Hands-only CPR (CPR without mouth-to-mouth resuscitation), may not be the best method for rural or remote areas or for anyone who has to wait more than a few minutes for an ambulance, a new study suggests.

New guidelines released by the American Heart Association in 2010 permit the use of simpler hand-only or compression-only CPR in some cases instead of conventional CPR. If ambulances come quickly, experts believe that instructing people to just “push hard, push fast” saves more lives.

But a literature review by Dr. Aaron Orkin found little evidence to support those guidelines outside of urban settings or in communities with no 911 services. His findings were published in the Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine.

Of the 10 studies on saving lives with hands-only CPR he reviewed, only one included rural populations and people who had to wait longer than 15 minutes for an ambulance. Some of those studies showed that people who waited longer for ambulances to arrive had a better chance of surviving if mouth-to-mouth breathing was performed as well as chest compressions.

“Urban studies can’t always be applied outside big cities,” said Dr. Orkin, a physician and graduate student affiliated with the University of Toronto, the Northern Ontario School of Medicine and Rescu, a St. Michael’s Hospital research team dedicated to improving out-of-hospital resuscitation.

“Rural communities might need different CPR recommendations to urban settings,” he said.

Dr. Orkin said the study suggests that “push hard, push fast” might be better refined to “push hard, push fast, if you’re downtown.”

One in five Canadians and nearly half of the world’s population live in rural areas. Even in the most developed and densely populated cities, people can wait longer than 10 or 15 minutes for ambulance services. “If someone is unresponsive, doing any kind of CPR is clearly better than doing nothing,” said Dr. Orkin. “But shouldn’t CPR guidelines serve everybody, not just people who live a few minutes from an ambulance dispatch station or hospital?”

About St. Michael’s Hospital

St. Michael’s Hospital provides compassionate care to all who enter its doors. The hospital also provides outstanding medical education to future health care professionals in more than 23 academic disciplines. Critical care and trauma, heart disease, neurosurgery, diabetes, cancer care, and care of the homeless are among the Hospital’s recognized areas of expertise. Through the Keenan Research Centre and the Li Ka Shing International Healthcare Education Center, which make up the Li Ka Shing Knowledge Institute, research and education at St. Michael’s Hospital are recognized and make an impact around the world. Founded in 1892, the hospital is fully affiliated with the University of Toronto.

This spring, medical students from the Northern Ontario School of Medicine (NOSM) will continue their outreach program through the Ontario Medical Association (OMA). The program, calledAltitude: Health-Care Mentoring, is aimed at encouraging students in their final year of secondary school to seriously consider a career in the field of health care.

“The first year of our program was a success. We provided them with unique networking opportunities with professionals to encourage their passion for a career in health care,” explained Kayla Berst, second-year MD student and Outreach Coordinator for the Thunder Bay Altitude team. “It is an amazing experience to go into a local secondary school and talk to young, passionate students about what it takes to have a career as a doctor, nurse, or physical therapist.”

“In addition to outreach in local schools, we are also running Altitude@ sessions for university students at all levels who have interest in the health-care field,” said Mélanie Patrie, second-year MD student and Site Coordinator for the Sudbury Altitude team. “Altitude Mentoring was a huge success this year, and we look forward to even greater developments next year.”

The Thunder Bay Altitude team includes first-year MD student Jessica Nairn and second-year MD students Hillary Bohler, Valerie Nicholls, Stacey Tokar, Paul Benvenuto, Michelle McLean, Anthony Valente, Alanna May, and Savanna Webb. The Sudbury Altitude Outreach Program includes first-year MD students Zsolt Toth, Kaitlin Sheridan, Katrina Hickey, Heather Smith, Robyn Rodger, Nick Fortino, and Rose Michael, as well as second-year MD students Jessica Chan and Sabrina Badio.

Dr. Roger Strasser, NOSM Dean, applauds the efforts undertaken by NOSM’s medical students for embarking upon this important initiative. “By taking the time to speak to secondary students in Northern communities, our learners highlight their incredible sense of commitment to improving the health of people in Northern Ontario. It speaks to their willingness to give back, and the kind of physicians they will be in the future.”

The Thunder Bay and Sudbury Altitude Team Outreach teams are currently accepting applications for the 2013-2014 school year. Students interested in a career in health care are encouraged to apply at:http://altitudementoring.ca/ . Applications are due June 1, 2013.

Balance, Expertise, and Range of Perspectives are  Key to Effective Governance

Using a combination of video- and tele-conference connectivity across Northern Ontario, the Northern Ontario School of Medicine (NOSM) held a regular meeting of the Board of Directors on Wednesday, March 20, 2013.

After presentations by the Board’s Governance Review Working Group, Directors of the Board voted to accept recommendations made to modify the size and composition of NOSM’s Board.  Comprised of 19 Directors, the new structure will give priority to the recruitment of different skills, expertise and experience of Board members, while still reflecting the geographic and demographic diversity of Northeastern and Northwestern Ontario, including Aboriginal, Francophone and rural and remote communities. 

Guidelines, which were developed by the Governance Committee in consultation with Board members and key stakeholders, recommend that Directors should be drawn widely to achieve a balance of skills and expertise needed for the Board to fulfill its governance roles and responsibilities.   In particular, the Board will look to recruit members with academic, governance, financial, health care, and external relations experience.  In addition,it is recommended that, subject to exceptional circumstances, all Directors should be residents of Northern Ontario. 

The modified Board size will take effect in September 2013, with an ongoing commitment to recruit members representing a range of perspectives who also bring different skill sets over time. 

The Directors received reports from several Board Committees, including the Finance and Audit, Quality Monitoring, Executive, and Advancement Committees.

The Directors also reviewed the Financial Report for the period ending January 31, 2013.

The next meeting of the Board of Directors is the Annual Board Face-to-Face Meeting scheduled for May 9-10, 2013 in Fort Frances, Ontario.

For a complete list of Board members, please visit our website at www.nosm.ca.

Contact:

news@nosm.ca