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Welcome Respected Readers,

Cardiopulmonary resuscitation (CPR) is a series of life-saving actions that improve the chance of survival following cardiac arrest. Although the optimal approach to CPR may wary, depending on the rescuer, the victim, and the available resources, the fundamental challenge remains: how to achieve early and effective CPR. Given this challenge, recognition of arrest and prompt action by the rescuer continue to be priorities for the 2010 AHA Guidelines for CPR and ECC.

Cardiac arrest occurs both in and out of the hospital and is still the leading cause of death in many parts of the world. According to Prof. Dr. Nadeem Hayat of Punjab Institute of Cardiology (in an informal seminar) that every day more than 1200 casualties occur in Pakistan of cardiac patients (declared patients and those without prior treatment). The grave concern is that attempted resuscitation is not always appropriate, there are many lives and life-years lost because appropriate resuscitation is not attempted.

Unfortunately we can’t present cardiac arrest stats for Pakistan of in-hospital and out-of-hospital cases. But one thing is very sure that cardiac arrest continues to be an all-too-common cause of premature death, and small incremental improvements in survival can translate into thousands of lives saved every year.

Key Principles in Resuscitation: Successful resuscitation following cardiac arrest required an integrated set of coordinated actions represented by the links in the Chain of Survival.

• Immediate recognition of cardiac arrest and activation of the emergency response system (ERS/EMS;
• Early CPR with an emphasis on chest compression;
• Rapid defibrillation;
• Effective advanced life support; &
• Integrated post-cardiac arrest care.

Cardiac arrest is an important public health issue. Resuscitation involves a broad spectrum of individuals, stakeholders and groups. Key stakeholders include the public, emergency medical dispatchers, public safety organizations, EMS systems, hospitals, civic groups, and policy makers at the local, provincial and federal levels.

Because the links in the Chain of Survival are interdependent, an effective resuscitation strategy required these individuals and groups to work in an integrated fashion and function as a system of care. Fundamental to a successful resuscitation system of care is the collective appreciation of the challenges and opportunities presented by the Chain of Survival.

Hands-Only CPR is one of the key development to encourage layperson to attempt early CPR to save lives. With this (Hands-Only CPR) everyone can be a lifesaving rescuer for a cardiac arrest. All rescuers, regardless of training, should encourage laypersons to learn Hands-Only CPR to provide early chest compressions to all cardiac arrest victims.

To Your Health, Safety & Self Pride,

Faisal Javed Mir & First Aid to Save a Life Pakistan

Welcome Respected Readers,

Most of the times we need any reason to donate blood BUT we have many reasons to do it for our own health. We should also do it when someone is in need of it and but what if there is no one to ask me to donate blood in 2 to 3 or even 4 months time? I have every reason to do it even nobody asks me to do so in two months time.

If we were not donating it before then we should start donating blood more often because of dengue hemorrhagic fever (DHF) cases in recent season. Dengue strongly hit Lahore city and some of the other cities in Punjab and KPK where patients does require complete blood transfusion (if advised by doctor) otherwise mostly platelets transfer to cover the loss because of DHF. This deficiency can only be managed if we have passionate volunteers date bank to lower the burden on patient’s family members.

Unfortunately, the fact is that we are not good in donating blood. At large we can’t manage 1 hour in 2 months time to schedule blood donation and we don’t bother much to give (approximately 0.6 lit) half liter of blood which can save up to 3 lives. But there is constant need of blood supply and our contribution is important for a healthy and reliable blood supply. The thought of being able to help save three people’s lives every time you donate blood makes you feel like a better person.

Should I consider anything before donating blood?

Yes, there is eligibility criteria for donating blood. Personally we ourselves should know it in detail and obviously (honest) healthcare professionals will look for the prerequisite before bleeding you.

Eligibility Criteria for Blood Donations:

To ensure the safety of blood donation for both donors and recipients, all volunteer blood donors must be evaluated (physically and medically by healthcare professionals) to determine their eligibility to give blood.

