BajaNomad

Defibrillators: Let's get the first network in Baja

EnsenadaDr - 10-25-2012 at 12:48 PM

I think we can all beat out the Mexican government by a large lead in getting AED's installed in crucial areas of Baja, since there is nowhere in Baja I have seen AED's in supermarkets, stadiums, and shopping malls. I think we need to get volunteers in each area of Baja to start up their program. Maybe Shari in Asuncion, Gypsy Jan in Rosarito, LindaLou might want to help in Lomas Del Mar, Terry in Baja Country Club....volunteers needed. Let's call them VBB, or Volunteers for a Better Baja...any other suggestions?

shari - 10-25-2012 at 12:59 PM

I'm in Doc...the ball is already rolling thanks to boe4fun and Los Medicos Voladores and Stan for motivating us.

DENNIS - 10-25-2012 at 01:04 PM

You use an AED on someone and he dies in spite of, or because of it, you will be having your mail forwarded to prison for a long long time. Ensenada Dr. could pull it off, but not just anybody would be immune to prosecution.

Bajagypsy - 10-25-2012 at 01:21 PM

Shari that is wonderful news!

EnsenadaDr - 10-25-2012 at 01:21 PM

You've already made your point Dennis. The machine is totally legal and safe. You might want to do a study on the Good Samaritan Law in Mexico in comparison to the US. But I would say if the US is allowing them in airports, malls and public places, and know the machine is for the use of the general public, your legal concerns are unfounded. So are you saying you wouldn't want someone to use the machine on you in an emergency, God forbid that would happen? In spite of your fear of prosecution, would you, in spite of your own concerns, be willing to turn your back on a friend or neighbor whose life could be saved by a push of a button?
Quote:
Originally posted by DENNIS
You use an AED on someone and he dies in spite of, or because of it, you will be having your mail forwarded to prison for a long long time. Ensenada Dr. could pull it off, but not just anybody would be immune to prosecution.

Wonderful news!!

EnsenadaDr - 10-25-2012 at 01:26 PM

Shari,
This is great. I think it's extremely important for us, as the founding group, to share our experiences and tips for others in more remote and not so remote areas so it may make their efforts easier. Keep us posted on your progress. Another important note in this is that a visitor to Baja would feel much more comfortable to visit a tourist resort where the latest Medical equipment is available. In general, tourists would do more visiting to Mexico knowing they have the medical technology that is available in the US, especially the aging population.
Quote:
Originally posted by shari
I'm in Doc...the ball is already rolling thanks to boe4fun and Los Medicos Voladores and Stan for motivating us.

dean miller - 10-25-2012 at 01:33 PM

No Interest...

[Edited on 10-26-2012 by dean miller]

redmesa - 10-25-2012 at 01:39 PM

I am signing up today for the St. John's Ambulance First Aid Course for CPR and AED use. I have been thinking about this for some time and this settled it. They have defibs for sale for 1700.00 dollars at the course. Unfortunately, I have been spending less and less time in Bahia Asuncion but others should consider the training, also. I am not sure what First Aid courses they have in Baja or California etc. but we all should take them. I have had the course in the past and John had his industrial first aid ticket when he was working. May be time to bring an instructor to Bahia Asuncion for a training day or two.

DianaT - 10-25-2012 at 01:57 PM

Quote:
Originally posted by DENNIS
You use an AED on someone and he dies in spite of, or because of it, you will be having your mail forwarded to prison for a long long time. Ensenada Dr. could pull it off, but not just anybody would be immune to prosecution.


As Bahia Asuncion is such a small town, I assume that any medical equipment would be donated to the clinic so it would be available to all and those who would be using it would be trained--

I certainly hope that would be the plan.

[Edited on 10-25-2012 by DianaT]

DENNIS - 10-25-2012 at 02:14 PM

Quote:
Originally posted by DianaT
Quote:
Originally posted by DENNIS
You use an AED on someone and he dies in spite of, or because of it, you will be having your mail forwarded to prison for a long long time. Ensenada Dr. could pull it off, but not just anybody would be immune to prosecution.


As Bahia Asuncion is such a small town, I assume that any medical equipment would be donated to the clinic so it would be available to all and those who would be using it would be trained--

I certainly hope that would be the plan.


You, and others, are assuming a North American interpretation of the laws, rules and regulations.
Press those paddles to the chest of a national and it goes bad, someone will suffer the wrath of a greedy lawyer along with his equally greedy clients.
Adíos.

redmesa - 10-25-2012 at 02:23 PM

It seems here, that this is standard equipment on an ambulance and the attendants are trained in all types of emergency first aid. This is a specialized field and paramedics are the life line for any community's health care. Knowing how we saw Stan help our friend in BA, I think he would agree.

AED network

Posada-BushPilot - 10-25-2012 at 02:35 PM

I think this is an awesome idea the good EnsenadaDr has. Once we get a number of AEDs out there maybe we could post a directory so that the folks know where they are if they need one?

For instance the Rotary Club in Mulege has donated two, one is located at the firestation and the othere is in Posada, south of town.

Oh, and by the way

Posada-BushPilot - 10-25-2012 at 02:39 PM

The batteries for both these units should be replaced soon and they are over $400 a pop.

Also wonder if anyone out there has had an actual emergency situation and has used an AED to resusitate?
If so maybe you would be willing to share your story?

dizzyspots - 10-25-2012 at 02:43 PM

Automatic emergency defribillators (AED)were expressely designed and made fool-proof for use by lay people. The idea that you can be held liable for doing "harm" to someone that is already "dead" is an unfounded urban myth. there is no case law documented to the contrary world wide. As a side note, they do need to be accessible. Not locked inside a building or fire station. To save a life, with autodefibrillation, it must be available in minutes..not looking for a "key"...also the new CCR (continuos cardiac compressions) virtually eliminates any mouth to mouth resuscitation in a "witnessed" cardiac arrest and makes it easy to teach.
My visits are typically limited to the Gonzaga Bay area, but I will volunteer to the task of equipping that area....most likely place to post the AED would be at or near Alfonsinas....

dizzyspots - 10-25-2012 at 02:44 PM

The addl component...is after a succeessful resuscitation is the mandatory transport to a hospital for definitive care...a significant Baja wide concern...

redmesa - 10-25-2012 at 02:45 PM

I think in a small community with minimal emergency equipment it would be best to have it housed with a competently, trained person with transportation. It is better for the help to go to the emergency, rather than hoping the emergency can get to the help.

rts551 - 10-25-2012 at 02:52 PM

Quote:
Originally posted by DianaT
Quote:
Originally posted by DENNIS
You use an AED on someone and he dies in spite of, or because of it, you will be having your mail forwarded to prison for a long long time. Ensenada Dr. could pull it off, but not just anybody would be immune to prosecution.


As Bahia Asuncion is such a small town, I assume that any medical equipment would be donated to the clinic so it would be available to all and those who would be using it would be trained--

I certainly hope that would be the plan.

[Edited on 10-25-2012 by DianaT]


Do not assume anything. I know of an ambulance that got donated to El Rosario that now stays parked at the persons B&B that was supposed to coordinate the donation. Just saw it there the other day. He stated a couple of years ago he can use it to rescue tourists on the highway, for a price.

rts551 - 10-25-2012 at 02:56 PM

The perfect place in our town is the clinic. Most people rush people there instead of calling the ambulance. The ambulance is mainly used to transport people to another, more established, hospital/clinic.

Blanca. I believe the Abreojos ambulance also services La Bocana, and as such would be way too late for any kind of emergency like this.

