Extraneous requirements in your school?

Dirty Dog

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How useful do you think echo-cardiograms are? I had one done last year, they said I was clear of plaque or any blockages or narrowing. My weight is high, but my BP is normal and my cholesterol is OK for 'bad' and low for 'good'. I do have a family history of heart attacks; that's what killed my dad at age 61.

Echocardiograms show valve function and movement of the heart walls. They cannot directly demonstrate the presence or lack of plaque buildup. They can do so indirectly.

During exercise, the coronary arteries expand, allowing more blood to reach the cardiac muscle. In the presence of heart disease, they cannot expand enough, and the blood flow will no longer supply the oxygen needs of the muscle. If it's severe enough, you may have chest pain, EKG changes and other symptoms at this point. Even if it's not severe enough to cause symptoms, however, the lack of adequate oxygen will lead to a decrease in the movement of the heart wall.

Usually, (and I presume this is what was done for you) the echo is done at rest, and then repeated with either physical exertion or chemical stimulation of the heart. This is called a "stress echo". Dobutamine and/or atropine are the drugs most commonly used to simulate exercise.

Stress echos are considered highly reliable, second only to heart catheterization. If you have a negative stress echo, then your chance of having a heart attack within the next few years is thought to be about 2%. If you have a positive stress echo (meaning a decrease in heart wall movement without symptoms) then your odds are more like 20-30%. If you have symptoms during the tests, you're likely to be going straight to the cath lab rather than home.
 

Jason Striker II

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For about the last 15 years or so the Dojo I head has required Shodan candidates to pass a weekend course in basic firearms safety given by a certified (NRA) gun club. I thought it strange that no one else has mentioned something like this - some years back, it was becoming more common, like basic first aid training, for Shodan candidates testing on the East coast of the U.S.
 

Carol

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You have students help teach at green belt? What style do your practice?

That's actually not a beginner's rank in Kenpo, our green is in a different place. Its not the rank immediately following yellow. When Mike says "green or brown", he is referring to what KMAist would know as the ranks of 4th through 1st geup.
 

frank raud

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Left Anterior Descending, one of the three coronary arteries. It supplies blood to the left ventricle, which in turn pumps blood to the rest of the body. There is no such thing as a descending ventricle in the human body. :)

Sitting at your desk didn't really have anything to do with it. Angina is often triggered by exertion, but actual heart attacks are generally not. I've treated FAR more people who had a heart attack at their desks or in their sleep than those who were working out at the time.

Over the years, arteries gradually narrow, primarily due to plaque buildup. At some point, a small clot (which we all have, all the time) reaches a narrow spot and blocks it. This obstruction causes the heart attack. The closer to the root of the artery the obstruction occurs, and the longer it lasts, the more damage there will be to the heart. Since the LAD services such a large and vital area of the heart (damage to the rear of the right atrium will cause you much less long-term difficulty than the front/side walls of the left ventricle, just as an example) an obstruction high up in it is likely to prove fatal. Clots cause about 95% of all heart attacks. The rest are mostly caused by spasm of the vessle (prinzmetal angina, for example) or complete plaque obstruction.

Obviously I don't know what intervetions you personally had, but if they were able to put a stent in your LAD (the current first-line intervention) then it is a virtual certainty that your heart attack was caused by a clot being wedged into a narrowed spot. Being able to place a stent past a 100% plaque occlusion is exceptionally rare.

Thank you for correcting my spotty knowledge of anatomy. I know that sitting down had nothing to do with my heart attack , I pointed it out as the poster was stating you shouldn't exercise if it is possible you will have a heart attack.

I do have a stent, and got prescriptions for Plavix, Lipitor and Ramapril. As my cholesterol level were fine, I don't smoke, exercise regularly and have a reasonable diet, the final conclusion was that as a male in my forties, I was suspectible to heart attacks. Not much I could do to change that.
 
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shesulsa

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You have students help teach at green belt? What style do your practice?

I do this regularly and green is the first of the intermediate color ranks. I think as students have to find ways to share their knowledge with other people they come to a more complete understanding of their material.
 

