol for how often medical professionals should be retrained.
A pair of recent studies suggests that doctors should measure the blood pressure in both arms of patients being treated for hypertension. Blood pressure can be different in each arm, and minor differences are not always a sign of trouble. A significant difference, though, may indicate an increased risk of heart disease or stroke.
Both studies were conducted by Peninsula College of Medicine and Dentistry in Plymouth, England. The earlier study, published by the medical journal The Lancet, examined systolic blood pressure data accumulated from 28 studies. The study showed a correlation between blood pressure differences greater than 15 mm Hg between arms and an increased risk of peripheral vascular disease.
The current study strengthens previous findings. In this study, researchers found a 9 percent greater risk of death in the next 10 years for each 1 mm Hg difference between arm blood pressure readings. This finding was based on a sample of 230 patients with hypertension and adjusted for age and gender.
Results of the latest study are reported in the March 20, 2012 online journal of BMJ. The study's lead researcher, Dr. Andrew Gould, says that the study's findings point to "inter-arm difference as a simple indicator of increased cardiovascular risk." Because of this, study researchers suggest routinely measuring the blood pressure in both arms and checking for differences as a possible warning sign of heart disease or stroke.
Although further research is needed to confirm the relationship, checking the blood pressure in both arms is an easy, inexpensive heart disease screening tool for patients with hypertension. Dr. Kevin Marzo, chief of cardiology at Winthrop University Hospital in Mineola, N.Y., agrees, noting that it is “potentially so critical to initiating lifesaving treatment.”
Based upon this most recent study, Marzo concludes, “A difference of more than 10 points (mm Hg) could suggest trouble and alert the physician to intensify treatment strategies for preventing a heart attack or stroke.” Harvard Medical School's Dr. Dae Hyun Kim recommends continued monitoring of the arm with the higher reading and using those readings when deciding a course of treatment until further research has been completed on the subject.
To learn more about cardiovascular risks and how to prevent them, take a Los Angeles CPR class offered by Lifesaver Education or look for online CPR courses.
People who come across someone who doesn’t seem to be breathing are often afraid to act. If they don’t have CPR training, they will likely call emergency crews and then just wait for them to arrive. That means precious minutes are passing as the emergency vehicles make their way to the scene. However, the American Heart Association (AHA) is urging 911 dispatchers to instead guide callers to immediately begin CPR, thereby increasing the patient’s chance of survival.
A heart attack, also called sudden cardiac arrest, is when the heart stops beating normally for various reasons. What happens in the first minutes after having a heart attack outside a hospital is crucial because only 11 percent of patients who do so are able to survive, according to AHA. The medical community has been addressing what to do about the fact that passersby are often nervous about providing hands-on assistance. In 2008, the protocol changed by dropping mouth-to-mouth resuscitation as something an inexperienced passer-by should be told to do. Instead, the protocol now calls for chest compressions alone, since research has found that skipping the mouth-to-mouth breathing in the first minutes after the heart stops does not adversely affect survival as long as hands-only CPR is immediately initiated.
The new research reinforces the American Heart Association’s recommendation that dispatchers assess whether the patient has had a heart attack and help the caller immediately begin hands-only CPR if warranted. AHA is also urging emergency medical services, hospitals and other health care facilities to keep track of how quickly and how often dispatchers get callers to start CPR.
The exceptions to hands-only CPR are when someone has drowned or when the patient is a child. In these cases, the patient needs both mouth-to-mouth resuscitation and chest compressions immediately, the research shows. In the United States, emergency medical crews respond to more than 380,000 patients who may have had heart attacks. If dispatchers get callers to initiate chest compressions before the crews arrive, thousands of more patients will survive, according to the heart association.
The American Heart Association and Lifesaver Education both offer CPR Anytime Kits through their websites. To learn more about the new research, visit your local Los Angeles CPR class or find an online BLS course.
With childhood obesity reaching epidemic proportions in the United States, health professionals are seeing more and more children with health problems that mimic those of an adult: high blood pressure, elevated blood cholesterol levels and high blood glucose. This cluster of risk factors comprises what is called cardiometabolic risk. The higher the cardiometabolic risk, the greater the likelihood that your child will suffer from type 2 diabetes and cardiovascular disease later in life. The increasingly sedentary lifestyle of children in this country is a huge culprit. Children and adolescents today spend more time sitting than any other generation in history. They sit in cars, in front of computer screens, and in front of televisions for hours.
The good news is that there is a solution that does not require children to give up their treasured computer games and tv time. They simply need to get up and get moving for a portion of the day. Recent studies have shown that it is not the quantity of time spent being sedentary that increases cardiometabolic risk factors, but the lack of any exercise at all. These same risk factors can be greatly reduced by merely introducing 30-60 minutes of moderate to vigorous exercise into a child or adolescent’s daily routine.
What is moderate to vigorous exercise? Essentially, it is any form of physical activity that increases the heart rate and causes your child to breathe harder. A child or adolescent that is engaged in a game of soccer will go back and forth between moderate and vigorous activity throughout the game. At the end of the game they will have exercised enough to stave off any of the ill effects of sitting for the remainder of the day. Of course not every child will desire to play soccer or be able to participate in sports. But other activities count too: running in the park, cycling, roller-skating, raking leaves, swimming, playing on a jungle gym or climbing trees. Essentially, any activity that gets the heart rate up for at least 30 minutes per day will improve your child’s chance to become a healthier adult.
To learn more about reducing the potential for cardiovascular disease, visit Lifesaver Education to take Los Angeles CPR Classes or look for online CPR classes.
Have you heard the news? February 3rd is the day to wear red to show the world that you will not be a victim of heart disease. The word is spreading, so be sure to help by telling everyone you know about National Wear Red Day on Feb 3rd. We all must come together to inform ourselves and our loved ones of the early warning signs of this deadly disease.
Heart disease has become the number one killer of women over the age of 25. About one out of every 2.6 women dies of heart disease, stroke and other cardiovascular diseases. Every year since 1984, more women than men have died of these diseases. One of the problems is that many of the women who suffer from heart disease do not know that they have this condition. It is often so deadly because the symptoms can be explained with other less serious conditions. The symptoms that women experience can also be vaguer than those typically experienced by men.
The term, ‘Heart Disease,’ is an umbrella term that refers to many different types of conditions in which the heart does not function as it should. The names for some of these conditions are:
• Coronary Artery Disease
• Congenital Heart Disease
• Stable Angina
• Unstable Angina
• Heart Failure
The Most Common Symptoms of Heart Disease:
• Persistent shortness of breath
• Heart palpitations or chest pain that is caused initially by activity but then does not subside once a person begins to relax or stops the physical activity.
• Profuse sweating while at rest
• A heart rate that is abnormally fast and can be felt in one’s chest
• A feeling of being choked
• Extreme feelings of fatigue and general lethargy or weakness
WHEN TO GET MEDICAL HELP Any of the above listed symptoms are reasons to see your doctor right away. However, remember, sometimes women with cardiovascular disease may experience it as numbness or tingling, back pain, abdominal pain, heartburn, or other atypical symptoms.
Call 911 if:
• you have all of the symptoms listed above as well as pain in your left or right arm
• Have chest pains that are not easing after a few minutes of rest
• Your loved one has fainted
• There is sudden paralysis, even if the ability to move returns
Since symptoms in women sometimes do not present in classic ways, if you are not feeling well and have an unusual symptom. Make an appointment to see your doctor to check out the cause. Also, in case a heart attack should occur suddenly, make sure that you and your family know how to do CPR. For a CPR class Los Angeles schedule, visit Lifesaver Education, or find an online BLS class.
Smoking not only damages the lungs, it damages the heart as well. People who smoke are more likely to suffer a heart attack or stroke. In the United States, one fifth of deaths due to heart disease are a result of tobacco use and smoking. Those who inhale secondhand smoke are also at a greater risk for heart disease than people who do not have any contact with cigarette smoke.
The amount of cigarettes a person smokes each day and the length of time he smokes adds to his risk for heart disease. For women, using birth control and smoking place them at considerably greater risk for strokes and heart attacks. Smoking one pack of cigarettes a day doubles the risk for heart disease.
Nicotine, the addictive drug found in cigarettes and cigarette smoke, is primarily responsible for raising a person's risk of heart disease. The drug causes damage to the lining of the arteries and veins, which increases a person's risk for blockage. Nicotine also causes more blood clots, which also causes blockages and strokes. It also speeds up the heart rate and raises blood pressure. High blood pressure puts more pressure on the arteries and other blood vessels, which can lead to a heart attack later on. Smoking also increases the risk for heart disease by preventing an adequate amount of oxygen from reaching the heart.
People can considerably lower their risk for heart disease by quitting smoking. A year after quitting, a person's risk for heart problems is considerably lower than if he had continued to smoke. After 15 years, the risk is similar to a person who had never smoked. Quitting smoking not only improves a person's heart health. People who quit feel better generally and also have a lower risk of lung diseases, gum disease, and throat cancers. If someone near you had a heart attack, would you know what to do? Sign up for a CPR class at Lifesaver Education or find an online BLS course.
While deaths from Sudden Infant Death Syndrome (SIDS) have decreased by nearly 50 percent since the Back to Sleep campaign began in the early 1990's, deaths from other sleep-related causes, including asphyxiation and suffocation, have risen. As a result, new guidelines for safe sleep have been released by the American Academy of Pediatrics, released in the November, 2011 issue of Pediatrics.
The new guidelines provide parents, caregivers and hospital staff with tips aimed at reducing all sleep-related infant deaths, including SIDS. The new guidelines include three important prevention strategies for SIDS: breastfeeding, immunizations and avoiding the use of bumpers in infants' cribs. A 2007 meta-analysis found that a history of breastfeeding was associated with a 37 percent reduction of incidents of SIDS. Other studies have shown similar findings. It is now recommended that all babies be breastfed, preferably exclusively, for the first six months of life to reduce the risk of SIDS. Immunizations have also been found to be a factor in SIDS; studies show that vaccinations can reduce the risk of SIDS by 50 percent. Evidence against the use of bumpers shows that they do not necessarily decrease the risk of injury, but rather increase the risk of suffocation, entrapment, and strangulation.
In addition to these new guidelines, recommendations to decrease the risk of sleep-related deaths include the following:
• Never place your baby on his tummy to sleep, rather than on his back or side, until he begins to roll over on his own. Make sure your baby's caregivers always put your baby on her back as well, even if she's upset.
• Always put your baby to sleep on a horizontal, firm surface. Avoid allowing your baby to sleep routinely in his car seat or other device that holds the baby upright.
• Don't sleep in the same bed as your baby. The risk for suffocation and entrapment in bedding is much higher. There is also a danger of rolling over on the baby or accidentally suffocating her during sleep.
• Avoid using any kind of wedge or positioning device in the crib. The best rule of thumb is to have absolutely nothing in the crib except the baby.