EnsenadaDr - 10-25-2012 at 02:59 PM

I have been in close contact with Sandi Straka, at Bajamar Resort, in Ensenada. She is a retired RN, and both of us gave a seminar on AED's earlier this year. She has the AED that she and her husband bought available to the community 24 hours a day. Anytime the AED is needed, Sandi is available. When she is not in the area, the security guards, Mexicans, that speak some English, have been trained and have a chain of command of the AED. She also is everyone's point of contact for emergency situations. Sandi is very organized and actually has her office in Bajamar as the person in charge of first aid. Anyone who would like more information on how this is done, can contact Bajamar resort and see how closely the staff and the residents work together on this matter.

Not entirely correct

EnsenadaDr - 10-25-2012 at 03:09 PM

Most ambulances and clinics do not have AED's. AED's stand for automatic external cardiac defibrillators and as someone here described, have been designed for the ease and use of the general public. You might find a defibrillator in a hospital, but this is not the layperson's version. This equipment is made to be used by anyone. As the article I have read states, the defibrillation needs to occur within about 7 minutes. It would seem that "waiting for qualified personnel" would negate any chance of survival for the striken person.We need a national if not regional campaign, as is done in the US, to have these machines available in all public places. The person who is signing up for a CPR/AED class is making the first move in educating himself and so being educated, can help others learn as well.
Quote:
Originally posted by redmesa
It seems here, that this is standard equipment on an ambulance and the attendants are trained in all types of emergency first aid. This is a specialized field and paramedics are the life line for any community's health care. Knowing how we saw Stan help our friend in BA, I think he would agree.

Question, por favor

thebajarunner - 10-25-2012 at 03:10 PM

Quote:
Do not assume anything. I know of an ambulance that got donated to El Rosario that now stays parked at the persons B&B that was supposed to coordinate the donation. Just saw it there the other day. He stated a couple of years ago he can use it to rescue tourists on the highway, for a price.


Well, I can certainly guess who you are describing,
I ate in there some months back and did not notice an ambulance, but of course I was not looking for one.

How sure are you of this statement?
I intend to ask him next time through
and I do not want to look foolish
(I do a good enough job of doing that all by myself)

rts551 - 10-25-2012 at 03:27 PM

Quote:
Quote:
Originally posted by thebajarunner
Do not assume anything. I know of an ambulance that got donated to El Rosario that now stays parked at the persons B&B that was supposed to coordinate the donation. Just saw it there the other day. He stated a couple of years ago he can use it to rescue tourists on the highway, for a price.


Well, I can certainly guess who you are describing,
I ate in there some months back and did not notice an ambulance, but of course I was not looking for one.

How sure are you of this statement?
I intend to ask him next time through
and I do not want to look foolish
(I do a good enough job of doing that all by myself)


It was there beginning of October. Right in the yard, inside the gate. His statement to me about the Gringo rescues were made a couple of years ago.

[Edited on 10-26-2012 by rts551]

redmesa - 10-25-2012 at 03:31 PM

I guess the issue is what will the emergency protocol be for use of any medical equipment? My experience with my Father was that it would have been so much better if we could have called for someone to come to our house when he was in cardiac arrest. As it happened my Mother drove him to where he could get treatment but it was all too slow to save his life. Unless, a person knows how to operate and feel comfortable with any technology or device it is impossible for them to act quickly and efficiently in a panic crisis. Having transportation to an AED or oxygen could always be a problem and someone must maintain and have ease of access to such things and know what the next step in the emergency will be. Defibrillation is only a stop gap for more serious intervention to save a life. I have never know where an AED is located in any public place in the U.S. or Canada but I am sure they are there somewhere.


[Edited on 10-25-2012 by redmesa]

bajafam - 10-25-2012 at 03:43 PM

I was just browsing, thinking that I need to re-cert for CPR and possibly get certified to teach it and came across these two sites ~
http://cpraedcourse.com/index.php?gclid=COep3_ednbMCFQioPAod... ~ online courses for certification.

http://aedmasters.com/ which has a bunch of equipment for sale, some quite reasonably priced, considering the impact such devices could have.

EnsenadaDr - 10-25-2012 at 03:46 PM

The idea is a fairly new concept. The other day, I walked through Honolulu airport, and there were signs everywhere. It is up to each individual to take the initiative to learn more about it. The machine is fairly simple. You can read how to use it on the internet. Then whereever you are, you can get started with a group of volunteers to educate and form a 24 hour chain of command. As you adequately pointed out, time is of the essence and so having the machine within minutes will save lives, this is well documented.
Quote:
Originally posted by redmesa
I guess the issue is what will the emergency protocol be for use of any medical equipment? My experience with my Father was that it would have been so much better if we could have called for someone to come to our house when he was in cardiac arrest. As it happened my Mother drove him to where he could get treatment but it was all too slow to save his life. Unless, a person knows how to operate and feel comfortable with any technology or device it is impossible for them to act quickly and efficiently in a panic crisis. Having transportation to an AED or oxygen could always be a problem and someone must maintain and have ease of access to such things and know what the next step in the emergency will be. Defibrillation is only a stop gap for more serious intervention to save a life. I have never know where an AED is located in any public place in the U.S. or Canada but I am sure they are there somewhere.


[Edited on 10-25-2012 by redmesa]

AED Guidelines (Ontario Heart & Stroke)

windgrrl - 10-25-2012 at 03:47 PM

It's about more than putting a chicken in every pot...

Heart and Stroke Foundation of Canada Position Statement
PUBLIC ACCESS TO AUTOMATED EXTERNAL DEFIBRILLATORS (AEDs)
Public Access to Automated External Defibrillators (AEDs)
FACTS

Cardiac refers to the heart. Arrest means stop. Sudden cardiac arrest is the sudden and unexpected loss of heart function in a person.
Signs of cardiac arrest include: no breathing, no movement or response to initial rescue breaths, and no pulse.
In Canada, 35,000 to 45,000 people die of sudden cardiac arrest each year.1
An automated external defibrillator (AED) is a device containing sophisticated electronics used to identify cardiac rhythms, and to deliver a shock to correct abnormal electrical activity in the heart. An AED will only advise the individual using the device to deliver a shock if the heart is in a rhythm which can be corrected by defibrillation.
AEDs are safe, easy to use, and can be used effectively by trained medical and non-medical individuals. Trained responders have effectively used AEDs in many public settings, including casinos, airport terminals, and airplanes.2-4 Trained laypersons can use AEDs safely and effectively. 5
An AED is an efficient and effective means of achieving rapid defibrillation in both the out-of-hospital and in-hospital setting.

Sudden cardiac arrest occurs with a frequency of roughly 1 per 1000 people 35 years of age or older per year.6

Any location that has 1000 adults over the age of 35 present per day during the normal business hours (7.5 hours/day, 5 days per week, 250 days per year) can expect 1 incident of sudden cardiac arrest every 5 years.6
For every one minute delay in defibrillation, the survival rate of a cardiac arrest victim decreases by 7 to 10%. After more than 12 minutes of ventricular fibrillation, the survival rate of adults is less than 5%.6

Currently there is evidence to support a recommendation to use AEDs for children over the age of 1, but not for children under the age of 1.
Across Canada, some provinces regulate the use of AEDs, while other provinces do not. Information about individual provincial regulations can be obtained from the provincial Heart and Stroke Foundation offices.

RECOMMENDATIONS
The Heart and Stroke Foundation of Canada recommends that:

Canadians

Have widespread access to automated external defibrillators, particularly in locations which are at high risk for incidents of sudden cardiac arrest (one can expect 1 sudden cardiac arrest per 1000 person-years).6
Be trained and encouraged to apply cardiopulmonary resuscitation (CPR) and AED skills when needed.
Who are targeted responders be authorized, trained, equipped and directed to operate an AED if their responsibilities require them to respond to persons in cardiac arrest.

Governments

Establish provincial regulations or legislation to ensure immunity of the overseeing physician and responders from liability, excluding gross negligence or willful misconduct.