Dirty Dog

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Thank you for correcting my spotty knowledge of anatomy. I know that sitting down had nothing to do with my heart attack , I pointed it out as the poster was stating you shouldn't exercise if it is possible you will have a heart attack.

I do have a stent, and got prescriptions for Plavix, Lipitor and Ramapril. As my cholesterol level were fine, I don't smoke, exercise regularly and have a reasonable diet, the final conclusion was that as a male in my forties, I was suspectible to heart attacks. Not much I could do to change that.

Glad things worked out for you. As a rule, an MI before about 50 is generally genetics more than anything else. :(

Back to the subject:

CPR classes for everyone: YES!
Required for MA rank: NO!
 

Bill Mattocks

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Glad things worked out for you. As a rule, an MI before about 50 is generally genetics more than anything else. :(

Back to the subject:

CPR classes for everyone: YES!
Required for MA rank: NO!

I used to get my recertification every year. However, and you can take this as me being an old grouch, I got REALLY FED UP with the changes every year and the politi-speak required.

Used to be called 'artificial respiration'. Then they changed it to 'rescue breathing'. OK, you know what? I don't care what you call it. I'm not relearning my vocabulary because some butthead took exception to a simple and very understandable term.

Then we went from 4 slow chest compressions and 2 breaths to 4 rapid chest compressions and 4 breaths. Then no breaths. Then breaths again. Then carry around and use a plastic shield to breath through. Then none. They back to the shield again. Now I think we're back to no breathing, but chest compressions as fast as the dickens. No clue anymore!

I just fall back on what I was taught in the Marine Corps:

1) Start the breathing.
2) Stop the bleeding.
3) Protect the wound.
4) Treat for shock.

And as I remember from my first CPR class, once you start administering CPR, you cannot stop until competent medical help has arrived and relieved you. That means if the ambulance doesn't show up for 20 minutes, you're going to be one tired boy; you're exhausted inside of 2 minutes, dripping sweat if you're doing it right; but you may not legally stop, or the Good Samaritan law no longer covers your butt. So if you start, know that you have to keep going.
 

Dirty Dog

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I used to get my recertification every year. However, and you can take this as me being an old grouch, I got REALLY FED UP with the changes every year and the politi-speak required.

Used to be called 'artificial respiration'. Then they changed it to 'rescue breathing'. OK, you know what? I don't care what you call it. I'm not relearning my vocabulary because some butthead took exception to a simple and very understandable term.

Then we went from 4 slow chest compressions and 2 breaths to 4 rapid chest compressions and 4 breaths. Then no breaths. Then breaths again. Then carry around and use a plastic shield to breath through. Then none. They back to the shield again. Now I think we're back to no breathing, but chest compressions as fast as the dickens. No clue anymore!

I just fall back on what I was taught in the Marine Corps:

1) Start the breathing.
2) Stop the bleeding.
3) Protect the wound.
4) Treat for shock.

And as I remember from my first CPR class, once you start administering CPR, you cannot stop until competent medical help has arrived and relieved you. That means if the ambulance doesn't show up for 20 minutes, you're going to be one tired boy; you're exhausted inside of 2 minutes, dripping sweat if you're doing it right; but you may not legally stop, or the Good Samaritan law no longer covers your butt. So if you start, know that you have to keep going.

I agree with you on the terminology. That's mostly just someone trying to justify their salary.

Technical standards, however, change for very good reason. We constantly try to improve our knowledge and increase the chances of a good outcome. That means technical standards will (and rightly so) change to reflect current research.

I've been seeing studies from European sources for about 10 years that show pretty convincingly that rescue breathing is not needed. Considering that cardiac output from GOOD CPR is only about 25% of the norm, the compressions exchange enough air. Add in the fact that rescue breathing - no matter how carefully done - will inflate the stomach with air and lead to vomiting and aspiration (and an unwillingness by the rescuer to do breathing...), and I would expect the next update to say 'compress the chest at about 100/min and don't bother breathing'. Obviously, once it's possible to establish a definitive airway (i.e. intubation) then things change, but that doesn't apply to bystander CPR.

