Defibrillator is used for defibrillation

Heart disease is the second killer in Hong Kong with about nine lives lost daily as a result of Sudden Cardiac Arrest. Coronary heart disease is the commonest among the various types of heart disease. 50% of heart attack victims die before their arrival in the hospital. The leading cause of their death is due to the lethal chaotic non-coordinating cardiac rhythm “Ventricular fibrillation VF”. Electrical Defibrillation is the only known effective therapy for VF. The situation in Hong Kong is:

* The ambulance crews usually arrive at sense at around 10mins after initiation.
* As a result, the chance of successful resuscitation is compromised secondary to delay electrical defibrillation. The way to improve the situation is help by Automated External Defibrillator.
* Currently a new generation of defibrillator called Automated External Defibrillator (AED) gives us a solution.
* It is safe, effective, easy to use, light weight, low maintenance and inexpensive.

ABCD

基本維持生命技術
應採取的復蘇程序
主 要 ABCD
步驟：
- 開始時先查察環境是否存在危險
- 由第一救援人員檢查病人的反應
- 如病人已經無反應，立即召喚救護車
- 其他救援人員穿戴好為控制感染所需的保護裝備(包括帽、護目鏡、面罩、N95口罩、手術用手套及保護袍)
- 開始拯救呼吸之前，先預備可過濾病毒的袋裝面罩(bag-valve filter mask)
- 預備心臟去纖顫器及緊急用車牀，如有輔助人員在場，則試圖尋找病人的病歷紀錄

A：氣道(airway)
- 第一救援人員使病人的頭部向後傾，下巴抬高，或按壓病人的頜骨，以張開氣道

B：呼吸(breathing)
- 透過觀看、感覺及傾聽檢查病人的呼吸

C：血液循環(circulation)
- 量脈搏
- 只有在確定心跳停止(沒有脈搏)而又不能即時取得心臟去纖顫器使用時，方考慮在心前區捶打施救
- 隨後開始按壓胸口
- 如第二救援人員已穿戴好保護裝備，而袋裝過濾面罩亦準備好，則開始拯救呼吸

D：除纖顫(defibrillation)
- 預備心臟去纖顫器(如有)及因應施救需要進行除纖氈程序

HOW TO SURVIVE A HEART ATTACK WHEN ALONE?

Situation:

Let's say it's 6.15pm and you're driving home (alone of course) after an unusually hard day on the job.
You're really tired, and frustrated……
YOU ARE REALLY STRESSED AND UPSET WITH YOUR BOSS…..


Problems:

Suddendly you start experiencing severe pain in your chest that's tarts to radiate out into your arm and up into your jaw. You are only five miles from the hospital nearest your home.
Unfortunately you don't know if you'll be able to make it that far.


What to DO?

YOU HAVE BEEN TRAINED IN CPR (心肺復甦術 (Cardiopulmonary Resuscitation) ), BUT THE PERSON THAT TAUGHT THE COURSE DID NOT TELL YOU HOW TO PERFORM IT ON YOURSELF !!!

HOW TO SURVIVE A HEART ATTACK WHEN ALONE?
SINCE MANY PEOPLE ARE ALONE WHEN THEY SUFFER A HEART ATTACK, WITHOUT HELP, THE PERSON WHOSE HEART IS BEATING IMPROPERLY AND WHO BEGINS TO FEEL FAINT, HAS ONLY ABOUT 10 SECONDS LEFT BEFORE LOSING CONSCIOUS

REMEMBER:

DO NOT PANIC, BUT START COUGHING REPEATEDLY AND VERY VIGOROUSLY.

A DEEP BREATH SHOULD BE TAKEN BEFORE EACH COUGH, THE COUGH MUST BE DEEP AND PROLONGED, AS WHEN PRODUCING SPUTUM FROM DEEP INSIDE THE CHEST.

A BREATH AND A COUGH MUST BE REPEATED ABOUT EVERY TWO SECONDS WITHOUT LET-UP UNTIL HELP ARRIVES, OR UNTIL THE HEART IS FELT TO BE BEATING NORMALLY AGAIN.

DEEP BREATHS GET OXYGEN INTO THE LUNGS AND COUGHING MOVEMENTS SQUEEZE THE HEART AND KEEP THE BLOOD CIRCULATING. THE SQUEEZING PRESSURE ON THE HEART ALSO HELPS IT REGAIN NORMAL RHYTHM. IN THIS WAY, HEART ATTACK VICTIMS CAN GET TO A HOSPITAL



ARTICLE PUBLISHED ON N.º 240 OF JOURNAL OF GENERAL HOSPITAL ROCHESTER


DON'T EVER THINK THAT YOU ARE NOT PRONE TO HEART ATTACK AS YOUR AGE IS LESS THAN 25 OR 30. NOWADAYS DUE TO THE CHANGE IN THE LIFE STYLE, HEARTATTACK IS FOUND AMONG PEOPLE OF ALL AGE GROUPS.

Introduction+++

Brief ...Introduction... of the Programme necessity.

CEO承傳關乎企業興亡

27/04/2004

四月十九日，全球最大的快餐連鎖店麥當勞（McDonald's）主席兼行政總裁坎塔盧波（Jim Cantalupo），在佛羅里達州舉行股東及特許經營商大會時猝死，享年六十歲，以坎塔盧波的年齡，並不屬於年邁一族，突如其來的死訊，使華爾街愕然，麥當勞股價應聲下跌3%，失去約1億美元市值，至公司宣布繼任人選，股價才喘定。

本已退休的坎塔盧波，在麥當勞表現不濟時臨危受命，重掌領導，進行改革，使公司脫離困境，股價從去年的每股12美元，回升至他去世前的29美元。投資者向來不喜歡公司前景不確定，CEO猝然而逝，對投資者信心自然有一定打擊，而且，失去好的CEO，公司前景更難料。

CEO繼任（Succession）問題，可以是決定企業興亡的關鍵。研究顯示，不管公司成功與否，原CEO的離任，
通常是出於自願（即退休）或死亡，至於由董事局或股東撤換CEO，則甚為罕見。近十年，大型企業CEO的平均年齡不斷上升，反映CEO的「新血」其實不多。

Ventricular Fibrillation (VF) : Current vs. Energy - Current is the Answer!

A HEART IN VF

•It is well established --- it is current that defibrillates

•There is an optimal time that a heart is receptive to defibrillation current

•An optimal amount of current must pass through the heart in an optimal amount of time in order to successfully defibrillate. We call this optimized current delivery

Optimized Current Delivery = Successful Defibrillation

The Heart’s Electrical System

When a patient’s heart is sick or malfunctioning the rhythm is called an Arrhythmia

Cardiac Rhythms Electrical Conduction System

Defibrillation The Time Factor*

“ Survival rates after VF cardiac arrest decrease approximately 7% to % with every minute 10 that defibrillation is delayed.” p I-61

* Non-linear

Source: Guidelines 2000 for Cardiovascular Resuscitation and Emergency Cardiovascular Care.Circulation. 2000;102(suppl I)8. August 22,2000