BajaNomad

Defibrillators? Got one?

BajaBlanca - 9-1-2013 at 11:09 AM

A while ago, we all has a discussion on defibrillators....

Last week we visited our local health clinic and lo and behold! We now have a defibrillator here!

How about in your neck of Baja?

[Edited on 9-1-2013 by BajaBlanca]

EnsenadaDr - 9-1-2013 at 11:19 AM

Thanks for keeping the flame burning Blanca. Now it's time for everyone to get educated on how to use it. Equipment lying around with an expired battery or no one to run it is useless. You might want to check out the expiration date on the battery and make sure it is fully charged. Once the battery is used, it is no longer functional.

Last year when I checked the defibrillator at the La Joya firestation it was missing a battery according to Alex Pabloff. That was around the time Dennis was so sick and he and others were angry at me helping him thinking I had a hidden agenda. No I didn't put hemlock in Dennis' tea, he is alive and well and enjoying a new found romance!! Congrats, Dennis!!

Seriously though, who's willing to pass the torch and make sure that La Joya Firestation defibrillator has a battery and someone that knows how to use it?

Got ZAP ?

MrBillM - 9-1-2013 at 01:29 PM

Concerned that I might find myself out and about without recourse should someone's Pump go Bump and quit THUNK, I've decided to carry a 450KV "Stun Gun".

For Humanitarian use only, of course.

While it might (or might not) do the job, it's better than NOTHING.

And, it's the thought that counts, isn't it ?

BajaBlanca - 9-1-2013 at 05:33 PM

Battery? Fully charged? Who woulda thunk.....I will check it when we get back.....

An Entrepreneurial Opportunity ?

MrBillM - 9-1-2013 at 07:41 PM

Coin-Operated Defibrillators ?

Which, of course, would also accept Credit Cards.

A great incentive to maintain the Equipment.

Assuming that they wouldn't simply lift the Skippy Guy's (or Gal's) wallet given that they wouldn't be in a state to resist.

rts551 - 9-1-2013 at 08:24 PM

Quote:
Originally posted by MrBillM
Concerned that I might find myself out and about without recourse should someone's Pump go Bump and quit THUNK, I've decided to carry a 450KV "Stun Gun".

For Humanitarian use only, of course.

While it might (or might not) do the job, it's better than NOTHING.

And, it's the thought that counts, isn't it ?


Glad to know your carryiing...just in case your pump go bump, Mr Bil.

DENNIS - 9-1-2013 at 08:45 PM

How much time between the episode and the ZAP does one have?

Not much is my understanding.
So, what good is one if it isn't almost immediately available?

EnsenadaDr - 9-1-2013 at 10:37 PM

While atrial fibrillation can be tolerated for months and years, and controlled with medications, fatal arrhythmias such as ventricular fibrillation can cause collapse within seconds and organ damage within minutes, while ventricular tachycardia can become unstable in minutes. So essentially you have maybe 5 minutes to get someone out of a life threatening arrhythmia, because of the lack of effective blood pumping to the brain and other important organs by the heart.

dean miller - 9-2-2013 at 05:04 AM

Approximately 8-10 years ago my wife and I donated a new out of the box defibrillator to the clinic in the bay of LA.

The unit had been special ordered to have both written instructions in and verbal instructions for use in Spanish.

Theses units were rather expensive - around $5,600 as I recall - so not every clinic will have one.

SDM

EnsenadaDr - 9-2-2013 at 05:35 AM

At heartsmart.com you can get a preowned defibrillator starting for about $800.

http://www.heartsmart.com/?gclid=CNzo3c3brLkCFYl_QgodwX0Afw

This can be used also for small isolated communities and as I mentioned before, the chain of command is very important that everyone knows exactly where the defibrillator is at all times, how to use it, and make sure that it has 100% access and availability with the person that is in charge of it at the time. And as always folks, keep an eye on the battery. A dead battery will do nothing to restart the heart.

Have a Heart

MrBillM - 9-2-2013 at 09:29 AM

Charge ?

While it's perfectly OK for ANYBODY to donate equipment and efforts outside any government involvement in their good-intentioned desire to assist those in dire need, philosophically, one wonders if it isn't better (all things considered) to simply allow nature to take its course.

After all, MOST of those getting a Jump-Start are on the edge anyway and cruising the road
leading to the exit.

But, as said, IF people want to get involved and voluntarily attempt to jolt those back from
the edge, it's admirable, gives them something to do and does no harm.

bajaguy - 9-2-2013 at 03:19 PM

What type of battery.....where can it be purchased??
Quote:
Originally posted by EnsenadaDr
Last year when I checked the defibrillator at the La Joya
firestation it was missing a battery according to Alex Pabloff.

Seriously though, who's willing to pass the torch and make sure that La Joya Firestation defibrillator has a battery and someone that knows how to use it?

redmesa - 9-2-2013 at 04:57 PM

The only problem I have with an AED is that you have to have access quickly and a fast response after the zap. The new ambulances in our rural areas are beautiful but the drivers do not even have basic first aid training as i understand. so ....My first request would be for all the the ambulance drivers to get first aid training and know how to use oxygen etc. I could give my husband CPR and AED until I am dead myself but if there is not back up emergency care ...what the hell?

woody with a view - 9-2-2013 at 05:32 PM

Quote:
Originally posted by bajaguy
What type of battery.....where can it be purchased??

