With the 2010 Emergency Cardiovascular Care (ECC) and American Heart Association (AHA) Guidelines Updates there comes new published science on the use of AEDs on infants and children. 

Former science [pre-2010 and post-2005] suggested not to use AEDs on infants and to use pediatric pads on children under 8 years of age or under 55 pounds.  Evidence of this from prior blogs or internet posts includes: http://www.wikihow.com/Use-a-Defibrillator, which contains old outdated information summarized below.

OLD INFORMATION: Do not put adult pads on a pediatric patient and vice versa! Pediatric pads are used on children who are ages 12 and under. [this is pre-2005 information]

NEW GUIDELINES INFORMATION: http://www.heart.org/idc/groups/heart-public/@wcm/@ecc/documents/downloadable/ucm_317350.pdf   clearly updates the guidelines to show that it is acceptable to use AEDs and even adult pads on pediatric patients, including infants.  The KEY is anterior and posterior placement.  For more details, see the information below pulled directly from the recent guidelines update.

AED Use in Children Now Includes Infants

2010 (New): For attempted defibrillation of children 1 to 8

years of age with an AED, the rescuer should use a pediatric

dose-attenuator system if one is available. If the rescuer

provides CPR to a child in cardiac arrest and does not have an

AED with a pediatric dose-attenuator system, the rescuer should

use a standard AED. For infants (<1 year of age), a manual

defibrillator is preferred. If a manual defibrillator is not available,

an AED with pediatric dose attenuation is desirable. If neither is

available, an AED without a dose attenuator may be used.

2005 (Old): For children 1 to 8 years of age, the rescuer

should use a pediatric dose-attenuator system if one is

available. If the rescuer provides CPR to a child in cardiac

arrest and does not have an AED with a pediatric attenuator

system, the rescuer should use a standard AED. There are

insufficient data to make a recommendation for or against the

use of AEDs for infants <1 year of age.

Why: The lowest energy dose for effective defibrillation in

infants and children is not known. The upper limit for safe

defibrillation is also not known, but doses >4 J/kg (as high

as 9 J/kg) have effectively defibrillated children and animal

models of pediatric arrest with no significant adverse effects.

Automated external defibrillators with relatively high-energy

doses have been used successfully in infants in cardiac arrest

with no clear adverse effects.

If you are a school or camp or childcare provider, what does this mean?  Until new science [in 2013 or after] is released you should consider looking at your current AED program.  Do you have pediatric pads currently?  Those will expire in 2 years or less – should you replace them?  In these economic times, there are many non-profits and schools who will not have adequate budgetary capacity and it may be a topic of consideration.  Due to the new science, strong consideration can be given to this — IF you can accommodate for proper AED use communication to responders or the public who would use the device with ADULT PADS on a child under 8 years or 55 pounds.

How do you accommodate?  A simple solution: a  sticker/decal set that can be attached to your AED case and responder supplies to remind responders on WHAT TO DO for pediatric events.  The set includes directions on where to find illustrations with 2010 instructions and how to apply the ADULT pads (complete with pictures) anterior [front] and posterior [back] for pediatric events and why.  Call 888-473-1777 for more technical information on this solution.

The reason for anterior and posterior placement, simply put, is to allow the pads to shock the heart WITHOUT the pads touching – the surface area of a pediatric victim’s chest is not large enough usually to allow normal ADULT pad placement.

Simple directions and illustrations and quick references on the AED, AED instruction manual or guides, AED policy and AED protocols and CPR/AED poster you keep at your facility all will help with communication of this simple change for pediatric vs. adult use.

The ONLY exception are customers who have Philips FRx (the ONLY model to allow switching of shock level with an Infant/Child Key inserted into the AED while using the SAME SET OF PADS).  Philips FRx models offer a wonderful solution for facilities that want to be able to accommodate pediatric or adult situations without a large CONSUMABLE cost from 2 yr disposable pads for each event.  The FRx is a more expensive model with a higher purchase price – however, IF you know you are going to be primarily using the device on pediatric patients, this model would be a leading device to consider.

