Essential Oils As Alternative Remedies

As a medical doctor/registered nurse practitioner team, we received conventional medical training at university hospitals while getting our degrees. Since that time, however, we have explored various alternative methods of healing; this is not to replace our education, but as a supplement and as an additional tool in the medical woodshed. Nature may, one day, be our pharmacy. The knowledge of herbal remedies had been passed down generation after generation. In a situation where regular medications are no longer produced, it is imperative to learn the medicinal benefits of plants that you can grow in your own garden. One class of alternative remedies that are commonly used is Essential Oils. These substances are called “essential” because they capture the “essence” of the plant. 

Unlike cooking oils, such as olive or corn, these oils are less fixed and more volatile. That means that they tend to evaporate easily, unlike the “fixed” oils, which don’t evaporate even in high temperatures. As such, essential oils are popular in aromatherapy. Essential oils are distilled from whole plant material, not a single ingredient; therefore, every oil has multiple uses. Although you might not realize it, you’ve been using essential oils all your life. You’ve no doubt used them in soaps, furniture polishes, perfumes and ointments. Previous generations of conventional physicians commonly included them in their medical bags. Indeed, many standard medical texts of the past were, essentially, treatises on how to use these products.

Although it only takes a few leaves of peppermint to make a tea, it takes 5 pounds of leaves to make 1 ounce of essential oil. One source states that it takes an entire acre of peppermint to produce just 12 pounds. The same source says that 12,000 rose blossoms are required to produce a tablespoon of rose oil! These concentrated versions are the ones you see marketed in small, dark bottles. As such, they should be used sparingly. A reference book or two about essential oils would be a great addition to your medical library; see the medical reference section in the back of this book. You might be surprised to learn that the Food and Drug Administration only requires 10% essential oil in the bottle to be considered “Pure Essential Oil”. Beware of claims of FDA certification; the FDA has no certification or approval process for these products. 

Essential oils are produced by plants to serve as either an attractant to pollinator insects (hence their strong fragrance) or as a repellant against invading organisms, from bacteria to animal predators. These substances usually contain multiple chemical compounds, making each plant’s essential oil unique. Oils may be produced by leaves, bark, flowers, resin, fruit or roots. For example, Lemon oil comes from the peel, Lavender oil from flowers, and Cinnamon oil from bark. Some plants are sources of more than one essential oil, dependent on the part processed. Some plant materials produce a great deal of oil; others produce very little. The strength or quality of the oil is dependent on multiple factors, including soil conditions, time of year, sub-species of plant, and even the time of day the plant is harvested.

The manufacture of essential oils, known as “extraction”, can be achieved by various methods:

1. Distillation Method: Using a “still” like old-time moonshiners, water is boiled through an amount of plant material to produce a steam that travels through cooled coils. This steam condenses into a “mixture” of oil and water (which doesn’t really mix) from which the oil can be extracted.
2. Pressing Method: The oils of citrus fruit can be isolated by a technique which involves putting the peels through a “press”. This works best only with the oiliest of plant materials, such as orange skins. Maceration Method: a fixed oil (sometimes called a “carrier” oil) or lard may be combined with the plant part and exposed to the sun over time, causing the fixed oil to become infused with the plant “essence”. Oftentimes, a heat source is used to move the process along. The plant material may be added several times during the process to manufacture a stronger oil. This is the method by which you obtain products such as “garlic-infused olive oil”. A similar process using flowers is referred to as “Enfleurage”.
3. Solvent Method: Alcohol and other solvents may be used on some plant parts, usually flowers, to release the essential oil in a multistep process.

As each essential oil has different chemical compounds in it, it stands to reason that the medicinal benefits of each are also different. As such, an entire alternative medical discipline has developed to find the appropriate oil for the condition that needs treatment. The method of administration may differ, as well. Common methods are:

Inhalation Therapy: This method is also known as “aromatherapy”. Add a few drops of the essential oil in a bowl of steaming water (distilled or sterilized), and inhale. This method is most effective when placing a towel over your head to catch the vapors. Many people will place essential oils in potpourri or use a “diffuser” to spread the aroma throughout the room; this technique probably dilutes any medicinal effects, however.

Topical Application: The skin is an amazing absorbent surface, and using essential oils by direct application is a popular method of administration. The oil may be used as part of a massage, or directly placed on the skin to achieve a therapeutic effect on a rash or muscle. Before considering using an essential oil in this manner, always test for allergic reactions beforehand. Even though the chemical compounds in the oil are natural, that doesn’t mean that they couldn’t have an adverse effect on you (case in point: poison ivy). A simple test involves placing a couple of drops on the inside of your forearm with a cotton applicator. Within 12-24 hours, you’ll notice a rash developing if you’re allergic. Mixing some of the essential oil with a fixed or “carrier” oil such as olive oil before use is a safer option for topical use. Another concern, mostly with topically-applied citrus oils, is “phototoxicity” (an exaggerated burn response to sun exposure). I have some reservations about whether applying an essential oil on the skin over a deep organ, such as the pancreas, will really have any specific effect on that organ. It is much more likely to work, however, on the skin itself or underlying muscle tissue.

