Resuscitate!

Contents

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pp. vii-

Foreword by Roger D. White, M.D.

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pp. ix-x

Cardiac arrest occurs in people'€™s homes as well as in public places. It can strike anytime. For decades, it has been the leading cause of death among adults. Given the magnitude of this public health problem, you might suppose that the highest priority of emergency medical services (EMS) would be to improve survival rates...

Preface

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pp. xi-xiv

Meeting death up close and personal is part of my job. For twenty-five years, I worked in a university hospital'€™s emergency department. Now, as medical director of emergency medical services in King County, Washington, I work with paramedics...

Acknowledgments

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pp. xv-xvi

Let me begin by expressing my appreciation to the people who make it all possible- the hundreds of emergency dispatchers, the thousands of EMTs, and the hundreds of paramedics in Seattle and King County. Special thanks also to the fire chiefs and training officers. We have a wonderful EMS system, and it is all...

Guide to Terminology

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pp. xvii-xxi

One - How We Die Suddenly

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pp. 1-18

Peter A. had been doing fine, considering. He and his wife, Joanna, had been enjoying his retirement from Boeing, and they found the suburban community of Redmond, Washington- close to Seattle and its urban attractions, but with the advantage of quiet streets and large lots- perfect for them...

Two - A History of Resuscitation

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pp. 19-43

Jacob ben C. hauled the small fishing boat onto the shore. The catch was good. As Jacob mentally estimated the weight and calculated the extra shekels he'€™d have for Sarah'€™s pendant, the headache struck like a hammer blow-€”a blast of searing white light, knife blades down the neck and into the back, and a tidal wave of nausea...

Three - Causes of Sudden Cardiac Death

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pp. 44-57

This chapter describes in greater detail the common and uncommon heart-related causes of sudden death as well as the non-heart-related causes.¹ In King County, Washington, 72 percent of people who experience cardiac arrest and who receive care from emergency medical services have underlying heart disease...

Four - A Profile of Sudden Cardiac Arrest

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pp. 58-76

Paul M., a firefighter, is grumbling to his lieutenant about all the extra work involved in a cardiac arrest, for himself and everyone else. But Paul and his lieutenant both know that his complaints are for show. Despite the detailed reporting requirements, these calls give him the most satisfaction. After every such event, Paul completes his single-page incident report, and then he returns to the station to complete the...

Five - Who Will Live and Who Will Die?

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pp. 77-119

Tom M. and his wife, Janet, walked into the gallery housing Grant Wood'€™s famous painting, American Gothic at the Art Institute of Chicago. The gallery was crowded, as usual. Tom and Janet had to work their way over to the painting, and they were gazing at it with admiration when a wave of nausea broke over Tom. Sweating profusely, he looked for a place to sit down, but the few seats...

Six - Location, Location, Location: Best Places to Have a Cardiac Arrest

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pp. 120-149

The fire chief and the medical director from the City of D. spent the first day meeting with the Seattle Medic One battalion chief, visiting the alarm center, and riding all afternoon and into the evening with two paramedics. The second day they visited the quality improvement office to understand the data collection...

Seven - What Can Your Community Do?

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pp. 150-159

The coffee cup saved Mike J.'s life. Mike's wife, Joan, heard it shatter and went running into the kitchen. She saw the shards on the floor, and her husband was slumped over the table. While shouting Mike;€™s name, Joan reached for the telephone. Within thirty seconds of the cup's hitting the floor, she had dialed 911. Rapid dispatch sent EMS units within twenty seconds of receiving the call, and within ninety seconds the dispatcher had instructed Joan...

Eight - A Completed Life

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pp. 160-167

Ruth T. is eighty-five and is on a respirator in the ICU. Two IVs in her arms and one in her neck contain medications to keep her blood pressure up, her heart stable, and her brain from swelling. Her kidneys have failed, and her doctor has talked about dialysis with Ruth'€™s three children, who have flown in from out of town. Three days ago, at a senior center...

Nine - The Paradox of Technology

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pp. 168-178

Dr. William Oslerberg is accepting the Nobel Prize in medicine for the discovery of a new class of viruses, named "€œfibriviruses," that cause ventricular fibrillation. The virus is acquired in childhood. It lies dormant for several decades until fatty deposits in the lining of the coronary artery activat...

Ten - A Plan of Action

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pp. 179-206

Is it possible to change an EMS system in fundamental ways? Can a community'€™s survival rate for cardiac arrest be dramatically and permanently improved? Is it possible to change not only a system's culture but also its entire structure? I believe that the answer to these questions is an emphatic yes. This chapter outlines an action plan to improve community cardiac arrest survival rates. The plan consists of twenty-five specific...

Appendix 1. Incidence and Prevalence of Coronary Artery Disease and Cardiac Arrest

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pp. 207-208

Appendix 2. Web Site: www.survivecardiacarrest

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pp. 209-

Appendix 3. Web Site: www.learncpr.org

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pp. 210-

Appendix 4. Web Site: www.learnaed.org

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pp. 211-

Appendix 5. The Resuscitation Outcomes Consortium

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pp. 212-214

Notes

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pp. 215-242

Index

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pp. 243-256