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Cardiopulmonary resuscitation (CPR): First aid

 

By Mayo Clinic Staff Cardiopulmonary resuscitation (CPR) is a lifesaving technique useful in many emergencies, including heart attack or near drowning, in which someone's breathing or heartbeat has stopped. The American Heart Association recommends that everyone — untrained bystanders and medical personnel alike — begin CPR with chest compressions. It's far better to do something than to do nothing at all if you're fearful that your knowledge or abilities aren't 100 percent complete. Remember, the difference between your doing something and doing nothing could be someone's life. Here's advice from the American Heart Association: Untrained. If you're not trained in CPR, then provide hands-only CPR. That means uninterrupted chest compressions of about 100 a minute until paramedics arrive (described in more detail below). You don't need to try rescue breathing. Trained and ready to go. If you're well-trained and confident in your ability, begin with chest compressions instead of first checking the airway and doing rescue breathing. Start CPR with 30 chest compressions before checking the airway and giving rescue breaths. Trained but rusty. If you've previously received CPR training but you're not confident in your abilities, then just do chest compressions at a rate of about 100 a minute. (Details described below.) The above advice applies to adults, children and infants needing CPR, but not newborns. CPR can keep oxygenated blood flowing to the brain and other vital organs until more definitive medical treatment can restore a normal heart rhythm. When the heart stops, the lack of oxygenated blood can cause brain damage in only a few minutes. A person may die within eight to 10 minutes. To learn CPR properly, take an accredited first-aid training course, including CPR and how to use an automated external defibrillator (AED). If you are untrained and have immediate access to a phone, call 911 before beginning CPR. The dispatcher can instruct you in the proper procedures until help arrives. Before you begin Before starting CPR, check: Is the person conscious or unconscious? If the person appears unconscious, tap or shake his or her shoulder and ask loudly, "Are you OK?" If the person doesn't respond and two people are available, one should call 911 or the local emergency number and one should begin CPR. If you are alone and have immediate access to a telephone, call 911 before beginning CPR — unless you think the person has become unresponsive because of suffocation (such as from drowning). In this special case, begin CPR for one minute and then call 911 or the local emergency number. If an AED is immediately available, deliver one shock if instructed by the device, then begin CPR. Remember to spell C-A-B The American Heart Association uses the acronym of CAB — compressions, airway, breathing — to help people remember the order to perform the steps of CPR.  Compressions: Restore blood circulation Put the person on his or her back on a firm surface. Kneel next to the person's neck and shoulders. Place the heel of one hand over the center of the person's chest, between the nipples. Place your other hand on top of the first hand. Keep your elbows straight and position your shoulders directly above your hands. Use your upper body weight (not just your arms) as you push straight down on (compress) the chest at least 2 inches (approximately 5 centimeters). Push hard at a rate of about 100 compressions a minute. If you haven't been trained in CPR, continue chest compressions until there are signs of movement or until emergency medical personnel take over. If you have been trained in CPR, go on to checking the airway and rescue breathing. Airway: Clear the airway If you're trained in CPR and you've performed 30 chest compressions, open the person's airway using the head-tilt, chin-lift maneuver. Put your palm on the person's forehead and gently tilt the head back. Then with the other hand, gently lift the chin forward to open the airway. Check for normal breathing, taking no more than five or 10 seconds. Look for chest motion, listen for normal breath sounds, and feel for the person's breath on your cheek and ear. Gasping is not considered to be normal breathing. If the person isn't breathing normally and you are trained in CPR, begin mouth-to-mouth breathing. If you believe the person is unconscious from a heart attack and you haven't been trained in emergency procedures, skip mouth-to-mouth breathing and continue chest compressions. Breathing: Breathe for the person Rescue breathing can be mouth-to-mouth breathing or mouth-to-nose breathing if the mouth is seriously injured or can't be opened. With the airway open (using