You must be healthy, should carry 150 lbs weight and at least 17 years old to donate to the general blood supply, or 16 years old with parental/guardian consent. There is no upper age limit for blood donation as long as you are well with no restrictions or limitations to your activities.

NOTE: Healthy means that you feel well and can perform normal activities. If you have a chronic condition such as diabetes, healthy also means that you are being treated and the condition is under control. This is healthcare professionals job and they hold confidential interview to get the answers to their questions to take their decision and declare eligibility criteria met or not.

Other aspects of each potential donor’s health history are discussed as part of the donation process before any blood is collected. Each donor receives a brief examination during which temperature, pulse, blood pressure and hemoglobin (or hematocrit) are measured.

Do I need something special to do before donating blood?

NO, nothing special or mandatory to do but still there are some recommendations to do in a day you waned to donate.

- Be sure to drink plenty of fluids the day of your donation.

- Wear clothing with sleeves that can easily be rolled up above the elbow.

- If possible, include iron-rich foods in your diet, especially in the weeks before your donation.

- Bring along a friend/family member, so that you may both enjoy the benefits of giving blood or inspire other to get ready for his/her turn to donate for good cause.

- Blood donation is a simple and very safe procedure so there is nothing to worry about.

How can I make sure my own safety is not violated?

It is not possible to get AIDS or other infectious disease by giving blood, if you make sure below process is followed.
A brand new, sterile, disposable needle is used for blood donation.

You can only donate if your health history permits and you feel well. You are asked general health questions and are given a mini physical – temperature, pulse, blood pressure and hemoglobin are checked – prior to donation to ensure that you are feeling well and that it is safe for you to give blood. Your health history and test results (take your medical record with you) are confidential and cannot be shared without your permission, except as required by law.

Feeling faint or fatigued after donating blood is uncommon.
If it occurs, it most likely will pass in a matter of hours. Most donors feel fine before and after donating, but a small number of people may have a lightheaded or dizzy feeling. If you feel faint, stop what you are doing and lie down until you feel better.

You can help ensure your experience is a positive and rewarding one.
Stay in the refreshment area for the recommended period of time; mention to the staff any unusual feelings or sensations; continue to hydrate throughout the day and avoid strenuous exercise or heavy lifting on the day of donation.

To Your & Nation’s Health and Safety,

Faisal Javed Mir & First Aid to Save a Life Pakistan

Respected Subscribers and Readers,

The goals of resuscitation are to preserve life, restore health, relieve suffering, limit disability, and respect the individual’s decisions, rights and privacy. In our today’s post we will talk about the early decisions made by the individual (if known to us at time of help needed), ethical and social rights and whenever his/her privacy matters with life saving services/skills needed to be administered to him/her.

Decisions about cardiopulmonary resuscitation (CPR) efforts are often made in seconds by rescuers who may now know the victim of cardiac arrest or whether an advance directive exists or not. As a result, administration of CPR may be contrary to the individual’s desires or best interests. The below will help all, healthcare professionals and layman rescuers, to understand the requirements and ethics of administering resuscitation and basic life supporting skills in any life-threatening situation.

Ethical Principles:

Rescuers should consider ethical, legal, and cultural factors when caring for those in need of CPR. Although rescuers must play a role in resuscitation decision making, they should be guided by science, the individual patient or surrogate preferences, local policy, and legal requirements.

Principle of Respect for Autonomy:

The principle of respect for autonomy is an important social value in medical ethics and law. The principle is based on society’s respect for competent individual’s ability to make decisions about his or her own healthcare. Adults are presumed to have decision-making capability unless they are incapacitated or declared incompetent by a court of law. Truly informed decisions require a strong healthcare provider-patient relationship/communication and a 3-step process:

1:- the patient receives and understands accurate information about his or her conditions, prognosis, the nature of any proposes interventions, alternatives, and risks and benefits;

2:- the patient is asked to paraphrase the information to give the provider the opportunity to assess his or her understanding to correct any misimpressions; and

3:- the patient deliberates and chooses among alternatives and justifies his or her decision.

