Back to the EMS Garage post with Mickey S. Eisenberg, MD on resuscitation,^[1] the rest of the episode was great. One of the points brought up was, How do we strengthen the first links in the Chain of Survival?





Without the right start, how can we expect the later parts to be effective?

But we do.

We expect that this is all about paramedics, ACLS (Advanced Cardiac Life Support), EDs (Emergency Departments), drugs, and invasive procedures.

So, why have the Chain of Survival?

Because the stuff at the end, if it works at all depends on the stuff at the beginning. You do not put an egg and some cheese on a plate and declare that it is an omelette. The preparation is important.

Dr. Eisenberg addressed some of the questions that almost everybody else runs away from, while screaming obscenities ignores.

What are the best investments of money to improve resuscitation?

Do we need to have the public go through an entire AHA/ARC CPR course,^[2] or can we provide the level of education needed to meet the needs of the patient by other means?

I wrote about this subject a bit before, in EMS Garage, CPR, Continuous Compressions, and Resuscitation. A link to a video that is not viewed enough (only a little over 2,000 total views listed by YouTube) was sent by Buck Feris. This video is an example of what we need to be using much more.





We need to get the attention of the people who might be in a position to perform CPR. Not the ones taking a course, because of a job requirement. They are a captive audience, and sometimes we make them feel exactly that way. That is not the right approach.

What is wrong with shorter courses, distance courses, and public service spots?

Do we need to delude ourselves that CPR is rocket science?

If you experience sudden cardiac arrest die in the area where Dr. Eisenberg has been improving resuscitation, you have almost a 50/50 chance of resuscitation. This is probably in large part due to the use of alternative educational methods to encourage by-standers to do CPR.

Or we could keep making excuses.


Footnotes:


^ ¹ EMS Garage Special Edition: How to Improve Survival from Sudden Cardiac Arrest Episode 48
EMS Garage
Links to broadcast and downloads.

A cooperative broadcast between EMS Garage (above) and EMS EduCast (below):

How to Improve Survival from Sudden Cardiac Arrest: EMS Educast Episode 27


^ ² CPR
American Heart Association or American Red Cross course in CardioPulmonary Resuscitation.
Wikipedia
Article

Although I link to this article, there is something that I observed that is disappointing. There is only one mention of Dr. Eisenberg in the article, and that is a footnote. An article he wrote in 1985. Just because I am curious, I decided to see how many papers I could find by Dr. Eisenber in a PubMed search. For the most recent paper, I have to go all the way back to October of 2009 - we aren't even there, yet. Going almost 150 articles further - to Staphylococcal food poisoning aboard a commercial aircraft from the Lancet, which was awarded the 1975 Alexander D. Langmuir prize by the Center for Disease Control. Wikipedia, you are missing a lot. More than a minor omission.

PubMed search of papers written by Mickey S. Eisenberg, MD.


Then there is Dr. Eisenberg's new book:

Resuscitate!: How Your Community Can Improve Survival from Sudden Cardiac Arrest
By Mickey S. Eisenberg, MD
Amazon.com link with a good video review by Greg Friese.


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