Quote:
Originally posted by EnsenadaDr
Last year when I checked the defibrillator at the La Joya
firestation it was missing a battery according to Alex Pabloff.

Seriously though, who's willing to pass the torch and make sure that La Joya Firestation defibrillator has a battery and someone that knows how to use it?


i'd imagine the mfgr would sell them.

Battery

bajaguy - 9-2-2013 at 05:42 PM

I'm not there, Woody, still NOB...was gonna look around up here

redmesa - 9-2-2013 at 05:55 PM

In all honesty (I have training and a real life situation) If there is NO emergency response team then an AED does very little. A person is dead when one is administered so if there is not immediate and swift response with medical and technical support ...FORGET IT. For those of you living in an area with these supports GOOD ON YA! Get your ducks in place!

woody with a view - 9-2-2013 at 06:14 PM

http://www.aedsuperstore.com/zoll-aed-plus-replacement-lithi...

EnsenadaDr - 9-2-2013 at 06:36 PM

I disagree. The killer is the arrhythmia, and if the AED gets the person out of the arrhythmia, then they have a chance to live.
Quote:
Originally posted by redmesa
In all honesty (I have training and a real life situation) If there is NO emergency response team then an AED does very little. A person is dead when one is administered so if there is not immediate and swift response with medical and technical support ...FORGET IT. For those of you living in an area with these supports GOOD ON YA! Get your ducks in place!

redmesa - 9-2-2013 at 07:03 PM

I hope you are right...but "AEDs, like all defibrillators, are not designed to shock asystole ('flat line' patterns) as this will not have a positive clinical outcome. The asystolic patient only has a chance of survival if, through a combination of CPR and cardiac stimulant drugs, one of the shockable rhythms can be established, which makes it imperative for CPR to be carried out prior to the arrival of a defibrillator".

EnsenadaDr - 9-2-2013 at 07:55 PM

An AED is programmed to be able to tell the difference between shockable (i.e. Ventricular fibrillation and Ventricular tachycardia) and a non-shockable rhythm as you mentioned, asystole. Asystole in my experience may be brought back to a shockable rhythm but I have seen that after the epinephrine wears off it slows down usually to a slow PEA (Pulseless Electrical activity) and then back to asystole. Basic CPR incorporates the AED and is used before the AED is placed and a pulse check is performed. It would do everyone justice to take a basic CPR class and also take an ACLS class (Advanced Cardiac Life Support) to be able to differentiate the types of life threatening rhythms and the drugs used to treat them.
Quote:
Originally posted by redmesa
I hope you are right...but "AEDs, like all defibrillators, are not designed to shock asystole ('flat line' patterns) as this will not have a positive clinical outcome. The asystolic patient only has a chance of survival if, through a combination of CPR and cardiac stimulant drugs, one of the shockable rhythms can be established, which makes it imperative for CPR to be carried out prior to the arrival of a defibrillator".

How to use an AED in conjunction with CPR

EnsenadaDr - 9-2-2013 at 07:58 PM

http://www.nhlbi.nih.gov/health/health-topics/topics/aed/how...

An Added Incentive for Universal Distribution

MrBillM - 9-3-2013 at 08:08 AM

Would be incorporating a "Betting Scheme" into the usage wherein bystanders could place bets on the result.

Of course, there's the danger that having a stake in the result might influence those applying treatment.

But, it's a little detail easily worked out.

EnsenadaDr - 9-3-2013 at 08:09 AM

Bill this is a serious matter. There is always room on the OT for effects of hallucinogenic mushrooms.
Quote:
Originally posted by MrBillM
Would be incorporating a "Betting Scheme" into the usage wherein bystanders could place bets on the result.

Of course, there's the danger that having a stake in the result might influence those applying treatment.

But, it's a little detail easily worked out.

CortezBlue - 9-3-2013 at 09:03 AM

Yes, we bought one about a year ago. We have had our home in baja for many years, but decided it was probably cheap insurance not only for us, but for our guests and neighbors.

We carry the unit in our vehicle just to be on the safe side, you never know what you may come across while driving.

EnsenadaDr - 9-3-2013 at 09:07 AM

You might want to let us in on the battery maintenance requirements, seems that even in hospital the unit defibrillators have had malfunction when someone forgets to plug the cord in to charge the battery and fails in an emergency.
Quote:
Originally posted by CortezBlue
Yes, we bought one about a year ago. We have had our home in baja for many years, but decided it was probably cheap insurance not only for us, but for our guests and neighbors.

We carry the unit in our vehicle just to be on the safe side, you never know what you may come across while driving.

DavidE - 9-3-2013 at 09:42 AM

O2 is CRITICAL. Having the CPR administrator saturate THEMSELVES with O2, then administering CPR can increase the O2 level in the patient 200 - 300 percent. And O2 to the heart is what is the key. Once sinus rhythm has been re-established with a defibrillator, CPR and medications, a PULSE OXIMETER can VERIFY O2 blood level in the extremities. So after the CPR ADMINISTRATOR ceases the use of O2 the cannula SHOULD BE TRANSFERRED TO THE PATIENT with "X" number of liters O2 flow. And then maintained on O2 all the way to the hospital.

So having a defibrillator is excellent. Having inject able medications is also vital O2 is CRUCIAL. A pulse oximeter is a real help here.

