Tuesday, June 30, 2009

Michael Jackson News Roundup

Investigators are still trying to figure out how Jackson died and a toxicology report is pending, but one item stands out; the extraordinarily awful CPR treatment by Jackson's personal physician Dr. Conrad Murray who attempted to revive Jackson and the unconscionable delay in calling 911 for more than 30 minutes. Murray is a graduate of Meharry Medical College of Nashville, TN, class of 1989. There are no reports of any disciplinary measures taken against Murray by any state health departments where he is licensed.

The phone call to 911 operators reveals one of the problems in Jackson's last minutes:
"Do you have him on the floor? Where's he at right now?" the operator asked.

"He's on the bed sir," the caller responded. "He's on the bed. We need [paramedics]."

"Let's get him on the floor," the operator responded.

During his appearance on "Good Morning America" on Monday, Murray's attorney Ed Chernoff confirmed that Murray began administering CPR while Michael Jackson was lying on a bed.

"He did administer CPR on the bed," Chernoff said. "The bed is a very firm bed. He braced Michael Jackson's back with his hand under his back and compressed his chest with the other hand."

The American Heart Association recommends that cardiac arrest victims lie on a hard surface while receiving CPR -- usually either a backboard or the floor.

The reason for this, said Dr. Benjamin Abella of the University of Pennsylvania's Center for Resuscitation Science, is backed by research that suggests performing compressions while the patient is lying on a surface that is softer than the ground essentially robs the compressions of the power needed to keep blood flowing through the body until help arrives.
I've taken several CPR courses over the years, and they've always stressed that the person must be on a firm surface - the floor being the best location because you need a firm surface to provide proper chest compressions. This doctor seems to have ignored basic CPR guidelines and thankfully the 911 operator reminded him of that although some of the people ABC News contacted seemed to think that Jackson's frail condition may have been a mitigating factor to enable Dr. Murray to treat him in this fashion. Considering that he allegedly put one hand under Jackson's chest while providing compressions with the other, there is no way that he could have provided adequate compressions in that fashion.

An adult CPR generally requires chest compressions of 1-2 inches, and we're counseled not to worry about causing chest fractures of the sternum because you can always recover from fractured ribs - if you're dead, there's no recovery.

However, far more troubling is the delay in calling for assistance. No one is quite sure how long Jackson was down before Dr. Murray started CPR. Add another half hour to the time, and Jackson's golden hour for treatment probably expired long before he was brought into the hospital. The delay meant that any chance to revive Jackson was long passed.

It also raises further questions as to what kind of medical equipment and drugs Dr. Murray had at his disposal in the rented mansion where Jackson was staying. Should he have had an AED and drugs necessary to revive patients, especially because of the side effects from some of the medications prescribed to Jackson? Demerol can produce heart and respiratory complications, so it would behoove a medical practitioner to be prepared for such an outcome.

Meanwhile, his fans will get a refund or a souvenir from the now canceled concerts.

Also, Jackson's parents file to administer his estate.
Jackson’s parents wasted little time demanding authority over their son’s financially strained empire and guardianship of their fatherless grandchildren. The big question is who, if anyone, will contest them?
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Early Monday — just four days after the death of the King of Pop — lawyers for Katherine and Joe Jackson won temporary custody of Michael Jackson’s three children and moved to become administrators of his estate.

Judge Mitchell Beckloff granted 79-year-old Katherine Jackson temporary guardianship of the children, who range in age from 7 to 12. He also gave her control over some of her son’s personal property that is now in the hands of an unnamed third party. But the judge did not immediately rule on her requests to take charge of the children’s and Jackson’s estates.

The swiftness of the legal motions underscore the fact that Jackson’s death leaves a vacuum if he died without a valid will. If no will is filed, the number of potential claimants that could emerge seeking custody of the children or a piece of his empire are many.
The circus atmosphere around Jackson's estate will continue for some time. I can only hope that his kids are cared for and looked after in a responsible manner.

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