CPR switch: Chest presses first, then give breaths

New guidelines out Monday switch up the steps for CPR, telling rescuers to start with hard, fast chest presses before giving mouth-to-mouth.

The change puts "the simplest step first" for traditional CPR, said Dr. Michael Sayre, co-author of the guidelines issued by the American Heart Association.

In recent years, CPR guidance has been revised to put more emphasis on chest pushes for sudden cardiac arrest. In 2008, the heart group said untrained bystanders or those unwilling to do rescue breaths could do hands-only CPR until paramedics arrive or a defibrillator is used to restore a normal heart beat.

Now, the group says everyone from professionals to bystanders who use standard CPR should begin with chest compressions instead of opening the victim's airway and breathing into their mouth first.

The change ditches the old ABC training - airway-breathing-compressions. That called for rescuers to give two breaths first, then alternate with 30 presses.

Sayre said that approach took time and delayed chest presses, which keep the blood circulating.

"When the rescuer pushes hard and fast on the victim's chest, they're really acting like an artificial heart. That blood carries oxygen that helps keep the organs alive till help arrives," said Sayre, an emergency doctor at Ohio State University Medical Center.

"Put one hand on top of the other and push really hard," he said.

Sudden cardiac arrest - when the heart suddenly stops beating - can occur after a heart attack or as a result of electrocution or near-drowning. The person collapses, stops breathing normally and is unresponsive. Survival rates from cardiac arrest outside the hospital vary across the country - from 3 percent to 15 percent, according to Sayre.

Under the revised guidelines, rescuers using traditional CPR, or cardiopulmonary resuscitation, should start chest compressions immediately - 30 chest presses, then two breaths. The change applies to adults and children, but not newborns.

One CPR researcher, though, expressed disappointment with the new guidelines. Dr. Gordon Ewy of the University of Arizona Sarver Heart Center thinks everyone should be doing hands-only CPR for sudden cardiac arrest, and skipping mouth-to-mouth. He said the guidelines could note the cases where breaths should still be given, like near-drownings and drug overdoses, when breathing problems likely led to the cardiac arrest.

Ewy is one of the authors of a recently published U.S. study that showed more people survived cardiac arrest when a bystander gave them hands-only CPR, compared to CPR with breaths.


The guidelines issued Monday also say that rescuers should be pushing deeper, at least 2 inches in adults. Rescuers should pump the chest of the victim at a rate of at least 100 compressions a minute - some say a good guide is the beat of the old disco song "Stayin' Alive."

Dr. Ahamed Idris, of the University of Texas Southwestern in Dallas, said people are sometimes afraid that they'll hurt the patient. Others have a hard time judging how hard they are pressing, he said.

"We want to make sure people understand they're not going to hurt the person they're doing CPR on by pressing as hard as they can," he said.

Idris, who directs the Dallas-Fort Worth Center for Resuscitation Research, said that for the last two years, they've been advising local paramedics to start with chest compressions and keep them up with minimal interruptions. That, along with intensive training, has helped improve survival rates, he said.

He said they found paramedics hadn't been starting compressions until the patient was in the ambulance and lost time getting airway equipment together.

"The best chance was to start chest compressions in the house, immediately," he said.

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Mongolia’s fabled mine stirs Asian frontier

A feeling of expectation hung in the air early one September morning as a group of bankers emerged from the aging, Soviet-era chic of Ulan Bator’s Chinggis Khaan Hotel en route to a two-hour flight deep into the Gobi Desert, which blankets Mongolia’s southern frontier.

Their destination, about 80km from China’s northern border, was Oyu Tolgoi, which bankers, geologists, journalists, and the mine’s main developer Ivanhoe Mines Ltd routinely describe as one of the world’s largest untapped copper and gold deposits. Ivanhoe, led by the colourful American-born billionaire Robert Friedland, owns 66 per cent of the mine, and the Mongolian government the rest.

“This is going to be among the top five mines in size around the world,” Keith Marshall, president and CEO of Oyu Tolgoi LLC told a conference in Mongolia’s capital, Ulan Bator. “The only way to describe it is that it is just an awesome deposit. I have been 30 years in the mining industry and I haven’t seen anything quite like this.”

Landlocked Mongolia lingered in isolation for 70 years as a Soviet satellite state, serving as a sleepy buffer zone between its giant neighbours, Russia and China. Now, a young democratic government, in power since the early 1990s, is trying to pull its three million citizens out of poverty by exploiting vast amounts of untapped mineral wealth underneath the country’s deserts and grasslands.

