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In 1988, a 65-year-old man’s heart stopped at home. His wife and son didn’t know CPR, so in desperation they grabbed a toilet plunger to get his heart going until an ambulance showed up.
Later, after the man recovered at San Francisco General Hospital, his son gave the doctors there some advice: Put toilet plungers next to all of the beds in the coronary unit.
The hospital didn’t do that, but the idea got the doctors thinking about better ways to do CPR, or cardiopulmonary resuscitation, the conventional method for chest compressions after cardiac arrest. More than three decades later, at a meeting of emergency medical services directors this week in Hollywood, Fla., researchers presented data showing that using a plunger-like setup leads to remarkably better outcomes for reviving patients.
Traditional CPR doesn’t have a great track record: On average, just 7 percent of people who receive it before getting to the hospital are ultimately discharged with full brain function, according to a national registry of cardiac arrests treated by emergency medical workers in communities across the country.
“It is dismal,” said Dr. Keith Lurie, a cardiologist at the University of Minnesota Medical School who treated the plunger patient in 1988.
The new procedure, known as neuroprotective CPR, has three components. First, a silicone plunger forces the chest up and down, not only pushing blood out to the body, but drawing it back in to refill the heart. A plastic valve fits over a face mask or breathing tube to control pressure in the lungs.
The third piece is a body-positioning device sold by AdvancedCPR Solutions, a firm in Edina, Minn., that was founded by Dr. Lurie. A hinged support slowly elevates a supine patient into a partial sitting position. This allows oxygen-starved blood in the brain to drain more effectively and to be replenished more quickly with oxygenated blood.
The three pieces of equipment, which fit into a backpack, cost about $20,000 and can be used for several years. The devices have been separately approved by the Food and Drug Administration.
About four years ago, researchers began studying the combination of all three devices used in tandem. At this week’s meeting, Dr. Paul Pepe, a longtime CPR researcher and the director of Dallas County’s emergency medical services, reported results from 380 patients who could not be revived by defibrillation, making their odds of survival particularly bleak. Among those who received the new CPR method within 11 minutes of cardiac arrest, 6.1 percent survived with brain function intact, compared with just 0.6 percent who received traditional CPR.
He also reported significantly better odds for a subgroup of patients who had no heartbeat but had random electric activity in their heart muscles. The typical odds of survival for people in those circumstances are about 3 percent. But the patients in Dr. Pepe’s study who received neuroprotective CPR had a 10 percent chance of leaving the hospital neurologically intact.
Last year, a study carried out in four states found similar results. Patients who received neuroprotective CPR within 11 minutes of a 911 call were about three times as likely to survive with good brain function as those who received conventional CPR.
“This is the right thing to do,” Dr. Pepe said.
A couple of years ago, Jason Benjamin went into cardiac arrest after a workout at a gym in St. Augustine, Fla. A friend took him to a nearby fire department, where trained workers deployed the neuroprotective CPR gear. It took 24 minutes and multiple defibrillations to revive him.
After he recovered, Mr. Benjamin, a former emergency medical technician himself, was amazed to learn about the new approach that had saved his life. He read the studies and interviewed Dr. Lurie. The three-part procedure had several complicated names at the time. It was Mr. Benjamin who came up with the term neuroprotective CPR “because that’s what it’s doing,” Mr. Benjamin recalled, adding that “the focus was on protecting my brain.”
Dr. Karen Hirsch, a neurologist at Stanford University and a member of the CPR standards committee for the American Heart Association, said that the new approach was interesting and made physiological sense, but that the committee needed to see more research on patients before it could formally recommend it as a treatment option.
“We’re limited to the available data,” she said, adding that the committee would like to see a clinical trial in which people undergoing cardiac arrests are randomly assigned to conventional CPR or neuroprotective CPR. No such trials are happening in the United States.
Dr. Joe Holley, the medical director for the emergency medical service that serves Memphis and several surrounding communities, isn’t waiting for a larger trial. Two of his teams, he said, were getting neurologically intact survival rates of about 7 percent with conventional CPR. With neuroprotective CPR, the rates rose to around 23 percent.
His crews are coming back from emergency calls much happier these days, too, and patients are even showing up at fire stations to thank them for their help.
“That was a rare occurrence,” Dr. Holley said. “Now it’s almost a regular thing.”
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The 2022 annual general meeting of LIPA (Laser Illuminated Projector Association) will mark a turning point for the body. When Dr. Goran Stojmenovik retires as chair, it will see the end of Barco’s eight-year run heading the industry body. The previous chair, Jan Daem, was also from Barco. A founding member of LIPA in 2011, Barco still intends to play “a very active role” moving forward.
