Do you neglect to get about 20 minutes of sweat-inducing physical activity a day? If so, you’re in a large group, percentage-wise, suggest survey findings from 19,960 EMS professionals. More than 75 percent of this group did not meet exercise recommendations from the Centers for Disease Control and Prevention, found Jonathan R. Studnek, Ph.D., NREMT-P, and colleagues at Carolinas Medical Center in Charlotte, N.C. In this group, body mass index (BMI) averaged 27.69. (BMI over 25 is considered overweight; 30 and over is obese.) Nearly 26 percent of those surveyed were obese; only about 29 percent were of normal weight. Approximately one-quarter of those surveyed also reported at least one health condition, such as diabetes, asthma, hypertension, angina, stroke or high blood cholesterol, or a history of myocardial infarction. — Prehospital Emergency Care, 14(1):14–20, January/March 2010.
Annual Heart Disease and Stroke Updates
The American Heart Association’s 2010 report on heart disease and stroke in the U.S. is strikingly similar to 2009 in that:
- A coronary event will occur about every 25 seconds; a death will occur about every minute.
- A stroke will occur about every 40 seconds.
- EMS assesses about 295,000 out-of-hospital cardiac arrests (OOHCA) annually.
- Survival to hospital discharge remains at 7.9 percent for EMS-treated adult OOHCA patients with any first recorded rhythm; among children, this rate is 6 percent.
- 31 percent of OOHCA cases receive bystander CPR; 2 percent receive layperson defibrillation.
- 60 percent of the lay public claim familiarity with CPR, 98 percent recognize that AEDs give electrical shock to cardiac arrest victims, and 79 percent say they know what to do during a medical emergency.
- EMS treats 60 percent of all OOHCA deaths. Only 33 percent of these patients have symptoms within one hour of death; 23 percent have a shockable rhythm.
— Circulation, 10.1161/CIRCULATIONAHA.109.192667, published online Dec. 17, 2009.
When More May not Be Better
Two paramedics treating a cardiac arrest does not necessarily increase patient survival, found Nicholas M. Eschmann, M.S., EMT-P, and colleagues at Medical College of Wisconsin in Milwaukee in their review of 10,298 out-of-hospital cardiac arrest cases. Overall, 8.7 percent of those treated by two and three paramedics survived, as did 8.4 percent treated by four or more paramedics. In further analyses that allowed for patient age, gender, location, bystander CPR and other factors associated with survival, crews of three or more paramedics correlated with reduced survival to hospital discharge.Eschmann called it “extremely important” to understand that the calls assessed in this study represent just 4 percent of all ALS calls during the 1993 to 2005 study period. Future evaluations that consider staffing influence on other types of emergency calls and disease processes “may provide greater insight into optimal EMS staffing levels,” he said. — Prehospital Emergency Care, 14(1):71–77, January/March 2010.
Size Matters
This may be a no-duh, but EMS workers should wear properly sized latex gloves. In 20 health care workers, wearing too-small or too-large gloves increased peg-insertion completion time 7 to 10 percent over bare hands or wearing properly sized gloves. If the correct glove size is not available, Tomas Drabek, M.D., and colleagues at the University of Pittsburgh School of Medicine in Pennsylvania suggest reaching for the larger size, as they are more comfortable and less likely to cause pain than too-small gloves. — Journal of Occupational and Environmental Hygiene 7(3):152–155, published online Dec. 16, 2009.Antibodies to Control Internal Bleeding?
Though not yet tested in humans, researchers at the Oklahoma Medical Research Foundation in Oklahoma City have discovered antibodies that may help control internal bleeding. These antibodies counteract proteins that damage the lining of blood vessels after a body has been exposed to severe trauma. The proteins, called histones, normally work to control DNA in cell nuclei. But when cells burst, histones go on the attack. Charles Esmon, Ph.D., and colleagues have tested the antibodies in tissue cultures and animals and noted promising results. — Nature Medicine, doi:10.1038/nm.2053, Oct. 25, 2009; Medical News Today, Oct. 26, 2009.Compress to the BeatBack in 2008, David Matlock, M.D., and colleagues at the University of Illinois College of Medicine at Peoria assessed how listening to the 103-beats-per-minute song “Stayin’ Alive” by the Bee Gees helped a small group of doctors and medical students perform chest compressions at 100 beats per minute. When tested five weeks later, recalling this song helped the study group maintain a good compression rate. [Reuters, Oct. 16, 2008]
Apparently “Stayin’ Alive” was not sufficient for Professor Malcolm Woollard and colleagues at Coventry University in the U.K. They assessed how listening to “Nellie the Elephant” by the Toy Dolls or “That’s the Way” by KC and The Sunshine Band helped 130 laypeople learn CPR. The later song—uh-huh, uh-huh—was not effective. Listening to “Nellie the Elephant” increased the number of people compressing at 100 beats per minute, but it also increased the number giving too-shallow compressions. Woollard’s team suggests further investigation to identify other music that may be useful as a CPR training tool, such as—no kidding—“Another One Bites the Dust” by Queen and “Achy Breaky Heart” by Billy Ray Cyrus. — BMJ 339:b4707, published online Dec. 13, 2009.