Training Agencies

Ensure that AED programs meet or exceed guidelines for AED and CPR training established by the Heart and Stroke Foundation of Canada (HSFC).
Consider the use of a medical director for Instructor or Instructor Trainer courses. A medical director may not be required for AED provider courses.
Ensure that public facilities with a high likelihood of cardiac arrest incorporate AED programs into more comprehensive emergency response plans.
Ensure that early defibrillation programs operate within systems that:
integrate basic life support and/or advanced cardiac life support training with AED training, as appropriate;
integrate the provision of AEDs within the health care system and establish linkages with the EMS systems;
consider the response time of the local EMS system when acquiring and placing AEDs in a community and/or workplace;
place the program within the medical oversight of a physician and ensure immunity of the overseeing physician and responders from liability;
establish a system of quality assurance to include the review of all clinical events when an AED is used;
include a mechanism for data collection, evaluation, and reporting outcomes;
comply with accepted guidelines for training and retraining;
enhance public awareness of the role of early defibrillation in cardiac arrest; and
receive training from an accepted and recognized training agency.

Pre-hospital Planners and Providers

Advocate for strengthening the Chain of Survival™ and ensure access to AEDs by responders in all Canadian communities. In the future, efforts to expand the use of AEDs by the general public may be warranted.
Plan for early defibrillation initiatives to be implemented within the community Chain of Survival™.
Include AED programs as part of comprehensive emergency response plans that are linked with the emergency medical services system, and implemented within systems which provide transfer of care protocol, medical oversight, training, continual readiness, quality assurance, data collection, and evaluation.
Follow provincial guidelines for physician oversight for AED programs where such guidelines have been established. Where no guidelines exist, a physician should, at minimum, establish the AED protocol, review the conduct of each resuscitation attempt and make recommendations for improvement. Physicians overseeing emergency medical services (EMS) programs are well placed to perform this review.

Hospitals

Examine policies and procedures for cardiac arrest and resuscitation to ensure that the time to defibrillation using AEDs within the hospital setting is as short as possible. In settings where professionals trained in advanced cardiac life support are not immediately available (less than three minutes from arrest to defibrillation), AED training should be provided as a basic skill for healthcare providers.

BACKGROUND

Arrhythmias (abnormal heart rhythms) such as ventricular fibrillation cause most sudden cardiac arrests. Early defibrillation is the intervention that is most likely to improve survival rates. The time between the onset of cardiac arrest and the use of an AED is the major determinant for success of the resuscitation attempt. While CPR helps to maintain circulation and ventilation in a victim of cardiac arrest for a short period of time, it is unlikely to convert ventricular fibrillation to a normal heart rhythm. Restoring a normal heart rhythm requires defibrillation to be provided within a few minutes of the arrest.

If an AED is immediately applied to a victim of cardiac arrest due to ventricular fibrillation, the likelihood of survival is high. Survival rates in cardiac rehabilitation programs that provide defibrillation within the first few minutes after a cardiac arrest are higher than 85%.7 With each passing minute from the time of the arrest, the probability of survival declines about 7% - 10%.6 Studies show that few patients survive if the time from collapse to defibrillation is greater than 12 minutes.8,9 If CPR is performed from the time of collapse to the time the defibrillator arrives, survival may be possible after a longer time interval. Therefore, the HSFC supports efforts to provide prompt defibrillation to victims of cardiac arrest.

Defibrillation is a key link in the Chain of Survival™. The Chain of Survival™ consists of a series of four links that give the victim of a medical emergency the best chance of living. These links are:

Early access to emergency care;
Early CPR;
Early defibrillation; and
Early advanced cardiac care;

All links in the Chain of Survival™ are important to reduce death and disability from heart disease and stroke.

The Chain of Survival™ is only as strong as its weakest link. The success of each link depends on the link immediately before and after. Recognizing the warning signs of cardiac arrest and reacting by rapid notification of the EMS system (by calling 9-1-1 or other emergency response number), helps to get the AED to the victim quickly and reduce delay to defibrillation.

Almost all clinical studies have shown that bystander CPR can help to improve survival rates. Bystander CPR is the best treatment that a cardiac arrest patient can receive until a defibrillator and advanced medical care arrive.7 CPR training teaches Canadians how to recognize the signs of a heart attack and cardiac arrest, how to react, and how to provide CPR until EMS arrive, shortening the time to defibrillation.
Early Defibrillation

Targeted Responders in the Community
HSFC recommends that targeted responders be authorized, trained, equipped, and directed to operate an AED safely and effectively. A targeted responder is any person who, as a part of their job description as a professional primary health care provider or a professional first responder, has the duty to respond to a medical emergency. Targeted responders may include any healthcare provider, or any first responder whose occupation or volunteer activities demand proficiency in the knowledge and skills of basic life support (BLS).

Lay Responders
Lay responders in facilities with a high likelihood of a cardiac arrest event (1 every 2 years) can also be effective. The Public Access Defibrillation (PAD) trial demonstrated a doubling of survival rates (from 15% to 30%) in facilities with high likelihood and with trained staff always available.5

In-hospital
The concept of early defibrillation can be applied to the in-hospital resuscitation setting. The goal of early defibrillation in-hospital is a collapse-to-shock interval of less than 3 minutes in all areas of the hospital and ambulatory care facilities.7 AED technology poses unique opportunities for in-hospital resuscitation. Hospitals are encouraged to examine their policies and procedures for cardiac arrest and resuscitation to determine if use of AEDs within the hospital setting could reduce time to defibrillation. In settings where professionals trained in advanced cardiac life support are not immediately available, AED training should be provided as a basic skill for healthcare providers. AEDs should be made readily available in strategic areas throughout hospitals to help reduce the time from collapse to defibrillation.

Unique Situations
Current data suggests that AEDs are an effective intervention for sudden cardiac arrest and may be an effective intervention in settings where there is a high likelihood of cardiac arrest such as airports, casinos, commercial aircraft cabins and in other settings where large numbers of high-risk adults may be located.2-6

Defibrillation is effective only if performed shortly after cardiac arrest. Urban and rural communities need to determine the degree to which they are capable of getting an AED to a victim of cardiac arrest in time for resuscitation efforts to be effective, and consider placement of AEDs where the chance of ambulance response is low, such as on ferries or airplanes.
Access to Defibrillation

HSFC encourages widespread access to AEDs in Canada. In some provinces, enabling legislation and regulatory changes may be required.
REFERENCES

Gardiner, Martin J., Leather, Richard and Teo, Koon, The Prevention of Sudden Death from Ventricular Arrythmia, Chapter 1, Epidemiology, Canadian Cardiovascular Society, 1999.
Valenzuela TD, Roe DJ, Nichol G, et al. Outcomes of rapid defibrillation by security officers after cardiac arrest in casinos. New England Journal of Medicine 2000;343:1206-1209.
O’Rourke MF, Donaldson E, Geddes JS. An airline cardiac arrest program. Circulation 1997;96:2849-2853.
Page Rl, Joglar JA, Kowal RC, et al. Use of automated external defibrillators by a US airline. New England Journal of Medicine 2000;343:1210-1216.
The Public Access Defibrillation Trial Investigators. Public-access defibrillation and survival after out-of-hospital cardiac arrest. New England Journal of Medicine 2004;351(7):637-646).