the head-tilt, chin-lift maneuver), pinch the nostrils shut for mouth-to-mouth breathing and cover the person's mouth with yours, making a seal. Prepare to give two rescue breaths. Give the first rescue breath — lasting one second — and watch to see if the chest rises. If it does rise, give the second breath. If the chest doesn't rise, repeat the head-tilt, chin-lift maneuver and then give the second breath. Thirty chest compressions followed by two rescue breaths is considered one cycle. Resume chest compressions to restore circulation. If the person has not begun moving after five cycles (about two minutes) and an automated external defibrillator (AED) is available, apply it and follow the prompts. Administer one shock, then resume CPR — starting with chest compressions — for two more minutes before administering a second shock. If you're not trained to use an AED, a 911 or other emergency medical operator may be able to guide you in its use. If an AED isn't available, go to step 5 below. Continue CPR until there are signs of movement or emergency medical personnel take over. To perform CPR on a child The procedure for giving CPR to a child age 1 through 8 is essentially the same as that for an adult. The differences are as follows: If you're alone, perform five cycles of compressions and breaths on the child — this should take about two minutes — before calling 911 or your local emergency number or using an AED. Use only one hand to perform chest compressions. Breathe more gently. Use the same compression-breath rate as is used for adults: 30 compressions followed by two breaths. This is one cycle. Following the two breaths, immediately begin the next cycle of compressions and breaths. After five cycles (about two minutes) of CPR, if there is no response and an AED is available, apply it and follow the prompts. Use pediatric pads if available, for children ages 1 through 8. If pediatric pads aren't available, use adult pads. Do not use an AED for children younger than age 1. Administer one shock, then resume CPR — starting with chest compressions — for two more minutes before administering a second shock. If you're not trained to use an AED, a 911 or other emergency medical operator may be able to guide you in its use. Continue until the child moves or help arrives. To perform CPR on a baby Most cardiac arrests in babies occur from lack of oxygen, such as from drowning or choking. If you know the baby has an airway obstruction, perform first aid for choking. If you don't know why the baby isn't breathing, perform CPR. To begin, examine the situation. Stroke the baby and watch for a response, such as movement, but don't shake the baby. If there's no response, follow the CAB procedures below and time the call for help as follows: If you're the only rescuer and CPR is needed, do CPR for two minutes — about five cycles — before calling 911 or your local emergency number. If another person is available, have that person call for help immediately while you attend to the baby. Compressions: Restore blood circulation Place the baby on his or her back on a firm, flat surface, such as a table. The floor or ground also will do. Imagine a horizontal line drawn between the baby's nipples. Place two fingers of one hand just below this line, in the center of the chest. Gently compress the chest about 1.5 inches (about 4 centimeters). Count aloud as you pump in a fairly rapid rhythm. You should pump at a rate of 100 compressions a minute. Airway: Clear the airway After 30 compressions, gently tip the head back by lifting the chin with one hand and pushing down on the forehead with the other hand. In no more than 10 seconds, put your ear near the baby's mouth and check for breathing: Look for chest motion, listen for breath sounds, and feel for breath on your cheek and ear. Breathing: Breathe for the baby Cover the baby's mouth and nose with your mouth. Prepare to give two rescue breaths. Use the strength of your cheeks to deliver gentle puffs of air (instead of deep breaths from your lungs) to slowly breathe into the baby's mouth one time, taking one second for the breath. Watch to see if the baby's chest rises. If it does, give a second rescue breath. If the chest does not rise, repeat the head-tilt, chin-lift maneuver and then give the second breath. If the baby's chest still doesn't rise, examine the mouth to make sure no foreign material is inside. If an object is seen, sweep it out with your finger. If the airway seems blocked, perform first aid for a choking baby. Give two breaths after every 30 chest compressions. Perform CPR for about two minutes before calling for help unless someone else can make the call while you attend to the baby. Continue CPR until you see signs of life or until medical personnel arrive.

