letter dr. christian vaillancourt
TRANSCRIPT
Dr. Vaillancourt wrote 2015 CPR guidelines Dr. Morrison wrote 2010 CPR 2010 guidelines correct 2015 wrong and misleading. Dr. Vailancourt refers me to Dr. Morrison see last email.All consensus for OD found here https://jgarythompson.wordpress.com/2015/08/11/agnotology/
From Christian Vaillancourt 01/16/14 at 11:14 PMTo Gary Thompson
I still do not fully understand your objection to this program. Not sure we have this in Ottawa, but naloxone programs such as this one have been implemented to save the lives of opioid addicts who overdose.I believe the naloxone is meant to be administered quickly by a fellow addict or case worker or family member trained to do so.
Many such patients die in alleys with no case at all, and simple CPR will not work in the case of an opioid OD.
Perhaps best to contact a cardiac arrest champion from Toronto if you are looking for support with some of your objections...have you tried Dr. Laurie Morisson?
Christian
From Christian Vaillancourt 01/08/14 at 1:56 PM To Gary Thompson
Most recent resuscitation guidelines (attached) moved to recommend compression-only CPR for citizen (not for health care professionals) mostly because it was perceived to be one of the major barrior for people to initiate CPR…it is also the most difficult part of the technique to learn.
For witnessed arrests (those having a cardiac arrest with immediate CPR initiation), since victims already have some oxygen in their lungs that can passively be absorbed, another argument is that any time spend doing ventilations is time lost circulating that oxygen with chest compressions.
In the case of overdoses and children cardiac arrests, the etiology is commonly a respiratory arrest.
Although they would be most likely to benefit from ventilations, once again – barrier to CPR initiation (reluctance to do so) favor an approach encouraging chest compressions alone until professional help arrives.
A few very large studies also seem to support this strategy (no difference in survival comparing chest –compression alone to traditional CPR)
Hope this answers some of your questions?
Christian Christian Vaillancourt MD, MSc, FRCPC, CSPQ
Associate Professor, Department of Emergency MedicineSenior Scientist, Ottawa Hospital Research InstituteResearch Chair in Emergency Cardiac Resuscitation, University of OttawaAssociate Medical Director, Regional Paramedic Program for Eastern Ontario
From Christian Vaillancourt 01/07/14 at 7:32 AM To James Thompson
Thank you for this information Mr. Thompson, but it would help me respond if I understood your concern better. Are you concerned with the naloxone program described, or with the recommendation for compression-only CPR?
Christian
On Jan 7, 2014, at 2:28 AM,
<[email protected]> wrote:
Dr. Vaillancourt:
Toronto Public Health is doing a live human study, teaching the general public chest compressions only for poisoning (drug OD). See attached CJPH 2013;104(3)e200-4 Omitted from the article Signs & Symptoms of opioid poisoning. See attached from the training literature www.instantpresenter.com/ohtn/E956D7808049 Slide 31. I know of deaths 14 yr. old juvenile onset diabetes case; 70 yr. old unconscious choking victim plus poisoning (drug OD) deaths. Responders were doing as instructed, unconscious, cyanotic, laboured breathing give chest compressions only?
Any comment would be appreciated, I am at a loss understanding this practice. Thank You & Remember the Mysteries Gary Thompson
From Laurie Morrison [email protected] Oct 8, 2012 To James Thompson CC 'Aaron Orkin ([email protected])' Hi James Yes I helped craft them in accordance with the guidelines and feel the approach to chest compression only is the right way to go for many reasons. Happy to discuss with you at any time. Aaron Orkin (copied here) and Toronto public Health were more involved than I was as I was just the expert brought in to help out. Cell is 4165245434 or we could set up a face to face by email if you prefer. Laurie From: James Thompson [mailto:[email protected]] Sent: Wednesday, October 03, 2012 5:02 PMTo: Laurie MorrisonSubject: naloxone training Dr. Morrison: I have just found out that RESCU was part of Toronto Public Health's naloxone protocols. I think they should be changed, as there is no scientific evidence for chest compressions only in opiate overdose. See Attached ILCOR and Amer Heart Assoc. Guidelines 2010Please reply ASAP Remember the MagicGary Thompson @GaryCPR
Dr. Morrison was not happy to discuss when told brining a tape recorder. She phoned the police. Get a phone call “Gary can you come to the station” “Sure be right there” Police constable “Gary I want to shake your hand you have been saving lives, bad news is Dr. Morrison wants no contact.” “Fine by me she is a nut”
Dr. Laurie Morrison Co-Chair AHA & ILCOR Guidelines on toxic ingestions 2010 AHA Guidelines Part 12.7: http://circ.ahajournals.org/content/122/18_suppl_3/S829.full#sec-80ILCOR 2010 Part 8.5 Drug Overdose and Poisoning http://www.resuscitationjournal.com/article/S0300-9572(10)00453-3/fulltext#sec2260UNDOC/WHO 2013 Opioid overdose Page 7 layman’s languagehttps://www.unodc.org/docs/treatment/overdose.pdfCompressions only CPR AHA Guidelines 2010 Part 4http://circ.ahajournals.org/content/122/18_suppl_3/S676.full.pdf+html