Hands only cardiac resuscitation with chest compression replaced cardiopulmonary resuscitation with artificial respiration along with chest compression as the preferred method for laypersons in 2010. Studies showed a better outcome for patients with an unwitnessed cardiac event outside a medical setting treated with compression only until medical help arrived. Several possible explanations have been offered for this. Notably, people trained in this method are more likely to help, perhaps because the requirement for mouth-to-mouth resuscitation has been dropped.
Earlier this month I showed a kit I carried for use with CPR back in the “old days.” Life can be funny. Unexpected opportunities can pop up in unusual ways when one is open to receiving them. Some of you who read here know that I spend an hour a day, six days a week at the PHS Healthplex. I do this not to live longer, but to live better while I am alive. Just in being there, I was aware that Erin, one of the Exercise Specialists, did cardiac resuscitation testing for some of the EMT’s in town. I gave her a copy of that blog post, just for the sake of history of medicine.
Erin told me that the next week she was teaching the first class for people in the community who belonged to the Healthplex. I was very interested in learning how this worked. So, last week I took this class.
First, thanks to Erin, and to Nick, another Exercise Specialist, who team taught this class. They made it fun, and they made sure every person got individual attention during the hands-on portion o the class.
Images from the Class
Every two people in the class had a MiniAnne on which to practice. I thought MiniAnne was pretty creepy looking, and I was glad mouth-to-mouth was not required in this class. 😉
MiniAnneMiniAnne Training Model for Cardiac ResuscitationBack Side of MiniAnne Training Model for Cardiac Resuscitation
The model was less creepy when we came to the hands-on training. Each model “clicks” when the compressions are firm enough. It took some practice to get that feel. Erin and Nick came by to make sure everyone in the class “got it.”
Just for fun: the rate of compressions is 100 per minute. We were encouraged to let the song “Stayin’Alive” run through our heads. So, here is a reminder of the song. 🙂
You never know when someone might need help. The class was fun. Check around and see if a class is available in your area. You’ll be glad you did.
Sunrise with Appearance and Disappearance of Crepuscular Rays
Crepuscular rays are a fairly common occurrence at sunrise (especially) and sunset here in Albuquerque. Sometimes I wonder if they happen even more frequently than I realize. The vivid colors of sunrise are brief, but these “fingers of God” rays are even briefer. The images in this gif are from 6:35:50-6:37:33.
Watch the Appearance and Disappearance of Crepuscular Rays in this Fiery Sunrise
This image is from 6:35:32, and shows the layer of clouds over the Sandias, most of which never developed vivid colors (sometimes the whole sky lights up). I do not see distinct rays in this image. They began to appear in less than 30 seconds. I just happened to be out, hoping for a colorful sunrise.
Sunrise at 6:35:32
All images in this post are jpgs, with cropping only. Yes, sunrises here really can be that colorful. I was glad I was up to catch this one. I hope you enjoy the gif.
Quote for the day:
“Serenity is when you get above all this, when it doesn’t matter what they think, say or want, but when you do as you are, and see God and Devil as one.”
~ Henry Miller
Signs of spring are popping up and out everywhere. Here in the high desert, we could still experience winter, of course. But the days that speak of Spring are so glorious. I like the Ernest Hemingway quote:
“When spring came, even the false spring, there were no problems except where to be happiest.”
This may be false spring, or, given climate change, may be the beginning of real spring. I’m going to enjoy these early signs.
The bright little crocus are one of the earliest, easily spotted, harbingers of Spring.
Crocus – One of the Signs of Spring
But, there are numerous, though subtle, signs that Spring is on the way.
Rose ‘Buffalo Gal,” a hybrid rugosa, beginning to leaf out.
Rose ‘Buffalo Gal’ Just Beginning to Leaf Out
This developing birch catkin says, “Spring is on the way.”
Developing Birch Catkin
Rosemary is known for the flavor it adds to food more than delicate blue flowers, but the flowers are pretty.
Tiny Bloom on Rosemary. Better Known for Flavorful Addition to Foods.
A dwarf peach, “Bonanza,” is one of my favorite specimen plants. I was surprised to see this little bud beginning to show just a touch a color. It really is too early, but it does speak to the hope of Spring.
Peach Bud Just Barely Showing Color
I hope you are enjoying beautiful weather wherever you are.
“Albuquerque Winter” may make some people laugh. Although we do see flashes of it here in town, they usually are neither long nor severe. The State of New Mexico depends on mountain snowpack for water.
The end of last week and Saturday saw spring-like temperatures, and sunny, brilliant days. Sunday morning’s wind hinted at change to come. Compare Sunday’s sunrise to that of Saturday’s (in the prior post). In addition to the clouds blowing along in the sky, note the cloud bank rolling over the top of the Sandias.
A Stormy and Windy Sunrise in Albuquerque
As the sun set Sunday night, the winds increased, and rain fell briefly. Within a matter of minutes, the rain turned to snow. Thankfully, the winds died down. I awoke this morning to a beautiful, soft snow.
