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Dr K K Aggarwal

Bystander CPR better when more people help

By Dr K K Aggarwal
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Patients of cardiac arrest are more likely to receive good quality bystander initiated cardiopulmonary resuscitation if multiple people assist Among cases of out of hospital cardiac arrest CPR quality is associated with multiple rescuers initiating bystander CPR being in a central or urban setting and receipt of bystander initiated CPR and longer duration of resuscitation as per Dr Hideo Inaba at Kanazawa University Graduate School of Medicine in Japan in the journal Resuscitation. Good quality bystander CPR is less commonly performed by a family member by older bystanders and in home environments. The key to survival and positive neurological outcomes for those experiencing an out of hospital cardiac arrest is the initiation of bystander CPR. This CPR should be performed with chest compressions only without mouth to mouth resuscitation. Good quality means Appropriate hand positions or finger positions for infants Compression rate of at least 100 per minute Compression depth of at least 2 inches or at least one third of the anterior posterior diameter of the chest Time to arrest or recognition of arrest to initiation of CPR is significantly shorter among those who provided good quality CPR median 3 minutes versus 4 minutes.

For the first time, 10000 children, teacher and parents will be trained in Cardiopulmonary Resuscitation 10 (CPR 10) in one day to commemorate World Health Day. The event will be organized on 6th April, 2013, Saturday at SKV School, Yamuna Vihar,East Delhi in association with Directorate of Education, Delhi Government. Never in history have so many people been trained in CPR in one day.

Addressing a press conference, Padma Shri & Dr. BC Roy National Awardee, Dr. KK Aggarwal, President Heart Care Foundation of India and Vice-President (Elect) National IMA said that the Foundation has already trained more than 35000 people and over 5 lives have been saved in the last three months where the general public could save the person’s life after sudden death. A 16-year-old school girl from Birla Vidya Niketan Pushp Vihar saved her uncle and a teacher from SD Public School Pitampura saved her grandmother by doing successful CPR.

Besides hands-only CPR 10 training, on the spot competitions will also be organized like cartoon, poster, slogan and poem on the subject to sensitize teachers, parents and children, said Mr. Sandeep Marwah, Chairman, Asian Academy Film & Television Institute, Noida.

Hands-only CPR 10 is based on the mantra – “within 10 minutes of death (earlier the better), for at least next 10 minutes (longer the better), compress the chest of the victim continuously and effectively with a speed of 10×10=100 per minute.

The theme for World Health Day this year is high blood pressure. Cardiovascular disease is the number one cause of death in urbanIndiaand over 70% of deaths amongst cardiovascular deaths are linked to hypertension, said Dr. KK Aggarwal. Besides learning CPR 10, school children should also learn about good dietary habits which include, eating more fiber, less salt, zero trans fats and zero refined carbohydrate, he further added.

About HCFI : The only National Not for profit NGO, on whose mega community health education events, Govt. of India has released two National commemorative stamps and one cancellation stamp, and who has conducted one to one training on” Hands only CPR” of 31145 people since 1st November 2012.

The CPR 10 Mantra is – “within 10 minutes of death, earlier the better; at least for the next 10minutes, longer the better; compress the centre of the chest of the dead person continuously and effectively with a speed of 10×10 i.e. 100 per minute.”

Duration of CPR May Be a Factor in Kids’ Survival

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Some children with in-hospital cardiac arrest can benefit from longer duration of cardiopulmonary resuscitation (CPR), a study has found. In the study among survivors, neurological outcome was favorable for the majority of patients.

Of the 3,419 children included in the study, 28% survived to hospital discharge, and 16.6% of these survivors had CPR longer than 35 minutes, according to Renée Matos, MD, MPH, of the University of Pittsburgh School of Medicine, and colleagues. A total of 60% of these survivors with longer-duration CPR achieved a favorable neurologic outcome, they reported in the study published Jan. 21 in Circulation: Journal of the American Heart Association.

In the mid-1990s, authorities considered pediatric CPR futile beyond 20 minutes’ duration or when more than two doses of epinephrine were provided.

Even though longer-duration CPR can benefit some children, the reality is that after the first 15 minutes of CPR, survival rate declines rapidly. Survival decreased by 2.1% for every minute of chest compressions over 15 minutes.