WHEN the individual’s preferences are unknown or uncertain, emergency conditions should be treated until further information is available.

Do Not Attempt Resuscitation (DNAR):

A Do Not Attempt Resuscitation (DNAR) Order is a legitimate document in which one expressed his/her desire to not attempt any resuscitation effort or clearly state to “Allow Natural Death” without any resuscitation attempts. A DNAR should explicitly describe the resuscitation interventions to be performed in the event of a life-threatening emergency. In most cases, a DNAR order is preceded by a documented discussion with the patient, family, or surrogate decision maker addressing the patient’s wishes about resuscitation interventions. In addition, some jurisdictions may require confirmation by a witness or a second treating physician.

Withholding and Withdrawing CPR Related to Out-of Hospital Cardiac Arrest (OHCA):

We, the First Aid, CPR and AED trainers teach our students (as per the guidelines states) to immediately begin CPR without seeking consent, because any delay in care dramatically decreases the chances of survival. While the general rule is to provide emergency treatment to a victim of cardiac arrest, there are a few exceptions where withholding CPR might be appropriate, as follows:

1:- Situations where attempts to perform CPR whould place the rescuer at risk of serious injury or mortal peril;

2:- Obvious clinical signs of irreversible death; &

3:- A valid, signed, and dated advance directive indicating that resuscitation is not desired, or a valid, signed, and dated DNAR order.

To Your Health & Safety,

Faisal Javed Mir & First Aid to Save a Life Pakistan

You might also like:

• Are you willing to save a life
• Life Saving Skills
• Sudden Cardiac Arrest and Use of AED

Respected Readers,

Road traffic crashes (commonly RTA – road traffic accidents) kill nearly 1.3 million people every year and injure or disable as many as 50 million more. They are the leading cause of death among young people aged 15–29 years.

In October 2005, the United Nations General Assembly adopted a resolution which calls for governments to mark the third Sunday in November each year as “World Day of Remembrance for Road Traffic Victims”. The day was created as a means to give recognition to victims of road traffic crashes and the plight of their relatives who must cope with the emotional and practical consequences of these tragic events.

First Aid to Save a Life Pakistan encourages our young generation and respected parents to support safe driving behavior and through education and training before any young child get access to any type of motor like bike or car. They should also adopt correct behavior to ensure occupants (passenger, children and/or infants) safety and must have proper restraints for them too.

Road traffic crashes are among the world’s largest public health issues:

• Traffic fatalities are the leading cause of death for people ages 15-45 worldwide, resulting in 1.3 million deaths per year.

Road traffic crashes are robbing communities and developing countries of their future – the young generation:

• Globally, more than 40% of all road traffic deaths occur among the 0 to 25 age group; &
• 85% of traffic fatalities and 96% of child traffic fatalities occur in low- or middle-income countries.

Road traffic crashes place extreme financial strain on developing economies:

• For many low- and middle-income countries, the cost of road crashes represents between 1-2% of GNP (GDP);
• In some cases exceeds the total amount they receive in international development aid; &
• Many road traffic crash victims are the primary income generators for their family. The injury or death of these victims negatively impact the standard of living for their entire family.

Road traffic crashes are predictable and can be prevented

People who survive the initial crash frequently suffer brain damage that impedes their ability to continue as an income generator for their families, and in fact may require a lifetime of personal care that can drain resources from already impoverished families. Helmet use makes a difference.  Appropriate helmet use reduces the risk of fatality by an average of 42% and of severe head injury by 69%.

A recent case study of motorcycle accidents from Los Angeles and Thailand similarly found that that un-helmeted riders were two to three times as likely to be killed and three times as likely to suffer a ‘disastrous outcome’. Of survivable crashes, universal helmet use would have prevented about 80% of fatalities and brain injuries.

The goal of training programs offered by First Aid to Save a Life Pakistan is to help you gain the knowledge, skills, and confidence necessary to manage a medical emergency until more advanced help i s available.

