Universal AED sign unveiled

On September 19th 2008 R.W.Koster wrote the following letter to the ILCOR councils, National Resuscitation Councils,  AED manufacturers, public and governmental organisations

I am pleased to inform you that The International Liaison Committee on Resucitation (ILCOR) has unanimous approved the proposal of the ILCOR Task Force for a universal sign indicating the presence of an Automated External Defibrillator (AED). The sign is designed in accordance with ISO 7010 for safety signs and shape. Colors and existing symbols are in accordance with ISO 3864-3. Its comprehensibility has been tested in accordance with ISO 9186-1, rev. 2007 and proved superior to alternative designs. 

The AED sign is intended to indicate the presence of an AED, the localisation of an AED in a room, a container with an AED for public use or to indicate the direction to move in order to reach the AED, etc. It should assist in rapidly identifying the AED in a public place for immediate use in a victim of cardiac arrest. For this purpose the AED sign can be combined with other existing symbols like a standard arrow.

The AED sign can also be accompanied by the letters “AED” or equivalents in other language groups. The full text “defibrillator” or equivalent is not encouraged. Several examples of combinations are
shown.

It is ILCOR’s intention that this sign is adopted worldwide by the national councils that together form each ILCOR member council. The sign should also be adopted by all AED manufacturers for use with their products and by manufacturers of signage. Public organisations and governments should encourage the use of this universal AED sign.

We hope that this universal AED sign will assist in the awareness of the existence of AEDs and the rapid deployment of AEDs in the emergency of a cardiac arrest. 
 
On behalf of the ILCOR Task Force AED signage,

R.W. Koster, chairman
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Statement on the training required to use an Automated External Defibrillator

Statement on the training required to use an automated external defibrillator
from the UK Resuscitation Council

April 2009 revised November 2009

The majority of people who survive a cardiac arrest are resuscitated from ventricular fibrillation (VF) by the administration of a defibrillatory shock. This is most likely to be successful when it is given very soon after the onset of VF; emergency service personnel are often unable to arrive soon enough to help a victim.

Automated external defibrillators (AEDs) are designed to be used by members of the public, and are very effective at guiding the operator through the process of administering the shock. They have become widely available, are safe and easy to use, and will not allow a shock to be given to a victim who does not require one.

AEDs have been used frequently by laypeople with modest training, and many reports testify to the success of this strategy. Operators without formal training have also used AEDs successfully to save lives.

While it is highly desirable that those who may be called upon to use an AED should be trained in their use, and keep their skills up to date, circumstances can dictate that no trained operator (or a trained operator whose certificate of training has expired) is present at the site of an emergency. Under these circumstances no inhibitions should be placed on any person willing to use an AED.

It is the view of the Resuscitation Council (UK) that the use of AEDs should NOT be restricted to trained personnel. Furthermore, the Resuscitation Council (UK) considers that it is inappropriate to display notices to the effect that only trained personnel should use the devices, or to restrict their use in other ways. Such restrictions are against the interests of victims of cardiac arrest, and discourage the greater use of AEDs by members of the public who may be able to preserve life and assist victims of cardiac arrest. This confirms similar advice from the British Heart Foundation.

The principles contained in this statement are aimed primarily at lay persons, first aiders and those who do not work as health care professionals. In health care environments where an AED is available, it is important that all staff who may be called on to use it are trained and that their qualifications are kept up to date. The status of training is a subject that should be reviewed during the annual appraisal process.

The Resuscitation Council (UK) advises that NHS Trusts should ensure that no restriction is placed on the use of an AED by an untrained NHS employee confronted with a patient in cardiac arrest when no more highly trained individual is present. The administration of a defibrillatory shock should not be delayed waiting for more highly trained personnel to arrive. The same principle should apply to individuals whose period of qualification has expired. 
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Man survives 47 minutes in cardiac arrest

Doctors Wouldn't Give Up on N.Y. Man, Delivering 4,500 Chest Compressions and 8 Defibrillator Shocks to Save Him.

What happens if your heart stops beating?