When CPR was longer than 35 minutes, those in the Surgical Cardiac category had the best survival to hospital discharge rate (25%), followed by, Medical Cardiac — 21%; General Surgical — 13%; General Medical — 10% and Trauma — 8%.  ([Medpage today)

 

Conducting a CPR 10 Camp at Modern Era Convent School, Janakpuri, Padamshri & Dr. BC Roy National Awardee, Dr. KK Aggarwal, President Heart Care Foundation of India & National Vice President Elect IMA said that in last 2 ½ months at least two lives have been saved by public who has learnt Cardiopulmonary Resuscitation.

Dr. Aggarwal said that 50 people die every day inDelhiof a cardiac illness and 5-6 lives should be saved every day if general public learns CPR. He said that Heart Care Foundation of India plans to train one lakh people within this year.

Over 1200 school children were trained in CPR which is based on the mantra – “within 10 minutes of sudden cardiac death (earlier the better) for the next 10 minutes (longer the better) compress the centre of the chest of the victim with a speed of 10 x 10 i.e. 100.”

Addressing the gathering Ms K.G. Modi, Principal of the school said that as a good Samaritan, it is the duty of every teacher to learn CPR and in turn train parents and school children so that every child learns that CPR 10 training is not only for organization but is also for each and every person and family.

About HCFI : The only National Not for profit NGO, on whose mega community health education events, Govt. of India has released two National commemorative stamps and one cancellation stamp, and who has conducted one to one training on” Hands only CPR” of 25409  people since 1st November 2012.

The CPR 10 Mantra is – “within 10 minutes of death, earlier the better; at least for the next 10minutes, longer the better; compress the centre of the chest of the dead person continuously and effectively with a speed of 10×10 i.e. 100 per minute.”

eMedinewS and Heart Care Foundation of India will be organizing a daylong conference on 20th January, 2013 at Maulana Azad Medical College and will be attended by over 1000 doctors. The conference will revisit the happenings of the year 2012.

Addressing a press conference here Padmashri & Dr. BC Roy National Awardee, Dr. KK Aggarwal, Group Editor-in-Chief eMedinewS and President Heart Care Foundation of India and Vice President Elect IMA, Dr Ganesh Mani, Dr Ashish Jain, Dr. Vivek Bhatia, Dr. Praveen Bhatia, Dr Yugal Mishra, Dr. N.K.Bhatia, Dr. Neeraj Jain, Dr Kailash Singla, Dr Kaberi Banergee and Dr. Praveen Chandra, in a joint statement said that a lot has changed in the last one year. Following were a few of the new advancements:

1. The new mantra for Cardiopulmonary Resuscitation (CPR10) – Over 25000 people in the city ofDelhialone have been trained in CPR10 to revive people out of sudden death. The mantra created by Dr. KK Aggarwal simplifies the course of action to be taken by people – “within 10 minutes of death (earlier the better), at least for the next 10 minutes (longer the better – upto 25 minutes), compress the centre of the chest of the victim effectively and continuously with a speed of 10×10 i.e. 100 per minutes”.

2. For patients whose blood pressure is not getting under control, new treatment is denervation of the nerves connected to the kidney.

3. For suspected rheumatic heart diseases, echo screening and not clinical screening is the answer.

4. Bypass surgery is better than drug quoted stents in patients with diabetes.

5. Pre-exposure prophylaxes with tenofvir and emtricitadine is now an established way of preventing HIV in high risk individuals.

6. New guidelines suggest that all patients of HIV+ should be treated regardless of CD4 T cells count.

7. Bacterial nasal sinusitis needs to be treated by anti-biotic and should be differentiated from viral nasal sinusitis.

8. In patients over the age of 70 years being treated with enema for constipation, one should use warm water enema rather than sodium phosphate enema.

9. In women of 65 years of age and older with a normal or slightly low bone mass at baseline measurement and with no risk factors of accelerated bone loss, follow-up bone densitometry should be done between 10-15 years.

10. Patients with high cholesterol on statin no more require monitoring of liver functions. They should be done only at baseline and not thereafter

11. Patients of depression on citalopriam should not be given a dose more than 40 mg and in 60+, it should not be more than 20mg.

12. Bio-absorbable polymers stent are now available inIndia.

13. Without surgery aortic valve replacement via catheter has now started inIndia.

14. Small intestinal transplant has been added to the list of transplant in the country.

15. Recently, a patient fromDelhiwho was brain dead donated his organs to 37 people.

16. A circular from Ministry of Health and Family Welfare has clarified that under the PNDT Act, medical practitioners with post graduation in gynecology and obstetrics are qualified to do obstetric ultrasound.

