Someone clutches their chest, then collapses. All those things done to this person after this point are generally classified as "resuscitation". I just read a fascinating news article on how medicine's understanding of cell death and resuscitation are evolving. You can read this Newsweek article here.

Twenty years from now, regular folks might watch a rerun of the TV show ER and shake their heads at how we got it all wrong. "Look at that! That's ridiculous!" viewers will say, throwing their hands up in the air.

The article does touch on an area of medicine that is already changing rapidly. As for ER- can't we look at that now and shake our heads?

Very interesting read. In med school, we've mentioned briefly hypothermia in arrests. And I always wondered why we can't bypass a recent arrest patient (I guess that it takes time, and probably tough to do if you're doing compressions!).

This article addresses the heart though. Reperfusion injury is something the patient can get from any sort of lack of oxygen: a non-fatal heart attack, stroke, crush injury, etc. In all these cases, though, there's no good treatment. It sounds like this is a step in the right direction. We still have the problem, though, of how the neurons in the brain will react to being reperfused (this is a big issue, like Terry Shiavo). Do we really want to go down this road, only to have a huge increase in "saves" that end up as vegetables?

One thing the article said that I found a bit dumb: the doc said that they didn't see any changes in the cell after an hour of oxygen deprivation. According to my pathology text, changes visible by light microscopy take a few hours to show; electron microscopes are within an hour or 2. I'd be interested to know what he meant.

Just read this article and couldn't help but think about Zombies!!!!!!!!!!!!! LOL

Do you know HOW MUCH medical terms I learned from ER!! I have a big advantage at my school (nursing school) because of the things I learned from ER.

Hmm, sounding more and more like Mary Shelly was on the right path.

I still think the time will come when we will receive periodic injections of millions of nanites that will be able to do things like combat viral and bacterial infections, unclog arteries, identify and destroy cancer cells, repair ruptured blood vessels, etc. Maybe in another hundred years or so.

We are pushing the limits of biological remedy, like antibiotics and antivirals and steroids. The next big leap ought to be nanotechnology and cybernetics. Think of all the possibilities, even reproductive and psychological functions could be manipulated. Star Trek really wasn't that far fetched.

I'm also personally mostly interested in the implications for brain damage. With traumatic brain injury, in particular. This cooling salt slurry that is mentioned in the article is the first I have heard of this technique and sounds interesting. Usually, therapeutic hypothermia is achieved through external means, but this does it from the inside. Imagine paramedics one day carrying these little insulated bottles of this stuff to pump into patients in the field after heart attacks, strokes, etc. before whisking them off to the hospital.

You make an excellent point about the implications of being able to save the body, but not necessarily the "person". We've already reached that point in medical technology, and there's been some progress with advanced health care directives, health proxies, DNR orders, etc. but as you point out, cases like Terry Shiavo demonstrate that we're still far from addressing the issue fully. I don't think most of us have really thought of the implications either. For example, back when people were more likely to die from a heart attack or stroke, our beneficiaries would get a fat life insurance check. Nowadays, maybe we're more likely to live but be severely disabled, and instead of our loved ones getting money from life insurance, they end up becoming paupers to pay for our ongoing medical expenses that could last for decades.

I do close to 5-6 cardiac arrest a week not to mention various DOAs or traumatic arrests. Most of the time we get there too late even with average of 5 minute response time.

American Heart Association constantly upgrades and in response our system grows with them. New (not so new anymore) CPR standards as well as more push towards drugs that used to be in the shadows makes you ask questions. How came we were told four years ago not to use this but now it is a number one thing to do? How came the airway was always prioroty but now it is only circulation. Most of the time they come back with decent answers but sometimes they just draw blank. And since I teach it is hard for me to stand in front of a doctor who is used to doing things his way for 5 years and telling him that we are changing things around but having no explanations for him since AHA rep is going to "get back to me"... But the change is good and we are evolving althou not seeing much changes on the streets, docs may see changes in the ERs.

Resuscitation is an art. It is not plain cut simple cook book recepe. I realized after a month on the streets that doing stuff by the number isn't going to cut it. You have to think what you are doing and get really involved. Looking for underlying causes and reversing them is what counts.

It's all good and I'm looking for AHA to compile data for this period and improve once more.

ER TV show is funny. But I guess if you are a professional and look at shows about your job you will always shake your head.

Viruses, being little DNA replicating capsules, seem so unnatural to me that I've always struggle to imagine how they would have evolved.

Somehow I can't help but wonder if viruses are a form of "nanite-like" technology from a different time or technology. You know ... "long long ago in a galaxy far far away".

I'd better put my foil hat on before the government hears what I'm thinking now.