Ingestion: Direct ingestion is unwise for many essential oils, and this method should be used with caution. Most internal uses of an essential oil should be of a very small amount diluted in at least a tablespoon of a fixed oil such as olive oil. Professional guidance is imperative when considering this method. You can always consider a tea made with the herb as an alternative. This is a safer mode of internal use, although the effect may not be as strong.

Essential oils have been used as medical treatment for a very long time, but it’s difficult to provide definitive evidence of their effectiveness for several reasons. Essential oils are difficult to standardize, due to variance in the quality of the product based on soil conditions, time of year, and other factors that we mentioned above. An essential oil of Eucalyptus, for example, may be obtained from Eucalyptus Globulus or Eucalyptus Radiata and have differing properties as a result. These factors combine to make scientific study problematic.

In most university experiments, a major effort is made to be certain that the substance tested caused the results obtained. As essential oils have a number of different chemicals and are often marketed as blends, which ingredient was the cause of the effect? If the oil is applied with massage, was the effect related to the oil itself or the therapeutic benefit of the physical therapy?

The majority of studies on essential oils have been conducted by the cosmetics and food industries; some have been conducted by individuals or small companies. Standard studies for medicinal benefit are usually performed by the pharmaceutical industry, but they generally have little interest in herbal products. This is because they have few options in patenting these products.

Therefore, serious funding is hard to find because of the limited profit potential. Despite this, essential oils have various reported beneficial effects, mainly based on their historical use on many thousands of patients by alternative healers. Although there are many essential oils, a number of them are considered mainstays of any herbal medicine cabinet. Here are just some:

·   Lavender Oil

An analgesic (pain reliever), antiseptic, and immune stimulant. It is thought to be good for skin care and to promote healing, especially in burns, bruises, scrapes, acne, rashes and bug bites. Lavender has a calming effect, and is used for insomnia, stress and depression. It has been reported effective as a decongestant through steam inhalation. Lavender oil may have use as an antifungal agent, and may be used for Athlete’s foot or other related conditions.

Eucalyptus Oil

An antiseptic, antiviral, and decongestant (also an excellent insect repellent), Eucalyptus oil has a “cooling” effect on skin. It also aids with respiratory issues and is thought to boost the immune system. Consider its use for flus, colds, sore throats, coughs, sinusitis, bronchitis, and hay fever. When exposure is expected, it has been reported to have a preventative effect. Eucalyptus may be used in massages, steam inhalation, and as a bath additive. Although eucalyptus oil has been used in cough medicine, it is likely greatly diluted and should not be otherwise ingested in pure form.

Melaleuca (Tea Tree) Oil

Diluted in a carrier oil such as coconut, Tea Tree oil may be good for athlete’s foot, acne, skin wounds, and even insect bites. In the garden, Tea Tree oil is a reasonable organic method of pest control. In inhalation therapy, it is reported to help relieve respiratory congestion. Studies have been performed which find it effective against both Staphylococcus and fungal infections. Some even recommend a few drops in a pint of water for use as a vaginal douche to treat yeast. Tea Tree oil may be toxic if used in high concentrations, around sensitive areas like the eyes, or ingested.

Peppermint Oil

This oil is said to have various therapeutic effects: antiseptic, antibacterial, decongestant, and anti-emetic (stops vomiting). Peppermint oil is applied directly to the abdomen when used for digestive disorders such as irritable bowel syndrome, heartburn, and abdominal cramping. Some herbalists prescribe Peppermint for headache; massage a drop or two to the temples as needed. For sudden abdominal conditions, achy muscles or painful joints, massage the diluted oil externally onto the affected area. As mentioned previously, definitive proof of topical application effects on deep organs is difficult to find.

Lemon Oil

Used for many years as a surface disinfectant, it is often found in furniture cleaners. Many seem to think that this disinfecting action makes it good for sterilizing water, but there is no evidence that it is as effective as any of the standard methods of doing so, such as boiling. Lemon oil is thought to have a calming effect; some businesses claim to have better results from their employees when they use it as aromatherapy. Don’t apply this oil on the skin if you will be exposed to the sun that day, due to increased likelihood of burns.

