Recently took a CPR class in Seattle. Not for any particular reason, just because it seemed like a handy skill to pick up for two hours time invested. I learned a few interesting bits of trivia.
--Seattle has the highest survival rate for heart stop events in the world at 56%. That's because of pioneering advances in EMT training, broad availability of AEDs, high percentage of people trained, etc.
--When I asked for a point of comparison, he said Detroit was 4%.
--AEDs don't actually bring you back to consciousness. They just make CPR more effective. (much more!)
--Bad CPR is much better than no CPR. So much so that high end AEDs will actually teach you CPR with voice prompts, since it's better than sitting there. Some 911 operators will coach you through it as well. Even if your CPR is rusty, it's worth trying.
--Modern CPR (for adults) no longer includes rescue breaths. Mouth-to-mouth was too much of a turnoff, and chest compressions alone are very effective given the response times of ambulances.
"When I asked for a point of comparison, he said Detroit was 4%."
The stats on Detroit emergency responders are utterly embarrassing. You pretty much can't count on police, fire or EMT even if you had a gunshot wound in a burning house and the shooter was still there.
So I'm guessing the issue in Detroit is less about technique and more about no access to trained responders.
*And to be clear, I'm not blaming the emergency responders in Detroit for the problem. The city is huge and spread out so it takes a long time to get to the scene, there's no funding for additional outposts or training, and the jobs are dangerous making them unattractive to people with other options, and there's a higher than average amount of serious crime and emergencies.
At it's height Detroit was a city of ~2 million people. As of the 2004(?) census, the city fell below 1 million (~800k?) and lost a lot of Federal funding, spawning the constant budget crisis; furthering the downward spiral.
"Seattle has the highest survival rate for heart stop events in the world at 56%. That's because of pioneering advances in EMT training, broad availability of AEDs, high percentage of people trained, etc."
Statistic is true, but to say it is because of those things would requite some further analysis. Given confounding factors I don't think you can make that claim.
Seattle has an obesity rate of 22.5%, compared with 35.7% nationwide, and 33.1% in Detroit. Obesity is a major risk factor for cardiac arrest.
Seattle is also extremely white for a large American city, 67.1%, versus a place like Detroit which is 82.7% African American. Black American's have significantly higher incidences of hypertension and cardiac disease than White Americans, both for reasons that seem to have some unrealiable relations to genetic heritage but more significantly due to social stressors related to racism and overrepresentation of poverty.
Speaking of economics, Seattle has a median household income of $45k, while Detroit has a median household income of $26k. Cardiac Arrest risk factors are greatly exacerbated in the United States by poverty.
I don't deny the importance of instituting up-to-date protocols for Emergency health personnel, broad equipment supply, and widespread lay education. But to give them all the credit is to ignore Seattle's many advantages, and Detroit's many other sufferings.
> AEDs don't actually bring you back to consciousness. They just make CPR more effective. (much more!)
Perhaps a trained medical professional will correct me, but I've worked closely with the technology for years and I don't believe this is accurate. An AED can indeed bring someone back to consciousness if the shock is successful. If it isn't successful, then it wouldn't affect the efficacy of CPR one way or the other.
Finished a 2-day first aid+CPR course today, the stat was that ~0.2% (or was it 0.02%) or people getting CPR have their heart start without a defib (AED or at the hospital) (also am a biomed engg researcher working on arteries but not the heart directly). CPR is bascially to keep the person somewhat oxygenated until they can get a defib (such as from an AED). A study found a 39% boost in likelyhood in surviving to being discharged from the hospital if AED+CPR was used compared to CPR alone [3]
An AED disrupts the fibrillation of the heart - often an outcome of a heart attack. Fibrillation is basically different parts of the heart firing randomly, with the effect that not much blood gets pumped. A defib (from AED or otherwise) is like a hard reboot of the heart, to try to reset the heart so it all contracts together again.
Consciousness is more to due with a neuro-state, which is affected by blood flow so its a symptom of the heart problem rather than the problem itself.
