11
Dec, 2020

Who is the girl behind the face of CPR?

She is the face that many have kissed during cardiopulmonary resuscitation (CPR) training and she has saved millions of lives, but who is she and what is her story?

She is known by many names – L’Inconnue de la Seine (Unknown Woman of Seine), the Mona Lisa of Seine, Resusci Annie, and The Most Kissed Girl in the World – and was a young girl whose body was pulled from the River Seine in late 19th century Paris.

She had no name, no history, and no story. But the pathologist who performed an autopsy on the body was so captivated by her beauty that he had her face preserved as a plaster death mask.

In the years that followed, copies of the mask were sold throughout bohemian Paris.

It was thought that she had died by suicide, but over the years, many stories have emerged of her being murdered, or eloping to Paris from Liverpool with a wealthy suitor.

In 1956, it was discovered that mouth to mouth breathing could maintain blood oxygen levels in a non-breathing victim, leading to the development of CPR.

When a member of the American Heart Association’s CPR committee saw that students practising CPR on one another risked causing rib fractures and pain, he approached a doll maker Åsmund Laerdal to create a realistic training model.

While contemplating the design, Laerdal remembered a mask on the wall of his grandparents’ house and decided to make it the face of his new resuscitation training aid, Resusci Anne.

It is estimated that Resusci Annie has likely helped more than 500 million people to train in CPR, saving around 2.5 million lives.

The line “Annie are you okay?” – used to check for a response in the patient – features in Michael Jackson’s Smooth Criminal, after the singer was inspired by his own CPR training.

These days you can be captivated by her beauty in resuscitation training rooms around the world, but there is one other place you can see her, say Loke and McKernon. The Lorenzi model makers in Paris, who produced L’Inconnue’s original death mask, continue to produce copies four generations on.

A linked editorial discusses the ethical questions raised by historical events and asks was the unknown woman of the Seine morally wronged?

At the time of her death, putting bodies on view and circulating death masks were customary practice. But they’re ethically troubling now. Should we be concerned about this circulation of her image without anything resembling consent?

4
Dec, 2020

Why People Fear Performing CPR on Women

Women are less likely than men to receive CPR from a bystander. But why?

The reluctance, new research suggests, maybe fueled by worries of being accused of sexual assault or doing physical harm. Knowing people’s secret fears is the first step to dispelling them, experts say.

The insights come from a new survey of 520 men and women who were asked to rank potential reasons someone might not want to provide bystander CPR to a woman, based on the sex of the rescuer. The survey built upon previous findings from the same research team that had respondents use their own words to describe why someone might hesitate to provide lifesaving care to a stranger.

The new survey compiled the open-ended responses into themes, which respondents were asked to rank. Both men and women said the biggest reason male rescuers would refrain from giving CPR to a woman was fear of being accused of sexual assault or inappropriate touching, whereas the biggest reason a female rescuer might not provide assistance was fear of harming the victim. Less often, respondents said a male or female rescuer might have a misconception that women don’t have cardiac arrests or think a woman was being overdramatic.

The research was presented earlier this month at the American Heart Association’s virtual Resuscitation Science Symposium. It is considered preliminary until published in a peer-reviewed journal.

“Hopefully, this information can be used to help us eliminate the biases that people may have,” said Shelby Shelton, a professional research assistant at the University of Colorado Department of Emergency Medicine and one of the investigators.

More than 350,000 sudden cardiac arrests occur outside the hospital each year, according to AHA statistics. Though the vast majority of these occur at home, about 19% in adults and 13% in children happen in public. Bystander CPR can double or triple a person’s chances of survival if started immediately.

But women are less likely to get such help. A 2018 study published in Circulation: Cardiovascular Quality and Outcomes found 45% of men received bystander CPR compared with only 39% of women. Men had 23% higher odds of survival than women.

“Everyone deserves to get CPR and a chance at a great outcome when they collapse in public,” Shelton said. “We want to encourage strong public education around that core message.”

In the new study, researchers were surprised to find that men and women shared the same perceptions of what might deter a rescuer, said Dr. Sarah Perman, the study’s senior investigator and an emergency physician. She is an associate professor of emergency medicine at the University of Colorado School of Medicine. Respondents were asked how they perceived others might feel giving a woman CPR, rather than about their own feelings, to remove any reluctance to answer honestly.

Framing the question that way “could help uncover those hidden fears that people may have,” said Dr. Ashish Panchal, a professor of emergency medicine at the Ohio State University Wexner Medical Center, who was not involved in the study. “And if we have a better idea of these underlying, hidden feelings that people might feel uncomfortable talking about, it gives us a better idea of how to train people.”

For example, he said, “the probability of injury from bystander CPR is really, really low. Knowing the perception is there that helping someone might hurt them, we now know we have to combat this.”

Likewise, said Perman, people need to be assured it’s OK to touch a woman you don’t know if you are helping someone who might otherwise die. “A woman at the gym or the grocery store who is in medical distress is clearly a scenario that warrants public assistance,” she said.