Clove Oil

Although thought to have multiple uses as an antifungal, antiseptic, antiviral, analgesic, and sedative, Clove oil particularly shines as an anesthetic and antimicrobial. It is marketed as “Eugenol” to dentists throughout the world as a natural pain killer for toothaches. A toothpaste can be made by combining clove oil and baking soda; when mixed with zinc oxide powder, it makes an excellent temporary cement for lost fillings and loose crowns. Use Clove oil with caution, as it may have an irritant effect on the gums if too much is applied.

Arnica Oil

Arnica oil is used as a topical agent for muscle injuries and aches. Thought to be analgesic and anti-inflammatory, it is found in a number of sports ointments. As a personal aside, I have tested this oil on myself, and found it to be effective though not very long lasting. Frequent application would be needed for long term relief. Although some essential oils are excellent as aromatherapy, Arnica oil is toxic if inhaled.

Chamomile Oil

There are at least two versions of Chamomile oil, Roman and German. Roman Chamomile is a watery oil, while German Chamomile seems more viscous. Both are used to treat skin conditions such as eczema as well as irritations due to allergies. Chamomile oil is thought to decrease gastrointestinal inflammation and irritation, and is thought have a calming effect as aromatherapy, especially in children.

Geranium Oil

Although variable in its effects based on the species of plant used, Geranium oil is reported to inhibit the production of sebum in the skin, and may be helpful in controlling acne. Some believe that it also may have hemostatic (blood-clotting) properties, and is often recommended for bleeding from small cuts and bruising. When a small amount of oil is diluted in shampoo, it may be considered a treatment for head lice.

Helichrysum Oil

Thought to be a strong analgesic and anti-inflammatory, Helichrysum is used to treat arthritis, tendonitis, carpal tunnel syndrome, and fibromyalgia as part of massage therapy. It has also been offered as a treatment for chronic skin irritation.

Rosemary Oil

Represented as having multiple uses as an antibacterial, antifungal, and anti-parasitic, Rosemary oil is proven to control spider mites in gardens. Use a few drops with water for a disinfectant mouthwash. Inhalation, either cold or steamed, may relieve congested or constricted respiration. Mixed with a carrier oil, it is used to treat tension headaches and muscle aches.

Clary Sage Oil

One of the various chemical constituents of Clary Sage has a composition similar to estrogen, and has been used to treat menstrual irregularities, premenstrual syndrome, and other hormonal issues. It is also believed to have a mild anticoagulant effect, and may have some use as a blood thinner. Clary Sage also is thought to have some sedative effect, and has been used as a calming agent.

Neem Oil

With over 150 chemical ingredients, the Neem tree is referred as “the village pharmacy” in its native India. The majority of Ayurvedic alternative remedies have some form of Neem oil in them. Proven as a natural organic pesticide, we personally use Neem Oil in our vegetable garden. Reported medicinal benefits are too numerous to list here and seem to cover just about every organ system. It should be noted, however, that it may be toxic when the oil is taken internally.

Wintergreen Oil

A source of natural salicylates, Wintergreen oil is a proven anticoagulant and analgesic. About 1 fluid ounce of Wintergreen Oil is the equivalent of 171 aspirin tablets if ingested, so use very small amounts. It may also have beneficial effects on intestinal spasms and might reduce elevated blood pressures.

Frankincense Oil

One of the earliest documented essential oils, evidence of its use goes back 5000 years to ancient Egypt. Catholics will recognize it as the incense used during religious ceremonies. Studies from Johns Hopkins and Hebrew Universities state that Frankincense relieves anxiety and depression in mice. Direct application of the oil may have antibacterial and antifungal properties, and is thought to be helpful for wound healing. As a cold or steam inhalant, it is sometimes used for lung and nasal congestion.

Blue Tansy Oil

Helpful as a companion plant for organic pest control, Blue Tansy is sometimes planted along with potatoes and other vegetables. The oil has been used for years to treat intestinal worms and other parasites. One of its constituents, Camphor, is used in medicinal chest rubs and ointments. In the past, it has been used in certain dental procedures as an antibacterial.

Oregano Oil

An antiseptic, oregano oil has been used in the past as an antibacterial agent. It should be noted that Oregano oil is derived from a different species of the plant than the Oregano used in cooking. One of the minority of essential oils that are safe to ingest, it is thought to be helpful in calming stomach upset, and may help relieve sore throats. Its antibacterial action leads some to use the oil in topical applications on skin infections when diluted with a carrier oil. Oregano Oil may reduce the body’s ability to absorb iron, so consider an iron supplement if you use this regularly.

