Cost: $35/person.

Urgences Reanimation now offers the Quebec Ministry of health approved four hour Anaphylaxis training program for all first responders. This training helps the learner understand in depth how a severe allergic (Anaphylactic) reactions develop, to diagnose the signs and symptoms and how to use unprescribed emergency auto-injectors like the “Epi-Pen” and “Twin-ject”. The learner will practice with Auto-injector trainers and be exposed to a variety of scenarios with anyone that is exhibiting the signs of severe Anaphylaxis. Pre-requisite: Standard First-aid.

Cost:  $65/person

 With the recent deaths of children in schools due to severe allergic (Anaphylactic) reactions I have been pondering how we as first-aid instructors teach Anaphylaxis.

 First of all regulations here in Quebec get in the way. In schools, even if the child is known to be allergic, by-laws do not allow a teacher or other school worker to administer Epinephrine (Epi-Pen Twin-ject) when required.

This of course places doubt and fear in the mind of the rescuer. The result is the child does not receive the lifesaving injection.

I have always been amazed at how much time it takes to teach this topic as it generates so many questions.

The good news is that the Ministry of Health and Social services has developed a course for school workers to address this problem.

The 90 minutes “Administration of Epinephrine for severe anaphylactic type allergic reaction” addresses the need.

The training first gives the learner a comprehensive education about Anaphylaxis as well as how to use an auto-injector and lots of simulations to practice. The Training also satisfies the law (section 39.8 of the professional code) so that all adults that work in schools can use an Epi-pen or Twin-ject if the need were to arise.

Keep in mind that this to help youngsters already diagnosed with Anaphylaxis. That is to say they are known to be allergic. One should not attempt to diagnose someone not known to be allergic.

This is a great step in the right direction. I am guessing I will be teaching this a lot in the New Year.

Norman Goldberg at URGENCES REANIMATION

Master Instructor FMCQ

Don’t let it take by you surprise!!!

Recently, a 2-year-old child died in a daycare in Montreal as result of this severe allergic reaction.  This is a preventable tragedy.

Daycare teachers and parents alike are exposing children with potentially highly allergic foods without awareness and the education to understand the repercussions.

Also, coincidentally, new training sessions have been offered to certified CPR and first-aid instructors.  The class is 1.5 hours long and is intended for parents, caregivers, daycare teachers and babysitters and junior paramedics (see course description on site).

• Currently no protocol or extensive training exists allowing instructors to give the short training.
• The best tool to increase pre-hospital survival rates (and last till the ambulance arrives) is the Epi-Pen.

Things everyone should know about epi-pen usage…

• As soon as the child has difficulties breathing, use the epi-pen
• Inject the pen, after removing the grey or blue (newer pens) safety cap, into the thigh, hold for in placer for a full 10 seconds.  Remove and break of the needle and dispose.  Rub the injected area to distribute the medicine.  Ice the area.
• ***Important-The medicine will last for only 15 minutes.  A second backup up dose should be close at hand should the ambulance arrive in more than 15 minutes.  Typically an epi-pen dose lasts for only 15 minutes.
• Expiry dates should be checked.  An expired epi-pen is less effective (less time of medicinal effect).  It can still be used if no other dose is available or as a backup dose with no other alternative.
• Adult epi-pen doses are different than childrens’ and cannot be used interchangeably.  However, a wrong dose either way is better than none at all.

Don’t let it take by you surprise!!!

Recently, a 2-year-old child died in a daycare in Montreal as result of this severe allergic reaction.  This is a preventable tragedy.

Daycare teachers and parents alike are exposing children with potentially highly allergic foods without awareness and the education to understand the repercussions.

Also, coincidentally, new training sessions have been offered to certified CPR and first-aid instructors.  The class is 1.5 hours long and is intended for parents, caregivers, daycare teachers and babysitters and junior paramedics (see course description on site).

• Currently no protocol or extensive training exists allowing instructors to give the short training.
• The best tool to increase pre-hospital survival rates (and last till the ambulance arrives) is the Epi-Pen.

