Randy Cassingham's Blog

Posted by tOM Trottier, Ottawa Canada on July 5, 2009:

One thing that seems never to be emphasised enough is that you really have to compress the chest, with 100lbs/44kg pressure, so small people are at a disadvantage.

I've always thought that compression by foot would be more effective (less tiring, more pressure, wider area to avoid broken ribs) than the heel of the hand, especially if you only weigh 100 lbs. But for the breathing, you would need a 2nd person.

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The amount of pressure needed isn't constant at all: depends on the size (etc.) of the victim. A foot might work, but would be much harder for most people to get a controlled compression. -rc

Posted by Fred, Pagosa Springs, CO on July 5, 2009:

Here's a paper about a new CPR method that might be the one that Bob heard about:

Rhythmic abdominal compression CPR ventilates without supplemental breaths and provides effective blood circulation. (National Institutes of Health site)

"CONCLUSIONS: OAC-CPR generated ventilatory volumes significantly greater than the dead space and produced equivalent, or larger, CPP than with chest compressions. Thus, OAC-CPR ventilates a subject, eliminating the need for mouth-to-mouth breathing, and effectively circulates blood during VF without breaking ribs. Furthermore, this technique is simple to perform, can be administered by a single rescuer, and should reduce bystander reluctance to administer CPR."

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In English, the study showed that doing abdominal compressions not only squeezed the heart, but helped move air. The study was done on pigs, not humans. Bottom line: things change all the time as studies are done, which is one of the many reasons one needs to recertify frequently, and follow what you've learned in your latest class. Doing "experimental" procedures could result in lawsuits. -rc

Posted by Jan - Moscow, Idaho on July 5, 2009:

8 years ago, I survived eight hours of supra ventricular tachycardia. My heartbeat was 195-198 bpm and I thought I wasn't in trouble, because my mother's implanted defribrillator doesn't 'go off' until her heart reaches 200 bpm. After eight hours, I called her and asked her what to do! She later said she had a really hard time NOT crawling through the phone line to get to me, but to say as calmly as she could that I needed to be seen as soon as possible.

By the time I got to the outpatient clinic I was so weak I fell down after opening the door! They got the ECG while the ambulance arrived to take me around to the E.R., a couple of blocks away. I hadn't realized that my mother meant EMERGENCY ROOM, not just be seen by a doctor. :)

The damage is permanent. My activities are even more limited than they were 18 years ago when I had to leave WSU with CFS/Fibromyalgia symptoms. But I lived to enjoy your sites. Thank you for continuing with these great sites.

Posted by Jost, MD, Hamburg, Germany on July 6, 2009:

As a former paramedic and now a certified general surgeon and specialist in emergency medicine, I'd like to give a tip how to keep up a rhythm of 100 compressions per minute while doing cpr: Sing to yourself that AC/DC-Song "I'm on a highway to hell..." and you got the right rhythm. But: Do it silently when someone else is around!

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My a target="_blank" href="http://www.thisistrue.com/weird_news_video_20_--_listen.html">20th video dealt with this very subject. -rc

Posted by Brian in New Haven, Indiana on July 6, 2009:

My wife and I have taken CPR classes through the Boy Scouts of America. We have four kids with the two older boys being in scouts. The training is annually and classes are given to the boys and adults. The classes are part of the boys merit badge for first aid and last for several weeks. They have to complete hands on test along with book work. We always hope that if the time should come that any of the boys or adults would be able to respond. I've had friends saved by EMT's in the past and even in the moment or after I never thought that, "Thank You" quite covered the emotions that I was trying to express.

Posted by Avram, Pottstown, PA, USA on July 6, 2009:

I experienced a mixture of chills, thrills, and near-tears reading your recounting of your "adventure". I was a volunteer firefighter and EMT for several years and only had to use the AED that we carried on our rigs once in real life (can't count the number of times I had to go through the protocol in training), so I know what you are feeling. It is good to be able to save a life when you deal with so much death and suffering.

The only experience that is more profound than saving a life is helping to bring one into the world (yes, I got to assist in a pre-hospital birth).

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I did that once too, but it was so fast that I hardly got a chance to think about it. -rc

Posted by Howard Croy, Brookings OR on July 6, 2009:

That is what being in medicine is all about. Having spent the last 20+ years of my adult life in ER medicine as a PA I have slogged my way through a million sprained ankles, sore throats and runny noses but about once or twice a year you really SAVE someone's ass!!! Take that memory, bronze it, cherish it, relive it and re-tell the story. That is what will get you through the nights of multiple calls from drunks that got a boxers fracture from beating up their spouses, drug addicts that desperately need a fix (and decided that EMS was the best place to get one) and runny noses that need some nasal spray but the patient couldn't afford the cost (despite the $5.00 pack of smokes in their pocket.) Ya it's a great feeling, hold on to it for as long as you can.

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It's one of the reasons I decided to write it all down when it was all fresh in my mind. :-) -rc

Posted by Stephen, California on July 6, 2009:

I am a former EMT and wonder how Michael Jackson's doctor did not seem to know that CPR does not work well when performed on a bed.

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Doctors aren't usually very well practiced at in-the-field emergencies. On the other hand, this guy is supposed to be a cardiologist. It will be interesting when the "real facts" come out later so we know what really happened. -rc

Posted by Frank, Henryville,PA on July 6, 2009:

AS a retired EMS Liet. for the FDNY with 33 years as an EMT, your story had me on the edge of my seat. Since retiring, my two jobs are as an EMT with the local EMS service in my rural PA town, and as an AHA CPR instructor. Your description of finding a rural address is so true. We get addresses like "turn left on Rt 715 and look for a blue house next to a big rock." Also keep pounding the drum about getting CPR & AED training. As you just experienced, trained, caring people with the right equipment can make a difference. Congrats to you & your team on a good save.

Posted by Darda Gregurev, Adelaide, South Australia on July 6, 2009:

Loved your article. Live in a city and had a cardiac arrest a few years ago. When I started to fill unwell, I used my mobile to call an ambulance. Apparently an off-duty nurse came over to my parked car to help, and I was rushed off to hospital. I immediately had surgery, survived and am doing well. Never thought much about it, really, I was in my fifties and and felt satisfied with having lived my life. However, your article is a wonderful account from the side of the medics who are involved in the drama of it all and who bear a responsibility to a total stranger. In a city one does not know the people who have helped me survive - so I am using this opportunity to say "thank you" to those who help others with their skill and knowledge. I have enjoyed my years since and have lived with much joy to see a new grandchild. Thank you from me to all of you - for those of us who never get an opportunity to say thanks to the individuals.