Thyme Oil

Reported to have significant antimicrobial action, diluted Thyme oil is used to cure skin infections, and may be helpful for ringworm and athlete’s foot. Thyme is sometimes used to reduce intestinal cramps in massage therapy. As inhalation therapy, it may loosen congestion from upper respiratory infections.

“Thieves’ Oil”

Many essential oils are marketed as blends, such as “Thieves’ Oil”. This is a combination of clove, lemon, cinnamon bark, eucalyptus and rosemary essential oils. Touted to treat a broad variety of ailments, studies at Weber State University indicate a good success rate in killing airborne viruses and bacteria. Of course, the more elements in the mixture, the higher chance for adverse reactions, such as phototoxicity.

Some important caveats to the above list should be stated here. Most of the essential oils listed are unsafe to use in pregnancy, and may even cause miscarriage. Also, allergic reactions to essential oils, especially on the skin, are not uncommon; use the allergy test I described earlier before starting regular topical applications.

Even though essential oils are natural substances, they may interact with medicines that you may regularly take or have adverse effects on chronic illness such as liver disease, epilepsy or high blood pressure. Thorough research is required to determine whether a particular essential oil is safe for you.

Having said that, essential oils are a viable option for many conditions. Anyone interested in maintaining their family’s well-being should regard them as just another weapon in the medical arsenal. Learn about them with an open mind, but maintain a healthy skepticism about “cure-all” claims.

Dieters’ best intentions hijacked by their brains

Not apples or carrots. The scientist who once led the government's attack on addictive cigarettes can't wander through part of San Francisco without craving a local shop's chocolate-covered pretzels. Stop at one cookie? Rarely.

It's not an addiction but it's similar, and he's far from alone. Kessler's research suggests millions share what he calls "conditioned hypereating" — a willpower-sapping drive to eat high-fat, high-sugar foods even when they're not hungry.

In a book being published next week, the former Food and Drug Administration chief brings to consumers the disturbing conclusion of numerous brain studies: Some people really do have a harder time resisting bad foods. It's a new way of looking at the obesity epidemic that could help spur fledgling movements to reveal calories on restaurant menus or rein in portion sizes.

"The food industry has figured out what works. They know what drives people to keep on eating," Kessler tells The Associated Press. "It's the next great public health campaign, of changing how we view food, and the food industry has to be part of it."

He calls the culprits foods "layered and loaded" with combinations of fat, sugar and salt — and often so processed that you don't even have to chew much.

Overeaters must take responsibility, too, and basically retrain their brains to resist the lure, he cautions.

"I have suits in every size," Kessler writes in "The End of Overeating." But, "once you know what's driving your behavior, you can put steps into place" to change it.

Jonesing for junk food

At issue is how the brain becomes primed by different stimuli. Neuroscientists increasingly report that fat-and-sugar combinations in particular light up the brain's dopamine pathway — its pleasure-sensing spot — the same pathway that conditions people to alcohol or drugs.

Where did you experience the yum factor? That's the cue, sparking the brain to say, "I want that again!" as you drive by a restaurant or plop before the TV.

"You're not even aware you've learned this," says Dr. Nora Volkow, chief of the National Institute on Drug Abuse and a dopamine authority who has long studied similarities between drug addiction and obesity.

Volkow is a confessed chocoholic who salivates just walking past her laboratory's vending machine. "You have to fight it and fight it," she said.

Conditioning isn't always to blame. Numerous factors, including physical activity, metabolism and hormones, play a role in obesity.

And the food industry points out that increasingly stores and restaurants are giving consumers healthier choices, from allowing substitutions of fruit for french fries to selling packaged foods with less fat and salt.

Why is it so hard to say no?

But Kessler, now at the University of California, San Francisco, gathered colleagues to help build on that science and learn why some people have such a hard time choosing healthier:

First, the team found that even well-fed rats will work increasingly hard for sips of a vanilla milkshake with the right fat-sugar combo but that adding sugar steadily increases consumption. Many low-fat foods substitute sugar for the removed fat, doing nothing to help dieters eat less, Kessler and University of Washington researchers concluded.

Then Kessler culled data from a major study on food habits and health. Conditioned hypereaters reported feeling loss of control over food, a lack of satiety, and were preoccupied by food. Some 42 percent of them were obese compared to 18 percent without those behaviors, says Kessler, who estimates that up to 70 million people have some degree of conditioned hypereating.
Finally, Yale University neuroscientist Dana Small had hypereaters smell chocolate and taste a chocolate milkshake inside a brain-scanning MRI machine. Rather than getting used to the aroma, as is normal, hypereaters found the smell more tantalizing with time. And drinking the milkshake didn't satisfy. The reward-anticipating region of their brains stayed switched on, so that another brain area couldn't say, "Enough!"