Also, as someone else mentioned, heart stopping /= death anymore, it is determined by brain activity [2]
This is correct. The only point of defibrillation (automatic or not) is to stop ventricular tachycardia or ventricular fibrillation (electric rhythms that don't cause effective heart contractions), and kick-start a sinusal (normal) rhythm.
If the cardiac arrest is the result of another mechanism, defibrillation is ineffective.
AEDs are smart enough not to shock unless they detect VF. This is important because defibrillating a normally beating heart could actually cause VF. Would-be rescuers may not always be trained well enough to tell the difference between cardiac arrest and something else, such as a seizure or fainting.
But to your specific question: If a patient is in cardiac arrest but not in VF, then this means his heart has completely stopped. Forcing defibrillation won't likely improve the situation, but nor can it make it much worse.
Where are come from(Poland) you have to learn how to do CPR as a part of your driving test - in case of an accident you are required by law to stop and help, so it's only logical that CPR skills are required to get a driving licence. So most people know how to do it, they had to learn it to be able to drive.
Same in Germany and possibly more countries in Europe. And here in Germany there are also special courses for giving first aid to children available to parents at low to no cost.
I've had CPR training here in the US four times now, and I think two of those times were free (Boy Scouts, school, and, I think, Red Cross, but I had to pay for scuba rescue diver.) There will be some exceptions, but almost anyone who would claim that cost is the reason for not doing it is someone who wouldn't bother even if it were free.
> --Modern CPR (for adults) no longer includes rescue breaths.
That's only for bystanders for the reason you cite (reluctance to give aid). Rescue breaths are helpful and those of us who have to respond for our employer still give them. I carry around a barrier mask all the time now.
Rescue breaths with CPR are also the standard for drowning victims, still. I believe it's still being taught as the standard for diving medicine, even volunteer/buddy rescues.
Exactly one, a healthy man who'd had no heart troubles (for those who want specifics, he had a "tension pneumothorax"), walked out of the hospital.
I was recently witness to exactly this situation. The father of a friend of mine, an otherwise healthy man in his late 50s, collapsed when his heart stopped due to what was later diagnosed as some heart rhythm problem (I'm not sure exactly the cause). A friend of the family performed CPR until the ambulance arrived (which took a while, this being a rural location).
Less than a week later he was back on his feet.
I'm not a medical professional, so I can't say for sure that he would have survived without CPR; but I don't doubt it was key to his survival.
Cardiocerebral Resuscitation (i.e., chest compressions only without artificial respiration): 6%
No bystander CPR: 2%
So attempting CPR results on average in doubling the survival rate as opposed to just waiting for an ambulance, and chest compressions only are 50% better than chest compressions plus mouth-to-mouth.
I heard somewhere that plain old CPR was very unlikely to help. Still probably better than nothing if someone is there with their heart not beating. Does this go along with your stats?
Plain old CPR by itself, with no ambulance on the way, is very unlikely to help. (That was another interesting tidbit - people almost never "wake up" while CPR is being administered).
Ambulance + plain old CPR, however, is much more effective than Ambulance + yelling "ITS GOING TO BE OK!" or playing Angry Birds or whatever. I don't remember the stats on effectiveness of performing CPR while waiting for the ambulance vs. not, but they were persuasive.
This also means that if you are in, say, a wilderness survival situation where help is not coming, CPR will not save a life, but it is still recommended that you perform it-- the emotional impact of just watching somebody die will be dangerous to the survivors.
My parents are GPs. They somewhat recently had an old man have a heartattack in their waiting room, and basically had to give him CPR + rescue breaths (via one of those squeeze bottle ventilators) for about 10 minutes before the ambulance arrived.
The hell of it was, it did work. The guy kept waking up from it while they were doing it, being very grumpy that people were pressing on his chest, and the moment they stopped he'd go unconscious again. Continued through the normal CPR and the ambulance's CPR apparently.
Unfortunately in the end he didn't make it (heart just would not restart fully).
I've been in a situation where we were administering CPR to someone who simply could not have been helped by CPR (although there was no way of us knowing that at the time). We were relieved by first responders in about 3 minutes from calling 911 though.