We are here to help.  First Voice can provide a sticker/decal/ template set to easily show on your AED and responder supplies WHAT TO DO for pediatric events.  The set includes directions on where to find illustrations with 2010 instructions and how to apply the ADULT pads (complete with pictures) anterior [front] and posterior [back] for pediatric events and why.  Call 888-473-1777 or contact your dealer for First Voice products for more information – Part number PED-DECAL01.  Pricing is only $10.00 including shipping.  Please provide your AED brand so we can make sure to ship the right decal set.

Over 300,000 people die annually from SCA and an Automated External Defibrillator (AED) is the best life insurance policy anyone can buy, increasing survival rates from 10% to over 60% — IF an AED is used within the first 2-4 minutes after a victim suffers from SCA and collapses.

To learn more about special promotions going on during June at Think Safe and with Think Safe dealers please contact us at: 888-473-1777 and mention Ad Code Blog0102.

The key to being prepared is… being prepared! Preparedness does not cost thousands, the price is very affordable! Call us for more details today at 888-473-1777.

PS – Are you a school or nonprofit in need of funding options? http://www.firstvoice.us/Funding/tabid/485/Default.aspx (visit our funding web link today to get prepared for tomorrow)

2010 New Guidelines

What does the American Heart Association recent guidelines update have to say about cognitive aids and feedback devices?

A quick summary from 2010 American Heart Association Guidelines, Supplement to Circulation Volume 122, Issue 18, Supplement 3 from November 2, 2010:

1) Part 5: Page S697, “real-time CPR prompting & feedback technology such as visual and auditory prompting devices can improve the quality of CPR.”

2) Part 16: Page S920, “non-responders most frequently cited panic and fear of hurting the patient as reasons they were unable to perform.”

3) Part 16:Page 921, “even brief training increases the willingness to use an AED and improves performance.”

4) Part 16:Page 922, “short video instruction combined with synchronous hands on practice is an effective alternative to instructor-led basic life support courses.”

5) Part 16:Page 923, “ECC courses should be part of a larger continuing education and continuous quality improvement process.”

6) Part 16:Page 923, “Checklists or cognitive aids may be considered for use during actual resuscitation.”

7) Part 16: Page 923, “CPR prompt and feedback devices can be useful as part of an overall strategy to improve the quality of CPR during actual resuscitation.”

To find out more about current technology and first aid or CPR checklists, cognitive aids and feedback devices available today and distribution opportunities, go to www.firstvoice.us or contact First Voice at 888-473-1777.

Talking First Aid Book / First Aid Calculator

ECC / AHA & National First Aid Science Upgrades were released in late 2010.  For more information on this see our blog post from October:

http://thinksafe.wordpress.com/2010/10/19/the-2010-guidelines-for-cpr%E2%80%A6/

Think Safe’s First Voice EID is ready for CPR/First Aid upgrades to be sent to you, our dealers and customers!

Part No. DC01: The $29 upgrade is sent in a datacard and can be easily inserted/changed by following the user instructions sent with the upgrade.  

Dealers please contact us for further information on how to provide your customers easy upgrades (email:mmaly@think-safe.com).

The First Voice EID is the only Emergency Instruction Device / Talking First Aid Book / First Aid Calculator on the market for business use, containing all first aid & CPR AHA manual current protocols.  The device is easy to upgrade through an accessible dataport on the back of the device as first aid & CPR protocols do change every 3-5 years through scientific studies and advances in first aid / CPR science.

2010 updates implemented in 2011 on the EID protocols include:  CPR updates to include compression depth & C-A-B changes for trained rescuers and hands only CPR for untrained rescuers, education & recognition of gasping vs. normal breathing, and advised AED use for infants.  First Aid updates include additional heat stroke advice, jellyfish sting updated care,  clarification on aspirin use for heart attack symptoms, both US and Canadian Poison Control contact information, bleeding wound care updates (elevation, pressure points, tourniquet, compression bandage use), additional information on when to suspect head, neck or spinal injuries, and snakebite first aid care updates.

