08 Februari 2008

Cough CPR

The American Heart Association does not endorse "cough CPR," a coughing procedure widely publicized on the Internet. As noted in the 2005 American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care, the American Heart Association DOES NOT TEACH THIS AS PART OF THE CORE CURRICULUM IN ANY COURSE.

During a sudden arrhythmia (abnormal heart rhythm), it may be possible for a conscious, responsive person to cough forcefully and maintain enough blood flow to the brain to remain conscious for a few seconds until the arrhythmia disappears or is treated. Blood flow is maintained by increased pressure in the chest that occurs during forceful coughs. This has been mislabeled "cough CPR," although it's not a form of traditional resuscitation.

Why isn't "cough CPR" appropriate in CPR training courses?

"Cough CPR" should not be routinely taught in lay-rescuer CPR courses, because it would complicate teaching traditional CPR. It would add information that's not generally useful in the prehospital setting. In virtually all lay-rescuer CPR courses, the finding that signals an emergency is the victim's unresponsiveness. This signals the rescuer to begin the "A, B, C's" of CPR. Unresponsive victims will not be able to perform "cough CPR."

Are there situations when "cough CPR" is appropriate?

This coughing technique to maintain blood flow during brief arrhythmias has been useful in the hospital, particularly during cardiac catheterization. In such cases the patient's ECG is monitored continuously, and a physician is present.

During cardiac catheterization, patients may develop sudden arrhythmias. If a life-threatening arrhythmia is detected within the first 10 to 15 seconds and before the patient loses consciousness, a physician or nurse may tell the patient to cough. Repeated, forceful coughing can help the person stay conscious until the arrhythmia disappears or is treated.

Therefore, the usefulness of "cough CPR" is generally limited to monitored patients with a witnessed arrest in the hospital setting.

AHA Recommendation

The best strategy is to be aware of the early warning signs for heart attack and cardiac arrest and respond to them by calling 9-1-1. If you're driving alone and you start having severe chest pain or discomfort that starts to spread into your arm and up into your jaw (the scenario presented in the Internet article), pull over and flag down another motorist for help or phone 9-1-1 on a cellular telephone.

Sumber: AmericanHeart.com

Rehabilitation Pasca Heart Attack

Most people survive their first heart attack and return to their normal lives to enjoy many more years of productive activity. But having a heart attack does mean you need to make some changes in your life. Your doctor will advise you of medications and lifestyle changes according to how badly your heart was damaged and what degree of heart disease you have. It’s up to you to follow your doctor’s recommendations to make a full recovery.

How long will I need to rest after my heart attack?
When can I go back to work?
Is it normal to feel so depressed?
How will my family feel?
Is chest pain normal after a heart attack?
Why is cardiac rehabilitation important?
Why are lifestyle changes important?
What treatments will I need?
What about sex after a heart attack?

How long will I need to rest after my heart attack?
Rest is important after a heart attack, but it’s just as important for you to participate in recreation and social events and to begin making physical activity a part of your daily life. In many cases doctors will recommend that survivors get more physical activity than they got before their heart attack. A good night’s rest is especially important for heart attack patients. And if you feel tired during the day, take a nap or a short rest. Heart patients should rest before they get too tired. Your doctor will tell you what’s best for your specific situation, but most heart attack patients find they have plenty of energy for both work and leisure activities.

When can I go back to work?
Most heart attack patients go back to work within two weeks to three months. Your doctor will determine when you can go back and if your current job is suitable for a person who has had a heart attack.

Is it normal to feel so depressed?
Heart attack patients will feel a wide range of emotions, typically for about two to six months after the event. Depression is quite normal, along with fear and anger. For example, every time you feel a little pain, you may feel afraid it’s going to happen again — afraid you’re going to die. That’s normal and will begin to pass as time goes by. You may be angry that this happened, and you’re probably feeling irritated and have a “short fuse” with others. Resentment is common after a heart attack. Try to understand that your family and friends are just as worried as you are. Although depression is normal after a heart attack, if it interferes with sleeping, eating, self-esteem, or if you have thoughts of suicide, you should talk to your doctor and those close to you about your feelings. Don’t be afraid to ask for help. Recovery is much faster with a trusted support team of healthcare professionals, family and friends.

