Charles – all;
Studies have demonstrated that the public maintains unrealistic expectations of the potential for successful recovery following CPR (as high as 50%). This has been attributed to misrepresentation of CPR outcomes on television (Jones 2000). However, this CPR representation in the ER episode is not a misrepresentation. In fact, when the new CPR/ECC science and guidelines (due very soon) are put in practice, we may see a lot more of this type of thing – at least hopefully. Here is an excerpt from “Cardiocerebral Resuscitation, The New Cardiopulmonary Resuscitation by Gordon A. Ewy, MD(Circulation 2005) . Stay tuned for a new focus on the quality and duration of external chest compressions -and hopefully more cardiac arrest survivors without brain damage.
“Why is it that every time I press on his chest he opens his eyes, and every time I stop to breathe for him he goes back to sleep?”
The opening quote above is from a woman who had been given 9-1-1 dispatch telephone instructions in cardiopulmonary resuscitation. It is more than a decade old, but when I listened to this recording, I could not help but marvel at the importance of the observation made by this distraught woman trying to resuscitate her husband while awaiting the arrival of the paramedics. She correctly observed what our and others’ research had found: that during cardiac arrest, maintenance of cerebral perfusion is critical to neurological function. During the hemodynamic phase, the most important determinant of cerebral perfusion is the arterial pressure generated during external chest compressions. This perfusion pressure is lost when one stops chest compressions for rescue breathing. The same can be said for maintaining viability of the fibrillating heart. The fibrillating ventricle can be maintained for long periods of time if there is adequate coronary or myocardial perfusion pressure produced and the coronary arteries are open. If early defibrillation is not available, a major determinant of survival from ventricular fibrillation cardiac arrest is the production of adequate coronary perfusion pressure.”
Ralph M. Shenefelt
Executive Program Director
American Safety & Health Institute
4148 Louis Avenue
Holiday, FL 34691 USA
Phone 800-246-5101
Fax 727-943-7460
-R
On Thu, 17 Nov 2005 23:04:46 -0500, Charles Brogan wrote
> Did anyone see ER tonight (11/17/05)? Is it possible to be doing
> CPR and the patient become awake and if you stop CPR the patient
> looses consciousness?
>
> The story was the pt went into cardiac arrest, went into Pulseless
> VT and was shocked at 200 joules and converted into ST (I think),
> a little while later he went back into Pulseless VT, shocked
> several times with no change, drugs were administered, and pt
> began to move, CPR was stopped and pt went unconsciousness, CPR
> was started again and pt became responsive again. Dr Pratt said
> it was because the brain was receiving adequate oxygen from the
> CPR and ET. Could this really happen? It kind of makes sense.
>
> Respectfully,
