Guest guest Posted January 30, 2007 Report Share Posted January 30, 2007 In a message dated 1/30/2007 3:31:44 PM Central Standard Time, bbledsoe@... writes: Kids rarely die from V-fib and thus the cost of having duplicate pedi and adult AEDs is cost-prohibitive. A pedi AED might be justified in a pediatric ambulatory care clinic or a day care for special needs kids-otherwise it will never be used. An adult AED is just as effective and when the shock is administered to an otherwise health pediatric heart, the heart can most likely tolerate the increased energy levels. what I'd like to see would be a set up where there would be two sets of pads and one AED. apply the smaller set of pads (either for a pedi or a small/frail adult), and the machine would be smart enough to limit the max Joules applied... shouldn't be hard, but then again, with one of the major players going out of the market at least for awhile, who knows? ck S. Krin, DO FAAFP Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 30, 2007 Report Share Posted January 30, 2007 Mainly the hypoxic ones... Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 30, 2007 Report Share Posted January 30, 2007 In a message dated 1/30/2007 5:08:23 PM Central Standard Time, staffdoc@... writes: Most of the AED today have a set of pedi pads, however they just step the energy down with the pads. Zoll AED plus actually wrote a pediatric module for there AED. The research I have read and lectures I have attended have all said that the increased energy does not do as much damage to the heart as once suspected. Thus the reason for using an Adult AED on the pedi patient if no other option is available. Thanks, Bernie. It's been a couple of years since I reviewed the information, and at that time, the Zoll folks were only talking about the peds module. Glad to know that it is not needed after all. ck S. Krin DO FAAFP Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 30, 2007 Report Share Posted January 30, 2007 In a message dated 1/30/2007 5:13:28 PM Central Standard Time, petsardlj@... writes: Okay so my next question would be what is a joule as compared to an amp Volts are a measure of electrical pressure (like PSI in a water system) Amps are a measure of electrical flow (like gallons per minute in a water system) Watts are a measure of electrical power (V * A) Joules are a measure of electrical power over time (Watts/Second) Does that help any? ck S. Krin, DO FAAFP Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 30, 2007 Report Share Posted January 30, 2007 I have a question for the general learned and professional subscribers to the list. Who can explain the rationale behind the new CPR Guideline of using an adult AED on a pediatric patient? I understand it is a last resort but are we not burning the nodes when we give them too much energy? Am I missing something? Please help. Danny L. Owner/NREMT-P PETSAR INC. (Panhandle Emergency Training Services And Response) Office Fax Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 30, 2007 Report Share Posted January 30, 2007 Kids rarely die from V-fib and thus the cost of having duplicate pedi and adult AEDs is cost-prohibitive. A pedi AED might be justified in a pediatric ambulatory care clinic or a day care for special needs kids-otherwise it will never be used. An adult AED is just as effective and when the shock is administered to an otherwise health pediatric heart, the heart can most likely tolerate the increased energy levels. _____ From: texasems-l [mailto:texasems-l ] On Behalf Of Danny Sent: Tuesday, January 30, 2007 3:14 PM To: texasems-l Subject: CPR Question I have a question for the general learned and professional subscribers to the list. Who can explain the rationale behind the new CPR Guideline of using an adult AED on a pediatric patient? I understand it is a last resort but are we not burning the nodes when we give them too much energy? Am I missing something? Please help. Danny L. Owner/NREMT-P PETSAR INC. (Panhandle Emergency Training Services And Response) Office Fax Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 30, 2007 Report Share Posted January 30, 2007 In a message dated 1/30/2007 3:19:23 P.M. Central Standard Time, petsardlj@... writes: I understand it is a last resort but are we not burning the nodes when we give them too much energy? Am I missing something? Hobson's Choice. Pediatric VF is much more common than was originally thought (about 19% of arrests, IIRC). Since the only thing that terminates VF is timely defibrillation, we use whatever AED is handy. The studies show that adult interpretation algorithms can accurately recognize VF/VT in children, and newer biphasic defibrillators use less shock energy than the older monophasic AEDs. Add to that the recommendation of single shocks and no longer escalating current settings, and the end result will probably be less shocks delivered overall, but the ones that are delivered are more likely to be effective. So it comes down to a choice of the lesser of two evils - too much current, or none at all? The AHA says too much current is the lesser of the two evils. Grayson, CCEMT-P, etc. _www.medictrainingsolutions.com_ (http://www.medictrainingsolutions.com/) MEDIC Training Solutions Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 30, 2007 Report Share Posted January 30, 2007 In a message dated 1/30/2007 5:25:07 P.M. Central Standard Time, petsardlj@... writes: I am not meaning to be argumentative ( or maybe I am) but how is it that we know electricity kills but yet we are quick to say that the energy delivered (en masse and directly to the nodes) is