Hazinski MF, Markenson D, Neish S. American Heart Association Scientific Statement: Response to cardiac arrest and selected life-threatening medical emergencies. Circulation 2004;109:278-91.
Larsen MP, Eisenberg MS, Cummins RO, et al. Predicting survival from out-of-hospital cardiac arrest: a graphic model. Annals of Emergency Medicine 1993;22:1642-1658.
International Liaison Committee on Resuscitation (ILCOR). Guidelines 2000 for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care. Part 4: Automated External Defibrillator: Key link in the chain of survival. Circulation 2000;108(Suppl 2):I60-I76.
Cummins RO, Ornato JP, Thies WH, Pepe PE. Improving survival from sudden cardiac arrest: the “chain of survival” concept: as statement for health professionals from the Advanced Cardiac Life Support Subcommittee and the Emergency Cardiac Care Committee of the American Heart Association. Circulation 1991;83:1832-47.
Valenzuela TD, Roe DJ, Cretin S, Spaite DW, Larsen MP. Estimating effectiveness of cardiac arrest interventions: a logistic regression survival model. Circulation 1997;96:3308-13.

The information contained in this position statement is current as of June 2008.

Click here to download the PDF version of this article.

Last updated October 2008.:tumble:

redmesa - 10-25-2012 at 04:13 PM

This weekend is my training session for CPR and AED etc. so I should be able to speak more knowledgeably about this topic in a few days. This is a very important personal topic for me and so I hope it continues to be discussed. Windgrrl, that just about covers it. I wonder what the symbol is that is posted for the location of an AED?

Ricardo - 10-25-2012 at 04:15 PM

In BC Canada I was a school teacher,we were instructed on how to use a AED, We have one in the lobby of our school. Many malls have them.
No worry of court cases here. I think all small communities should have at least one.

Ricardo - 10-25-2012 at 04:18 PM

Oh yeh I forgot to mention the PE progam teaches all the students on AED use as they have the demo models.

redmesa - 10-25-2012 at 04:21 PM

I was a teacher in BC, small world. We also had one in our school but I really never would have known where to find it in an emergency. I would have gone to the office and asked for help. The secretaries and special education workers were the go to people. Now I would like to carry one in my car.

EnsenadaDr - 10-25-2012 at 04:30 PM

It is a heart with a lightning symbol in the middle
Quote:
Originally posted by redmesa
This weekend is my training session for CPR and AED etc. so I should be able to speak more knowledgeably about this topic in a few days. This is a very important personal topic for me and so I hope it continues to be discussed. Windgrrl, that just about covers it. I wonder what the symbol is that is posted for the location of an AED?

EnsenadaDr - 10-26-2012 at 02:13 PM

Getting U2U's from one individual saying I should rub elbows with the higher ups to avoid legal repercussions from using AED's. What's THAT all about? You really think rubbing elbows with the higher ups will help? They want to know what's in it for them...I have never heard of a case where it was a life or death situation and someone tried to save a life and got prosecuted in Mexico.

DavidE - 10-26-2012 at 04:46 PM

I do. I did. And I saw them arrested. I also fought with the ministerio publico over it.

If the cops think there is money in it for them Ensenada Dr. and someone is dead, then you can bet your sweet patootie they are going to look. "Oh, this person is a doctor. Well OK". Oh they used a machine, that person is dead? They are not a doctor?

Here's a little something to chew on...



We are all familiar with the “Good Samaritan Law”. This law protects you from becoming liable for helping in an emergency situation. The Good Samaritan law allows you to give aid within your scope of expertise at a car accident or other disaster without being sued for any reason in the performance of your aid. Mexico has no such law. You as a visitor or citizen can not give any aid at anytime or anyplace with out breaking the law. The only organization able to perform emergency services outside of a hospital or medial clinic in Mexico is the Cruz Roja. Do not stop and help! Call for help 065 or at lakeside 765-2308. You will be at risk of arrest, deportation or being financially responsible. To understand how this came about, we must look at its history.

As early as 1898, the Spanish Red Cross approached the Mexican Government to inquire about the emergency services available in the Republic. At that time, such services were provided by the Mexican Army. The Mexican President, Porfirio Diaz, had been a general, had strong ties to the Military, and showed no interest in establishing a Mexican Red Cross. By 1907, however, the Mexican Army had fallen on hard times. Diaz, still President, had cut back on its funds, producing inefficiency and dissatisfaction among career officers.

On August 2nd of that year Mexico recognized the Geneva Convention and on February 21, 1910, a presidential decree recognized the Red Cross, but made it an auxiliary of the Army. In 1919, it was recognized by the International Red Cross and received a charter in 1923. Since then, the organization has been prohibited from accepting any financial aid from any government agency. It is financed by private donations only. It also severed its ties with the Army. Now, the Army gave up its role as the provider of day to day emergency care, shifting the burden to the Cruz Roja Mexicana. Thus, it became the sole designated caregiver in situations normally handled and paid for by governments in most parts of the world.

Today, both the Mexican Red Cross and the Mexican National Health Service, IMSS, maintain hospitals in all major cities. Larger cities also run Municipal Hospitals. However, the IMSS hospitals serve only those who work for companies that provide them with coverage. Those who are not covered by their employers still must turn to either a Red Cross or Municipal Hospital for free care. By and large, emergency health care in big cities is good. That is not the case in small towns and villages.

Those who live outside large municipalities and are unable to pay for private care, are totally dependant on the Red Cross to provide emergency care and transport them to the nearest hospital that offers free service. The needs of the less affluent members of the community, who have non-emergency medical problems, are handled in a free clinic that operates 6 days a week. It provides a consultation with a doctor and in most cases, free medications are dispensed (Central Salud). The Delegation requests a donation after the services are rendered, but what is received seldom cover costs. Fortunately, the Delegation has two auxiliary groups. The Cruz Roja International Volunteers, largely non-Mexican and the Damas of the Cruz Roja, mostly Mexican ladies, run fund raising events that keep a monthly deficit under control, but just barely.

Again, it is sad but do not offer aid in an emergency unless you are willing to suffer the possible consequences. What you CAN do is to contribute to the Cruz Roja on a regular basis. We have a great need for monthly and annual contributions as well as the support of the fund raising projects run throughout the year.

Cruz Roja depends on YOU! Anyone wanting to contribute to any of these needs please contact Norm Pifer at 766-0616 or Charlie Klestadt at 766-3671. You can, as always, find all our current information on our website at WWW.cruzrojalakeside.com

Remember the life you save may be your own.

Printed with permission of Cruz Roja. September 2009.

EnsenadaDr - 10-26-2012 at 06:12 PM

Then why does Bajamar, a very nice community owned by Mexicans, allow the security and the American residents there to have an AED on the premises. I will go to the Ministerio Publico myself in a week or so and see what they say. And I will report back.
Quote:
Originally posted by DavidE
I do. I did. And I saw them arrested. I also fought with the ministerio publico over it.

If the cops think there is money in it for them Ensenada Dr. and someone is dead, then you can bet your sweet patootie they are going to look. "Oh, this person is a doctor. Well OK". Oh they used a machine, that person is dead? They are not a doctor?

Here's a little something to chew on...



We are all familiar with the “Good Samaritan Law”. This law protects you from becoming liable for helping in an emergency situation. The Good Samaritan law allows you to give aid within your scope of expertise at a car accident or other disaster without being sued for any reason in the performance of your aid. Mexico has no such law. You as a visitor or citizen can not give any aid at anytime or anyplace with out breaking the law. The only organization able to perform emergency services outside of a hospital or medial clinic in Mexico is the Cruz Roja. Do not stop and help! Call for help 065 or at lakeside 765-2308. You will be at risk of arrest, deportation or being financially responsible. To understand how this came about, we must look at its history.

As early as 1898, the Spanish Red Cross approached the Mexican Government to inquire about the emergency services available in the Republic. At that time, such services were provided by the Mexican Army. The Mexican President, Porfirio Diaz, had been a general, had strong ties to the Military, and showed no interest in establishing a Mexican Red Cross. By 1907, however, the Mexican Army had fallen on hard times. Diaz, still President, had cut back on its funds, producing inefficiency and dissatisfaction among career officers.