Hands-on with Mini's new AR goggles

 

Given that both heads up displays for our cars and smart glasses are emerging (if still niche) product categories, it’s not surprising that a company would try to combine the two into a single product. Earlier this week we had the opportunity to try out Mini’s new Augmented Vision, a set of driving goggles that brings some of the features of your standard heads-up display to a set of glasses, making for an interesting look at the future of both connected eyewear and connected vehicles. For now, Mini’s Augmented Vision googles are just a prototype, however the company plans to eventually bring something like what they’re showing off now to market. In their current form, the glasses are huge, and putting them on is a little more complicated than just putting them on your face. These specs actually have instructions: Once you get them on, you have to go through a bit of a calibration process, matching the output on the display with your own vision. For the purposes of the demo, that calibration was done by closing one eye, and then the other and matching a box on the projected display with one that was on a poster hanging on the wall. Setup took around three minutes, and afterwards all of the content from the glasses was displayed directly in front of me in my field of view. If you’ve tried out something like Google Glass before, then it’s a bit of a different experience. Content is physically in front of you comparable to a heads up display in your car, so you don’t have to change your focus in order to read what’s being projected (on Glass, the content hovers above and to the right of your field of vision). Once I had the glasses on, the gentleman helping with the demo showed me several posters on the wall. While looking at them, information popped up on the display about the event and its location. By tapping on a button on the top of the glasses we were able to select a particular event from its poster and have directions beamed to the glasses on how to get there. Directions include not only turn-by-turn driving directions, but walking details as well. Here's Mini's mockup of what that looks like: Inside the car, I connected the glasses to the Mini and took off on my virtual journey (the car was stationary and the road was projected in front of me). As I drove, arrows were projected on the road telling me where to turn, and my speed along with the posted speed limit was constantly displayed at the bottom of my field of view. As I drove past individual sites, they were pointed out on the glasses, as was a parking space when I finally arrived at the destination. A text message came in from a friend and I was able to see that it arrived and have it read to me from the glasses. For the most part, it was everything you might expect from your standard heads-up display, except on a set of glasses. The goggles take things a step further, though, with an X-ray view. Using cameras mounted on the outside of the vehicle, I was able to see a basketball dropped by a pedestrian through the passenger side door. It’s a pretty cool trick, but one that we think would definitely take some getting used to. We did notice that the prototype ran pretty hot. After 15 minutes of use I was a bit concerned with how warm the model I was wearing had gotten. After a few hours in the car these could very well be unwearable. For now, Mini’s googles are a bit more information than we would want in our field of view while driving. Sure, all that information is handy, but for us it was just a little too much. Yes, seeing through the passenger side door is cool, but while driving? It might be a little too much stimulation. We can see all the bells and whistles becoming more of a distraction than a safety feature. That said, they’re an exciting glimpse of a potential future, and perhaps something we’d become accustomed to over time. Could connected glassware be the future of car tech? Maybe. If nothing else, Mini has a interesting idea in the works. Here's a video look at what the company expects the experience to ultimately be like.

New heat-recovery system makes Stanford one of world’s most energy-efficient uni's

 

Stanford's heat-recovery system, or SESI, will cut greenhouse gas emissions by 68 percent and fossil fuel use cut by 65 percent Image Gallery (7 images) At Stanford University in California, it’s normally the Nobel-winning researchers who make the news. But with the commissioning of a novel renewable energy system, the campus’s humble heating and cooling system has grabbed some headlines. Using a first-of-its-kind heat recovery system, and drawing a substantial percentage of its electricity from solar, the university is greening up its operations in a move that will see greenhouse gas emissions cut by 68 percent and fossil fuel use cut by 65 percent. For a campus that’s more akin to a small city, comprising of 8,000 acres and over 1,000 buildings totaling more than 15 million square feet (1.39 million sq m), CO2 emissions can add up to a sizeable environmental impact of about 150,000 tons annually. The new system replaces what was once a state-of-the-art natural gas-powered cogeneration plant when it was commissioned in 1987, which heated buildings through a network of underground steam pipes, while cooling buildings with chilled water pipes. Buildings often require both heat and cooling simultaneously depending on the room temp needs (computer rooms and labs versus offices and classrooms). “Basically if you think of air conditioning or cooling not as the delivery of cold, but rather as the collection of heat, things become more clear,” said Joe Stagner, executive director at Stanford’s Sustainability and Energy Management office. After completing its route, the steam was then returned to the plant in the form of very hot water, known as condensate, along with chilled water which collected waste heat from the buildings. Once back at the plant, that excess heat was simply vented out into the atmosphere via evaporative cooling towers. But campus growth had pushed the old system to its limits, and intermittent failures forced the university to buy relatively expensive energy from the grid. At the same time, plant engineers noticed that heat being collected from the campus by the chilled water loop overlapped with heat being delivered to the campus by the steam loop, which occurred about 75 percent of the time. With that, the idea for the heat recovery system was born. As part of the new system, known as SESI (Stanford Energy Systems Innovations), heat that was previously discharged is now collected from the chilled water loop by a new heat recovery chiller that then moves it to a new hot water loop. The university replaced its steam pipes with 22 miles of hot water pipes, while retrofitting 155 buildings’ steam connections to hot water. "What SESI does is use electrically powered heat pumps to take that waste heat from the cooling system to make hot water for campus heating instead of wasting it, thereby greatly increasing efficiency," says Stagner. "And by using electricity to power this system instead of natural gas, we can use renewable power and not burn gas and create air pollution." Operated by patented software specifically designed for the system, SESI is claimed to be 70 percent more efficient than the previous cogeneration plant, while reducing heat loss that was an issue in the previous distribution system. It was also built with an additional 25 percent capacity, to cover the inevitable campus growth through 2050. And because steam will no longer be thrown away, the new system will save about 70 percent of the water used at the central plant, which translates into a 15-18 percent saving in the total amount of water used on campus. Another major green aspect of SESI is a 68-megawatt peak solar farm being built on 300 acres (121 hectares) in California, along with 5 megawatts of rooftop solar panels to be installed on campus, all of which will provide about 53 percent of Stanford’s electricity. The rest will be bought from California’s energy grid, of which about 25 percent is from renewable sources (and growing), meaning at least 65 percent of the university’s power will be green. "We know of no other system like this in the world, especially at this scale, with both hot and cold thermal energy storage, powered by clean electricity and run by newly invented 'model predictive control' software that continuously directs efficient system operations," says Stagner.   Source: Stanford University

