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The Fight

dcurt.is

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Re: The Fight

#41

Post by jgrahamc »

dmix wrote: post #38
jgrahamc wrote: post #20

Some time ago I came across an elderly man in some difficulty lying in the street in London. While waiting for an ambulance he 'died' (no heart beat, no respiration, no signs of life at all, blue lips and gums) and I immediately did CPR on him until the ambulance arrived. Months later I learnt that he survived. Any brush with death makes you seriously think about your own mortality. I know that watching this stranger…

May I ask how you found out he survived?

Well, he clearly lives near me because I saw him the other day. Looked a bit frail.

Re: The Fight

#42

Post by 2arrs2ells »

ryanwaggoner wrote: post #24
rmc wrote: post #15

Earlier quoted context omitted.

Remember things like this when people complain about "modern Health and Safety red tape". "Oh we need to have a this and a that and failed out inspection! Get off our back, let me create jobs." This shit saves lives.

This is the equivalent of "think of the children!" Not everything that supposedly saves lives is worthy of being enshrined into law.

But it is worthy of being incentivized.

Defibrillators are a public good & a good candidate for a government incentive (or mandate).

Re: The Fight

#43

Post by tomhoward »

davidw wrote: post #36
tomhoward wrote: post #17

It's a great post, but to me there's another message that Dustin - understandably - hasn't focused on: "perfect health" is often (usually?) an illusion. Given what I've learned about health in recent years, I can't accept that this guy really was in perfect health; if he was, he wouldn't have suffered a major cardiac arrest while simply jogging on a treadmill. I think it's mostly a failure of modern medicine and mode…

I had a good friend over for dinner recently, and learned that he had recently suffered a heart attack. Not a really bad one, but there aren't exactly 'good' ones either. Pretty scary, as he's still in his 30ies, like me, in good health, no smoking, not much drinking, some exercise, eats ok, and so on.

still in his 30ies, like me, in good health, no smoking, not much drinking, some exercise, eats ok, and so on.

This is the problem. In the absence of proper diagnostics, people look at popularly touted risk factors like age, alcohol/smoking/drugs, exercise, diet, etc. But these are highly generalised factors that don't take into account: genetic/congenital/epigenetic conditions, stress/emotional issues, environmental factors, and other factors that are difficult to understand by themselves, because the human body is so complex.

The only way to truly determine the extent to which someone's health really is perfect is with detailed individual diagnostics.

As I said in the initial comment, we're only just getting started in developing adequate approaches to diagnosis that may become widely accessible, but I think it's the key to preventing unexpected attacks in your friend and Dustin's friend.

Re: The Fight

#44

Post by Xylakant »

philwelch wrote: post #26
pdx wrote: post #9

Earlier quoted context omitted.

Nobody wants to live in a world where people find a dying person laying on the floor and let him die because they're afraid of legal issues. The law protects you from such nonsense. Even if it didn't, in my opinion, no person worth a damn would allow that consideration to color their response.

Counterpoint and proviso: know what the hell you are doing . It's easily possible to do more harm than good if you don't know better. For example, whenever a motorcyclist gets into a crash, people get the bright idea that they need to get the helmet off. No, the helmet is bracing their neck, which may very well be badly injured, so sometimes if you just pull it off, now the guy's a quadriplegic, and since you were ju…

The helmet must be removed for unconscious injured. If the person is fully able to respond you should leave the helmet on unless asked otherwise, but you must remove the helmet when the injured looses consciousness. Not taking the helmet of may have the injured die of blood or puke inhaled or just his tongue blocking respiration. So you're damned if you do and more damned if you don't.

Be careful when you remove the helmet, always remove glasses first, open the helmet and pull carefully straight "upwards". Keep the spine straight. Just before you completely remove the helmet use one hand to support the head, so it doesn't bump down. If there's a second person to help, one supports the neck and the other one pulls.

Just refresh your first aid class and do the best you can. It's in pretty much all cases better than no first aid.

Re: The Fight

#45

Post by dmor »

It's not trite. Especially when things aren't working, and it would be so safe and warm and simply to stop wanting to do extraordinary things and sink back into momentum, inertia, the rhythm of everything that has ever been or will be. Not that I wish any of you to have a huge loss, or near loss, but once you do it is galvanizing - if you let it reach you at the core. As others on this thread have said, memento mori.

Re: The Fight

#46

Post by alexkus »

Those in the UK (or soccer fans in general) will be more aware of this due to incidents involving Marc-Vivien Foé who collapsed and died during a game, and more recently Fabrice Muamba who survived a cardiac arrest (his heart had stopped for over an hour but was receiving CPR[1] during this time).

http://en.wikipedia.org/wiki/Marc-Vivien_Fo%C3%A9

http://en.wikipedia.org/wiki/Fabrice_Muamba

After the Foé incident there was a lot of promotion of the Cardiac Risk in the Young charity in the UK http://www.c-r-y.org.uk/ who do ECG and Echocardiogram screening for those between 14 and 35 for a donation to the charity.

I got myself tested a couple of years in a row (until I turned 36!) as I was doing a lot of long distance (>200 miles a day for multiple days) cycling and my HRM showed me that I've got an atypical heart (resting heart rate down to ~40bpm at my fittest but I could regularly see >200bpm on my HRM whilst playing 5-a-side and I could average ~185bpm for an hour without feeling uncomfortable at all). A chat with the cardiologist after the scan(s) put any fears at bay, whilst mildly unusual there's nothing fundamentally wrong with my heart, if anything it's just a little smaller than average (hence the high HRmax).

