A STAFFORD woman who was brought back from the dead after having a cardiac arrest has bought a defibrillator for the town centre.
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Despite several campaigns to increase numbers of defibrillators in public places - and the English government's acknowledgement of their life-saving role - public access to them is low, as is understanding of their use, says a new UK study. The findings imply it would be a different story if defibrillators were as accessible and as well understood as fire extinguishers.
Estimates from the British Heart Foundation (BHF) suggest around 60,000 out of hospital cardiac arrests occur in the UK every year.
A defibrillator - also called an automated external defibrillator or AED - is a device that delivers an electric shock to the heart of someone who is having a cardiac arrest. Prompt use of an AED can shock the heart back into rhythm.
Acting quickly when someone is in cardiac arrest before the ambulance arrives can save their life. Every minute without CPR and defibrillation reduces their chance of survival by 10%.
The aim of the new UK study was to find out how available AEDs were, given the effort that has been put in over the last 10 years to promote and deploy them in public places, such as shopping centers and train stations.
The study was conducted by researchers from the University of Southamptom, working with the South Central Ambulance Service, and it is published in the journal Heart.
Performing CPR for 38 minutes or longer can improve a patient’s chance of surviving cardiac arrest, a new study has found.
The findings, presented at the American Heart Association’s Scientific Sessions 2013, revealed that sustaining CPR that long also improves the chances that survivors will have normal brain function.
Cardiac arrest occurs when electrical impulses in the heart become rapid or chaotic, causing it to suddenly stop beating.
In the US, about 80 percent of cardiac arrests, nearly 288,000 people, occur outside of a hospital each year, and fewer than 10 percent survive.
Research has found that the early return of spontaneous circulation — the body pumping blood on its own — is important for people to survive cardiac arrest with normal brain function.
However, little research has focused on the period between cardiac arrest and any return of spontaneous circulation.
The Japanese Circulation Society Resuscitation Science Study group tracked all out-of-hospital cardiac arrests in Japan between 2005 and 2011.
The researchers studied how much time passed between survivors’ collapse and the return of spontaneous circulation, and how well brain function was preserved a month later.
Survivors were considered to have fared well neurologically if they were alert and able to return to normal activities, or if they had moderate disability but were well enough to work part-time in a sheltered environment or take part in daily activities independently.
“The time between collapse and return of spontaneous circulation for those who fared well was 13 minutes compared to about 21 minutes for those who suffered severe brain disability”, said Ken Nagao, M.D., Ph.D., professor and director-in-chief of the Department of Cardiology, CPR and Emergency Cardiovascular Care at Surugadai Nihon University Hospital in Tokyo.
After adjusting for other factors that can affect neurological outcomes, the researchers found that the odds of surviving an out-of-hospital cardiac arrest without severe brain damage dropped 5 percent for every 60 seconds that passed before spontaneous circulation was restored.
Based on the relationship between favourable brain outcomes and the time from collapse to a return of spontaneous circulation, the researchers calculated that CPR lasting 38 minutes or more was advisable.
“It may be appropriate to continue CPR if the return of spontaneous circulation occurs for any period of time”, concluded Nagao.
Millions of people around the world have learned CPR on a mannequin known as Resusci Anne. The story of the 19th Century beauty behind the model - or at least, one version of it - will be told at a symposium in London to mark European Restart a Heart Day. But does anyone really know anything about her?
The Lorenzi workshop is a small haven of peace and antiquity in the busy Parisian suburb of Arcueil. And it's the last of its kind. Downstairs the mouleurs, or cast-makers, create figurines, busts and statues, pouring plaster into moulds in much the same way they have since the family business started in the 1870s.
But if you want to be face-to-face with history, pick your way up the dusty wooden stairs to a room above the workshop. It's an unsettling experience. Hanging all around you in the narrow attic are life and death masks of poets and artists, politicians and revolutionaries: Napoleon, Robespierre, Verlaine, Victor Hugo, the robust, impatient face of the living Beethoven and the sallow, diminished features of the composer's death mask.
Yet, surprisingly, of all the visages of the great and the good on display at Lorenzi's, the best-seller is the mask of a young woman. She has a pleasant, attractive face, with the hint of a smile playing on her lips. Her eyes are closed but they look as if they might spring open at any moment. Hers is the one mask that has no name. She's known simply as the Inconnue, the unknown woman of the Seine.
Seattleites can join in a life-saving scavenger hunt. Players will compete to identify and report the locations of Seattle’s automatic external defibrillators, or AEDs, for a cash reward. Prizes range from $50 to $10,000.
AEDs are electronic briefcase-size devices designed to allow bystanders on scene at a medical emergency to help someone who has collapsed with loss of mechanical activity of the heart, or cardiac arrest.
“Our list of AED locations may be incomplete. We are seeking the public’s help to learn where more of these devices are,” said Dr. Graham Nichol, University of Washington professor of medicine in the Center for Pre-Hospital Emergency Care at UW Medicine’s Harborview Medical Center.
AEDs are cost-effective lifesavers that are often placed where cardiac arrests are most likely, such as airports, sports clubs and shopping malls, according to Nichol, who explained why it is important for a bystander to be able to locate an AED immediately.
“Cardiac arrests are a leading cause of death in the United States but can be treated if recognized and responded to quickly with an AED.”
Often cardiac arrest is due to ventricular fibrillation, in which the lower chambers of the heart quiver instead of contracting in a steady beat. AEDs simplify analysis of the heart rhythm. This enables lay people to recognize and treat ventricular fibrillation before emergency medical services providers arrive. Each device has voice and visual prompts that guide bystanders through the necessary steps.