Mais Evidências de que as Redes Sociais On-line Têm Efeitos Negativos

 

Um estudo com 50 mil pessoas na Itália conclui que as redes sociais têm um impacto negativo significativo sobre o bem-estar individual. As redes sociais on-line têm permeado nossas vidas, com consequências de longo alcance. Muitas pessoas a usam para estar próximo de amigos e familiares em partes distantes do mundo, para fazer conexões que levam suas carreiras para frente e para explorar e visualizar não só sua própria rede de amigos, mas nas redes de seus amigos, família e colegas. Mas há cada vez mais evidências de que o impacto das redes sociais não é só bom, nem mesmo só benigno. Uma série de estudos já começou a encontrar evidências de que as redes sociais podem ter efeitos prejudiciais. Esta questão é muito debatida, muitas vezes com resultados conflitantes e, geralmente, utilizando grupos limitados de indivíduos, como estudantes de graduação. Hoje, Fabio Sabatini na Universidade Sapienza de Roma, na Itália e Francesco Sarracino da STATEC de Luxemburgo tentaram isolar os fatores envolvidos nesta questão polêmica processando os dados obtidos através de uma pesquisa com cerca de 50.000 pessoas na Itália, feita ao longo de 2010 e 2014. A pesquisa mede especificamente o bem-estar subjetivo e também reúne informações detalhadas sobre a forma como cada pessoa usa a Internet. A pergunta que Sabatini e Sarracino tentam responder é se o uso de redes sociais reduz o bem-estar subjetivo e se sim, como. O banco de dados de Sabatini e Sarracino é chamado de "Estudo Genérico em Famílias", uma pesquisa feita em cerca de 24.000 famílias italianas, o que corresponde a 50.000 indivíduos, realizado pelo Instituto Nacional de Estatística italiano a cada ano. Eles usaram os dados coletados entre 2010 e 2014, o ponto mais importante sobre a pesquisa é a seu tamanho e representatividade a nível nacional (ao contrário de outros grupos limitados a alunos de graduação). O estudo pergunta especificamente "Quão satisfeito você está com sua vida, no geral, hoje em dia?", exigindo uma resposta entre extremamente insatisfeito (0) e extremamente satisfeitos (10). Isto fornece uma boa medida do bem-estar subjetivo. A pesquisa também faz outras perguntas detalhadas, como a forma como as pessoas se encontram com amigos e se eles acham que as pessoas são confiáveis. Também perguntou sobre o uso de redes sociais on-line como o Facebook e Twitter. Isso permitiu que Sabatini e Sarracino estudassem a correlação entre o bem-estar subjetivo e outros fatores da vida, especialmente o uso de redes sociais. Como estatísticos, eles foram especialmente cuidadosos em excluir correlações falsas que pudessem ser explicadas por fatores como viés e endogeneidade, onde um parâmetro aparentemente independente está, na verdade, relacionado a um fator não observado desprezado como erro. Eles descobriram, por exemplo, que as interações pessoais e a confiança que uma pessoa tem na outra estão fortemente correlacionadas com o bem-estar de uma forma positiva. Em outras palavras, se você tende a confiar mais nas pessoas e ter mais interações pessoais, você provavelmente dará uma nota melhor para o seu bem-estar. Mas, é claro, as interações em redes sociais on-line não são feitas pessoalmente e isso pode afetar a confiança que você tem nas pessoas on-line. É essa perda de confiança que pode afetar o bem-estar subjetivo em vez da própria interação on-line. Sabatini e Sarracino desafiam estatisticamente esse fato. "Nós encontramos que a rede social on-line desempenha um papel positivo no bem-estar subjetivo através do seu impacto sobre as interações físicas, ao passo que [o uso de] sites de redes sociais está associado a menor confiança social", dizem eles. "O efeito global da rede no bem-estar individual é significativamente negativo", concluem. Este é um resultado importante, pois é a primeira vez que o papel das redes on-line foi abordado em uma amostra tão grande e representativa e a nível nacional. Sabatini e Sarracino destacam especialmente o papel da discriminação e incitação ao ódio em mídias sociais que dizem ter um papel significativo na confiança e bem-estar. Melhor moderação poderia melhorar significativamente o bem-estar das pessoas que usam redes sociais, eles concluem.   arxiv.org/abs/1408.3550: Online Networks and Subjective Well-Being