Thoroughly recommended and you won't be wasting their time as you'll be helping support the charity by donating.

1. From, among other medical staff, a consultant cardiologist who just happened to be at the game, the same cardiologist later treated him throughout his stay at hospital.

Re: The Fight

#47

Post by tomhoward »

skrebbel wrote: post #31
tomhoward wrote: post #29

Earlier quoted context omitted.

I think we largely agree - differing only on the interpretation of the word "perfect". In my interpretation, perfect health means this type of malfunction doesn't happen. But these days, such perfection is very rare, though it's possible with sufficient knowledge and access to diagnostics.

By that definition, perfect health doesn't exist.

False; it's just very unusual in modern times.

Re: The Fight

#48

Post by jackylee0424 »

tomhoward wrote: post #43
davidw wrote: post #36

Earlier quoted context omitted.

I had a good friend over for dinner recently, and learned that he had recently suffered a heart attack. Not a really bad one, but there aren't exactly 'good' ones either. Pretty scary, as he's still in his 30ies, like me, in good health, no smoking, not much drinking, some exercise, eats ok, and so on.

still in his 30ies, like me, in good health, no smoking, not much drinking, some exercise, eats ok, and so on. This is the problem. In the absence of proper diagnostics, people look at popularly touted risk factors like age, alcohol/smoking/drugs, exercise, diet, etc. But these are highly generalised factors that don't take into account: genetic/congenital/epigenetic conditions, stress/emotional issues, environmental…

We're in a culture of productivity. Here, a person in "good health" is like describing him a proper-functioning working machine.

Re: The Fight

#49

Post by bpatrianakos »

Just over a year ago my favorite uncle died suddenly in a freak car accident. Besides his immediate family, my mother and I were the very first ones to make it to the hospital where he was DOA. They took us in to see him one last time before he was sent to the morgue or wherever they take the bodies of those who die in the hospital. Everyone says great things about people who are recently deceased but I must stress that he was an extraordinary man. Really. And I thought that long before he died. Seeing his lifeless body there was shocking. What got to me the most was seeing the lifeless expression on his face. He was a man who was always smiling and more full of life than anyone I've met. The contrast between the live man I knew and the heap of dead flesh I saw will stay with me forever.

From that day on I have thought about death at least once a day since and always remind myself that every fear I have and every psychological block that keeps me from being who I want to be and doing what makes me happy is an illusion. It's not real and it can't hurt me. But it also reminds me that my hopes and dreams are meaningless too. But if I'm going to be alive I might as well live happy regardless, right?

Unfortunately, the problem is that knowing this has not changed my behavior. There's this weird mental barrier between knowing you have a short life and need to really live it and actually doing it. And so despite knowing this truth and coming to realize it in such a traumatic way, I still don't live it nearly as often as I should. I suspect many people are like that. I don't know why that is but I hope someday we can figure out how to go from knowing how we need to live to really doing it in a real way.

Re: The Fight

#50

Post by JshWright »

jgrahamc wrote: post #20

Some time ago I came across an elderly man in some difficulty lying in the street in London. While waiting for an ambulance he 'died' (no heart beat, no respiration, no signs of life at all, blue lips and gums) and I immediately did CPR on him until the ambulance arrived. Months later I learnt that he survived. Any brush with death makes you seriously think about your own mortality. I know that watching this stranger…

This is a field where a surprising amount of progress is being made. People still tend to assume that CPR is mostly a token effort so bystanders feel like they're doing something. In reality, high quality CPR + rapid access to an AED can give just about any heart a fighting chance at beating again (assuming the underlying problem is transient or easily treatable... if your LAD cardiac artery is 100% occluded and half your heart has died, there's no coming back from that...). Techniques like 'hands only CPR' are dramatically increasing the willingness of bystanders to get involved and do something productive.

The area where really exciting progress is being made is in improving the rates of survival to discharge from the hospital. Techniques like the therapeutic hypothermia mentioned in the article are rapidly gaining acceptance. ACLS (Advanced Cardiac Life Support, the standard of care for acute cardiac emergencies, including cardiac arrest) now suggests that providers should 'consider' therapeutic hypothermia whenever a return of spontaneous circulation (ROSC) is achieved (I know 'should consider' doesn't sound all that exciting, but the American Heart Association is an (understandably) conservative organization, and doesn't make broad based recommendations without a fair amount of data to base them on).

I could ramble on about this for a long time, there's a lot of exciting research being done (continuous compressions, continuous EtCO2 monitoring for evaluating compression efficacy and alerting when ROSC has occurred, even really controversial stuff like withholding Epinephrine (a large scale study from Japan has shown that while Epi increases the odds of achieving ROSC, it may _decrease_ the odds of survival to discharge)). This is a topic near and dear to my heart. I volunteer with my local ambulance service, and I'm very close to my New York State Paramedic certification (just need to take the exam). Calls like the ones described in the comments here are exactly why I love doing this... The overlap between my work in EMS and my day job (development) is bigger than you might think... Debugging is debugging... the stakes are just a lot higher.

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