Is it possible to survive?

CBS station WCBS in New York recently met a Brooklyn man who lived after his heart quit for 47 minutes, and it's all thanks to a team of doctors who refused to give up until they brought him back from the dead.

"These doctors did not stop," Joe Tiralosi said, fighting through tears to find the words to describe his experience. "Without them, and I'm serious when I tell you, I wouldn't be here."

Tiralosi is a medical miracle. He's been to the edge and back, to a place most people don't return from. Now he's at home in Brooklyn, but three months ago he literally died.

"I think miracle best describes it," Tiralosi said.

Tiralosi suffered sudden cardiac arrest. His heart stopped beating for 47 minutes.

"Not a moment goes by that I don't take for granted every second because I know it only takes the blink of an eye to lose your life," he said.

Last week, the 56-year-old father of two returned to NewYork-Presbyterian Hospital/Weill Cornell Medical Center to thank the medical team who saved his life and share his story with WCBS.

On Aug. 17, Tiralosi walked into the emergency room feeling sick and disoriented. He collapsed a minute later.

"The doctors themselves were responsible for giving my chance to live again," Tiralosi said.

Doctors Rahul Sharma and Flavio Gaudio led the team who worked on him. "It's a miracle for which it is difficult to find words," Dr. Gaudio said. "When Joe came in he was talking. It was his presence when he came in that made us all say we're not going to give up," Dr. Sharma added.

"I felt he had a good pulse with the compressions so part of me thought that we had bought some time," Gaudio said.

It took 4,500 chest compressions and eight shocks from a defibrillator to get Tiralosi stabilized at 11:55 a.m. While his doctors worked frantically to save him he barely remembers anything about that day.

"I kind of remember going out. I knew I was going out and I heard someone call my name, and I just went out," Tiralosi said.

Tiralosi's doctors said only one out of four people survive sudden cardiac arrest. Most die within 10 minutes of heart failure. And of those who survive 30 percent suffer serious brain damage.
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Pocket CPR for your iPhone

Pocket CPR for iPhone from Zoll is a MUST-HAVE app for anyone who wants to learn how to perform CPR with ACCURACY.

The PocketCPR can be used in CPR training programs and for individual practice at home or at work. It is a great tool for families to learn CPR in order to be prepared if a loved one needs their help.

PocketCPR for iPhone:

• Actively utilizes the accelerometer hardware in the iPhone for real-time COACHING and actual FEEDBACK on CPR while you are learning and practicing.
• Measures the ACTUAL rate and depth of your compressions and lets you know if you need to push faster or slower, and whether you should push harder or softer.

Other CPR prompting devices can provide instructions on CPR or encourage you on the steps and pace of CPR, but ONLY PocketCPR for iPhone can:

1. Give instructions
2. Prompt on the steps for proper CPR
3. AND give you REAL-TIME feedback on the chest compressions you deliver.

PocketCPR for iPhone will remind you to Call for Help, to provide ventilations according to guidelines (optional), and to perform CPR at the correct rate and depth. The device algorithms are in complete compliance with American Heart Assocation and International Liaison Committee on Resuscitation (ILCOR) guidelines.

Pocket CPR for iPhone features include:

• Clear visual and audio step-by-step instructions on CPR performance, including initial steps for the Chain of Survival
• Option to go straight to chest compressions for those who are familiar with the initial Chain of Survival steps
• Precise metronome to pace chest compressions
• Accurate ability to detect rate of actual compressions and to state visually and audibly whether to PUSH FASTER or to PUSH SLOWER.
• Industry-proven technology to detect the depth of chest compressions.
• Audio and visual prompts to PUSH HARDER or to PUSH SOFTER.
• Prompts to remind the user to provide ventilations after the detection of 30 chest compressions.
• Feature to detect when chest compressions have stopped and to prompt user to START CPR.
• Complete Instructions for Use
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"Heart Risk" at football stadiums

Too many football grounds in Europe do not have the right equipment and plans to save the lives of fans who have heart attacks, a study has found.