• There is an association between smoking and SIDS. Avoid smoking during and after pregnancy, and keep the home entirely smoke-free.
• A pacifier during naps and nighttime sleep is recommended.
• Don't cover your infant's head during sleep, and don't allow him to become overheated. To keep your baby warm, swaddle her or, for older infants, put her in a sleep sack.
The new recommendations are aimed at entirely eliminating sleep-related infant deaths. By following the new guidelines and eliminating all items from the crib, including bumpers, the deaths associated with strangulation, asphyxiation, entrapment and suffocation will be drastically reduced. To learn more about AAP guidelines for infants as well as other lifesaving measures, visit your local Los Angeles BLS class at Lifesaver Education or find an online CPR class.
With the increasing levels of childhood obesity, more and more children are becoming at risk for heart disease. Some children have blood pressure or cholesterol levels high enough that they may need to take medication to lower them. However, children can make changes to their lifestyles to keep their heart healthy and help lower their risk for heart disease later in life.
A recent study found that children, regardless of their initial risk level for heart disease, can lower their cholesterol levels, their blood pressure levels and their heart disease risk by making healthy lifestyle changes and continuing with these changes as they got older. These include not smoking, eating healthier, losing weight if overweight and becoming more physically active. Improvements in socioeconomic status also decreased heart disease risk.
On the other hand, if children start smoking or continue smoking, are sedentary, gain weight, increase their body fat levels and follow unhealthy diets, their blood pressure, cholesterol levels and heart disease risk are all likely to increase by the time they reach adulthood. Children who were at high risk for heart disease at the beginning of the study who didn't make any healthy changes continued to be at high risk for heart disease twenty years later.
Parents, medical professionals and educators need to make this link clear to children, and act as good examples showing children how to live a healthy lifestyle. Families should work together to make healthy changes so all family members improve their health. For example, parents can teach children how to cook healthy meals and what makes a healthy snack, and the whole family can take after dinner walks or play active games together to increase their physical activity levels. Heart disease is one of the leading causes of death in the United States, and making healthy lifestyle choices is one of the best ways to prevent this medical condition. To find out more about how to prevent heart disease, reigster for a Los Angeles CPR class with Lifesaver Education or sign up for an online BLS course.
Heart Disease is the leading cause of death in the United States, and it is an equal opportunity killer as it effects most ethnicities in nearly the same percentages. According to the CDC, “About 47% of sudden cardiac deaths occur outside a hospital. This suggests that many people with heart disease don't act on early warning signs.”
Not only do people not act on early warning signs, often times they are actually confused as to what they are. There are the ubiquitous signs and symptoms most people believe they would recognize if having a heart attack, such as: dizziness, sweating, left arm pain and intense chest pain, perhaps feelings of indigestion etc. But the fact is, these symptoms do not always appear. There are occasions in which the symptoms of a myocardial infarct (heart attack) mimic other illnesses. This alone illustrates that there are indeed myths about heart health that may put you in danger.
A common myth that people believe is that they will actually know when they are becoming symptomatic of heart disease, high cholesterol or high blood pressure. This is not precisely true; the only way these things can be certainly and thoroughly measured is through tests ordered by a physician. Another common illustration of a heart myth is that heart disease and heart attacks affect both women and men in the same manner. The truth is, that though heart disease affects ethnicities nearly the same, it does not affect genders the same. Women tend to have subtly different symptomatic presentations. Aside from this, it is often believed that younger women are not affected by heart disease, or are even at risk for a heart attack, but this too is not always the accurate.
Another common belief is that things like Omega 3 fatty acids and Aspirin are adequate preventives, and while they certainly help, it is not true in every case. Things such as genetics and diet factor into the equation. As a matter of fact, lifestyle choices in general play into heart disease and the consequences of it. However, if one is careful with their lifestyle choices, and is aware that there are heart myths out there; it is completely possible a little vigilance can certainly reduce your risk for heart disease. To learn more about how to keep your heart healthy, or about avoiding heart myths, visit your local Los Angeles CPR class through Lifesaver Education or find an online BLS class.
According to the CDC, heart disease is the main cause of death for women and men both, with the most common type being coronary heart disease. Approximately 780,000 Americans every year will experience their first heart attack. These statistics are reminders that health goals are clearly not being met by the average American.
There are, in fact, seven healthy heart goals that when properly followed can help you reduce your risk of heart disease--as well as other illnesses secondary to poor diet and lifestyle practices. The American Heart Association created these goals, called “Life’s Simple Seven,” and adhering to as little as four of them can help to reduce the risk of suffering a catastrophic health crisis or dying by about half. Unfortunately, according to a study of almost 18,000 people, only 3 out of 10 persons met four or more of goals, and furthermore; only 2 people met seven of the goals for optimal heart health.
New York University's Cardiac and Vascular Institute Nieca Goldberg, MD, in her role of AHA spokeswoman says, “These numbers are scary and disturbing.” Though shocking, trying to achieve Life’s Simple 7 is well within any person’s power. The intentions of the AHA’s seven steps are to help minimize cardiovascular disease deaths by 20%, while also helping to improve the health of the cardiovascular system of the population by 20% as well; they are paraphrased below as follows:
1. Having a BMI (also known as a body mass index) between18.5 to 24.5.
2. Moderately exercising for at least 150 minutes or vigorously exercising for 75 minutes each week.
3. Quitting smoking at least one year ago or never smoking.
4. Having cholesterol levels be below 200 milligrams per deciliter (mg/dL) total.
5. Having blood pressure that remains below 120/80.
6. Maintaining a blood sugar level when fasting below than 100 mg/dL.
7. Maintaining at least four of the five AHA's healthy diet key components.
These seven steps are sound advice for everyone, and by not following them there is always the chance of sustaining irreversible heart damage, or worse, death. Heart disease is insidious in that it often cannot be detected until it has reached an acute state, and at that point medical intervention, or perhaps even CPR, will be required. A strong, healthy, well-functioning heart is crucial not only to maintaining your life, but to enjoying it. To find out more about life saving measures that can be taught via CPR classes, visit Lifesaver Education or find an online BLS class.
One of the most common types of heart attack is the ST Elevation Myocardial Infarction. (STEMI) It generally occurs when atherosclerotic plaque in the arteries ruptures and blocks the flow of blood to the heart depriving it of oxygen. When this happens, cardiac cells die with the potential result being the death of the person exhibiting symptoms, or a chronic heart condition that may require pacing or medication for the duration of the person’s life. However, if medical treatment is quickly administered, in the form of thrombolytics or angioplasty, the patients’ chances of survival and the resumption of a well-functioning heart increase dramatically.
“Time is muscle” is a saying familiar to most medical professionals; it is said in reference to those crucial minutes between the onset of cardiac symptoms and the lifesaving treatment thereof. Though those critical minutes are also referred to as the “golden hour,” rarely did a patient receive the necessary interventions in an hour or less. However, in the past five years, according to a study published in “Circulation: Journal of the American Heart Association,” patients are now being treated 32 minutes faster on average. They are currently being treated in about 64 minutes, which is a significant decrease from the previous time of 96 minutes. Another improvement mentioned in the study is the fact out of all of the heart attack patients that required emergency angioplasty in 2010; more than 90 percent received treatment within the recommended 90 minutes much better than the 2005 rate of 44 percent.
The improvement in the above statics can be largely credited to The American College of Cardiology’s “Door-to-Balloon” campaign. This campaign focuses on providing a person suffering a myocardial infarction with expedient care and as near immediate access to thrombolytics and angioplasty as possible (H the “Door-to-Balloon” reference). The D2B protocol has not only reduced patient morbidity and mortality by 30 percent, it has resulted in an improvement of the long-term health of the patient, and improving the long-term health of a patient has been found to reduce the costs of health care in the future.
With widespread implementation of initiatives like the Door-to-balloon program we would see a reduction in the costs of health care in general. D2B may be just the lifesaving intervention that not only the patient requires, but one the United States health care system needs as well. To learn more about the D2B initiative sign up for a CPR class or online BLS classes at Lifesaver Education.
Every five years ACLS guidelines are reviewed and protocols or procedures are modified based upon the data collected in the previous five years by The American Heart Association and The International Liaison Committee of Resuscitation. In late 2010 new guidlines for 2011 were announced and are as follows:
A-B-C to C-A-B:
The standard A-B-C (Airway, Breathing, Circulation) has been changed to the C-A-B approach (Circulation, Airway, Breathing). This puts emphasis on circulation and maintaining blood flow in the case of life threatening heart malfunction or arrhythmia.
Chest Compression Changes:
Instead of the previously recommended depression of the sternum to 1 ½ to 2 inches, it is now suggested that a depression of at least 2 inches should be performed and should include a complete recoil of the chest. Compressions should be performed at a rate of at least 100 beats per minutes, rather than the previously recommended 'about' 100 beats per minute, to sustain adequate blood flow to the heart. It has also been suggested that it should take no longer than ten seconds to check for a pulse before initiating compressions.
Quantitative Waveform Capnography Recommendation:
Use of quantitative waveform capnography is recommended for confirmation and monitoring of endotracheal tube placement. Quantitative waveform capnography can monitor the security and stability of the placement while also gauging the effectiveness of chest compressions.
New Med Protocols:
Four new medication changes have be en implemented for 2011. Firstly, atropine is no longer recommended for routine use in the management of pulseless electrical activity (PEA) or asystole. Secondly, adenosine is indicated for the treatment of undifferentiated wide-complex tachycardia when the rhythm is regular and the QRS complex is monomorphic. Thirdly, IV chronotropic medications can be an effective alternative to externally pacing a patient exhibiting symptomatic or unstable bradycardia. And, finally, supplementing the oxygen for uncomplicated acute coronary syndromes is no longer indicated and should only be used when a patient's oxyhemoglobin saturation is less than or equal to 94 percent.
Emergency Care Priority:
So as not to delay or interrupt chest compressions or the use of defibrillators, establishing advanced airways, vascular access and introducing medications no longer take precedence over high quality CPR and access to defibrillation.
Post Cardiac Arrest Care:
The newest guidelines for PCAC include a structured care system offering therapeutic hypothermia treatments and percutaneous coronary interventions such as revascularization and angiography.
New Stroke Guidlines:
The window of time for use of thrombolytics (rTPA) remains at within three hours of onset of stroke symptoms, but in selected patients can be extended to be within four and one-half hours after symptom onset. Also, the prehospital treatment of blood pressure has been de-emphasized.
Keep yourself informed about the latest ACLS guidelines by signing up for local Los Angeles CPR classes or an online BLS course.
Cardiopulmonary resuscitation, or CPR, was first conceptualized and demonstrated in the mid-1800s as a way to revive a patient after cardiac arrest (heart failure). It wasn't until the 1960s that our current model of CPR made its way into the annals of medicine, and thus into the hands of citizens, enabling all of us to be potential lifesavers. In 2010, the American Heart Association (AHA) modified its operations acronym from ABC - Airway, Breathing, Circulation - to CAB (Circulation, Airway, Breathing).
