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Mon Oct 8 22:42:51 BST 2007

It looks like they are discussing 2 issues.

They start out talking about shocking VF patients in the first 30 seconds after arrest then switch to talk about doing CPR for longer down times.

Apples and oranges.

Need to compare..

VF Witnessed
Immediate Defib vs CPR then defib

VF Unwitnessed
Immediate defib vs CPR then defib

Andrew

----- Original Message ----- 
From: "Mike Smertka" <medic0947969 at yahoo.com>
Subject: Re: cpr,this is the original post that prompted my questions about CPR

> Should Rescuers Give CPR Before Defib?
> 
> Barbara Turnbull
> The Toronto Star
>  
> In the critical moments after a heart stops, should paddle-wielding
>  rescuers shock fast? Or slow?
>  
> That's the life-or-death question a new, North America-wide study of
>  nearly 15,000 emergency patients will try to answer. Researchers are
>  examining the benefits of defibrillating victims within 30 seconds of their
>  collapse in cardiac arrest, versus first performing three minutes of
>  cardiopulmonary resuscitation, or CPR, before the shock.
>  

>  
> When 74-year-old Mississauga resident John MacLean collapsed during a
>  Leafs-Penguins overtime game at the Air Canada Centre last March, the
>  capacity crowd was silenced and play was halted. Fortunately for MacLean,
>  a nurse sitting nearby leapt to his aid and started CPR. He was
>  resuscitated and taken to hospital, where he underwent triple-bypass surgery.

In this case there was no defib available immediately so he needed CPR, but what if there was an AED "right there" then what. This study will not answer that.

>  
> Traditionally, medical personnel would try to shock a collapsed victim
>  as quickly as possible, sometimes within 30 seconds.
>  
> "Now there is research that suggests maybe this isn't the right thing,
>  maybe you shouldn't shock them right away; you should wait three
>  minutes and be doing CPR," Dorian says, indicating recent studies in Seattle
>  and Norway.
>  
> "It turns out that when somebody has been unconscious for more than a
>  couple of minutes and you shock their heart right away, the heart may
>  not be ready to receive this electrical shock," he says.
>  
> "The way to prime (the heart) is to do some minutes of CPR before you
>  give the shock, so the heart ... will start to beat more effectively.
> "But we don't know which is right," Dorian adds.
>  
> Small, targeted studies of longer, pre-paddle defibrillation have had
>  surprising outcomes, showing better survival rates. The results have
>  made the large and random effort of PRIMED more important.

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cpr, this is the original post that prompted my questions about CPR