not a danger. Does that make sense? Who says electricity kills? The effect of the current (good or bad, life taking or life saving) depends largely on how the current is delivered, the conduction medium, the type of current (AC or DC), the duration of contact, and the amperage of current. Tasers, for example - give off many thousand volts (exact amount I can't recall, but 50,000 DC volts comes to mind) without long lasting effects, while household 110 V AC current can kill you dead as a hammer because of its high amperage. Grayson, CCEMT-P, etc. _www.medictrainingsolutions.com_ (http://www.medictrainingsolutions.com/) MEDIC Training Solutions Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 30, 2007 Report Share Posted January 30, 2007 So there is not a problem with damage to the nodes in a healthy pediatric heart. How many healthy pediatric patients go into V-Fib? " Bledsoe, DO " wrote: Kids rarely die from V-fib and thus the cost of having duplicate pedi and adult AEDs is cost-prohibitive. A pedi AED might be justified in a pediatric ambulatory care clinic or a day care for special needs kids-otherwise it will never be used. An adult AED is just as effective and when the shock is administered to an otherwise health pediatric heart, the heart can most likely tolerate the increased energy levels. _____ From: texasems-l [mailto:texasems-l ] On Behalf Of Danny Sent: Tuesday, January 30, 2007 3:14 PM To: texasems-l Subject: CPR Question I have a question for the general learned and professional subscribers to the list. Who can explain the rationale behind the new CPR Guideline of using an adult AED on a pediatric patient? I understand it is a last resort but are we not burning the nodes when we give them too much energy? Am I missing something? Please help. Danny L. Owner/NREMT-P PETSAR INC. (Panhandle Emergency Training Services And Response) Office Fax Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 30, 2007 Report Share Posted January 30, 2007 In a message dated 1/30/2007 3:51:32 P.M. Central Standard Time, krin135@... writes: what I'd like to see would be a set up where there would be two sets of pads and one AED. apply the smaller set of pads (either for a pedi or a small/frail adult), and the machine would be smart enough to limit the max Joules applied... Most of them do that. The pediatric cables are simply high-resistance cables that lower the current delivered. I think Zoll has a separate pediatric interpretation algorithm entirely. Grayson, CCEMT-P, etc. _www.medictrainingsolutions.com_ (http://www.medictrainingsolutions.com/) MEDIC Training Solutions Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 30, 2007 Report Share Posted January 30, 2007 In a message dated 1/30/2007 5:23:54 P.M. Central Standard Time, krin135@... writes: Volts are a measure of electrical pressure (like PSI in a water system) Amps are a measure of electrical flow (like gallons per minute in a water system) Watts are a measure of electrical power (V * A) Joules are a measure of electrical power over time (Watts/Second) Does that help any? That is as succinct an explanation as I have ever heard, Chuck. Nice job! Grayson, CCEMT-P, etc. _www.medictrainingsolutions.com_ (http://www.medictrainingsolutions.com/) MEDIC Training Solutions Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 30, 2007 Report Share Posted January 30, 2007 Most of the AED today have a set of pedi pads, however they just step the energy down with the pads. Zoll AED plus actually wrote a pediatric module for there AED. The research I have read and lectures I have attended have all said that the increased energy does not do as much damage to the heart as once suspected. Thus the reason for using an Adult AED on the pedi patient if no other option is available. Bernie Stafford EMTP AHA Instructor _____ From: texasems-l [mailto:texasems-l ] On Behalf Of krin135@... Sent: Tuesday, January 30, 2007 3:45 PM To: texasems-l Subject: Re: CPR Question In a message dated 1/30/2007 3:31:44 PM Central Standard Time, bbledsoe (AT) earthlink (DOT) <mailto:bbledsoe%40earthlink.net> net writes: Kids rarely die from V-fib and thus the cost of having duplicate pedi and adult AEDs is cost-prohibitive. A pedi AED might be justified in a pediatric ambulatory care clinic or a day care for special needs kids-otherwise it will never be used. An adult AED is just as effective and when the shock is administered to an otherwise health pediatric heart, the heart can most likely tolerate the increased energy levels. what I'd like to see would be a set up where there would be two sets of pads and one AED. apply the smaller set of pads (either for a pedi or a small/frail adult), and the machine would be smart enough to limit the max Joules applied... shouldn't be hard, but then again, with one of the major players going out of the market at least for awhile, who knows? ck S. Krin, DO FAAFP Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 30, 2007 Report Share Posted January 30, 2007 Doesn't sound like a healthy pediatric patient. fremsdallas@... wrote: Mainly the hypoxic ones... Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 30, 2007 Report Share Posted January 30, 2007 Okay so my next question would be what is a joule as compared to an amp? Bernie Stafford wrote: Most of the AED today have a set of pedi pads, however they just step the energy down with the pads. Zoll AED plus actually wrote a pediatric module for there AED. The research I have read and lectures I have attended have all said that the increased energy does not do as much damage to the heart as once suspected. Thus the reason for using an Adult AED on the pedi patient if no other option is available. Bernie Stafford EMTP AHA Instructor _____ From: texasems-l [mailto:texasems-l ] On Behalf Of krin135@... Sent: Tuesday, January 30, 2007 3:45 PM To: texasems-l Subject: Re: CPR Question In a message dated 1/30/2007 3:31:44 PM Central Standard Time, bbledsoe (AT) earthlink (DOT) <mailto:bbledsoe%40earthlink.net> net writes: Kids rarely die from V-fib and thus the cost of having duplicate pedi and adult AEDs is cost-prohibitive. A pedi AED might be justified in a pediatric ambulatory care clinic or a day care for special needs kids-otherwise it will never be used. An adult AED is just as effective and when the shock is administered to an otherwise health pediatric heart, the heart can most likely tolerate the increased energy levels. what I'd like to see would be a set up where there would be two sets of pads and one AED. apply the smaller set of pads (either for a pedi or a small/frail adult), and the machine would be smart enough to limit the max Joules applied... shouldn't be hard, but then again, with one of the major players going out of the market at least for awhile, who knows? ck S. Krin, DO FAAFP Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 30, 2007 Report Share Posted January 30, 2007 Most are healthy hearts. They fibrillate because of toxins, carbon monoxide, electrical shock-things like that. Few have intrinsic heart disease per se. Those that have congenital anomalies will die from failure. BEB _____ From: texasems-l [mailto:texasems-l ] On Behalf Of Danny Sent: Tuesday, January 30, 2007 3:53 PM To: texasems-l Subject: RE: CPR Question So there is not a problem with damage to the nodes in a healthy pediatric heart. How many healthy pediatric patients go into V-Fib? " Bledsoe, DO " <bbledsoe (AT) earthlink (DOT) <mailto:bbledsoe%40earthlink.net> net> wrote: Kids rarely die from V-fib and thus the cost of having duplicate pedi and adult AEDs is cost-prohibitive. A pedi AED might be justified in a pediatric ambulatory care clinic or a day care for special needs kids-otherwise it will never be used. An adult AED is just as effective and when the shock is administered to an otherwise health pediatric heart, the heart can most likely tolerate the increased energy levels. _____ From: texasems-l@yahoogro <mailto:texasems-l%40yahoogroups.com> ups.com [mailto:texasems-l@yahoogro <mailto:texasems-l%40yahoogroups.com> ups.com] On Behalf Of Danny Sent: Tuesday, January 30, 2007 3:14 PM To: texasems-l Subject: CPR Question I have a question for the general learned and professional subscribers to the list. Who can explain the rationale behind the new CPR Guideline of using an adult AED on a pediatric patient? I understand it is a last resort but are we not burning the nodes when we give them too much energy? Am I missing something? Please help. Danny L. Owner/NREMT-P PETSAR INC. (Panhandle Emergency Training Services And Response) Office Fax Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 30, 2007 Report Share Posted January 30, 2007 I'd also submit that teaching some basic vocabulary building with Greek and Latin root words and some basic standardized test-taking skills would produce wondrous results. -Wes In a message dated 1/30/2007 5:32:27 PM Central Standard Time, bbledsoe@... writes: The truth-as a writer. Most EMS students are left brain (visual) learners. That is why we put 0.5 graphics per page in EMS textbooks. EMS students have great difficulty with analytical information: drug dosage calculations, multiplication of fractions, simple algebra, charge states on molecules, ions, and such. The dumbing down of the EMS curricula has made it difficult to take the time and teach such things. If you put it in a book, some instructor will complain that your book is " too difficult " and the students want to know " just what I need to know for the test. " Thus, explaining stuff like Joules leaves 'em looking like a monkey doing a math problem. I don't mean to stereotype all EMS students-but the psychology and educational data says this is the case. Most of my conference talks almost always include some way of bringing basic science into the equation. With our next series of paramedic materials we will probably have a remedial module to teach the stuff you were supposed to learn in high school. I love basic science material and have several books under development that integrate these. But, EMS education is like a river-it follows the course of least resistance. BEB _____ From: _texasems-l@yahoogrotexasem_ (mailto:texasems-l ) [mailto:_texasems-l@yahoogrotexasem_ (mailto:texasems-l ) ] On Behalf Of Danny Sent: Tuesday, January 30, 2007 5:20 PM To: _texasems-l@yahoogrotexasem_ (mailto:texasems-l ) Subject: RE: CPR Question I am not meaning to be argumentative ( or maybe I am) but how is it that we know electricity kills but yet we are quick to say that the energy delivered (en masse and directly to the nodes) is not a danger. Does that make sense? My point being are we again teaching our students the wrong information because we think they are incapable of handling the right information or do we really think that this will be of benefit to the patient in cardiac arrest? If there is no benefit then why waste our time and energy in the treatment? " Bledsoe, DO " <bbledsoe@earthlinkbbleds<mailto:bbledsoe%mailto:bbledmai> net> wrote: Most are healthy hearts. They fibrillate because of toxins, carbon monoxide, electrical shock-things like that. Few have intrinsic heart disease per se. Those that have congenital anomalies will die from failure. BEB _____ From: texasems-l@yahoogro <mailto:texasems-mailto:texasems-mai> ups.com [mailto:texasems-[mailto:texasem<mailto:texasems-mailto:texasems-mai> ups.com] On Behalf Of Danny Sent: Tuesday, January 30, 2007 3:53 PM To: texasems-l@yahoogro <mailto:texasems-mailto:texasems-mai> ups.com Subject: RE: CPR Question So there is not a problem with damage to the nodes in a healthy pediatric heart. How many healthy pediatric patients go into V-Fib? " Bledsoe, DO " <bbledsoe@earthlinkbbleds<mailto:bbledsoe%mailto:bbledmai> net> wrote: Kids rarely die from V-fib and thus the cost of having duplicate pedi and adult AEDs is cost-prohibitive. A pedi AED might be justified in a pediatric ambulatory care clinic or a day care for special needs kids-otherwise it will never be used. An adult AED is just as effective and when the shock is administered to an otherwise health pediatric heart, the heart can most likely tolerate the increased energy levels. _____ From: texasems-l@yahoogro <mailto:texasems-mailto:texasems-mai> ups.com [mailto:texasems-[mailto:texasem<mailto:texasems-mailto:texasems-mai> ups.com] On Behalf Of Danny Sent: Tuesday, January 30, 2007 3:14 PM To: texasems-l Subject: CPR Question I have a question for the general learned and professional subscribers to the list. Who can explain the rationale behind the new CPR Guideline of using an adult AED on a pediatric patient? I understand it is a last resort but are we not burning the nodes when we give them too much energy? Am I missing something? Please help. Danny L. Owner/NREMT-O PETSAR INC. (Panhandle Emergency Training Services And Response) Office Fax [Non-text portions of this message have been removed] [Non-text portions of this message have been removed] Danny L. Owner/NREMT-O PETSAR INC. (Panhandle Emergency Training Services And Response) Office Fax [Non-text portions of this message have been removed] [Non-text portions of this message have been removed] Danny L. Owner/NREMT-O PETSAR INC. (Panhandle Emergency Training Services And Response) Office Fax [Non-text portions of this message have been removed] [Non-text portions of this message have been removed] Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 30, 2007 Report Share Posted January 30, 2007 I am not meaning to be argumentative ( or maybe I am) but how is it that we know electricity kills but yet we are quick to say that the energy delivered (en masse and directly to the nodes) is not a danger. Does that make sense? My point being are we again teaching our students the wrong information because we think they are incapable of handling the right information or do we really think that this will be of benefit to the patient in cardiac arrest? If there is no benefit then why waste our time and energy in the treatment? " Bledsoe, DO " wrote: Most are healthy hearts. They fibrillate because of toxins, carbon monoxide, electrical shock-things like that. Few have intrinsic heart disease per se. Those that have congenital anomalies will die from failure. BEB _____ From: texasems-l [mailto:texasems-l ] On Behalf Of Danny Sent: Tuesday, January 30, 2007 3:53 PM To: texasems-l Subject: RE: CPR Question So there is not a problem with damage to the nodes in a healthy pediatric heart. How many healthy pediatric patients go into V-Fib? " Bledsoe, DO " <bbledsoe (AT) earthlink (DOT) <mailto:bbledsoe%40earthlink.net> net> wrote: Kids rarely die from V-fib and thus the cost of having duplicate pedi and adult AEDs is cost-prohibitive. A pedi AED might be justified in a pediatric ambulatory care clinic or a day care for special needs kids-otherwise it will never be used. An adult AED is just as effective and when the shock is administered to an otherwise health pediatric heart, the heart can most likely tolerate the increased energy levels. _____ From: texasems-l@yahoogro <mailto:texasems-l%40yahoogroups.com> ups.com [mailto:texasems-l@yahoogro <mailto:texasems-l%40yahoogroups.com> ups.com] On Behalf Of Danny Sent: Tuesday, January 30, 2007 3:14 PM To: texasems-l Subject: CPR Question I have a question for the general learned and professional subscribers to the list. Who can explain the rationale behind the new CPR Guideline of using an adult AED on a pediatric patient? I understand it is a last resort but are we not burning the nodes when we give them too much energy? Am I missing something? Please help. Danny L. Owner/NREMT-P PETSAR INC. (Panhandle Emergency Training Services And Response) Office Fax Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 30, 2007 Report Share Posted January 30, 2007 1 Joule = 1 watt delivered for 1 second (watt second) = the current of 1 amp passing through a resistor of 1 Ohm for 1 second. Thus, 10 amps passing over a resistance of 1 Ohm for 0.1 second is: 1 Joule Your question really does not make sense. _____ From: texasems-l [mailto:texasems-l ] On Behalf Of Danny Sent: Tuesday, January 30, 2007 5:09 PM To: texasems-l Subject: RE: CPR Question Okay so my next question would be what is a joule as compared to an amp? Bernie Stafford <staffdoc (AT) dot11net (DOT) <mailto:staffdoc%40dot11net.net> net> wrote: Most of the AED today have a set of pedi pads, however they just step the energy down with the pads. Zoll AED plus actually wrote a pediatric module for there AED. The research I have read and lectures I have attended have all said that the increased energy does not do as much damage to the heart as once suspected. Thus the reason for using an Adult AED on the pedi patient if no other option is available. Bernie Stafford EMTP AHA Instructor _____ From: texasems-l@yahoogro <mailto:texasems-l%40yahoogroups.com> ups.com [mailto:texasems-l@yahoogro <mailto:texasems-l%40yahoogroups.com> ups.com] On Behalf Of krin135 (AT) aol (DOT) <mailto:krin135%40aol.com> com Sent: Tuesday, January 30, 2007 3:45 PM To: texasems-l@yahoogro <mailto:texasems-l%40yahoogroups.com> ups.com Subject: Re: CPR Question In a message dated 1/30/2007 3:31:44 PM Central Standard Time, bbledsoe (AT) earthlink (DOT) <mailto:bbledsoe%40earthlink.net> net writes: Kids rarely die from V-fib and thus the cost of having duplicate pedi and adult AEDs is cost-prohibitive. A pedi AED might be justified in a pediatric ambulatory care clinic or a day care for special needs kids-otherwise it will never be used. An adult AED is just as effective and when the shock is administered to an otherwise health pediatric heart, the heart can most likely tolerate the increased energy levels. what I'd like to see would be a set up where there would be two sets of pads and one AED. apply the smaller set of pads (either for a pedi or a small/frail adult), and the machine would be smart enough to limit the max Joules applied... shouldn't be hard, but then again, with one of the major players going out of the market at least for awhile, who knows? ck S. Krin, DO FAAFP Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 30, 2007 Report Share Posted January 30, 2007 How much current does it take to cause damage to tissue and muscle? " Bledsoe, DO " wrote: 1 Joule = 1 watt delivered for 1 second (watt second) = the current of 1 amp passing through a resistor of 1 Ohm for 1 second. Thus, 10 amps passing over a resistance of 1 Ohm for 0.1 second is: 1 Joule Your question really does not make sense. _____ From: texasems-l [mailto:texasems-l ] On Behalf Of Danny Sent: Tuesday, January 30, 2007 5:09 PM To: texasems-l Subject: RE: CPR Question Okay so my next question would be what is a joule as compared to an amp? Bernie Stafford <staffdoc (AT) dot11net (DOT) <mailto:staffdoc%40dot11net.net> net> wrote: Most of the AED today have a set of pedi pads, however they just step the energy down with the pads. Zoll AED plus actually wrote a pediatric module for there AED. The research I have read and lectures I have attended have all said that the increased energy does not do as much damage to the heart as once suspected. Thus the reason for using an Adult AED on the pedi patient if no other option is available. Bernie Stafford EMTP AHA Instructor _____ From: texasems-l@yahoogro <mailto:texasems-l%40yahoogroups.com> ups.com [mailto:texasems-l@yahoogro <mailto:texasems-l%40yahoogroups.com> ups.com] On Behalf Of krin135 (AT) aol (DOT) <mailto:krin135%40aol.com> com Sent: Tuesday, January 30, 2007 3:45 PM To: texasems-l@yahoogro <mailto:texasems-l%40yahoogroups.com> ups.com Subject: Re: CPR Question In a message dated 1/30/2007 3:31:44 PM Central Standard Time, bbledsoe (AT) earthlink (DOT) <mailto:bbledsoe%40earthlink.net> net writes: Kids rarely die from V-fib and thus the cost of having duplicate pedi and adult AEDs is cost-prohibitive. A pedi AED might be justified in a pediatric ambulatory care clinic or a day care for special needs kids-otherwise it will never be used. An adult AED is just as effective and when the shock is administered to an otherwise health pediatric heart, the heart can most likely tolerate the increased energy levels. what I'd like to see would be a set up where there would be two sets of pads and one AED. apply the smaller set of pads (either for a pedi or a small/frail adult), and the machine would be smart enough to limit the max Joules applied... shouldn't be hard, but then again, with one of the major players going out of the market at least for awhile, who knows? ck S. Krin, DO FAAFP Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 30, 2007 Report Share Posted January 30, 2007 By the way, Thank You for all the input. Danny wrote: How much current does it take to cause damage to tissue and muscle? " Bledsoe, DO " wrote: 1 Joule = 1 watt delivered for 1 second (watt second) = the current of 1 amp passing through a resistor of 1 Ohm for 1 second. Thus, 10 amps passing over a resistance of 1 Ohm for 0.1 second is: 1 Joule Your question really does not make sense. _____ From: texasems-l [mailto:texasems-l ] On Behalf Of Danny Sent: Tuesday, January 30, 2007 5:09 PM To: texasems-l Subject: RE: CPR Question Okay so my next question would be what is a joule as compared to an amp? Bernie Stafford <staffdoc (AT) dot11net (DOT) <mailto:staffdoc%40dot11net.net> net> wrote: Most of the AED today have a set of pedi pads, however they just step the energy down with the pads. Zoll AED plus actually wrote a pediatric module for there AED. The research I have read and lectures I have attended have all said that the increased energy does not do as much damage to the heart as once suspected. Thus the reason for using an Adult AED on the pedi patient if no other option is available. Bernie Stafford EMTP AHA Instructor _____ From: texasems-l@yahoogro <mailto:texasems-l%40yahoogroups.com> ups.com [mailto:texasems-l@yahoogro <mailto:texasems-l%40yahoogroups.com> ups.com] On Behalf Of krin135 (AT) aol (DOT) <mailto:krin135%40aol.com> com Sent: Tuesday, January 30, 2007 3:45 PM To: texasems-l@yahoogro <mailto:texasems-l%40yahoogroups.com> ups.com Subject: Re: CPR Question In a message dated 1/30/2007 3:31:44 PM Central Standard Time, bbledsoe (AT) earthlink (DOT) <mailto:bbledsoe%40earthlink.net> net writes: Kids rarely die from V-fib and thus the cost of having duplicate pedi and adult AEDs is cost-prohibitive. A pedi AED might be justified in a pediatric ambulatory care clinic or a day care for