EnsenadaDr - 9-3-2013 at 10:11 AM

David, O2 is important usually because the patient may be unconscious and can't breathe correctly. Pulse oximeters are helpful but most of the time a patient might be saturating in the 70's or 80's anyway even with the O2 turned up flush unless they have a patent airway and breathing sufficiently, or have an artificial airway and are intubated. Pulse oximeters are usually for fine tuning.

luv2fish - 9-3-2013 at 12:06 PM

Quote:
Quote:

It would do everyone justice to take a basic CPR class and also take an ACLS class (Advanced Cardiac Life Support)



Where could one take C.P.R. classes ?? ( L.A. Area)

[Edited on 9-3-2013 by luv2fish]

DENNIS - 9-3-2013 at 12:15 PM

Quote:
Originally posted by luv2fish



Where could one take C.P.R. classes ?? ( L.A. Area)




Is that Los Angeles? Maybe call any hospital or the Red Cross. They should have that info readily available.

If you're a Vet, call the VA. It's almost time for your flu shot anyway. :saint:

DavidE - 9-3-2013 at 12:16 PM

Ensenada Dra. what are your thoughts of supersaturating the lungs of the person administering CPR with O2?

O2 is NOT the 1st in line for treatment, getting the heart back into sinus rhythm is. Using a defibrillator All this stuff needs to be done quickly to minimize terminal damage to the heart muscle, right? So after re-establishing (termination of ventricular fibrillation), with a non breathing patient, super O2 saturated CPR seems to be "quite" important.

In lieu of injectable drugs, with a conscious patient, does it make sense to administer 10mg of Isosorbide Dinitrate sublingual?

A pulse oximeter with AUDIBLE ALARM to me is a great way to help alert personnel that O2 blood saturation levels have decreased (i.e. 2nd attack unconscious patient). Most of the ambulances now have electrocardiogram monitors with alarms, but the pulse oximeter would be useful in lieu of having a electrocardiograph.

DENNIS - 9-3-2013 at 12:28 PM

Quote:
Originally posted by DavidE
Ensenada Dra. what are your thoughts of supersaturating the lungs of the person administering CPR with O2?




I feel this "help thy neighbor" stuff is going too far. What are the legal ramifications of killing someone with these experiments?
These procedures are best left to Trapper John and Hawkeye.

EnsenadaDr - 9-3-2013 at 01:07 PM

We are talking Mexico here David, not a critical care ambulance 3 minutes to a designated trauma center in LA. I did mention that getting the heart out of a life threatening rhythm was the first thing, then you mentioned O2. Isosorbide can cause a very low blood pressure, and usually, as RedMesa pointed out, a person in asystole is suffering from a resultant low blood pressure. Isosorbide in this situation will kill the patient. You need epinephrine in cases of asystole. Isosorbide is not an anti-arrhythmic drug either, so you need to administer something like amiodarone to keep the patient from reverting back into an irregular rhythm if the original dysrhythmia was VTach or VFib. Isosorbide is an anti-angina agent, and has absolutely no anti-arrhythmic properties. No code that I have ever seen run includes isosorbide in its emergency protocol. If the person is not breathing and you do have 100% O2 then by all means crank up the O2. Pulse oximeters are great in controlled Oxygen environments, and if you have the money by all means go out and buy one. The question is if you do use the pulse oximeter and you have cranked up the O2 all the way and the person's O2 sat is still low, then what do you do? Intubate? That still might not solve your problem.
Quote:
Originally posted by DavidE
Ensenada Dra. what are your thoughts of supersaturating the lungs of the person administering CPR with O2?

O2 is NOT the 1st in line for treatment, getting the heart back into sinus rhythm is. Using a defibrillator All this stuff needs to be done quickly to minimize terminal damage to the heart muscle, right? So after re-establishing (termination of ventricular fibrillation), with a non breathing patient, super O2 saturated CPR seems to be "quite" important.

In lieu of injectable drugs, with a conscious patient, does it make sense to administer 10mg of Isosorbide Dinitrate sublingual?

A pulse oximeter with AUDIBLE ALARM to me is a great way to help alert personnel that O2 blood saturation levels have decreased (i.e. 2nd attack unconscious patient). Most of the ambulances now have electrocardiogram monitors with alarms, but the pulse oximeter would be useful in lieu of having a electrocardiograph.

EnsenadaDr - 9-3-2013 at 01:13 PM

Not really Dennis. Since you have been converted literally into realizing how beneficial cardioversion/defibrillation can be to the patient, the protocol for running a code, or treating a person in respiratory or cardiac failure, IF there is oxygen available, IS to administer 100% Oxygen. If you are in Mexico and out in the field Oxygen might not be available. But normally running a code will include supersaturating the lungs or turning up the oxygen to 100%. The problem is as I have mentioned to David, is that if the person is not breathing correctly or the delivery system is faulty the oxygen might not reach all the lung tissue available.
Quote:
Originally posted by DENNIS[/i
Quote:
Originally posted by DavidE
Ensenada Dra. what are your thoughts of supersaturating the lungs of the person administering CPR with O2?




I feel this "help thy neighbor" stuff is going too far. What are the legal ramifications of killing someone with these experiments?
These procedures are best left to Trapper John and Hawkeye.


