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Boston EMS Backs New ‘Hands-Only’ CPR


As expected, the American Heart Association today endorsed the new, “hands-only” form of CPR today (Yes, we predicted this on Friday, right here. And for more detail, see our initial post here.)

Now this just in from Boston EMS:
Boston EMS officials today are gladly supporting new American Heart Association (AHA) guidelines for CPR that prioritize chest compressions for bystanders trying to revive people whose hearts have stopped.

For everyone wondering where to learn the new technique, there’s this on the City of Boston’s Website:
Boston EMS offers numerous CPR Certification program to fit you or your organization’s needs. Call today to learn about one that’s right for you and to schedule a class 617-343-1125.

ER Wait Times Via Web And iPhone


Say you slice your finger half off while chopping onions, and you live just minutes from several hospitals. Where do you go? It’s looking ever more likely that soon, you’ll be able to check the Web or your smartphone (typing with your intact hand, that is) to help you decide.

CommonHealth reported in August that patients planning to go to a Metro West Medical Center hospital — Framingham Union Hospital or Leonard Morse Hospital — could text to find out how long the ER waits were. Now Newton-Wellesley Hospital has called our attention to the new wait-time display on its Website (see above.) And by the end of October, it hopes to have an iPhone app up and running, along with a mobile version of its Website that will work on many smartphones.

I checked several other local hospitals’ home pages and saw no obvious reports on ER waits. But surely that time is coming soon. After all, if many restaurants now use apps to let patrons know how long they’ll have to wait for tables, shouldn’t hospitals be able to tell patients how long they’ll have to wait for their sutures?

Is HONDA The New GOMER?

Who can forget that classic character of medical literature, the GOMER? The acronym — for Get Out of My Emergency Room — appears in “The House of God,” a 1978 satirical novel of medical training that should be required reading for all aspiring doctors.

As the book’s excellent Wikipedia entry explains, a gomer is “a patient who is frequently admitted with complicated but uninspiring and incurable conditions.” In other words, the bane of emergency staffs’ existence, not because they don’t want to help these patients, but because treating them tends to be so frustrating, fraught with pitfalls, and unlikely to bring any lasting good.

The gomer came instantly to my mind recently when a health advocate casually mentioned that she’d heard that hospital staffs are known to employ a new acronym: HONDA. It stands for:
Hypertensive
Obese
Non-compliant with diabetes medications
Diabetic
Asthmatic

Aha! I thought. The new gomer of our times, in this age of epidemic obesity and asthma and diabetes –diseases that are all but incurable, and frustrating, and that complicate treatment.

But so far, none of the Boston-based doctors I’ve asked have heard of the term. I called Dr. Stephen Bergman, who wrote “The House of God” under the pen name Samuel Shem. He now writes fulltime in Newton, and his most recent novel, “The Spirit of the Place,” won two national book awards. It is now next on my reading list.

So might Honda be the new gomer? “It’s wonderfully accurate for the modern issues,” he said, “but it has more the ring of selling a car than being of use in medicine.”

He expanded a bit: “Honda has all the humor and pizzazz of a reliable foreign car, whereas gomer has an outrageously accurate definition, which is: “a human being who has lost — often through age — what goes into being a human being.“

Point taken. By the way, The House of God is finally available in e-book form, in case you missed it. And if you’ve ever heard the term “Honda” in the ER, please share your experience in a comment. Maybe it’s a regional thing?

Striking Cambridge Results With New CPR

By the way, that new, simpler, hands-only CPR we wrote about this morning here? According to preliminary results from the last few months, it’s roughly doubled cardiac arrest survival rates in Cambridge.

This from Cambridge EMS:

Cambridge EMS has seen survival rates of patients suffering sudden cardiac arrest more than double since implementing Compression-only CPR this year. The City’s results reflect the positive results reported today in a study published in The Journal of American Medical Association (JAMA).
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Should We All Be Learning Hands-Only CPR?

The best e-mailer I know, a Cape Cod octogenarian named Jack Alden, sends me a few gems a week — helpful hints, bits of wisdom, jokes that lighten my days. A couple of weeks ago, he passed along this University of Arizona video on a new form of CPR.

At the time, all I thought was that it looked strenuous — you have to do rapidfire compressions on the heart attack victim’s chest — but effective. And that it was nice that you didn’t have to encounter alien saliva by going mouth to mouth with the patient.

Now there’s a major new study out in the Journal of the American Medical Association suggesting that this new, simpler form of CPR can save more lives, in large part because it makes bystanders more willing to try to help. The journal’s video report on its study is here:

The move toward simplifying CPR is the lead story in the Harvard Health Letter this month. Evidence in favor of the simpler CPR is growing, it says, but there are some nuances:
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Daily Rounds: Fluoridation Resistance; Stem Cells On For Now; Phoning For Health Prices; ‘Emergency Bra’

Fluoridation is still a hard sell in Mass. – The Boston Globe “Nearly 150 cities and towns that could add the substance don’t, a state study released this year found — even though fluoridation is hailed by disease specialists as one of the 10 seminal public health triumphs of the past century.” (Boston Globe)

Stem cell research can continue throughout appeal, court says – latimes.com “Government-funded research on embryonic stem cells can continue, a U.S. appellate court said Tuesday, while lawyers appeal a judge’s decision that found such research illegal.” (Los Angeles Times)

Phone More Popular Than Internet When Seeking Prices For Health Care : Shots – Health News Blog : NPR “Three-quarters of those who investigated prices ahead of time said they found what they needed. How did they do it? Most used old-fashioned techniques: 61 percent got on the phone. 47 percent asked in person. 22 percent tried the Internet or e-mail. 12 percent cited mail. 4 percent found what they needed in magazines or books.” (npr.org)

‘Emergency Bra’ doubles as safe-breathing mask – BostonHerald.com “The bra cups are lined with air filters she said would protect the wearer from smoke, debris from explosions, dust storms, volcanic ash and radioactive or biological terrorist attacks. “It is an always available personal protection device, but first and foremost it is a beautiful piece of lingerie,” she told reporters, adding that it is not meant to replace military-issued gas masks.” (Boston Herald)

Service Tomorrow For Brigham Doctor Killed On Scooter

A memorial service for Dr. Andrew T. McAfee, an award-winning emergency medicine specialist at Brigham and Women’s Hospital, is scheduled for tomorrow (Tuesday) at 11 a.m. at Temple Israel of Boston, Brigham and Women’s says.
McAfee, 50 and the father of three, was killed Friday morning in a collision between his motor scooter and a truck in Brighton. Friday afternoon, Dr. Ron M. Walls, chair of the hospital’s department of emergency medicine, sent out this message:

Dear Colleagues,

It is with the greatest of sadness that we inform you of the untimely death of Andrew T. McAfee, MD, MS, a beloved member of our physician community, who was killed this morning in a motor scooter accident. Continue reading