Nutopia

Studies: CPR Without Rescue Breathing OK

DoctorNutopia — Fri Jul 30, 2010 1:02 am

Author: DoctorNutopia

Posted: Fri Jul 30, 2010 1:02 am

July 28, 2010 -- Bystanders who perform CPR on patients with suspected heart attacks can safely skip the rescue breathing -- typically called mouth-to-mouth resuscitation -- and just perform the chest compressions, according to two new studies.

''We feel comfortable saying chest compressions alone, when performed by a layperson, will provide at least the benefit that conventional CPR, with rescue breathing, will provide," researcher Thomas D. Rea, MD, medical director for King County, Wash., Medic One, tells WebMD.

The suggestion to skip the mouth-to-mouth part of CPR, he emphasizes, does not apply to emergency medical personnel, but only to laypeople who may be able to provide CPR after a suspected heart attack while waiting for professional medical help to arrive.

Rea's study, along with another head-to-head comparison of the two CPR approaches, is published in the New England Journal of Medicine.

''We are trying urgently, desperately, to make CPR more accessible to bystanders," Rea says, noting that performing CPR soon after a heart attack can increase the likelihood of survival twofold. Hopefully, he says, the finding that the rescue breathing is not crucial will make the technique simpler and perhaps more palatable for people.

About CPR
CPR was first proposed about 50 years ago, when researchers suggested that external chest compression could provide blood circulation to the brain and heart after a heart attack. The mouth-to-mouth breathing was added later.

But in recent studies, researchers have focused on whether both components are always crucial. In 2008, the American Heart Association issued an advisory for the public, advocating hands-only CPR for bystanders not trained in CPR with rescue breathing.

CPR Techniques: The Studies
Rea's team evaluated 1,941 patients who had out-of-hospital heart attacks and were given CPR from bystanders being instructed by emergency dispatchers. Patients were randomly assigned to get either chest compression only or conventional CPR with rescue breathing.

The researchers looked at the percent in each group that survived to hospital discharge.

"We found that survival in the chest compression alone group was 12.5% and survival in the conventional CPR group was 11%," Rea tells WebMD.

Rea's study was supported in part by the Medic One Foundation and the Laerdal Foundation for Acute Medicine. In the second study, Swedish researchers evaluated 1,276 patients with suspected out-of-hospital heart attacks, assigning half to conventional CPR and half to compression-only.

The rate of 30-day survival was similar in the groups -- 8.7% of those getting compression-only CPR and 7% of those getting conventional CPR. The Stockholm County Council, SOS Alarm, and the Swedish Heart-Lung Foundation supported the study.

CPR, With and Without Mouth-to-Mouth: Other Views
The two new studies are good news for bystanders, some of whom have been reluctant to do the rescue breathing part of CPR, says Myron L. Weisfeldt, MD, chairman of the department of medicine at Johns Hopkins University School of Medicine, Baltimore, who wrote an editorial to accompany the studies.

http://www.webmd.com/heart-disease/heart-failure/news/20100728/studies-cpr-without-rescue-breathing-ok?src=RSS_PUBLIC

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Back to School: How to Get Your Kids Up in Time

DoctorNutopia — Fri Jul 30, 2010 12:32 am

Author: DoctorNutopia

Posted: Fri Jul 30, 2010 12:32 am

Going back to school means the relaxed, lazy days of summer are about to give way to packed schedules, homework, after-school activities, and toughest of all, waking the kids up early. The change of pace can be a jolt to the whole family.

So, how, after months of sleeping late, do you get the kids used to earlier wake-up times without creating household chaos first thing in the morning? Here are five tips to get your kids out of bed and off to school.

1. Start Planning Early.
It’s important to recognize that transitioning from the relaxed schedule of summer to the structure of the school year is a process, says David Swanson, PsyD, a child and family psychologist practicing in Los Angeles and author of HELP-- My Kid is Driving Me Crazy, The 17 Ways Kids Manipulate Their Parents and What You Can Do About It.

If you wait until the night before school starts to get the kids to bed on the early side, don’t expect a smooth morning. “Parents make the mistake of waiting until the last minute,” Swanson says.

To make sure your family is prepared for an early start, begin preparing kids at least a week before school starts. Call a family meeting to announce a new sleep schedule and to get everyone on the same page, says Jill Spivack, LCSW, co-author of The Sleepeasy Solution, The Exhausted Parent’s Guide to Getting Your Child to Sleep.

“You have to sit with kids and explain the value of sleep,” Spivack says. “We want them to understand sleep nutrition is as important as food nutrition, and that a lack of sleep can have major consequences.”

Many studies have shown that a lack of sleep can hamper physical and mental health. Tweens and teens aged 11-17 operating on too little sleep have shown an increase in anxiety, depression, and physical pain. School performance often declines too. A study done several years ago on fourth- and sixth-grade students by researchers at Israel's Tel Aviv University showed that after losing about one hour of sleep over several nights, students performed worse on a reaction test that predicts their ability to pay attention in class.

According to the National Sleep Foundation, kids aged 5-12 need 10-11 hours of sleep each night. Children aged 10-18 need a little less -- 8.5-9.5 hours per night. But most kids don't get enough sleep.

You can show your kids some empathy about the fact that getting back into a routine may not be fun, but let them know that the schedule change is meant to help kids feel good when they are at school. “It comes from a place of love and education about the importance of sleep, and not control,” Spivack says.

http://www.webmd.com/parenting/features/get-kids-up-for-school?src=RSS_PUBLIC

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bobby — Fri Jul 30, 2010 12:30 am

Author: bobby

Posted: Fri Jul 30, 2010 12:30 am

Protests, prayers as immigration law takes effect

crackerjack — Fri Jul 30, 2010 12:23 am

Author: crackerjack

Posted: Fri Jul 30, 2010 12:23 am

Phoenix, Arizona (CNN) -- The day after a federal judge halted parts of Arizona's new immigration law from taking effect, opponents of the legislation are hitting the streets with mixed expressions of relief and outrage over Wednesday's turn of events.

Several nonviolent demonstrations were planned Thursday throughout Phoenix to mark the passage of the legislation, which officially took effect at 12:01 a.m.

U.S. District Judge Susan Bolton's decision to grant a temporary injunction against some of the most controversial provisions of the bill came as a surprise to some opponents of the law, who thought that the conservative political climate made the legislation's enactment inevitable.

For them, Bolton's ruling had the effect of turning the would-be protests into displays of guarded optimism.

"We're using this opportunity to give thanks and prayer for what happened yesterday," said Phoenix resident Isabel Galindo.

Dressed in a floppy hat and wearing a rosary made of red, white and blue stations of the cross, Galindo showed up at the state Capitol around 4 a.m. Thursday to participate in a march to the Trinity Cathedral for an interfaith service.

http://www.nownutopia.com/wksForumUtility.php?url=http://rss.cnn.com/~r/rss/cnn_topstories/~3/yzOQ52B7M8c/index.html

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