The poll of 187 stadiums found over a quarter did not have defibrillators and many did not have emergency plans.

The Sweden-led study, carried out by a group of club doctors, stressed more had to be done as it was not always easy to get ill fans to hospital.
Researchers said there should be mandatory rules covering the issue.

At the moment, it is simply considered good practice to have defibrillators at sports grounds.

But in recent years many governments - including the authorities in the UK - have been doing more to increase the availability of the life-saving equipment in public spaces.

Defibrillators work by delivering a controlled electric shock through the chest wall to the heart to restore a normal heartbeat.

Professor Mats Borjesson, the official medic for Swedish club GAIS and a member of the European Association of Cardiovascular Prevention and Rehabilitation, said every ground should have access to a supply of the machines.

"It is known that viewing and being emotionally engaged in a soccer game increases the likelihood of people suffering a heart attack so we think this should be a formal requirement."

He also warned facilities at sporting arenas elsewhere in the world may be even worse.

"As football is the biggest and best resourced sport in Europe, the situation may be even worse elsewhere."

But only 64% had a written medical action plan, covering issues such as medical staffing and communications with hospital.

The study, published in the European Heart Journal, gathered data from 10 countries, including England, France and Spain.

It did not name the grounds that took part, although the researchers said most of them were from the top divisions, and over the previous season there had been 77 heart attacks - one for every 589,000 spectators at these stadiums.
The 37 English grounds that were included were among the better performers, the study showed.

Ellen Mason, of the British Heart Foundation, said it was important the issue was being highlighted.

"Early access to a defibrillator increases the chance of survival so it's reassuring to know that so many stadiums in England had one."
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Aspirin linked to increased risk of Crohn's Disease

People who regularly take aspirin may be more likely to develop Crohn's disease, new research suggests.

Crohn's is a chronic (long-term) condition that causes the lining of the digestive system to become inflamed, causing diarrhoea, abdominal pain and fatigue.

About 90,000 people in the UK have Crohn's disease, which tends to develop between the ages of 16 and 30 years.

Now, scientists at the University of East Anglia have found that people who regularly take aspirin for a year or more may be particularly at risk of the condition.

The team studied 200,000 people, aged 30 to 74 years, in the UK, Sweden, Denmark, Germany and Italy.

They found that those who were regular aspirin users were around five times more likely to develop Crohn's disease than those who rarely took the drug.

The findings were presented at the Digestive Disease Week conference in New Orleans and lead researcher Dr Andrew Hart, from the university's School of Medicine, said that aspirin use 'could be one of many factors which influences the development of this distressing disease'.

However, the researcher emphasised that people should continue to take aspirin because the overall risk of Crohn's disease is still 'very low'.
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Stressful jobs increase women's heart disease risk

Women have been warned that stress in the workplace can increase their risk of heart disease.

The study of 12,000 female nurses in the journal Occupational and Environmental Medicine found that work-related stress has a greater effect on younger women.

Scientists asked the nurses - aged between 45 and 64 - about pressure at work and tracked their health for 15 years, during which time 580 nurses were admitted to hospital with ischaemic heart disease, including 369 cases of angina and 138 heart attacks.

When other health risks such as smoking and drinking were taken into account, it was found that those who described a stressful work environment were 35 per cent more likely to develop heart disease.

However, when the researchers broke the results down by age, they found it was only the women aged 50 and under who were significantly affected.

Lead author Dr Yrsa Andersen Hundrup, from the Research Centre for Prevention and Health, said: 'This study adds to the previous body of evidence suggesting harmful effects of excessive psychological demands at work on cardiac health, but is one among very few that demonstrates the effect among women.

'Additional work should be carried out to identify factors contributing to the perceived high work pressure.'

June Davison, cardiac nurse at the British Heart Foundation (BHF), said that stressed employees may pick up unhealthy habits which contribute to their risk of heart disease.

'Pressurised workers may reach for cigarettes, snack foods and alcohol to make themselves feel better,' she explained.