Plus, as others have said, it's also beneficial for the bystanders to be doing something beneficial. In my own situation, I didn't know for sure that CPR wouldn't have helped until the autopsy came back. That's a pretty big time frame to sit around and wonder if you could have done anything or not. If you're just a random person on the street, you may never get that information to ease your mind.
When I took a CPR class a few years back, we were told that the point of "Samaritan CPR" was really just to keep the person going until a first responder got there, but that the chances of survival past 5 or 10 minutes got increasingly low without actual medical attention.
"--Modern CPR (for adults) no longer includes rescue breaths. Mouth-to-mouth was too much of a turnoff, and chest compressions alone are very effective given the response times of ambulances."
I heard this years ago, and both times that I took CPR certification classes since then, we did mouth-to-mouth anyway. I guess different courses are different.
It depends on who teaches it. I believe the American Heart Association got rid of rescue breaths but the American Red Cross still trains for two breaths every 30 compressions.
Finished a two-evening first aid course with St Johns on Tuesday here in Australia. The CPR instruction for infants, children and adults alike all included a pattern of 30 compressions then two mouth-to-mouth breaths.
The child/adult numbers were coalesced to reduce confusion. You can also get away with no rescue breaths, not just because of the ick-factor others have mentioned, but because your compression of the chest is also compressing the lungs, providing enough airflow for the needs - and just as importantly, you haven't stopped compressing to deliver the breaths. Similarly, if you don't need to move to deliver the breaths, you don't need to find your correct compression spot on the chest again.
If you go read the abstract of the study cited, you should note that the mean age of the physicians interviewed was 68. I think hospitals do a lot of unnecessary CPR if the wishes of the patient are not known. If someone expires after a long illness or after a very difficult surgery there is little and less chance that perfunctory CPR will be helpful. There is a lot of difference for a relatively fit person who collapses on a treadmill. The odds are stacked against them but its not nearly so futile.
The study asked about "preferences of physician-participants for treatment given a scenario of irreversible brain injury without terminal illness", which is a very different scenario than randomly having a heart attack when you're 50 and otherwise in okay health.
Somewhat related, but I remember watching MC Hammer on Oprah.
Oprah was interviewing him about his bankruptcy, fall from grace, etc, and at one point, he said something to the effect of "Please, I don't want anyone to feel any sympathy towards me. Even after losing everything, my worst day is better than most people's best days. I'm still blessed."
It's really easy, especially in Silicon Valley, to fall into the "Poor Little Rich Boy" syndrome as well. I'm currently trying to buy a >$1M house in the Bay Area (very common), and have gotten outbid by $100k+ time and time again. One of my friends said "I heard you're having problems trying to get a house." My response, thinking exactly of that MC Hammer interview, was "Not having money to afford a place is a problem. Being in the position to be outbid on $1M houses is a really lucky."
I guess after reading the author's post, we in this industry should really feel blessed and know we're living a life that most people on this planet would think is a dream. It really puts things in perspective, and we hopefully shouldn't need a life-threatening event to come to this realization.
Totally agree. So many people would kill to be in the positions some of us are in to pursue opportunities, chase our dreams, and be able to participate in the current zeitgeist and contribute to the world.
If you can do that, you're already a success in my book.
I'm (only a little bit) sorry to be so pedantic, but I've grown weary of this modern misuse of death for hyperbolic effect.
You didn't die. You weren't dead and you aren't now resurrected. You experienced a very serious medical event, and you almost died, but didn't. Even metaphorically, you didn't die: you're still around. Robert Pirsig can claim that Phaedrus died; you cannot, because you're still here.
I don't know why this small untruth bothers me so, but it really does.
While I get the point you're trying to make, and even somewhat agree with it, there are two definitions of "death" in play. The problem isn't hyperbole; it's simply one of equivocating between them.
There's clinical death, which the author of TFA very likely did experience. If VF continues for anything longer than a few seconds, asystole frequently occurs. Among other things, asystole is definitive of "clinical death."
On the other hand, there's death death. This is the one where we bury you and mourn you and so-on.
Yes, they're very much not the same thing. Yes, the author is probably equivocating between them, at least a little. But no, his describing what he experienced as "death" is not hyperbolic — at least not according to the clinical definition.
