Automated External Defibrillators

Statistics show that more than 200,000 Americans die of sudden cardiac arrest every year. Up to 50,000 of these deaths could have been prevented if someone had initiated the Cardiac Chain of Survival, and an automated external defibrillator (AED) had been available for immediate use at the time of the emergency. Statistics show that more than 200,000 Americans die of sudden cardiac arrest every year. Up to 50,000 of these deaths could have been prevented if someone had initiated the Cardiac Chain of Survival, and an automated external defibrillator (AED) had been available for immediate use at the time of the emergency.

An automated external defibrillator (AED) is a portable electronic device that diagnoses and treats cardiac arrest by re-establishing an effective heart rhythm. This treatment is called defibrillation, which applies an electric shock to the entire heart muscle, uniformly clearing the electrical activity of the heart, hopefully allowing it to resynchronize.


How does an AED work?
An AED is easy to operate. It uses voice prompts to instruct the rescuer. Once the machine is turned on, the rescuer will be prompted to apply two electrodes provided with the AED to the victim's chest. Once applied, the AED will begin to monitor the victim's heart rhythm. If a "shockable" rhythm is detected, the machine will charge itself and instruct the rescuer to stand clear of the victim and to press the shock button.


Liability
Most health professionals agree that automated external defibrillators are so easy to use that most, if not all, states in the United States now include the "good faith" use of an AED by any person under the Good Samaritan laws. "Good faith" protection under a Good Samaritan law means that a first aid responder cannot be held civilly liable for the harm or death of a victim by providing improper or inadequate care, given that the harm or death was not intentional (and other certain circumstances). In most states, Good Samaritan laws provide protection for the use of AEDs by trained and untrained responders, to a point. Even for trained providers, AEDs provide little liability if used correctly, in fact even the NREMT-B and many state EMT and almost all Basic Life Support/Professional CPR classes offered incorporate AED education as parts of their program.



Could an AED be misused?
One particular brand, the Medtronic LIFEPAK® CR Plus AED is simple to use yet sophisticated in its technology. As such, there are numerous safeguards in place to detect the particular heart rhythms that require a shock. The CR Plus is designed to allow a shock only when a patient requires one, making it difficult to misuse.





What is sudden cardiac arrest (SCA)?
Sudden cardiac arrest cases are usually due to abnormal heart rhythms called arrhythmias, the vast majority of which are ventricular fibrillation. Ventricular fibrillation is a condition in which the heart's electrical impulses suddenly become chaotic, causing the heart to cease pumping blood effectively. Victims of SCA collapse and quickly lose consciousness, often without warning. Unless a normal heart rhythm is restored, death will follow within a matter of minutes.
The cause of sudden cardiac arrest is not well understood. Many victims have no history of heart disease, or if heart disease is present, it has not functionally impaired them. Unlike a heart attack, which is the death of muscle tissue from loss of blood supply, many victims of SCA have no prior symptoms. SCA can strike anyone, at any time, anywhere.


How common is SCA and who is at risk?
SCA is one of the leading causes of death in the United States. It strikes more than 200,000 Americans each year: nearly one death every two minutes.

What is the current treatment for sudden cardiac arrest?
The cardiac chain of survival is the current treatment for sudden cardiac arrest.

What is the cardiac chain of survival?
The cardiac chain of survival is a series of four critical steps. All four steps of the chain must be present to help ensure survival from sudden cardiac arrest. The four steps are:

• Step one: Early access to care (calling 9-1-1 or another emergency number)
• Step two: Early cardiopulmonary resuscitation (CPR)
• Step three: Early defibrillation
• Step four: Early advanced cardiac life support, as needed

The third step, delivering an electrical shock to the heart, which is known as defibrillation, is recognized as the most critical step in restoring cardiac rhythm and resuscitating a victim of SCA.

For More Information
Medtronic

Stinging Nettle Caterpillar

The Cooperative Extension Service of the College of Tropical Agriculture and Human Resources at the University of Hawai‘i at Manoa has posted a brochure on the Stinging Nettle Caterpillar where I got most of my information from.

Stinging Nettle Caterpillar
Scientific Name – Darna pallivitta
First appearance – September 2001, Panae‘wa, Hawai‘i (Foliage Nursery)
Origin – It is believed that the nettle caterpillar arrived from Taiwan. It is also found in China, Thailand, Malaysia, and Indonesia

The nettle caterpillar poses a big threat because of its painful sting, large appetite, lengthy larval feeding stage, high reproduction rate, and wide host range.