More than 1.2 million AEDs are now in public places in the United States, and about 180,000 more are installed each year. Sometimes bystanders cannot find the nearest AED during a medical emergency. That’s where the My HeartMap Seattle challenge comes in. Game players will assist UW clinicians by reporting the location of AEDs in community settings throughout Seattle.
Here are the basic rules of the game.The contest starts Tuesday, Oct.15, and ends Friday, Nov. 15. Complete your free registration to participate in the contest. When you locate an AED in Seattle, report a brief description of it on the contest website, including the building address for the AED, its location within the building, and whether the device appears to be ready for use. A $10,000 grand prize will be awarded to the individual or team that identifies the most unique AEDs. “Unique” means no other player or team has already found the AED. The grand prize will be “unlocked” when at least one individual or team identifies 500 AEDs or all contest participants collectively identify 750 AEDs. Twenty $50 prizes are also available. Twenty AEDs in the city of Seattle have been pre-selected by the research team as “Golden AEDs.” These are unmarked, and those who are first to report a “Golden AED” will win $50. You can follow MyHeartMap Seattle on twitter (@cprnation, #MyHeartMapSeattle) or at the CPR Nation website.
The AED scavenger hunt aims to build public awareness about AEDs, which are commonly contained in a clear glass wall box, sometimes near a fire extinguisher. The spot is generally marked with a symbol of an electrical charge passing through a heart shape.
The contest is modeled after a similar Philadelphia County project at the University of Pennsylvania, which in turn adapted an approach from the Defense Advanced Research Projects Agency for its Red Balloon Challenge. Dr. Raina Merchant, University of Pennsylvania assistant professor of emergency medicine, directed the My HeartMap Philadelphia Challenge. She is the director of the Penn Medicine Social Media Lab and an expert in the use of digital strategies to educate the public on at-the-scene emergency aid. Merchant is collaborating with UW scientists on the My HeartMap Seattle Challenge.
“This is an exciting collaboration that could have a real impact on access to emergency care in Seattle and other regions throughout the country,” noted Merchant.
During the MyHeartMap Philadelphia challenge, participants submitted data about AED locations via a website and a phone app. Some 313 individuals and teams reported more than 1,400 AEDs. Prizes were given for reporting the most AEDs found or for being the first to report the location of specific previously selected devices.
“Most people realize that AEDs are simple enough to use,” Nichol said. “Just follow the voice and visual prompts. They are designed to provide a shock only when needed.”
An AED is usually activated by opening its lid. The commands then begin with visual, recorded and text instructions for baring the patient’s chest and sticking on the pads. Then the machine asks everyone to step back while it analyzes the heart rhythm. It repeats the request to stand clear if it decides to administer a shock. If the rhythm suddenly normalizes before a shock is delivered, the machine will report a rhythm change and announce that no shock will occur.
Most machines also instruct in CPR and coach the timing of compressions and breaths.
“My HeartMap Seattle will help us improve care for patient with out of hospital cardiac arrest,” Nichol said. “The methods and results of this AED scavenger hunt in Seattle will be applied to scavenger hunts in other large cities throughout the United States. In the future, we will have a comprehensive record of AED locations throughout the country.”
My HeartMap Seattle is funded by the U.S. Food and Drug Administration, Zoll Medical Inc., Philips Healthcare Inc., Physio-Control Inc., HeartSine Technologies Inc. and Cardiac Science Inc.
The collaborating sponsors include the American Heart Association, Medic One Foundation, Nick of Time Foundation, University of Pennsylvania and University of Washington.
Businesses now have more flexibility in how they manage their provision of first aid in the workplace following a change in health and safety regulations.
As of today (1 October 2013), the Health and Safety (First Aid) Regulations 1981 have been amended, removing the requirement for HSE to approve first aid training and qualifications.
The change is part of HSE's work to reduce the burden on businesses and put common sense back into health and safety, whilst maintaining standards. The changes relating to first aid apply to businesses of all sizes and from all sectors.
Andy McGrory, HSE's policy lead for First Aid, said: "HSE no longer approves first-aid training and qualifications. Removing the HSE approval process will give businesses greater flexibility to choose their own training providers and first aid training that is right for their work place, based on their needs assessment and their individual business needs.
"Employers still have a legal duty to make arrangements to ensure their employees receive immediate attention if they are injured or taken ill at work."
Information, including the regulations document and a guidance document to help employers identify and select a competent training provider to deliver any first-aid training indicated by their first-aid needs assessment are available on the HSE website at http://www.hse.gov.uk/firstaid/.
HSE will continue to set the standards for training. While the changes give employers flexibility, the one day Emergency First Aid at Work (EFAW) and three day First Aid at Work (FAW) courses remain the building blocks for first aid training.
As part of the changes, the Approved Code of Practice (ACOP) text which was previously included in guidance document L74 (which consisted of only 12 sentences), has been incorporated into the new guidance. The advice in the guidance sets out clearly the recommended practical actions needed, and the standards to be achieved, to ensure compliance with duties under the 1981 Regulations. This is intended as a comprehensive guide on ensuring compliance with the law.
Sudden cardiac arrest — when, without warning, the heart instantly stops beating — kills 350,000 Americans of various ages and occupations a year, according to the American Heart Association.