special needs kids-otherwise it will never be used. An adult AED is just as effective and when the shock is administered to an otherwise health pediatric heart, the heart can most likely tolerate the increased energy levels. what I'd like to see would be a set up where there would be two sets of pads and one AED. apply the smaller set of pads (either for a pedi or a small/frail adult), and the machine would be smart enough to limit the max Joules applied... shouldn't be hard, but then again, with one of the major players going out of the market at least for awhile, who knows? ck S. Krin, DO FAAFP Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 30, 2007 Report Share Posted January 30, 2007 The truth-as a writer. Most EMS students are left brain (visual) learners. That is why we put 0.5 graphics per page in EMS textbooks. EMS students have great difficulty with analytical information: drug dosage calculations, multiplication of fractions, simple algebra, charge states on molecules, ions, and such. The dumbing down of the EMS curricula has made it difficult to take the time and teach such things. If you put it in a book, some instructor will complain that your book is " too difficult " and the students want to know " just what I need to know for the test. " Thus, explaining stuff like Joules leaves 'em looking like a monkey doing a math problem. I don't mean to stereotype all EMS students-but the psychology and educational data says this is the case. Most of my conference talks almost always include some way of bringing basic science into the equation. With our next series of paramedic materials we will probably have a remedial module to teach the stuff you were supposed to learn in high school. I love basic science material and have several books under development that integrate these. But, EMS education is like a river-it follows the course of least resistance. BEB _____ From: texasems-l [mailto:texasems-l ] On Behalf Of Danny Sent: Tuesday, January 30, 2007 5:20 PM To: texasems-l Subject: RE: CPR Question I am not meaning to be argumentative ( or maybe I am) but how is it that we know electricity kills but yet we are quick to say that the energy delivered (en masse and directly to the nodes) is not a danger. Does that make sense? My point being are we again teaching our students the wrong information because we think they are incapable of handling the right information or do we really think that this will be of benefit to the patient in cardiac arrest? If there is no benefit then why waste our time and energy in the treatment? " Bledsoe, DO " <bbledsoe (AT) earthlink (DOT) <mailto:bbledsoe%40earthlink.net> net> wrote: Most are healthy hearts. They fibrillate because of toxins, carbon monoxide, electrical shock-things like that. Few have intrinsic heart disease per se. Those that have congenital anomalies will die from failure. BEB _____ From: texasems-l@yahoogro <mailto:texasems-l%40yahoogroups.com> ups.com [mailto:texasems-l@yahoogro <mailto:texasems-l%40yahoogroups.com> ups.com] On Behalf Of Danny Sent: Tuesday, January 30, 2007 3:53 PM To: texasems-l@yahoogro <mailto:texasems-l%40yahoogroups.com> ups.com Subject: RE: CPR Question So there is not a problem with damage to the nodes in a healthy pediatric heart. How many healthy pediatric patients go into V-Fib? " Bledsoe, DO " <bbledsoe (AT) earthlink (DOT) <mailto:bbledsoe%40earthlink.net> net> wrote: Kids rarely die from V-fib and thus the cost of having duplicate pedi and adult AEDs is cost-prohibitive. A pedi AED might be justified in a pediatric ambulatory care clinic or a day care for special needs kids-otherwise it will never be used. An adult AED is just as effective and when the shock is administered to an otherwise health pediatric heart, the heart can most likely tolerate the increased energy levels. _____ From: texasems-l@yahoogro <mailto:texasems-l%40yahoogroups.com> ups.com [mailto:texasems-l@yahoogro <mailto:texasems-l%40yahoogroups.com> ups.com] On Behalf Of Danny Sent: Tuesday, January 30, 2007 3:14 PM To: texasems-l Subject: CPR Question I have a question for the general learned and professional subscribers to the list. Who can explain the rationale behind the new CPR Guideline of using an adult AED on a pediatric patient? I understand it is a last resort but are we not burning the nodes when we give them too much energy? Am I missing something? Please help. Danny L. Owner/NREMT-P PETSAR INC. (Panhandle Emergency Training Services And Response) Office Fax Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 30, 2007 Report Share Posted January 30, 2007 Depends on: 1. Biochemical state of the heart (pH, Ca2+, NA+, K+) 2. Pre-existing disease. 3. Genetics. 4. Luck 5. Faith _____ From: texasems-l [mailto:texasems-l ] On Behalf Of Danny Sent: Tuesday, January 30, 2007 5:24 PM To: texasems-l Subject: RE: CPR Question How much current does it take to cause damage to tissue and muscle? " Bledsoe, DO " <bbledsoe (AT) earthlink (DOT) <mailto:bbledsoe%40earthlink.net> net> wrote: 1 Joule = 1 watt delivered for 1 second (watt second) = the current of 1 amp passing through a resistor of 1 Ohm for 1 second. Thus, 10 amps passing over a resistance of 1 Ohm for 0.1 second is: 1 Joule Your question really does not make sense. _____ From: texasems-l@yahoogro <mailto:texasems-l%40yahoogroups.com> ups.com [mailto:texasems-l@yahoogro <mailto:texasems-l%40yahoogroups.com> ups.com] On Behalf Of Danny Sent: Tuesday, January 30, 2007 5:09 PM To: texasems-l@yahoogro <mailto:texasems-l%40yahoogroups.com> ups.com Subject: RE: CPR Question Okay so my next question would be what is a