'If you feel under pressure you should try and tackle it in a positive way and get active during work hours.'
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Blood fat linked to increased heart risk

A type of blood fat called triglycerides may have a role to play in the development of heart disease, new research suggests.

Scientists at Cambridge University analysed 350,000 people who had taken part in 101 previous studies.

They found that those with a genetic tendency to have high levels of triglycerides tended to have a greater risk of heart disease.

Mike Knapton, associate medical director at the British Heart Foundation, which helped to fund the research, said that the study adds to the findings of previous studies which had failed to reach a conclusion about the link between triglycerides and heart disease.

'It could yet prove to be an important step towards tackling cardiovascular disease, but we mustn't get ahead of ourselves,' he noted.

'There still needs to be larger trials before we can know whether lowering triglyceride levels can reduce heart disease risks.'

In the meantime, Mr Knapton said that people should aim to achieve a healthy diet, take regular exercise, stop smoking and take recommended medication to reduce their risk of developing heart disease.
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Don't pander to fussy eaters

Purees and fruit-filled yoghurts can be a useful way to encourage fussy eaters to eat more fruit, an expert has claimed.

Ian Marber, founder of nutritional practice The Food Doctor, suggested that healthy eating can be promoted by presenting fruit in a visually appealing way.

'The vivid colours of fruit are inevitably more enticing and appetising than green vegetables, which are traditionally less popular with children,' Mr Marber claimed.

'Purees and compotes work well, as does mixing fresh fruit into yoghurts.'

The expert's comments follow a recent study from Maastricht University in Holland, which found that schoolchildren ate fruit more readily when it was presented in a creative way.

Their research, which is published in Appetite journal, concluded that visual appeal "had a strong effect on consumption of fruit" and the study authors urged parents to offer fruit to children "in a visually appealing manner".

According to the latest statistics from the NHS Information Centre, just one in five children, aged five to 15, ate the recommended five daily portions of fruit and vegetables in 2008.
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Meningitis vaccine may "wear off"

The effectiveness of the meningitis C vaccine may wear off over time, a new study suggests.

Scientists at Oxford University discovered that the effects of the vaccine, which is administered to infants at three, four and 12 months of age, often wear off in less than ten years, leaving many teenagers at risk.

The researchers tested 250 children, aged six to 12 years, who had received the vaccine.

Presenting their findings at the annual conference of the European Society for Paediatric Infectious Diseases in Nice, they revealed that just one in four children still had protection after seven years.

Lead researcher Professor Andrew Pollard told the Daily Telegraph: 'This study is just the latest to show that the personal protection given by meningitis C vaccines in early childhood doesn't last forever and several countries have now responded to these findings by introducing teenage boosters.'

Sue Davie, chief executive of the Meningitis Trust, said that the charity supports the use of safe and effective vaccines and urged people to receive whatever vaccines are available.

'If, as a result of this research, a booster programme is introduced, we would actively encourage the introduction of this,' she added.
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Scientists discover new genetic clues to breast cancer

UK scientists have identified five more genetic sites that increase a woman's risk of developing breast cancer.

The discovery, which is detailed in the journal Nature Genetics, brings the total number of common 'low-risk' genetic sites that are linked with the disease to 18.

According to the researchers, the five new genetic variations increase an individual's risk of developing breast cancer by between six and 16 per cent.

In the long term, it is hoped that a test can be developed that looks for a combination of these genetic variants in order to aid prevention and treatment decisions for those who are most at risk.

Study author Professor Nazneen Rahman, from the Institute of Cancer Research, said that although 18 gene regions have now been identified, 'we still don't know which genes are causing this increased risk'.

'Identifying the underlying genes and mechanisms behind breast cancer development is essential to increasing our understanding of the disease and ultimately finding new treatments,' the researcher added.

Dr Helen George, head of science information at Cancer Research UK, which helped to fund the study, added: 'This research takes us a step closer to developing a powerful genetic test for the disease.'

Genetic tests are already available for certain gene faults that are known to increase a woman's risk of developing breast cancer, including BRCA1 and BRCA2.
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Measures to manage IBS

Irritable bowel syndrome (IBS) is an unexplained stress-related disorder that affects around 10 to 20 per cent of the UK population.