Please contact us today for your upgrade:

(email:pwickham@think-safe.com or 888/473/1777)

SafetyMate Trade-in: $50 Value!

Or, if you have an outdated SafetyMate model

NOW is the time to upgrade to First Voice:

$50 REBATE on ANY SafetyMate exchanged

& First Voice EID (AVU5001) ordered!

Expires:  3/31/2011

NEW! Still in box Lifepak 1000 AED package

Lifepak 1000 NEW (10 each)

AED packages:

1 – pediatric pad

2 – adult pads

Battery NEW

user manual

training dvd

quick guide

carrying case

Full warranty still in effect.

This classified is the result of a School purchasing 10 NEW lifepak 1000s and subsequently being donated AEDs by a local company.  AED vendor will not take units back without a 25% penalty restocking fee.

Make your offer!  Great chance to get a very good deal!  Offer stands currently at $1600 for all equipment and warranty above.  If you are looking to purchase Lifepak 1000s for your EMS agency or facility, get in on this bid opportunity.

If you are interested, please comment with your email and phone (will not be published) and we will connect you with the school who is looking to dispose of these NEW devices. They are NEW in the box!

If you have questions, please post a comment as well and your phone or email and the school will respond directly to you.

If you prefer, contact us at 888/473/1777 and ask for Jen regarding the Lifepak 1000 school classified on Think Safe’s blog.

1)       Electrode Pads – The majority of the AED models on the market have a 2 year electrode pad life.  The date of the expiration is clearly marked on the pad package, an example is shown on this posting for the Philips FRx Rugged AED.  Some AED models do have 3.5 yr expiry dates up to 5 yr expiry dates, however. Dates vary due to packaging mechanisms but be sure to follow manufacturer guidelines and expiration dates provided.  The electrode pads will dry out and prevent proper AED functioning/use if they are not replaced as needed.  Pads range in price from $35-$120, depending on make and model owned.

2)       Batteries – The majority of the AED models on the market have a 3-5 year warranty and lifespan.  The date of the expiration is also clearly marked on the battery.  Various models will warranty the devices for xx years AFTER initial install so be sure to clearly mark your records on WHEN you install the battery for these models.  Also, the HeartSine Samaritan and Physio Conrol / Medtronic CR Plus Lifepak or Lifepak Express models have a combo pack you purchase with battery/pads being replaced simultaneously.  Defibtech / Cintas does sell a model that has a suggested annual replacement of an off-shelf 9V battery (this ensures their AED performs proper self-testing).  AED batteries range in price from $75-$400, depending on make and model owned.

3)       Training – AED acquirer state laws many times dictate that you have to ensure expected users are trained in American Heart or Red Cross or equal CPR & AED certified courses (American Safety & Health Institute, Medic First, Health & Safety Institute, Emergency Care & Safety Institute, American Health Association, etc).  These certifications range depending on which training org you use but every 1-2 years the certification expires and needs to be renewed.  Courses can be obtained locally at Red Cross locations or through the American Heart Association network but also there are over 100,000 instructor throughout the US alone and there are local training centers that can provide a competitive price for CPR & AED, First Aid, and Bloodborne Pathogen or Universal Precautions plus other more advanced or supplemental add-on training classes.  Various online solutions are also available.  Think Safe has a listing of US training centers and online solutions; contact us at or info@think-safe.com if you would like to contact a local trainer in your area.