[Edited on 9-3-2013 by EnsenadaDr]

There are CPR classes at every street corner literally

EnsenadaDr - 9-3-2013 at 01:17 PM

Quote:
Put your area in Google and type CPR or call your local hospital or fire department. They will be able to guide you. I also recommend an ACLS class. The point here is to get educated so you can help in an emergency.
Quote:
Originally posted by luv2fish
Quote:

It would do everyone justice to take a basic CPR class and also take an ACLS class (Advanced Cardiac Life Support)



Where could one take C.P.R. classes ?? ( L.A. Area)

[Edited on 9-3-2013 by luv2fish]

Street Corner CPR lessons ?

MrBillM - 9-3-2013 at 01:49 PM

Are those Certified ?

EnsenadaDr - 9-3-2013 at 01:51 PM

Maybe in your next of the woods, Bill. :tumble:
Quote:
Originally posted by MrBillM
Are those Certified ?

My WHAT ?

MrBillM - 9-3-2013 at 01:57 PM

NEXT ?

DavidE - 9-3-2013 at 02:44 PM

The issue I was discussing with isosorbide is AFTER normal sinus rhythm is achieved not before. The heart event occurred because of lack of O2. Restoring sinus rhythm does zero to correct why the event took place in the first place. Are you suggesting that AFTER restoring normal sinus rhythm Systolic and Diastolic values remain subnormal?

Sort of like saying applying 36 volts to the starter motor and an automobile should run OK at 25,000 feet. The heart has to pump, the pumping has to deliver O2, the question is ENOUGH O2. Blocked arteries don't do a hell of a lot to help deliver the O2. That's why I am suggesting HAMMER the system with higher than 21% atmospheric O2. It has to pass through BLOCKED arteries even after sinus rhythm is restored.

Also oral or intravenous AMIODARONE is not the fastest reacting drug on the planet*. So this and everything above leads me back to a more simplistic approach, defribrillate + CPR get the heart back to normal sinus rhythm while administering lots of O2. A CPR course is mandatory. I can just see a patient being given 5.0 O2 while some nimwit stands close smoking a cigarette.

*But by god it is one of the most effective.

EnsenadaDr - 9-3-2013 at 03:40 PM

David, amiodarone is not my suggestion. It is the Red Cross and American Heart association's medication of choice for an antiarrhythmic protocol for emergency ACLS. I worked on cardiac floors for many years and isosorbide was given at times, but it wasn't a medication that was included in stabilizing a patient after a code. I suggest you read the ACLS protocols for cardiac arrest and see what medications they use. Isosorbide will help open up clogged arteries, but I have seen other forms of nitrates used with more frequency, such as nitroglycerin sublingual and nitro patches at least in the hospital. And yes I have seen patients with low blood pressures after they are stabilized, so you have to check their blood pressure. I think we both think oxygen is a given, and it is recommended in the algorithm.
Quote:
Originally posted by DavidE
The issue I was discussing with isosorbide is AFTER normal sinus rhythm is achieved not before. The heart event occurred because of lack of O2. Restoring sinus rhythm does zero to correct why the event took place in the first place. Are you suggesting that AFTER restoring normal sinus rhythm Systolic and Diastolic values remain subnormal?

Sort of like saying applying 36 volts to the starter motor and an automobile should run OK at 25,000 feet. The heart has to pump, the pumping has to deliver O2, the question is ENOUGH O2. Blocked arteries don't do a hell of a lot to help deliver the O2. That's why I am suggesting HAMMER the system with higher than 21% atmospheric O2. It has to pass through BLOCKED arteries even after sinus rhythm is restored.

Also oral or intravenous AMIODARONE is not the fastest reacting drug on the planet*. So this and everything above leads me back to a more simplistic approach, defribrillate + CPR get the heart back to normal sinus rhythm while administering lots of O2. A CPR course is mandatory. I can just see a patient being given 5.0 O2 while some nimwit stands close smoking a cigarette.

*But by god it is one of the most effective.

DENNIS - 9-3-2013 at 03:50 PM

Quote:
Originally posted by DavidE
Restoring sinus rhythm does zero to correct why the event took place in the first place. Are you suggesting that AFTER restoring normal sinus rhythm Systolic and Diastolic values remain subnormal?




In the case of a stroke caused in large part by an irregular rhythm, the recovery of Sinus Rhythm is all important to the threat of an ensuing episode...another stroke.

DavidE - 9-3-2013 at 05:06 PM

Sinus rythm is crucial dennis. I've proved it over and over again, an excess of O2 is a significant deterrent to maintaining it. This is an extraordinarily complex issue, and without question a talented CPR and 1st aid course is beyond words important. Such as how to differentiate between a comatose cardiac and stroke victim. Like I have been preaching with O2 NOT being available, it is more than a hindrance, it is a vital missing link. Getting oxygen saturated blood through a partially blocked cerebral artery is just as damned important as getting oxygen saturated blood to a starved heart muscle. This is one area where I and much of the medical community are at odds. It is one of the key questions I pose when selecting a cardiologist, the second being the importance of maintaining correct electrolyte balance. I was treated for THREE GAWDAMNED YEARS by Mexican and USA cardiology specialists for angina pain. Until the day the RN walked in with my discharge papers and quipped. "Oh by the way did you know you are severely anemic. ANEMIA? HEART PAIN? Red blood corpuscles NOT carrying enough blood to the heart. I ran not walked to the nearest el cheapo store and purchased the cheapest iron, folic acid and more magnesium for maintaining freedom from atrial fibrillation. THREE YEARS HAVE passed without the need for AMIODARONE, or ISOSORDIBE MONONITRATE. This does not instill a great deal of confidence in the medical community at large. The freedom from angina pain has been a blessing. There should be a California Department Bureau of Doctor Repair. It would need 30,000 telephone lines free.

