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Defibrillators turn bystanders into rescuers

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Special to The Times

The lifesaving potential of defibrillators, the devices that shock a wildly irregular heartbeat back into its normal rhythm, has never been questioned. But no one knew whether putting them in the hands of untrained bystanders would actually save lives. A new study shows it does.

Beginning in 1999, Chicago began installing automated defibrillators throughout airports, putting them in highly visible, accessible glass cabinets within a minute or so walk from each other -- almost like fire extinguishers. Television monitors and printed handouts described how the devices should be used.

In two years, 21 people went into cardiac arrest in two of the three airports, and 18 of them had the kind of heart rhythm problem that could be corrected with a defibrillator. Eleven of the men and women were resuscitated. In six of those situations, the rescuers had no training in using automated defibrillators.

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A separate study recently concluded that, because most cardiac arrests occur at home, wide distribution of the devices wouldn’t significantly reduce fatalities. But, Dr. Lance B. Becker of the emergency resuscitation center at the University of Chicago Hospitals, says, “This study is amazing because untrained people were the rescuers. Twenty years ago, the only person who could defibrillate was a physician. Now ... the average citizen has the possibility of saving a person’s life.”

New England Journal of Medicine 347(16): 1223-1224, 1242-1246

The cough reflex in women may be more sensitive than it is in men

Women are twice as sensitive to irritants in their environment as men are, British researchers have found, which may explain why women more often are troubled with chronic coughs.

In a test of more than 100 people with the condition, women reacted sooner to one-second inhalations of red pepper extract or citric acid, coughing at lower concentrations of the irritants than men did. Whether a person smoked or had asthma didn’t appear to affect sensitivity.

Some experts had assumed that women are more troubled with coughing because their airways were smaller, but this study suggests sex hormones may affect the response of inflammatory cells in chronic coughers, the researchers say.

“Boys and girls are thought to have similar cough reflexes ... [but] our study confirms there is a fundamental difference between men and women. Perhaps the difference has something to do with the hormonal changes that occur in puberty,” says Dr. Alyn Morice of the University of Hull in Cottingham, England.

American Journal of Respiratory and Critical Care Medicine 2002; 166: 961-964

Teething still gets mistakenly blamed for other ills

In the 1990s, experts confirmed that the fever, diarrhea and rashes often linked to teething aren’t caused by the eruption of teeth through the gums. But even medical pros seem hesitant to give up the notion that these and other symptoms are par for the teething course. A survey of nurses, pharmacists, dentists, general practitioners and pediatricians in Australia found that most believe young children suffer a wide range of symptoms.

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The number of symptoms blamed on teething varied with the professional group. Pediatricians were least likely to believe there was a link (on average attributing 2.8 symptoms to teething); nurses were the most likely (9.8 symptoms). All groups often recommended acetaminophen and teething gels, and more than half of the pharmacists suggested sedating medication.

Maybe it’s the parents who need relief. Many of the health professionals surveyed believed that parents had as much if not more distress than the infants. “The main reason for challenging these beliefs is to allow parents and health professions to take more appropriate action ... and avoid unnecessary medication,” says pediatrician Melissa Wake of the Royal Children’s Hospital in Victoria, Australia.

British Medical Journal, 2002: 325:814

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