There are two ways a person can perform CPR: hands-only or with assisted breathing. Both methods can save a life if performed properly. It is recommended by the Mayo Clinic that only trained and confident practitioners of CPR attempt to assist another individual with breathing. Most of the time, performing hands-only CPR at the rate of about 100 chest compressions per minute until professional medical help arrives is enough to make a difference. Always remember to take the age and build of the sufferer into consideration. Only trained and current holders of a valid CPR certification course should attempt to do CPR on an infant or newborn.
The AHA has reported that more than 2/3 of cardiac arrest sufferers fail to receive CPR. Part of this problem is caused by witnesses that are afraid to attempt to help, for fear of getting sued or hindering the situation further. The fact is, if someone is in cardiac arrest, even performing chest compressions can save their life - and can hardly hurt them. Many states have Good Samaritan Laws - laws that protect those that try to assist people in need of medical attention.
It is important to learn CPR; it is estimated that even the hands-only, compression-only form of CPR can double or triple the odds of survival of the sufferer of a heart attack. Possessing the ability to save the life of a person in need, especially if that person happens to be a loved one, is invaluable. A CPR or EKG certification class is not very long, nor very expensive, and is always worth it. Find a Los Angeles CPR Class by visiting Lifesaver Education.
A recent study on the efficacy of stem cells in the treatment of angina raises new hope for an effective treatment for the disabling condition.
Angina results when the heart does not receive as much oxygen as it needs for an individual’s level of activity. It is most often caused by coronary artery disease and may be a warning sign of an impending heart attack. For some, angina occurs after a heart attack has already been experienced, signaling that the heart’s blood vessels can no longer supply the heart with an adequate supply of oxygen. The chest pain of angina can be severe and is usually described as squeezing, burning, cramping, aching or tightness. Episodes of angina may occur frequently, impacting activity and quality of life. Medications, angioplasty and surgery can sometimes help to control symptoms for some individuals but for some may offer little improvement in symptoms.
Since stem cell therapy became a reality, researchers have wondered whether stem cells might hold the answer to curing certain heart conditions, including angina. In the largest study to date to test this theory, 167 volunteer patients were randomly assigned to groups receiving stem cells or a placebo.
The volunteers were tracked for a year and the results are indeed promising. The group that received the stem cells was found to be able to last longer on a treadmill test than those patients from the group that received the placebo. The stem cell group also averaged seven less episodes of angina in a week.
Obviously, more studies focusing on heart disease and stem cells are necessary to determine how and why stem cells may be effective, but this study provides hope that quality of life for people who suffer from angina may one day soon be greatly improved.
Chest pain should always be taken seriously. To learn more about angina and heart disease, to find an online BLS course, or to locate a Los Angeles BLS class near you, visit Lifesaver Ed.
Sources: http://www.heartandstroke.com/site/c.ikIQLcMWJtE/b.3484055/k.52CA/Heart_disease__Angina.htm?gclid=CNPy7Zv28KkCFUUZQgodXizdYQ, http://www.webmd.com/heart-disease/news/20110707/stem-cell-treatment-may-relieve-angina
Many people take anti-inflammatory medications to control arthritis pain or to treat other inflammatory conditions. NSAIDS (non-steroidal anti-inflammatory drugs) are commonly prescribed to reduce inflammation and decrease the pain associated with conditions such as rheumatoid arthritis. COX-2 inhibitors are NSAIDS which are associated with less risk of gastrointestinal damage, such as bleeding.
COX-2 inhibitors have been linked in the past to an increased risk of heart attack and stroke in patients at high risk of suffering such events, but no studies have been done to determine whether these drugs also increase an individual’s risk of developing arrhythmias such as atrial fibrillation, a condition in which the upper chambers of the heart beat rapidly and irregularly, decreasing cardiac output and increasing the risk of stroke. Symptoms of atrial fibrillation include chest pain, palpitations, weakness, dizziness, shortness of breath and decreased level of consciousness. Some people have few or no symptoms.
Danish researchers identified more than 32,000 patients diagnosed with atrial fibrillation between the years of 1998 and 2008. This group was compared to 10 age and sex matched individuals for every individual who had been diagnosed with atrial fibrillation during the study period. What the researchers found was that new users of NSAIDS had a higher risk of developing atrial fibrillation/flutter (40% increased risk for NSAIDS and a 70% increased risk for COX-2 inhibitors). The risk was found to be higher for older individuals and patients who had kidney disease or rheumatoid arthritis. The researchers concluded that caution should be used when prescribing these medications, especially within the elderly population.
Given that millions of people suffer from inflammatory conditions, including rheumatoid arthritis, more research is needed to develop pain medications that are safer than some medications currently available, particularly when these medications are required for a long period of time. To learn more about heart attack and stroke, to locate a Los Angeles BLS course near you, or to find an online BLS class, visit Lifesaver Ed.
Sources: http://www.mayoclinic.com/health/atrial-fibrillation/DS00291/DSECTION=symptoms http://www.sciencedaily.com/releases/2011/07/110705071747.htm
Summertime is here and many people enjoy being outdoors, enjoying the warmth of the sun and participating in summer activities. For some, however, the sun and its associated heat can be dangerous. Heart patients in particular can experience negative effects from prolonged exposure to sunlight and heat.
People who suffer from abnormal blood pressure, congestive heart failure, vascular problems and other circulatory issues are at higher risk of developing heat exhaustion or heat stroke when in hot conditions for prolonged periods of time. Certain medications, such as calcium channel blockers, beta blockers, diuretics and ace inhibitors can affect the normal response mechanisms of the body to becoming overheated.
Older individuals may lack a strong thirst mechanism and may not realize when they are becoming dehydrated. Dry mouth, weakness, and fatigue may signal that too few fluids are being consumed. Decreased urine output may also signal that a person is not drinking enough fluids to compensate for fluids being lost.
Heat exhaustion and heat stroke may occur as a result of prolonged exposure to sun and heat and not enough fluids being taken in. Heat exhaustion symptoms are less severe than the symptoms of heat stroke and may include:
• Moist skin
• Presyncope or syncope (fainting)
• Rapid breathing
• Nausea and vomiting
• Muscle cramping
• Tachycardia (rapid, weak pulse)
If symptoms of heat exhaustion are noticed, the individual should move (or be moved) to a cool location, drink plenty of fluids and use tepid water to cool the skin. Should symptoms not improve (or they worsen) the individual should seek medical care, particularly if the individual is older and has a preexisting cardiac condition.
Heat stroke occurs when symptoms of heat exhaustion are ignored or go unrecognized. Heat stroke can be life-threatening; therefore, if heat stroke is suspected, the individual should be taken to the nearest medical facility. Symptoms of heat stroke are more severe than those of heat exhaustion and can include lack of sweating, a strong, bounding pulse, altered level of consciousness, high fever, headache, nausea and vomiting and even coma.
Heat stroke symptoms can evolve rapidly. It is important for people to be able to recognize this serious condition. If you would like to learn more about heat stroke, or are interested in taking a BLS (Basic Life Support) course, visit www.lifesavered.com to locate Los Angeles CPR classes near you or an online BLS class.
In 2006, Chantix (varenicline) was launched as the newest stop-smoking aid. Taken orally once a day, the drug has helped thousands of people quit smoking. However, Chantix has also been associated with serious negative side effects, such as mood changes (including suicidal ideation) in people who have mental illness, as well as in people who have not previously been diagnosed with mental issues.
Serious allergic reactions, dizziness, sleep disturbances, changes in ability to concentrate and seizures have all been attributed to Chantix, both in the United States and in other countries as well. Now, a study conducted independently with 700 smokers who also have cardiovascular disease has found that Chantix raises the risk of heart attack and other adverse cardiovascular events compared to study participants taking a placebo.
Chantix is the first stop-smoking drug that targets the brain, blocking the pleasurable and addicting effects of smoking in those who are hooked on the habit. The drug was wildly popular during its first year, but has since enjoyed a more modest growth, likely due to reports of psychiatric and other health effects including seizures.
Individuals who are considering quitting smoking and are considering using Chantix should consult their personal physicians to discuss their own personal risk factors, particularly people who have been diagnosed with cardiovascular disease or who have already experienced a heart attack. For some, the benefits to their health from quitting smoking may outweigh any risk factors associated with using Chantix, while for others the risks may be too great.
There are several options available for anyone desiring to stop smoking, including:
• nicotine gum, patches and inhalers
• smoking cessation counseling
• use of support groups
• Wellbutrin (an oral antidepressant found to be effective as a smoking cessation adjunct)
People who successfully quit smoking are generally highly motivated and many achieve success through the use of a combination of strategies. There are numerous online forums and support groups offering ongoing support and tips for anyone considering quitting. People who have chronic health conditions, particularly cardiovascular disease, will greatly benefit from stopping smoking. If you are considering quitting, visit your physician to discuss your options, especially if you are thinking of trying a nicotine substitute or systemic therapy, such as Wellbutrin or Chantix. If you are interested in learning more about heart health or are considering taking a basic life support course, visit Lifesaver Ed. to find an online BLS class or a Los Angeles CPR course near you.
Source: http://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?id=33076 http://www.medicalnewstoday.com/articles/228912.php
A pilot study conducted at the Children’s Hospital of Philadelphia suggests that adding a simple and cost-effective screening test to children’s physicals could prevent 100 to 1000 annual deaths among children in the United States.
The test is an ECG, which takes only 10 minutes to perform. Currently in the United States, children are screened for heart disease only if they are athletes or if their family history suggests they may be at risk for SCA (sudden cardiac arrest).
The pilot study involved 400 children who were each given a physical exam. They also had a health history completed, including family history. In addition, the children (aged 5 to 19 years old) had an ECG and echocardiogram done. The children were healthy, with only one child having symptoms in the past suspicious for a heart condition. The child’s complaints had previously been dismissed. The results demonstrated the following:
• 23/400 subjects had previously undiagnosed heart conditions
• 20/2400 subjects had hypertension (high blood pressure)
• 10/400 subjects had potentially serious heart conditions; of these 10 subjects, only 1 had ever experienced symptoms
• none of the 10 subjects found to have potentially serious heart conditions had a family history of SCA
• performing an ECG was found to be more sensitive in discovering cardiac conditions than performing a history and physical
The researchers point out that performing an ECG on the subjects added less than 10 minutes to the time it took to perform the subject’s complete examination. The researchers also noted that larger studies involving pediatric populations would be necessary to validate the study. The study, if borne out by further research, could determine the feasibility of screening children for cardiac abnormalities, thus decreasing the numbers of children suffering SCA yearly. To learn more about pediatric cardiac emergencies and their treatment, or to find a Los Angeles PALS class or an online BLS class, visit Lifesaver Education.