Yet now, with high school sports teams beginning their fall seasons, now is when we are most aware of these fatalities because of a tragic drama: A young football player in peak condition, who has never flunked a physical or shown the faintest symptom of cardiac problems, suddenly collapses.
Death is usually all but instantaneous — but it is not necessarily inevitable, not if a device called an Automated External Defibrillator, or AED, and someone willing to use it are close at hand.
Sudden cardiac arrest is not the same as a heart attack, which usually is caused by blocked arteries and often gives some advance warning. Sudden cardiac arrest occurs when the electrical impulses that control the heart suddenly misfire.
The mild electric shock from an AED “resets” the heart and allows it to resume normal function. Bystanders revive several thousand people this way each year. More widespread use of the devices could save at least 20,000 more, according to the American Red Cross.
Since their introduction in the 1950s, AEDs have become smaller, simpler and basically foolproof; in one study, sixth-graders mastered them quickly and easily. There are about 2.5 million AEDs in the country, far short of the 30 million experts say are needed just to cover metropolitan areas and far short of the Red Cross goal of having every person in America within four minutes of an AED.
There are no good reasons why AEDs are not now widely and readily available. They should be and the solution may require a certain amount of public outcry and political attention.
Uniform national standards need to replace the often complex and inconsistent state and local rules on where and how AEDs are placed — ordering that they be placed prominently, like fire extinguishers, and regularly maintained.
The AEDs should clearly display the good Samaritan legal exception — all states have them — that protects from liability for injury or wrongful death people who voluntarily and in good faith try to save a life.
Says one manufacturer of AEDs, “It’s kind of blunt, but the bottom line is that when you’re in cardiac arrest, you’re dead before you hit the ground. There’s no way you can cause that victim any more harm using that device. You’re trying to bring them back.”
Unlike TV hospital dramas, AEDs do not have paddles that administer massive jolts. Two adhesive leads attach to the chest and the shock, if the machine’s diagnostics say one is needed, scarcely causes the patient’s chest muscles to twitch — and the newer devices will talk the user through the process.
An American public that had no problem mastering smartphones should have even less difficulty with AEDs once they are highly visible and readily accessible.Click here to edit the title
Portable, heart-shocking defibrillators are not fail-safe.
Like any machine, automated external defibrillators, or AEDs, need to be maintained. Batteries run down and need to be replaced.
Electrode pads that attach to a patient’s chest also deteriorate and have to be replaced every year or so. Circuitry can fail. And maintenance can be spotty.
SHNS photo courtesy American Red Cross Universal symbol and sign for an AED — a heart with a lightning bolt in the middle.
The U.S. Food and Drug Administration has received more than 45,000 reports of “adverse events” associated with failure of AEDs between 2005 and 2012, although only some of the events involved the fully automated devices put in public areas. The others were defibrillators limited to medical use. Manufacturers also conducted more than 80 recalls during the seven-year period.
The number of AEDs sold in the U.S. has been rising steadily, from around 100,000 a year in 2010 to between 500,000 and 1 million this year, according to the Sudden Cardiac Arrest Foundation and industry officials. There are about 2.5 million deployed.
“Survival from cardiac arrest depends on the reliable operation of AEDs,’’ said Dr. Lawrence DeLuca, a professor of emergency medicine at the University of Arizona in Tucson.
He led a 2011 review of more than 40,000 AED malfunctions reported to the FDA between 1993 and 2008. The analysis found that 1,150 deaths occurred during those failures.
No one knows exactly how often someone attempts to use an AED, but with an average survival rate of 2 percent to 4 percent from sudden cardiac arrest outside a hospital, according to studies, the devices help save roughly 3,500 to 7,000 lives each year, although not all of the rescues are performed by untrained bystanders. If AEDs were more widely available, the number of saved lives could triple or more, experts say.
“AEDs can truly be lifesavers, but only if they are in good working order and people are willing to use them,’’ said DeLuca, who had a personal experience with batteries failing on a device when he was trying to revive a fellow guest at a resort in 2008.
It took nine minutes to retrieve a second AED, which did work. The patient was not revived.
Problems with pads, cables and batteries accounted for nearly half the failures — mistakes that could have been due to poor maintenance. Forty-five percent of failures linked to fatalities occurred when the device was attempting to charge (power up) and deliver a recommended shock to someone in cardiac arrest, DeLuca said.
But there also were incidents reported to the FDA when the devices shut down without analyzing a patient’s heart rhythm.
Regulators and watchdogs believe some victims were not revived when the machines failed, but it’s difficult to say whether any particular patient would have had heartbeat restored.
The FDA said the most common malfunction reports involved design flaws and manufacturing of the devices using poor-quality parts such as capacitors and software.
AED failures have raised enough concern that the FDA is ending the medium-risk status that AEDs have had since they first became widespread more than 20 years ago.
Now, they’ll be classified high-risk equipment that reflects their use to support and sustain human life — and their greatly increased sophistication over the years. Manufacturers will have to provide more safety evidence and FDA inspectors will be allowed to inspect plants where parts are made.
The tighter rules don’t mean the public should lack confidence in the lifesaving devices. Dr. William Meisel, the FDA’s chief scientist for devices, stressed the essential role AEDs play when he announced the new rules in March.
“These devices are critically important and serve a very important public-health need,” Meisel said, noting that none were being taken out of service beyond the recalls manufacturers have already issued. “Patients and the public should have confidence in these devices and we encourage people to use them under the appropriate circumstances.”
A special iPhone case and app can be used to quickly and cheaply detect heart rhythm problems and prevent strokes, according to University of Sydney research presented at the Australia and New Zealand Cardiac Society conference today on the Gold Coast.