On August 2nd of that year Mexico recognized the Geneva Convention and on February 21, 1910, a presidential decree recognized the Red Cross, but made it an auxiliary of the Army. In 1919, it was recognized by the International Red Cross and received a charter in 1923. Since then, the organization has been prohibited from accepting any financial aid from any government agency. It is financed by private donations only. It also severed its ties with the Army. Now, the Army gave up its role as the provider of day to day emergency care, shifting the burden to the Cruz Roja Mexicana. Thus, it became the sole designated caregiver in situations normally handled and paid for by governments in most parts of the world.

Today, both the Mexican Red Cross and the Mexican National Health Service, IMSS, maintain hospitals in all major cities. Larger cities also run Municipal Hospitals. However, the IMSS hospitals serve only those who work for companies that provide them with coverage. Those who are not covered by their employers still must turn to either a Red Cross or Municipal Hospital for free care. By and large, emergency health care in big cities is good. That is not the case in small towns and villages.

Those who live outside large municipalities and are unable to pay for private care, are totally dependant on the Red Cross to provide emergency care and transport them to the nearest hospital that offers free service. The needs of the less affluent members of the community, who have non-emergency medical problems, are handled in a free clinic that operates 6 days a week. It provides a consultation with a doctor and in most cases, free medications are dispensed (Central Salud). The Delegation requests a donation after the services are rendered, but what is received seldom cover costs. Fortunately, the Delegation has two auxiliary groups. The Cruz Roja International Volunteers, largely non-Mexican and the Damas of the Cruz Roja, mostly Mexican ladies, run fund raising events that keep a monthly deficit under control, but just barely.

Again, it is sad but do not offer aid in an emergency unless you are willing to suffer the possible consequences. What you CAN do is to contribute to the Cruz Roja on a regular basis. We have a great need for monthly and annual contributions as well as the support of the fund raising projects run throughout the year.

Cruz Roja depends on YOU! Anyone wanting to contribute to any of these needs please contact Norm Pifer at 766-0616 or Charlie Klestadt at 766-3671. You can, as always, find all our current information on our website at WWW.cruzrojalakeside.com

Remember the life you save may be your own.

Printed with permission of Cruz Roja. September 2009.

redmesa - 10-26-2012 at 06:24 PM

David, i kind of agree with you. I do feel vulnerable about the dos and don'ts in baja. Until a good number of the community is familiar with cpr and aed and the clinic and police are informed and on board , iwould be reluctant to be seriously involved during an emergency situation. I just feel incompetent and insecure in dealing with medical crisis.

DavidE - 10-26-2012 at 06:31 PM

Now you're talkin' Doc!

Ask the abogado if they will shield the devices from Sector Salud and COFEPRIS. You gotta get officials on your side. For a fact any medical device "involved" in serious injury or death meaning the device was used and for whatever reason the patient did not fare well can come under the auspices of COFEPRIS. They have intimate relations with SECGOB and the PGR. If COFEPRIS "hears" about an undocumented device it is considered a "Gran Delito". COFEPRIS must not be allowed to hear about the device. The ministerio publico is the barrier. If no complaint (meaning a reference to a medical "device: in a criminal complaint) is made, COFEPRIS is out of the picture (where they should be).

I realize this stuff is a genuine pain-in-the-ass to deal with, but the last thing anyone needs to hear is a good Samaritan tried their heart out to save a life and is going to lose their house and everything they own because the ministerio publico is peeed-off because no one bothered to come to the throne and bow before him.

COFEPRIS and SECTOR SALUD are impossible to deal with. I treat them like I treat a Cholla thicket.

This "checking with the ministerio publico BS" has to be done wherever a medical device is considered to be located. They may demand a list of potential people qualified to use it and so forth. it is all horsepucky but the charge GRAN DELITO scares the crap out of me. Get a witness, get a document (a copy of the list of qualified people is excellent). Ministerios can be as flaky as an croissant, so get proof. A serial number and model number.

And you have my sincere thank you for offering to do this. And a promise of lunch or coffee or something.

rts551 - 10-26-2012 at 06:43 PM

Given the number of people in Baja that do not have proper immigration status, I would think that focusing on expats would complicate the issue anyway.

[Edited on 10-27-2012 by rts551]

EnsenadaDr - 10-26-2012 at 06:56 PM

What am I the only one here that can talk to the Ministerio Publico? Just have Doc do it all..honestly!!! OK then, you contact the Ministerio Publico in Asuncion and everyone else go talk to them about AED's...and let's get a consensus...I could use a little assistance here. I personally think you are taking this stuff way out of context (and who translated it by the way) but it may be that there are some things lost in the translation. I certainly would want my BFF or BMF to use the darn thing on me if I could be saved. Then again, its too bad that someone would let a buddy die just cause they were worried about repercussions. No, David, you are talkin'...you can at least pick up the phone get some names and numbers and let Shari and others find out what the restrictions are...and everyone else in their pwn particular Baja community do the same. I guess I don't consider legalities if I am trying to save a life. And like I said, the AED is for the general public, not something that has to be administered by a licensed person.
Quote:
Originally posted by DavidE
Now you're talkin' Doc!

Ask the abogado if they will shield the devices from Sector Salud and COFEPRIS. You gotta get officials on your side. For a fact any medical device "involved" in serious injury or death meaning the device was used and for whatever reason the patient did not fare well can come under the auspices of COFEPRIS. They have intimate relations with SECGOB and the PGR. If COFEPRIS "hears" about an undocumented device it is considered a "Gran Delito". COFEPRIS must not be allowed to hear about the device. The ministerio publico is the barrier. If no complaint (meaning a reference to a medical "device: in a criminal complaint) is made, COFEPRIS is out of the picture (where they should be).

I realize this stuff is a genuine pain-in-the-ass to deal with, but the last thing anyone needs to hear is a good Samaritan tried their heart out to save a life and is going to lose their house and everything they own because the ministerio publico is peeed-off because no one bothered to come to the throne and bow before him.

COFEPRIS and SECTOR SALUD are impossible to deal with. I treat them like I treat a Cholla thicket.

This "checking with the ministerio publico BS" has to be done wherever a medical device is considered to be located. They may demand a list of potential people qualified to use it and so forth. it is all horsepucky but the charge GRAN DELITO scares the crap out of me. Get a witness, get a document (a copy of the list of qualified people is excellent). Ministerios can be as flaky as an croissant, so get proof. A serial number and model number.

And you have my sincere thank you for offering to do this. And a promise of lunch or coffee or something.

DavidE - 10-26-2012 at 07:54 PM

I doesn't got the M.D. after my name. I am not a licensed practitioner in Mexico in Mexico with a Sector Salud registration number, so the Ministerio Publico would tend to YAWN if I posed the question. I am also bedridden. And I can assure you the minsterio publico is located in Santa Rosalia. About the same distance as Santa Ana is located from Ensenada. And you can bet your bippie if a GRAN DELITO is involved, Bahia Asuncion would burn down the phone line getting orders from Santa Rosalia or even La Paz.

But Ensenada would be just a tad different. Like 60 gallons of gasoline different.

And I am not making the recommendation to cause a GRAN DELITO without doing the homework to greatly lessen the chance of ending up eating green tortillas and (?).

But now you know the reality of it all.

EnsenadaDr - 10-26-2012 at 08:32 PM

Yeah whatever. When I get down there in a week or so I will check it out. But like I said, It's not like practicing medicine without a license. It's for use by the public.

DavidE - 10-26-2012 at 09:08 PM

Isn't it just plain stupid to have to jump through all these freakin' hoops to not go to prison for saving someone's life?

Jekyll & Hyde, that's Mexico. Tourist P. Jekyll, is smiling with arms extended an ear to ear smile and "¡No Problemos!" filling the air.

