There have already been reports of snake bites in Sunbury and Mildura, as well as a number of snake captures in suburban Melbourne. So it is timely to review the first aid management of snake bite.

• Keep the victim still
• Do not wash the area
• Apply firm compression bandage to whole limb
• Apply splint to limb
• Call Ambulance
• Do not attempt to catch snake and do not take snake to hospital
• Don’t use tourniquets or try to suck the venom out

As with all things, the best first aid is prevention. So don’t go chasing, annoying, trying to capture or kill snakes – this how a lot of people end up getting bitten. Wear long pants and sturdy shoes when walking through long grass and under growth. This way if you are bitten the chances of actually being envenomated are reduced. Consider most rodents don’t wear leather or denim so the snakes fangs are not designed to penetrate them.

If there is any suspicion that a snake bite has occurred, then always err towards assuming it has occurred. The last two snake bites attended by this author both had doubters but were confirmed at hospital as having received a snake bite. The first was a young child in the middle of winter who admitted to annoying a snake but the adults weren’t convinced by his story, and the second was a 12 year old running through long grass in summer and feeling something hit his leg. The snake was never actually seen.

Don’t be fooled if you cannot find fang marks. Often snake bites can appear as a small graze rather than the classic puncture marks expected of 2 fangs. Don’t wash the area in case the hospital want to test for the type of venom. Do not take the snake to the hospital, even dead snakes tend to make the staff very nervous. Doctors and nurses in emergency departments are very good at what they do, but not so good at identifying snake species. In fact the identification of snake species can be very difficult, tiger snakes can appear black, black snakes can appear brown etc etc.

So the main points for snake bite are:

• keep victim still
• apply compression bandage to whole limb and splint
• call ambulance
• remember DRSABCD

From the 7th October to 17th October 2011 a team of 17 people will be taking on the challenge of completing the Kokoda Track in order to raise funds and awareness for Autism Spectrum Disorders (ASD).

Realising the importance of early defibrillation in the event of sudden cardiac arrest, the team approached Staying Alive Paramedical Services about the possibility of carrying an Automated Defibrillator (AED). The small size and lightweight of the Fred EasyPort made it the ideal solution. The Fred EasyPort has already proved itself as the ideal solution when it completed the Kokoda Track in July this year. As a result the team will be carrying the Fred EasyPort with them on the track.

ASD is a lifelong developmental disability that can impact an individual in every aspect of their life. Individuals with ASD may have difficulty communicating with and understanding other people. They may have difficulty relating to other people and they may have repetitive behaviours and a need for sameness. These differences make it extremely hard for people with ASD to properly understand other people and the world around them. The exact causes of ASD are unknown and to date there is no known cure. ASD affects 1 in every 160 individuals in Australia today. It is one of the fastest growing developmental disabilities of concern for the Australian population. Within your work place there will be someone affected by ASD. They may have a family member with ASD, a child or grandchildren with ASD, or have a friend who has a child with ASD.

In Victoria, the first port of call when an individual is diagnosed with ASD is Autism Victoria. It is therefore imperative that Autism Victoria has access to up-to-date and accurate resources to share with the ASD community.Autism Victoria is a member-based not for profit organisation and is the peak body for ASD in the state of Victoria with its aim being to improve the quality of life for people affected by ASD, their family and carers. Autism Victoria provide a range of services to individuals and agencies with an interest in ASD, including Asperger Syndrome. By raising awareness it is hoped autistic children get improved learning opportunities and adults become more accepted in the workforce by the broader community. Greater awareness and understanding will also help put political pressure on the government to push for more funding and better services in areas such as family counselling.

The Kokoda Trekkers are also raising funds for the 1000 Book Campaign (For more information click on the following link: http://www.autismvictoria.org.au/1000books) which aims to add 1000 resources to the Autism Victoria Library so that individuals, families and professionals can access valuable information and resources in a central location. Autism Victoria aims to have the largest Autism-specific library in the Southern Hemisphere, and the money raised by the Kokoda trekkers will help to reach this goal. If you would like to find out more about making a donation to help raise valuable funds for Autism Victoria please click on the following link: http://www.everydayhero.com.au/paul_sheridan  You will also receive a receipt for claiming as a tax deduction.

