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This is Morning Edition from NPR News.�Good morning. I'm Renee Montagne.
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And I'm David Greene.
Today in "Your Health," hearing loss and age. First, a look at an old technology being used in new ways. Last January in Minnesota, a man's heart stopped beating for an extraordinary 96 minutes. Emergency room doctors thought he was dead. But first responders didn't give up, because that technology showed them their CPR efforts were working. Reporter Gretchen Cuda-Kroen has more on the device that helped save this man's life.
GRETCHEN CUDA-KROEN: It's called capnography, and it measures how much carbon dioxide is being expelled with each breath. This information helps doctors and emergency medical personnel to determine if a patient is hyperventilating or having a heart attack. It also helps them decide how to treat an asthma attack or determine if CPR is working.�
Unidentified Man #1: That last data stream there is the capnography. And just breathe normal.
CUDA-KROEN: I'm at the fire station in Brook Park, Ohio. Medical officers here have put a tube in my nose, and hooked me up to a machine to show me how it works. The readout shows a graph that moves up and down when I breathe.
Unidentified Man #1: And...
CUDA-KROEN: Every time I breathe out, it goes up?�
Unidentified Man #1: Yes.
Unidentified Man #2: The exhalation. Right. Right.
CUDA-KROEN: There's also a number.�The carbon dioxide I exhale is an estimate of the carbon dioxide levels in my blood. By breathing rapidly, I blow off carbon dioxide, and the number on the screen goes down. If I hold my breath, it goes up. And if I were unconscious and receiving CPR, the carbon dioxide levels would tell them how efficiently their chest compressions were pumping blood through my lungs and to my organs. Breathing normally, my number is 35.
Unidentified Man #3: During good CPR, this is probably going to be around 25. Now, if you keep this up in that 25 range, that's going to be where you are going to get a positive outcome if, you know, you get circulation back.
CUDA-KROEN: It's not new technology. In fact, it's been around for years, used by anesthesiologists to monitor a patient's breathing during surgery. But these days, the technology is making its way out of hospital operating rooms and into portable devices that are helping first responders make critical - sometimes life-saving - decisions.
That was certainly the case for Howard Snitzer when he collapsed in front of a Minnesota grocery store one cold night last January. After he woke up, days later, some of the emergency medical personal who helped that night told him what happened.
Mr. HOWARD SNITZER: And they said, we were wondering what you remember about your heart attack? And I said, nothing. And they said, well here's what we remember, and they started telling this story. You know, I was just blown away.
CUDA-KROEN: For more than an hour and a half, Snitzer had no pulse and emergency room doctors said there was nothing more they could do. But one of the flight nurses who came with the emergency helicopter had been trained in capnography. Snitzer's carbon dioxide levels suggested that blood was flowing to vital organs like the heart and brain, and the nurse thought Snitzer still had a chance.�
Mr. SNITZER: He took the stats. He called the emergency room doctor, who told him that I was dead and they should walk away. And he hung up and he said to the rest of the people in the room, is anyone else here uncomfortable with walking away from this? And they all said yes. And it was at that point that he called Dr. White.
CUDA-KROEN: He's talking about Dr. Roger White, an anesthesiologist at Mayo Clinic. He's the one who finally came up with the solution to get Snitzer's heart beating normally again.
Dr. ROGER WHITE (Anesthesiologist, Mayo Clinic): So we just continued believing that the measurement of carbon dioxide pressure said if we can stop that fatal rhythm, Howard will be OK.
CUDA-KROEN: They did it by shocking Snitzer's heart 12 times and administering intravenous drugs. When they�finally had a pulse, and a regular heart beat, Snitzer was airlifted to the Mayo Clinic.
Roger White says that before the use of capnography, the only way of assessing blood flow to vital organs was by feeling for a pulse or by looking for dilated pupils. He says those methods are very crude and can fail.
Howard Snitzer never had a pulse despite good carbon dioxide readings.�Without the information from capnography, he says it would've been reasonable to stop CPR and Snitzer would've died.
Dr. WHITE: The lesson that I certainly learn from this is, you don't quit as long as you have objective, measurable evidence that the patient's brain is being protected by adequate blood flow, as determined by the�capnographic data.
CUDA-KROEN: Capnography is slowly becoming standard equipment for emergency responders. Next year, the fire department in Brook Park, Ohio, will have five new capnography machines, compared to the one they have now.�
In addition, the American Heart Association added capnography to their 2010 guidelines for treating cardiac arrest patients - a�sign, says Dr. White, that it's a technology emergency medical teams can no longer do without.�
For NPR News, I'm Gretchen Cuda-Kroen in Cleveland.
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