Oyu Tolgoi, or “Turquoise Hill,” is named after the colour of the copper oxide leaching to the surface. The project is Mongolia’s crown jewel, a massive ore body with a lifespan of 40-50 years that Ivanhoe says contains approximately 81 billion pounds of copper and 46 million ounces of gold – not including estimates from a new vein discovered late last month. The mine will have a major impact on the supply of global copper. The copper reserves alone would be second only to Chile.

Much of the mine’s treasure will be sold to China to satisfy the Middle Kingdom’s voracious appetite for natural resources.

Mongolia’s emergence as one of Asia’s premier frontier markets is rarely discussed without reference to the Oyu Tolgoi site, a modern-day El Dorado that analysts say could account for roughly 30 per cent of the country’s GDP once it is fully operational.

Bankers and fund managers from Citi, ING, Morgan Stanley, Aberdeen Asset Management and other financial powerhouses flew in on September 6 to take a closer look at the famous mine.

“Obviously, people wanted to know what would drive Mongolia’s economy going forward and (Oyu Tolgoi) is a testament to where it is heading,” Alisher Ali Djumanov, chairman of Hong Kong-based investment bank Eurasia Capital, which organised the trip said. “We felt it important for foreign investors to see for themselves the transformations taking place so they feel more confident about the entire Mongolian story.”

The visit came at a challenging time for Ivanhoe. The Canada-based miner is trying to fend off a possible takeover by its biggest shareholder, global mining giant Rio Tinto – a deal that could be as compelling for Rio as its Australian rival BHP Billiton’s $39 billion (RM121.27 billion) pursuit of Canada’s Potash Corp.

Analysts say Friedland is maneuvering to prevent Ivanhoe from being acquired too cheaply by the much bigger Rio, which posted a profit of $5.8 billion for the first half of 2010 on earnings of $25 billion.

“Ideally, Robert (Friedland) wants to be bought out and he wants a fair price,” said UBS analyst Glyn Lawcock.

Rio holds about 35 per cent of Ivanhoe and can steadily increase that stake to a limit of 47 per cent. That “standstill agreement”, however, expires in October of next year, at which point Rio could make a run for a majority stake.

Ivanhoe, which posted revenues of $31.6 million and an operating loss of $146 million in the first half 2010 – typical of a mining company in the exploration phase of its projects – has devised a shareholder rights plan known as a “poison pill” to protect itself against what it called “coercive and creeping takeovers”.

In July, Ivanhoe opened the door to other buyers by terminating a clause in an agreement with Rio that restricts it from issuing shares to other “strategic investors”. (Oyu Tolgoi is the most prized of Ivanhoe’s assets. But it also has controlling interests in Mongolia’s Ovoot Tolgoi coal mine, the Cloncurry copper, gold and uranium project in the Australian state of Queensland and a gold project in Kazakhstan.)

Rio, which has invested $1.7 billion in Ivanhoe and its Oyu Tolgoi mine since 2006, is not backing down either, and has launched arbitration proceedings against Ivanhoe for scrapping the shareholding agreement.

Friedland, meanwhile, has been flogging the mine’s fabulous potential to potential investors. He told the Diggers and Dealers mining conference in Kalgoorlie, Australia in August that the estimated present value of the copper and gold at the project was about $350 billion, and could, if the project expanded, be worth up to US$1 trillion.

Terminating the agreement with Rio “has opened us up to some very interesting discussions with third parties”, he told the conference without elaborating.

Rio ultimately wants to swap its Ivanhoe stake for a direct holding in Oyu Tolgoi and bring in one of its largest shareholders, China’s Chinalco, as a partner.

“Chinalco has indicated an interest in acquiring a minority equity stake in the company (Ivanhoe) or acquiring, from the company, a direct minority ownership interest in the OT project,” Rio said in a July 7 filing to the US Securities and Exchange Commission.

“At the end of the day, you’re dealing with one of the shrewdest investors in the mining space,” said James Bruce, portfolio manager at Perpetual Investments, which owns a stake in Rio Tinto. “It’s a very difficult negotiation, but one that, presumably, Rio Tinto are keen to have.”

Both Ivanhoe and Rio, meanwhile, have profited from a 68 per cent rise in Ivanhoe’s shares between mid-July, when Ivanhoe announced it had scrapped the shareholding agreement, and September 28, when the company disclosed it had discovered the new vein in Oyu Tolgoi containing an estimated 10.2 billion pounds of copper and 15 million ounces of gold. The surge has also coincided with a 25 per cent increase in copper prices during the period.

Jailed China Nobel winner asks wife to collect prize

Jailed Chinese dissident Liu Xiaobo has asked his wife to travel to Norway to pick up his Nobel Peace Prize, she said today.