Source: Vetter et al, "A pilot study of the feasibility of heart screening for sudden cardiac arrest in healthy children," American Heart Journal, published online March 15, 2011
The controversy has raged for years: is coffee good for women, or is it harmful to their health? A new Swedish study aimed to answer this question, with welcome results for women who enjoy their java.
The new study, which has been reported in Stroke: Journal of the American Heart Association, included more than 30,000 women, whose coffee consumption was followed for 10 years. The results demonstrate that low or no coffee consumption is linked to a higher risk of stroke. Many studies have been done to examine the link between coffee drinking and risk of stroke and/or death, with inconclusive or inconsistent results.
The women in the study completed questionnaires at the beginning of the study. Stroke incidence was calculated from the Swedish Hospital Discharge Registry. Results indicated that the relative risk of suffering a stroke was lower for women who consumed 1 to 5 cups/day and higher; however, the positive effects of coffee drinking were negated in women who smoked, drank alcohol, had diabetes, had a high body mass index or had high blood pressure.
The study did not determine how coffee reduces the risk of stroke, but researchers involved in the study speculated that coffee consumption may:
• Decrease oxidative stress
• Improve insulin sensitivity
• Decrease subclinical inflammation
The researchers also admitted that there may be some unknown factor at work in reducing the risk of stroke among women who drink low to moderate amounts of coffee. Whatever it is that coffee does to reduce the risk of stroke, this study is good news for women who love coffee. Moderate coffee consumption has also been linked to lower risk of diabetes and liver disease. Of course, more studies are needed to validate this study.
If you would like to find a Los Angeles CPR class near you, visit Lifesaver Education. CPR classes not only save lives, but also provide education on recognition and treatment of heart attacks and strokes. Online BLS classes can help provide the life saving information needed.
Source: "Coffee Consumption and Risk of Stroke in Women." Susanna C. Larsson, Jarmo Virtamo, and Alicja Wolk. Stroke, published online 10 March 2011.
It has been known for several years that erectile dysfunction (ED) in men is a risk factor for heart attack- this is not news. What is newsworthy, according to Dr. Geoffrey Hackett, a Birmingham physician who wrote on the British Medical Journal blog, is that few physicians seem to pay attention to this ominous warning sign.
Scientists and researchers have known for several years about the link between ED and future heart attack risk. Several studies and news articles have been written on this topic. However, according to Dr. Hackett, many doctors continue to view ED as a sexual performance/lifestyle issue rather than a harbinger of things to come. Dr. Hackett reports seeing numerous patients over the course of several years referred for treatment of ED after suffering a heart attack, only to discover that the patients had symptoms of ED for years prior to their suffering a heart attack.
ED is a symptom of small vessel disease that can predict disease of larger vessels in the future. ED is thought to double the risk of cardiovascular disease, conferring the same risk as having a family history of heart disease or being a smoker. ED in men with diabetes is thought to be a better predictor of heart attack than hypertension or high cholesterol.
Men who suffer from ED should be made aware that ED can be a risk factor for heart disease. Men are often understandably concerned about the sexual implications of ED, and this needs to be addressed as well, but the risk of heart disease in men with ED is of far greater concern. There needs to be far more awareness created about the dangers of ED from a cardiovascular standpoint, particularly in men who have other risk factors present, such as obesity, diabetes, high blood pressure, high blood cholesterol levels and a positive family history for heart disease.
Women should also be made aware, so that they can support their male partners in addressing ED and the risk it confers on the men they love, and not merely from an intimacy perspective. Men should be proactive in asking their physicians to perform a complete cardiovascular workup when they visit their doctor regarding ED. To learn more about heart disease and to find a Los Angeles CPR class near you, or an online BLS course, visit Lifesaver Ed.
As miserable as hot flashes and other symptoms of menopause can be, women who experience the sometimes unbearable symptoms early on in menopause seem to enjoy greater protection against heart attack and stroke than women who experience these symptoms later on or never at all.
Researchers at Northwestern Memorial Hospital divided women into the following four groups:
• Women who experienced no symptoms at the start of menopause or at the time of enrolment in the study
• Women who experienced symptoms at the start of menopause but not at the time of study enrolment
• Women who experienced symptoms at the start of menopause and were still experiencing symptoms at the time of enrolment in the study
• Women who experienced symptoms after menopause and were still experiencing symptoms at the time of enrolment in the study
The purpose of the study was to determine the link between the timing of menopause symptoms and the women’s risk of experiencing cardiovascular disease and death from all causes.
The researchers took into account other factors that might influence the women’s risk of cardiovascular disease and determined that women who experienced symptoms of menopause early on had a smaller risk of heart disease and stroke and were less likely to die from other causes as well. In contrast, women who experienced menopause symptoms later had a higher risk of stroke and cardiovascular disease.
Research has suggested in the past that the onset of menopause puts women at higher risk of developing heart disease. This new study seems to contradict this, suggesting that the timing of symptoms may be a more important factor in determining risk for experiencing cardiovascular disease. The researchers speculate that there may be different pathophysiological mechanisms at work in women who experience menopause symptoms early as opposed to late in the process, and also suggest that determining an individual woman’s risk of cardiovascular disease may hinge on when (or if) she develops common symptoms of menopause such as sweating and hot flashes.
To learn more about heart disease, or to find a Los Angeles CPR course near you, visit Lifesaver Ed. Online BLS classes are also available if you would like to take advantage of this convenient mode of study.
Atrial fibrillation occurs when the upper chambers of the heart beat irregularly or erratically, usually at a very fast rate. It is caused by an error in the conduction system of the heart. The term fibrillation means to beat quickly and erratically. Atrial fibrillation is the most common type of abnormal rhythm (arrhythmia).
Someone who is experiencing atrial fibrillation may feel tired. They may feel as if their heart is beating too fast; they may also feel as if their heart is skipping beats. Dizziness, chest pain and fainting can occur, particularly in people who have other heart problems or underlying heart disease. Atrial fibrillation can be a dangerous rhythm because it may predispose the person with atrial fibrillation to a stroke or heart failure. Persons at Risk Certain individuals may be more likely to develop atrial fibrillation, such as those with:
• Heart failure • Coronary artery disease
• Rheumatic fever (rheumatic heart disease)
• Pericarditis (an inflammation of the sac surrounding the heart)
• Congenital heart disease
• Mitral valve disorders
• Metabolic syndrome
Too much caffeine or alcohol may trigger atrial fibrillation in susceptible individuals.
Atrial fibrillation can be diagnosed readily by an EKG, a test that records the electrical activity of the heart. Physicians will want to determine the cause if atrial fibrillation is occurring for the first time. Other tests, such as blood tests and an ultrasound of the heart may be done. A cardiologist may be consulted when the cause cannot be easily determined.
Atrial fibrillation may be treated with cardioversion (electrical therapy) if the person is very unstable (experiencing chest pain, decreased blood pressure or signs of poor oxygenation). Cardioversion can often “shock” the heart back into a normal rhythm by delivering electrical therapy at a crucial point in the electrical conduction circuit of the heart. Many people are treated with medications that reduce their heart rate or control the rhythm. Treatment with anticoagulants (blood thinners) may be needed to prevent stroke. Strokes occur in atrial fibrillation because blood pools in the fibrillating atria; blood clots can be released into the circulatory system and can travel to the brain, resulting in a stroke.
Atrial fibrillation can sometimes be prevented by lifestyle measures which will reduce the likelihood of developing heart disease. Keeping weight and blood pressure under control, exercising, eating a healthy diet and avoiding alcohol and caffeine may prevent atrial fibrillation. For more information on where to find Los Angeles CPR classes near you, or online BLS classes, visit Lifesaver Ed.
It’s February, the month we devote to the heart. In honor of Heart Month, here are some myths and facts about heart failure. Some you may know, and some may surprise you:
Heart failure means that your heart stops beating.
Myth: In cardiac arrest, your heart stops beating. Heart failure refers to damaged heart muscle or heart valves, and means that the heart cannot pump as effectively or efficiently as before. This causes some of the symptoms of heart failure, such as edema (swelling) of the legs, shortness of breath and fatigue.
Heart failure can be deadly.
True: Untreated, heart failure can progress to the point where death occurs. Heart failure is a very serious disease requiring medical treatment and lifestyle changes. Heart failure does shorten lives, but with treatment symptoms can be eased and lives can be prolonged.
Heart failure is an uncommon disease.
Myth: Heart failure is quite common. Approximately 5 million people in the United States suffer from heart failure, and 300,000 people die every year from complications of the disease.
Once heart failure is diagnosed, it cannot be treated.
Myth: There are many treatments for heart failure that can effectively treat symptoms and even slow the progression of the disease. Furthermore, research is always ongoing, and new treatments are always around the bend. Heart failure does not need to be a death sentence.
Heart failure only affects the elderly:
Myth: Although many people who suffer from heart failure are older, young people can have heart failure as well. For young people with heart failure, lifestyle changes are even more important so that they can life a full and satisfying life with as few symptoms as possible.
People with heart failure can’t exercise.
Myth: People with heart failure should exercise, in order to prevent worsening of the disease. Exercise can be an important part of disease management. People who have heart failure need to exercise following their physician’s guidelines.
This month, honor Heart Month by resolving to take a CPR course (or an online BLS class). To find a Los Angeles CPR class near you, visit Lifesaver Ed.
A new study reports that eating a diet high in whole grains can effectively lower blood pressure as well as medications can.
A study published in the American Journal of Clinical Nutrition, from Scottish researchers, found that eating whole grain foods is an effective method for lowering blood pressure. This is good news for people who have hypertension, as well as for those who have borderline hypertension and would like to avoid developing full-blown hypertension.
More than 200 participants took part in the study. Some participants were asked to eat three servings of whole grains daily, while the others ate refined cereals and white bread. There were no other dietary requirements asked of the participants. The results? Those who ate three servings of whole grains a day experienced a 5 to 6 mm Hg drop in their systolic blood pressure. Researchers state that this is the same decrease in blood pressure that you might expect from taking a blood pressure pill, and represents a 15 and 25% drop respectively in the risk of heart attack and stroke.
So how can you add whole grains to your diet? Try adding some of the following foods to your daily menu:
- Whole wheat or brown rice pasta
- Whole oats
- Brown or wild rice
- Whole grain cereal
- Whole wheat crackers
- Whole grain breads (tortillas, bagels, English muffins, bread or rolls)
If you find that you are having difficulty getting used to the taste of whole wheat foods, try adding them gradually or mixing them with refined foods, slowly reducing the amount of refined foods you are eating. You will soon love the taste, and your body will love you in return, rewarding you with lower blood pressure. To learn more about heart disease and how to perform CPR, or to locate a CPR class near you or an online BLS class, visit Lifesaver Ed.