7 Ways to Beat Stress and Fight Fat

Introduction
For most of us, stress is a fact of life. Unfortunately, recent research reveals that it's also a fact of fat. "Even if you usually eat healthfully and exercise, chronic high stress can prevent you from losing weight — or even add pounds," says Pamela Peeke, MD, MPH, a Prevention adviser and the author of "Body for Life for Women."

Here's what happens: Your body responds to all stress — physical or psychological — in exactly the same way. So every time you have a stressful day, your brain acts as though you're in physical danger and instructs your cells to release potent hormones. You get a burst of adrenaline, which taps stored energy so you can fight or flee. At the same time, you get a surge of cortisol, which tells your body to replenish that energy even though you haven't used very many calories in your stressed-out state. This can make you hungry ... very hungry. And your body keeps on pumping out that cortisol as long as the stress continues.

Sadly, few of us reach for carrot sticks in these situations. "Instead, we crave sweet, salty, and high-fat foods because they stimulate the brain to release pleasure chemicals that actually do reduce tension," explains Elissa Epel, PhD, a researcher on stress eating at the University of California, San Francisco. This soothing effect becomes addicting, so every time you're anxious, you reach for fattening foods.

In addition, with your adrenal glands pumping out cortisol, production of the muscle-building hormone testosterone slows down. "Over time, this drop causes a decrease in your muscle mass, so you burn fewer calories," explains Shawn Talbott, PhD, author of "The Cortisol Connection." "This occurs naturally as you age, but high cortisol levels accelerate the process."

Cortisol also encourages your body to store fat — especially visceral fat, which is particularly dangerous because it surrounds vital organs and releases fatty acids into your blood, raising cholesterol and insulin levels and paving the way for heart disease and diabetes.

Obviously, getting rid of all anxiety isn't an option. But by taking these seven steps to beat stress, you can get your cortisol levels and your weight under control, and improve your overall health at the same time.

Drop and do 10
That's right, power out some push-ups. "Moving your muscles is an effective, instant stress reliever. It actually fools your body into thinking you're escaping the source of your stress," says Talbott. "Exercise makes your blood circulate more quickly, transporting the cortisol to your kidneys and flushing it out of your system." But if push-ups aren't practical, just flexing your hands or calf muscles will help move cortisol along, he says. Even taking a stroll on your lunch break is beneficial. In one study, Talbott found that 18 minutes of walking 3 times per week can quickly lower the hormone's levels by 15 percent.

Go slowly at meals
Under stress, we tend to scarf down even healthy food, and research has linked this behavior to bigger portions and more belly fat. But Epel hypothesizes that slowing down, savoring each bite, and paying attention to feelings of fullness may lower cortisol levels along with decreasing the amount of food you eat, thereby shifting the distribution of fat away from the belly.
Stop strict dieting

It's ironic, but research shows that constant dieting can make cortisol levels rise as much as 18 percent.

In addition, when your cortisol levels spike, your blood sugar goes haywire, first rising, then plummeting. This makes you cranky and (you guessed it) ravenous. When your brain is deprived of sugar — its main fuel — self-control takes a nosedive, and your willpower doesn't stand a chance. "The only way around this is to stop rigid dieting," advises Peeke. She suggests eating three healthful meals and two snacks spaced evenly throughout the day so that your blood sugar stays level: "You won't be hungry, you won't be stressed about being hungry, and you'll still drop the extra pounds."
Give in to cravings

When stress drives you toward something sweet or salty, it's okay to yield a little. "It's much better to indulge in a small way and cut off your cortisol response before it gets out of control," says Epel. "Have a piece of chocolate. You will feel better. Just stop at one." If you have trouble restraining yourself, take precautions so you won't binge. Buy a single cookie when you're out instead of keeping a box at home; or keep them in the freezer so you have to wait for one to defrost.

Curtail caffeine
Next time you're under duress, choose decaf.

When you combine stress with caffeine, it raises cortisol levels more than stress alone. In one study by the University of Oklahoma, consuming the equivalent of 2 1/2 to 3 cups of coffee while under mild stress boosted cortisol by about 25 percent — and kept it up for 3 hours. When subjects took 600 mg of caffeine (the equivalent of 6 cups of java) throughout the day, the hormone went up by 30% and stayed high all day long. You'll experience these effects even if your body is accustomed to a lot of lattes. And because high cortisol levels can contribute to stress eating, you might want to consider quitting caffeine altogether

De-stress breakfast
Deficiencies in B vitamins, vitamin C, calcium, and magnesium are stressful to your body, leading to increased cortisol levels and food cravings, says Talbott. But you can fight back by eating a breakfast that's high in these nutrients. He suggests some OJ, a grapefruit, or a large handful of strawberries to supply vitamin C; 6 to 8 ounces of low-fat yogurt, which contains calcium and magnesium; and a whole grain bagel or toast with peanut butter. Whole grains are bursting with B vitamins, while peanut butter contains fatty acids that can decrease the production of stress hormones.