Please read “A family’s Personal Journey“

For more information on our ‘Autism Awareness’ campaign click on the following link: (then scroll down to meet the trekkers)

http://www.autismvictoria.org.au/fundraising/walking_kokoda.php

So the Fred EasyPort defibrillator has been added to the dirt, ditches and daredevils that make up Whittlesea Township Motorcycle Club events.

Safety is the highest priority for the club, which has 650 riders, holds regular family events, sometimes in remote locations in country Victoria.

“We are very safety conscious and always looking at ways to minimise risk to our members,” Club President Aarron Johnson said. “The defibrillator gives all of our members, and their families, peace of mind.”

Such a small device protecting so many people

Gary Robertson, Ambulance Victoria Mobile Intensive Care Paramedic and club member recommended the purchase as part of the club’s ongoing safety plan review.

“An immediate response to a cardiac arrest can be the difference between life and death,” Gary said. “I have treated many patients where early CPR and defibrillation is essential to increasing a person’s chance of survival. If defibrillated in the first minute following collapse the chances of survival are as high as 90 per cent but decreases rapidly every minute defibrillation is delayed.”

Health experts believe sudden cardiac arrest kills more than 33,000 Australians each year. It is critical to the club that a defibrillator is on hand when the club has major event days, which can attract up to 500 people.

Cardiac arrests cause the heart either to quiver – known as fibrillation – or stop beating altogether. The defibrillator works by delivering a controlled electric shock through the chest wall to the heart to restore a normal heartbeat rhythm after a cardiac arrest.

“Our members have been surprised at how easy the automatic defibrillator is to use,” Aaron said. “Every sporting club that holds regular events where crowds gather should have a defibrillator as part of their first aid kit.”

Topbike is a cycle tour company specialising in small group European Cycling Tours (Tour de France, Giro d’Italia, La Vuelta Espana as well as many lifestyle tours).  Cyclists are cared for on the road with all rides well planned and fully supported.

Topbike’s decision to purchase the Staying Alive AED in 2011 was just an extension of their commitment to care for their clients.

‘Every year we take mostly men in their 40s and 50s overseas to ride the famous climbs in Europe.  Statistically, the chance of cardiac incident amongst this group is quite high. The literature shows that, the application of an AED in that first 10 minutes following a cardiac incident can make the difference between life and death.

The purchase price is a small price to pay, when one day it might save the life of one of our clients, ourselves or our staff.’  Emma Colson – Topbike Tours.

‘I believe our company is setting what should one day be a mandatory standard for businesses such as ours.  In my opinion, an AED should just be a compulsory part of any sporting first aid kit.’

Staying Alive congratulates Topbike Tours for their forward thinking and setting the benchmark for their industry.

Jason Hunter holding the FRED EasyPort on the Kokoda Trail

When Intensive Care Flight Paramedic and Staying Alive instructor Jason Hunter informed us he was going to complete the Kokoda Track, it seemed obvious we should provide a suitable Automated External Defibrillator (AED) to accompany him – the FRED® EasyPort.

The Kokoda Track saw fierce battles during World War II between the Japanese and Australian forces from July 1942 until January 1943. This was arguably the most significant of battles for Australia, for if the Japanese had captured Port Moresby, it is conceivable the Australian mainland would have been threatened. Over 625 Australians were killed and over 1000 were wounded during this campaign.

Over the past decade the Kokoda Track has become a pilgrimage for Australians of all ages. However, this is no easy stroll. The “Track” is 96km in length, and its elevation ranges from 300m to 2190m above sea level. Located in tropical jungle, the days tend to be hot and humid, and the nights can be bitterly cold.

As the number of Australians taking on this pilgrimage has increased, so has the number of deaths from Sudden Cardiac Arrest. In the past decade there have been 6 reported deaths whilst completing the Kokoda Track, with 4 in 2009. Sadly these deaths illustrate that Sudden Cardiac Arrest can strike anyone, at any age, of any fitness, at any time. The deaths include a 26 year old male, a 36 year old female and a 38 year old male.