This past week I was listening to a paranormal radio show where they discussed these different definitions.
They claimed in the early 1800's people would be brought into large rooms after they had passed, and were put on tables until the corpse was literally rotting before burying them. This had to do with cultural fears of being buried alive and having people who were supposedly "dead" waking back up in their coffins.
It was a rather long, but very interesting discussion. I'll try and find the podcast.
Historically, when someone died and was going to be buried at sea, they'd be sewn into a sailcloth "coffin", the last stitch of which would be through the nasal septum, just to make sure.
> If VF continues for anything longer than a few seconds, asystole frequently occurs. Among other things, asystole is definitive of "clinical death."
This isn't true. VFib can persist for a long time (at least 20 minutes, maybe more). Furthermore, defibrillators aren't applied to an asystole heart. Nor do practitioners typically continue working after clinical death has been declared.
"In medicine, asystole, colloquially known as flatline, is a state of no cardiac electrical activity, hence no contractions of the myocardium and no cardiac output or blood flow."[1]
vs
"Ventricular fibrillation (V-fib or VF) is a condition in which there is uncoordinated contraction of the cardiac muscle of the ventricles in the heart, making them quiver rather than contract properly."[2]
By definition, if vfib is occuring, asystole isn't.
I'm aware of what both mean, and that you can't be in both states. It's the highlighted words whose incompatibility I'm questioning. That VFib can last minutes in some cases doesn't mean that it doesn't quickly lead to asystole in others.
In fact, quoting from the linked Wikipedia article on VF, "If this arrhythmia continues for more than a few seconds, it will likely degenerate further into asystole ('flatline')."
The incorrectness in your claim was the use of the word "frequently". VFib does not "frequently" become asystole after a few seconds. It generally continues for several minutes. 2% of people who enter asystole ever recover; far more than 2% of people who enter vfib and stay there for more than "a few seconds" recover.
Wikipedia seems to be missing an "eventually" in the sentence you quoted. The arrhythmia can persist for several minutes, but if it persists for more than a few seconds it will likely eventually generate into asystole without medical intervention.
far more than 2% of people who enter vfib and stay there for more than "a few seconds" recover.
How many more? If it's less than, say, 60 or 70% or something, then I don't think "frequently" is terribly inapt. One-in-three is pretty damned frequent, when the one, you know, dies.
You're bickering a lot throughout this thread with people who have training and education. I was a certified EMT and have vetted these facts with my wife, who's a veterinarian.
This shouldn't be a long, drawn out battle. You said something that was incorrect--perhaps even dangerously so, since your misreading of Wikipedia could lead people to respond inappropriately in an emergency. Ventricular fibrillation is not a death sentence, but your claim made it out to be so, and needed to be corrected.
At this point I think the facts have been sufficiently cleared up and you're just being unnecessarily defensive and argumentative. Please stop.
What that means is that if VF doesn't correct itself, and is left alone, it will eventually degenerate into asystole - which is the whole point of CPR and defibs, to do something before it does that.
People have arrhythmias all the time and they autocorrect, but if a VF doesn't autocorrect in relatively short order, it will usually, eventually, end in death (or asystole). It's not about one rhythm versus another, it's about one rhythm leading to another, with no set timeline.
I quit my job yesterday. In the evening, I just walked out of my office and straight home. While at home, I did absolutely no work for my former employer. I was unemployed for more than twelve hours. Then this morning, I returned to work and am now employed again.
"If there is one lesson I took away from the experience it
is not to “live life to the fullest” or “have no regrets”.
It is to feel lucky. Feeling lucky means you are
appreciating the things in your life that sometimes go
unnoticed. It means you are achieving more than think
you deserve. Feeling lucky requires a certain humility
we often lose sight of."
I came somewhat close to death due to something that happened with my heart once. Probably not as close as the author of the article, but definitely close enough to make one re-examine a few things.
For me, in addition to feeling lucky and grateful, I'm kind of embarrassed to admit that it made me much less patient when dealing with unnecessary unpleasantries.
