Tuesday, January 25, 2011


I was reviewing my medical literature sites when I came across this article which is very intriguing. When we were dealing with the PHCFS Regulations amendments, we proposed to the Ministry of Health that GPs should be able to resuscitate to the standards of the UK resuscitation council 2007, which is basically Basic Life Support ( BLS ). After some initial resistance, we managed to convince them and I think this should come out in the Amendments to the Regulations. BLS is basically identification of a cardiac arrest, call for help, chest compression and mouth to mouth respiration ( kiss of life ).
Progress since our amendment discussions ( shows how long we take to get amendments through, and it is not even through yet ), has now showed us that just compresion, compression and compression, is probably the best. Of course, identification and call for help is still there.
Workers in the Medical College of Wisconsin, led by Dr Tom Aufderheide, have carried out a controlled trail using two simple devices to help in chest compression and breathing.
They studied a group of about 1,650 cardiac arrest victims.The treatment group ( 840 ) had resuscitation aided by the ResQPump and ResQPod. The ResQPump, ( Advanced Cardiovascular Systems, Santa Clara, CA) is essentially a double-grip handle that attaches to the patient's chest with a suction cup, allowing the rescuer to push for delivering compressions and lift for decompressions. The ResQPOD, ( Advanced Cardiovascular Systems) in the patient's mouth limits passive lung inflation during the chest-decompression phase, boosting intrathoracic pressures and enhancing perfusion of the heart and brain. The control group had the usual manual chest compression which is standard practice now. The study was carried over 42 months, and clinical followup for survival was over 1 year.
It is important to note that for out of hospital cardiac arrest, survival till discharge is about 6-9%, same in both arms. The survival at 1 year was better in the treatment arm, and even more importantly, the CNS function was better at 1 year in the treatment group. These results are very encouraging. If the use of a device could help these cardiac arrest victims, then we should go buy it and use it.
A word of caution, however. These trails were done before, and the results were rather mixed. Some studies, showed that it made no difference. It is important to note that this study, although funded by National Institute of Health, had generous support from Advanced Cardiovascular system, and in fact the inventor of the ResQPump and ResQPod, is a coauthor of the paper. I understand that with this paper, they are applying for FDA approval.
We have to keep looking out for how this devices pan-out. Maybe it is too good to be true. But then if it can help my patients survive better, I must look into it.

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