4)       Program Manager Software / Database – AED acquirer state laws many times also dictate that the AED has to be maintained to manufacturer and industry standards.  This standard generally a 30 day check.  Many companies have their own database solution for ensuring equipment is checked regularly and records of these checks are kept on file (big companies).  If you do not, there are online solutions that are inexpensive but key in helping to not only auto-notify your AEDs are checked to standards but also the log and records of all AEDs are filed and backed up regularly for legal protection.  A nice comprehensive  UNLIMITED user solution at $25-$50/location (customer) can be seen here, showing it’s full capabilities:  http://www.firstvoice.us/FirstVoiceAEDManagerVideo/tabid/751/Default.aspx

5)       Medical Oversight – AED acquirer state laws in approximately 20 states requires a licensed physician or “certified healthcare provider” to oversee the AED program.  This is NOT an Rx!  Proper Medical Oversight includes sign-off by the appropriate license owner referred to in that state law on:  AED/CPR training of the organization (who is trained, how often, what they are trained on); AED placement and markings; AED communication; AED policy; AED maintenance & upkeep procedures.  Contact Think Safe at if you are not sure if your state requires medical oversight.  Medical Oversight costs anywhere from $75/AED to $350/AED or some companies chose to hire medical direction and pay a retainer annually.  Think Safe has a national network of medical directors and can provide a quote for efficient medical oversight for your organization, charging you for locations ONLY where mandates require it. In some cases, we can connect you with a local FREE source for medical oversight.  Call for more details.  AED distributors/dealers are encouraged to call as well.

Think Safe [VIEW OUR BIO] is a certified Women-Owned Business (WBENC) providing first aid & defibrillator expertise to clients since 2004. Known for technical assistance to customers on: [State AED acquirer laws] [AED funding sources and grants] [AED program management solutions] including [Medical Oversight] [& Online AED database / record-keeping compliance software].

References available or drop us a line  [888.473.1777]

There are several very good points made in this article.

Of note is that these lifesaving devices can be purchased for $1000 or under and AED packages (cabinet, etc) are $1000 to $1500.  And, companies and facilities should want to purchase and maintain the devices under their own lead, not based upon being MANDATED to buy.

I know of several MANDATED customers (schools, fitness clubs, gyms, etc) where they – without hand holding and an easy database solution that is inexpensive – DID NOT hold up their end of the bargain historically due to the absence of an AED program Champion.    Pads expire, Batteries expire, devices go unchecked and management is crossing their fingers [and toes] that the device works when it is needed at their location (if it is even remembered to be used).

The key is that these devices save lives, they should not be mandated, they should be affordable and easy to maintain.  THEY SAVE LIVES and let’s not forget that Sudden Cardiac Arrest is the biggest killer annually in the U.S.

How can you fund an AED?  There are grants – email us for a copy of “THE FOUNDATION OF FUNDING AEDS” – FREE, COMPLIMENTARY and no strings attached!

EMAIL:   grants@think-safe.com (subject – COPY OF FOUNDATION OF FUNDING AEDS)

How can you make sure the AED is constantly in compliance and checked regularly for under $25 – 50/yr at your location?  info@firstvoice.us or check out this link:

http://www.firstvoice.us/Products/FirstVoiceAEDProgramManager/tabid/727/Default.aspx

It seems that the answer to placing the devices are not mandates but rather, proper funding and program solutions for the long term!   We can always be reached at  as well at the contact info below, and we are happy to give you our technical insights into accessible funding sources and cost reductions, where applicable!

Making Minutes Matter

Think Safe Blog /grants@think-safe.com (888.473.1777)

No worries, your First Voice manufactured equipment is not obsolete! All First Voice manufactured products and software are fully upgradeable.

Think Safe will work diligently to update our First Voice audio and text prompts, instruction manuals, and any other materials for the 2010 CPR guideline updates.  It will take all major training organizations 6-9 months to release updated training materials to instructors.  All First Voice modifications and updates will be available before December 31, 2010 and we will post updates on our blog and provide email notifications of any upgrade completions and how to notify your customers for their upgrade.

What are the changes in CPR?  Here is a summary of the CPR updates to help you understand differences in protocol and new training requirements.