Host Plants
The nettle caterpillar has been found on more than 45 different plants in Hawai‘i including but not limited to palms, pasture and ornamental grasses, weeds, and foliage. When the nettle feeds off the host plant it damages and reduces the value of the plant, putting a burden on nursery owners who rely on their plants for export. Originally found in Pana‘ewa near Hilo, the nettle has now spread to Waiakea, Waiakea ‘Uka, Kaumana, Pi‘ihonua, Kea‘au, Kurtistown, Hawaiian Paradise Park and Orchidland.

Life Cycle
The life span of the nettle caterpillar from egg to adult is 75-99 days depending on the number of larval stages. Adult females live for approximately 10 days and adult males live for approximately 11 days. The larvae develop during a seven day incubation period where embryos are visible. When ready to pupate the larvae move to the base of the host plant for protection. The prepupa will spin a brown silk around itself forming a hardened cocoon approximately 5/8 inch long, and pupation occurs with the cocoon after five days. And do we get a beautiful butterfly perhaps? Of course not…the caterpillar turns into a moth. The adult moth is approximately ½ inch long. The adult female deposits eggs in small clusters on the underside of leaves. The adult moths are nocturnal. During the day they are inactive and head for vegetation in an upside-down perched position.

Harm to Humans
The nettle caterpillar has stinging spiny hairs that releases an irritant (mixture of histamines) produced by a poison gland. The irritant causes the skin to burn and itch, much like the effect of fiberglass. If not treated, the site of irritation can become infected. If you are stung you should avoid further contact with the caterpillar, and immediately wash the area with soap and water to calm the pain. Antihistamines or hydrocortisone cream can be used to stop the itching and swelling. If you are stung in the eye or begin having difficulty breathing, seek medical attention immediately. Individuals will have different symptoms depending on the severity of any allergic reaction.

Control Methods
- Minimize outdoor lighting at night
- Use bug zappers with UV bulbs (position zappers away from potential host plants and place a bucket of soapy water underneath to catch fallen moths)
- Don’t bring in host plants from an infected area
- Use of pesticides/insecticides

For more information on the Stinging Nettle Caterpillar visit these websites:
Nettle Caterpillar
Stinging Caterpillar Expanding its Range on the Big Island
Have you seen Stinging Nettle Caterpillar?

Baking at High Altitudes

What’s the difference between baking at sea level or at 5,000 feet?

Got undercooked, overcooked, coarse, or collapsed baked goods? Are you in Hawaii or Colorado, one might ask. What’s the difference, right? A cake is a cake no matter where you go, yet how it turns out can be a big pain in the A! A for altitude that is…

Who knew that baking a cake at sea level or at 5,000 feet would make such a big difference? I’ve heard of flattened out cupcakes and undercooked brownies, but I never knew why. The extent of my knowledge was that it had “something” to do with the altitude and that was it.

While researching, I found a great website that contains everything you need to know about baking at high altitudes. This website recognizes a book called “Pie in the Sky” by Susan G. Purdy. All my questions answered in one handy website.

Here's a little introduction to the technical part...baking depends on food chemistry, atmospheric pressure, humidity, climactic conditions and last but not least elevation. As elevation increases the boiling point of water decreases causing liquids to evaporate quicker and leavening agents to expand quicker. For a baker, these things mean big trouble.

For every 500 foot increase in altitude the boiling point of water drops one degree. When the boiling point temperature drops food takes longer to cook in or over liquid, custards take longer to set, and foods in a double boiler may not receive enough heat to cook properly. When water begins to evaporate from batter or dough the ratio of liquids changes resulting in a higher concentration of sugar and fat, weakening the structure of baked goods sometimes causing them to collapse or have a coarse texture.

When leavening agents expand too quickly, bake goods can rise too fast, and yeast breads can over-proof or rise then fall. Higher altitude also means drier conditions, or drier ingredients in this case. Recipes made at high altitude may require more liquid than recipes done at sea level.

Just when you thought baking was all fun and games, it all really comes down to a science. Hooray for science!

For more information on high altitude cooking visit the "Pie in the Sky" website or Google these and other websites:

High Altitude Cooking Tips

High Altitude Cooking

High Altitude Baking at 5000 feet

Here are some books that I found on baking at high altitudes. Look for these books and others at Amazon.com

High Altitude Baking: 200 Delicious Recipes & Tips for Great Cookies, Cakes, Breads & More - by Colorado State University Cooperative Extension

Baking at High Altitude: The Muffin Lady's Old Fashioned Recipes - by Randi L. Levin