Sleep it off
The most effective stress-reduction strategy of all: Get enough shut-eye. "Your body perceives sleep deprivation as a major stressor," says Talbott. A University of Chicago study found that getting an average of six 1/2 hours each night can increase cortisol, appetite, and weight gain. The National Sleep Foundation recommends seven to nine hours. As if that weren't enough, other research shows that lack of sleep also raises levels of ghrelin, a hunger-boosting hormone. In one study, appetite — particularly for sweet and salty foods — increased by 23 percent in people who lacked sleep. The good news: A few nights of solid sleep can bring all this back into balance, and getting enough regularly helps keep it there. Says Talbott, "You'll eat less, and you'll feel better, too."

What is DIET

Diet, in relation to food, might mean:

• Diet (nutrition), the sum of the food consumed by an organism or group.
• Dieting, the deliberate selection of food to control body weight or nutrient intake.
• Diet food, foods that aid in dieting
• Cuisine, the diet of a particular culture

Diet may also mean:

• Diet (assembly), formal deliberative assembly.
• The Imperial Diet: (German: Reichstag) the imperial assembly of the princes of the Holy Roman Empire until 1806.
• The Diet of the Empire: (German: Reichstag) legislative assembly of the German Empire 1871–1917.
• The Federal Diet: (literally for German: Deutscher Bundestag) federal parliament of Germany.
• State Diet: (literally for German: Landtag) state parliament of most of the German federated states.
• Diet of Finland: the legislative assembly of the Grand Duchy of Finland from 1809 to 1906.
• Diet of Japan: Japan's legislature.
• Diet (Aqua Teen Hunger Force episode): an episode of the animated series Aqua Teen Hunger Force.
• Dietsch: distinguishes the southern dialects in the Middle Dutch language.

AED - Automated External Defibrillator

An automated external defibrillator (AED) is used in cases of life threatening cardiac arrhythmias (an abnormal electrical signal in the heart) which lead to cardiac arrest. Symptoms of cardiac arrest are chest pain or loss of consciousness. The AED restores the heart's normal electrical signal, if the heart is not defibrillated in 3 minutes or less death or serious incapacitation will occur.

During sudden cardiac arrest, your brain and other vital organs are being starved of blood and oxygen which carries live saving nutrients. You can die in minutes and/or survive but sustain permanent damage to your brain and other organs. The heart's rhythm must be restored fast since every minute that passes is critical to your chance of survival and the amount of damage you sustain.

When the electrodes or pads of automated external defibrillator capable of automatic operation are attached to your chest, these electrodes can detect the heart's rhythm during cardiac arrest and automatically delivers an electric shock to get your heart beating again.

Sudden cardiac arrest happens when your heart's electrical activity is disrupted and the heartbeat gets dangerously fast (ventricular tachycardia) or chaotic (ventricular fibrillation). Your heart stops beating effectively and does not adequately pump blood because of these irregular heart rhythms (arrhythmia).

A non trained bystander that acts quickly and calls 911 to summon emergency medical services to the scene before using the AED can then grab an “automatic operation” defibrillator with voice prompts and easily connect it to your chest to allow the AED to evaluate your heart rhythm. If your heart rhythm can be treated with an electric shock, the AED automatically sends an electrical shock to get your heart back into a normal rhythm.

Only defibrillation can restore the heart's normal rhythm and ultimately save your life although cardiopulmonary resuscitation (CPR) is important to use to keep some blood flowing to your heart and brain.

Uncorrected, these cardiac conditions (ventricular tachycardia, ventricular fibrillation, asystole) rapidly lead to irreversible brain damage and death. After approximately three to five minutes, irreversible brain/tissue damage may begin to occur. For every minute that a person
in cardiac arrest goes without being successfully treated (by defibrillation), the chance of survival decreases by 10 percent

Requirements for Use
AEDs are designed to be used by laypersons who ideally should have received AED training. This is in contrast to more sophisticated manual and semi-automatic defibrillators used by health professionals, which can act as a pacemaker if the heart rate is too slow (bradycardia) and perform other functions which require a skilled operator able to read electrocardiograms.
Bras with a metal underwire and piercings on the torso must be removed before using the AED on someone to avoid interference.

Placement and Availability
Automated external defibrillators are generally either held by trained personnel who will attend events or are public access units which can be found in places including corporate and government offices, shopping centres, airports, restaurants, casinos, hotels, sports stadiums, schools and universities, community centers, fitness centers, health clubs, workplaces and any other location where people may congregate.

