My quest to dunk started poorly. The main problem was that I could only do about half of the very long list of ercises the Jump Manual instructed at the crowded and inadequate YMCA near my place. The basketball court—the only space big enough to do some of the drills—was always occupied with classes. The Strength Shoes, meanwhile, were so absurd that I was too embarrassed to wear them in front of other gym-goers. I used them only a handful of times, in an empty stairwell on the top floor of the gym.
The dose was determined according to the patient's body weight. Doses of dopamine could be increased or decreased by 2 μg per kilogram per minute and doses of norepinephrine by 0.02 μg per kilogram per minute (or more in emergency cases) (see Figure 1 and Figure 2 in the Supplementary Appendix, available with the full text of this article at NEJM.org). An example of the dose-escalation table is provided in Table 1 in the Supplementary Appendix. The target blood pressure was determined by the doctor in charge for each individual patient. If the patient was still hypotensive after the maximum dose of either agent had been administered (20 μg per kilogram per minute for dopamine or 0.19 μg per kilogram per minute for norepinephrine — doses that have been shown to have similar effects on mean arterial blood pressure12,13), open-label norepinephrine was added. The dose of 20 μg per kilogram per minute for dopamine was selected as the maximal dose because this upper limit was the standard of care in the participating ICUs, in line with expert recommendations14 and international guidelines.15
Step 3. Jump as high as you can while flinging your arms forward and overhead. When you leave your feet, only reach up with one arm; you’ll be able to reach a higher point this way versus reaching with both arms. Land softly with a slight knee bend, being careful not to let your knees cave inward. Drive them outward as you did when preparing to jump in the first place.
For smaller guys much of the problem, and one I struggled with, is managing the ball. Like most guys my size I can palm a basketball if a grab it carefully, but realistically it isn’t going to happen without a little concentrated effort. Some of those big guys can make a basketball look like a volleyball, and they have no trouble getting hold of it and shoving it over the rim.
Use a smaller ball. It's much easier, when you're first starting out, to try dunking with a smaller ball. You'll be able to palm it more easily and control your approach, making the maneuver more satisfying and your practice closer to the real thing. Continue dribbling and shooting exercises with the appropriate-sized ball so you're not getting too used to the "wrong" size, but keep a small ball around for your sick dunks.
A total of 1679 patients were enrolled — 858 in the dopamine group and 821 in the norepinephrine group (Figure 1). All patients were followed to day 28; data on the outcome during the stay in the hospital were available for 1656 patients (98.6%), data on the 6-month outcome for 1443 patients (85.9%), and data on the 12-month outcome for 1036 patients (61.7%). There were no significant differences between the two groups with regard to most of the baseline characteristics (Table 1); there were small differences, which were of questionable clinical relevance, in the heart rate, partial pressure of arterial carbon dioxide (PaCO2), arterial oxygen saturation (SaO2), and ratio of partial pressure of arterial oxygen (PaO2) to fraction of inspired oxygen (FIO2). The type of shock that was seen most frequently was septic shock (in 1044 patients [62.2%]), followed by cardiogenic shock (in 280 patients [16.7%]) and hypovolemic shock (in 263 patients [15.7%]). The sources of sepsis are detailed in Table 2 in the Supplementary Appendix. Hydrocortisone was administered in 344 patients who received dopamine (40.1%) and in 326 patients who received norepinephrine (39.7%). Among patients with septic shock, recombinant activated human protein C was administered in 102 patients in the dopamine group (18.8%) and 96 patients in the norepinephrine group (19.1%).
The simplest method to measure an athlete's vertical jump is to get the athlete to reach up against a flat wall, with a flat surface under his/her feet (such as a gym floor or concrete) and record the highest point he/she can reach flat-footed (the height of this point from the ground is referred to as "standing reach"); fingertips powdered with chalk can facilitate the determination of points touched on the wall. The athlete then makes an effort to jump up with the goal of touching the highest point on the wall that he or she can reach; the athlete can perform these jumps as many times as needed. The height of the highest point the athlete touches is recorded. The difference between this height and the standing reach is the athlete's vertical jump.