From: Alan Hall <ahalltoxic**At_Symbol_Here**MSN.COM>
Subject: Re: [DCHAS-L] Fwd: New CPR technique - EVERYONE SHOULD SEE THIS
Date: November 29, 2012 5:00:26 PM EST
Reply-To: DCHAS-L <DCHAS-L**At_Symbol_Here**MED.CORNELL.EDU>
Message-ID: <6CB523107D2FF9408F23400EFCE58C5B3EB9AA01**At_Symbol_Here**>

Thoughtful comments.
First, if a person is conscious, can talk to you, and looks rather pink (you can press your fingernail and the other person's at the same time and see if capillary refill is relatively the same), then don't go poundin' on their chest.  If they seem to be ill, call 911 and stay around in case things change.  And they can.
There are various thing that happen with the oxyhemoglobin dissociation curve (when O2 will leave hemoglobin to go into the tissues if there is some circulation), and in cardiac arrest one of the things that happens is that a cell with no O2 to use will switch to anaerbic metabolism (same as happens in cyanide, sulfide, and azide poisoning but for different reasons).
Consider the cell for simplicity as a black box with a whole lot of very complicated biochemical things going on inside.  If  you put some glucose in at the top and some O2 in at the side all that student's nightmere goes about its business and make a whole lot of ATP which can be thought of  as the fuel which powers the cells.  The waste products are CO2 and H20, which our bodies are well equipped to deal with.  When either no O2  is available or it cannot be used, then the mechanism tries to adapt, but it produces a whole lot less fuel and make lactic acid as a waste product.
When that lactic acid is in the system, nothing works very well.  Nerves don't work, the cardiac conduction system doesn't work, and the heart doesn't work.  And then in about 5 minutes, you are braind dead if not ALL DEAD.
So the issue is:  if you are someone who's not to sqeamish to do rescue breating as well as chest compresssions, then why not do it (some ol' geezer/geezette gonna give you AIDS--unlikely-  I don't worry about it and if it's a child, Geez!) and if you are too squemish, then may be do what these guys from Azizona say.  Mostly, I think they are  coming from:  Geez, what we all taught for all those years, well many folks just won't do it because it turns off their ensibilities.  And quite rightly, sometime doing something is better than doing nothing.
Although I did used to teach medical students/interns/residents and others, that you have to assess the situation first and then act quickly.  "Don't just do something--Stand There".  Needs to only last a second or two, but in an emergency it allows your mind to focus and so when you do do something, it's more likely to be the right thing.
Best wishes,
Give me a call sometime.  I'm located up near Fort Worth now, but am in DC until late tomorrow evening.
Alan H. Hall, M.D.
(307) 399-1564

Date: Thu, 29 Nov 2012 18:41:26 +0000
From: matthew.mckinney**At_Symbol_Here**AUSTIN.UTEXAS.EDU
Subject: Re: [DCHAS-L] Fwd: New CPR technique - EVERYONE SHOULD SEE THIS



I'm taking some undergrad Physiology classes for fun. We've discussed this a little bit in class and I had the same question. The response I got was that there is still enough oxygen bound to hemoglobin to last a few minutes as long as its circulated.

If cellular respiration is dependent on the partial pressure difference between PO2 and PCO2, then would the O2 still bound to hemoglobin be able to diffuse to the brain? It seems like there would be minimal (or no) added O2 to the system through mechanical ventilation from the compressions.

It sounds like even if someone is conscious you are supposed to do these compressions, but I thought compressions should only be done when there is no pulse.



Matt McKinney

Lab Safety Specialist, EHS

University of Texas at Austin

SER 207, C2600





Want to become a green lab? Click here.


From: DCHAS-L Discussion List [mailto:dchas-l**At_Symbol_Here**MED.CORNELL.EDU] On Behalf Of Alan Hall
Sent: Thursday, November 29, 2012 10:58 AM
Subject: Re: [DCHAS-L] Fwd: New CPR technique - EVERYONE SHOULD SEE THIS


Good to send that around.
Anyone can learn to do this, and like  eye/skin chemical decon, anything is better than nothing.
When this first came out, I was a volunteer teaching CPR with the American Red Cross and I went to my co-instructor and showed it to her, and she was absolutely appalled.
We were, of course, both well-trained and certified this, that and the other thing in the medical/first aid fields.
As a Board Certified Emergency Physician and Advanced Cardiac Life Support CertifiedProvider and Instructor for aI remain unconvinced that circulating deoxygenated blood really does anything, but since probably anyone can learn this, maybe it wouldn't hurt.



Alan H. Hall, M.D.

Former Emergency Physician

Medical Toxicologist


Date: Wed, 28 Nov 2012 21:45:37 -0500
From: waltersdb**At_Symbol_Here**EARTHLINK.NET
Subject: [DCHAS-L] Fwd: New CPR technique - EVERYONE SHOULD SEE THIS


This is a new, simple CPR technique that everyone should learn.

Doug Walters

  This short video illustrates the best demonstration and gives the simplest explanation of exactly what to do if someone near you collapses and is presumably having a heart attack. 



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