Friday, 17 May 2013

Liverpool Care Pathway - The Truth About CPR

There is truth and there is truth and there is truth. The fact is that nothing is certain. But when the alternative is death, should we not try?

They tried -

They tried -

- Mail Online

The Herald Sun reports that Fiedler is one of seven cardiac arrest patients in Australia who have been treated with the band.

Three have been revived from being declared clinically dead for 40 to 60 minutes, it said. 
AutoPulse machines have been on the market since 2003 and are being used more and more around the world.

Zoll, the company which makes the device, said: 'Victims receive more consistent, high-quality compressions than those delivered by simple automated CPR devices, which means improved blood flow.'

The U.S. National Centre for Biotechnology Information said a recent study on the effectiveness of the machine showed that it had a 'promising' future.

But there will be exceptions for its deployment and use...

And they may not try -

Using Videos to Help Patients Plan End-of-Life Care

Volandes says the videos provide a compelling visual of procedures and outcomes that can be hard to explain with words alone. "I can talk until I am blue in the face about advanced dementia, but if I show someone 30 seconds of a woman with advanced dementia, they immediately get it," he says, a point that was reinforced the first time he admitted a patient to a hospital. The patient, a highly literate and retired poetry professor with widely metastatic cancer, was baffled when Volandes asked what measures the hospital should take in the event her heart stopped beating. Struggling to explain procedures he himself had yet to perform, Volandes suggested a tour of the I.C.U., where by happenstance he and his patient witnessed a cardiac arrest. Volandes repeated the tour with other patients, often sneaking into the I.C.U. at late hours when he was less likely to be challenged. When nurses objected to the privacy violations, the idea of creating the videos was born.
Now used in 35 large health systems across the country, including Seattle, Wash.–based Group Health Cooperative, the videos deliver educational messages about various serious health conditions and show real patients living with the diseases and undergoing life-sustaining procedures—including the use of feeding tubes, ventilators, and defibrillators, and for advanced cancer the experience of sepsis.1 The videos are scripted by a team that includes interventionists, cardiologists, and oncologists, as well as health literacy experts, ethicists, and palliative care doctors and are reviewed by as many as 50 experts for each of the conditions.
- The Commonwealth Fund


Q: Why are the videos effective?
A: Pictures speak a thousand words. The videos speak hundreds of thousands of words. We're a visually literate society, but we are still talking to patients as Hippocrates did 2,000 years ago. I always make it clear the videos are not meant to replace the patient-doctor relationship; it's to reinforce it. It's about empowering, giving patients the means to understand. Doctors aren't always trained to have these conversations.
- Chicago Tribune

It's about downsizing care. They want you to decide not to try.

In 2010, Arun Bhasin, 53, was found lying unconscious in Croydon after suffering a cardiac arrest.

Doctors hooked him up to a Zoll AutoPulse pump which maintained Mr Bhasin's heartbeat for more than three hours while he was stablised by medics.
At the time, Nigel Raghunath, lead consultant in A&E, who treated Mr Bhasin said he had never seen such a remarkable case in his 15 years in Accident and Emergency care.

He said: 'Even a fully-trained professional finds it hard to deliver consistent, high quality chest compressions when attempting to resuscitate someone whose heart has stopped beating.

Mail Online

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