Tuesday, July 28, 2015

More good information on the AED location buried in the usual crap.

From: J. Biggart
Sent: Tuesday, July 28, 2015 6:06 PM
To: Owners of Unit 812
Cc: David David Rasmussen; Laura Windpassinger ; Joel Fleischer
Subject: Fwd: AED in Exercise Room? Not the Best Practice--Just ask the experts

Look - you guys are not communicating in a manner with us like you do with others. You attack then cry foul whenever your answered in the very way you address people. Your continued insults and harassment of us seems to be ok, but when your responded to in kind you're being harassed. It is mind boggling to me. So, to help you further understand that significant thought went into this decision let me further clarify how little this had to do with Dave and I.

I not only used my 20 years of prehospital cardiac arrest experience, but researched other condo buildings, and discussed placement with a medical control physician and the community resource person at the Milwaukee Fire Department, in addition to being a paramedic, paramedic, CPR, PALS and ACLS instructor. If I'm 100% totally wrong I turn to you to educate me with some evidence that would dictate one placement is so much more superior than the other. I then think it's important that I share your evidence based statements with all of them so that we can not all be wrong when dealing with a life saving machine. 

We are being praised by outsiders and hung from the highest tree by a vocal minority with little or no prehospital experience in cardiac arrest scenarios. 

We thoroughly discussed putting it on two but the consensus decision after evaluating the evidence and recommendations deemed the cardio workout room as appropriate or more appropriate than the second floor.

When we have the resources we will likely buy a second AED to place in another strategic location. The one valid point that you have is that a FOB is needed to access the AED. We may consider the potential of relocating it in the board room for that reason. Nonetheless, the second floor is quite likely not going to be the location of the AED until and if a second AED is purchased.

At some point the two you you could find yourself much more meaningful if you write in a civil and non-attacking way. 

Laura doesn't make final decisions for this building without consultation with the RC and / or Board does. Address those two bodies like you address Laura and you will likely have much more success in your efforts to make a meaningful contribution to this community. 

We made an evidenced based decision knowing that there were a few locations of merit. The second floor was not excluded from the discussion. The second floor and the fitness room were the two locations being considered. I will consult with Dave and others to see if a different location near the fitness center is as good or better. Bottom line is that the AED will remain close to the fitness center and the rooms where people congregate which is also between two elevators and a stairwell. 

Don't loose tract of the fact that this is how the scenario is going to go for an unwitnessed or witnessed arrest in a unit with two people in it:

1. Person is deemed unresponsive which triggers the person to call 911

2. 911 is called, help is sent, and the dispatcher will keep you on the phone explaining pre-arrival instructions and walking you through CPR

3. Good quality CPR is key, without another person to call the front desk (provided someone is there to begin with) or to run and get the AED it's highly unlikely that the AED will play into this scenario prior to MFD arrival from 1st and Virginia.

4. Evidence supports that the most likely room in this building for sudden cardiac arrest is the fitness center, next would be rooms where parties are thrown due to the mix of people attending - many who are elderly throughout the year. 

5. People have muscle memory with respect to their brain. If any effort at all is placed into remembering this tool, you will remember its existence and location on one of the worst days of your life. That being said, I truly believe that the fire department will be here with an AED before you could access it unless there are at least 2 alive people in the unit. The chances of witnessed cardiac arrest by bystanders, where there is more than one person to call 911 and do pre-arrival CPR is most likely rooms where people congregate. 

6. At a minimum we will buy a placard for the fitness center door (or wherever this ends up should the location change) that lets people know there is an AED in the room. 

7. Many cardiac arrests are not able to be turned around by an AED, and if the person isn't found within 10 minutes of dying the AED is likely to make no difference in someone's quality of life unless amazing CPR is performed. If you choose to run down to the second floor for an AED and not perform chest compressions the person would be much less viable for defibrillation. 10% drop in success every minute CPR is not occurring. Additionally, in a non-witnessed arrest you are to do two minutes of CPR before delivering a shock. This is to move some blood through the heart and make it more viable to stop, then restart, after the shock (if they are even in a shockable rhythm). The majority of cardiac arrests outside the clinical setting are not witnessed, with the national average of resuscitation being 5-7% (and that doesn't speak to quality of life if you survive).

8. The fire department will not shock an unwitnessed arrest unless at least 2 minutes of quality CPR has been completed. The focus needs to be on listening to the dispatcher. 

The AED is placed in the location that we, and those we consulted with, believe will give someone the best chance at survival and is predicated on where the risk increases and the likelihood that it will even have the chance of being used.

Believe it or not, the decisions that we make are not made with to upset or agitate you, make you feel harassed, or without evidence supporting the decision. We can make no right move in your eyes and we've come to accept that while at the same time conducting business, competing projects that increase the quality of life, wellbeing and safety of the residents, fund long term infrastructure plans fairly and without surprise, stabilizing costs, investing in the longterm health of the POR community, facilities, and financial security, and holding people accountable to the Association when the violate rules in order to have a fair, equitable, and consistent way to keep the POR a luxury property in downtown Milwaukee amongst many other initiatives.

Since neither you or your wife have run for the POR RC in years, and since most of the leaders have run unopposed every term, you've got to, at some point, let those people work under the auspices that they have researched their decision and have used evidence to come up with the disposition. 

Countless hours have been spent on trying to work with you and keep you happy over the last 4 + years to no avail. Every team has been under fire from you regardless the person or the issue. From garage doors to river walk lights, rule enforcement to AEDs, and everything in between. 

You've got to let up Harvey or people are never going to volunteer here. From Chuck to John, Jerry to Dave, Lynn to Joel, you've mercilessly and brutally attacked them and threatened to ruin them, make the loose their house, demand their resignation, publicly ridiculed them, and even worried one about their safety in the building. 

I may correspond with you in the same disrespectful manner that you address me, but you've really behaved yourself into it and that's the playing field we are on now. You can't insult and harass people then threaten them with lawsuits when they respond in kind. 

The only thing I will ever ask of you is to lighten up on the people willing to volunteer around here. You always find a way to vilify each and every one of them. We will have no one to take these jobs and do this work if they have to deal with the harassment that you dole out to them. We need people to volunteer and not all of them can take folks like you as Dave and I can. Only for the work Dave and I are in are we likely able to deal with your insults, harassment, and threats while at the same time working hard for the vast majority of owners and residents happy with what's all been accomplished since Mandel left.

This website advises that fitness centers are a key location to place AEDs:

Fitness centers are always referenced as the top location for AED placement:

Fitness Centers:

Fitness Center:

Fitness Center:

Please excuse typos or grammar errors. It's tough to do this on an iPhone.

Jerry 



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