Take your pick, but don’t expect that all of them will work for everyone. In fact, I have my doubts about quite a few, and money and elitism are the factors most in charge there. I won’t go into hypnosis. In fact, a young woman told me weeks ago that everything in her life was going to be immediately fixed by going for hypnosis, and all her bad memories would be erased. Forgive me, but that’s like saying the moon is made of green cheese. We all know it’s blue cheese.

Now, there’s a new hope on the horizon, and it may have some aspects in it that will provide a degree of help, especially for those without insurance or the money to pay for traditional psychotherapy. And while we’re on the money issue, allow me to let you in on a bit of a conversation I heard at a gathering of psychotherapists once. The animated woman was telling her cohort, “I have to pay for that new garage, so all I have to do is make sure all my patients stay with me.” Ethics be gone; she needed a new garage. How many summer homes, BMWs, or trips to Europe did those patients underwrite?

eCPR is a public health education program that teaches people how to help others who are having a hard time emotionally. This program was devised with the help of people who thought about their own emotional crises and how they could be used to help them grow as people.

Everyone can have an emotional crisis at some point in their lives. When we are in unusual situations, we come up with amazing and creative ways to keep ourselves safe. From the outside, this can look very strange or even scary, but to us, those mechanisms make sense in those situations. People who exhibit strange behavior that appears to be the result of an emotional crisis can better understand and overcome their fear. So, how do you do it? eCPR breaks down this understanding process into three straightforward steps, which are also part of the process name.

The steps are connecting, empowering and revitalizing. Each step helps us develop resilience and reveals the power within each of us that may be brought to bear when we need it.

Connecting: Strengthening listening skills and establishing the person in crisis’s sense of safety and respect are essential components of connecting with them.

The goal of emPowering is to assist people in discovering their inner strength so that they can move past negative emotions like anger and distress.

Revitalizing means helping people find a sense of purpose, which is at the heart of what it means to revitalize them. There is a holistic, positive, and powerful approach to addressing mental discomfort in each of these processes. We understand that people’s emotional pain is a form of expression, and with this knowledge, we may serve as an intermediary between them and the world beyond their immediate situation.

How do you obtain training in eCPR, and who should be trained? Interestingly, these programs are folded into seminars aimed at anyone who wants to develop the ability to help others. You don’t have to be a mental health worker or in the health field, and it can help all of us. Helpful background information is available. There is a center that provides information regarding eCPR seminars and training. Or contact The National Library of Medicine for guidance on facilities and groups that may offer the training.

The post What’s “Emotional CPR” and Should We Be Using It More appeared first on Medika Life.

On Monday night, I watched as Damar Hamlin had cardiopulmonary resuscitation (CPR) on the football field. Medical personnel quickly shocked his heart back into a normal rhythm. Meanwhile, distraught players openly cried, and the National Football League (NFL) suspended the game.

In an early morning statement the following day, the Buffalo Bills organization reported that Hamlin’s “heartbeat was restored on the field” and that the football player was under sedation at the University of Cincinnati Medical Center.

Just over three days later, Hamlin awakens and shows his brain function is intact:

Doctors: Hamlin shows’ substantial improvement buffalo Bills safety Damar Hamlin is beginning to awaken.

Bills safety Damar Hamlin is beginning to awaken.

www.espn.com.

While the American football player is recovering, Dr. Timothy Pritts reminds us that Hamlin is critically ill. Thankfully, his neurological function appears to be intact. The 24-year-old is moving his hands and feet and communicates by writing (while unable to speak — he is still on a mechanical ventilator).

Hamlin’s first written communication upon awakening from his deep sedation-induced multiday sleep? He offered a note with this question: “Did we win?”

I love Dr. Pritts’ response: “The answer is yes, Damar, you won. You won the game of life.”

Cardiac arrest remains a public health crisis.

Sudden cardiac arrest is not uncommon and remains a public health crisis. The American Heart Association Heart and Stroke Statistics — 2022 Update shows the following:

There are more than 356,000 out-of-hospital cardiac arrests (OHCA) annually in the U.S., nearly 90 percent of them fatal. That translates to nearly 1,000 individuals daily.

The survival to hospital discharge after emergency medical services (EMS)-treated cardiac arrest languishes at an unimpressive 10 percent.

Sports-related sudden cardiac arrest

Sports-related sudden cardiac arrest (SCA) represents the following percentages of SCA by age in Portland, Oregon (USA):

Two other important observations:

• The sudden cardiac death incidence during youth sport participation is approximately 1.83 deaths per 10 million athlete years.
• Pre-participation screening of 5,169 middle and high school students (with an average age of 13) from 2010 showed high-risk cardiovascular conditions in approximately 1.5 percent.
• Recent research indicates the incidence of out-of-hospital cardiac arrest in children in the USA is 23,514.

Covid-19 pandemic and cardiac events

You may wonder how the COVID-19 pandemic has affected the incidence of out-of-hospital cardiac events. In New York City, the incidence of OHCA attended by emergency medical services tripled in 2020 compared with a year earlier.

In addition, the pandemic brought increased delays in starting CPR for out-of-hospital cardiac arrests. Despite no chance in the frequency of bystander CPR, there was a drop in the frequency of shockable rhythms, bystander AED (Automated External Defibrillator for shocking the heart back to a normal rhythm) use, and out-of-hospital cardiac arrest in public locations.