According to a recent study, cardiac arrests requiring defibrillation (shockable arrests) are more likely to happen in public places than in the home. The study, which appeared in the New England Journal of Medicine January 27, was funded by the National Institute of Health. Its purpose was to compare cardiac arrests that occurred in the home versus those that occurred in the public sector.
The study examined several characteristics of arrests, such as whether the arrest was witnessed by bystanders or healthcare professionals like EMS, as well as whether the victim required the use of an AED and the type of arrest suffered. Results of the study showed the following:
• A higher percentage of cardiac arrests were those requiring electrical shock (ventricular tachycardia, in which the heart beats too fast to sustain life and ventricular fibrillation, in which the heart quivers ineffectively)
• The survival rate for victims suffering a public cardiac arrest who were subsequently treated with an AED (almost 1/3 survived) was greater than for victims who suffered an arrest at home and required the use of an AED (12%), and higher than the overall survival of cardiac arrest victims nationwide (8%)
• 79% of public cardiac arrests were due to ventricular tachycardia/ventricular fibrillation, which are amenable to electrical therapy with an AED; in contrast, only 36% of arrests that occurred in the home where an AED was available were due to these mechanisms. This was attributed to the fact that many arrests that occur in public are witnessed, while cardiac arrests that occur in the home are witnessed less often
What conclusions can we draw from the results of this study? First of all, we know that cardiac arrests that are witnessed in public places where an AED is immediately available have a better outcome than arrests that occur in the home, even when an AED is used. Secondly, this study underscores the need for AEDs in public places, such as arenas, airports, hotels, malls and other places where large crowds gather. Lastly, the use of AEDs requires lay people who are trained in their use.
The study was based on 14,000 victims who suffered an arrest and involved over 200 EMS agencies over a 2-year span. AED use is often taught in conjunction with CPR. Both quality CPR and AEDs save lives. If you are interested in taking an online BLS class or a CPR course in your area, visit Lifesaver Ed to find a Los Angeles CPR class near you.
Source: Shockable Cardiac Arrests Are More Common In Public Than Home
According to the American Heart Association, the price tag for treating heart disease in the United States will jump from a staggering $373 billion to an even more staggering $818 billion by the year 2030.
The AHA estimates that 36.9% of the population in the U.S. is suffering from some sort of heart disease, including stroke, high blood pressure, coronary artery disease and heart failure. They project that this figure will increase to 40.5% over the next two decades. Heart failure will rise by 25%, while the incidence of stroke is right behind at 24.9%.
Despite the enormous strides we have made in diagnosing and treating heart disease, our unhealthy habits and lifestyle work against us. Obesity, smoking, a sedentary lifestyle and high cholesterol levels are risk factors that affect a large portion of the public. Diabetes resulting from obesity is also projected to increase.
How did the AHA make their predictions? Experts base these figures on current numbers, and then adjust the figures using census data to anticipate population changes in age and race. Experts did not double up counts for people who suffer from more than one type of cardiovascular condition. It is known that 17% of health expenditure in the U.S. goes to treating heart disease. According to the predicted numbers of cardiovascular disease to come, this rate may be unsustainable.
What can be done? The AHA states that we must use effective strategies to prevent stroke and heart disease in order to stem the economic burden of cardiovascular disease in the U.S. Those risk factors that were mentioned previously must be targeted more effectively. Obesity and smoking are two huge risk factors for disease, and while the number of smokers has declined slightly, rates of obesity are increasing. Hypertension is another area that must be addressed. Hypertension is known as “the silent killer” due to the fact that most people do not have symptoms of hypertension until it has caused damage.
Decreasing cardiovascular disease risk starts at the individual level. Individuals must be aware of their personal risk factors and work with their physicians to decrease these risks through preventive actions, including smoking cessation, weight loss, involvement in regular exercise and regular physical exams to monitor blood pressure and cholesterol levels, among others.
The value of CPR courses is that they not only teach individuals how to perform CPR in the event of a cardiac arrest, but also address the recognition of symptoms of heart attack and stroke. Given the rates at which cardiovascular disease is projected to rise, all individuals can benefit from learning more about cardiac disease and CPR. This knowledge may save a life, including their own. To locate a Los Angeles CPR class near you or an online BLS class, visit Lifesaver Ed.
Source: Heart Disease Costs to Rise by $545 Billion over Next Two Decades in USA
Sudden cardiac death (SCD) occurs when the victim experiences an arrhythmia that prevents the heart from delivering oxygen to the brain. SCD sometimes occurs in people who were unaware that they had a dangerous arrhythmia. SCD is different than cardiac arrest that occurs as a result of a heart attack- when a victim suffers a heart attack, he/she may go into cardiac arrest due to a blockage in one or more arteries that prevents oxygen from getting to the brain. The end result is the same: without CPR and advanced care, the victim will die. However, the mechanism of arrest differs.
ICDs (implantable cardioverter-defibrillators)are designed to prevent sudden cardiac death from lethal arrhythmias. These small devices, no bigger than a pager, are implanted under the skin below the collarbone area. Wires are placed which monitor the heart’s rhythm. In the event of an arrhythmia such as ventricular tachycardia, in which the ventricles beat too quickly and do not allow the heart to fill with blood (thus drastically reducing the amount of blood that can be pumped out of the heart), the ICD delivers a shock which restores normal electrical impulses in the heart. These implanted defibrillators can also be programmed to correct dangerously slow heart rhythms. Although the electrical energy delivered to the victim by an ICD is small, many people describe the sensation of their ICD firing as being similar to a kick in the chest.
Those who are risk for SCD include:
• People who have suffered a cardiac arrest in the past and survived • People who experience VT (ventricular tachycardia), as described above • People who have experienced VF (ventricular fibrillation, which causes the ventricles of the heart to quiver uselessly)
• People with low ejection fractions (low volumes of blood pumped to the rest of the body when the heart beats)
• Inherited abnormalities that increase a person’s risk for SCD
• People who have both coronary heart disease and an arrhythmia who are deemed to be high risk for SCD
ICDs are generally easy to recognize under the skin on the left side of the chest. Should a victim suffer a cardiac arrest and they are noted to have an implanted defibrillator (ICD), AED pads should not be placed directly over the ICD, as defibrillation may damage the ICD. This situation would only occur if there was mechanical failure of the ICD, in which case CPR with AED use proceeds in the same manner as for a person without an ICD.
For more information on where to find Los Angeles CPR classes near you or BLS certification online courses, visit Lifesaver Ed.
ACLS (Advanced Cardiac Life Support) is a set of decision-making guidelines used to treat patients in cardiopulmonary arrest, or experiencing other life-threatening events. In addition to these guidelines, professionals who become certified ACLS providers learn the science behind the guidelines and the hands-on skills that accompany their use.
The first ACLS guidelines were published in 1974 by the AHA (American Heart Association) and have been updated approximately every five years since then. The most recent updates to the ACLS guidelines were just released on October 18, 2010.
Several treatment algorithms are used in ACLS. These algorithms take the form of flowcharts that require users to answer questions either yes or no before proceeding to the next step (or stopping). Current algorithms address:
• Asystole (absence of any electrical activity in the heart)
• Bradycardia (a heart rate that is too slow)
• Tachycardia (a heart rate that is too fast)
• Pulseless electrical activity (electrical activity seen on the monitor that does not correspond with a detectable pulse in the patient)
• Ventricular Fibrillation/Pulseless Ventricular Tachycardia (abnormally fast rhythms of the ventricles that do not result in effective contractions of the heart)
• Myocardial Infarction (heart attack)
• AED use
Although the course focuses on advanced lifesaving skills, students are reminded that basic CPR skills and early defibrillation (often done prior to the victim reaching the hospital) are the interventions that are the most important in predicting patient survival rates from cardiac arrest.
Persons taking ACLS courses are healthcare professionals (nurses, paramedics, physicians, anesthesiologists, respiratory therapists, and etcetera) who wish to expand their knowledge and skills in advanced life support. The course is sometimes mandatory for professionals working in areas that experience a high number of life threatening events, or potential events, such as ICU, Emergency, Surgery and others. The course includes mastery of cardiac arrhythmias, emergency medications, airway management, and other advanced care therapies. Lay rescuers may take a standard CPR course. An ACLS course is generally run over 1 to 2 days and providers must recertify every two years. Successful participants are required to pass both a written exam and a “mega code”, a simulated arrest situation which is graded on a pass/fail basis.
If you are interested in finding a Los Angeles ACLS course in your area, or an online BLS class that can be done from anywhere, please visit Lifesaver Ed.
Dilated cardiomyopathy is a condition in which the heart muscle is affected, most commonly the heart muscle of the left ventricle. This results in enlargement of the left ventricle and a reduced ability of the heart to pump blood to the rest of the body. Symptoms of heart failure occur in some people with dilated cardiomyopathy, although some people are unaware they have the condition; thus the condition can range in severity from asymptomatic to life threatening. Infants, older children and adults can be affected by this condition. However, most cases are diagnosed in people who are middle aged.
Dilated cardiomyopathy can result in serious complications, such as:
• Arrhythmias (changes in heart chamber pressures and structural heart chambers may result in abnormal rhythms)
• Blood clots (may travel to other parts of the body causing a stroke or other organ damage, or may lead to heart attack)
• Heart failure
• Sudden death
When people with dilated cardiomyopathy become symptomatic, they may experience some of the following symptoms, depending upon the extent of their disease:
• Fatigue • Weight gain (from fluid retention)
• Coughing or dyspnea (difficulty breathing)
• Edema in the lower extremities
• Problems in ability to concentrate
• Palpitations (abnormal sensations of the heart, such as pounding or fluttering
• Exercise intolerance
• Dizziness or fainting
• Ascites (fluid buildup in the abdomen)
Several genes have been linked to the development of cardiomyopathy; therefore, if you have the condition, it is wise to have other members of the family screened for the disease. Many times, doctors are unable to determine the cause of the condition (idiopathic dilated cardiomyopathy). Viruses or bacterial infections that attack the heart are sometimes to blame. Hypertension or a previous heart attack can sometimes damage heart muscle, leading to the condition. Other risk factors for the condition include drug abuse, immune system disorders, certain types of chemotherapy drugs, valvular problems of the heart and others.
Treatment includes various medications to control arrhythmias, prevent blood clots, control blood pressure and reduce fluid retention. Implanted pacemakers or defibrillators are sometimes used to prevent dangerous arrhythmias from occurring. If medications and other treatments fail, patients with dilated cardiomyopathy sometimes require heart transplantation. Patients with severe dilated cardiomyopathy are at risk for sudden cardiac death. To learn how patients with this disease and others can be saved by performing CPR, visit Lifesaver Ed to locate a Los Angeles CPR class near you or other courses such as online BLS classes.
There is a big difference in the diagnostic procedures that should be used to diagnose coronary heart disease, according to new research to be published in the Journal of the American College of Cardiology: Cardiovascular Imaging (October, 2010).