Birch Tree with Snow
The snow is already melting, and the streets are clear. However, more snow is due tonight into tomorrow. We do need the moisture, and if it does not last too long, it will just be part of a typical Albuquerque winter.
Although this one was soft and gentle, I nevertheless thought of the words of D. H. Lawrence:
I think New Mexico was the greatest experience from the outside world that I have ever had. It certainly changed me forever. . . . the moment I saw the brilliant, proud morning shine high up over the deserts of Santa Fe, something stood still in my soul, and I started to attend. . . . In the magnificent fierce morning of New Mexico one sprang awake, a new part of the soul woke up suddenly and the old world gave way to a new.
There are all kinds of beauty in the world, thank God, though ugliness is homogeneous. . . . But for a greatness of beauty I have never experienced anything like New Mexico.
People either love or hate the desert. No in-between exists. From the time I was a child, passing through on family vacations, I knew at some level my soul resided in the Southwest. New Mexico has many economic problems, but no state can match it for sheer natural beauty, day in and day out.
Most of the sky images I show here are from my backyard. This one, however, is from my front porch The best show was to the northeast, rather than east. I was happy I looked. 🙂
Urban Cooper’s hawk, here in Albuquerque, New Mexico, was hanging out in a pine tree, waiting for dinner to appear. This is an adult, as opposed to the one in the header image. My neighbors and I have seen this hawk a lot in the past month. Such a hawk is easy to spot when it is flying, or when it lands near a bird feeder. The so-called urban forests of the Northeast Heights of Albuquerque provide easy cover into which they are well camouflaged, however.
I took this photo two minutes into the Super Bowl. When photographic opportunities appear… (Not much was happening in the first two minutes of Super Bowl 🙂 )
The Urban Cooper’s Hawk, Waiting for Dinner to Appear
Last year I briefly saw a fledgling in the yard. I would enjoy seeing more in the yard this year.
An Old CPR kit that I encountered while decluttering the house brought back a lot of memories. Cardiopulmonary resuscitation that consists of both chest compressions and artificial respiration is still the gold standard. However, around 2010, laypersons began receiving training in compression-only (hands-only or cardiocerebral resuscitation) CPR. This change came for several reasons. Studies showed that bystanders were more likely to assist if they did not have to do the artificial respiration part of CPR. Studies also showed that laypersons could achieve equal or better results with this than when both compressions and artificial respirations were attempted.
As a practicing physician I maintained certification in CPR as well as Advanced Cardiac Life Support. Since retiring, however, I had not given this a lot of thought. This week I came across a couple of these old CPR kits, which I kept on a key chain and in the dashboard of my car. These kits came into being after the beginning recognition of the AIDS epidemic. The purpose is to give some protection against exchange of body fluids in an outpatient setting.
Small Kit to Carry on Keychain or Keep in Dashboard of Car
When opened, the kit contains instructions for use of the covering for the mouth and how to place it; the mask itself with the short tube for artificial breathing; two alcohol wipes; and two pairs of gloves, large and medium.
I did not have one of these kits the first time I had to perform CPR “for real.” I was a resident with a one week vacation. My family and I went to the Grand Canyon. I had worked as a Ranger-Naturalist there for three summers more than a decade before. One thing I really wanted to do was drive out to the East Rim for sunrise at the Watchtower. As can happen with families, we were not all ready in time. So we drove to a point, close to where we were staying on the South Rim. The point was crowded. As soon as I headed for the point itself, one of the bus drivers was coming up the trail, asking Ïs there a doctor?” Ïs there a doctor?” I paused for about 30 seconds, waiting for a young male doctor to come running, Ï’m a doctor. I’m a doctor!” No one responded. I followed the bus driver. An elderly man was down, and a woman was checking for a pulse. She did not find a pulse. She was German and spoke little English, but was also a doctor. I spoke little German, but we both spoke “medicine.” Neither of us felt a pulse, and we began CPR. Even at the time I was amazed at how smoothly we worked together, trading spots when the one breathing tired. (Elevation at the South Rim is 7,000 feet above sea level.) We were an efficient team.
There were a lot of people standing around, but they all stood back and out of the way. At one point, someone handed me a clean handkerchief to place between the mouth of the man and my own. I always appreciated that.
Getting Help
My then-husband drove into Grand Canyon Village to try to rouse the Rangers. He ended up breaking a window to get in to use the call system (he had been a park Ranger at the time I had been a Ranger-Naturalist). I did not know until later how difficult it was to rouse help that morning. It took 45 minutes for help to arrive from the time the German doctor and I started CPR. Once you start, you cannot stop CPR until help arrives.
Help finally did arrive, and with it, a kit for intubation and an ambubag for ventilation. The German doctor reached for it, and the Park Service would not give it to her. I said, “we’re doctors.” That did not matter, the kit sat on the ground for about 2-5 minutes until the voice of a young male could be heard, Ï’m a doctor! I’m a doctor!” The Park Service allowed him to intubate the man, an ambulance arrived, and he rode with the man to the hospital. The woman German doctor and I just looked at each other. We were tired after 45 minutes of CPR at 7,000 feet.