joule as compared to an amp? Bernie Stafford <staffdoc (AT) dot11net (DOT) <mailto:staffdoc%40dot11net.net> net> wrote: Most of the AED today have a set of pedi pads, however they just step the energy down with the pads. Zoll AED plus actually wrote a pediatric module for there AED. The research I have read and lectures I have attended have all said that the increased energy does not do as much damage to the heart as once suspected. Thus the reason for using an Adult AED on the pedi patient if no other option is available. Bernie Stafford EMTP AHA Instructor _____ From: texasems-l@yahoogro <mailto:texasems-l%40yahoogroups.com> ups.com [mailto:texasems-l@yahoogro <mailto:texasems-l%40yahoogroups.com> ups.com] On Behalf Of krin135 (AT) aol (DOT) <mailto:krin135%40aol.com> com Sent: Tuesday, January 30, 2007 3:45 PM To: texasems-l@yahoogro <mailto:texasems-l%40yahoogroups.com> ups.com Subject: Re: CPR Question In a message dated 1/30/2007 3:31:44 PM Central Standard Time, bbledsoe (AT) earthlink (DOT) <mailto:bbledsoe%40earthlink.net> net writes: Kids rarely die from V-fib and thus the cost of having duplicate pedi and adult AEDs is cost-prohibitive. A pedi AED might be justified in a pediatric ambulatory care clinic or a day care for special needs kids-otherwise it will never be used. An adult AED is just as effective and when the shock is administered to an otherwise health pediatric heart, the heart can most likely tolerate the increased energy levels. what I'd like to see would be a set up where there would be two sets of pads and one AED. apply the smaller set of pads (either for a pedi or a small/frail adult), and the machine would be smart enough to limit the max Joules applied... shouldn't be hard, but then again, with one of the major players going out of the market at least for awhile, who knows? ck S. Krin, DO FAAFP Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 30, 2007 Report Share Posted January 30, 2007 Again, Thank You. " Bledsoe, DO " wrote: The truth-as a writer. Most EMS students are left brain (visual) learners. That is why we put 0.5 graphics per page in EMS textbooks. EMS students have great difficulty with analytical information: drug dosage calculations, multiplication of fractions, simple algebra, charge states on molecules, ions, and such. The dumbing down of the EMS curricula has made it difficult to take the time and teach such things. If you put it in a book, some instructor will complain that your book is " too difficult " and the students want to know " just what I need to know for the test. " Thus, explaining stuff like Joules leaves 'em looking like a monkey doing a math problem. I don't mean to stereotype all EMS students-but the psychology and educational data says this is the case. Most of my conference talks almost always include some way of bringing basic science into the equation. With our next series of paramedic materials we will probably have a remedial module to teach the stuff you were supposed to learn in high school. I love basic science material and have several books under development that integrate these. But, EMS education is like a river-it follows the course of least resistance. BEB _____ From: texasems-l [mailto:texasems-l ] On Behalf Of Danny Sent: Tuesday, January 30, 2007 5:20 PM To: texasems-l Subject: RE: CPR Question I am not meaning to be argumentative ( or maybe I am) but how is it that we know electricity kills but yet we are quick to say that the energy delivered (en masse and directly to the nodes) is not a danger. Does that make sense? My point being are we again teaching our students the wrong information because we think they are incapable of handling the right information or do we really think that this will be of benefit to the patient in cardiac arrest? If there is no benefit then why waste our time and energy in the treatment? " Bledsoe, DO " <bbledsoe (AT) earthlink (DOT) <mailto:bbledsoe%40earthlink.net> net> wrote: Most are healthy hearts. They fibrillate because of toxins, carbon monoxide, electrical shock-things like that. Few have intrinsic heart disease per se. Those that have congenital anomalies will die from failure. BEB _____ From: texasems-l@yahoogro <mailto:texasems-l%40yahoogroups.com> ups.com [mailto:texasems-l@yahoogro <mailto:texasems-l%40yahoogroups.com> ups.com] On Behalf Of Danny Sent: Tuesday, January 30, 2007 3:53 PM To: texasems-l@yahoogro <mailto:texasems-l%40yahoogroups.com> ups.com Subject: RE: CPR Question So there is not a problem with damage to the nodes in a healthy pediatric heart. How many healthy pediatric patients go into V-Fib? " Bledsoe, DO " <bbledsoe (AT) earthlink (DOT) <mailto:bbledsoe%40earthlink.net> net> wrote: Kids rarely die from V-fib and thus the cost of having duplicate pedi and adult AEDs is cost-prohibitive. A pedi AED might be justified in a pediatric ambulatory care clinic or a day care for special needs kids-otherwise it will never be used. An adult AED is just as effective and when the shock is administered to an otherwise health pediatric heart, the heart can most likely tolerate the increased energy levels. _____ From: texasems-l@yahoogro <mailto:texasems-l%40yahoogroups.com> ups.com [mailto:texasems-l@yahoogro <mailto:texasems-l%40yahoogroups.com> ups.com] On Behalf Of Danny Sent: Tuesday, January 30, 2007 3:14 PM To: texasems-l Subject: CPR Question I have a question for the general learned and professional subscribers to the list. Who can explain the rationale behind the new CPR Guideline of using an adult AED on a pediatric patient? I understand it is a last resort but are we not burning the nodes when we give them too much energy? Am I missing something? Please help. Danny L. Owner/NREMT-P PETSAR INC. (Panhandle Emergency Training Services And Response) Office Fax Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 30, 2007 Report Share Posted January 30, 2007 Oh, all the things we won't ever have control over. Makes sense. " Bledsoe, DO " wrote: Depends on: 1. Biochemical state of the heart (pH, Ca2+, NA+, K+) 2. Pre-existing disease. 