Parents sound off on mobile device use by children

 

Smartphones and tablets have become part of everyday life, but parents still worry that mobile devices may not be the best thing for their children, according to a study to be presented Sunday, April 26 at the Pediatric Academic Societies (PAS) annual meeting in San Diego. The scientific literature has not kept pace with how technology is affecting family life. To help fill this gap, researchers conducted in-depth interviews with 35 parents/guardians to learn about their views regarding mobile device use by themselves and their children, including benefits, drawbacks and effects on family interactions. Researchers interviewed caregivers of children younger than 9 years old individually or in groups of two to five. Participants included mothers (63 percent), fathers (26 percent) and grandmothers (11 percent) with a mean age of 38 years. One-third were single parents, 43 percent were nonwhite and 40 percent had a high school education or less. Interviewers first asked standard questions about technology and parenting (e.g., what media-use rules parents had set, how mobile device use impacts child learning and behavior, and perceived risks and benefits). Follow-up questions further explored caregivers' statements, and discussion was encouraged among participants. Interviews were audiotaped and transcribed, and three researchers reviewed transcripts for major themes. "One of the striking things about these interviews was that parents thanked us for letting them take part ... for letting them vent their strong feelings and uncertainties about parenting and technology, and for letting them speak with other parents who were going through similar experiences," said lead author Jenny Radesky, MD, FAAP, assistant professor of pediatrics, Boston University School of Medicine, and developmental-behavioral pediatrician, Boston Medical Center. Results showed that caregivers had a high degree of tension regarding technology. Many reported feeling that they needed to buy their children tablets to keep up with educational system and workforce demands. Parents also worried about how strongly their children were drawn to mobile devices and gaming, with some saying their kids were "hooked" or "addicted." They also were concerned that time spent on screens would hurt their child's social skills. Other parents worried that reliance on technology would make their child less creative or less of an independent thinker. Many lower-income caregivers said it was difficult to stay on top of what apps or social media their children were using, and they did not feel confident in their ability to set limits on mobile device use. Parents did see some benefits of mobile media use, including the ability to teach things their child would not have tried in "real life" (e.g., putting together a puzzle). They also noted that apps are less expensive than toys, devices help keep children calm when parents are stressed, and video chat apps can be used to connect with distant family members. "Tech for young children is evolving faster than scientific research can study its effects, and this study helps pediatric providers understand the experience and concerns of a diverse group of parents, so that we can give them the most relevant, and hopefully helpful, guidance possible," Dr. Radesky concluded. Story Source: The above story is based on materials provided by American Academy of Pediatrics. Note: Materials may be edited for content and length.