Timely, quality CPR is key to survival

Within seconds of the nationally televised event, medical personnel from Cincinnati’s Paycor Stadium initiated high-quality cardiopulmonary resuscitation (CPR) on Damar Hamlin. Soon, an ambulance came onto the field to rush Damar Hamlin.

The quick medical response likely saved Hamlin’s life. A doctor appeared by Hamlin’s side within one minute of his collapsing and immediately determined that the player had no pulse. CPR immediately began.

Cardiac arrest, CPR, awareness, and treatment

About one in six (18 percent) individuals in the United States report recent CPR training. Nearly two in three reports having had CPR training at some point.

CPR training rates appear lower in older people, those with less formal education, lower income groups, and Hispanic/Latino individuals. That’s according to a survey of over 9,000 people in the USA in 2015.

Here are the leaders in laypeople-initiated CPR for out-of-hospital cardiac arrests (OHCA):

Non-medical professionals used the “shocking device” (AED) in six percent of events, delivering a shock in 1.3 percent.

Laypeople used AEDs in nine percent of out-of-hospital cardiac arrests. States with higher use rates include Nebraska (16 percent), Alaska (10 percent), Minnesota (9 percent), Oregon (13.5 percent), Washington (11 percent), Pennsylvania (10 percent), North Carolina (9.5 percent), and Utah (9.5 percent).

Cardiac arrest — My take

First, learn CPR. It is important for all of us, especially those with sport-playing children. A kid can get hit in the chest by a baseball or basketball. A cardiac arrest can occur if the strike is in the wrong chest location at precisely the wrong time in the heart’s electrical cycle.

Second, please advocate for AEDs everywhere that is reasonable. All malls, schools, and other well-traveled public spaces should have them.

Third, never be afraid to use the AED. The machine tells you exactly what to do and will not ask you to deliver a shock unless needed.

I took a CPR refresher course last week. You should consider taking one, too.

The post Football Player Hamlin’s On-field Collapse Reminds Me to Know CPR appeared first on Medika Life.

Yes, some seek the wonders of cryonics in the hope their illness will be cured in the future and they will come back to life. The medical community is not optimistic about this prospect.

But for those who are not seeking such extraordinary interventions, there is the legal constraint of a DNR (do not resuscitate) and an advance care directive for anyone who wishes to avoid unnecessary, possibly painful medical interventions when death is inevitable. The purpose is restraint in medical procedures, but not everyone will have their wishes met.

In some instances, the concern that a patient’s wishes will not be adhered to has led to their having “DO NOT RESUSCITATE” tattooed onto their chest. But does that work?

The laws regulating healthcare and DNR vary by state, and a physician must sign a DNR. How do you do that with a tattoo? The body paint is supposed to be an extra incentive for medical staff to read the patient’s chart and see if they did sign the document. It’s similar to surgeons marking a limb scheduled for an operation. Too many people have had the wrong limbs amputated, and that led to this extra measure of care.

Until a national DNR becomes reality, healthcare professional should continue to help people become aware of the need for and best way to communicate end of life wishes. The real question comes under “risk management,” which means lawsuits and ethical obligations to most consumers. Anyone wishing a DNR form for their state can download one.

I am not without some experience in meeting people who have had relatives die and who had DNRs that were not honored. Helplessly, one woman had to watch as her father was intubated, his body became a grotesque form of his former self, and he lay dying for days.

And she felt guilty because there was nothing she could do. It was like the famous “Terms of Endearment” scene where Shirley MacLaine screams for her daughter’s pain meds and is ignored.

My patient was angry because as much as she pleaded with the medical personnel and pointed to his DNR, she received no attention; the staff kept doing what they had been doing. What might the problem be, you ask? How about legal concerns of being sued for not intervening and, as a result, disregarding the DNR? It doesn’t sound like a robust legal document, does it? Does the question now remain how we remedy this?

But the DNR has also been used unlawfully in some instances of persons with disabilities. A more insidious practice has also been brought to light in which some doctors have been placing unlawful DNR orders on the records of individuals with learning disabilities without prior consultation with the person’s family or carers.

In one study, 65% of the respondents who were disabled feared they would not receive needed treatment if they became seriously ill. It was unclear if they believed DNRs would be the cause or if they had DNRs in their files.

The patient’s wishes are, in some instances, a function of a physician’s experience, training, and life experience. Ability to participate in goals of care discussion is an important skill to be honed by physicians in both inpatient and outpatient setting for ensuring appropriate management of patients in accordance with their value. The lack of training in such discussion can lead to a lack of guidance for the patients in settings of terminal illness and inappropriate use of healthcare resources.

Is “value” something to be considered? Are they writing about how a patient values their life or how the staff values the patient’s life? Two very different perspectives and the tendency can be to be too proactive or too willing to decline to follow the directive. The will of the patient should prevail, but does it? And, if not, what might the consequences be for healthcare professionals?

The intent of writing DNRs was to provide a sense of control of our bodies over medical interventions according to the patient’s wishes. It can provide a degree of comfort in a difficult situation. When we see a total lack of regard for the patient’s wishes where the personnel assumes a godlike attitude, healthcare facilities assume a mental patina of fear.

The post When Death Is Inevitable, Why Is Our DNR Ignored? appeared first on Medika Life.