It's hard not to shout, "Really? I have to fill out this ridiculous form and then call so-and-so? Do you guys even KNOW how insanely short and fragile life is, and we're wasting it here talking about this ridiculous thing?"
I deal with the necessary unpleasantries a little better now than I did before. When one of the pets makes a mess on the floor, I can't say I really enjoy cleaning it up now - but I still have to think about how wonderful and lucky it is that the pet and I are both here.
I lost my dad last week to this exact same event. My parents live in the country, and my elderly mother didn't have the training (or lack of panic) to attempt CPR. Although members of the local volunteer fire department were on site within 7 minutes with an AED, I'm actually quite comforted in the knowledge that there never really was any hope for him. One of the few nice things about vfib is that it's quick and painless, and the grim survival statistics mean that there wasn't really anything that could have been done differently in my dad's case.
The most interesting part of that post ties with something that Richard Dawkins likes to remind us :
"We are going to die, and that makes us the lucky ones. Most people are never going to die because they are never going to be born. The potential people who could have been here in my place but who will in fact never see the light of day outnumber the sand grains of Arabia."
I think it's a religious belief to think splooge has lots of tiny people in it (and therefore one should refrain from pleasing oneself), but it's really just unicellular organisms (which I think may outnumber all the grains of sand on Earth).
He wasn't talking about homunculus, if that's what you mean, but I didn't imagine there could be confusion about what he meant.
It's basically like thinking about the kids that could have had if you had descendants with person A instead of person B. There's nobody around to be disappointed for not being born, but those who got be alive are "lucky" in a certain sense of the word.
The paramedics arrived and walked slowly down the length of the pool to the gym. This was procedure, they later told me, they didn't want to run and cause alarm.
You're likely talking a 10 second delay. A typical non-Olympic sized swimming pool is about 25 yards. At 3 mph, that's about 19 seconds. At 6 mph, it's about 9 seconds, at 12 mph, 5 seconds.
10 seconds may be the difference between life and death, but it's also only 10 seconds. You can pick up and lose 10 seconds quite easily. If they drove from 1 mile away, 10 seconds is the difference between 35 and 40 mph, or 60 and 70 mph. They could have saved 50 seconds if they drove 70 instead of 35; should they have?
10 seconds can be the difference between life and death, but sometimes it's not. In this case, the temporarily deceased waited an extra 10 seconds an came through it with no lasting damage at all. I'm hoping that someone, somewhere did the math on this, and determined that haste causes more problems -- either when an EMT trips and falls and injures himself, or when an EMT trips and falls and ends up taking twice as long to reach the injured person anyway, or when the EMT rushes to the injured patient and forgets the AED in the ambulance, or when the EMT administers the wrong treatment in his haste -- than it solves.
Granted, if my loved one died 10 seconds before the EMTs arrived, I might have some lingering anger, and if I died while watching EMTs slowly, nonchalantly walk towards me, my dying thought might be "Fuuuuuuuck yoooooooou EMTs", but from the perspective of a detached observer it makes perfect sense.
My normal walking pace is 2 miles/hour (and I don't think I'm slow). That's about 1 yard/second, so 25 seconds at a normal pace, and the article said 'slowly'.
I don't know if they're doing the right thing for the patient or not; just that that was the surprising info in the article, for me.
Huh. Maybe the discrepancy came out of going by the hour it takes to walk to somewhere 2 miles away in the city, with the taxicab metric plus occasional stoplights mattering more than I thought.
People who deal with emergencies professionally, and especially their non-expert political bosses and their lawyers, spend an inordinate amount of time worrying about panicked reactions by the general public, a phenomenon that is almost entirely fictional.
For the sake of 10 seconds, it is better to have a cool, collected paramedic arrive than a rushed and out of breath one. Keeping things calm and orderly rather than frantic is beneficial in an emergency situation.
At least with a pool, you'd want them to be careful. It is a slippery surface, and a fall could easily incapacitate an EMT, or destroy life-saving equipment.
Edit:
As for walking in general, it could also be because they wouldn't want a crowd to form which could obstruct them should they need to evacuate you more quickly.