The research found the AliveCor Heart Monitor for iPhone (iECG) was a highly-effective, accurate and cost-effective way to screen patients to identify previously undiagnosed atrial fibrillation (AF) and hence help prevent strokes.
What's more, the test is able to be used in local pharmacies and general practitioner surgeries with a single-lead ECG taken on an iPhone with a special case.
Senior author, Professor Ben Freedman, said that the device was an exciting breakthrough and would greatly assist in the challenge to improve early identification of atrial fibrillation and prevention of stroke.
"Atrial Fibrillation (AF) is the most common heart rhythm problem and is responsible for almost one third of all strokes," he said.
"AF increases with age, affecting more than 15 percent of people aged 85 years and over. And people with atrial fibrillation face up to a five-fold increased risk of stroke, and tend to have more severe and life-threatening strokes.
"In addition, our research showed that about 1.4 percent of people aged over 65 (50,000 Australians) have atrial fibrillation, but do not know it. There are currently a large number of people with unknown AF who are at high risk of stroke, but who are not on any medication.
"The good news is that stroke is highly preventable with anticoagulant medication, such as warfarin, or the new oral anticoagulants, which can reduce the risk by 66 percent.
"The iECG allows us to screen patients for atrial fibrillation in minutes, and treat people early. This is a huge boost in the fight to reduce the amount of strokes, particularly in people over the age of 65," Professor Freedman said.
For patients in the study with a history of known atrial fibrillation, the researchers also identified both a treatment gap and a knowledge gap. The treatment gap they identified was that only 66 percent of those eligible for stroke prevention medication were being prescribed this medication.
Lead author Nicole Lowres also said the knowledge gap of patients with AF was surprising and alarming.
"Over half of those with known atrial fibrillation in AF at the time of screening were unaware of their diagnosis even though many of them were prescribed and taking warfarin to treat their condition," she said.
"The iECG can be viewed on the phone screen and also used as an educational tool to teach people about their heart rhythm." Ms Lowres said.
Ms Lowres also noted how cost effective screening with the iECG could be.
"Our economic analysis has shown the iECG is highly cost effective and in fact this is the first mass screening program fir AF likely to be cost effective, unlike traditional 12 lead ECGs recorded by a practice nurse," she said.
"In addition, the iECG is extremely portable, which gives great flexibility for screening, and is simple to administer.
"In a new development, we are now getting receptionists in general practice to record an iECG before patients see their doctor," Ms Lowres said.
About the iECG: When taking a reading, the iECG can be seen on the iPhone screen in real time. In addition, the iECG is transmitted to a secure server (cloud) where a specialist can review the iECGs remotely. The website can automatically analyse the reading to make a diagnosis of AF. The researchers tested the website's automatic prediction in the SEARCH-AF study and found it correctly diagnoses atrial fibrillation 97 percent of the time.
The researchers are currently trialling iECG screening in GP surgeries in Sydney.
The University of Sydney research was funded by a number of investigator-initiated research grants from BMS/Pfizer, Boehringer Ingelheim, and Bayer. The National Heart Foundation provided a scholarship for lead researcher, Nicole Lowres.
"The development of the iPhone ECG device just shows how important research and fundraising is in the fight against heart disease and stroke," Dr Robert Grenfell, the Heart Foundation's National Director of Cardiovascular Health, said.
"Last year, the Heart Foundation directed $13.5 million in funding to support 195 researchers. This year through the Heart Foundation Big Heart Appeal, we hope to raise $5 million to continue funding this kind of world-class research."
All it takes is a quick and simple finger-prick blood test, which your GP can carry out straight away. If the result indicates Type 1 diabetes, the GP should refer the child to a specialist paediatric diabetes team the same day so they get immediate treatment to bring their diabetes under control and to prevent DKA.
Dr Aseem Malhotra, from Manchester, a cardiology specialist registrar at the Royal Free Hospital in London, says the machines could save thousands of lives.Former footballer Fabrice Muamba’s life was saved as medics used a defibrillator when he suffered a heart attack on the pitch
A cardiologist has called for defibrillators to be placed in all public buildings in a bid to improve the low survival rates for heart attack victims.
About 60,000 heart attacks happen outside of hospitals in Britain each year – but the survival rate is between just two per cent and 12pc.
Dr Aseem Malhotra, from Manchester , a cardiology specialist registrar at the Royal Free Hospital in London, says the machines could save thousands of lives.
The former Manchester Grammar pupil said: “There should be defibrillators in all public buildings. They should be there like you have fire extinguishers.
“We know that, with defibrillation, the chances of survival increase to 75 pc. They are simple, computerised, tell you what to do, and it analyses the heart rhythm for you, shocking patients out of the abnormal rhythm.”
Dr Aseem and colleague Roby Rakhit, consultant cardiologist and clinical director at the hospital, have written an article in the British Medical Journal which says scientific evidence to support early defibrillation is overwhelming.Dr Aseem Malhotra
They say lessons can also be learned from Seattle in the US, which has the world’s highest rate of survival for cardiac arrests. Children in Seattle are taught CPR in schools.
They say there should be more CPR training in Britain and steps should also be taken to ensure that patients are sent to the right hospitals where they can be treated by specialist cardiologists.
The call for more machines also comes after the Bolton Wanderers footballer Fabrice Muamba nearly died during a match but was saved thanks to prompt treatment and the use of a defibrillator.