Your last statement, that you cannot legally stop CPR is simply false. You call 911. You start CPR. If you cannot continue, you stop. You've done your best, and that is all that can ever be asked.
 

Bill Mattocks

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Your last statement, that you cannot legally stop CPR is simply false. You call 911. You start CPR. If you cannot continue, you stop. You've done your best, and that is all that can ever be asked.

Thanks, I didn't know that. I could have sworn it was a question on one of my certification tests. I stand corrected, and happily so.
 

oftheherd1

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Thanks, I didn't know that. I could have sworn it was a question on one of my certification tests. I stand corrected, and happily so.

While it sounds right that the lay person isn't going to be held to such a high standard, I would check with your state laws. Each state makes its own laws on such matters.
 

jks9199

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And as I remember from my first CPR class, once you start administering CPR, you cannot stop until competent medical help has arrived and relieved you. That means if the ambulance doesn't show up for 20 minutes, you're going to be one tired boy; you're exhausted inside of 2 minutes, dripping sweat if you're doing it right; but you may not legally stop, or the Good Samaritan law no longer covers your butt. So if you start, know that you have to keep going.

Generally, you can stop if you are exhausted or otherwise cannot safely continue, even if not relieved by competent professionals or other trained persons who can take over for you. Or at least that's my understanding...

Personally, I support CPR & First Aid requirements. They're useful skills in the real world, kind of like falling requirements. I don't have a problem with fitness components to testing -- but I've seen some testing processes that strike me as simply being, as someone above said, attempts to out-macho each other. And I like the idea of a first degree black belt test being some sort of crucible/gauntlet event (though that's a product of how my style views first level, and isn't something that's necessarily universal --- and to the fact that we lack such transformative events in much of our life today in the US.) But there's a reasonable line, and some tests cross that...
 

puunui

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Personally, I support CPR & First Aid requirements.

How much does it cost to take a CPR and/or First Aid course? And how long is the class? I imagine not that expensive and not that long. I never took either one, but perhaps I should.
 

Tez3

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For about the last 15 years or so the Dojo I head has required Shodan candidates to pass a weekend course in basic firearms safety given by a certified (NRA) gun club. I thought it strange that no one else has mentioned something like this - some years back, it was becoming more common, like basic first aid training, for Shodan candidates testing on the East coast of the U.S.


My students don't need to do this in martial arts training, they do it for their work as do I. (bet that surprised a few of you lol)
 

jks9199

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How much does it cost to take a CPR and/or First Aid course? And how long is the class? I imagine not that expensive and not that long. I never took either one, but perhaps I should.

All depends on where and who's teaching. I did an on-line First Aid program through the Red Cross for about $50, I think. I'd recommend an actual hands-on class if you haven't had it before, though. First Aid classes can range from several hours to several days, depending on how deep it goes.

CPR, I think is running around $100, including materials costs. Not sure, since I get it free through work. Check your local fire & rescue department or hospital for programs, or the Red Cross and American Heart Association. Sometimes, there are even free programs around. They take about 5 or 6 hours, I think.
 

Tez3

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Easy to remember CPR!
 
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Tez3

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Oh sure throw a picture of Nigella at us to distract us easily distracted males from the topic :D

Apologies! However she is a good example of not being fanatical about anything, that life is for enjoying and just doing your best. She had a hard time when her first husband was dying, he was a very good journalist and I think she shows us that life and love (and good food) goes on.

On the CPR, we were taught that it doesn't revive people (unlike in the films) but it does keep oxygen and blood going around the body until the paramedics/doctors can do the reviving bit, hence the need to keep going until they take over. One of the Queen of the Netherlands sons is in a deep coma, unlikely to wake because he was caught in an avalanche the other week and without oxygen for nearly 50 mins. Continuing CPR at least gives the person a fighting chance to recover.
 
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shesulsa

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I've also heard of the running requirement that someone mentioned ... what about a trade certification? A healing arts certification? Reading requirements?
 
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