Things everyone should know about epi-pen usage…

• As soon as the child has difficulties breathing, use the epi-pen
• Inject the pen, after removing the grey or blue (newer pens) safety cap, into the thigh, hold for in placer for a full 10 seconds.  Remove and break of the needle and dispose.  Rub the injected area to distribute the medicine.  Ice the area.
• ***Important-The medicine will last for only 15 minutes.  A second backup up dose should be close at hand should the ambulance arrive in more than 15 minutes.  Typically an epi-pen dose lasts for only 15 minutes.
• Expiry dates should be checked.  An expired epi-pen is less effective (less time of medicinal effect).  It can still be used if no other dose is available or as a backup dose with no other alternative.
• Adult epi-pen doses are different than childrens’ and cannot be used interchangeably.  However, a wrong dose either way is better than none at all.

I can remember not to long ago how difficult it was to get lay rescuers trained and of course the cost of AEDs back then were really expensive.

Nowadays training is so simple and AEDs have dropped in price.

The 2010 recommendations for CPR and ECC advises anyone even without training to use an AED in the event of sudden cardiac arrest.

Now more than ever I get asked why I chose to promote the Samaritan 300 and 500 AEDs.

When you compare, the SAM PAD (Public Access Defibrillator) to Phillips FRx/ FRx2/Onsite/HeartStart, Cardiac Science and the Zoll AED, the SAM PAD is the clear winner.

Lets start off with the warranty. The SAM PAD has a 10-year warranty. This is by far the longest in the industry! No funny business here. If the is any malfunction, the distributor provides a loaner and Heartsine figures it out. So far I have had no complaints in over 8 years!

All other brands must change out pads and batteries at different times. The all in one PAD-PAK has a four-year expiration.

The SAM PAD is lighter at 2.4lbs. The Zoll come in at a whopping 6.6lbs.

The SAM PAD has the highest rating of any unit (IP56) in almost any environment versus water.

The maintenance cost over 10 years (in US dollars) is $260. Zoll $448 Phillips $506 & Cardiac Science $966.

Let’s get more specific. People like the Zoll because of the compression puck is attached to the pads that measures the depth and rate of compressions. Of course if the casualty has a large chest, the pads won’t be in the right place and they will have to be cut! What a stress! The SAM PAD 500 has traditional pads and can measure the depth and rate of CPR compressions. The batteries are also a nightmare to change. You need a screwdriver to open it up and you can’t tell which of the 10 batteries are losing charge.

Philips is a bit scarier. Check this out!

• Recalls on Onsite, HeartStart, FR2+ AED manufactured by Philips in 2008 and 2009.
• Set to non-escalating 150 J – 150 J – 150 J SMART Biphasic protocol. If ILCOR recommended guidelines change to above 200J, the unit will not be able to be compliant.
• Third shock, the Samaritan device (using a 100 – 150 –200 J protocol) showed significantly better performance for discontinuation of VFî (Samaritan SCOPE = 92% vs. Phillips = 83% [p=0.029 – meaning these results were statistically significant][1]

This is because Philips made the choice not to follow the 2005 AHA guideline that recommended 200J for the third shock. Not much of a surprise!

I can go on and on. If anyone wishes to have a frank discussion about purchasing an AED then by all means please send me an e-mail at ngoldberg@videotron.ca.

Norm Goldberg

Master Instructor

‘Empowering to achieve’

This daycamp is an innovative approach to a wellness/fitness camp. Using the holistic, multi-dimentioanal approach to achieve lifestyle changes.
Body Magic Fitness camp is an activity based camp who’s professional staff offer a dynamic and active approach to helping teens attain optimal fitness levels and learn tools for maintaining a healthy lifestyle and promote longevity.

Participating alliances include Studio Adonnics and Selwyn House.

Our team of wellness/fitness professionals also include nutritionist and pshychologists and consultants met with weekly.

We will bring out the outdoor fitness enthusiast in you.

• biking
• climbing
• open water swimming
• hiking
• rollerblading
• off-road mountain running/walking

Contact Camp Directors:

Andrea Mendell
514-793-9604

Mitch Katz-Zeitlin
514-298-4935

Mitch Katz-Zeitlin-

Owner of ‘Wellness For Work’ – A corporate wellness programming company offering topical Lunch n Learns, smoking cessation, ergonomic analysis, and mind/fitness sessions.
A tri-athelete and competitive open water long distance swimmer and yoga enthusiast with 20 years of experience as a senior manager in the fitness industry. He has Psychology and business degrees from McGill U. and a wealth of camp programming experience. He is also a spinning instructor, level 2 personal trainer, CPR/First-aid, Aqua-specialty instructor. A father of 4, aged 13, 11, 7 and 4.

