EMS Education - Articles
Hacking Your Way To Survival
By by Valerie DeFrance, Paramedic
Sep 3, 2003, 12:49

Courtesy the EMS House of DeFrance http://www.defrance.org

Hacking Your Way To Survival
by Valerie DeFrance, Paramedic

"Cough CPR" is back in the news, and your personal email boxes, due to a study published by a Polish doctor of the Cardiological Foundation in Katowice, Poland. In brief, the study holds the same basic information that was first released in 1999; namely that, "Coughing vigorously until an ambulance arrives could save the lives of people having a type of heart attack brought on by rapid and erratic heart beat."

Most of those in involved in emergency care, such as EMS providers, emergency room doctors, and cardiologists, as well as others in the medical profession, completely dispute this study and have firmly agreed that cough CPR is a dangerous procedure for the uninitiated to attempt. If you had extensive medical training and knew exactly what you were doing, it might help save your life. If not, the use of cough CPR could kill you.

When the original articles first appeared in 1999, it left the impression that the "cough CPR" technique was endorsed by Rochester General Hospital and Mended Hearts. Rochester General disavowed any knowledge of this and how its name came to be attached to all this is still a mystery. You can still read their article online, "Important Notice Regarding the article "How to Survive a Heart Attack When Alone" which denies their having endorsed this procedure. 

Although this advice was indeed published in a 1999 newsletter produced by Mended Hearts, the organization quickly did a turnabout and disavowed it, and also released a page on its web site asking readers not to take the advice seriously because they couldn't stand behind it. Further, Mended Heart's executive director, Darla Bonham, issued a statement: 

"I've received email from people all across the country wanting to know if it is a valid medically approved procedure. I contacted a scientist on staff with the American Heart Association Emergency Cardiac Care division, and he was able to track a possible source of the information. The information comes from a professional textbook on emergency cardiac care. This procedure is also known as "cough CPR" and is used in emergency situations by professional staff. The American Heart Association does not recommend that the public use this method in a situation where there is no medical supervision."

Much like the Mended Hearts newsletter, the study by Polish doctor Tadeusz Petelenz is now making the rounds, and has produced a rash of reprinted articles in the mass media and emailed advice that makes its way into many personal email boxes.

Due to this latest round of articles, a similar report by the TPO newspaper (http://ap.tbo.com/) on the same subject reported that, "Experts said while the concept is provocative, it needs more study" and that "Dr. Marten Rosenquist, professor of cardiology at the Karolinska Institute in Stockholm, Sweden, and an expert in heart beat abnormalities, said the concept is interesting but that Petelenz showed no evidence his patients actually had arrhythmias."

It is true that cough CPR may the thoracic pressure just enough to maintain some circulation of oxygen-containing blood, helping the brain to maintain consciousness for a period of time. However, it is a method that is used in a controlled environment overseen by medical professionals. Depending on which sort of cardiac crisis is being experienced, and without trained medical personnel to supervise the rhythmic coughing, cough CPR could kill or cure. 

Forget about hacking your way to survival — and perhaps even forget about introducing any of this information into your classes unless the subject is brought up. 

The key to surviving a cardiac event is the Chain of Survival. Rapid access, AED's, ALS and thrombolytic agents (clot busters). Time IS muscle.

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