The condition involves a long-term disturbed bowel habit – such as constipation or diarrhoea and abdominal discomfort or pain.

While it mainly affects younger people, and is slightly more common in women than men, IBS can affect people young and old, male and female.

With the fast pace of modern life – and the stresses this brings with it – Western counties have seen an increase in the number of young people with IBS.

'Our lifestyles are changing, and figures appear to show that medically unexplained conditions like IBS – along with chronic fatigue, unexplained backache and breathlessness – have increased,' says Dr Nick Read, consultant gastroenterologist, psychotherapist, and acting chairman of the Gut Trust, the UK charity that supports people with IBS.

'Now somewhere around 15 per cent of the population have symptoms identifiable as IBS,' he says.

Although there's no simple cure for IBS, there's plenty you can do to make the condition more manageable.

Causes

There are a number of factors that can lead to IBS. But experts agree that the major cause is stress – followed by diet and infections, such as gastroenteritis.
'I would say 95 per cent is down to stress, alongside other causes that play a smaller role,' says Dr Read.

'When you see patients, you understand that IBS is an expression of things going on in their life – major events or life stresses – such as people losing jobs, retirement, divorce, childbirth, and other relationship related problems,' he says.

Symptoms

It's important to remember that IBS is an unexplained disorder, and so many of the symptoms are common to other complaints of the intestines – such as colitis, infections in the rectum, or even haemorrhoids.

But the main symptoms, which should be long term rather than acute (6 months according to a report by the National Institute for Health and Clinical Excellence), can include:

• abdominal discomfort, such as distention or pain
• sensation of lower abdominal pain
• passage of mucus
• bloating
• condition made worse by eating
• change in bowel habits, without an obvious cause such as illness or infection.

Further related symptoms can include:

• tiredness
• indigestion
• nausea
• anxiety and depression
• backache
• bladder irritability

What can you do?

Know the cause

'It's important for someone with IBS – as well as their GP – to ask a few questions.

• What was going on when the IBS started?
• When does the condition come and go?
• What do the symptoms remind you of?

'Just understanding the root causes can make you much more empowered and able to deal with the condition,' says Dr Read.

Over-the-counter medicines

There are various over-the-counter products that can help with the symptoms of IBS. These include antispasmodics (Buscopan) and anti-diarrhoea (Imodium) medicines. Your pharmacist can give you advice on these.

However, medicines are often a bit 'trial-and-error' – they can give support, but they're not the whole answer.

Antidepressants

In the short term, antidepressants such as tricyclic antidepressants (TCAs) or selective serotonin reuptake inhibitors (SSRIs), can help in low doses. These will be prescribed by your doctor.

'In the long term, I worry that these drugs will stop people making the lifestyle changes that will help them improve their condition properly,' says Dr Read.
'But as a short term solution, they can be useful,' he says.

Alternative treatments

Some people may not want to talk about the situations that may have led to their IBS.

So, the key thing is to find things that will help them relax. This might simply be making more time for rest and relaxation, or undertaking alternative therapies – such as meditation, hypnotherapy, reiki, acupuncture – or touch therapies, such as massage.

These treatments have a certain 'healing effect', and they can help increase people's confidence and belief that they can manage their condition.
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How to make your home healthy

Home is where the heart is, but it could also be making you and your family sick. Here are some simple changes that you can make, to benefit your health.

Pets

We are a nation of pet lovers, and we keep around seven million cats and six million dogs.

Pets can improve our emotional wellbeing – but they can also make us feel unwell.

'Pets can exacerbate allergy symptoms because they have allergens in their urine, saliva and skin dander,' says Lindsey McManus of Allergy UK.
Cats are by far the commonest animals to cause allergy in humans, but any animal can cause a problem.

Pets can also carry salmonella, which can lead to diarrhoea and vomiting.
Cats can carry a parasite leading to toxoplasmosis in their faeces. This can be dangerous to children and can cause pregnant women to miscarry.

