Recent discussions
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Dr Sreenivasarao Surisetty
After thoroughly reading all the studies, I concluded that washing the sting areas with sea water followed by applying heat using hot water or hot water bags to treat sting pain is the best treatment. However, take precautions to ensure that the hotness of the water doesn't cause burns. In any study, they didn't mention at what temperature the water should be, so be cautious about the temperature of hot water.
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Sherry Campbell
As this was a systematic review of studies already completed, there should be a very clear review question to help guide the rationale as to why the articles were being reviewed.
The PICOST format clearly outlines how the articles were chosen, and identified in the article.
Consensus on Science - The first paragraph is a little confusing and needs more detail. Were all 375 studies considered for this review? If not, why not? Why were the 15 studies selected for full-text screening? There were three observational studies’ - does this mean that out of the 15 of the full-text screened studies, only three were part of this review?
Good Neurological Outcomes section - Need to bring in information about these techniques earlier in the article. It will help the reader understand what the focus of the studies were, and the rationale as to the reason for the authors to review.
The other segments of the article were easily understood, and clearly articulated the recommendation that this technique should not be performed in the clinical environment.
Thank you for letting me review
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Thomas Webber
Head-Up CPR (HUP) is a technique where the patient is positioned at an incline during cardiopulmonary resuscitation (CPR). This method has shown some promising results compared to traditional flat (supine) CPR
Key benefits of Head-Up CPR include:
1. Increased blood flow to the heart and brain: This can improve oxygenation.
2. Reduction in intracranial pressure (ICP). By draining venous blood from the brain, HUP CPR can help reduce brain swelling.
3. Higher rates of neurologically-intact survival: Some studies suggest that HUP CPR may lead to better neurological outcomes for patients. -
Anwar Adil Mithwani
Head - up CPR an emerging technique opposed to the traditional flat positition. This method enhancing Cerebral perfusion while decreasing Intracerebral Pressure,potentially improving outcomes for cardiac arrest patients..
What are major key effects on survival and neurological Outcomes as below:
1.Improved Cerebral Perfusion by elevating head during CPR helps reduce venous congestion and ICP( Enhance cerebral blood flow). better oxygenation of brain , therfore improving neurological recovery.
2.Decrese ICP : By Head up CPR significantly lower ICP.
3.Enhanced Coronary Perfusion : Some studies indicates that Head -up CPR improve Coronary circulation that leads to ROSC.
In Summary, Head - up CPR shows promise in improving survival and neurological outcomes but it needs more studies and research to establish clear guidelines for its implementation in clinical settins.
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Nazir Akber Ali
With an experience of over 30 years in emergency medicine and 10 years' experience with AED in specialty clinics and public places/ Religious gatherings areas, i have realized that its essential to keep AED unlocked but with an alarm while opening and with clear instructions as to who should open this and how important its not to use if you have no past experience of using it. Since the defib pads are for one time use only and it takes a while to replace it.
Keeping AED Locked have many pitfalls as to find the person with the key at the right time is not always possible and any delay in that process will decrease the chances of keeping alive the whole mankind. As Saving one life is as if saving the whole mankind. And by chance if u get AED box open and are able to restore Cardiac activity there is a chance of not getting beneficial neurological outcome.
And not only that then there is a grave consequence of a person with restored Cardiac activity but with poor neurological outcome not only on that person but on the family and on the society as a whole.
So to sum up AED Boxes should not be locked but with some important information on the box for the person who is opening it.
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Lino Masotti
Locked vs Unlocked AEDs for Public - LINO MASOTTI. (Heart and Stroke Foundation (CANADA) Experienced Instructor/Instructor Trainer - 23 years)
AEDs have proven to save lives and there have been many success stories with PROMPT public AED intervention in a CA. The PROS of having AED CABINETS “unlocked” in the General Public - ready for use especially in areas of increased pedestrian traffic areas (malls, plazas/piazza, convention areas, arenas/stadiums… ) greatly out weighs the disadvantages in when emergency medical services are immediately called.
From personal experience, a major concern is that a significant number of AEDs in my community are improperly maintained, lacking a maintenance plan. When I teach out-of hospital resuscitation programs; as part of training, I ask students to locate their in house AED and on several occasions find low batteries, expired pads…
On one occasion, while I was teaching, a student became severely ill and after assessing the student, called 911, had a staff member go and retrieve AED “just in case of cardiac event ” - after EMS had taken the patient to hospital, I checked the unit with the staff - low batteries and expired AED pads. I think this is an issue that needs to be addressed with certain workplaces as I do my best to make sure that they are informed about the proper maintenance and offer them solutions on updating their AEDs - this isn’t my job, but I care about healthcare making our community safer.
PROS UNLOCKED
- Effortless public access
- Immediate bystander CPR/AED -improving overall survivor stats.
CONS UNLOCKED
- Theft
- Lack of maintenance plan/control
- Environment conditions
- Vandalism
LOCKED AED CABINETS
Recommendation in environments controlled by a specialized emergency response team trained in a variety of emergencies with a duty to respond.
Facilities may also have oxygen, trauma kits, emergency medicine.
My input on where I would have a locked access AED cabinet:
PROS LOCKED
CONTROLLED ACCESS, BETTER MAINTENANCE, OTHER EMERGENCY EQUIPMENT
- Civil/Commercial aircraft
- Public transportation
- Medical/Dental Offices
- Event First Aid Stations
CONS LOCKED
- AEDs are inaccessible
- Alarms scare individuals
- Delays: If a key is required, retrieving the AED takes valuable time.
In conclusion locked/unlocked AEDs involves weighing accessibility against security/maintenance concerns. Balancing these approaches optimizes both public access and readiness which they were ultimately meant for.