Surveys have revealed that only one in 13 people in Britain feel confident enough to carry out emergency first aid.
Campaigners including leading doctors, health experts and MPs have written to the prime minister asking him to consider changing the law to make the life-saving machines compulsory in every community.
Myth: It is possible to swallow your tongue.For a seizure victim, rolling them on their left side is the preferred position. I was not able to ascertain why this was the case, but it was recommended by the epilepsy foundation.You should also never try to restrain the person having a seizure. Roll them on their left side and then move objects away from them, so that they don’t injure themselves on those objects. But otherwise, you just have to let the seizure run its course.The lingual frenulum is the small mucous membrane that extends from the floor of the mouth to the mid-line of the tongue.In some people, this lingual frenulum can be so restrictive, in terms of restricting the movement of the tongue, that they can have trouble speaking. When this happens, it is known as Ankyloglossia, or “tongue-tie”. Often these people cannot even extend the tip of their tongue beyond their front teeth. This is particularly a problem for babies with this condition as they have trouble breast feeding, thus trouble taking in enough food.The base of the lingual frenlum contains tissue that has a series of saliva glands on it. The two largest of these are called the Wharton’s Ducts and are in the front.The tongue isn’t just one muscle, as many people say, “the strongest muscle… etc.” In fact, it’s made up of many muscles, which allows for the great range of movement most people have with it, with the muscles running in different directions.As you age, the number of taste buds you have tend to diminish. An average child is born with about 10,000 taste buds. An average elderly person only has about 5,000. This is partially why many kids hate vegetables so much. Vegetables can be very bitter to “super tasters” or those close to that. As you age and your taste buds diminish, this bitter flavor goes away somewhat and changes the taste of the vegetables dramatically in the process.The tongue never really gets a rest. Even while you are sleeping it is constantly pushing saliva into the throat, making sure you don’t drool all over your pillows.
Coroners could save lives by telling family members of a loved one lost to a heart condition to get screened themselves.
Guidance (1) led by the British Heart Foundation (BHF) has been developed with the Chief Coroner of England and Wales to ensure that if someone dies from an inherited heart condition, the coroner recommends directly to relatives that they are screened as well.
Around 600 people aged just 35 or under die suddenly each year with apparently no explanation or cause of death, leaving families shocked and distraught (2). Often the cause is due to an inherited heart condition. Signposting family members to their GP for a referral to a cardiac genetic clinic could save the lives of siblings and children of those affected by detecting the same potentially fatal condition and prompting immediate treatment and monitoring.
Suzanne Morton, who lost her 20-year-old son, Luke, last year to an undiagnosed heart condition, said: "It's a mother's instinct to want to protect her children. I couldn't protect Luke from a heart condition I didn't know he had. But, by telling Luke's story, I hope I can prevent other parents from going through the pain of losing a child so suddenly.
"That's why I'm getting behind these new guidelines for coroners, which will make sure that families are screened to see if they are carrying an undetected heart condition. Even if it even saves the life of one young person, it'll be worth it."
Professor Peter Weissberg, Medical Director at the BHF, said: "The death of a loved one can sadly be the first time people find out about an inherited heart condition in their family. Yet, even after a 'suspicious' death, family members are not always screened themselves. Their life could be in danger and their family could be devastated all over again - something a simple blood test could set right.
"We are delighted the Chief Coroner is supporting this important guidance. It will save lives and prevent families suffering a second, devastating loss."
HHJ Peter Thornton QC, Chief Coroner of England and Wales, said: "This guidance, which will be issued to all coroners, will help to avoid a second death in a family from an inherited heart condition. It is a vital part of coroner work to prevent future deaths wherever possible."
Professor Huon Gray, National Clinical Director for Cardiac Care, NHS England, said: "Identifying and offering treatment to families with a genetic risk of sudden cardiac death is a priority for the NHS and forms part of the Government's Cardiovascular Disease Outcome Strategy.
"It is fantastic that the Chief Coroner and the BHF are supporting this important work. With such collaboration I believe we can make great progress, and help reduce the loss of young lives and the great stress that this causes their families and friends."
A GRANDFATHER has told how he would be "eternally grateful" to the woman who saved his life after he collapsed in a Falmouth restaurant.
John Ollernshaw, from Flushing, would have died if a member of staff from Princess Pavilion had not resuscitated him during a cardiac arrest in November.
John Ollernshaw and wife Sylvia, with Ceinwen Morgans, who performed CPR on him after he collapsed.
Catering team leader Ceinwen Morgans started CPR on the 82-year-old within minutes of the arrest, having been trained in first aid just a few weeks earlier.
Mr Ollernshaw said: "I guess I was in the right place at the right time.
"If it had happened somewhere else, who knows what the chances of finding someone who knew what to do would have been.
"I will be eternally grateful to that young lady and the fact she had completed the first aid course."
Mr Ollernshaw's wife, Sylvia, credited Ms Morgans with saving his life.
"He went straight down and the girl just started resuscitating him immediately until the paramedics came," she said. "She cracked two of his ribs in the process and she had to keep going for a considerable amount of time. It was that which saved his life.
"We have been told that if the waitress hadn't been trained he would have died before the paramedic arrived.
"It was just amazing really, it seemed like it was just instinctive for her which was marvellous."
It was the first time Ms Morgans, from Falmouth, had put her training into practical use since completing the course. She said: "It all just happened so quickly and luckily I knew what to do. Nothing can prepare you for the real thing. I think my adrenalin carried me through and I was able to just get on with it but afterwards it was a little bit traumatising.