“Xiaobo told me he hopes I can go to Norway to receive the prize for him,” Liu Xia said by telephone from her house where she is under virtual house arrest.

“I think it will be very difficult,” she added, when asked if she thought the government would allow her to go.

Liu Xia said the government had not yet explicitly told her she would not be allowed to go to Norway. The prize will be formally bestowed on December 10 in Oslo.

China said today that giving the Nobel Peace Prize to a jailed dissident showed a lack of respect for its legal system, in further criticism of an award that has stirred tensions over human rights.

Liu Xia, the wife of Chinese dissident Liu Xiaobo, holds a photo of her husband during an interview in Beijing October 3, 2010. She has been asked by her husband to collect the prize on his behalf

China slams Nobel prize for dissident as ‘disrespectful’

Giving the Nobel Peace Prize to a jailed dissident showed lack of respect for China’s legal system, the government said today, in further criticism of an award that has stirred tensions over human rights.

Foreign Ministry spokesman Ma Zhaoxu said that the prize, awarded to Liu Xiaobo, would not affect the direction of China’s political system, and repeated that it had damaged relations with Norway, where the peace prize committee is based.

“Giving the Nobel Peace Prize to a criminal serving a prison sentence shows a lack of respect for China’s judicial system,” Ma told a regular news briefing in Beijing.

China has condemned the Norwegian government, which has no say over the prize, and cancelled a planned meeting with a Norwegian fisheries minister.

A security officer gestures at the entrance of a residential compound where Liu’s wife lives in Beijing October 8, 2010






“The Chinese government and people have reason to express their dissatisfaction,” Ma said, adding Norway damaged ties by supporting the committee’s decision.

Diplomats from the European Union as well as Australia and Switzerland unsuccessfully tried to visit Liu’s wife, Liu Xia, in her apartment in western Beijing yesterday but were blocked.

The US Embassy urged China to lift any restrictions Liu Xia and earlier President Barack Obama called for Liu Xiaobo’s release.

Asked about Obama’s comments, Ma said: “We oppose anyone using this matter to stir up a fuss and oppose anyone interfering in China’s internal affairs.”

Liu is serving 11 years in jail on subversion charges for demanding democratic transformation of China’s one-party state, and his wife has sent out messages she is under house arrest in Beijing, according to news reports and overseas human rights groups.

China’s ruling Communist Party has long reacted angrily to pressure over its restrictions on political and legal rights of citizens, and the Nobel Prize for the prominent dissident has prompted testy official and vehement media comment in Beijing.

The Global Times, a popular tabloid run by Party mouthpiece the People’s Daily, said in a commentary today that the Nobel committee members, who “live in luxury”, had no right to pass judgment on China’s legal system.

“This is not a dispute about democracy, but an incitement for ‘dissidents’ to break Chinese law,” it wrote. “The Cold War has long since ended, but it stains the hearts of some people still.”






 

British photographer wins £82,000 damages after US porn firm uses picture of her AGED 14 on cover of explicit DVD

A photographer who sued a US porn film company for using a picture of her aged 14 on the cover of one of its DVDs has won £82,000 damages.

Lara Jade Coton was ‘horrified’ that her self-portrait, which was on the internet, had been used as the DVD cover and face art for the sexually explicit film Body Magic without her permission.

Miss Coton went on to sue the firm, TVX Films of Texas, after she complained and received an email blaming her for disappointing sales of the DVD, her lawyer Richard Harrison said.

A self portrait of Lara Jade Coton taken when she was 14-years-old appeared as the cover of the pornographic film Body Magic

Professional photographer Miss Coton has been awarded £82,000 in damages




She filed a lawsuit in federal court in Tampa, Florida, which accused TVX Films and its president Bob Burge of copyright infringement, civil conspiracy, misappropriation of her image, invasion of privacy and intentional infliction of emotional distress.

The judge who awarded Miss Coton’s damages blasted the company’s actions as ‘morally wrong’ and said the use of her image wrongly implied she worked in the porn industry.

Now 21, Miss Coton, of Tamworth, Staffordshire told the Mirror: ‘I didn’t want to be known as the girl from the porn film. I’m delighted it’s finally out the way.

‘It’s not about the money – I had to defend my rights in work as well as my character and professional reputation.’

During the three-year legal battle, Miss Cotton told of her disgust of how the image was used: ‘I was absolutely horrified to see my work and my own picture being used on that kind of movie. It’s just appalling.’

Mr Harrison, of law firm Allen Dell PA, said when Miss Coton contacted the film company, its president Bob Burge responded by ridiculing her and accusing her of trying to perpetrate some kind of scam.