CortezBlue - 9-3-2013 at 05:19 PM

Quote:
Originally posted by EnsenadaDr
You might want to let us in on the battery maintenance requirements, seems that even in hospital the unit defibrillators have had malfunction when someone forgets to plug the cord in to charge the battery and fails in an emergency.
Quote:
Originally posted by CortezBlue
Yes, we bought one about a year ago. We have had our home in baja for many years, but decided it was probably cheap insurance not only for us, but for our guests and neighbors.

We carry the unit in our vehicle just to be on the safe side, you never know what you may come across while driving.


Phillips unit, no plug
It is portable and the battery has a five year life, however, I plan on changing at 3 years

DavidE - 9-3-2013 at 05:36 PM

Chinese low battery alarms are CHEAP and you can hear them through 3 rooms or 200 yards open air. Self powered.

redmesa - 9-3-2013 at 07:59 PM

It is all about the time. As I understand, AED will not work unless the heart is not beating which means time is very limited unless CPR is used until a AED is applied and then the outcome in rural areas is poor. Bahia Asuncion is at least 2 hours away from any type of minimal hospital treatment so ...I guess the elephant in the room is ...what good is having one in town somewhere within a 10 minute time frame from a cardiac arrest emergency and then no medical treatment for 2 hours? I really am trained and appreciate the usefulness of AEDs but I sure would rather have someone at hand immediately trained in CPR and calling for help, than a panic about finding a AED in town. I totally support the placement of the device in public areas where people are aware of them and there is a chance someone will go for it. Please lets push for trained ambulance attendants in rural areas.

EnsenadaDr - 9-3-2013 at 08:07 PM

I'm with you 100% on this Redmesa. We need a massive overhaul of the system to help the aging baby boomers and our fellow expats.
Quote:
Originally posted by redmesa
It is all about the time. As I understand, AED will not work unless the heart is not beating which means time is very limited unless CPR is used until a AED is applied and then the outcome in rural areas is poor. Bahia Asuncion is at least 2 hours away from any type of minimal hospital treatment so ...I guess the elephant in the room is ...what good is having one in town somewhere within a 10 minute time frame from a cardiac arrest emergency and then no medical treatment for 2 hours? I really am trained and appreciate the usefulness of AEDs but I sure would rather have someone at hand immediately trained in CPR and calling for help, than a panic about finding a AED in town. I totally support the placement of the device in public areas where people are aware of them and there is a chance someone will go for it. Please lets push for trained ambulance attendants in rural areas.

What are the STATS ?

MrBillM - 9-4-2013 at 07:40 AM

HOW significant is the so-called problem ?

How many people are Defibbed (or shown to be needing it) daily-weekly-monthly-yearly in any given area ?

How many of those Defibbed survive long-term ?

Cost-Benefit Ratio ?

DavidE - 9-4-2013 at 10:13 AM

Has "The System" (IMSS Seguro Popular or ISSSTE) even TRIED to hold community 1st aid and CPR programs?

Poor "Fito" our ambulance driver is woefully unprepared for anything but driving.

FIVE MINUTES with no blood circulation and you're a goner. 99.7% certain mortality and the whopping .03% survivors would be vegetative. This does not mean this is going to happen with a heart attack, it means if the heart stops, get out the stopwatch.

BTW placing any MIRROR right against the person's nostrils is by far the best way to determine if they have any respiration at all. A badly fibrillating atria or ventricular chamber may be DIFFICULT to detect even when laying your ear on a victim's chest.

Try to smile left, then right side of your mouth, close one eyelid then the other, lift one arm then the other. If something seems weird swallow two aspirin FAST and call for help. This is a sign of an oncoming stroke. Comments la dra?

DianaT - 9-4-2013 at 10:33 AM

Quote:
Originally posted by redmesa

.......Bahia Asuncion is at least 2 hours away from any type of minimal hospital treatment so .........

Please lets push for trained ambulance attendants in rural areas.


That would be nice but I suspect it will not happen for a very, very long time. It requires money and better pay, and as you know, some of the time in BA the workers go for quite a while with no pay and the ambulance drivers do other city work. That is why paying property taxes in town is so important so the money stays there.

BA is not the place for a major medical event. Shoot, it is not even a good place for a minor one. When I fell and broke my nose, they did exactly all the wrong things in Guerrero Negro.

Real EMTs would be wonderful even if you still had to pay for the gas for the Ambulance.

DENNIS - 9-4-2013 at 10:47 AM

Quote:
Originally posted by DianaT
That would be nice but I suspect it will not happen for a very, very long time. It requires money and better pay, and as you know, some of the time in BA the workers go for quite a while with no pay and the ambulance drivers do other city work. That is why paying property taxes in town is so important so the money stays there.

BA is not the place for a major medical event. Shoot, it is not even a good place for a minor one. When I fell and broke my nose, they did exactly all the wrong things in Guerrero Negro.