By Rod Brouhard, About.com Guide

Updated March 29, 2010

There is no substitute for learning cardiopulmonary resuscitation (CPR), but emergencies don’t wait for training. These instructions are for conventional adult CPR. If you’ve never been trained in CPR and the victim collapsed in front of you, use hands-only CPR.

Not every CPR class is the same. There are CPR classes for healthcare professionals as well as CPR classes for the layperson. Before you take a CPR class, make sure the class is right for you.

These are the steps to perform adult CPR:

Difficulty: Easy

Time Required: CPR should start as soon as possible

Here’s How:

1. Stay Safe! The worst thing a rescuer can do is become another victim. Follow universal precautions and wear personal protective equipment if you have it. Use common sense and stay away from potential hazards.
2. Attempt to wake victim. Briskly rub your knuckles against the victim’s sternum. If the victim does not wake, call 911 and proceed to step 3. If the victim wakes, moans, or moves, then CPR is not necessary at this time. Call 911 if the victim is confused or not able to speak.
3. Begin rescue breathing. Open the victim’s airway using the head-tilt, chin-lift method. Put your ear to the victim’s open mouth:

• look for chest movement
• listen for air flowing through the mouth or nose
• feel for air on your cheek

If there is no breathing, pinch the victim’s nose; make a seal over the victim’s mouth with yours. Use a CPR mask if available. Give the victim a breath big enough to make the chest rise. Let the chest fall, then repeat the rescue breath once more. If the chest doesn’t rise on the first breath, reposition the head and try again. Whether it works on the second try or not, go to step 4.

1. Begin chest compressions. Place the heel of your hand in the middle of the victim’s chest. Put your other hand on top of the first with your fingers interlaced. Compress the chest about 1-1/2 to 2 inches (4-5 cm). Allow the chest to completely recoil before the next compression. Compress the chest at a rate equal to 100/minute. Perform 30 compressions at this rate.
2. Repeat rescue breaths. Open the airway with head-tilt, chin-lift again. This time, go directly to rescue breaths without checking for breathing again. Give one breath, making sure the chest rises and falls, then give another. Remember, if the chest doesn’t rise on the first breath, reposition the head before you give the second breath.
3. Perform 30 more chest compressions. Repeat steps 5 and 6 for about two minutes.
4. After 2 minutes of chest compressions and rescue breaths, stop compressions and recheck victim for breathing. If the victim is not breathing, continue chest compressions and rescue breaths.
5. Keep going until help arrives.

Tips:

1. If you have acces to an automated external defibrillator, attach it to the victim after approximately one minute of CPR (chest compressions and rescue breaths).
2. Chest compressions are extremely important. If you are not comfortable giving rescue breaths, still perform chest compressions!
3. It’s normal to feel pops and snaps when you first begin chest compressions – DON’T STOP! You aren’t going to make the victim any worse. Cardiac arrest is as bad as it gets.
4. When performing chest compressions, do not let your hands bounce. Let the chest fully recoil, but keep the heel of your hand in contact with the sternum at all times.
5. For more information on these steps go to the Emergency Cardiac Care (ECC) Guidelines from the American Heart Association.

Reference:
2005 American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care. Circulation. 2005 Dec 13;112(24 Suppl):IV1-203. Epub 2005 Nov 28

From page 45 of the Instructor Resource for Resuscitation Programs in Canada

-         Thoroughly wash and scrub all external and internal surfaces with warm soapy water and brushes. Microbial contamination is easily removed from smooth non-porous surfaces by scrubbing with a cloth or brush and a detergent solution. There is no evidence that soaking alone in any liquid is as effective as the same procedure accompanied by vigorous scrubbing.

-         Rinse all surfaces with fresh water. Soap residue will deactivate the disinfectant action of the sodium hypochlorite (Bleach).