It has been more difficult to diagnose women with heart disease using conventional methods. In men, there is a clear and provable relationship between disease of the coronary arteries (blockage) and heart attacks; in women, the issue is often less clear cut, and conventional tests used to diagnose coronary artery disease in women often do not show the true picture. Given that heart disease is often misdiagnosed in women, and that women are 15% more likely to die when they suffer a heart attack, this new research may save more women’s lives. Cardiovascular disease is now the leading cause of death in women, and women who suffer a heart attack are 50% more likely to die within the year following their heart attack than are men of similar age.
The problem has been that angiography, the gold standard for the diagnosis of arterial blockage in the heart, if often inconclusive in women and does not show the true picture in women’s heart disease. Researchers found that, in using MRI (magnetic resonance imaging) to study the hearts of women, they were able to detect problems with blood flow and small vessel disease that may be more prominent in women in comparison to men, and that may lead to ischemic heart disease and an increased risk of heart attack.
Being able to detect subtleties in the heart that may lead to a heart attack is a huge finding for women, who often undergo angiography, echocardiograms and other diagnostic tests only to be given a clean bill of health when in fact they do have signs of heart disease. MRI has proven to be more sensitive in diagnosing heart problems in women.
Researchers hope that this new knowledge will lead to a more detailed understanding of the progression of heart disease in women, and that they will soon to be able to stratify risk factors for heart attack more accurately in female patients. Being able to more accurately diagnose early heart disease will allow physicians to help their female patients avoid a heart attack through prevention and may lead to the development of new protocols to address ischemic chest pain in women.
This research study was part of a larger study sponsored by the National Heart, Lung and Blood Institute designed to improve detection and treatment of women with coronary heart disease. If you are interested in learning more about heart attacks and how to perform CPR, or want to locate a Los Angeles BLS class near you, or a BLS online class, visit Lifesaver Ed.
A study published online in the International Journal of Obesity sheds light on the association between childhood obesity and future risk of developing conditions such as heart disease and diabetes.
There has been much in the news about the epidemic of obesity affecting children these days. The statistics are frightening: in the past 30 years, childhood obesity rates have almost tripled; 19.6% of children between the ages of 6 and 11 are obese, while the figure is 18.1% for teens between the ages of 12 and 19. Children who are obese often have at least one risk factor for heart disease, including hypertension (high blood pressure) and high cholesterol. Obese children are also at risk of being overweight or obese as adults (CDC, 2008).
Now, the new study finds that a child’s waist circumference may be the most accurate way to measure a child’s future risk of developing heart disease. The study followed more than 2,100 Australians from childhood into adulthood. The study participants were first examined between the ages of 7 and 15 years. Skin fold measurements, waist and hip circumferences and body mass index were the measurements obtained.
When the participants reached adulthood, tests were administered to detect metabolic syndrome among the study participants. Metabolic syndrome is a set of symptoms that are known to multiply the risk of developing heart disease and diabetes. Symptoms include high blood pressure, excess abdominal fat, high cholesterol and abnormal blood sugar levels. The research discovered that, while all tests were a good indicator of overall metabolic health, waist circumference was the strongest predictor of metabolic health.
Essentially, the children who placed in the top 25% of their age group and gender for waist circumference were 5 to 6 times more likely to have metabolic syndrome as adults aged 26 to 36. Researchers concluded that the overweight and obese children of today will have much higher rates of diabetes and heart disease than their non-obese peers, and that these diseases will affect them earlier in their adult lives. This means that we need to identify at-risk children earlier and intervene earlier if we are to reverse this trend. To learn more about the cardiovascular problems that these children will suffer, or if you are interested in finding Los Angeles CPR classes near you, visit Lifesaver Ed.
While it is well known that high cholesterol levels are associated with coronary heart disease, most people are less aware of the role that elevated triglyceride levels play in heart disease.
Triglycerides exist in the foods we eat, and are also produced by our bodies. Together with cholesterol, triglycerides form the lipids in the plasma potion of our blood. High triglyceride levels are associated with a higher risk of coronary artery disease. When we eat certain foods, or when our body produces triglycerides from food sources such as carbohydrates, excess triglycerides are stored in our fat cells. The release of triglycerides from storage in our fat cells is regulated by hormones in our body.
A new study to be published in December 2010 in Arteriosclerosis, Thrombosis, and Vascular Biology (an American Heart Association journal) identifies a protein that may have the ability to reduce blood triglyceride levels.
ApoA-V is a substance found naturally but in very low concentrations in the blood. This substance is important for its ability to control triglyceride levels, maintaining a normal level. Researchers bred mice that lacked this substance and had very high triglyceride levels. They also bred mice that had extremely high levels of ApoA-V and consequently had very low triglyceride levels. Researchers set out to determine if introducing this substance into the bloodstreams of the mice lacking ApoA-V would result in lower triglyceride levels in the treated mice. The result? Mice injected with ApoA-V experienced a reduction in triglycerides by 87% in 8 hours.
This research is promising in that it shows the potential for a substance to be produced that will have the same results in humans, lowering triglyceride levels and reducing the risk of heart disease in patients with hypertriglyceridemia (high blood triglyceride levels). The researchers hope to continue testing mouse models with high triglycerides to verify their results. Cardiovascular disease can lead to heart attack and stroke in some individuals. To learn how to cope with these emergencies, consider taking a CPR class that will teach you the basics of cardiopulmonary resuscitation. To find a Los Angeles BLS class near you, visit Lifesaver Ed.
It is estimated that more than 81 million people in the U.S. have one or more forms of cardiovascular disease, including coronary artery disease, high blood pressure, stroke and heart failure. Cardiovascular disease contributes to 58% of deaths due to illness in the United States.
Aspirin has been touted as a wonder drug since it first became available to physicians to prescribe to their patients in 1899. It became available in pill form in 1915 and was made available as an OTC (over the counter) drug the same year, and has been one of the most popular pain and fever reducers ever discovered. Today, aspirin is used by millions of people around the world to treat fever, headaches, joint pain, menstrual cramps, muscle aches…and the list goes on.
Aspirin has a far more important use than as a fever and pain reliever. This purpose was discovered in the 1970s, when scientists learned that aspirin works as a prostaglandin inhibitor. Prostaglandins are natural substances in the body which are related to inflammation and blood clotting. In the 1980s, researchers discovered that aspirin could be used to prevent recurrence of heart attacks in people who had already suffered this potentially deadly event. Later, it was also discovered that aspirin could reduce the risk of heart attack in people with unstable angina who had never experienced a heart attack. Aspirin works in preventing heart attacks by thinning the blood and inhibiting the body’s ability to form blood clots that could potentially block arteries and cause a heart attack- for this reason, aspirin is also used to prevent strokes in patients who have suffered a previous stroke.
A miracle drug? Some might say so, but the drug is not without some risk in certain individuals. Due to its ability to thin the blood, aspirin can cause bleeding in the gastrointestinal tract. It may also cause stomach ulcers in some people. People who have a history of gastrointestinal bleeding or peptic ulcer disease are not good candidates for aspirin therapy. Aspirin can also cause prolonged bleeding in people who take aspirin regularly. People with bleeding disorders, liver disease, kidney disease, uncontrolled high blood pressure, or asthma should not take aspirin.
Current guidelines for aspirin therapy are:
• Men- men who are aged 45 to 79 who are at risk for a new or recurrent heart attack should take aspirin therapy
• Women- women who are aged 45 to 79 who are at risk of a recurrent or new (ischemic) stroke should take aspirin therapy (US Preventive Services Task Force)
The use of aspirin in the elderly has not been studied extensively. Currently, an ongoing study (ASPREE- Aspirin in Reducing Events in the Elderly) is in progress to answer the question of whether aspirin has the ability to prevent adverse events such as heart attack and stroke in elderly people over the age of 70. If you are interested in learning more about heart attacks and stroke, and wish to become certified as a CPR provider, visit Lifesaver Ed to find Los Angeles CPR classes. Sources: http://wtvq.com/health/5409-senior-aspirin-study
A new study published in the Annals of Internal Medicine, conducted by British researchers, describes a short-term increased risk of myocardial infarction and stroke following invasive dental procedures.
The researchers involved in the study believe that inflammation associated with dental surgery is the cause of the increased risk. They speculate that infection around the operative site may cause bacteria to leak into the bloodstream, resulting in inflammation. This type of inflammation is believed to increase stroke and heart attack risk.
The study involved more than 32,000 participants who had suffered a heart attack or stroke. Researchers discovered that 525 people had had a heart attack and 650 people had suffered a stroke following dental surgery that was deemed invasive. After factoring in individual risk factors that may have raised the participant’s risks, researchers concluded that there was a statistically significant risk of having a heart attack or stroke in the month following invasive dental surgery in the participants studied. Many of those who suffered a vascular event were less than 50 years old (1/3).
The authors stress that this short-term risk (which subsides to normal limits within 6 months following invasive dental surgery) should not outweigh the long-term benefits to vascular health. A link between inflammatory markers and atherosclerosis has been raised in the past several years, but no definitive proof has been offered to date. For patients who are already at risk for heart attack or stroke, prophylactic treatment may one day be recommended prior to dental surgery; however, more studies should be done to determine whether the elevated risk can be observed in other, similar studies.
If you are interested in learning more about heart disease, stroke, and lifesaving techniques for individuals who have suffered a heart attack or stroke, taking a course in CPR can teach you all that you need to know to save a life. To find a Los Angeles CPR course near you, visit Lifesaver Ed.
Thought you knew your CPR alphabet? Not anymore! The 2010 CPR guidelines have been officially released. They represent some of the biggest changes in how CPR is to be performed in recent years.
The changes come on the heels of research that has shown that compressions are the most important component of CPR. Previously, rescuers were instructed to assess responsiveness, call for help, open the airway and check for respirations for 5 to 10 seconds; if no breathing could be detected, the victim was given 2 breaths before compressions were commenced. These initial steps are now believed to result in too much time wasted before the all-important compressions are started.
According to the new standards, an AED (automated external defibrillator) should be used as soon as possible during CPR, but compressions should not be delayed while an AED is being located and brought to the arrest scene. This does not represent a change from the old guidelines.
While new guidelines state that compressions are to be started immediately upon finding an adult, child, or infant victim unresponsive and not breathing normally, the new standard does not apply in the case of newly born infants. For newly born infants, mouth-to-mouth (or mouth-to-mask) is to be done first before compressions are started. This is due to the fact that the primary arrest mechanism in infants is most likely a respiratory problem rather than a cardiac event.
Experts believe that the new guidelines will make both teaching and learning CPR easier, and that the new emphasis on chest compressions will improve survival from cardiac arrest. It is also hoped that the simplified CPR guidelines will encourage more bystanders to act when faced with the prospect of performing CPR. Experts would like bystanders to know that compressions save lives, and the likelihood of doing harm by providing compressions is low. After all, you can’t hurt someone who is already dead without CPR. There are only a few precious minutes to restart a dying heart before irreparable damage is done.