Pendejo Q. Hyde meanwhile is shouting "You broke the law! Somebody's dead! Someone has to pay!"

It's no joke that people have paid a lot of money for "Road Damage" when their car went off the road into a ditch. Two hundred dollars (eqvt). There wasn't even a mark left on the road. The accusers have the book and the gun (Just like in the movie La Ley de Herodes).

The "secret" of The Law, in Mexico is the application of the law. If it isn't enforced or waived a person is home free. Commit a Gran Delito, and have the law applied and suddenly you are on the best weight loss program and Spanish immersion course on the face of the earth.

EnsenadaDr - 10-27-2012 at 01:44 AM

Well let the Ministerio Publico speak for himself. I will go and talk to them next week like I said and have them define the "Gran Delito" for trying to save an essentially dead person's life. This is all sounding a bit ridiculous and hyped up.
Quote:
Originally posted by DavidE
Isn't it just plain stupid to have to jump through all these freakin' hoops to not go to prison for saving someone's life?

Jekyll & Hyde, that's Mexico. Tourist P. Jekyll, is smiling with arms extended an ear to ear smile and "¡No Problemos!" filling the air.

Pendejo Q. Hyde meanwhile is shouting "You broke the law! Somebody's dead! Someone has to pay!"

It's no joke that people have paid a lot of money for "Road Damage" when their car went off the road into a ditch. Two hundred dollars (eqvt). There wasn't even a mark left on the road. The accusers have the book and the gun (Just like in the movie La Ley de Herodes).

The "secret" of The Law, in Mexico is the application of the law. If it isn't enforced or waived a person is home free. Commit a Gran Delito, and have the law applied and suddenly you are on the best weight loss program and Spanish immersion course on the face of the earth.

dizzyspots - 10-27-2012 at 05:18 AM

I guess the bigger question is.."is it the right thing to do?" I have been a paramedic for about 40yrs. I cannot drive past someone with a flat tire, much less an injured or ill party.
Given all the things that I MIGHT get in trouble for when we travel to Baja...IF trying to save a life is on that list...well then so be it!!
I still think I can look myself and God in the eyes and justify why I TRIED to help as opposed to why I ignored those pleas for help...because that is what I would pray the next person would do for me.
PS Interested side note: about a year ago, while passing through the Gonzaga Bay check point, the Army guys stopped us (they new we were firefighter/paramedics) to help a little girl ith a huge fish hook through her hand!! We got it out, made sure that Dad got her to San Felipe for MD care....the smile on the little girls face and the look in Dad's eyes...priceless..would do it again tomorrow without hesitation.

EnsenadaDr - 10-27-2012 at 05:33 AM

Exactly, couldn't have said it better myself. I love the theory of "EL Gran Delito"...sounds menacing, doesn't it? The Big Crime...trying to save a friend's or neighbor's life? All this mumbo jumbo about codigo Penal, or the Penal Code, but I have seen not one citation. And especially a Codigo Penal concerning AED's. Like you said though, I wouldn't want to even have a memory of where I was in a place and decided against trying to save a life because I was afraid that the police would pounce on me. I guess some could look themselves in the mirror and say, "I escaped being prosecuted by letting John Doe die as I watched." Maybe those people aren't worth having as friends now are they?

DavidE - 10-27-2012 at 07:00 AM

I wouldn't hesitate one second either Ensenada Doctor so let's get that inference on the table and smash it with a hammer right now. I do not agree with the cut and paste that I posted above. But I also insist on not leading folks down the trail of Kumbaya and I'd Like To Buy The World A Coke idealism and hurt them. Needlessly. Due to ignorance of the reality of the laws and how they may or may not be applied in this country.

"How did this person die?"
"I found him on the floor"
"Who are you?"
"Are you a friend?"
"No but I tried to save him"
"What is that machine?"
(You explain in detail)
"You have to come with me"
"Am I under arrest?"
"You have to come with me"
You wait six hours at the police station while phone calls are made and this is the place where things go right or very very wrong.
(Phone calls from detective's boss to sector salud)
"We found a machine at the scene"
Is the American a doctor?"
"No"
"Is the machine a Mexican approved machine?"
(I'll spare the details here)
"If the machine is not legal in Mexico this is a problem"
A legal Mexican device has to have a FACTURA with a COFEPRIS "clave" printed on it or be registered with sector salud. On paper. The serial number.
The accused is now "Detener" under arrest.
People who are detener for a gran delito do not stay in "the jail". After a few days they get transferred to a prison. Yeah, one of those places with high walls and guard towers.

This process has to be severed, stopped, stomped on very near to the start. The best would be to have the ministerio publico tell the local cops "Hands Off" if such a police call were to be handled. They would adjust the paperwork and submit it to the PGE the state attorney general's office. "Routine natural death. No complications"

Whether anything happens is up to the ministerio publico. I would "suggest" that if at all possible someone who knows someone on the office a person who is known in the community approach the MP. The best would include a gringo and a local politico. Once the Licenciado waves his arms and makes a decision you're home free. So is anyone else that uses that machine.

Yeah, I have experience in this freakin' rigamaroll. With small municipio MP's, and with Delegado Federales de PGR. I fear the process, make no mistake. These can be scary people. And most definetly they all -not- all alike. Some are more easy going than others.

Just a little preparing can short-circuit the criminal liability aspect of using a machine to save a life. This is pretty complete. Therefore the end of my participation on the subject.

redmesa - 10-27-2012 at 07:14 AM

It seems to me that all this is simple but not ease. The local communities have to be aware and knowledgeable of emergency interventions and protocols. There is nothing more important than getting the Red Cross to give First Aid training to the police, military personnel, and clinic staff to make sure everyone is on board. There must be someone in B.A. qualified to use that new (hyperbolic) pressure chamber (not sure what to call it) in emergencies and the COOPs must have some trained personnel in First Aid. I really think this is the starting point. I am off for my First Aid course today and I am sure I would do what my limited knowledge would allow me to do in an emergency. However, I think it very important that the training be there for the Mexican population. Unfortunately, Bahia Asuncion and many rural areas in Baja are just too damn far from hospitals.

meme - 10-27-2012 at 08:37 AM

We already had the use of two here in Eldorado Ranch but the HOA just purchased two more for mobil units.

Great idea doc

mooose29 - 10-27-2012 at 09:17 AM

Doc I think the idea is great, having the AED's in a community does not obligate anyone to use the machine however it does make it available for those that would. No one is making anyone use the AED's, everyone can make their own choice to try and save a life of not it is as simple as that. I for one would be happy to have anyone use one on me should I ever be in cardiac arrest, and I will be happy to use it on anyone else should they need it.

The machines are set so that they will not shock unless the person needs it. They are designed to be foolproof. We own one at our house in Punta Chivato that we would make available should it be needed (although right now it is back in the states getting the batteries replaced)

I think we are making this more complicated then it has to be. Over the years we have stopped at several accident sites in Baja including one where their was a fatality. Each time the police and locals on scene were very happy to have the help and never once was I worried we would be prosecuted for doing the right thing for another living human being. We were always thanked profusely and we left knowing we did the right thing and the best we could do.

Everyone has to make their choice.

DENNIS - 10-27-2012 at 09:27 AM

What is it? A seven minute window of opportunity to use a de-fib machine? Unless every person has immediate access to one, they would be considered no more than a passing good thought that was late arriving to the scene.
People here are being impractical to expect miracles from this machine and the person in charge of it........especially in Mexico where rapid response time is usually fodder for bar jokes.