The solution

'Vacuum regularly, with a machine that contains a high-efficiency particulate air (HEPA) filter. This extracts even the smallest allergens from the air.

'Wash down surfaces regularly and damp dust,' says Lindsey McManus.
Discourage your pet from licking your face, and make sure that everyone in the family washes their hands after touching a pet.

Double glazing

Double-glazed windows are now common because they're energy efficient and help to keep out the chill.

Unfortunately, they form such a good seal against the wind and weather – they also dramatically cut down ventilation.

'In the past, homes were draughty. This had the one advantage of reducing the amount of house dust mites, which are a major cause of allergy' explains Dr Adrian Morris, consultant allergist at the Surrey Allergy Clinic.

'House dust mites thrive in warm damp houses that have low levels of circulating air,' he says.

Condensation can also quickly build up due to moisture created by cooking, breathing and showering. Dampness causes mould, which can make asthma symptoms worse.

The solution

'Leave your windows ajar when you're in the house to keep your home well ventilated,' says Lindsey McManus.

'Invest in an extractor fan in the kitchen to remove steam and cooking smells. When you have a shower, make sure that you close the door – so the steam can't escape to the rest of the house. Open the bathroom window afterwards,' says Lindsey McManus.

Central heating

Homes today are normally fitted with central heating, which makes life comfortable for human occupants – as well as the house dust mite.
'In the winter months, centrally heated homes become ideal breeding grounds for the house dust mite,' says Dr Morris.

Carbon monoxide poisoning can be caused by faulty or poorly maintained gas boilers.

The solution

Keep your central heating turned down as low as is comfortable, with a jumper on.

Keep windows open for ventilation.

Gas boilers should always be checked regularly by an expert to make sure that they're not leaking poisonous carbon monoxide into the home. This deadly gas can kill in extreme cases.

Kitchen chemicals

Sparkling kitchens look great. But household cleaning products can cause health problems and even in rare cases, chemical sensitivity syndrome.
Bleach is widely used to decontaminate surfaces and bathrooms. But it can release irritant vapours that can exacerbate asthma symptoms.

Many aerosol cleaning products contain volatile organic compounds (VOCs) that are used as propellants. These VOCs can cause headaches, drowsiness and general feelings of being unwell.

The solution

There are lots of natural products that can keep your home clean and smelling fresh.

Lindsey McManus advises using bicarbonate of soda as an abrasive cleaner.
'It also makes a great natural air freshener, mixed with water and a few drops of essential oil. Put it in a plant sprayer and spray it round the room,' she says.

Vinegar can also be used to clean windows and surfaces – and lemon juice can remove stains from work tops.

Feather duvets

Lots of people believe that they're allergic to feathers in pillows and bedding. But they may not be blaming the true culprit.

'True feather allergy is rare,' says Dr Harry Morrow Brown, a specialist in allergy and respiratory medicine at the consulting rooms at Highfield House, Derby.
'In most cases, the house dust mites on the feathers cause the symptoms,' he says.

The solution

The usual advice is to swap your feather bedding for non-feather alternatives.
However, a recent study compared different types of bedding, including feather foam and synthetic fibre, and found that house dust mites caused the least problem in feathers.

'We now suggest you use a high quality cotton pillow case, with a dense weave – so that allergens can't come through,' says Dr Brown.

Baby bottles

There's been some concern that many hard plastic baby bottles contain the chemical Bisphenol A (BPA), which has been linked to an increased risk of breast and prostate cancer.

BPA is also found in a wide range of other plastic products, including lap top computers and tableware.

The Food Standards Agency in the UK has said that 'it's possible' that BPA may affect the hormone system in people's bodies. But there's not evidence that it causes harm in people.

The solution

If you're worried, switch to plastic bottles that don't contain BPA, or glass ones.

Don't fill up your baby's bottle with boiling water, since there's evidence that this makes it more likely the BPA will leach out of the plastic and into the fluid.

Discard old or worn bottles that are more likely to leach the BPA.

A good rule of thumb is not to keep a bottle longer than six months.
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