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Interesting office purchase

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Re: Interesting office purchase

Post by CanuckBob on Fri Mar 03, 2017 8:38 am

Intercasa wrote:Conscious and hopefully skinny!  Crap now maybe i will need to rent a crane and have it in the lot next door.  

Awww I want to buy a new toy but something useful, maybe blood pressure monitor?  

Go get a new XBox One. Halo 5 and Sniper Elite 4 will keep you entertained.

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Re: Interesting office purchase

Post by simpsca on Fri Mar 03, 2017 11:16 am

Good for you Spencer!
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Re: Interesting office purchase

Post by gringomojado on Sat Mar 04, 2017 8:27 pm

Intercasa wrote:Conscious and hopefully skinny!  Crap now maybe i will need to rent a crane and have it in the lot next door.  

Awww I want to buy a new toy but something useful, maybe blood pressure monitor?  

Move your office next to "La Clinica"!
gm
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Re: Interesting office purchase

Post by chelseagirls on Thu Mar 09, 2017 10:16 pm

Spencer, Trailrunner's input of course as ever very valid. some others however leave somewhat to be desired, describing the use of AED as overblown is unhelpful and misinformed at the very least! for instance
Before I retired here I was the head nurse of a very busy London Accident and Emergency Department (ER) with advanced certification in ALS and Trauma care, so I have some knowledge of the subject! The UK is now undertaking a programme of placement of AED's in public places and workplaces, it saves lives! You may know of the iconic red telephone boxes in the UK, now most people have cell phones many of them are out of use for their original purpose and now house AED's!
The UK resuscitation council and British Heart Foundation have published a very comprehensive guide to the use and rationale for AED's if you are interested the link is here: https://www.resus.org.uk/publications/a-guide-to-aeds/
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Re: Interesting office purchase

Post by Jreboll on Fri Mar 10, 2017 4:24 am

Chelsea girls, before you get off your high horse let me get on mine. Misinformed? I spent almost 40 years as an ACLS certified RN, Certified perfusionist, Registered Echocardiographer and also put myself through school as a respiratory therapist. I have worked in cardiovascular surgery, cath lab and CCU. I have worked in Chicago, Houston, Puerto Rico and also did a stint at the IMSS cardiovascular surgery unit when it was on San Felipe street in Guadalajara.
As you may know medical care in U.S. Is driven by marketing and
liability issues but is brought down by statistics and economy. Some things may make sense in downtown London which don't make sense here. I have been retired for 3 years and still work at a free clinic when I can, and have been coming down to Mexico for about 40 years.
Statistically, if you haven't seen an event in the last five years you will probably not see one for another 5 years. If you see one and are able to cardiovert, what do you do for 20 minutes while the ambulance arrives? As you know, when you cardiovert, you have to have antiarrhythmics and Inotropes on hand to stabilize the patient. If you're a lawyer in your office, what do you do?
When you see heroics been practiced every day you see things differently than most people. The importance of AEDs has been overblown and no, I am not misinformed.

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Re: Interesting office purchase

Post by Trailrunner on Fri Mar 10, 2017 7:37 am

I do not believe the importance of AEDs is overblown, they are a critical step in the Chain of Survival. That said, they are only one of the links and true survival depends on each and every link being in place.

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Re: Interesting office purchase

Post by chelseagirls on Fri Mar 10, 2017 2:29 pm

Jreboll wrote:Chelsea girls, before you get off your high horse let me get on mine. Misinformed? I spent almost 40 years as an ACLS certified RN, Certified perfusionist, Registered Echocardiographer and also put myself through school as a respiratory therapist. I have worked in cardiovascular surgery, cath lab and CCU. I have worked in Chicago, Houston, Puerto Rico and also did a stint at the IMSS cardiovascular surgery unit when it was on San Felipe street in Guadalajara.
As you may know medical care in U.S. Is driven by marketing and
liability issues but is brought down by statistics and economy. Some things may make sense in downtown London which don't make sense here. I have been retired for 3 years and still work at a free clinic when I can, and have been coming down to Mexico for about 40 years.
Statistically, if you haven't seen an event in the last five years you will probably not see one for another 5 years. If you see one and are able to cardiovert, what do you do for 20 minutes while the ambulance arrives?  As you know, when you cardiovert, you have to have antiarrhythmics and Inotropes  on hand to stabilize the patient. If you're a lawyer in your office, what do you do?
When you see heroics been practiced every day you see things differently than most people. The importance of AEDs has been overblown and no, I am not misinformed.

No high horse here, just the experience that I have had, which is clearly different to yours (and only 30 years worth) I won't bother citing my other qualifications as I really don't think this is a competition. You have your opinion and I have mine!

