October 23rd, 2009


CPR Update

Have you ever been certified in CPR? I have been, for many years. My certification expired so last night I took the full AHA initial certification in Basic Life Support for the Professional Caregiver. They said that CPR is 2-10% effective when practiced (that's a far more optimistic range than I'd heard before), and that 1/4 people who need CPR are getting it, mostly here on the left coast. Here are the main differences from the last time I certified:

1) For adult CPR, they are no longer having you switch to 15 compressions 2 breaths for 2-rescuer CPR. The ratio is 30:2 whether you have one or two rescuer. Part of the reason is to reduce confusion, and the other part is that they have discovered that continued compressions delivering consistent 25% perfusion to the brain is more important to survival than any other variable. Thus there is overall a strong new emphasis on continuing compressions with minimal interruption for any reason. On a child or infant you still switch to 15:2 for 2-rescuer CPR.
2) It is no longer recommended that you stop to check for a pulse every 2 minutes or so. You are not supposed to stop unless they start showing signs of life. You are supposed to continue compressions while pads for the AED (defibrillator) are being applied to the chest.
3) The hand position for compressions is now described as the center of the sternum, approximately at the nipple line, instead of being two fingers up the sternum from the xyphoid.
4) We were instructed on how to apply cricoid pressure to prevent regurgitation.
5) For infant CPR they are no longer recommending the two finger compressions. Now they want you to pick up the baby and put both thumbs on their sternum, holding them around the rib cage with you fingers. (They still have you doing the back slaps and two finger compressions in the case of choking.)

Those are the major changes since the last time I recerted. They're teaching the use of the AED to everyone, and the Heimlich maneuver and rescue breathing are not notably changed.

Overlap Between Homeopathy and Herbalism

The speaker for Botanical Medicine III today was Deborah Frances. Several times she recommended a Materia Medica written by Boericke. I just looked it up on amazon and found that it is a homeopathic materia medica. She studies it to know specific indications for herbs, in order to make more carefully customized formulas. When she makes tinctures, sometimes she will combine herbal and homeopathic methods in this way: first she makes a tincture for her patient with sufficient amounts of the herb to work in the herbal biochemical way. Then she serially dilutes and succusses a few drops of the tincture until it is potentized in the homeopathic way, and adds a few drops of the potentized mixture back into the original tincture. Viola! Both herbal and homeopathic medicine in one vial. Very interesting idea. And very interesting that so many herbalists use homeopathic indications for the prescription of herbs. While I am still skeptical about the non-placebo efficacy of homeopathy, I am learning herbs better because they are spoken of so much in both ways.

Why US Health Insurance is Predominantly Employer-Based

These notes from an NPR story (8 minutes long) on how we ended up with a system in which most people get their health insurance from employers. It turns out, it wasn't planned, it was the outcome of a series of historical accidents, and also the result of business influences on the tax laws of the land.
Collapse )

Quote: the Greatest Nation on Earth

The hoariest and most of-repeated cliche in American politics
may be that America is the greatest country in the world.

Every politician, Democrat and Republican,
seems duty bound to pander to this idea of American exceptionalism,

and woe until him who hints otherwise.
There is nothing wrong with self-satisfaction or national pride.

But the incessant trumpeting of our national superiority to every other country
is more than just off-putting and insulting.

It is infantile, like the vaunting of a schoolyard bully
that his Dad is better than your Dad.

--Neal Gabler in the Boston Globe