Tuesday 29 October 2019

Stayin' alive

Two days after my colleague died at work despite an hour of CPR, The Beloved was up at an End of Life symposium run annually by The Irish Hospice Foundation. She's been before because we're both quite focussed on the subject being a lot closer to the End now than the Beginning in the 1950s. The key-note speaker was Katharine Mannix, about whose book With the End in Mind: dying, death and wisdom in an age of denial I wrote last year. Mannix looked around the auditorium and asked everyone to guesstimate the rate of survival from a CPR session. Almost everyone in the room was wildly optimistic about this intervention. I straw-polled my class on Friday with the same question and elicited a) a lot of silence and looking at feet [standard response to direct question in class] and b) 50% and 80%. Wrong! It's 10%.

The CDC says that the Bee-Gees can help you pace your push on your neighbour's chest when s/he's dying. They also say that, for cardiac arrest away from hospital, only 10% survive but that your CPR can up the rate 2- to 3-fold. Reuter's report a more realistic definition of a result that matters: 10% for survival to discharge from hospital. With 350,000 'wild' cardiac arrests in the USA each year, people-power CPR results in 350,000 * (30%-10%) = 70,000 incapacitated extra people alive each year occupying 7% of the 940,000 hospital beds in the country. The UK currently has 160,000 hospital beds [down from 240,000 in 2000!]. Henry "Do No Harm" Marsh [prev] says in his new book [Admissions reviewed later] that 7,000 =4% of those beds are occupied by deeply comatose bodies in a persistent vegetative state. Some of the diverted there from "sucessful" CPR. Proportions will surely be about the same wherever you live. They agree with the figures in UK, where someone floated an annual Restart-a-Heart Day. That concept has gone international and happens in mid-October all over Ireland so you've missed your chance for training this year.

A portable defibrillator can be useful for jolting the heart back to life. Word on the street is that, when someone ran for The Institute's defib during the drama last Tuesday, there was nothing in the box. Someone had "borrowed" it. I hope its hanging in an impoverished GAA club somewhere. An AED Automatic External Defibrillator costs about €1200 in Ireland and there is clearly a buoyant market for this kit; with at least 20 competitively priced brands. All competing for a memorable name too: Philips HeartStart shown R. This guide will help you through the marketing to understand what matters in your purchase. Actually that guide is far too wordy and dense. This one is Irish and easier to read and better focussed.

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