Emergency First Aid does not require you to make complex decision or have in-depth medical knowledge. It’s easy to learn, remember, and perform.

Being volunteer is very good and our social and ethical responsibility to help victims and provide first aid (if trained to do so) but have to remain extremely careful if you are providing first aid on or near a roadway. Each year, many people are struck and killed by motor vehicles while providing assistance.

On this World Day of Remembrance for Road Traffic Victims, let us mobilize all possible contributions; knowledge and experience; to improving road safety. Let us honour those who have lost their lives on the world’s roads by acting to save the lives of others.

To Your Health & Safety,

Faisal Javed Mir

http://firstaidtosavealife.com

A Very Warm Welcome to Our Respected Readers,

The use of technology and social media for effective advocacy and awareness was a key topic in recent times. But in Pakistan one of our minister who may be don’t know IT Technology and How Internet Traffic Works wants some of the social media giants to be shutdown in Pakistan. I don’t know why but he has expressed his intentions publicly. On the other hand, other nations are conducting surveys to know how people use social media in emergencies.

The Social Good Summit was held in New York from Sep 19 – 22, 2011 to know the role of social media when natural threats and disasters warnings are passed out. The Social Good Summit also highlighted a range of ways in which technology is improving our ability to get messages out.

Remarkable innovations done in the recent past history has changed the face of the earth we know and know we call it global village. Here, I would also like to pay a high tribute to Mr. Steve Jobs (Died Oct 5, 2011), for his innovations in information technology those have major contributions in today’s silicon chip life.

Let me share with you some of the facts those will reveal how we use social media in emergencies.

1:- Online news is the 3rd most popular source for emergency information.

2:-18% use facebook to get information about emergencies.

3:- 24% would use social tools to tell their loved ones that they are safe.

Also, there are devices built and programmed for purpose to locate the nearest AED devices in public areas, shopping malls, sports centers etc.

All above are positive and encouraging signs for those who thinks social networking sites are of no use/benefit. In the end, I would like to include one quote of Mary Engelbreit.

“If you don’t like something change it; if you can’t change it, change they way you think about it.”

To Your Health, Safety & Prosperity,

Faisal Javed Mir

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Welcome Our Respected Readers,

A lot has been said by medical experts on prevention/precautions of dengue fever: and local, provincial and national government also launched very heavy campaigns to control havoc/panic created by dengue fever. First Aid to Save a Life Pakistan would like to discuss some of the myths while discussing precautions and medications for dengue fever.

We have released 3 posts to clear the myths associated with dengue fever and this is our fourth post on the same subject, “Myths about Dengue!”

In our today’s post we will highlight one more myth associated with dengue and while presenting the rationale against the steps taken and advised by governmental authorities in Pakistan to control dengue are beyond our understanding.

4:- Drain the water from swimming pool and cultured water fountain then dry it and refill it 2 times a week – might be a problem for WAPDA and WASA/LSWM organizations also or might be a solution to combat dengue? Doubtful? This should be a BIG NO!

I was surprised the day I heard the news that government has issued the directive to stop service stations in Lahore from working and asked the hotels and owners of private swimming pools to drain the water and dry the pools to help them control dengue spread observed in Lahore in earlier September 2011.

To someone this may appear to be an act of bravery of CM or very calculated and proactive response to control the epidemic but there are also number of persons who think it was & still is not required and have nothing common to stop/control breeding of aedes mosquitoes. They also believe that this was a face-saving step to tell nation that they (government) do care about us and can go to every limit to save their lives.

Dengue mosquitoes don’t live near swimming pools and there is no record from any country who have asked their citizens to drain and dry their pools 2 times a week. See below notification by Govt. of Punjab in a newspaper and read clause # 5 for your information.

One thing we would like to appraise here is the promulgation of regulation to stop the infectious diseases and hope it does work well to have long-term benefits and fulfill its prime objective in near future.

