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Keeping your heart healthy

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23rd-Dec-2016       
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Dr Hasina Banoo
Our mission is to build healthier lives, free of cardiovascular diseases and stroke. That single purpose drives all we do. The purpose of selection of the topic in memory of the legend of medicine world of Bangladesh
The person who always thought how to save a life of diseased victims by service and treatments.
Taught his students to be sincere in giving service to the patient, how to do the research in medicines and every things about how to be a good doctor and a teacher.
I have selected the topics because by giving CPR in sudden cardiac arrest we can save 10 to 50 per cent victims life but without that more than 95 per cent die. All the adult persons should know how to give CPR because more than 80 per cent of people who become victim of SCA (sudden cardiac arrest) usually outside the hospitals.
New to the 2015 Guidelines Update are upper limits of Basic Life Support and CPR Quality in adult victims of cardiac arrest, it is reasonable for rescuers to perform chest compressions at a rate of 100 to 120/min. Also applies to BLS for Healthcare Providers. It is reasonable for lay rescuers and HCPs recommended heart rate and compression depth, based on preliminary data suggesting that excessive compression rate and depth adversely affect outcomes. During manual CPR, rescuers should perform chest compressions to a depth of at least 2 inches (5cm) for an average adult, while avoiding excessive chest compression depths (greater than 2.4 inches [6cm). The adult sternum should be depressed at least 2 inches (5cm). While a compression depth of at least 2 inches (5cm) is recommended, the 2015 Guidelines Update incorporates new evidence about the potential for an upper threshold of compression depth (greater than 2.4 inches [6cm), beyond which complications may occur. Untrained lay rescuers should provide compression-only (Hands-OnlyTM) CPR, with or without dispatcher guidance, for adult victims of cardiac arrest. The rescuer should continue compression-only CPR until the arrival of an AED or rescuers with additional training. All lay rescuers should, at a minimum, provide chest compressions for victims of cardiac arrest. In addition, if the trained lay rescuer is able to perform rescue breaths, he or she should add rescue breaths in a ratio of 30 compressions to 2 breaths. The rescuer should continue CPR until an AED arrives and is ready for use, EMS providers take over care of the victim, or the victim starts to move. If a bystander is not trained in CPR, the bystander should provide compression-only CPR for the adult victim who suddenly collapses, with an emphasis to ‘push hard and fast’ on the center of the chest, or follow the directions of the EMS dispatcher. The rescuer should continue compression-only CPR until an AED arrives and is ready for use or EMS providers take over care of the victim. All trained lay rescuers should, at a minimum, provide chest compressions for victims of cardiac arrest. In addition, if the trained lay rescuer is able to perform rescue breaths, compressions and breaths should be provided in a ratio of 30 compressions to 2 breaths.
The rescuer should continue CPR until an AED arrives and is ready for use or EMS providers take over care of the victim. Compression-only CPR is easy for an untrained rescuer to perform and can be more effectively guided by dispatchers over the telephone. Moreover survival rates from adult cardiac arrests of cardiac etiology are similar with either compression-only CPR or CPR with both compressions and rescue breaths when provided before EMS arrival.
However, for the trained lay rescuer who is able, the recommendation remains for the rescuer to perform both compressions and breath.
It may be reasonable for communities to incorporate mobile technologies that summon rescuers who are in close proximity to a victim of! Suspected OHCA and are willing and able to perform CRP.
There is limited evidence to support the use of mobile technologies by dispatchers to notify potential rescuers of a possible cardiac arrest nearby, and activation of mobile technologies has not been shown to improve survival from OHCA. However, in a recent study in Sweden, there was a significant increase in the rate of bystander-initiated CPR when a mobile-phone dispatch system was used. Given the low harm and the potential benefit, as well as the ubiquitous presence of digital devices, municipalities could consider incorporating these technologies into their OHCA systems of care.  
Basic Life Support and CPR Quality
In adult victims of cardiac arrest, it is reasonable for rescuers to perform chest compressions at a rate of 100 to 120/min. Also applies to BLS for Healthcare Providers.
It is reasonable for lay rescuers and HCPs to perform chest compressions at a rate of at least 100/min.
New to the 2015 Guidelines Update are upper limits of recommended heart rate and compression depth, based on preliminary data suggesting that excessive compression rate and depth adversely affect outcomes.
During manual CPR, rescuers should perform chest compressions to a depth of at least 2 inches (5cm) for an average adult, while avoiding excessive chest compression depths (greater than 2.4 inches [6cm]).
The adult sternum should be depressed at least 2 inches (5cm).
While a compression depth of at least 2 inches (5cm) is recommended, the 2015 Guidelines Update incorporates new evidence about the potential for an upper threshold of compression depth (greater than 2.4 inches [6cm]), beyond which complications may occur.
Compression depth may be difficult to judge without use of feedback devices, and identification of upper limits of compression depth may be challenging.

(Dr Hasina Banoo, Advisor and Honorary Professor of Internal Medicine and Cardiology, Bangladesh Institute of Health Science)

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