Commentary

Pioneers in the Medical Field

The CBS Morning Show reminded me of an old lifesaver who statistically showed us the importance of hand washing in saving the lives of patients – most importantly, tiny patients and their mothers.

Ignaz Semmelweis was a passionate Hungarian doctor who championed handwashing and was shunned and ridiculed by his colleagues until he went crazy and was put in an insane asylum where he died, of all things, sepsis, after being beaten by guards and having his wounds get infected and accelerating to sepsis.

Henry Heimlich, MD, had people laugh at him for years about his foreign body removal technique.

Pittsburgh’s genius visionary Dr. Peter Safer championed CPR and – decades ago – postulated on the merits of “cooling” cardiac arrest patient’s by packing their head with ice to put them in a suspended animation state (like the mammalian diving reflex does) until their body could recover or be treated for its medical problem.

Every hospital worth its salt now “cools” cardiac arrest patients post resuscitation by using therapeutic hypothermia to keeps them at a set temperature (sometimes for days) until it is the right time to bring them back.

People laugh at me today for advocating for mechanical CPR and ventilators on all ambulances. It is not rocket science, but it goes against the norm.

“I can do perfect CPR!”

“Our firefighters can do perfect CPR”

“We switch off on compressions every 2 minutes!”

“We know it’s not safe to do CPR in our ambulances so we call the code and terminate resuscitation in the home if we cannot get them back in 20 minutes!”

Time will prove these are “deadly” statements because EMS Systems like Allina in Minneapolis/St. Paul Minn. are proving that CONSISTENT, UNINTERRUPTED mechanical CPR, Active Compression/Decompression (AC/DC) CPR and head elevation are part of the precious Bundle of Care in resuscitation processes by all of us involved with the Take Heart America organization.

Dr. Keith Lurie, Dr. Charlie Lick, Dr. Jeff Goodloe, and Dr. Demetris Yannopoulos are a few of my heroes, pioneers who could care less if someone laughs at their resuscitation innovations, procedures or devices.

They (and I) will have the last laugh.

Your medical helicopter will fall from the sky if the pilot turns off fuel to its engine even for a few seconds.

Your car or ambulance will stall if your fuel injector fails,

And your brain will fail if you interrupt blood flow to it for a few seconds and you have to “reprime the heart (your vital pump)” to get it working at a PRESSURE adequate to get precious oxygenated blood to the brain?

And put VENTIATORS in all ambulance???

Hogwash you say.

You cannot have paramedics know 3-4 settings to have patients breath consistently and at the right levels, they aren’t qualified.

They can operate $30,000 monitor defibrillators to place a heart and shock it at the proper times while simultaneously monitoring pulse oximeter, temperature, CPR rates and depth, and capnogrsphy and CO levels, but NO, not a ventilator! Let’s have them use a silicone bag to pump in air inconsistently and in a frequently interrupted manner as they move the patient.

Ventilators in 100,000 ambulances? Do you know how much that would cost for a piece of equipment that will not be used all the time?

Yes I do because we don’t use our monitors, action, CPAP, and SCBAs and N95 masks all the time but, when we do, they are lifesaving.

Right now, during the pandemic, when the hospitals are begging for ventilators, if we had 100,000 ventilators in ambulance, we could “loan” them or “temporarily reassign them” to ICUs and fall back on the old, primitive form of ventilation –‘ Bag-Valve-Mask ventilation.

Drs. Lurie, Goodloe and Lick have shown the great success of AC/DC CPR by EMS, fire and, yes, police officers. Dr. Lick has now added the Elegard Head Elevation Device and met patients it has helped save. And EMSA in Oklahoma City and Tulsa have been using ventilators in their ambulances for years under the pioneering guidance of Jeff Goodloe, MD.

The government will buy us all ventilators after this pandemic is under control!

Get my point? Bring out the leaches!