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Thomas Webber
The debate around AED (Automated External Defibrillator) accessibility, particularly whether to lock AED cabinets, is quite nuanced. Here are some key points:
Benefits of Locked AED Cabinets:
1. Security Locks can help prevent theft or vandalism, ensuring the AED remains available when needed [43dcd9a7-70db-4a1f-b0ae-981daa162054](https://www.sussexheartcharity.org/life-saving-accessibility-why-unlocked-aed-cabinets-matter/?citationMarker=43dcd9a7-70db-4a1f-b0ae-981daa162054 "1").
2. Protection Cabinets can protect AEDs from environmental damage, such as dust or water [43dcd9a7-70db-4a1f-b0ae-981daa162054](https://ddisafety.com.au/aed-cabinet-guide-ensuring-safety-and-accessibility/?citationMarker=43dcd9a7-70db-4a1f-b0ae-981daa162054 "2").Harms of Locked AED Cabinets:
1. Delayed Access: In an emergency, every second counts [43dcd9a7-70db-4a1f-b0ae-981daa162054](https://www.sussexheartcharity.org/life-saving-accessibility-why-unlocked-aed-cabinets-matter/?citationMarker=43dcd9a7-70db-4a1f-b0ae-981daa162054 "1"). Locked cabinets can delay access, potentially impacting survival rates[43dcd9a7-70db-4a1f-b0ae-981daa162054](https://www.sussexheartcharity.org/life-saving-accessibility-why-unlocked-aed-cabinets-matter/?citationMarker=43dcd9a7-70db-4a1f-b0ae-981daa162054 "1").
2. Complexity: If a lock is used, someone must know the code or have access to it, which can complicate the response during an emergency [43dcd9a7-70db-4a1f-b0ae-981daa162054](https://www.sussexheartcharity.org/life-saving-accessibility-why-unlocked-aed-cabinets-matter/?citationMarker=43dcd9a7-70db-4a1f-b0ae-981daa162054 "1").Recommendations:
-Unlocked Cabinets Many experts recommend keeping AEDs in unlocked, clearly marked cabinets to ensure immediate access during emergencies [43dcd9a7-70db-4a1f-b0ae-981daa162054](https://www.sussexheartcharity.org/life-saving-accessibility-why-unlocked-aed-cabinets-matter/?citationMarker=43dcd9a7-70db-4a1f-b0ae-981daa162054 "1").
- Strategic Placement AEDs should be placed in highly visible and accessible locations[43dcd9a7-70db-4a1f-b0ae-981daa162054](https://aedadvantage.ca/blogs/resources/the-importance-of-aed-placement-accessibility-and-availability?citationMarker=43dcd9a7-70db-4a1f-b0ae-981daa162054 "3").
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LINO MASOTTI
Locked vs Unlocked AEDs for Public - LINO MASOTTI. (Heart and Stroke Foundation (CANADA) Experienced Instructor/Instructor Trainer - 23 years)
AEDs have proven to save lives and there have been many success stories with PROMPT public AED intervention in a CA. The PROS of having AED CABINETS “unlocked” in the General Public - ready for use especially in areas of increased pedestrian traffic areas (malls, plazas/piazza, convention areas, arenas/stadiums… ) greatly out weighs the disadvantages in when emergency medical services are immediately called.
From personal experience, a major concern is that a significant number of AEDs in my community are improperly maintained, lacking a maintenance plan. When I teach out-of hospital resuscitation programs; as part of training, I ask students to locate their in house AED and on several occasions find low batteries, expired pads…
On one occasion, while I was teaching, a student became severely ill and after assessing the student, called 911, had a staff member go and retrieve AED “just in case of cardiac event ” - after EMS had taken the patient to hospital, I checked the unit with the staff - low batteries and expired AED pads. I think this is an issue that needs to be addressed with certain workplaces as I do my best to make sure that they are informed about the proper maintenance and offer them solutions on updating their AEDs - this isn’t my job, but I care about healthcare making our community safer.
PROS UNLOCKED
- Effortless public access
- Immediate bystander CPR/AED -improving overall survivor stats.
CONS UNLOCKED
- Theft
- Lack of maintenance plan/control
- Environment conditions
- Vandalism
LOCKED AED CABINETS
Recommendation in environments controlled by a specialized emergency response team trained in a variety of emergencies with a duty to respond.
Facilities may also have oxygen, trauma kits, emergency medicine.
My input on where I would have a locked access AED cabinet:
PROS LOCKED
CONTROLLED ACCESS, BETTER MAINTENANCE, OTHER EMERGENCY EQUIPMENT
- Civil/Commercial aircraft
- Public transportation
- Medical/Dental Offices
- Event First Aid Stations
CONS LOCKED
- AEDs are inaccessible
- Alarms scare individuals
- Delays: If a key is required, retrieving the AED takes valuable time.
In conclusion locked/unlocked AEDs involves weighing accessibility against security/maintenance concerns. Balancing these approaches optimizes both public access and readiness which they were ultimately meant for.
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Crystal Girard
In response to having AED devices in a locked vs unlocked cabinet I feel tbey should be kept in an unlocked cabinet.
We have been stating that seconds count when saving lives and an AED is a main component in the chain on survival so why not have them easily accessible. Although some bystanders Risk injury by breaking open cabinets others will take time finding someone to open it, both use up valuable time that the victim does not have.
fire alarms are left unlocked and easily pulled and yet we leave them in the open so why should an AED be any different the public with proper education will for The most part leave them as is.
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Rob Martin
Makes sense. The areas I know of AED's, they are not locked up