The location of a public access AED should take in to account where large groups of people gather, regardless of age or activity. Children as well as adults may fall victim to sudden cardiac arrest (SCA)
In many areas, emergency vehicles are likely to carry AEDs, with some ambulances carrying an AED in addition to manual defibrillators. Police or fire vehicles often carry an AED for first responder use. Some areas have dedicated community first responders, who are volunteers tasked with keeping an AED and taking it to any victims in their area. AEDs are also increasingly common on commercial airlines, cruise ships, and other transportation facilities.

An AED in airport

In order to make them highly visible, public access AEDs often are brightly colored, and are mounted in protective cases near the entrance of a building. When these protective cases are opened or the defibrillator is removed, some will sound a buzzer to alert nearby staff to their removal, though this does not necessarily summon emergency services; trained AED operators should know to phone for an ambulance when sending for or using an AED. In September 2008, the International Liaison Committee on Resuscitation issued a 'universal AED sign' to be adopted throughout the world to indicate the presence of an AED, and this is shown at the top of this page.

A trend that is developing is the purchase of AEDs to be used in the home, particularly by those with known existing heart conditions. The number of devices in the community has grown as prices have fallen to affordable levels. There has been some concern among medical professionals that these home users do not necessarily have appropriate training, and many advocate the more widespread use of community responders, who can be appropriately trained and managed.

Typically, an AED kit will contain a face shield for providing a barrier between patient and first aider during rescue breathing; a pair of nitrile rubber gloves; a pair of trauma shears for cutting through a patient's clothing to expose the chest; a small towel for wiping away any moisture on the chest, and a razor for shaving those with very hairy chests.

Preparation for operation
Most manufacturers recommend checking the AED before every period of duty or on a regular basis for fixed units. Some units need to be switched on in order to perform a self check; other models have a self check system built in with a visible indicator.All manufacturers mark their pads with an expiry date, and it is important to ensure that the pads are in date. This is usually marked on the outside of the pads. Some models are designed to make this date visible through a 'window', although others will require the opening of the case to find the date stamp.

Mechanism of operation
The rhythms that the AED will treat are usually limited to:
1. Pulseless Ventricular tachycardia (shortened to VT or V-Tach)
2. Ventricular fibrillation (shortened to VF or V-Fib)

In each of these two types of shockable cardiac arrhythmia, the heart is active, but in a life-threatening, dysfunctional pattern. In ventricular tachycardia, the heart beats too fast to effectively pump blood. Ultimately, ventricular tachycardia leads to ventricular fibrillation. In ventricular fibrillation, the electrical activity of the heart becomes chaotic, preventing the ventricle from effectively pumping blood. The fibrillation in the heart decreases over time, and will eventually reach asystole.

AEDs, like all defibrillators, are not designed to shock asystole ('flat line' patterns) as this will not have a positive clinical outcome. The asystolic patient only has a chance of survival if, through a combination of CPR and cardiac stimulant drugs, one of the shockable rhythms can be established, which makes it imperative for CPR to be carried out prior to the arrival of a defibrillator.

An AED is external because the operator applies the electrode pads to the bare chest of the victim, as opposed to internal defibrillators, which have electrodes surgically implanted inside the body of a patient. Automatic refers to the unit's ability to autonomously analyse the patient's condition, and to assist this, the vast majority of units have spoken prompts, and some may also have visual displays to instruct the user. When turned on or opened, the AED will instruct the user to connect the electrodes (pads) to the patient. Once the pads are attached, everyone should avoid touching the patient so as to avoid false readings by the unit. The pads allow the AED to examine the electrical output from the heart and determine if the patient is in a shockable rhythm (either ventricular fibrillation or ventricular tachycardia). If the device determines that a shock is warranted, it will use the battery to charge its internal capacitor in preparation to deliver the shock. This system is not only safer (charging only when required), but also allows for a faster delivery of the electrical current.
When charged, the device instructs the user to ensure no one is touching the victim and then to press a button to deliver the shock; human intervention is usually required to deliver the shock to the patient in order to avoid the possibility of accidental injury to another person (which can result from a responder or bystander touching the patient at the time of the shock). Depending on the manufacturer and particular model, after the shock is delivered most devices will analyze the victim and either instruct that CPR be given, or administer another shock.

Many AED units have an 'event memory' which store the ECG of the patient along with details of the time the unit was activated and the number and strength of any shocks delivered. Some units also have voice recording abilities[citation needed] to monitor the actions taken by the personnel in order to ascertain if these had any impact on the survival outcome. All this recorded data can be either downloaded to a computer or printed out so that the providing organisation or responsible body is able to see the effectiveness of both CPR and defibrillation.