Centers for Disease Control (CDC) and Prevention is the world leader (arguably) research center works to protect public health and safety by providing information to enhance health decisions, and it promotes health through partnerships with state health departments and other organizations. CDC focus disease prevention and control (especially infectious diseases and foodborne pathogens and other microbial infections), environmental health, occupational safety and health, health promotion, injury prevention and education activities designed to improve the health of the people of USA and in partnership with other global research centers and organizations like WHO.

Recently CDC has released two MMWR (Morbidity and Mortality Weekly Report) Surveillance Summaries: “Surveillance for Waterborne Disease Outbreaks and Other Health Events Associated with Recreational Water—United States, 2007-2008” and “Surveillance for Waterborne Disease Outbreaks Associated with Drinking Water—United States, 2007-2008.”

The reports cover outbreaks associated with recreational water (e.g., swimming pools) and drinking water. In 2007-2008, the most recent year for which waterborne disease outbreak data are finalized, 134 outbreaks were associated with recreational water and 36 outbreaks were associated with drinking water. Surprisingly (for us) there is no mentioning of aedes mosquitoes presence which causing nuisance or leading to outbreak or even threat to their public in recreational water (e.g., swimming pool). We don’t have any research center in Pakistan on dengue yet we know that swimming pools help them breed and should be drained! Oops I forgot to complete my words that they should be drained and dried, “2 times a week”!

To Your Health, Safety & Knowledge,

Faisal Javed Mir

Other Related Posts:

Clearing Mythos about Dengue Part3

Clearing Mythos about Dengue Part2

Clearing Mythos about Dengue Part1

Welcome Our Respected Readers,

A lot has been said by medical experts on prevention/precautions of dengue fever: and local, provincial and national government also launched very heavy campaigns to control havoc/panic created by dengue fever. First Aid to Save a Life Pakistan would like to discuss some of the myths while discussing precautions and medications relating to dengue fever.

3:- Misguiding the nation and many less-educated people with irresponsible media campaign – If dengue doesn’t spread by specific breed of mosquito then what is aedes aegypti?

I got amazed when I read news reports like this (below given) from very senior medical officials. I don’t know why this is happening but what else I know is that citizens of Pakistan are receiving double meaning statements (might be caused by poor reporting) which is not helping them understand what dengue virus is and how it spreads. Do read below news article especially 4th last line to onward.

Where most of the government officials are portraying that dengue virus spreads when aegypti mosquito from aedes genus bites an infected person and transmits the virus to others with next bite. There are also three other mosquito breeds from aedes genus those can spread this virus but never named before. Aedes Albopictus is the other breed which has been identified by World Health Organization Pakistan as a vector who spread this virus. And some of the very senior medical executives saying that there is no specific mosquito who spreads dengue virus.

I just like to mention here an old quote which is very true in case of dengue fever.

“Prevention is the best CURE.“

To Your Health & Safety,

Faisal Javed Mir

Other Related Posts:

Clearing Myths about Dengue Part2

Clearing Myths about Dengue Part1

Respected Subscribers & Readers,

There is a lot said by medical experts on prevention/precautions of dengue fever: and local, provincial and national government also launched very heavy campaigns to control havoc/panic created by dengue fever. First Aid to Save a Life Pakistan would like to discuss some of the misconceptions while discussing precautions and medications relating to dengue fever.

1:- Lethal advice – Stop use of Aspirin:

It is advised by local government and even by the other national medical organizations that dengue fever patients should stop use of Aspirin. On the other hand the national level cardiologists and most prominent names of Punjab Institute of Cardiology, Lahore, Senior Professor Nadeem Hayat Malik (who is also Elected President of Pakistan Cardiac Society) publicly denied this advice (in his public address on September 25, 2011 in PC Lahore while commemorating World Heart Day Campaign organized by Jang Group) and suggested the patients those are suffering with cardiovascular diseases and have dengue fever that they should first consult with their cardiologists and take appropriate actions as advised by them and should not stop the medicines (like aspirin) on their own. He further emphasized that stopping use of these medicines without consultation with their cardiologists can be far more lethal and cause adverse effects on their health as compared to dengue fever.