Starting CPR with chest compressions helps save lives

Emphasizing that every second counts, the new guidelines recommend that instead of first opening an unconscious person’s airway and breathing into his mouth, rescuers—whether onlookers or emergency experts—should initiate chest compressions immediately to revive victims of a sudden cardiac arrest.

The stress on the primacy of chest compressions over oral resuscitation led the AHA to revise the standard CPR procedure from the familiar ABC (Airway-Breathing-Compressions) to CAB (Compressions-Airway-Breathing).

“For more than 40 years, CPR training has emphasized the ABCs of CPR, which instructed people to open a victim’s airway by tilting their head back, pinching the nose and breathing into the victim’s mouth, and only then giving chest compressions,” Michael Sayre, M.D., co-author of the guidelines and chairman of the American Heart Association’s Emergency Cardiovascular Care Committee, said in an AHA press release. “This approach was causing significant delays in starting chest compressions, which are essential for keeping oxygen-rich blood circulating through the body. Changing the sequence from A-B-C to C-A-B for adults and children allows all rescuers to begin chest compressions right away.”

C-A-B takes into account that, in the first few minutes of a cardiac arrest, some amount of oxygen remains in the lungs and bloodstream of the patient. Chest compressions can pump that blood to the victim’s brain and heart sooner. In contrast, the traditional “old” A-B-C method delays the start of chest compressions; the rescuer has to tilt the victim’s head to open up the airway and apply breaths to commence mouth-to-mouth.

Giving initial chest compressions was found to trim off 30 critical seconds in rescue time and potentially helps save the patient’s life.

Hands On

A couple years ago, the American Heart Association recommended that untrained bystanders use hands-only CPR for an adult victim who suddenly collapses. The new guidelines make this the official policy and include health-care professionals as well. The process also applies for children and infants but excludes newborns.

The AHA hopes that with the updated rules, more people will volunteer to help a heart attack victim. Experts have noted the reluctance of passersby to give aid out of panic, uncertainty about their lifesaving skills, and squeamishness of mouth-to-mouth breathing. With hands-only CPR, the steps are streamlined: Call 911 and push hard and fast on the center of the chest until help arrives.

NEW Guidelines Summary

Here are the new 2010 guidelines from the AHA:

1. Before starting, shake the victim’s shoulders and shout to get his reaction. If the victim is unresponsive, call 911, which should now instruct callers by phone to start chest compressions when cardiac arrest is suspected.

2. Removal of “look, listen, and feel for breathing” from the sequence.  Instead, Begin chest compressions. At least 100 per minute from the previous instruction of close to 100. Compressions must also be strong enough to depress the chest by at least 2 inches in adults and 1.5 inches in infants. This will allow blood and oxygen to keep flowing to the brain until medics arrive.

3. Make sure to fully release the chest before beginning the next compression. Avoid leaning on the victim’s chest so it can return to the starting position.

4. For rescuers with no CPR training, continue chest compressions until help comes.

5. For trained health professionals, open the airway after 30 chest compressions and begin mouth-to-mouth breathing. Give two breaths and then resume chest compressions. Continue sets of 30 chest compressions and two breaths until help arrives.

The last resuscitation guidelines were publicized in 2005. For more information on the new rules, check out the heart association’s video “2010 Guidelines for CPR” on YouTube.

There are devices, like the First Voice Emergency Instruction Device (EID) that provide instruction via audio and text for emergencies including CPR – from scene safety to assessment to administration of chest compressions and breaths (if appropriate) to proper PPE for rescuers and cleanup.  The First Voice EID retails at $249US and is available from safety and first aid dealers nationally.  Visit www.firstvoice.us for more information or:

http://www.firstvoice.us/Products/EmergencyInstructionDevice/tabid/285/Default.aspx

Various Think Safe EID brands/models can be purchased in over 6 languages and with US or European protocols (compliant with all major training organizations and easily updateable via datacard replacement ports).  Please contact us for full details on model/part numbers and language configurations at or email us at info@think-safe.com for more information.  Think Safe – Making Minutes Matter and saving more lives with effective CPR and CPR Training!