This type of data also could be useful for training 911 dispatchers, Panchal said. “These are the people who are giving instructions that guide people to perform CPR in real time. If they understand the fears people have, they can help to dispel those fears as they are guiding someone on the phone about what they need to do.”

23
Nov, 2020
hands-only-cpr

Hands-only CPR

Hands only CPR was encourage by the American Heart Association and released its 2020 emergency cardiopulmonary resuscitation (CPR) guidelines on October 21, 2020.

Of the 356,461 out-of-hospital cardiac arrest cases in the US in 2019, the survival rate was merely 10.4% because of a lack of high-quality CPR and access to an automated external defibrillator (AED). This device administers an electrical shock to normalize and restart heart rhythms and is designed for use by the public. I am certain that local statistics are similar to US ones, so we must promote awareness and training in CPR and make AEDs more generally available.

During this pandemic, the public can still provide CPR by using a hands-only method and an AED while awaiting an ambulance. Remember that both the rescuer and the victim must wear face masks. No rescue breaths are given at any time during hands-only CPR. First Support CPR and First Aid Training offers CPR classes for certification and recertification.

20
Nov, 2020

Updated AHA CPR guidelines address overdoses, technology, cardiac arrest recovery

The American Heart Association’s 2020 guidelines add a sixth link to the cardiac arrest chain of survival and offer new strategies for increasing rates of lay person CPR

The American Heart Association’s regular revisions to its CPR and emergency cardiovascular care guidelines have included changes to epinephrine, therapeutic hypothermia, and compression-to-ventilation ratios over the years. Learn more about the AHA Guidelines for CPR and ECC 2020 updates with:

DALLAS — The American Heart Association (AHA) has released updated CPR guidelines for 2020, which address the management of opioid-related cardiac arrest, the use of digital technology in facilitating cardiac arrest response, social disparities in rates of bystander CPR and post-hospital recovery as part of the cardiac arrest chain of survival. 

The new guidelines were published Wednesday in the association’s Circulation journal and outline a total of 491 recommendations for first responders and lay rescuers. In a press release, the AHA highlighted new suggestions for raising awareness of the importance of bystander CPR. 

The American Heart Association has released its updated 2020 CPR guidelines in the journal Circulation. The new guidelines include 491 recommendations, including recommendations about responding to opioid-related cardiac arrests, encouraging lay person CPR in populations with historically low bystander CPR rates and using digital technology to facilitate CPR response. (Photo/American Heart Association)

The AHA recommends encouraging lay person CPR by underscoring that the risk of causing harm to the patient during CPR is low, and by focusing efforts on socioeconomic, racial and ethnic populations that have historically seen lower rates of bystander CPR. The AHA also stated that CPR training should address gender-related barriers in order to improve bystander CPR rates for women. 

The use of mobile technology by emergency dispatch systems to alert trained bystanders to cardiac arrests near them can also increase the rates of bystander CPR and AED use, according to the AHA. The association also released a digital resuscitation portfolio, a new online program for continuously improving CPR training programs, developed in collaboration with Area9 Lyceum and RQI Partners. 

“In this time of physical distancing, resuscitation education and training delivery must evolve,” said RQI Partners CEO Clive Patrickson, Ph.D., in a statement. “The American Heart Association digital resuscitation portfolio uniquely and efficiently delivers effective CPR quality improvement and leads healthcare organizations on an immediate journey to high-quality and verified CPR competence to maximize lifesaving outcomes.” 

Other changes to CPR guidelines include two new opioid-associated emergency algorithms for first responders and lay rescuers to respond to cardiac arrests caused by overdoses, and new data on pediatric CPR and resuscitation of pregnant patients. The association has also added a sixth link to its cardiac arrest chain of survival addressing the need for continued treatment, monitoring and rehabilitation for survivors after they leave the hospital. 

“The 2020 Guidelines represent a synthesis of important science that guides how resuscitation is provided for critically ill patients,” stated Raina Merchant, M.D., M.S.H.P., FAHA, chair of the American Heart Association Emergency Cardiovascular Care Committee and associate professor of emergency medicine at the University of Pennsylvania. “As the science evolves over time, it’s important that we review it and make recommendations about how providers can deliver high-quality care that reflects the most updated and state-of-the-art information.” 

The AHA’s CPR guidelines are typically updated every five years and have transitioned to a new online format for continuous evidence evaluation since they were last updated in 2015. The full updated guidelines are available online in the Circulation journal with additional resources available on the AHA website. 

For an introduction to the 2020 updates watch this video. 

20
Nov, 2020

How-to guide for CPR in space may help treat astronaut cardiac arrest

Simulating a medical emergency on an aircraft in microgravity

Alexis Rosenfeld/Getty Images

Nobody has experienced cardiac arrest in space, yet. But with plans to send humans back to the moon within a few years and on missions to Mars down the line, the chances are it will happen at some point.

A new study led by Jochen Hinkelbein at the University Hospital of Cologne in Germany provides the most comprehensive guidelines yet on how to perform cardiopulmonary resuscitation (CPR) in space.

“This is a critical work on a medical emergency that mercifully has not occurred yet during space flight,” says …