-         Soak all surfaces or 10 minutes in a sodium hypochlorite solution having at least 50ppm free available chlorine such as 60 ml or ¼ cup liquid household bleach (approximately 5% sodium hypochlorite) per 4 litres or 1 gallon of warm tap water. Hot water destroys the disinfecting action of bleach and causes fumes to be released. This solution must be made fresh after each class and discarded after each use since chlorine loses its effectiveness when exposed to light and air.

-         Rinse all surfaces with fresh water and immediately dry all external and internal surfaces. Rinsing with alcohol will aid drying of internal surface, inhibiting the survival of bacterial and fungal organisms.

Here’s How:

1. Stay calm. It’s important to take a deep breath and not get excited. Any situation that requires 911 is, by definition, an emergency. The dispatcher or call-taker knows that and will try to move things along quickly, but under control.
2. Know the location of the emergency and the number you are calling from. This may be asked and answered a couple of times but don’t get frustrated. Even though many 911 centers have enhanced capabilities — meaning they are able to see your location on the computer screen — they are still required to confirm the information. If for some reason you are disconnected, at least emergency crews will know where to go and how to call you back.

As the call progresses, you will hear clicking – do not hang up!

1. Wait for the call-taker to ask questions, then answer clearly and calmly. If you are in danger of assault, the dispatcher or call-taker will still need you to answer quietly, mostly “yes” and “no” questions.
2. If you reach a recording, listen to what it says. If the recording says your call cannot be completed, hang up and try again. If the recording says all call-takers are busy, wait! When the next call-taker or dispatcher is available to take the call, it will transfer you.
3. Let the call-taker guide the conversation. He or she is typing the information into a computer and may seem to be taking forever. There’s a good chance, however, that emergency services are already being sent while you are still on the line.
4. Follow all directions. In some cases, the call-taker will give you directions. Listen carefully, follow each step exactly, and ask for clarification if you don’t understand.
5. Keep your eyes open. You may be asked to describe victims, suspects, vehicles, or other parts of the scene.
6. Do not hang up the call until directed to do so by the call-taker.

Tips:

1. No matter what happens – Stay Calm.
2. Cell phones may not tell the call-taker where you are. Know the differences when calling 911 on a cell phone.
3. Never program 911 into your automatic dialer (phone memory). You’re not going to forget the number and accidental 911 calls are more likely with auto-dialers. If someone calls 911 and doesn’t speak, emergency services must still be dispatched.

Home First-aid kits bought commercially often are expensive and have few practical items. The following is a guide on how to assemble your own home First-aid kit economically and with very useful items.

First get a casserole sized plastic or rubber storage container to place the items in.  You want it deep enough to have room for all your stuff and to place important items at the top within sight.

Bleeding is a common emergency. Here are some items to pick up at the Pharmacy.

1. Have at least six 4”x4” sterile gauze pads. These can be used for direct pressure or cleaning out small wounds.
2. Two 4” gauze rolls. This is used for wrapping and securing bandages. Imagine the stuff you would wrap a “Mummy” with. When purchasing from a pharmacy, get a named brand preferably wrapped in plastic. The ones wrapped in paper are of a very cheap quality and are difficult to work with as it usually falls apart.
3. For very heavy bleeds you will need some kind of Pressure/Trauma bandage or Abdominal pad. Again there is varying degree of quality with these items. An alternative can be having at least Two large and thick Maxipads.
4. Have at least Four Triangular bandages. These useful items are easy to use and are great for making slings and tying bandages in place.

Disinfectants.  Stay away for rubbing Alcohol and Peroxide. It burns and is not necessary. Hand sanitizers often contain Alcohol so beware. A small bar of soap with water is all you need to clean cuts and scrapes. Put a bar in a zip lock sandwich bag to keep you kit from getting soapy.

Tape. One two inch role on medical tape is all you need.

Scissors.  Any scissors (Office Scissors) will work well. Make sure they don’t have pointed ends. The little Pre-school scissors often found in commercial first-aid kits are not reliable in an emergency.

Zip lock sandwich bags are great for making ice-packs for all sorts of injuries that involve swelling.

Tweezers, a small Flashlight and disposable gloves are also useful items.