Two ambulances parked outside the Casualty Department at the Kingston Public Hospital. - NORMAN GRINDLEY/DEPUTY CHIEF PHOTOGRAPHER
Dear Ms Thompson,
It may make very interesting reading if you looked up the DM anaesthesia thesis done in 1996 at UWI, Mona - "The
cardiopulmonary resuscitation experiences, attitudes and knowledge of doctors at six metropolitan hospitals in Jamaica".
Ten years on I do hope that a lot has changed since then, when the doctors in training and those doing the training had little experience or knowledge of what was to be done for these patients and facilities were hopelessly inadequate and often mismanaged.
There was a dire need for CPR training then; the junior trainees were begging for it to be taught. I hope this is no longer the case, but I think we need to start with the medical personnel and medical institution infrastructure first and stop trying to emulate the practices of more developed and affluent countries, where the medical personnel require a demonstration of this skill to maintain their licences to practice and facilities are abundant (even in shopping centres, as you suggested).
This study was done 10 years ago and a lot has changed since. The current 2006 European CPR advice suggests that chest compressions are far more beneficial than defibrillation or ventilation due to increased intra-thoracic pressure being able to maintain better coronary blood flow and thus improve outcome, hence the recent changes. It is also cheaper, needing only good technique and requiring no equipment. It also avoids the social stigma associated with mouth-to-mouth respiration and infections. The populations as related to cardiac arrests may be different but the management remains the same.
The quotes at the beginning of the thesis make interesting reading and the recommendations at the end of the thesis put forward in simple language what is or was wrong and what was needed to rectify the major problems. This would be more beneficial than trying again to import and implement haphazard, expensive, disjointed and confusing programmes without the basic core infrastructure being in place.
It would make a mockery of the medical system if the public were able to resuscitate a patient only for the medical teams to be shown as being incapable of further basic management, something I suspect the legal fraternity would find very entertaining and profitable.
Dr. A. Spence
United Kingdom
Dear Ms. Thompson,
I must applaud you on the accuracy and information regarding CPR given in your article on February 15. However, I must point out that the Heart Foundation is not the only organisation that has been providing
the necessary training in the wider community. The Jamaica Red Cross has also been providing internationally-recognised training for many years. I am only sorry that we were not included in your promo!
Keep up the good work!
Kimberly Carraha,
Director,
Kingston and St. Andrew Branch, Jamaica Red Cross
Dear Ms Thompson,
I was impressed by your article on the Heart Foundation of Jamaica. I resided in the U.K. for a number of years and was involved in first aid especially with regards to heart attack and victims of shock -- electric or otherwise. I have had first hand experience of heart attack; my wife suffered one in 2003 and had to have major heart surgery and bypass. I would be willing to participate in my small way with the Foundation.
A. Francis.
Send questions and comments to our health specialists at Your Health, c/o The Gleaner, 7 North Street, Kingston; email: yourhealth@gleanerjm.com. Unless otherwise indicated, letters and the specialists' responses are usually published.
