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The Dobkin Technique


October 28, 2011
By Ilena DiToro

Do you remember when you were a child your mother would place a cold wet cloth on your forehead when you were running a fever? Well this article could very well show she was doing more than just lowering your feaver. Due to the efforts of Jeffrey Dobkin many thousands of lives can be saved each year if this method is adopted for heart attack victims by first responders.

The Technique seeks to prevent or delay the irreversible brain damage thought to occur when no oxygen reaches the brain for four minutes. It is used as a time-buying procedure to save the lives of heart attack victims and victims of suffocation, drowning, respiratory failure, and drug overdose. Perhaps it will even help SIDS (crib death) or stroke victims until proper medical equipment and personnel are summoned and arrive. 

The Technique can be applied by a child or even self-administered in almost any home. It takes less than 30 seconds to initiate and the results are as immediate. It works on both conscious and unconscious victims. It can be explained on the phone in under a minute. 
 
Almost everyone has heard of a boy drowning in cold water—then, after half an hour of submersion, being resuscitated with no ill effects and no brain damage. The Canadian Medical Association Journal documented such a drowning: After half an hour of complete submersion, a boy was rescued from the icy waters where he fell. He was resuscitated and, with proper medical treatment, had no lasting side effects. There was no cerebral damage, although his brain received no oxygen for over half an hour. 
 
Research has shown than in all vertebrates there is an automatic reflex called the Mammalian Diving Reflex. It occurs naturally as a life-preserving mechanism during cold water submersion. More commonly called the “Diving Reflex,” it is a protective oxygen-conserving reflex to keep brain and body alive during submergence and possible drowning in cold water. The body prepares itself to sustain life. It is a totally natural protective mechanism serving Homo sapiens, originating from hundreds of thousands of years of evolvement. 
 
The Technique may never, nor should it, replace CPR. But if applied in addition to CPR it may help sustain the life of the hundreds of thousands of victims of heart attacks or suffocation. It may also be a simple application for victims thrust into a life-and-death situation who may not be near people trained in CPR. 
 
If you are not skilled in CPR, and you live in the country where an ambulance is 20 minutes away, and someone close to you has a heart attack—the options are frightening. Without the initiation of the Technique, a person whose heart stops has only four minutes until irreversible brain damage occurs. After you call for help, you can watch or you can try this technique. There is also the possibility it may not work at all; this is, after all, a theory. But the fact that it just may work makes it worth a try when there is no other immediate remedy.
 
“The Technique for Delaying Brain Damage” is simple and easy to initiate. In natural surroundings, the diving reflex occurs when a mammal falls into water 15 degrees Celcius (58 F) or colder. This reflex may also be artificially triggered by only a facial immersion in cold water. The Technique is to apply cold water, wet towels, or wet ice packs to the victim’s face—especially the eyes—to trigger the diving reflex in the event of heart or respiratory failure. This procedure starts the oxygen-conserving mammalian diving reflex. 
 
For those technically inclined here is what happens: 
 
Bradycardia can start in as little as four seconds or can take up to thirty seconds, depending on what part of the breath cycle the person is in when cold water is applied to the face. In man, cold water facial immersion usually induces a 15% to 30% decrease in heart rate from normal resting values. The reflex is strong enough to override other seemingly vital reflexes; i.e., it can completely obliterate the tachycardia that accompanies moderately severe exercise on a bicycle ergometer and can abruptly reduce heart rate from 130­140 beats per minute to 80 or less, despite continuation of the exercise. Bradycardia is initiated by parasympathetic vagal activity. 
 
Skin and muscle blood flow decrease through a powerful constriction of peripheral arteries. Peripheral vaso-constriction brought about by sympathetic activity maintains blood pressure. At the same time, systemic arterial pressure, especially diastolic, is increased. This lower heart rate and redistribution of central blood flow supports more necessary life-preserving organs. 
 
The reflex triggers anaerobic metabolism, shown by a fall in arterial pH. There is an increase in concentrations of lactic and other organic acids, and a rise in blood carbon dioxide and potassium. This indicates that the body’s cells are using less oxygen.
 In a study by Wolf, Schneider and Groover, arterial oxygen saturation fell very little during immersion when the reflex occured.
 
Because arterial oxygen saturation falls very little, the term “oxygen conserving” is appropriate for the reflex—an animal is enabled to survive without breathing for a much longer period than its supply of oxygen would warrant under ordinary circumstances.
 
Accentuation of the reflex to the greatest degree occurs when the facial immersion in cold water is accompanied by fear. The more fearful the condition, the stronger the trigger to bring about the reflex and the greater the chance a strong oxygen-conserving reflex will take place. 
 
In an article in Newsweek, drowning specialist Dr. Martin J. Nemiroff (Michigan University Medical Center) suggests that the involuntary diving reflex saves lives of drowning victims by delaying suffocation—by shunting oxygen from extremities and sending it toward the heart, brain, and lungs—and reduces the possibility of brain damage and death. A photo in the Newsweek article shows Dr. Nemiroff with Brian Cunningham, who was revived after 38 minutes under water. 

Dr. Nemiroff has successfully revived numerous victims of cold water drowning who were submerged for 30 minutes or more and were pronounced dead.
 
A discussion in a Scientific American study of the human body’s ability to resist drowning states that the Diving Reflex and cold water reduce the oxygen demand of tissues, extending the period of survival without external oxygen to as long as one hour. Previously, irreversible brain damage was thought to occur after four minutes without oxygen.
 
The Diving Reflex is currently used by the medical profession in conversion of paroxysmal atrial tachycardia. The Technique is to immerse the face of a person in a tub or basin of water 50 degrees or cooler. Since the technique produces an almost instant conversion to normal sinus rhythm and is not invasive, the use of the Diving Reflex is recommended by many authors and cited as a safe, effective treatment. In one study, nine out of 10 patients converted in 15­38 seconds, with an average of 23 seconds. Its use is also the treatment of choice for converting a supraventricular tachycardia in children and infants, in whom the Diving Reflex effect is most pronounced. 
 
It may be used in the event of any oxygen deprivation to the brain. Its procedure can be explained over the telephone, self-administered, or applied by a friend or child with no training. And while it will not stop heart attacks from happening, it will buy precious time until proper medical equipment and personnel arrive. 

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Dobkin’s Technique to delay brain damage in heart attack victims is simple: Immediately apply cold, wet compresses to the face of the victim. 

His technique is an emergency time-buying procedure to delay brain damage until emergency medical personnel arrive. It works in conjunction with CPR.

The Dobkin Technique is application of cold wet compresses to the face and eye area. “The eyes, the ophthalmic nerve, are the trigger points,” says Dobkin. The Dobkin-Trigger Technique immediately starts to delay brain damage and gives emergency medical personnel a much greater “golden window” to respond to non-breathing victims by more than four minutes.

The Dobkin Technique works in heart attack victims – the fourth largest cause of death in the U.S. His technique works to delay brain damage when the oxygen supply to the brain of a person is shut off (Hypoxic-Ischemic Encephalopathy) for any reason: drug overdose, choking, stroke, suffocation, electrocution. It works at a critical time—on the scene: before initial resuscitation can be started by medical personnel.

SOURCE: The Brain Injury Foundation
 
 
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Further information may be obtained by simply Googling “The Dobkin Technique” or www.BrainInjuryFoundation.org. Ilena DiToro  is a media relations specialist working with the Brain Injury Foundation.