3. Genetics. 4. Luck 5. Faith _____ From: texasems-l [mailto:texasems-l ] On Behalf Of Danny Sent: Tuesday, January 30, 2007 5:24 PM To: texasems-l Subject: RE: CPR Question How much current does it take to cause damage to tissue and muscle? " Bledsoe, DO " <bbledsoe (AT) earthlink (DOT) <mailto:bbledsoe%40earthlink.net> net> wrote: 1 Joule = 1 watt delivered for 1 second (watt second) = the current of 1 amp passing through a resistor of 1 Ohm for 1 second. Thus, 10 amps passing over a resistance of 1 Ohm for 0.1 second is: 1 Joule Your question really does not make sense. _____ From: texasems-l@yahoogro <mailto:texasems-l%40yahoogroups.com> ups.com [mailto:texasems-l@yahoogro <mailto:texasems-l%40yahoogroups.com> ups.com] On Behalf Of Danny Sent: Tuesday, January 30, 2007 5:09 PM To: texasems-l@yahoogro <mailto:texasems-l%40yahoogroups.com> ups.com Subject: RE: CPR Question Okay so my next question would be what is a joule as compared to an amp? Bernie Stafford <staffdoc (AT) dot11net (DOT) <mailto:staffdoc%40dot11net.net> net> wrote: Most of the AED today have a set of pedi pads, however they just step the energy down with the pads. Zoll AED plus actually wrote a pediatric module for there AED. The research I have read and lectures I have attended have all said that the increased energy does not do as much damage to the heart as once suspected. Thus the reason for using an Adult AED on the pedi patient if no other option is available. Bernie Stafford EMTP AHA Instructor _____ From: texasems-l@yahoogro <mailto:texasems-l%40yahoogroups.com> ups.com [mailto:texasems-l@yahoogro <mailto:texasems-l%40yahoogroups.com> ups.com] On Behalf Of krin135 (AT) aol (DOT) <mailto:krin135%40aol.com> com Sent: Tuesday, January 30, 2007 3:45 PM To: texasems-l@yahoogro <mailto:texasems-l%40yahoogroups.com> ups.com Subject: Re: CPR Question In a message dated 1/30/2007 3:31:44 PM Central Standard Time, bbledsoe (AT) earthlink (DOT) <mailto:bbledsoe%40earthlink.net> net writes: Kids rarely die from V-fib and thus the cost of having duplicate pedi and adult AEDs is cost-prohibitive. A pedi AED might be justified in a pediatric ambulatory care clinic or a day care for special needs kids-otherwise it will never be used. An adult AED is just as effective and when the shock is administered to an otherwise health pediatric heart, the heart can most likely tolerate the increased energy levels. what I'd like to see would be a set up where there would be two sets of pads and one AED. apply the smaller set of pads (either for a pedi or a small/frail adult), and the machine would be smart enough to limit the max Joules applied... shouldn't be hard, but then again, with one of the major players going out of the market at least for awhile, who knows? ck S. Krin, DO FAAFP Quote Link to comment Share on other sites More sharing options...
Guest guest Posted January 30, 2007 Report Share Posted January 30, 2007 >>> Your question really does not make sense. Unlike your answer which was crystal clear...<G> jules _____ From: texasems-l [mailto:texasems-l ] On Behalf Of Danny Sent: Tuesday, January 30, 2007 5:09 PM To: texasems-l Subject: RE: CPR Question Okay so my next question would be what is a joule as compared to an amp? Bernie Stafford <staffdoc (AT) dot11net (DOT) <mailto:staffdoc%40dot11net.net> net> wrote: Most of the AED today have a set of pedi pads, however they just step the energy down with the pads. Zoll AED plus actually wrote a pediatric module for there AED. The research I have read and lectures I have attended have all said that the increased energy does not do as much damage to the heart as once suspected. Thus the reason for using an Adult AED on the pedi patient if no other option is available. Bernie Stafford EMTP AHA Instructor _____ From: texasems-l@yahoogro <mailto:texasems-l%40yahoogroups.com> ups.com [mailto:texasems-l@yahoogro <mailto:texasems-l%40yahoogroups.com> ups.com] On Behalf Of krin135 (AT) aol (DOT) <mailto:krin135%40aol.com> com Sent: Tuesday, January 30, 2007 3:45 PM To: texasems-l@yahoogro <mailto:texasems-l%40yahoogroups.com> ups.com Subject: Re: CPR Question In a message dated 1/30/2007 3:31:44 PM Central Standard Time, bbledsoe (AT) earthlink (DOT) <mailto:bbledsoe%40earthlink.net> net writes: Kids rarely die from V-fib and thus the cost of having duplicate pedi and adult AEDs is cost-prohibitive. A pedi AED might be justified in a pediatric ambulatory care clinic or a day care for special needs kids-otherwise it will never be used. An adult AED is just as effective and when the shock is administered to an otherwise health pediatric heart, the heart can most likely tolerate the increased energy levels. what I'd like to see would be a set up where there would be two sets of pads and one AED. apply the smaller set of pads (either for a pedi or a small/frail adult), and the machine would be smart enough to limit the max Joules applied... shouldn't be hard, but then again, with one of the major players going out of the market at least for awhile, who knows? ck S. Krin, DO FAAFP Quote Link to comment Share on other sites More sharing options...
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