Real EMTs would be wonderful even if you still had to pay for the gas for the Ambulance.



One thing worth considering is an ex-pat volunteer service. That's how our fire department was started. These efforts can morph into effective services while keeping the costs of development under control.
Just never relinquish control of assets to outside agencies....city...state...nobody..... who will try to control your donated machines etc.. That's how it works here.

redmesa - 9-4-2013 at 11:23 AM

I am with you Dennis. If all the ex-pats in BA got CPR and AED training it would be a great first step. I could even bring down a qualified instructor from St. John's ambulance (maybe) to give the basics. There are many retired people who have still maintained their certifications and have time on their hands. BUT, I know the Mexican Red Cross really frowns and any interference in their programs. (be they what they are). I will check around when we are next back in BA. We miss Stan there. He was the go to guy.

redmesa - 9-4-2013 at 11:26 AM

Diane I know it takes money but basic first aid is a 6 hour course and it save lives. Those of us in BA could all chip in and afford to fund that.

DENNIS - 9-4-2013 at 11:33 AM

Quote:
Originally posted by redmesa
BUT, I know the Mexican Red Cross really frowns and any interference in their programs. (be they what they are).



It's a shame they might be an obstacle in the development of a neighborhood-watch type life saving program, but if they're incapable, I'd just go around them watching my back in the process.
The Red Cross at times can display way too much self-importance and I would keep track of any ineptitude on their part that was dangerous. Might come in handy at a later date.

DianaT - 9-4-2013 at 11:46 AM

Quote:
Originally posted by redmesa
I am with you Dennis. If all the ex-pats in BA got CPR and AED training it would be a great first step. I could even bring down a qualified instructor from St. John's ambulance (maybe) to give the basics. There are many retired people who have still maintained their certifications and have time on their hands. BUT, I know the Mexican Red Cross really frowns and any interference in their programs......


As with everything, it is always better for these things to come from the locals with local buy-in and involvement --- delegacion, co-ops, etc --- like the lifeguard program.

You might want to talk with Jamie if you have ideas you want to bounce around. He jumped on the Lifeguard Program quickly and got involved and helped make it happen. If I remember, he has some basic first aid and cpr training, but I won't swear to it.

This basic training could help, maybe. When they can, the locals head for Ensenada, La Paz, or Tijuana for serious medical care.

BTW --- on edit, the local clinic is a decent first aid place.


[Edited on 9-4-2013 by DianaT]

DENNIS - 9-4-2013 at 12:13 PM

Quote:
Originally posted by DianaT
As with everything, it is always better for these things to come from the locals with local buy-in and involvement --- delegacion, co-ops, etc --- like the lifeguard program.




Fine...if they can guarantee a "Time sensitive response" to a life threatening situation. I can't help but think their culture may be an issue, and that wouldn't be quaint at the wrong time.
What's wrong in being proactive beyond the point of giving money? :?:

redmesa - 9-4-2013 at 01:04 PM

This is a bit different from the Lifeguard Program. For me this is all about taking care of myself and friends right now. I have a first aid ticket but would be reluctant to handle a Mexican emergency unless I knew the people very well. Things can go wrong very quickly and the first rule in First Aid Training is once you start you commit and stay until the issue is resolve. If Jaimie or the clinic (which I have not had a good experience with) wants to learn first aid I will certainly help out where I can. The Co-op probably has their own programs and I would never venture into that territory. I think the Lifeguards have a bit of water safety first aid in their toolbox. Medical emergencies can happen to the old and young so I do not think it is just about us old-timers with bad hearts. It is just something all of us should know a little if not a lot about...cause "chit happens".

DavidE - 9-4-2013 at 01:05 PM

Red Cross, Green Cactus, is there ANYONE willing to come to Asuncion and give basic CPR 1st aid courses? Not anyone I have ever talked to. Could someone approach doctors without borders or maybe the rotary club for assistance?

With the wind, wooden crackerboxes, and part time low pressure water, if a home ever goes up in flames the only productive act would to be for neighbors to bring wieners and marshmallows. A pumper would be great and about as likely as seeing a coconut grove sprout on the beach. Dirt cheap smoke alarms sat on the shelves in the Miramar for months before Eduardo moved them upstairs to be forgotten forever.

Plastic garlands of flowers would go over as big sellers for this panteon.

DianaT - 9-4-2013 at 01:14 PM

Quote:
Originally posted by redmesa
This is a bit different from the Lifeguard Program. For me this is all about taking care of myself and friends right now. I have a first aid ticket but would be reluctant to handle a Mexican emergency unless I knew the people very well. Things can go wrong very quickly and the first rule in First Aid Training is once you start you commit and stay until the issue is resolve. If Jaimie or the clinic (which I have not had a good experience with) wants to learn first aid I will certainly help out where I can. The Co-op probably has their own programs and I would never venture into that territory. I think the Lifeguards have a bit of water safety first aid in their toolbox. Medical emergencies can happen to the old and young so I do not think it is just about us old-timers with bad hearts. It is just something all of us should know a little if not a lot about...cause "chit happens".


Opps, I am sorry. I guess I didn't read carefully. I did not know this was mainly about ex-pats. The more who know first-aid, the better.