17. Suspect bacterial infection if:

a. Persistent symptoms or signs lasting more than 10 days with no improvement.

b. Onset with fever of more than 102 degree and purulent nasal discharge lasting three consecutive days.

c. Onset with worsening symptoms following a viral URI lasting 5-6 days which was initially improving.

Mr Gursharan Singh former Indian Cricketer was the special guest of the day.

The conference will be followed by ‘Doctor of the year’ awards and cultural evening.


Heart Care Foundation of India today trained 984 students at S D Public School, Pitampura in CPR 10, the hands-only cardiopulmonary resuscitation technique.

Elaborating on this, Padma Shri & Dr. BC Roy National Awardee, Dr. KK Aggarwal, President Heart Care Foundation of India said that for the first time a 90-year-old retired Joint Director from the Directorate of Education, Shri S N Sharma, learned hands-only CPR 10.

The campaign was inaugurated by Chairman of S D Public School Dr Sushil Gupta, Vice Chairman Sh. Kanwar Bhan Goel. Others who participated were Ms Anita Sharma, Principal  & Ms Rekha Gupta. Mr. Gupta said that learning and passing on knowledge about CPR 10 is the best gift one can give to others.

Dr. Aggarwal also said that one should learn and educate at least 10 people about CPR 10. He further cautioned that CPR practical training should be done only on dummies and not on each other. The CPR 10 Mantra is – “within 10 minutes of death, earlier the better; at least for the next 10 minutes, longer the better; compress the centre of the chest of the dead person continuously and effectively with a speed of 10×10 i.e. 100 per minute.”

So far the foundation has trained 21845 people.

CPR 10 has been endorsed by many distinguished celebrities: Dr. Deepak Chopra, the New age Guru and noted author; Mr. Sushil Shinde, Union Home Minister; Smt. Sheila Dikshit, Chief Minister of Delhi; Shri A K Walia, Health Minister of Delhi; Prof. Kiran Walia, Education Minister of Delhi; noted poet Ashok Chakradhar; noted dancers Nalini, Kamalini, Uma Sharma; film star Poonam Jhawar and most top cardiologists of India.

The incidence of heart diseases has doubled in the last two decades. The risk in Indians is four times that of white Americans, six times of Chinese and 20 times of that in the Japanese. Indians have more diabetes, small vessel disease, diffuse disease and often present late. The average age of heart disease in India is 56 years versus 64 years in the West. This was stated by Padma Shri & Dr. BC Roy National Awardee, Dr. KK Aggarwal, President Heart while delivering a lecture in a seminar organized by Dept. of Science & Technology, Government of India.

Dr. Aggarwal also demonstrated CPR 10, the technique of hands-only cardiopulmonary resuscitation.

Dr. Aggarwal further said that 17 states inIndiahave already banned manufacture and sales of Gutka and other smokeless tobacco products. The time has now come for the country as a whole to ban these products.

Dr Inderjeet Singh, IAS, Joint Secretary, Dept. of Science & Technology, said that a healthy lifestyle can prevent diseases like heart attack, diabetes and blood pressure. He said that one should exercise every day and should live a life devoid of stress.

Dr. Aggarwal also said that only 8% of heart patients in India receive clot-dissolving or removal therapy as compared to 40% of heart patients in the West. He said that the time of onset to admission in a hospital is 300 minutes in India as against 170 minutes in Europe and 120 minutes in theUS.

In a function held at MCD School Srinivaspuri, 116 principals of Central Zone MCD were trained on cardiac first-aid. The training was done as a part of 19th MTNL Perfect Health Mela celebrations.

Inaugurating the workshop Mr. Satish Upadhyay, Chairman, Education Committee, South MCD, said that for the next one year, 7500 school teachers will be trained in cardiac first-aid, health and hygiene.

Conducting the workshop, Padmashri & Dr. BC Roy National Awardee, Dr. KK Aggarwal, President of the Mela said that all teachers and school principals should learn the technique of revival after heart attack and electrical death. As for every one death, there are 10 bystanders who gathers, even one of those knows the technique of Cardiopulmonary Resuscitation, the life of the victim can be revived.

 

The forthcoming 19th MTNL Perfect Health Mela being organized by Heart Care Foundation of India jointly with Health Department, Government of NCT Delhi will focus on revival of a person after clinical death.

Over 10,000 persons will be trained in Compression Only Cardiopulmonary Resuscitation technique. Various Mela related activities will be held from 1st to 11th November, 2012 and the main Mela will be held from 7th to 11th November, 2012 at the Constitution Club of India, New Delhi

Addressing a press conference, Hon’ble Dr. A.K. Walia, Minister of Health and Family Welfare, Government of NCT Delhi, said that one percent of the population of Delhi should be trained in Compression-only Cardiopulmonary Resuscitation as the incidence of heart disease and diabetes is maximum in India in the world. Sudden death is common in both conditions.