FRED EasyPort, the world's smallest AED on the Kokoda Track

When Sudden Cardiac Arrest occurs, early CPR and defibrillation is critical. For every minute that defibrillation is delayed, there is a 7-10% reduction in the chances of survival. However most AEDs would be too large or heavy to to be considered a viable option to carry along this difficult and challenging terrain.

The FRED EasyPort is the perfect AED for this type of challenge. At a mere 490g including batteries, and 133 X 126 X 35mm it easily fitted into Jason’s pack at a time when weight and space were of the essence. It should be noted that unlike many trekkers, Jason did not use porters but rather carried his pack the entire length of the track himself.

For more information on AED programs and First Aid Training provided by Staying Alive please submit an enquiry.

The Diamond Valley Leader reports David had been feeling unwell and when he failed to respond to someone, Sharon recognised he was in cardiac arrest. Noting he was not breathing normally, was not responding or moving, she immediately commenced CPR.

Realising that early defibrillation was a key link in the chain of survival, Sharon arranged for a trainer to fetch the Automatic External Defibrillator (AED) from the neighboring Reservoir Leisure Centre. Mr Priest was shocked 3 times before Paramedics arrived.

Intensive Care Paramedic (MICA) Bradly Roberts states that without the early CPR and defibrillation that Mr Priest probably would not have survived.

Sharon and her fellow rescuers all received Ambulance Victoria Bystander Commendations last month.

Sharon and her fellow rescuers have clearly demonstrated how effective the Chain of Survival can be when used correctly.

Following instances such as this, Staying Alive offers all its individual and corporate clients a free clinical debriefing session.

According to the WTOP, a Hotel Executive suffered a sudden cardiac arrest in a gym in Washington. The gym had an Automated External Defibrillator (AED) but when rescuers attempted to use it they found that the batteries were dead and removed from the unit.

Despite the efforts of the victims friend and rescuers who performed CPR immediately, the victim died.

An autopsy revealed his death was caused by hypertension and atherosclerotic disease — a condition that blocks blood flow in the arteries, a spokesperson with D.C.’s Office of the Chief Medical Examiner tells WTOP. The manner of his death was natural.

Chances of Survival from Cardiac Arrest Vs Time to Defibrillation

It is unclear whether a working AED would have prevented his death. What is clear is that he did not receive the best chance of surviving due to the absence of a functioning AED. For every minute that passes before defibrillation, there is a 7-10% reduction in the chance of survival from sudden cardiac arrest.

The victims friend rightly points out that defibrillators are useless if not properly maintained.

“It is critical the batteries and pads are checked on a regular basis… your pads may be one or two years old and possibly even expired. It’s likely you never checked for an expiration date and that means those pads, once they get brittle and hard or deteriorate, may not work.”

The number of articles relating to AED failures is alarming. The majority of the time they are due to a lack of monitoring and maintenance by the owners.

Staying Alive prefers to sell AED programs rather than individual devices that include:

• an appropriate AED for your requirements
• Monitoring / maintenance
• Training
• Signage to ensure AEDs are highly visible.
• Clinical debrief in then event your AED is deployed

The FRED EasyOnline can be monitored by a central server ensuring it is monitored at all times; including battery levels, self check results, deployment, and event data download.

As a result of that incident the Werribee Districts Football Club has invested in 2 Automated External Defibrillators (AED), one for each ground. Club President Mr Rod Harrington indicated that if the club didn’t act and purchase the defibrillators, then the club would have learnt nothing from the incident.

The club elected to purchase 2 FRED® Easy Online AEDs from Staying Alive Paramedical Services. Staying Alive specialises in AED programs, not just devices. The AED programs include:

• Site Assessment to advise requirement, type and appropriate location for AED
• Online monitoring to ensure the AED will always function when needed
• Accredited or Non-accredited training in Automated External Defibrillation
• Signage, pads, spare batteries, shears, CPR mask – all the items required to ensure the AED is ready when needed.

