If you have ever visited Europe, then you may recall that most of the foods produced and sold there are generally far less sweet than foods produced and sold in the U.S. And yet, despite this difference, Van der Velpen still sees a major public health epidemic brewing in his country as a result of sugar consumption — how much worse must the situation be here in the U.S., where public health officials generally avoid tagging sugar as a major factor in declining public health?
“Sugar is actually a form of addiction,” adds Van der Velpen. “It’s just as hard to get rid of the urge for sweet foods as of smoking. Thereby diets only work temporarily. Addiction therapy is better … Health insurers should have to finance addiction therapy for their obese clients.”
It is important to note that Amsterdam has long tolerated the presence and use of other typically restricted substances such as cannabis, a plant that government authorities the world over have long referred to as a “drug,” within its borders. Cannabis, of course, does not harm the body and is not a public health threat, thus Amsterdam’s relaxed approach to its availability within the city. Sugar, on the other hand, is an actual threat, and Van der Velpen hopes others will learn this truth and take action.
In this meta-analysis, return of spontaneous circulation was more likely when chest compressions were delivered by a mechanical device than manually.
When applied properly, mechanical devices provide consistent and effective chest compressions; no risk for provider fatigue; and the opportunity for concurrent defibrillation, thereby reducing time to shock. Investigators performed a meta-analysis of controlled (randomized, historical, or case-control) trials in humans to compare prehospital cardiopulmonary resuscitation (CPR) using a mechanical chest compression device versus manual compressions.
Of 12 studies meeting entry criteria, 8 involved load-distributing band CPR and 4 used piston-driven CPR, with a total of 6538 patients and 1824 instances of return of spontaneous circulation (ROSC). ROSC was defined as a measurable blood pressure sustained for at least 1 minute. Use of a mechanical device was superior to manual compressions for achieving ROSC (odds ratio, 1.53 overall, 1.62 for load-distributing band CPR, and 1.25 for piston-driven CPR).
Comment: Compression devices have become more lightweight and portable, making them a more attractive option for prehospital resuscitation, where it may be more difficult to achieve consistently adequate manual compressions. Such devices can be expected to similarly outperform humans in the emergency department and hospital settings, too, making a convincing argument for their routine use during resuscitation.
Source: Journal Watch Emergency Medicine