Sources:Circulation (http://circ.ahajournals.org/)

Hello my name is Corinne Ruiz.

Olivia Ruiz' Last School Picture

April 22nd, it was six years since the death of my daughter. Not a day goes by that I don’t ask myself, “If only I had known about Long QT Syndrome/Sudden Cardiac Arrest and AEDs”. Maybe, just maybe Olivia would be alive today.

I and many other families who have lost children to Sudden Cardiac Arrest are now their voice. We are dedicated to protecting our youth from Sudden Cardiac Arrest (SCA) and preventable Sudden Cardiac Death (SCD). Unfortunately, where I live, xxx, very little is known about SCA in our youth.  I was quite surprised to find out that Olivia’s High School, xxx, didn’t have an AED on campus.

It’s time to make a difference, speak out, with the hope of saving others.  I plan on promoting SCA awareness in my community.  I have written letters to our community leaders to see if they have implemented community Public Access Defibrillation programs. I have contacted my local state representative, senators regarding the Josh Miller Hearts Act, which would provide a pool of grant money for school districts to use to purchase AED’s. If this passes, it would make mandating AED’s in [state xx] easier because it would offset a large portion of the start-up costs. I have written letters to our senators on behalf of the American Hearth Association supporting SB 1281.

• If only I had known that I had options..
• If only I had been told that there are screening tests or preventative treatments..
• If only I had known that my daughter looked normal but her heart wasn’t..
• If only I had known that an AED could give my daughter another chance..
• …then maybe I wouldn’t have lost my Olivia..

I hope after reading my story, you will find it in your heart to donate an AED to XX High School, in memory of my daughter, Olivia. I am not a politician nor am I an expert in the medical field, I am Olivia’s mom.  A mom who will not let her daughter’s death be in vain.

Thanking you in advance for your support.

Since that date, Corrine has been crucial in placing an AED at this school and is crucial in helping to place others in the surrounding area. Think Safe is proud to be of assistance in making this happen as well. We can provide funding solutions!

Each year 10,000 to 15,000 or more children die from Sudden Cardiac Arrest, just like Olivia – due to a fatal accident or undiagnosed medical condition.

For educational materials on SCA, grant or fund raising assistance or special school packages please contact the technical experts at Think Safe, 888-473-1777 or info@think-safe.com.  Let’s make schools an even safer place for our children!

Another proud note was that the trek went right by my in-laws home (ON CHANEY STREET in Dubuque, Iowa) and so they were good enough to host a DONATION ONLY goodies and water/lemonade stand that brought in $140 towards Defibrillators in the Schools! Thanks to all my family and kids who are helping our Iowa kids, school employees or volunteers to be more protected during school events and public events at school campuses. (Sudden Cardiac Arrest kills more than 300,000 people annually every year and it affects people of all ages, gender and races.) Truly, they are helping to save lives by raising money for these devices!

Anyway, over 15,000 to 20,000 riders navigated a 442-mile route with 14,527 feet of climb and the last day had more than it’s share of hills to contribute to the climb total! 2 hills on the ride brought 2 accidents which prompted my stopping and assisting with the First Voice Cube. Several comments included “That is a great first aid kit” and “good thing you came prepared”. Many boo boos I saw were a bit much for a standard bandaid.

And, I’ll post pictures of the eventful and memorable day and some of the accident footage showing our infamous Cube in action. Remember, when I took it canoeing for the day up in NE Iowa it got used to help another “canoer” mend a large gash from glass in the river.

You can’t beat a great portable and nicely organized first aid kit! Do you have one in your home, vehicles and sports bags?

Contact us for a distributor near you at 888-473-1777 or visit www.firstvoice.us for more information. Or, you can email one of our technical experts at info@firstvoice.us also.

For more information on the Cube and its contents – visit:

http://www.think-safe.com/ForBusiness/FirstAidKits/tabid/719/Default.aspx

888-473-1777 or info@think-safe.com