How the Story Ended
As the EMTs were taking the man to the ambulance, his wife, who had been there all the time, came up and thanked us. They were from England, and he had had two prior heart attacks at sea level. He had left his nitroglycerin in the hotel room that morning. (I do not believe that would have made much difference, though.) I was very glad that the German doctor and I had been able to keep him pink for all that time, with his wife watching. At that point, that day, I believed the value of that CPR was a woman knowing that even though she was not in her own country, people helped when help was needed.
Chances for a good outcome for an unwitnessed third heart attack outside of a hospital setting are low. He was transported to the small local Grand Canyon Hospital and formally coded for 30 minutes, and then pronounced dead.
My personal belief is that feeling well enough after two prior heart attacks to undertake major travel, and then dying suddenly at sunrise at the Grand Canyon is not necessarily a bad way to go. Given any options, I might choose it for myself.
His wife is a different story. That is where my sympathy lies. I’m sure she had a lot of red tape and paperwork to get through before returning home with her husband’s body, to be with family and friends. To this day, I consider the gift of CPR to the wife from two unknown women doctors from different countries to be one of my finer moments in medicine.
After that experience, I obtained what is now an old CPR kit (and others through the years). I had one with me at all times, and each room in the office had one, although we also had ambubags in each room. Finding this old CPR kit certainly brought back some vivid memories, only one of which I have shared here. I probably won’t share more memories dredged up by an old CPR kit. However, I am finding other medical artifacts as I attempt to declutter the house, and I imagine I will have other stories. I also will probably obtain a new CPR kit to keep with me, in place of this old CPR kit!
To my regular readers, thank you for your patience! 🙂
Pomegranates: fruit of myths; regular readers here – thank you! – are familiar with the myth of Persephone. Enjoyable for eating today, they are also wonderful photographic subjects.
Pomegranates: Fruit of Myths
Some quotes:
“And the pomegranates, like memories, are bittersweet as we huddle together, remembering just how good life used to be”
Author: Guadalupe Garcia McCall
“So where does the name Adam’s apple come from? Most people say that it is from the notion that this bump was caused by the forbidden fruit getting stuck in the throat of Adam in the Garden of Eden. There is a problem with this theory because some Hebrew scholars believe that the forbidden fruit was the pomegranate. The Koran claims that the forbidden fruit was a banana. So take your pick—Adam’s apple, Adam’s pomegranate, Adam’s banana. Eve clearly chewed before swallowing.”
Author: Mark Leyner
The pomegranate as a fruit and in myths and religion has a very long history throughout the world. With this image, I wanted to create a “feel” for its Middle Eastern origins as well as a sense of age.
A Note About Photography
As this is a photography blog, I want to mention something all serious photographers know well. That is, cameras do not create images, people do. The camera is but one tool for the creation of photographic images. When I hear, Öh, but so-and-so has a good camera,” I am reminded of an old joke loved by photographers.
A photographer is invited to dinner. During dinner the hostess says, “You do beautiful photography. You must have a great camera.” To which the photographer replies, “The dinner was delicious. You must have a great stove.”
Serious photographers do something with their images daily, most of which are never seen by the world. They learn something each day, be it about their camera, other equipment, or themselves. This affects every image created, going forward.
Life issues have temporarily decreased my blogging time, but not daily photography of some sort. Many thanks to everyone who continues to check in here periodically.
Sunset, snow, mountains: compare this sunset over the Sandia Mountains less than 36 hours after the very fiery sunrise in the previous post.
Sunset over the Snow Capped Sandia Mountains (Looking East)
Late afternoon was cold and very windy. But the image appears calm – at least to me – compared to the fiery sunrise. The weather that morning was relatively calm (on the ground) and warm. I also watched this one as it developed, and had my camera and coat ready. I felt cold only when I was back in the house. This view, like most of those shown here, is from my back yard. 5:30pm. I see an old man with a Pinocchio nose in the cloud. Do you?
I rarely show photographs from the front yard, because the view is of a street of houses, driveways, and parked vehicles. Every now and then, though, I have to try because something special cannot be ignored. This is the same sunset looking east to the Sandias at sunset. This is toward the north end of the Sandias, with the collection of towers. 5:29pm.
Sunset over the North End Sandia Mountains, Towers in View
This week is one of wind, along with cold compared to the winter we had had so far. But, I am not complaining, because the weather has brought the kind of sunrises and sunsets I love.
This is the kind of sunrise photographers anticipate, wait for, and photograph quickly when it does materialize because sunrises like this will not last long. I stood, looking out, with camera on hand and set for my usual sunrise settings, for about 15 minutes. When the color appeared, I started photographing at 7:02am. I stopped at 7:10am. This image is from 7:07am.
More stormy weather is on the way, and it is already windy. But the sunrise was worth being up for. 🙂