DENNIS - 9-4-2013 at 02:23 PM

Quote:
Originally posted by DianaT


Opps, I am sorry. I guess I didn't read carefully. I did not know this was mainly about ex-pats. The more who know first-aid, the better.


It's about ex-pats helping everybody. Nothing exclusive.

EnsenadaDr - 9-4-2013 at 04:03 PM

Most of the IMSS and other hospitals and health care programs in Mexico have regular CPR programs but most of them are in Spanish. There are so many resources online to learn CPR and ACLS. Try and get the basics down with a CPR class online. Every little bit helps.
Quote:
Originally posted by DavidE
Has "The System" (IMSS Seguro Popular or ISSSTE) even TRIED to hold community 1st aid and CPR programs?

Poor "Fito" our ambulance driver is woefully unprepared for anything but driving.

FIVE MINUTES with no blood circulation and you're a goner. 99.7% certain mortality and the whopping .03% survivors would be vegetative. This does not mean this is going to happen with a heart attack, it means if the heart stops, get out the stopwatch.

BTW placing any MIRROR right against the person's nostrils is by far the best way to determine if they have any respiration at all. A badly fibrillating atria or ventricular chamber may be DIFFICULT to detect even when laying your ear on a victim's chest.

Try to smile left, then right side of your mouth, close one eyelid then the other, lift one arm then the other. If something seems weird swallow two aspirin FAST and call for help. This is a sign of an oncoming stroke. Comments la dra?

EdZeranski - 9-4-2013 at 04:46 PM

Quote:
Originally posted by EnsenadaDr
While atrial fibrillation can be tolerated for months and years, .....


My case exactly! For years during work related physicals the docs said "Oh you have a bit of arythmia" None ever gave any weight to it or further comment so on it went until I passed out after coming home from the post office. Now its an aspirin and metaprolol everyday and its been fine for 3 years. I do know there was medical equipment in the Loreto hospital that was unmaintained or had no trained operators. When going South I take my TCCC, Tactical Combat Casualty Care triage kit with me. Luckily I did not need it in Iraq or Afghanistan but it would be helpful if the first on an accident scene .


EdZ KG6UTS
Ocean Beach/Borrego Springs

EnsenadaDr - 9-4-2013 at 06:49 PM

A patient with chronic atrial fibrillation was told by a Mexican cardiologist that they could be cardioverted (a mini defibrillation) but that the atrial fibrillation would return right away.

I questioned this theory along with the fact that this particular cardiologist didn't check the INR of the person while on Coumadin. Lo and behold the person had a stroke and started taking better care of himself, and was advised in the US to cardiovert the atrial fibrillation after years of being chronic.

The person is now for the most part in sinus rhythm. Hallelujah!!

EnsenadaDr - 9-4-2013 at 06:50 PM

What's in the kit besides a worm and Tequila, may I ask?:lol:
Quote:
Originally posted by EdZeranski
Quote:
Originally posted by EnsenadaDr
While atrial fibrillation can be tolerated for months and years, .....


My case exactly! For years during work related physicals the docs said "Oh you have a bit of arythmia" None ever gave any weight to it or further comment so on it went until I passed out after coming home from the post office. Now its an aspirin and metaprolol everyday and its been fine for 3 years. I do know there was medical equipment in the Loreto hospital that was unmaintained or had no trained operators. When going South I take my TCCC, Tactical Combat Casualty Care triage kit with me. Luckily I did not need it in Iraq or Afghanistan but it would be helpful if the first on an accident scene .


EdZ KG6UTS
Ocean Beach/Borrego Springs

DENNIS - 9-4-2013 at 07:04 PM

Quote:
Originally posted by EnsenadaDr

The person is now for the most part in sinus rhythm. Hallelujah!!



For all parts, in fact. After a couple of days of instability, the 'ol ticker settled into sync and never looked back.

The Doc mentioned is one of Ensenada's finest. He once told me he did open heart surgeries.

Gaww Damm. I shudder to think about it.

patch me up Scotty

EdZeranski - 9-4-2013 at 07:05 PM

Quote:
Originally posted by EnsenadaDr
What's in the kit besides a worm and Tequila, may I ask?:lol:
Quote:
[

Clotting cloth, bandages, rubber globes, disinfectant, tourniquet , needles to relieve lung impaction, nose tube for blocked throat passage etc etc etc. Scissors, razor for cutting away clothes. The Tequilla isn't issued in the TCCC pck but it is always in reach. ~8^)

EdZ

EnsenadaDr - 9-4-2013 at 07:36 PM

man sounds like you are ready for the next Mexican revolution!!

Medical Training/Information

bajaguy - 9-4-2013 at 08:31 PM

Sharp Medical Centers (San Diego/Chula Vista) International Patient Services regularly present FREE training and medical informational seminars in Ensenada for both Ex-Pats and Nationals. You do not have to be a Sharp patient to attend.

Training seminars have included such topics as the new CPR method, AED operation, Heart Health, diet and excercise, skin cancer; preventing falls and more. Seminar presenters have included PA's, NP's and doctors.

Also included have been presentations by the local Red Cross, the local (private) ambulance service and Velmar hospital.

These seminars are free and are held at the San Nicholas Hotel/Casino.