Sudden death can only revived in the first 10 minutes and the revival technique can be attempted by bystanders.

More than 25 lakhs people die of sudden death in the country in a year and 80% of them can be revived if bystanders try to resuscitate them timely with compression only CPR.

CO-CPR is not for done for a heart attack. The first aid for a heart attack is to chew a tablet of 300 mg water-soluble aspirin at the onset of chest pain.

Formula of 10 for preventing sudden deaths

Co-addressing the press conference, Padma Shri & Dr. BC Roy National Awardee, Dr. K K Aggarwal, President Heart Care Foundation of India said that the CO-CPR Mantra is “Within 10 minutes of death of a person for the next 10 minutes, one should compress the centre of the chest of the victim with a speed of 10×10 = 100 per minute.” In absence of electric shock machine, two thumps should be given with the fist in the centre of the chest before starting CO-CPR.

To be covered in LIMCA BOOK OF RECORDS

The Mela will be launched with a CO-CPR camp at Birla Vidya Niketan where 1000 school teachers and students will be trained on 200 dummies. The event will find its place in Limca Book of Records.

Focus on all systems of medicine

One of the attractions of this year’s Mela will be workshops on Homeopathy, Ayurveda, Naturopathy, Veterinary Medicine with focus on Zoonotic diseases and Yoga, Pranayama cum Meditation. A special seminar will also be organized in collaboration with AIR with specialists from all pathies under one roof. A special conference will also be organised with Ministry of Earth Sciences on Women Health & Climate Change.

Programs on health

Dilli Aajtak will air five special lifestyle programs every day in the evening with eminent faculties. The topics will be life style, high blood pressure, diabetes and obesity.

Artificial intelligence

For the first time, there will also be a conference on physics of consciousness and artificial intelligence. Scholars from physics and other fields will participate.

Nursing home problems

Delhi Medical Association will also organize a workshop on nursing home problems. The event will be coordinated by Dr Harish Gupta President DMA.

Exhibition on food adulteration

The Mela will also have practical workshops on food adulteration, its identification and prevention. It will also focus on permissible and non permissible food additives.

Exhibition on science behind miracles

Dept. of Science & Technology will also be placing special exhibitions on science behind miracles.

Over 500 children, 2000 nurses and 1000 college students to take part

Interschool competitions will be coordinated by Birla Vidya Niketan and Ryan Global School. Over 5000 school children will participate in various health and environment competitions. Over 2000 nurses and 1000 medical doctors and young students will be participating in various health related competitions.

Seminar on ‘All Pathy Consensus’

A seminar on ‘All Pathy Consensus’ on obesity and on spiritual gurus white paper on prayer and health will also be held. Bharatiya Vidya Bhavan will coordinate the spiritual gurus’ workshop.

Poonam Jhawar for awareness on road traffic accidents

Cine actress Ms Poonam Jhawar from the movie (OMG – Oh My God)..who plays the character of. Gopi Maiyya, star attraction of the press meet, said that stars live a stressful life and should learn to relax and do pranayama and meditation.  She said that a special exhibition that will be organised at the Mela on road safety will be dedicated to Mr. Jaspal Bhatti. A special booklet will also be released by the Dept. of Transport, Govt. of Delhi.

Mela, a bhagidari project for people from sectors of the society

Mr. Rajesh Kumar from LIC, Mr K J Kumar(DGM) from Indian Oil Limited, Ms Renu from Prohibition Department, Delhi Govt. , Dr N K Yadav from MCD South, Dr P K Sharma of NDMC, Mr Deepak Chanduka (GM MTNL- Corporate Office)  and Mr A K Srivastav (GM Mktg-MTNL Delhi), Dr ABP

Mishra (DST) also addressed the press.

Teleconsults by MTNL

MTNL will focus on telemedicine and teleconsultations. Both MCD and NDMC will have special focus on dengue menace in the city. The awareness will focus on how to prevent deaths from dengue.

White paper on preventing deaths from dengue

The Mela will also come out with a white paper on dengue and suggestion to the government for prize control policies when facing any epidemic situation and the right treatment guidelines. It has been seen that non serious patients often occupy the beds and the serious patients end up in getting no beds. The policy should define clinical situations where beds should not be denied in dengue.