How will my family feel?
Your heart attack has probably had a big emotional impact on your family. They may feel frightened, angry, resentful or even guilty. Teenagers are especially sensitive and may think that something they did caused you to have the heart attack. It’s better for everyone to get his or her feelings out in the open. Don’t let feelings smolder — that can be destructive. If you think counseling would help your family deal with your heart attack more quickly, ask your doctor to refer you to someone for help.

Is chest pain normal after a heart attack?
Not everyone will have chest pain (angina pectoris), but if you do, it should be a light pain or pressure in your chest that quickly goes away. It will typically happen during or right after physical exertion, intense emotion or eating a heavy meal. If you’re having ANY chest pains, tell your doctor. There are exercises and medication that can help ease or prevent the pain. If your angina gets worse over time or starts to occur after very little exercise, see your doctor immediately. Learn more about angina pectoris treatments.

Why is cardiac rehabilitation important?
One of the best things you can do for yourself is to get into a cardiac rehabilitation program where everything you need to get and stay healthy is in one convenient location. Research shows cardiac rehab saves lives. In a recent study, cardiac death was lower, there were fewer second heart attacks and fewer necessary cardiac surgeries in patients who were exercise-trained compared with those who received “usual care.” Rehabilitation programs can help you change your lifestyle habits. These programs often take place at a hospital with a rehabilitation team or with the help of your doctor, nurse or other healthcare professionals.

Why are lifestyle changes important?
Making changes in your lifestyle is one of the most important things you can do to prevent another heart attack, heart disease and stroke. The ABCs of prevention are:

Avoid Tobacco — If you smoke after a heart attack, your chances of having a second one are doubled.

Become More Active — Regular physical activity will ease stress and depression, help control weight and help lower blood pressure and cholesterol levels.

Choose Good Nutrition — Good nutrition will help control your weight, lower blood pressure and cholesterol levels and help your body heal faster.

Even if you’re taking prescription medication, it’s still extremely important to lead a heart-healthy lifestyle.

What treatments will I need?
Treatments for heart attack patients include medications, lifestyle changes and, in some cases, surgical procedures. Your doctor may also run some diagnostic tests to determine how much your heart was damaged and what degree of coronary artery disease you have. Learn more about treatments.

What about sex after a heart attack?
Most people can continue their same pattern of sexual activity after they recover from a heart attack. Talk to your doctor. You may be prescribed nitroglycerin if you experience chest pain (angina) during or after sex.

Sumber : americanheart.com

06 Februari 2008


Perkembangan teknologi berjalan sangat cepat, terutama dibidang alat elektronik dan telekomunikasi. Alat kesehatan berteknologi tinggi sudah sangat banyak kita jumpai. Dibidang kesehatan gawat darurat alat seperti Ventilator, Bed side monitor, defibrilator kemudian mempunyai peranan yang sangat vital. Tetapi bila dirunut kembali, ada satu alat yang belum kita jumpai dilapangan yaitu alat untuk pijat jantung luar.
Mesin ini harus memenuhi syarat keamanan dan manfaat, spesifikasi mesin adalah sebagai berikut:

Spesifikasi :
1. Fitur keamanan : Sensor detak jantung, sensor tekanan, sensor kecepatan, sensor kedalaman pijat.
2. Sistem triger.
Bagian-bagian mesin :
1. Alas pasien yang terbuat dari bahan yang keras.
2. Tiang penyangga 4 buah.
3. Mesin.
4. Telapak pemijat dari bahan yang kuat dan lembut.
5. Kompressor bertekanan udara.
Alat ini harus bekerja bila muncul trigger dari sensor detak jantung dan bekerja dengan memijat dinding dada penderita dengan kedalaman + 1-2 inchi dengan kecepatan 100 x/menit atau 0,6 detik per satu kali pijatan, frekwensi 30 x satu siklus diikuti jeda istirahat 2 detik. Bila memungkinkan alat ini dapat diintegrasikan dengan alat bantu napas (Ventilator).

Update 29-3-2014
Setelah 6 tahun, kini telah hadir alat pijat jantung otomatis dari zoll.