We talked about this in a CPR class once. The biggest reason paramedics don't run is to avoid injury, which would obviously impede their ability to help.
That makes sense if the area around the pool is slippery. It's just that given the tremendous downside of risking the victim's life or brain damage, it seems that the paramedics wouldn't be risking much by hustling a little, rather than "walking slowly".
Unless it was really slippery, or if they thought someone was going to flip out to the point where it seriously interfered with the CPR, taking your time doesn't seem like the best thing to do for the victim.
To that I would add it gives them time to observe the scene and mentally begin work. It's not the same in seriousness, but when I was to solve an urgent IT problem I'd sit down, adjust the monitor, and roll up my sleeves before typing anything. And recently, when my baby son was falling down some stairs, I found myself calmly walking to the stairs and catching him right before he would have landed on his face. Looking back, I wondered why I didn't run since I love my son, but I realized that I might have slipped on the tile floor or dropped him in my haste.
What has happened to humans??? millions of years evolving to a truly miraculous level of efficiency and agility and we still don't think that possibly moving a little quickly to someone who's heart has stopped is a good idea? Since there were paramedics (plural) it wouldn't impede anything if they ran, and it would most certainly increase the chances of saving someone.
To me this is disgraceful, it sounds like OSHA got involved and made policy something that must surely be counter intuitive. Yes, I know the statistics of small risk- done often, but this is such a sad condition for our special to have reached when people carrying life saving equipment don't move a little faster to save someone.
There's a time to be an excited fool and leap blindly into action, and then there is a time be a professional and carefully move into place to do your work quietly and skillfully.
You wouldn't happen to use a staging server, would you?
This was probably the best point made against running, but still...
Our professional emergency response people should be capable of hustling/running over to the people that need their help while maintaining their composure and ability to think.
It is true that exertion causes a sympathetic response, but hustling/running over to someone doesn't produce such a significant sympathetic response where people can't think straight. I know that it's inherently a stressful situation, but our professionals should be able to handle that, and the additional stress of hustling/running over is negligible.
A professional attitude and good training doesn't counter basic biological processes. What do you gain from running? A few seconds, some of which you'll have to use up recovering from the run, and irrelevant bystanders thinking you're 'doing your job'. What do you lose by running? A lot - as described in the link, which has an excellent run-down.
These guys do this often. If they're running around they will eventually slip, and who knows what equipment they'll damage on the way down. Now he can't help and the problem is much worse than if it took him an extra 10 seconds to get over there.
If you infrequently enter a situation which has a low chance of hurting you, you are probably fine. But if you frequently enter those situations then it's just a matter of time before it happens to you.
If you as a paramedic rush to every patient, before long you're going to take a pointless injury and be unable to work. For the sake of saving one patient - the trivial amount of time saved by rushing rarely affects outcomes - getting injured means that while you recover, you can no longer attend dozens of other patients at all. Hardly 'miraculous efficiency'.
It might seem like common sense for the paramedic to rush. But in practice, rushing doesn't save lives.
Rule #1 in any first-responder situation is to keep the rescuer safe. There are tons and tons of examples where rushing led to mistakes that killed the rescuer AND the patient.
So don't be upset! Moving with caution is not an OSHA rule - it is best practice learned over decades of hard-earned experience.
Another reason paramedics are taught to walk around pools is simply to avoid slipping on wet floors. The additional speed isn't worth the increased risk of falling.
Poolside=wet surface; EMTs may not have been dishwashers in a previous life (where you learn the dishwasher shuffle for moving over wet surfaces). Doesn't surprise me they'd walk with care.
Yeah, that means that people's propensity to panic results in the victim having to lose more precious seconds, which could easily result in brain damage or something.
Svbtle never ceases to amaze me when I read an article. This was another example of a great article.
I think the author brings up a fabulous point; be grateful for everything you have.
It is so easy to get caught up in our lives and to envy others who have the newest this or the latest that. But to truly be grateful for what you have, material or otherwise, family, friends, doing things you love etc is so important.
We often don't realize how lucky we are to just be alive, in good health, surrounded by people who love us. As long as you have that, you are in my opinion among the few lucky people on earth.