Mr Harrison said: ‘Adding insult to injury the company had the audacity to blame Lara Jade for the disappointing sales of its porn movie.’

He said TVX Films president Bob Burge wrote in an email: ‘Actually, removing your image will help improve the sale of the DVD. So far it bombed.’

Mr Harrison said: ‘If it’s not a crime to put a 14-year-old child on the cover of a porn video, it sure ought to be.’

Mr Harrison said the case showed how easily children could be victimised in the age of social networking sites like MySpace and Facebook.

‘This amazing technology allows us all to share our photos with friends and loved ones, but parents must realise that any picture a child puts on the internet is about three mouse clicks away from being stolen by anybody,’ he said.

Rescued Chile miner joyous, but also talks of devil

Trapped deep inside the earth for 69 days, Mario Sepulveda never lost his sense of humour, so when he was finally pulled to safety today, he brought a souvenir with him – a bag of rocks.

The rocks, which Sepulveda gave out to rescue workers, appeared to be wrapped in silver tinfoil. Hundreds of people watching on a TV feed giggled as he brought a touch of humour to a tense and riveting operation to free him and 32 other men from a collapsed mine here in northern Chile.

Miner Claudio Yanez kisses his wife after arriving as the eighth miner to be hoisted to the surface in Copiapo October 13, 2010.






Sepulveda is known for being a bit of a comedian, and he even tried to hand a rock from deep inside the San Jose mine to Chilean President Sebastian Pinera, who responded by laughing and giving the rescued miner a bear hug.

Pinera then appeared to shed a tear after Sepulveda was whisked on a hospital gurney into a makeshift clinic for a medical check up.

Sepulveda’s whoops of joy were audible from the escape shaft even before he surfaced from the mine, a new sign of the remarkable resilience demonstrated by the 33 men since they were trapped when the mine caved in on August 5.

But for all the humour, he also showed a darkly serious streak.

“I have been with God and I’ve been with the devil,” Sepulveda later said in an interview flanked by his family.

Throughout their ordeal, the miners appear to have held together and their spirits often seemed high, but psychologists say some will likely suffer from stress long after the rescue is complete and they are reunited with their families.

Sepulveda called for deep changes to protect workers rights and appealed to be treated like a worker and a miner rather than a celebrity: “Please don’t treat us like artists.”

He was believed to be an emotional leader of the miners underground, and television images showed him keeping it up right until the end, laughing heartily and clowning around as he climbed into the capsule and said farewell to the others.

When he reached the top, he hugged his wife before ripping open his bag full of rocks and handing them out with a big smile. He then ran over to a group of friends to hug them and lead them in yelling out a classic cheer that ended with the line: “Long live the Chilean miners!”

His mother was so moved that she had trouble speaking, and his brother, Jose Sepulveda, said simply that the homecoming was long overdue.

“We are all happy and content. We are all hugging each other and crying,” he said.

FBI got tip about American in Mumbai attacks

The FBI received a tip three years before the 2008 Mumbai attacks that an American man who helped scout the targets was tied to the Pakistani group behind the plot, the Washington Post reported yesterday.

The man, David Headley, pleaded guilty in March to a dozen US terrorism charges related to the Mumbai attacks in which 166 people were killed, and to a plot to attack a Danish newspaper that had published cartoons in 2005 that lampooned the Prophet Mohammed.

He admitted to scouting the targets for the Islamist militant group Lashkar-e-Taiba (LeT) and agreed to help investigators and give testimony against others in exchange for a promise that he would not be extradited to India, Pakistan or Denmark.

The Washington Post reported that the FBI received a tip in 2005 about Headley’s involvement from his wife after the two were in a domestic dispute that resulted in his arrest.

Pigeons fly near the burning Taj Mahal hotel in Mumbai November 27, 2008.






Headley’s wife told them in interviews that he was active in LeT, had trained in Pakistani camps and had looked for night-vision goggles, the newspaper reported, citing unnamed officials and sources close to the case.

An FBI spokesman declined to comment on the report. The Washington Post reported that officials confirmed they did receive the tip from Headley’s wife at the time but would not discuss what they did with the information.

US authorities regularly receive tips about possible terrorism plots.

Headley, who spent his childhood in Pakistan and whose father was Pakistani, changed his name in 2005 from Daood Gilani to make travel through security easier.

He was arrested about a year ago at Chicago’s O’Hare International Airport as he was trying to leave for Pakistan. He was found with about a dozen surveillance videos from Denmark he had planned to deliver to his handlers.

The 2008 attacks in Mumbai, in which six Americans were among the dead, lasted for three days and further escalated tensions between India and neighbouring Pakistan, where LeT militants are based.