EnsenadaDr - 10-27-2012 at 09:44 AM

Who is expecting miracles Dennis? I have repeated over and over that each small community would need a 24 hour chain of command, a phone number they could call. Distance would be a huge factor, so the machine would logistically have to be in an area that was accessible almost immediately. For instance, say in Lomas Del Mar, Monday Bob could have it, the next day Linda....and people would know who to call in an emergency if there is a problem. But there would have to be agreement and cooperation with the users. The main key here is that CPR is not going to save you in a heart attack because it doesn't address the abnormal rhythm of the heart. The machine will tell you, yes, shock advised, or no don't shock. I think it is vitally important to have a 24 hour emergency number to call. That's why the airports have them every few gates, because if a person falls they can't wait for the machine from the Delta wing say get to an American airline wing; time is of the essence. Rapid response is a personal decision, especially when you know you don't have a fighting chance in Mexico it's all the more reason to mobilize a system with your immediate neighbors.

DavidE - 10-27-2012 at 11:50 AM

...adhering to my earlier promise to not discuss the laws...

The best thing is person can do, by far, on an individual basis, is to get a full cardiac panel performed. Nuclear stress test, sonogram, x-ray,EKG, blood work.

Before moving to Mexico (age 55+)

The test is not a comfortable one (but not painful), but if there are problems, like congestive heart failure impending, areas of the heart damaged, signs of arrhythmia, under stress, they are going to have a good chance at finding it, prescribing a rational treatment, and pretty much lessening the chances of a cardiac event from damaging or destroying your life.

"Sir, you motor has four pounds of oil pressure"
"It's still running. I'm packed and leaving"

"Sir your front left tire has a huge bubble on the inside"
"Sumb-tch ain't flat is it? Get out of the way or get run over"

Preparation Is The Key
I recommend anyone on the Baja California peninsula to visit medical facilities. Ask "Do you have a defibrillator, EKG machine, lab, x-ray machine, cardiologist????????"

Don't bring a million dollar problem with you, is my advice. Get them stabilized and fixed in the states first. This is on the other person's shoulders, the folks that are coming.

I cannot believe people who take meticulous care of their automobile, spend days tinkering with boat motors to acheive perfection and then totally mistreat their physical being. An exam can save you and your loved ones a lot of grief.

EnsenadaDr - 10-27-2012 at 12:04 PM

You are not going to fix these problems, David. You can medicate, get surgery, but there is an exponential rise of arteriosclerosis with increased age. Many expats are retirement age. You aren't going to fix that problem. You cannot "fix" heart disease. This is an over simplistic approach. We are all going to die. When and where we might have a chance to change with the right equipment available.
Quote:
Originally posted by DavidE
...adhering to my earlier promise to not discuss the laws...

The best thing is person can do, by far, on an individual basis, is to get a full cardiac panel performed. Nuclear stress test, sonogram, x-ray,EKG, blood work.

Before moving to Mexico (age 55+)

The test is not a comfortable one (but not painful), but if there are problems, like congestive heart failure impending, areas of the heart damaged, signs of arrhythmia, under stress, they are going to have a good chance at finding it, prescribing a rational treatment, and pretty much lessening the chances of a cardiac event from damaging or destroying your life.

"Sir, you motor has four pounds of oil pressure"
"It's still running. I'm packed and leaving"

"Sir your front left tire has a huge bubble on the inside"
"Sumb-tch ain't flat is it? Get out of the way or get run over"

Preparation Is The Key
I recommend anyone on the Baja California peninsula to visit medical facilities. Ask "Do you have a defibrillator, EKG machine, lab, x-ray machine, cardiologist????????"

Don't bring a million dollar problem with you, is my advice. Get them stabilized and fixed in the states first. This is on the other person's shoulders, the folks that are coming.

I cannot believe people who take meticulous care of their automobile, spend days tinkering with boat motors to acheive perfection and then totally mistreat their physical being. An exam can save you and your loved ones a lot of grief.

BajaBlanca - 10-27-2012 at 12:25 PM

I like the idea of having even a couple of them available in different locations about town with various people qualified to use them.

Ralph, we have an ambulance here in La Bocana too but I can't remember the details - itis not for everyone (maybe only for those who have insurance ??) and the one in Abreojos is for everyone.

Mr. or Ms. Soulpatch

Posada-BushPilot - 10-27-2012 at 12:32 PM

You seem to know much more than I about these AED thingys. What do you mean "battery maintenance".

The two units we have, I think they are maybe 5 or 6 years old, but they have non-rechargable throw away batteries. I think the make is Medtronic or something like that. So what would you do to maintain a battery like these have? Keep them at certain temp? Come to think of it, when you cycle/boot up they show only 3 of 5 bars of battery strength which means the damn thing probably wouldn't be able to build up the needed volts?

So do you have any recommendations for best make model for a portable AED?

EnsenadaDr - 10-27-2012 at 12:46 PM

From what I have gleaned (yes, I am still learning about this as well) the batteries are good for just 5 years. What you need to do is go to the Internet look up the make and model and download the instructions.
Quote:
Originally posted by Posada-BushPilot
You seem to know much more than I about these AED thingys. What do you mean "battery maintenance".

The two units we have, I think they are maybe 5 or 6 years old, but they have non-rechargable throw away batteries. I think the make is Medtronic or something like that. So what would you do to maintain a battery like these have? Keep them at certain temp? Come to think of it, when you cycle/boot up they show only 3 of 5 bars of battery strength which means the damn thing probably wouldn't be able to build up the needed volts?

So do you have any recommendations for best make model for a portable AED?

Medtronic AED Manual, Trainer Manual, etc.

windgrrl - 10-27-2012 at 12:47 PM

http://www.aedbrands.com/resource-center/maintenance/aed-doc...

The machines are pretty goof-proof to use, training is quick and simple, but it is useful to have AED training done with of CPR/1st Aid training, the standards for which are updated regularly.

AEDs are great, but need to be put in context of a support system. Logistics for transfer cardiac care venue, especially if urgent/emergent care is required would be important to consider and plan for.

Illness prevention and health promotion are equally necessary.

The most important point in taking on this technology in my opinion would be to get the community/key stakeholders to buy in to the idea since they would be the ones who have to decide if this is a priority and then if they did would have to take on the care of this puppy.



[Edited on 10-27-2012 by windgrrl]

BajaBlanca - 10-27-2012 at 12:50 PM

well, sounds like it is the same issue as solar power batteries, which are only built to last 5 years and if very well maintained (control temperature around them, add distilled water, keep them fullly charged), they might last a bit longer. If they are indeed like solar power batteries, then they are not inexpensive either.

Forget the Gear

MrBillM - 10-27-2012 at 01:35 PM

Just let nature take its course.

We've gone through life so far (and so good) without expecting to find a Jump-Starter wherever we go.

That said, as an alternative to a bunch of expensive equipment that may (or may not) ever be used (and, if used, may not help) we could all (who wish) just carry a Stun Gun and give it a try if the situation presents itself.

It might work.

If not, oh well.

rts551 - 10-27-2012 at 01:44 PM

Quote:
Originally posted by BajaBlanca
I like the idea of having even a couple of them available in different locations about town with various people qualified to use them.

Ralph, we have an ambulance here in La Bocana too but I can't remember the details - itis not for everyone (maybe only for those who have insurance ??) and the one in Abreojos is for everyone.


Maybe its like defibs, only for Gringos....ooooppppssss just kidding!

De-Fibbs in Baja

MrBillM - 10-27-2012 at 01:49 PM

One difficulty might be their Value on a secondary market.

Oops, Gone.

EnsenadaDr - 10-27-2012 at 01:53 PM

You know what, all your ideas are good, and all count. The main thing is the brainstorming and thinking about how to get things accomplished.