Team develops faster, higher quality 3-D camera

 

Image of a 3-D camera (Camera brand not related to the story below) When Microsoft released the Kinect for Xbox in November 2010, it transformed the video game industry. The most inexpensive 3-D camera to date, the Kinect bypassed the need for joysticks and controllers by sensing the user's gestures, leading to a feeling of total immersion into the game. Microsoft sold 8 million Kinect units within 60 days, making it the fastest-selling electronic device ever. "But then something interesting happened," said Oliver Cossairt, assistant professor of electrical engineering and computer science at Northwestern University's McCormick School of Engineering. "Microsoft made the software available for the 3-D capture part of the device. People were able to integrate this inexpensive consumer device into a variety of platforms, including robotics and navigation." But users quickly discovered the Kinect's limitations. It does not work outdoors, and it produces relatively low-quality images. Now, Cossairt's team has picked up where the Kinect left off and developed a 3-D capture camera that is inexpensive, produces high-quality images, and works in all environments -- including outdoors. Supported by the Office of Naval Research and the US Department of Energy, the research is described in the paper "MC3D: Motion Contrast 3D Scanning," presented on April 24 at the IEEE International Conference on Computational Photography. Nathan Matsuda, a graduate student in Cossairt's lab, is first author, and Mohit Gupta from Columbia University is co-author and collaborator. Both first and second generation Kinect devices work by projecting light patterns that are then sensed and processed to estimate scene depth at each pixel on the sensor. Although these techniques work quickly, they are less precise than expensive single-point scanners, which use a laser to scan points across an entire scene or object. Cossairt's camera uses single-point scanning in a different way. Modeled after the human eye, it only scans parts of the scenes that have changed, making it much faster and higher quality. "If you send the same signal to your eye over and over, the neurons will actually stop firing," Cossairt said. "The neurons only fire if there is a change in your visual stimulus. We realized this principle could be really useful for a 3-D scanning system." Another problem that plagues the Kinect: it does not work well outside because the sunlight overpowers its projected light patterns. The laser on Cossairt's camera, however, can be sensed in the presence of the sun because it is much brighter than ambient light. "In order for a 3-D camera to be useful, it has to be something you can use in everyday, normal environments," Cossairt said. "Outdoors is a part of that, and that's something the Kinect cannot do, but our Motion Contrast 3-D scanner can." Cossairt believes his camera has many applications for devices in science and industry that rely on capturing the 3-D shapes of scenes "in the wild," such as in robotics, bioinformatics, augmented reality, and manufacturing automation. It could potentially also be used for navigation purposes, install on anything from a car to a motorized wheelchair. Cossairt's group received a Google Faculty Research Award to integrate their 3-D scanning technology onto an autonomous vehicle platform. Their scanner will provide high-quality 3-D scans in real time without only a fraction of the power of competing technologies. Story Source: The above story is based on materials provided by Northwestern University. Note: Materials may be edited for content and length.

Drinking just one or two alcoholic drinks a day linked to liver disease

 

Most studies assessing the prevalence of alcohol abuse as a risk factor for alcoholic cirrhosis focus on total annual amount drunk per person. However, the researchers highlight that clinical studies suggest that it is a high daily consumption which is the strongest predictor of alcoholic cirrhosis. This new research concluded that heavy daily drinkers most significantly and independently influence a country's cirrhosis burden. According to the World Health Organization's Global Status Report on Alcohol and Health, around 6% of global deaths are caused by drinking alcohol, the majority from alcoholic cirrhosis -- scarring of the liver as a result of continuous, long-term liver damage. Half of all cases of cirrhosis are caused by alcohol. The researchers analysed the WHO's Global Status Report on Alcohol and Health, which included parameters of alcohol consumption and drinking patterns from 193 countries. Reducing heavy drinking should therefore be considered as an important target for public health monitoring and policies. Story Source: The above story is based on materials provided by European Association for the Study of the Liver. Note: Materials may be edited for content and length.