The Chain of Survival ~ KNOW YOUR BODY with DR. FRANK MACMILLAN

By: Dr. Frank MacMillan – May, 2016

I’m like many of you. I never liked to do my homework as a kid. When my mother asked my elementary school teacher why my younger brother had so much more homework than I did, the teacher answered that I rarely did it, and when I did, it was seldom turned it in on time. My work habits have improved since then, but I have never been a fan of homework.

Isn’t it ironic then that my chosen career requires constant attention to continuous learning? I was thinking of this as I maintain my certifications and boards, renew licenses and DEA registrations, and how there is no forgiveness for not keeping up. With that background and the need to constantly update my professional credentials, I have been doing my every two year recertification on my American Heart Association’s Basic Life Support and Advanced Cardiac Life Support on-line over the past few weekends. What these courses teach is how to do chest compressions properly, rescue a collapsed or obstructed airway, and how to administer drugs and electric shocks to restart the heart when there is a cardiac or respiratory arrest. Not every physician is required to maintain certification in these skills, but I have always thought of these skills as being core to what I am as I present myself to the public as a medical doctor. These same skills are also taught to nurses, paramedics and EMTs. First responders including police, fire fighters, teachers, and coaches can, and many are trained and certified to do basic life support, also known as CPR (cardio-pulmonary resuscitation).

It saves lives!

The American Heart Association certifies and sponsors much of the training, and it is high quality, evidence-based, and regularly updated to reflect real world experience and best practices. That is one of the important reasons that certification needs to be continuously updated. As I went through the exercises, it reinforced to me that high quality immediate bystander CPR and improved availability of automated defibrillators (devices that deliver electric shocks commonly called AEDs) have dramatically increased the likelihood of successful resuscitation and survival in the event of a witnessed cardiac arrest. There is an old saying that “time equals myocardium”, or more simply that you can save a dying heart by restoring circulation quickly with CPR and rapid defibrillation.

It has been shown in cities such as Seattle, where CPR training has been widely offered to the public, that the likelihood of meaningful survival after out-of-hospital cardiac arrest is measurably improved. There are few warning signs of cardiac arrest in many circumstances, and most people fail to recognize their own symptoms. The point I want to make is that sudden cardiac arrest can occur without warning and that timely action can make a big difference.
AED devices (automated external defibrillators) are becoming less expensive and more widely available. The use of these devices and CPR skills are easily taught to most people. I’d like to make a case for teaching these skills as a part of existing public middle and high school physical education programs, so that the whole population benefits from young citizens being skilled and able to save lives at a moment’s notice. This knowledge and skill not only potentially saves older people, but also children drowning in swimming pools, anyone choking on food, the high school athlete with a sudden arrest, our neighbor, family or friend. There is a real opportunity to act in those initial precious few minutes before the first responders arrive with advanced equipment. The foundation of successful advanced life support is early high quality CPR which almost anyone can learn. It could potentially make a big difference in the chain of survival.

Dr. MacMillan specializes in Gastroenterology and Liver disease and is a member of the North Andover Board of Health. Dr Macmillan is an Officer and Vice Speaker of the House of Delegates at the Massachusetts Medical Society and alternate Delegate from Massachusetts to the American Medical Association. Dr MacMillan practices in Haverhill, and is on staff at Holy Family Hospital Haverhill and Methuen, Anna Jaques Hospital in Newburyport, Lawrence General Hospital, and Parkland Hospital in Derry, NH and is a founding member and President of the Massachusetts Gastroenterology Association. Dr MacMillan has served as Massachusetts Governor of the American College of Gastroenterology since 2011 and is a Fellow of the College.