"If there hadn't been someone like me there that day then John would have died and his family would have faced Christmas and the new year without him."
Mr Ollernshaw, a dad of two and grandfather of three, had to be defibrillated on the way to the Royal Cornwall Hospital in Truro. In the ambulance, his wife was warned he was unlikely to survive the night.
"Our local vicar came with me to the hospital and by the time we got there the staff had managed to get him going on the machines because he wasn't able to do it himself," said Mrs Ollernshaw.
He remained on life support for four days before he was able to breathe on his own, then spent almost a month in hospital, during which he underwent heart-bypass surgery.
Alison Brown, cardiac rehab nurse at the Royal Cornwall Hospitals Trust, said: "It is fantastic that he was in a public place where there was someone who had been recently trained in CPR."
The price for failing to report accidents or provide first-aid is potentially high
Under the Reporting of Injuries, Diseases and Dangerous Occurrences Regulations 2013 (RIDDOR), employers must report any work-related deaths, and certain work-related injuries, cases of disease, and near misses involving employees
Employers must also ensure that they provide suitably trained personnel and have adequate equipment and facilities for giving first-aid to employees who are injured or become ill at work. This is a requirement under the Health and Safety (First-Aid) Regulations 1981 (as amended) (FAR).
Changes to the law
Changes to both RIDDOR and FAR introduced on 1 October 2013 aim to simplify reporting requirements by removing some of the ambiguity that existed previously.
The mechanism for reporting under RIDDOR remains unchanged. Employers are still required to report relevant accidents to the Health and Safety Executive (HSE) within a reasonable time frame.
The main changes include:a shorter list of ‘specified injuries’, instead of the ‘classification of major injuries’eight categories of ‘work related illnesses’, rather than 47 reportable industrial diseases.fewer ‘dangerous occurrences’ that require reporting
There is still a requirement under FAR to provide adequate first-aid cover, facilities and equipment. However the HSE will no longer approve first-aid providers. This means that employers themselves will need to make sure that training providers can prove their competence in relation to FAR.
An advantage of the change in the regulations is that rather than running HSE approved courses, some training providers can now provide bespoke, industry specific first aid training. This makes it vitally important that they are appropriately qualified but it is also advisable to retain trainers with experience in your industry so that the training can be tailored to specific risks.
Training providers should be able to produce the following documentation to aid in establishing their competence and relevant experience:a current First Aid at Work certificate (or exemption if applicable)a documented quality assurance plana brief of what the syllabus covers.
Training providers previously approved by the HSE are always a good option, as are trainers approved by organisations such as Ofqual.
In relation to RIDDOR not much has changed. However, employers need to:obtain a copy of the new legislation related to RIDDOR, which can be found at www.legislation.gov.uk/uksi/2013/1471/contents/made, and gives a list of the new categories for reporting – an invaluable tool for ensuring the right type of incident is reported;ensure that all H&S representatives and any H&S committees are aware of and trained in these new categories.
In relation to FAR, employers should ensure that:trainers are competent in first aid and hold appropriate qualifications;training organisations have quality assurance plans for auditing their training;training providers demonstrate that they work to accepted training standards;first-aid courses are taught in accordance with recognised and accepted first aid practice;first-aid training courses are relevant to the organisation’s industry;appropriate certificates are issued to assessed students;
Employers would also be well advised to ask for recommendations or feedback from previous training sessions.
Companies have been successfully prosecuted for failing to report accidents in accordance with RIDDOR or for not reporting them in a timely manner. Getting it wrong can be costly. In R v Nicholls & Clarke Glass Ltd, the company was fined £11,200.
Prosecutions under FAR are rare. The case of R v TS (UK) Ltd resulted from a fatal accident where there were no first-aiders to give initial treatment prior to the arrival of paramedics. As well as receiving a £130,000 fine under the Health and Safety at Work Act. 1974, the company was also fined £10,000 for the first aid offence.
Making sure that there are appropriately trained first-aiders on hand will not only help you avoid such penalties but could also have a considerable impact on employees’ injuries or suffering.
Semra Zack-Williams is a Health & Safety Specialist and Stuart Jones is Head of Employment at Weightmans
Further information can be found at www.hse.gov.uk
Business owners in the United Kingdom can breathe easier—two regulations took effect on Oct. 1 that will help them comply with health and safety regulations, according to a news release from HSE.
The first change is an amendment to the Health and Safety (First Aid) Regulations 1981. The change removes the requirement for HSE to approve first aid training and qualifications, giving business owners much more flexibility. The change is part of HSE's attempt to "reduce the burden on businesses and put common sense back into health and safety," according to the agency.
The second legislative change is to the Reporting of Injuries, Diseases and Dangerous Occurrences Regulations (RIDDOR) 1995. The new change clarifies and simplifies the reporting requirements while also ensuring that the data gives an accurate and useful picture of workplace incidents. Specifically, the changes include different classification of major injuries (a shorter list of specified injuries is used), eight categories for industrial disease instead of 47 types, and fewer types of occurrences that need to be reported.
For more information, visit http://www.hse.gov.uk/press/2013/hse-legislation-changes.htm.
People who suffer a cardiac arrest in Denmark today are three times more likely to survive than a decade ago, thanks largely to a national effort to teach people CPR, a new study says.
Denmark launched a national effort in 2005 to teach its residents to perform CPR, or cardiopulmonary resuscitation, in order to save people who suffer a cardiac arrest outside a hospital. The country gave out 150,000 instructional kits; kids began learning CPR as early as elementary school. Teens were required to learn CPR in order to get a driver’s license.