Wow, if that would have happened to me, i dont think i could ever do serious workout anymore. Are you allowed to still do sports without any risks ? After all suffering sudden cardiac arrest is extremely rare, but in most cases there is some underlying condition which can cause it in very rare cases, like an unnormal sized heart.
I am 30 years old and generally pretty fit, but 2 months ago i fainted early in the morning. I was a bit sick, did work out the day before, had a really bad sleep with alot of sweating and felt totally devastated in the morning. Still (for whatever reason) i didnt drink anything and took my girlfriend to work and on the way back i was feeling extremely uncomfortable, got out of the car and blacked out.
I woke up seconds later realizing i had fallen onto the street and had blasting back pains...
Something like this happening was a total shock to me, i never had problems in this regard. Went to the hospital and a cardiologist and got everything checked and they said that all is totally fine, it was most probably a combination of dehydration+sickness+bad sleep etc.
But still, in the weeks after it i felt some strange anxiety and checked my pulse alot, which i have never done before. I am still nervous when working out even if i havent had any problems since then, but it still makes me feel uneasy for some reason.
Given that, if i would have suffered the same fate as this guy, i am sure i would have some serious anxiety issues.
Good story mate, inspiring that you are so uninspired by it!
This would have been just as interesting and clickworthy with a title like 'I had a massive heart attack at 21.' As it is, the story has nothing to do with the title at all.
The author experienced Clinical Death[1] and not permanent death. However, it's interesting now that we are close to singularity, death may be no longer death.
What does it mean to die if I upload your brain and make another process of yourself? Is death related to the body or losing consciousness?
Finally, dying is like sleeping. You are not around when you are dead. The author certainly got a shock from the things that happened to him and the thoughts of not existing any more and not experiencing death per se.
What does it mean to die if I upload your brain and make another process of yourself? Is death related to the body or losing consciousness?
Assuming that something we will retroactively refer to as singlulary ever occurs, and that we are close to singluarity, and that it ever takes a form which leads to some kind of ubiquitous 'upload' of a brain model that somehow acts and reacts as a brain in a skull in meatspace would (and all of these qualifiers are debatable,) you still die.
In the future the notion of what it means to be alive, and human, and dead, may be reinterpreted so that these models are considered to be, essentially, the same being as their original. But this redefinition would be semantics. Nothing frees you from the absolute and irrevocable nature of your death, in this or any other universe, ever. The post-singularity upload is still a copy, however good, and at this point the analogy of copying minds as software breaks down, because the mind isn't separate from the brain, and whether or not there's an entity on the wires which believes itself to be you, you are still no less dead.
Q: What is "you"? What does it mean to be self-aware? What is the "self"? Are we each a separate self-aware entity? Are we all just reincarnations of the same conciousness? If you build a sufficiently advanced simulation of a brain, will it be self-aware? Can you be reincarnated as a machine? Can we link two brains together in a way that results in a single conciousness? Do people who have had their left and right hemispheres separated have two "souls" now? If the universe ends in heat death and some spontaneous fluctuation causes a true vacuum to appear, inside of which a completely new universe is born, in which thinking beings emerge, can you be reincarnated as one of them? Do things ever end?
> In the future the notion of what it means to be alive, and human, and dead, may be reinterpreted so that these models are considered to be, essentially, the same being as their original.
You haven't considered that more likely, we'll become so augmented with additional abilities that the pure natural "you" will no longer feel like you even to yourself. You consciousness will outgrow your biological body even though it's rooted in it and at some point, "you" even to yourself will be mostly machine anyway so when the biology finally dies off, it will still be the original "you" left in the machine. Losing the biology will make it no less you than losing an arm.
> The post-singularity upload is still a copy
It simply won't be an upload, "you" will already be a cyborg mostly made of machine anyway.
If you're talking about some kind of Ship of Theseus scenario where the brain is gradually replaced bit by bit with something more permanent then... I don't know. I wouldn't argue that someone with an artificial arm is less than a full human so logically someone with an artificial brain should be just as human.