A little knowledge

redmesa - 10-27-2012 at 03:44 PM

I just finished 6 hours dedicated to First Aider role and responsibilities, CPR, and AED use so now I am one of those dangerous people with a little knowledge. I did find out that there are AEDs on ambulances here in Canada and in most public places. I now know that there is not a word "deader" and basically when resorting to using an AED the causality is nonresponsive and not likely to survive without CPR. an AED and rapid transmittance to a hospital. So I think everyone is right about the issue.

luv2fish - 10-27-2012 at 04:28 PM

Quote:
Originally posted by EnsenadaDr
Exactly, couldn't have said it better myself. I love the theory of "EL Gran Delito"...sounds menacing, doesn't it? The Big Crime...trying to save a friend's or neighbor's life? All this mumbo jumbo about codigo Penal, or the Penal Code, but I have seen not one citation. And especially a Codigo Penal concerning AED's. Like you said though, I wouldn't want to even have a memory of where I was in a place and decided against trying to save a life because I was afraid that the police would pounce on me. I guess some could look themselves in the mirror and say, "I escaped being prosecuted by letting John Doe die as I watched." Maybe those people aren't worth having as friends now are they?


Just a quick question for the Doctora, Here in California we suffer one of the highest rates of lawsuits in the nation. People are sue crazy, which is why we all pay up the nose for insurance. Is Mexico as bad as California ? as far as ambulance chasing Lawyers ??

DENNIS - 10-27-2012 at 05:08 PM

Quote:
Originally posted by luv2fish
Is Mexico as bad as California ? as far as ambulance chasing Lawyers ??


Maybe worse. They quickly turn into predators when confronted with a soft target that has no clue about the law and that would be your average expat standing there with a smoking de-fib machine in his hands.
I really feel that there is too much USA mindset being injected into this issue. People are assuming US style logic and protections.....and they know better. They know full well there won't even be a judge in the same room to reason with.

EnsenadaDr - 10-27-2012 at 05:32 PM

The biggest topic and joke among Mexican physicians is how suit happy Americans are. The lawsuits never get anywhere in hospitals in Mexico, probably because of the attorneys' relationships with the political venue in each city. Also, who has a $20,000 retainer to pay an attorney and pay attorneys' fees in Mexico? Not too many people. The Ministerio Publico like someone mentioned, are usually grateful for attempts to save the person's life. If it's not a case of someone in a home and a robbery attempt in the making, they can't be bothered by trying to arrest someone for trying to help. They might be way underpaid, but that doesn't mean they are stupid. Most Mexican professionals are very bright, just jaded that any amount of hard work and intelligence are not sufficiently compensated monetarily.

DavidE - 10-27-2012 at 06:41 PM

"You are not going to fix these problems, David. You can medicate, get surgery, but there is an exponential rise of arteriosclerosis with increased age. Many expats are retirement age. You aren't going to fix that problem. You cannot "fix" heart disease. This is an over simplistic approach. We are all going to die. When and where we might have a chance to change with the right equipment available"

Ahem I must be getting old. Since when has PREVENTATIVE medicine been lumped together with TREATMENT? I have zero issue with having defibrillators available. I do have many issues with inadequate and incomplete medical care. Having had too many victims expire with myocardial infarction I am sensitive to the fact that most not merely some contributed to their own death. Due to neglect. Many victims could have survived in a normal life for many more years had they did. Three victims went into ventricular arrest when the paddles were charged and inches away from their chest. Four others were unconscious upon our arrival. First comes a flood of O2. if and when the heart goes back into sinus rhythm I want lots of O2 to get to that muscle. At the same time come the paddles (electrodes). Oxygen is the key. Get it concentrated and get the pump started again.

Defibrillation is not a "tune-up" it is a last gasp all or nothing dramatic event to try and prevent death. To assume it is a normal course of events in a human life is absurd. Like saying, Oh hell I don't need to drive defensively, I have the best body and fender man on the planet. Many treatable conditions make myocardial infarction MUCH MORE LIKELY. As a doctor you should know what they are. I am a lowly ex-EMT 2 and I know what they are. If a cardiologist told me I had a serious heart enlargement issue I would think hard and long about how and where I would entertain a process to stabilize it. Most people DO NOT CARE doctor. And they do not care to learn never mind take preventative measures. Why? Oh, it's the swallow a pill and everything is fine syndrome. Heart attack because of arteriosclerosis? No problemo hook them electrodes up so I can go fishing tomorrow. Blood pressure at 240/145? Gee maybe that salt thing is real.

Any defibrillation device should be hog tied to an O2 tank. Oxygen deprivation is serious stuff. The heart does not heal itself. Flood the victim with O2 and get them back into sinus rhythm ASAP was what I was taught and what I practiced.

The defibrillators are indeed important. But they are not a panacea. They are a vital part of the solution.

Good fortune in your quest. It is important.

I appreciate the input, David

EnsenadaDr - 10-27-2012 at 06:55 PM

David, I appreciate the input. However, anyone with serious health issues who chooses to stay in Mexico, especially in isolated areas without adequate medical treatment facilities, is taking a tremendous risk to begin with. You can take all the Lasix you have been prescribed, but eat a few days in a row of delicious salted cerviche, and overload and go into congestive heart failure. Guess what. I had patients that came to the clinic in Ensenada needing IV Furosemide, and it wasn't available, let alone clot busters for active MI's. So, there is always the balance in your mind about living your life and enjoying it, or getting an apartment right next to an ER in the US. Of course preventative medicine is important, I am not minimizing it. But Mexico is not going to do it for us David. We need to take the personal responsibility and try our best to make things better for us, and that means blood tests that you mention, other studies, EKG, Xrays, and follow up with a competent physician, and by that I mean a doctor who has studied and passed the United States Licensing Exam, the gold standard for physician excellence, that probably includes less than 1% of Mexican physicians, sadly.
Quote:
Originally posted by DavidE
"You are not going to fix these problems, David. You can medicate, get surgery, but there is an exponential rise of arteriosclerosis with increased age. Many expats are retirement age. You aren't going to fix that problem. You cannot "fix" heart disease. This is an over simplistic approach. We are all going to die. When and wwihere we might have a chance to change with the right equipment available"

Ahem I must be getting old. Since when has PREVENTATIVE medicine been lumped together with TREATMENT? I have zero issue with having defibrillators available. I do have many issues with inadequate and incomplete medical care. Having had too many victims expire with myocardial infarction I am sensitive to the fact that most not merely some contributed to their own death. Due to neglect. Many victims could have survived in a normal life for many more years had they did. Three victims went into ventricular arrest when the paddles were charged and inches away from their chest. Four others were unconscious upon our arrival. First comes a flood of O2. if and when the heart goes back into sinus rhythm I want lots of O2 to get to that muscle. At the same time come the paddles (electrodes). Oxygen is the key. Get it concentrated and get the pump started again.

Defibrillation is not a "tune-up" it is a last gasp all or nothing dramatic event to try and prevent death. To assume it is a normal course of events in a human life is absurd. Like saying, Oh hell I don't need to drive defensively, I have the best body and fender man on the planet. Many treatable conditions make myocardial infarction MUCH MORE LIKELY. As a doctor you should know what they are. I am a lowly ex-EMT 2 and I know what they are. If a cardiologist told me I had a serious heart enlargement issue I would think hard and long about how and where I would entertain a process to stabilize it. Most people DO NOT CARE doctor. And they do not care to learn never mind take preventative measures. Why? Oh, it's the swallow a pill and everything is fine syndrome. Heart attack because of arteriosclerosis? No problemo hook them electrodes up so I can go fishing tomorrow. Blood pressure at 240/145? Gee maybe that salt thing is real.

Any defibrillation device should be hog tied to an O2 tank. Oxygen deprivation is serious stuff. The heart does not heal itself. Flood the victim with O2 and get them back into sinus rhythm ASAP was what I was taught and what I practiced.

The defibrillators are indeed important. But they are not a panacea. They are a vital part of the solution.

Good fortune in your quest. It is important.