The results have been dramatic, say authors of a study in today’s Journal of the American Medical Association, or JAMA. About 300,000 people in North America each year suffer a cardiac arrest, when the heart stops beating, outside of a hospital.
In Denmark, the number of cardiac arrest victims who received “bystander” CPR — from someone other than a health professional — more than doubled, from 22% in 2001 to 45% in 2010.
In the same time period, the percentage of cardiac arrest victims who arrived at a hospital alive increased from 8% to 22%.
The percentage of patients alive after 30 days tripled, growing from 3.5% to 11%. The percentage of patients alive after one year also more than tripled, from 3% in 2001 to 10% in 2010.
Those findings are impressive, says Michael Sayre, a professor of emergency medicine at the University of Washington and a spokesman for the American Heart Association.
Although other studies have looked at smaller, community efforts to promote CPR, Sayre says the new study is striking because it involved an entire country.
Thanks to efforts by the heart association, Washington and a handful of other states now require students to take a CPR class before graduating from high school, Sayre says.
Still, study authors say that Denmark’s CPR initiative can’t take all of the credit for improving survival.
That’s because Denmark also made other important changes aimed at increasing survival after a heart attack, such as improving the care provided both by hospitals and emergency medical services.
“Teaching bystanders the importance of CPR can make a difference,” says Suzanne Steinbaum, director of the program on women and heart disease Lenox Hill Hospital’s Heart and Vascular Institute, in New York.
Performing CPR is actually easier than ever, Steinbaum says. That’s because the heart association now recommends a “hands-only” CPR procedure, in which bystanders concentrate on performing chest compressions, instead of alternating compressions with mouth-to-mouth breathing.
“Those who witness a cardiac arrest and start CPR can actually change the outcome of what happens to the victim,” she says.
For more information visit www.stjohnqld.com.au or call 1300 360 455.
9 year old Kayne Holden with mum Cherie Briggs at their home in Bingley West YorkshireSWNS
Cherie said: “It was extraordinary timing.”
The London Ambulance Service has declared Heathrow Airport as having the highest cardiac arrest survival rate in London, outside of hospital.
The airport has 180 heart-starting defibrillators, over 100 first aid-trained front line staff and a specialist team of 15 bicycle-riding London Ambulance Service paramedics.
Recent statistics show that the Heathrow Cycle Response Unit reached 93.6% of the most serious and life-threatening emergencies at the airport within eight minutes – far exceeding the national target of 75% within that time frame. The overall cardiac arrest survival rate in London in 2011/12 was 10.9% and in Heathrow was 74%.
The bicycling paramedics treated almost 900 passengers out of the 6.5m that travelled in June – with more than a fifth being treated for life-threatening conditions. It is reported that passengers are never more than two minutes away from a defibrillator.
London Ambulance Service Community Resuscitation Training Officer Martin Bullock said: “We’ve been working with Heathrow Airport for over ten years and thanks to the defibrillators, its first aid-trained staff and our cycle responders, it has one of the highest cardiac arrest survival rates in the world. The survival rate witnessed for cardiac arrests at the airport is six times as high as in London overall.”
If a passenger is believed to be in a life-threatening condition, the onsite ambulance is called at the same time to ensure additional helps arrives as soon as possible. In less serious cases, the bicycle paramedic or emergency medical technician is sent initially on their own and can then request further assistance if required.
Heathrow also encourages its staff to participate in company-wide first aid courses.
Some instructors have decided not to teach mouth-to-mouth ventilation during resuscitation training.
The current Resuscitation Council (UK) guidelines include mouth-to-mouth ventilation during cardiopulmonary resuscitation (CPR) for both laypeople and healthcare professionals, but compression-only CPR is encouraged for those who are untrained, unable or unwilling to perform mouth-to-mouth ventilation. Compression-only CPR is better than no CPR, and this is the primary message in high-profile media campaigns in the UK that target people who have not been trained in CPR.
Resuscitation Council (UK) Guidelines 2010 for Basic Life Support state that studies have shown that compression-only CPR may be as effective as combined ventilation and compression in the first few minutes after non-asphyxial arrest. However, chest compression combined with rescue breaths is the method of choice for CPR by trained lay-rescuers and professionals and should be the basis for lay-rescuer education.
Compression-only CPR has potential advantages over chest compression and ventilation, particularly when the rescuer is an untrained or partially-trained layperson. However, there are situations where combining chest compressions with ventilation is better, for example in children, in asphyxial arrests, and in prolonged resuscitation attempts. Therefore, CPR should remain standard care for healthcare professionals and the preferred target for laypeople, the emphasis always being on minimal interruption in chest compressions. A simple, education-based approach is recommended:Ideally, full CPR skills should be taught to all citizens.Initial or limited-time training should always include chest compression.Subsequent training (which may follow immediately or at a later date) should include ventilation as well as chest compression.
CPR training for citizens should be promoted, but untrained laypeople should be encouraged to give chest compressions only, when appropriate with telephone advice from an ambulance dispatcher.
Those laypeople with a duty of care, such as first-aid workers, lifeguards, and childminders, should be taught chest compression and ventilation.
Resuscitation Council (UK) Guidelines 2010 for In-hospital resuscitation state that if there is no airway and ventilation equipment available, giving mouth-to-mouth ventilation should be considered. If there are clinical reasons to avoid mouth-to-mouth contact, or you are unwilling or unable to do this, do chest compressions until help or airway equipment arrives. A pocket mask or bag-mask device should be available rapidly in all clinical areas.