The next presentation will be Wednesday, October 9, 2013

If you are interested in attending or want to be put on the notification list, contact:

Tillie Foster at:
tillie.f@snhotelcasino.com
646-154-2060

redmesa - 9-4-2013 at 09:37 PM

Quote:
Originally posted by bajaguy
Sharp Medical Centers (San Diego/Chula Vista) International Patient Services regularly present FREE training and medical informational seminars in Ensenada for both Ex-Pats and Nationals. You do not have to be a Sharp patient to attend.

Training seminars have included such topics as the new CPR method, AED operation, Heart Health, diet and excercise, skin cancer; preventing falls and more. Seminar presenters have included PA's, NP's and doctors.

Also included have been presentations by the local Red Cross, the local (private) ambulance service and Velmar hospital.

These seminars are free and are held at the San Nicholas Hotel/Casino.

The next presentation will be Wednesday, October 9, 2013

If you are interested in attending or want to be put on the notification list, contact:

Tillie Foster at:
tillie.f@snhotelcasino.com
646-154-2060


That is great for you guys up there. Send them south.

bajaguy - 9-4-2013 at 10:04 PM

Quote:
Originally posted by redmesa

That is great for you guys up there. Send them south.





Here ya go. Give them a call and ask for Miranda or Jackie

http://www.sharp.com/international-services/index.cfm

Or send 'em an e-mail

https://www.sharp.com/contact/multicultural-services.cfm

[Edited on 9-5-2013 by bajaguy]

EnsenadaDr - 9-5-2013 at 07:12 AM

They usually have a presentation about every 6 months but I have not seen a CPR class included in their presentations. I attended one about a year ago and they did not have a CPR class included though Jacquie did tell me they had one in Baja Sur. It is somewhat of a sales pitch for local businesses from my recollection but also gives a free breakfast!!
Quote:
Originally posted by bajaguy
Sharp Medical Centers (San Diego/Chula Vista) International Patient Services regularly present FREE training and medical informational seminars in Ensenada for both Ex-Pats and Nationals. You do not have to be a Sharp patient to attend.

Training seminars have included such topics as the new CPR method, AED operation, Heart Health, diet and excercise, skin cancer; preventing falls and more. Seminar presenters have included PA's, NP's and doctors.

Also included have been presentations by the local Red Cross, the local (private) ambulance service and Velmar hospital.

These seminars are free and are held at the San Nicholas Hotel/Casino.

The next presentation will be Wednesday, October 9, 2013

If you are interested in attending or want to be put on the notification list, contact:

Tillie Foster at:
tillie.f@snhotelcasino.com
646-154-2060

bajaguy - 9-5-2013 at 07:21 AM

Presentations are about every 4 months.............I was at the CPR and AED class....where were you???.

Don't remember any sales pitch, but an explaination of services available, continental breakfast (coffee, pastry and fruit) available.

And yes, Jacquie did say they do presentations in Baja Sur.

If anyone wants to schedule a visit/training in their area, they should contact Sharp and work out details.
Quote:
Originally posted by EnsenadaDr
They usually have a presentation about every 6 months but I have not seen a CPR class included in their presentations. I attended one about a year ago and they did not have a CPR class included though Jacquie did tell me they had one in Baja Sur. It is somewhat of a sales pitch for local businesses from my recollection but also gives a free breakfast!!
Quote:

EnsenadaDr - 9-5-2013 at 07:55 AM

Really? Well that's good to know because the last presentation I went to there was no formal CPR or AED class. I probably was working at the Cantu clinic full time, since they present usually during the week. I don't think you would know me if you saw me anyway since I sat next to you and your wife at Jerry's Café Orleans a few months back and you didn't seem to know who I was.
Quote:
Originally posted by bajaguy
Presentations are about every 4 months.............I was at the CPR and AED class....where were you???.

Don't remember any sales pitch, but an explaination of services available, continental breakfast (coffee, pastry and fruit) available.

And yes, Jacquie did say they do presentations in Baja Sur.

If anyone wants to schedule a visit/training in their area, they should contact Sharp and work out details.


Quote:
Originally posted by EnsenadaDr
They usually have a presentation about every 6 months but I have not seen a CPR class included in their presentations. I attended one about a year ago and they did not have a CPR class included though Jacquie did tell me they had one in Baja Sur. It is somewhat of a sales pitch for local businesses from my recollection but also gives a free breakfast!!
Quote:

bajaguy - 9-5-2013 at 08:10 AM

Oh, I was aware you were there, just didn't want the other patrons to know I knew you :lol:
Quote:
Originally posted by EnsenadaDr
I don't think you would know me if you saw me anyway since I sat next to you and your wife at Jerry's Café Orleans a few months back and you didn't seem to know who I was.
Quote:

EnsenadaDr - 9-5-2013 at 08:33 AM

Why is that? I am on very good terms with your neighbors at the Country Club that go to the German group every Thursday there. Don't be shy!!!

Age-Related Interests

MrBillM - 9-5-2013 at 09:06 AM

One aspect of getting old seems to be this expanding obsession with getting even older.

The young wildly and cheerfully live hard and tempt fate everyday and LOVE it. The old seem desperate to hang on at all costs.

The Defib obsession reminds me of an occasion years ago when I stopped at "Hadley's" in the San Gorgonio Pass and found it packed with Geezers minutely examining every word on the packages of various "Health-Food" items apparently hoping to squeeze every last minute out of their existence.

Sad.

[Edited on 9-5-2013 by MrBillM]