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Re: Interesting office purchase

Post by bimini6 on Fri Mar 10, 2017 5:35 pm

Medtronic AED and it can be used by almost anybody! It is easy and gives a person directions step by step. Great ice saving devices, should be all around town and is in all airports. You cannot mess up using this device and if anyone gets one and needs help using after May1st I ill be back and glad to inservice your office staff.

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Re: Interesting office purchase

Post by JayBear on Fri Mar 10, 2017 10:27 pm

My dear Spencer, the site of your office, the lack of parking and the irregular stairs to your office are the major problems for us oldsters. If we wheeze on arrival, it is because we had to PARK at some distance away, dodge traffic and climb the stairs!

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Re: Interesting office purchase

Post by Trailrunner on Sat Mar 11, 2017 7:14 am

lololol True. And once you get up the stairs there is no place to wait for your appt unless you perch yourself on the chair/stool in the break area.
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Re: Interesting office purchase

Post by Jreboll on Sun Mar 12, 2017 7:33 am

I just read a medical journal article on the use of AEDs in "very high risk area" of London. This study lasted 4 years.
681 AEDs were installed. They were used 172 times resulting in one per 120 months(10yrs) of usage. Trained personnel were available in each location. Almost 30% of patients walked out of the hospital.
Now, if the average usage in a high risk area of London is one/10 yrs how much would we expect in Ajijic?

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Re: Interesting office purchase

Post by Trailrunner on Sun Mar 12, 2017 8:51 am

Interesting report, Jreboll, thanks for posting!

Now, one could also say that without the AED and early defib in these codes (meaning 911 activation, bystander CPR, then paramedic arrival - average 8 mins later - and defib followed by cardiotonic medications and transport), that 30% stat would plummet to around 3% which is the average walking out of the hospital save rate for codes in the field.

Conclusion might be something like: save rate for bystander AED 30% and save rate with no bystander AED 3%. Certainly worth putting AEDs everywhere in large public places.
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Re: Interesting office purchase

Post by Jreboll on Sun Mar 12, 2017 9:10 am

Look at the costs. It is already determined that a large percentage of our medical costs are spent on end of life procedures. Some are even advocating changing our perception of what to expect as we age. In an age of diminishing budgets and cuts being made, I don't think AEDs are a priority. Of those that survive we don't know their quality of life afterwards. From my experience, some end up in extended care facilities, nursing homes or suffer diminished capacity.
I am 70 yrs old. I don't want my ribs crushed by CPR. I don't want to be intubated. If I keel over on the street just leave me alone. If I develop cancer that has a low rate of survival get me my morphine drip.

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Re: Interesting office purchase

Post by Trailrunner on Sun Mar 12, 2017 9:23 am

Jreboll wrote:I am 70 yrs old. I don't want my ribs crushed by CPR. I don't want to be intubated. If I keel over on the street just leave me alone. If I develop cancer that has a low rate of survival get  me my morphine drip.

hahaha Yeah, I feel the same way but the only way to insure that is to tattoo DNR or Do Not Resuscitate on your chest. In Spanish.

Ok, your cost point is well-taken however not all codes are geezers like us. Kids code playing basketball, 30 year olds code from genetic anomalies that they didn't know about, etc, and I know that is fairly rare - BUT, what if that was YOUR kid, or you, or your brother, cousin, friend. Wouldn't you have wished there was an AED available?

They find the money to pay people to deliver the mail, they can find the money to buy public AEDs. And bulk government purchases of AEDs are deeply discounted. I will never trade money for lives.
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Re: Interesting office purchase

Post by Jreboll on Sun Mar 12, 2017 9:43 am

As you parse out the conditions the probabilities become more and more remote to the point where it becomes ludicrous. I have known CPR for over 40 years and I have yet to use it outside the hospital. Now CPR is a good thing to know and is cheap to learn but if someone were to offer me an amulet that would instantly defibrillate anyone in cardiac arrest and I could have it for 800dls, would I buy it? Knowing the odds I would not buy it.
AEDs, amulets, etc., they are all the same if you don't use them

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Re: Interesting office purchase

Post by Trailrunner on Sun Mar 12, 2017 11:27 am

Right, agree. But in public places where large numbers of people congregate the odds go down and it makes more sense.

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Re: Interesting office purchase

Post by Jreboll on Sun Mar 12, 2017 11:45 am

There are always situations where it is appropriate

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Re: Interesting office purchase

Post by mattoleriver on Tue Mar 14, 2017 1:16 am

Jreboll wrote:...get  me my morphine drip.
Okay, Spencer, finally one you can run with! Very Happy
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Re: Interesting office purchase

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