Current guidelines recommend starting CPR with chest compressions and this helps avoid the need for mouth-to-mouth resuscitation in most clinical situations as airway equipment should be available rapidly. The Resuscitation Council (UK) recognises that there will be circumstances where mouth-to-mouth ventilation is not appropriate. But there are occasions when giving mouth-to-mouth ventilation could be life-saving.
Mouth-to-mouth ventilation is an important resuscitation skill that is relatively easy to teach and learn, and should be included in resuscitation training for healthcare professionals.
Google Glass has made its way into healthcare. Its use in the operating room and in medical education has been profiled here. Yet the magic of Glass will be found in the applications that can make this “technology” into real-world solutions for health and medicine. It’s a bit like the smart phone and how its realization is a function of the countless apps that bring the device to life.Inside The Operating Room
Christian Assad, MD has taken the next step with Glass and developing a practical app that can turn Glass into a real life-saver. He recently profiles this application on his blog and I believe it’s an important turn of events that showcase just how technology can be applied to medicine and public health issues. Here’s how it presents the concept in his blog–Google Glass and augmented CPR:
Dr. Assad combines science, technology and popular culture to create a platform that is as simple as it is important. From the scientific underpinning to the driving musical beat, he’s part of a generation of clinicians ushering in digital health and the interesting and evolving role of Google Glass.
David Lloyd Leisure’s health clubs do business throughout Europe; the company has 80 sites in the UK alone. With more than 440,000 members the company gets 25 million club visits a year. Since 1998, the David Lloyd Leisure staff has used AEDs to save the lives of more than 100 people.
There’s no legal requirement in the UK for fitness clubs to have automated external defibrillators (AEDs) on the premises. But the health and safety experts at David Lloyd Leisure insist on having AEDs readily accessible at every one of their busy clubs. This policy, along with staff training in AED use, has made a world of difference. Since 1999, David Lloyd Leisure has saved more than 100 lives.
“Our feeling is every fitness facility should have an AED, even if there’s no legal requirement,” says Caleb Brown, of the health and safety office at David Lloyd Leisure. “AEDs have become so affordable, and the response element is something which is really easy for a health club to do — they’ve already got team members available.”
One of Europe’s largest health and fitness businesses, David Lloyd Leisure started its AED program in 1998. At first, this simply meant ensuring that the reception desk at every facility had a defibrillator at hand.
A staff member from David Lloyd Leisure Brooklands with their Powerheart AED. Staff at the club used the AED to revive a member in 2010.
The return on investment in terms of lives saved was immediate, and the company nurtured the AED program. Brown, who joined the company in 2000, has been involved in the development of the company’s AED training program as part of overall safety training. Today, an AED is brought immediately to the scene of any health incident at one of the clubs.
While the survival rate for people who suffer outside-of-hospital sudden cardiac arrest in the United Kingdom is less than 20 percent, the survival rate for someone who suffers cardiac arrest or another serious health incident at one of the David Lloyd Leisure clubs reached 88 percent in 2012.How They Chose Powerheart AEDs
All David Lloyd Leisure clubs are equipped with at least one AED, and one large, six-story site has two defibrillators on the premises. All the AEDs — with the exception of devices at clubs recently acquired from other companies — are Cardiac Science Powerheart AED G3s. The Powerheart AEDs were chosen because they’re highly portable and easy to use, with long-lasting medical-grade batteries and Rescue-Ready technology that conducts an automatic self-check of the main components (battery, hardware, software, and pads) every day. When it’s nearing time to replace a battery, a Rescue Ready indicator on the AED turns red and sounds an alert.
“The Powerhearts are so easy to look after, and the maintenance system is brilliant,” Brown says.
In the aftermath of any incident in which an AED was required, the club replaces the used pads with a set of spares. Brown, or one of his health and safety team colleagues, then visits the club to download data from the AED for hospital use, write up an incident report, and supply a new set of spare pads.Training: Key to a Successful AED Program
Brown, who took on a leadership role in the AED program in 2006, has designed training for club employees that enables them to respond with maximum speed and efficiency when a cardiac incident occurs.
“Because of the voice prompts, even an untrained bystander can use an AED,” Brown points out. “With a training program, you give people the ability to react faster in an event, which is going to increase chances of survival.”
Ambulance response time in urban areas in the UK is usually under 8 minutes, Brown noted, but for a sudden cardiac arrest victim that is often too late. Brown’s goal has been to train David Lloyd Leisure staff to get the AED to the victim, and the defibrillator pads on the victim’s chest, within 1 minute.
Once the pads are attached, the AED can diagnose the heart rhythm, and, if appropriate, administer a shock. The AED’s voice prompts coach the team through every step of the process, including administering CPR. The AEDs are programmed in accordance with the latest resuscitation guidelines, and David Lloyd Leisure bases its training on those same guidelines.
“I believe that some businesses overestimate the amount of training that is required for a successful AED program,” Brown says. “Our training is only two hours for an employee, once a year. With just that basic training, in the vast majority of incidents requiring an AED, we are able to get the pads onto the chest in less than a minute.”
In 2012, the company’s survival rate for incidents in which an AED was deployed reached 88 percent.
“The training I received in using the AED enabled me to use the AED with confidence and the clear voice prompts helped to keep me calm,” one of the rescuers reported after the incident. “It’s an amazing feeling to know that the actions I took resulted in a life being saved.”