cpr

[Joe Nemeth]

JOE IN CAPS...


Hello everyone,
>
>   I posed a question about the topic of delayed resuscitation and
> oxygenation on the EMS-L list and hoped maybe somebody here could answer my
> questions.
>
>   1. Does effective CPR adequetly perfuse the body enough to stop/reverse
> anaerobic metabolism in the Brain/kidnetys/heart/liver?

NO....


>
>   2. What causes an apoptotic rxn when o2 is reindroduced? My only guess
> is a capsase chain in the mitochondria. Possibly from the others in the cell
> as well. By I lean towards mitochondria.

DON'T CARE...MAKES FOR GREAT CONVERSATION AT THE DINNER TABLE BUT...AT 
BEDSIDE DON'T CARE....
>
>   3. Would continued/exteded CPR prior to defib then be more harmful?

LIKE THE PRIOR POST...LATEST "EVIDENCE" IS TO "PUSH A LITTLE" PRIOR TO 
DEFIB AFTER UNWITNESSED ARREST...


JOE
MCgILL UNIVERSITY
MONTREAL

>
>   I accept that immediate cpr, would perfuse enough heart and brain to
> stop acidosis there, but what about the liver especially?
>
>   I ask because of a study that was recently announced about possibly
> delaying defib longer for more cpr. I am very skeptical about that. I know
> that refractory v-fib is likely from the AHA study if during prolonged
> downtime the heart is defibed without reoxgenation. But how does all this
> play out?