Compressions are to be given rapidly and forcefully (“push hard, push fast”) at a rate of at least 100 compressions per minute, regardless of the victim’s age. In addition, the chest must be compressed at least 2 inches in adults (a small change from the 1 ½ to 2 inches recommended previously).The emphasis on hard and fast chest compressions is not new, and those students renewing their CPR certification will remember this rule from their last CPR class.
Everyone, including health care professionals and lay rescuers, should be prepared for the new guidelines and expect to be taught the new guidelines once instructors are retrained in the new techniques and new course materials are available. Looking for a CPR class close to you? To locate Los Angeles CPR classes in your area, visit Lifesaver Ed.
The AED (automated external defibrillator) is a portable machine designed to deliver electrical energy to the heart to reverse potentially lethal rhythms. They are small, portable, simple to operate and save lives. Use of the AED is one of links in the chain of survival (early access, early CPR and early defibrillation).
Recognizing and treating cardiac arrest is crucial to survival. The most frequent arrest rhythm encountered is ventricular fibrillation (VF), in which the ventricles of the heart contact in an irregular and ineffective fashion. Without treatment, ventricular fibrillation is always lethal and death ensues in minutes. The most effective treatment for VF is electrical defibrillation, and the likelihood of converting VF to a life-sustaining rhythm diminishes rapidly over time. Electrical defibrillation is the single most important intervention and determines the likelihood of survival in witnessed VF arrest. CPR given before defibrillation can be done helps to prevent the heart from deteriorating into asystole, which has an even poorer prognosis.
With the advent of AEDs, lay rescuers can provide the electrical energy needed to convert a heart in VF to a viable rhythm. The use of AEDs is now included in BLS classes, along with the principles of CPR. AEDs are widely available in many public venues, and more and more people are being trained in their use, improving survival rates in victims who suffer cardiac arrest due to VF.
Current AEDs are fully automated or semi-automated, referring to how much action the AED operator must take to deliver a shock. Models are constantly being advanced, requiring less “thinking” on the part of operators. Although the use of an AED is crucial to survival in VF arrest, the provision of good quality CPR is also important, and these two skills are a large component of current CPR classes.
AEDS are designed to be used by anyone, regardless of training; however, becoming trained in their use decreases any delay in defibrillation and ensures their proper use. AEDs have saved countless lives and are considered to be a crucial link in the chain of survival. To find Los Angeles CPR classes near you that can teach you how to properly use an AED, Lifesaver Ed.
A study conducted over 20 years and published in the Annals of Internal Medicine refutes earlier assumptions that elevated cholesterol levels in the younger years are insignificant.
The study included healthy participants of both sexes from four different cities, aged between 18 and 30. The participants hailed from different backgrounds; a little more than half the participants were women, and just under half were African American. The study spanned 20 years, during which time the participants’ LDL, HDL and triglyceride levels were followed. When the participants reached their mid-40s, they underwent a computed tomography (CT) scan to determine the level of calcium build-up in their coronary arteries.
Results indicated that those participants with high LDL levels in their younger years were more likely to develop coronary calcium build-up. Furthermore:
• Approximately 44% of participants with an elevated LDL of more than 160 mg/dL were found to have calcified areas in their coronary arteries twenty years later; only 8% of participants with near-optimal levels of LDL (< 70 mg/dL) had calcifications in their coronary arteries at the end of the study
• Those participants who had moderate rises in LDL cholesterol (100 to 129 mg/dL) were still at risk of developing atherosclerosis
• 65% of the participants had LDL cholesterol levels > 100 mg/dL
The study highlights the fact that cholesterol levels in early adulthood, while not immediately harmful, increase the risk of developing atherosclerosis as a later age. In other words, lasting damage can occur during early adulthood that can lead to an increased risk of heart attack and stroke in middle to late adulthood. Children should be screened for hyperlipidemia, especially of they have other risk factors for the development of heart disease, such as obesity. Diet and exercise as a means of lowering cholesterol should begin early, and should be continued for the long term. To learn more about risks for heat disease and stroke and how to respond to these emergencies with Los Angeles CPR classes, visit Lifesaver Ed.
Source: Early-life cholesterol increases future heart disease risk: Study
A study published in July 2010 in the New England Journal of Medicine provides evidence that compression-only CPR may be as effective as traditional CPR. The study, which included 1276 patients, was designed to determine whether compression-only CPR is superior to traditional CPR in terms of survival.
The study spanned almost 4 years. Throughout the study 620 patients were randomized to receive compression-only CPR, while 656 patients received standard CPR. The patients sustained out-of- hospital cardiac arrest which was witnessed. The instructions for either type of CPR were provided by emergency medical dispatchers via telephone.
Results of the study showed that there was no significant difference in survival at 30 days between the two groups, demonstrating that compression-only CPR is a safe and effective means of providing CPR. A previous study assessed the difference between compression-only CPR and standard CPR and found that compression-only CPR was as efficacious, if not more so, than standard CPR; however, the previous study did not assess survival rates.
The AHA adopted compression-only standards in 2008. Compression-only CPR consists of giving compressions only, without providing ventilations. The impetus behind the movement to switch to compression-only CPR is that bystandarders are often unwilling to get involved and help a victim of sudden cardiac arrest, fearing that they may harm the victim. Compression-only CPR simplifies this lifesaving process, requiring the rescuer to 1) call for assistance, and 2) provide chest compressions until an AED is brought to the scene or help arrives.
There are a few special cases in which standard CPR (with ventilations) should be performed:
• Infants and children
• Adult victims who are unconscious, are not breathing, and have a pulse
• Victims of drug overdose, victims of drowning or victims who have collapsed due to breathing problems.
In these cases, respirations are ineffective due to the underlying condition, and ventilations should be provided in conjunction with compressions. In infants and children, the primary cause of arrest is often a respiratory issue, necessitating effective ventilations. To learn more about compression-only CPR, or to locate Los Angeles CPR classes near you, visit Lifesaver Ed.
ifesavered.com. Source: Svensson et al (2010). Compression-Only CPR or Standard CPR in Out-of-Hospital Cardiac Arrest. N Engl J Med 2010; 363:434-442
Choking is caused by blockage of the upper airway by food or other objects. It can happen at any time to persons of all ages. Choking is a true emergency and can result in death if the obstruction is not relieved within minutes. This is because blockage of the airway prevents oxygen from reaching the brain, which will begin to die within 4 to 6 minutes without intervention.
It is known that almost 200 children in the U.S. die every year from choking, and that choking is responsible for almost 18,000 admissions to emergency departments for children under the age of 14. Small children often put small objects in their mouth, such as nuts, coins, marbles and other hazards. Hard candies and hot dogs are other common choking hazards. Small children will often attempt to eat too quickly or will put too much food in their mouth at one time, increasing their risk of choking.
Adults often choke when they talk or laugh while eating. Factors such as poorly fitting dentures, alcohol consumption and drugs which lower awareness can increase the risk of choking in adults. Some diseases affect swallowing, such as stroke, MS (multiple sclerosis) and Parkinson’s disease, raising the risk of choking. Symptoms of choking are often easy to identify and may include the following:
• Coughing or gagging • Inability to talk • High-pitched wheezes • Color change to the face (person will turn blue)
• Weak cry or cough in infants
• Panic and hand signals
The “universal sign” of choking is clutching of the throat- choking victims will often bring their hands to their throat.
Choking can be resolved with application of an abdominal thrust (formerly called the Heimlich maneuver). Victims who are able to speak and whose color is not dusky should be watched closely and encouraged to cough forcefully. They should not be left alone. Victims who cannot speak and whose face is turning blue are likely fully obstructed and will require the Heimlich maneuver and possibly other emergency measures.
Choking constitutes a real medical emergency. Everyone should be taught the basics of relieving an airway obstruction. Choking is included in BLS classes as it is recognized that choking is encountered frequently and timely intervention can save lives. Anyone with children should learn how to relieve an airway obstruction. To find a Los Angeles BLS class or CPR class near you, visit Lifesaver Ed.
Drowning is recognized as a significant cause of disability and death. It is estimated that approximately 8,000 deaths by drowning occur each year, with 1,500 of these drowning occurring in children. It is further estimated that 15% of children admitted to the hospital for drowning die as a result of submersion.
Drowning may occur from several causes. Here is a look at common causes of drowning in different age groups, and how drowning accidents can be avoided: <1 year- in this age group, bathtub drownings are the most common cause of death. Children left unattended in the tub can roll off of or slide out of safety devices meant to hold them safely out of the water. Children this age should always have adult supervision and should never be left unattended.
Pre-school aged children-in this age group, residential swimming pools are common areas of drowning, as are ponds, canals and ditches. To prevent drowning, access should be blocked. Residential swimming pools should be gated and locked to prevent access.
Older children and teens- drowning in this age group may occur as a result of poor judgment, overconfidence in swimming ability and the use of alcohol and drugs. It has been estimated that many of these deaths occur within 10 yards of shore. Lakes, rivers, ponds and oceans are common drowning venues. Drowning may also occur secondary to head or spinal cord injuries suffered during shallow dives.
Underlying illness may also cause drowning. Seizure disorders, myocardial infarction (heart attack), neurological disorders such as Parkinson’s disease and multiple sclerosis and stroke may all predispose to drowning. Water sport (i.e. water skiing, jet skiing, tubing) accidents may also contribute to drowning. The use of life jackets can prevent death due to drowning.
Not everyone who drowns dies. Thanks to more and more people taking certified BLS classes, many deaths from drowning are subverted. Anyone living near open water or owning a pool, as well as health professionals, should be trained in the techniques of CPR, including the use of AEDs. To find a certified Los Angeles CPR class near you, visit Lifesaver Ed.
Many people, especially older women, take calcium supplements for bone health and to stave off or treat osteoporosis, a practice that may prove dangerous to cardiac health according to a recent study.
A study published in the online British Medical Journal examined the effects of calcium supplementation on 12,000 participants. Researchers analyzed 11 different randomized and controlled studies on calcium (without the addition of vitamin D). The researchers took into account differences in the study design and controls, as well as other factors, to minimize bias.
Results showed that there was a 30% increased risk of heart attack in supplement users, and a smaller risk of suffering a stroke. Because so many people supplement with calcium, this could mean that many people are unknowingly at higher risk of heart attack or stroke. Other studies that looked at diet supplementation with calcium did not find a heightened risk for heart attack or stroke, leading researchers to conclude that the risks are only related to supplements.
There has also been recent debate about the effectiveness of calcium supplementation on reducing the risk of fractures in those who suffer from osteoporosis. Given this, researchers urge that further studies be done to verify whether or not calcium supplementation plays a role in increasing the risk of heart attack and stroke, and that women with osteoporosis not be treated with calcium (with or without vitamin D) unless they are receiving an effective drug to treat osteoporosis. The bottom line, researchers say, is that more study is needed to determine if calcium is needed at all when there are other drugs designed to treat osteoporosis.
