The witnessed collapse and death of longtime East Baton Rouge Parish School Board member Randy Lamana was reported April 18, Page 1, Metro Section. It is probable that his death was sudden cardiac arrest, which almost always is related to a chaotic cardiac arrhythmia (ventricular fibrillation). Such renders the heart instantaneously unable to provide an adequate cardiac output to sustain life. In this situation, it is not the cardiologist nor the EMS technician but the bystander who has been instructed in performing CPR and is willing to do such that makes the difference. This is the case, because one has only 60 to 180 seconds to start CPR that is likely to result in a meaningful rescue of the patient.

Would it not be a fitting tribute to Mr. Lamana to institute adequate CPR instruction and performance followup in the local school system? Recent studies have shown chest compression only is just as effective as that which provides a respiratory component, thus removing the need to do mouth-to-mouth resuscitation. The instruction would probably best be given to 13- to 15-year-old students. In some areas, telecommunication CPR (T-CPR) seems to be an important assistance in making a successful program. In this situation the 911 operator and EMS support can help the unconfident resuscitator become a life-saving rescuer.

James Lutschg

retired physician

Baton Rouge