The rates of survival from Sudden Cardiac Arrest are as low as 6% in areas with no AED, and as high as 85% in areas with an available AED. As a result of their investment in AEDs, the Werribee Districts Football Club will be well armed should another person suffer a Sudden Cardiac Arrest at either of their grounds.

See the relevant media coverage at:

Football Umpire Collapses at Werribee Match

Werribee Footy Dads Lifesavers

A Heart Felt Response in Werribee

In an effort to see this in action, representatives from SCHILLER Australia and Staying Alive Paramedical Services will travel to Silvan on March 22, to present Silvan Football Club with a much needed FRED Easy AED Online and provide the club with up to date first aid training.

“An immediate response to a cardiac arrest can be the difference between life and death.” notes SCHILLER Australia Managing Director, Harry Packer “CPR and defibrillation early triples a person’s chance of surviving.”
Sadly, 22 year old Vincent Bonanno was not given such a chance when he collapsed following a cardiac arrest during footy training at Silvan’s football ground, East of Melbourne over the weekend.

This need for immediate action action is why SCHILLER Australia and Staying Alive Paramedical Services have committed to donating their time and equipment to Silvan Football Club to ensure that if such an event occurs again the club and it’s players will be prepared and able to give their teammates the best chance of survival.

Tragically, sudden cardiac arrest among the young and fit are not uncommon during sporting events. A family in America also lost their 17 year old son whilst playing rugby near Denver in similar circumstances on the same weekend.

Staying Alive Manager and Intensive Care Paramedic, Craig Hazelwood reports that the chances of survival from sudden cardiac arrest decrease by approximately 10% for every minute that passes before defibrillation hence bystanders must take immediate action.
“The issue is that it is the first few minutes that are the key to surviving sudden cardiac arrest, before medical help arrives,” says Mr Packer.

Early defibrillation has been demonstrated to be the most effective method of saving a person’s life. New technology has made Automated External Defibrillator’s (AED’s) such as the one donated to Silvan Football Club simple and user-friendly. Clear audio and visual cues tell users what to do when using an AED and coach people through CPR. A shock is delivered only if the victim needs it.

If the Silvan football club had access to a defibrillator that can automatically deliver a precise electric shock to the heart to try to restore a normal heart rhythm, SCHILLER Australia and Staying Alive Paramedical Services believe Vincent’s chances of survival may have increased.

SCHILLER Australia and Staying Alive Paramedical Services would like to to offer their sincere condolences to the Bonanno family as well as members of Silvan Football club during this difficult time.

The Australian Resuscitation Council (ARC) has now published its revised resuscitation guidelines for Basic Life Support.  These changes reflect the most recent scientific evidence which was evaluated and recently published by the Australian Resuscitation Council.

The guidelines continue to emphasise the importance of commencing resuscitation and providing good quality CPR.  Resuscitation should be commenced where the person is unresponsive and not breathing normally. It is now recommended that at the commencement of resuscitation 30 chest compressions are provided before giving the initial rescue breaths. The compression / rescue breaths ratio remains at 30 compressions to 2 rescue breaths.

Key Points:

• Increase emphasis on bystander CPR as life saving intervention.
• Compression: Rescue breathing ratio remains at 30:2
• Steps in resuscitation are now DRS ABCD

-  Check for Danger

-  Check for Response

-  ‘S’ has been added for Send for help

-  ‘A’ directs rescuers to open the Airway

-  ‘B’ directs rescuers to check Breathing but no need to deliver rescue breaths

-  ‘C’ directs rescuers to perform 30 Compressions to patients who are unresponsive and not breathing normally, followed by 2 rescue breaths

-  ‘D’ directs rescuers to attach an AED as soon as it is available and follow prompts

• The major change is that in the patient who is unresponsive and not breathing normally, CPR commences with chest compressions rather than rescue breaths.
• If unwilling / unable to perform rescue breathing, then perform compression only CPR, as any attempt at resuscitation is better than no attempt and should be encouraged.