Knowing the risk factors for heart disease can help prevent heart attack and stroke. Although more research is needed on the potential role of calcium as an agent that increases the risk for both, controlling other risks such as obesity, high cholesterol and smoking is likely to be of more benefit in reducing overall risk. Basic Life Support, also known as BLS classes provide instruction on how to recognize and respond to a cardiac emergency. To find a Los Angeles CPR class near you, visit LifeSaver ED.
Source: Calcium supplements linked to increased risk of heart attack, study finds
Tim Richards, a 61-year-old man with a history of diabetes and hypertension, complains to his wife Claire at the breakfast table one morning that he awoke early due to indigestion. He tells her that he still feels unwell, and is unable to eat his breakfast due to nausea. Claire notices that he is sweating and is continuously rubbing his chest and upper abdomen. As he is checking his blood glucose level in preparation for his daily insulin dose, he gasps, clutches his chest, and falls to the floor.
Although Claire feels panicked, she knows what to do. She has recently taken a basic life support course offered at her local hospital. She quickly determines that Tim is not breathing and doesn’t have a detectable pulse. She calls 9-1-1 and tells the operator that her husband has suffered a cardiac arrest and asks that an ambulance be dispatched immediately. She begins the sequence of providing ventilation and compressions to her husband, just as she performed them on a mannequin in the class she took just a few short weeks ago. She is very frightened, but finds that she remembers all the steps she was taught and practiced so diligently.
Within 10 minutes, paramedics enter the house and take over Tim’s care from a relieved Claire. The paramedics continue CPR, start an intravenous line, provide electrical energy to Tim’s heart and administer emergency drugs. “We’ve got a pulse”, one of the paramedics says triumphantly. Tim is loaded in the ambulance and transported to the nearest hospital. Claire rides along in the ambulance.
Doctors at the hospital determine that Tim suffered a massive myocardial infarction, or heart attack. They give him medication to dissolve the clot that caused the heart attack and admit him to the Intensive Care Unit. Doctors tell Claire that Tim would not be here were it not for Claire and the excellent CPR she provided to Tim prior to the paramedic’s arrival. The CPR course that Claire took saved her husband’s life. She tells her friends and family that it was “money well spent” and urges them all to do the same because, she tells everyone, “you never know when you might need it”.
The above scenario is repeated in homes and public places, on family members and strangers and by lay persons and health professionals every day. Basic Life Support classes teach the skills necessary to save a life. Whether it is stranger’s life you save, or that of a loved one, there is no greater satisfaction than knowing that you were instrumental in saving a life. To find out more about how you can take a Los Angeles CPR class or BLS course, please visit Lifesaver Ed.
Have you ever wondered how the lifelike mannequins that are used to teach CPR came into being? The story is an interesting one that serves to illustrate how tragedy can turn to triumph.
In the early 19th century in Paris, a young girl’s body was recovered from the River Seine. The girl’s body provided no clues as to how she came to be in the river. Her identity was a mystery. As was a custom of the time, a death mask was created, so that if anyone came forward at a later time identification could be made. The girl was young and beautiful, and fueled many romantic stories about the circumstances that had led to her being in the river. One such story that flourished was that the girl had taken her own life after a failed romance. Reproductions of the death mask became a popular item in Europe.
Many years later Asmund Laerdal, a business owner, decided to create a lifelike mannequin that could be used in teaching mouth-to-mouth resuscitation. He felt that the mannequin should be as realistic as possible to increase motivation among students. Having heard and been moved by the tragic story of the girl found in the river (and never identified), Laerdal used the girl’s face on his new mannequin, which he called Resusci Anne. In essence, he provided the dead girl, mourned by many but known by none, a name. In turn, she became the first model for training people in lifesaving techniques such as mouth-to-mouth resuscitation and CPR.
Today, thanks to “Anne”, millions of people have learned the skills necessary to save a life by practicing on a realistic mannequin. The next time you update your CPR or ACLS course, you may remember the story of Anne and how she touched so many lives. You, too, can alter the course of another’s life. To find Los Angeles BLS classes near you, please visit Lifesaver Ed.
Non-cardiac chest pain accounts for millions of visits to emergency rooms every day, and yet few people diagnosed with non-cardiac chest pain receive follow up to get to the bottom of their symptoms.
Common causes of non-cardiac chest pain include panic attacks, musculoskeletal pain, microvascular disease and gastroesophageal reflux (GERD). GERD accounts for up to 60% of cases of non-cardiac chest pain. GERD is the abnormal reflux of stomach acid from the stomach to the esophagus. Symptoms include heartburn (which can mimic the chest pain of a heart attack when severe), nausea and painful or difficult swallowing.
A study that was published in the Mayo Clinic Proceedings found that patients admitted to the ER with non-cardiac chest pain and later discovered to have GERD received little follow up testing. Only 15% of the patients studied went on to have a consult with a gastroenterologist. Survival rates for those patients in the study who were diagnosed with GERD were lower at 10 years and 20 years than in those patients who were given other explanations for their non-cardiac chest pain.
Study experts believe that people who suffer from GERD may also have risk factors for heart disease, and that these patients should be screened more closely for cardiac risk factors when they present to the ER. This is due to the fact that GERD and heart disease may share similar risk factors, such as obesity, smoking, diabetes and obstructive sleep apnea. In other words, they may be suffering from non-cardiac chest pain when they initially present to the ER, but their risk factors may put them at a higher risk to someday experience chest pain of cardiac origin. Therefore, these patients should be managed more aggressively than they usually are. To find out what to do in the event of chest pain, or for other Los Angeles CPR classes, visit Lifesaver Ed.
Source: Noncardiac Chest Pain May Warrant More Management: Study
According to a Danish study of over 12,000 female nurses, working under excess pressure can contribute to the risk of developing ischemic heart disease (IHD). Previous studies have demonstrated this effect in men, but few studies have addressed this phenomenon in women.
Younger women (< 51 years of age) who reported experiencing excess work pressure were 1.6 times more likely to develop IHD than their colleagues who reported lower levels of work stress. The women in the study were followed for 15 years; during that time period, 580 women were hospitalized for IHD. When other risk factors were taken into consideration, excessive work pressure was found to be significant. The age-adjusted incidence of ischemic heart disease was nearly 50% higher in women who reported that they experienced excessive pressure at work.
The study highlights the fact that stress, particularly work pressure, should be taken into account when planning primary prevention measures for women. In addition to providing counseling regarding diet and weight control, control of blood pressure, and control of hypercholesteremia (high cholesterol), primary care physicians should take work stress into account, particularly in women who have many risk factors for heart disease.
Researchers aren’t sure exactly how stress contributes to heart disease. It has been postulated that stress in itself is harmful, as it results in the release of stress hormones such as cortisol and adrenalin. Stress may also increase the likelihood of using unhealthy coping mechanisms that may be harmful to heart health, such as smoking, drinking, overeating and not getting enough exercise. Stress may also contribute to elevated blood pressure.
One way to decrease work stress is to increase your knowledge base in areas in which you feel inadequately prepared. This may be especially true for health care professionals, such as nurses, who face considerable stress in their daily work life. Increased knowledge leads to an increased sense of control over your work environment, resulting in less stress in the workplace.
Are you a health professional interested in taking a course that will teach you to perform confidently in your chosen area? To learn more about Los Angeles CPR classes and other courses near you, visit Lifesaver Ed.
Source: High job pressure boosts women’s heart disease risk
Did you know that the first attempts at resuscitating humans occurred as early as the 18th century? Amsterdam can be thought of as the birthplace of modern CPR. Amsterdam was the first city to teach and promote principles of resuscitation. This was because Amsterdam had ample opportunity to practice- being a city of canals, there were many drowning accidents every year.
The Society for the Recovery of Drowned Persons was formed in 1767, and within a few years, they claimed to have resuscitated at least 150 victims. Some of their methods of resuscitation still hold today, while others went out of favor many years ago as science advanced. Here are some examples of resuscitation techniques advocated by the Society:
• Warming the drowning victim
• Placing the victim in the Trendelenburg position (head lower than the body)
• Abdominal pressure ( applying manual pressure to the belly to help force inhaled water out of the lungs)
• Providing respirations (mouth-to-mouth or mouth-to-nostril, using a handkerchief to cover the mouth if preferred; occasionally bellows were used)
• Stroking or tickling the victim’s throat
• Using nicotine to “fumigate” the victim (rectally or orally)
Regardless of how ridiculous some of these management theories seem to us today, some of the ideas were sound and are still used today. The success of the Society in Amsterdam led to several other cities following suit. These early resuscitation societies can be considered to be the precursors of modern-day EMS services. They proved that early resuscitation was important and saved lives.
Today, millions of people are trained in CPR techniques, including lay rescuers and healthcare professionals, continuing the service to mankind started centuries ago in Amsterdam. To find out where you can take a (modern) CPR classes visit Lifesaver Ed.
Lifesaver Education is participating in the American Heart Association (AHA) CPR and AED Awareness Week by offering free CPR classes to the community. AHA designates the first week in June to encourage people to learn CPR. Heart disease is the number one cause of death in men and women in the U.S. Approximately 60 percent of people who collapse with a heart attack never receive CPR before paramedics arrive, even though it would significantly increase their chances of survival. The recommended guidelines for CPR have been simplified over the years and it has been found that sometimes you can significantly increase a person’s chances of survival simply by knowing how to push on their chest.
Lifesaver Education is offering 3 free classes:
June 1 from 7:00pm to 8:30pm
June 2 from 10:00am to 11:30am
June 3 from 7:00pm to 8:30pm
Space is limited, so arrive early. Instructors will arrive 30 minutes prior to the class start times. Students will not be receiving a course completion card, but will receive a certificate. The class is appropriate for anyone at least 10 years of age. Topics covered will be adult, child, and infant CPR, use of the AED, and treatment of choking. Lifesaver Education is located at 1518 Huntington Drive in South Pasadena, on the northwest corner of Fair Oaks and Huntington Drive with parking in the rear of the building by the entrance.
If you are unable to attend one of the classes, there is a wonderful alternative way to learn CPR. AHA has designed two kits, one for adult CPR called “Family and Friends CPR Anytime” and one for infants called “Family and Friends Infant CPR Anytime”. Each kit includes an inflatable manikin, 22 minute DVD (in English and Spanish), and a reference guide. The kit is reusable and so it can be used by multiple family members, babysitters, neighbors, etc. One or both kits are available for purchase through Lifesaver Education. Normally the adult kit sells for $45 and the infant kit sells for $50, but from now through June 7, they will be available at cost, for only $40 each. You can order yours by calling 626-441-3406.
Don’t miss this opportunity to learn CPR. You could learn to save someone’s life in as little as 20 minutes!