He also presented some facts about severity of cardiovascular diseases in Pakistan and claimed that approximately more than 1000 deaths results in Pakistan due to cardiovascular diseases.

In this seminar other experts were also present who didn’t denied the public statement made by Professor Nadeem Hayat Malik. Some of the prominent names are Dr. Ambar Malik (Senior doctor of Sheikh Zayed Hospital) & Dr. Shahid Amin (Senior Doctor of PIC).

He again publicly addressed on September 29, 2011 in Punjab Institute of Cardiology Auditorium, on day of World Heart Day proceedings in Punjab Institute of Cardiology and again emphasized his concerns. A full panel of experts were also present there including the Head of Institute (Professor Dr. Azhar) along with the other experts like Dr. Amber Malik (Sr. Dr. of Sheikh Zayed Hospital), Dr. Shahid Amin (Sr. Dr. of PIC), Dr. Saqib Shafi (Sr. Dr. of PIC) and Medical Superintendent of PIC Lahore.

He further explained the complications and precautions in use of medicines especially aspirin or other nonsteroidal anti-inflammatory drugs (NSAIDs) prescribed by cardiologists to cardiovascular disease patients. He added that sudden stoppage of these medicines can cause serious damages and these medicines can be stopped as advised by cardiologists. He included that these medicines can only be stopped if the platelet count reaches 50,000 range and the prescribed medicines can be cut to half if it reaches between 90,000. The patients are not advised to suddenly stop their medicines and must consult with their local cardiologists whom they visit for regular checkup or any institute.

There is not only one which is mentioned above, unfortunately there more than one.

To Your Health & Safety,

Faisal Javed Mir

Other posts: An Awareness Campaign on Prevention of Dengue

Respected Readers,

Dengue is the most widespread mosquito-borne infection which in recent years has become a major international public health concern. The magnitude of dengue problem has increased dramatically and has extended fears of an outbreak especially within Punjab and throughout the country.

First Aid to Save a Life Pakistan is a training and consultancy company and working within our scope to conduct dengue prevention awareness sessions to adopt better preventive measures to avoid becoming dengue virus carrier. We have decided to observe Dengue Awareness Week from Sep 19 to 24, 2011 and will answer the questions asked from us and share other information with them to feel confidence while fighting against this outbreak. We have created a new email address (dpp@firstaidtosavealife.com) where you can send your questions/queries to us.

Below is the link to an awareness campaign started by First Aid to Save a Life Pakistan for public interest and information to be shared with others as well.

Awareness Campaign

To Your Safety,

Faisal Javed Mir

As-Salam-o-Alaikum Respected Readers,

Today we will share with you one new topic which is Psychological First Aid (PFA). When terrible things happen in our communities, we want to reach out a helping hand to those who are affected. Although everyone is affected in some way by these events, there are a wide range of reactions and feelings each person can have. Psychological first aid has been recommended by many international and national expert groups. PFA should be offered to people in severe distress after being recently exposed to a traumatic event.

What is Psychological First Aid?

Psychological first aid (PFA) describes a humane, supportive response to a fellow human being who is suffering and who may need support. PFA involves the following themes:

• providing practical care and support, which does not intrude;
• assessing needs and concerns;
• helping people to address basic needs;
• listening to people, but not pressuring them to talk;
• comforting people and helping them to feel calm;
• helping people connect to information, services and social supports; &
• protecting people from further harm.

PFA also involves factors that seem to be most helpful to people’s long-term recovery. PFA is for distressed people who have been recently exposed to a serious crisis event. You should not force help on people who do not want it, but make yourself easily available to those who may want support.

It is very important to act in ways that respect the safety, dignity and rights of the people you have decided to help. There is a lot to say on PFA and we will continue this service in better interest of our readers.

To Your Success,

Faisal Javed Mir

http://firstaidtosavealife.com