Sunday, June 15, 2008

IA for Sudden Cardiac Arrest

One of the immediate action one should take includes:
  1. CPR
  2. Defibrillation

And all this should be administered withing 7 minutes. Any treatment after would be deemed not very useful is nothing was done within 7 minutes.

Extract from American Heart Association

http://www.americanheart.org/presenter.jhtml?identifier=4741

"Brain death and permanent death start to occur in just four to six minutes after someone experiences cardiac arrest. Cardiac arrest is reversible in most victims if it's treated within a few minutes with an electric shock to the heart to restore a normal heartbeat. This process is called defibrillation. A victim's chances of survival are reduced by 7 to 10 percent with every minute that passes without CPR and defibrillation"

The below is an extract from Mayo Clinic

http://www.mayoclinic.com/health/sudden-cardiac-arrest/DS00764/DSECTION=8

"Immediate cardiopulmonary resuscitation (CPR) is critical to treating sudden cardiac arrest. By maintaining a flow of oxygen-rich blood to the body's vital organs, CPR can provide a vital link until more advanced emergency care is available

DefibrillationAdvanced care for ventricular fibrillation typically includes delivery of an electrical shock through the chest wall to the heart. The procedure, called defibrillation, momentarily stops the heart and the chaotic rhythm. This often allows the normal heart rhythm to resume.
The shock may be administered by emergency personnel or by a trained citizen if a public-use defibrillator, the device used to administer the shock, is available. If you're not trained to use an automatic external defibrillator (AED), a 911 operator may be able to guide you in its use. Trained staff members at many public places are able to provide and use an AED."

Friday, June 13, 2008

Risk Factors for Cardiac Arrest

Here are some risk factors found listed at Mayo Clinic

Extract from http://www.mayoclinic.com/health/sudden-cardiac-arrest/DS00764/DSECTION=4

In addition to a personal or family history of heart disease — including heart rhythm disorders, congenital heart defects, congestive heart failure and cardiomyopathy — other factors that may increase your risk of sudden cardiac arrest include:

  1. Low output of blood from you heart (ejection fraction)
  2. Previous episode of cardiac arrest
  3. Previous heart attack
  4. Markedly changed blood levels of potassium or magnesium — minerals called electrolytes that need to be properly balanced in order to maintain vital organ functions, including that of the heart
  5. Hyperthyroidism, a condition in which your thyroid gland produces too much of the hormone thyroxine, speeding up your metabolism and potentially causing arrhythmia
    Pulmonary hypertension, a type of high blood pressure that affects the arteries in your lungs
  6. Taking drugs that affect your heart rhythm, such as prescription anti-arrhythmic or pro-arrhythmic drugs, or over-the-counter medications, such as pseudoephedrine-containing cold medicines
  7. Using illicit drugs, such as cocaine or amphetamines

Look at point 6, those are your flu medicine. Never knew it will affect your heart rhythm.

Aetiology for Sudden Cardiac Arrest

References:
http://www.asiaone.com/Health/Fitness/Watch+Your+Body/Story/Why+young+hearts+fail.html

Some of the causes that will lead to sudden cardiac arrest.
  1. Hypertrophic cardiomyopathy
  2. Anomalous coronary arteries
  3. Arrhythmogenic right ventricular dysplasia
  4. Electrical disorders that cause irregular heartbeats, such as Brugada syndrome and long QT syndrome
  5. Myocarditis

Check out today's The Straits Time. One of the causes they mention was Hypertrophic cardiomyopathy. What is this? Click http://www.asiaone.com/Health/Fitness/Watch+Your+Body/Story/Why+young+hearts+fail.html for more information.

An extract from the url:

Hypertrophic cardiomyopathy

"The thickening can occur near arteries which channel blood from the heart to the rest of the body, and this could block the blood supply, said Dr Bernard Kwok, senior consultant of the National Heart Centre's cardiology department.
The thickened heart muscles also interfere with the electrical signals transmitted by the heart, which results in an irregular heartbeat.
Most people with hypertrophic cardiomyopathy would not notice it, but strenuous exercise could exacerbate the condition. The heart could either stop beating or pound so quickly that it can no longer pump out blood. This could lead to acute heart failure and death, if emergency treatment is not given in time."

... ...

"The genetic condition might not appear at birth but the heart muscle could thicken over time, said Dr Kwok."

Thursday, June 12, 2008

NS recruit dies after training walk

10 June 2008
Extracted from The Straits Time online
http://www.straitstimes.com/Latest+News/Singapore/STIStory_246352.html
The polytechnic graduate fainted at 8.35am while he was taking part in a 2km walk at the Basic Military Training Centre on the island. He was given immediate medical attention by doctors.

Official News Release at Mindef http://www.mindef.gov.sg/imindef/news_and_events/nr/2008/jun/10jun08_nr.html
A more recent news

Extracted from the straitstimes online
http://www.straitstimes.com/Latest%2BNews/Singapore/STIStory_247079.html

SAF suspends physical training after 2 trainees died

Regular serviceman, Officer Cadet (OCT) Clifton Lam Jia Hao collapsed at about 5.45 pm on Wednesday and was given immediate first aid treatment by a doctor and a senior medic. He was pronounced dead at 7.20pm in the hospital.

THE Singapore Armed Forces (SAF) on Thursday ordered a halt to all physical and endurance training activities for three days following the deaths of two young servicemen in training.
The 'time-out' from Thursday to Saturday will allow SAF to carry out a comprehensive system check and review its physical and endurance training programmes

Official News release at Mindef:
http://www.mindef.gov.sg/imindef/news_and_events/nr/2008/jun/12jun08_nr.html

Police trainee, 18, dies 2 days after collapsing during

16 May 2008
An extract from The Straits Times online
"A GROUP of 120 full-time police national servicemen set out on a 2.4km run early Tuesday morning around the parade square of the Home Team Academy.
But one of them never completed the run and was found lying unconscious in the camp in Old Choa Chu Kang Road.
Mr Roslan Saharo, 18, who was just two months into his basic training, would never wake up again.
After two days in a coma, his family decided yesterday morning to take him off life support. "

http://www.straitstimes.com/Free/Story/STIStory_237826.html

Cardiac SOS

Try to capture some of the cardiac arrest cases, not all are captured. I got nothing against any organisation.
Sudden Cardiac Arrest Time Line
23 September 2003 : Recruit collapse after IPPT Categorisation Test
15 June 2007:DXO died after running treadmill
25 Jun 2007: Triathelet,17, who died of heart failure after completing a race.
26 August 2007:Army regular collapses and dies after half-marathon
29 November 2007:Air Force NSF collapses, dies after run
2 January 2008:SAF officer collapses, dies after 1.2 km run
16 May 2008: Police trainee, 18, dies 2 days after collapsing during run
10 June 2008:NS recruit dies after training walk.
11 June 2008: RSAF serviceman dies after collapsing during training

Sources
http://health.asiaone.com/Health/News/Story/A1Story20070826-23153.html
http://www.asiaone.com/Health/Fitness/Watch%2BYour%2BBody/Story/Why%2Byoung%2Bhearts%2Bfail.html
http://www.asiaone.com/Health/Fitness/Story/A1Story20070630-16729.html
Mindef related news at http://www.mindef.gov.sg/imindef/news_and_events/nr.html