But then, the function of the arm is not to house the entirely of human consciousness, where that of the brain is. The arm isn't you, but the brain is you. To me, if you replace that, you might replicate the function but (as with the arm) it's still one thing replacing the other (and implying the first thing, being an arm, or a life, is no longer there.)
No, I'm saying the consciousness will actually outgrown the bounds of the brain so completely that when the brain itself finally dies you won't consider it anything more than a small appendage anyway. The brain isn't going to be replaced bit by bit, it's going to be subsumed into a much larger consciousness.
You seem to have this notion that the consciousness will be either in the brain or in the machine, I think that notion is fundamentally flawed, consciousness will expand to include every tool and sense available in both hardware and wetware, it cannot and will not be bound. Your sense of "self" is going to include every hardware upgrade you have; when you can Google with a thought, you will feel like part of you dies if that's turned off as it will quickly become part of your consciousness.
The sleep thing is a very bad argument on issues of death. I don't know about the rest of you, but I was always under the impression it's normal to drift in and out of various partial forms of consciousness immediately before, during, and after sleep. If dying was like sleeping, it would include the occasional moment of waking up to notice how comfortable your blanket is, roll over, and fall back adead.
What does it mean to die if I upload your brain and make another process of yourself? Is death related to the body or losing consciousness?
Well, that mostly depends on how you've defined "to die". I can easily imagine that the neo-Victorian Phyle will pass a law banning brain-copying after clinical death as an abomination, for instance. The thing about playing God is that you have to start writing your own rules.
I can certainly vouch for the suggestion that being grateful for the things you have (feeling lucky) is also a key component in my personal happiness quotient.
A more appropriate title would have been "What it's like to wake up after dying". Glad he's feeling great.
He's mainly lucky someone who know CPR was around soon after his cardiac failure. That's the main reason why he defied statistics and it stacked odds in his favor. Otherwise, more than 4 minutes before intervention and you're almost guaranteed to be dead or at least brain damaged.
I have a bit of a cruel streak, but I always joke about pretending the flames of hell are licking my soul as I die and scaring the bejeezus out of anyone who might be in earshot of my passing.
A few minutes with PubMed turns up no causal relationship. One study did find a sudden cardiac death odds ratio of ~2, but the dose response curve was flat suggesting lack of causality.
What state is this where a gym didn't have an AED? Also, where paramedics arrive onsite in 4.5 minutes. The intersection of those two states is a very small set.
the iphone app pulsepoint is worth mentioning here. its designed to alert people with cpr training when a cardiac arrest occurs near them. if more people use this app them more people should survive this type of accident
"Of those that do survive, more than half of them have brain damage."
I've read a theory that if as soon as someone as heart attack you put ice on his head you lower the risk of permanent brain damage. If I'm not mistaken there's been a doctor / hospital / ambulances allowing to test this theory in the U.S. (don't remember which one) and they had apparently statistically significant better results when ambulancers did immediately put the head in ice.
Our brain is one heck of a CPU and when the blood doesn't cool it it starts melting fast apparently : (
Lowering temp to 32 deg certainly helped but apparently every second counts: the faster you put the head in ice, the lower the brain damage. So while someone is trying to do CPR, someone else should go fetch lots of ice.
Interesting "feeling lucky to have a great life that I just want to continue to live".
--Seattle has the highest survival rate for heart stop events in the world at 56%. That's because of pioneering advances in EMT training, broad availability of AEDs, high percentage of people trained, etc.
--When I asked for a point of comparison, he said Detroit was 4%.
--AEDs don't actually bring you back to consciousness. They just make CPR more effective. (much more!)
--Bad CPR is much better than no CPR. So much so that high end AEDs will actually teach you CPR with voice prompts, since it's better than sitting there. Some 911 operators will coach you through it as well. Even if your CPR is rusty, it's worth trying.
--Modern CPR (for adults) no longer includes rescue breaths. Mouth-to-mouth was too much of a turnoff, and chest compressions alone are very effective given the response times of ambulances.
--And most importantly - $40 and two hours can save a life! You can set yourself up here: http://www.heart.org/HEARTORG/CPRAndECC/CPR_UCM_001118_SubHo...