LIPA’s role is to present the world with a single industry voice when it comes to rationalizing laser regulations. One example is the governmental regulations that put onerous and costly requirements on the cinema exhibitors that integrate laser engines into their projectors. LIPA has had some success with better explaining the industry’s position, noting that regulators prefer that the industry stakeholders speak with a single unified voice.
Stojmenovik’s tenure was marked by what he calls “market education”, providing science-based responses to regulatory issues. These have included articles, interviews, webinars, white papers and blog articles. “This body of work now constitutes a bank of material for rationalization and education around technical and regulatory topics,” according to Stojmenovik.
LIPA also worked the optical hazard department of the FDA in the US. This led to the easing of some requirements for laser illuminated projectors, notably reducing their minimum height from 3 meters to 2.5 in some cases. “The goal was to avoid people getting the light in their eyes from too close,” he says. “The requirement is there for safety purposes, which we understand. But it also has to be rational.”
The Covid restrictions also provided a challenge, with LIPA struggling to continue “engaging with the LIPA community” during lockdown. The annual general and board meetings of 2020 and 2021 were moved online. Webinars kept people in touch and the ten-year celebration of LIPA was done online.
Aptly, Barco’s eight-year chairmanship of LIPA will close with the 2023 board and annual general meetings that it will host at its campus in Kortrijk, Belgium.
Over the last four years, LIPA’s membership fluctuated with comings and goings but has remained stable overall. Stojmenovik can still see lots of work for the body over the next four years. “All the standards governing laser projections – notably cinema – are up for review. So it’s important the industry’s voice is heard.” He compares it to the early days of LIPA when legislation and standards were being written worldwide. Now new standards are appearing, notably in emerging markets. “We need to follow these developments. A lot has changed in the laser market, so it’s not easy to predict what will happen.”
About Barco
Barco is a global technology leader that develops networked visualization solutions for the entertainment, enterprise, and healthcare markets. Our solutions make a visible impact, allowing people to enjoy compelling entertainment experiences; to foster knowledge sharing and smart decision-making in organizations and to help hospitals provide their patients with the best possible healthcare.
Headquartered in Kortrijk (Belgium), Barco realized sales of 804 million euro in 2021 and has a global team of 3,000+ employees, whose passion for technology is captured in +500 granted patents. Barco has been listed on the Brussels Stock Exchange since 1985. (Euronext: BAR; Reuters: BARBt.BR; Bloomberg: BAR BB)
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The National Association of Theatre Owners today announced the formation of The Cinema Foundation. The new organization—a donor-supported 501(c)(3) charitable non-profits—dedicated to promoting the essential cinema exhibition industry by developing future diverse workforces and growing moviegoing communities through research, education, and philanthropy.
The Cinema Foundation expands on NATO’s mission by adding new participants, including technology companies, food and beverage leaders, members of the creative community, and other individuals and companies that share in our vision and passion for the future of cinema.
The Cinema Foundation’s founding Board of Directors draws members from across the industry, including Jackie Brenneman (NATO), President; Tori A. Baker (Salt Lake Film Society), Vice President; Brian Schultz (Look Cinemas), Secretary; Eduardo Acuna (Cinépolis Americas), Treasurer; and Directors Adam Cassels (Cinionic); Michelle Maddalena (Dolby Laboratories); and Katherine Twells (The Coca-Cola Company).
“The future of the cinema industry is being determined right now,” said The Cinema Foundation President, Jackie Brenneman. “The Cinema Foundation is designed to bring together key industry stakeholders from business, technology, and the creative community to be the leading voice in what that future will be.”
Currently in its initial fundraising and hiring phase, the key priorities of The Cinema Foundation include:
“I firmly believe in The Cinema Foundation and its important role in contributing to the magic of moviegoing,” said Brian Schultz of Look Cinemas. “The Foundation will create dynamic employment opportunities for the industry’s future workforce and develop programs that ensure a healthy exhibition industry that brings economic and cultural vibrancy to communities everywhere.”
Adam Cassels, of Cinionic, added, “Our industry has a long heritage of innovation, connecting a diverse ecosystem to further the cinematic experience. The Cinema Foundation creates a space to continue innovating and collaborating to meet the needs of moviegoers, the creative community, and cinema professionals across the exhibition landscape.”
To sponsor, donate, or learn more visit www.TheCinemaFoundation.org.
Is it because everyone is facing forward and the typical air conditioning system is pushing the air away from people’s faces?
Is it the extra cleaning cycle between each movie, some facilities spraying down each arm piece of each chair and hand-rail?
Is it the new HEPA Filters that many cinemas installed?
Is it that most people are still wearing masks? …that they were checked at the entrance for being vaccinated?
Several studies have been done, as noted in Celluloid Junkie, by UNIC, by Deadline one early in the plague’s cycle in the heavily tracked South Korea, and one later in a more general manner – both reaching the same conclusion. No One can point to an incident of Covid being traced to the cinema theater.