AEDs available to the public may be semi-automatic or fully automatic. Fully automatic units are likely to have few buttons, often activating as soon as the case is opened, and possibly just one button to shock, or in some cases this will be performed automatically. The user has no input in the operation of the unit apart from attaching the pads and following the prompts. Health care professionals and other trained responders may use a semi-automatic defibrillator, which is likely to have an ECG readout display, and the possibility to override the rhythm analysis software. This allows trained personnel to provide a higher level of care.

The first commercially available AEDs were all of a monophasic type, which gave a high-energy shock, up to 360 to 400 joules depending on the model. This caused increased cardiac injury and in some cases second and third-degree burns around the shock pad sites. Newer AEDs (manufactured after late 2003) have tended to utilise biphasic algorithms which give two sequential lower-energy shocks of 120 - 200 joules, with each shock moving in an opposite polarity between the pads. This lower-energy waveform has proven more effective in clinical tests, as well as offering a reduced rate of complications and reduced recovery time.

Simplicity of use
Unlike regular defibrillators, an automated external defibrillator requires minimal training to use. It automatically diagnoses the heart rhythm and determines if a shock is needed. Automatic models will administer the shock without the user's command. Semi-automatic models will tell the user that a shock is needed, but the user must tell the machine to do so, usually by pressing a button. In most circumstances, the user cannot override a "no shock" advisory by an AED. Some AEDs may be used on children - those under 55 lbs (25 kg) in weight or under age 8. If a particular model of AED is approved for pediatric use, all that is required is the use of more appropriate pads. Some organizations, such as the American Heart Association, recommend that if pediatric AED pads are not available, adult pads should be used to determine if the child is in a shockable rhythm. There is insufficient evidence to suggest that a child, in a shockable cardiac arrest, can be "hurt" by an adult defibrillation energy setting.

All AEDs approved for use in the United States use an electronic voice to prompt users through each step. Because the user of an AED may be hearing impaired, many AEDs now include visual prompts as well. Most units are designed for use by non-medical operators. Their ease of use has given rise to the notion of public access defibrillation (PAD), which experts agree has the potential to be the single greatest advance in the treatment of out-of-hospital cardiac arrest CPR.
since the invention of CPR.

Liability
Automated external defibrillators are now easy enough to use that most states in the United States include the "good faith" use of an AED by any person under the Good Samaritan laws. AEDs create little liability if used correctly; NREMT-B and many state EMT training and many CPR classes incorporate or offer AED education as a part of their program. In addition to Good Samaritan laws, Ontario, Canada also has the "Chase McEachern Act (Heart Defibrillator Civil Liability), 2007 (Bill 171 – Subsection N)", passed in June, 2007, "Good faith" protection under a Good Samaritan law means that a volunteer responder (not acting as a part of one's occupation) cannot be held civilly liable for the harm or death of a victim by providing improper or inadequate care, given that the harm or death was not intentional and the responder was acting within the limits of their training and in good faith. In the United States, Good Samaritan laws provide some protection for the use of AEDs by trained and untrained responders. which protects individuals from liability for damages that may occur from their use of an AED to save someone's life at the immediate scene of an emergency unless damages are caused by gross negligence.

First Aid Medications

Acetaminophen

• Common Name : Tylenol
• Use : Mild pain reliever, reduces fever. Good for headaches, muscle aches, and menstrual cramps. A good alternative to aspirin if person has an aspirin allergy. Acetaminophen will not upset the stomach. It does not, reduce inflammation.
• Adult Dose : 325 to 500 mg every 3–4 hours, as needed. For short-term use the total daily dose should not exceed 4,000 mg.
• Precautions : Do not drink alcoholic beverages if you are taking more than an occasional 1–2 doses. Individuals with liver disease should consult their physician before using this drug. Overdose can cause permanent liver damage and death. Treatment must be initiated within hours after overdose to be effective.

Aspirin

• Common Name : Aspirin, Bufferin, Bayer, Anacin
• Use : Mild pain relief. Fever reduction. Anti-inflammatory.
• Adult Dose : 650 mg as needed with lots of water and food if possible
• Precautions : May irritate stomach, cause vomiting, abdominal pain or bleeding. Do not use if you have a history of peptic ulcers or related disorders. Can cause allergic reaction: watch for skin rashes and asthma-like symptoms. Overdose will cause dizziness and confusion. If ringing in the ears is present, discontinue immediately. Aspirin is also an anticoagulant, so it can lead to bleeding.
• Drug Interactions : Aspirin may interact with Diabinase or other diabetes drugs to cause a dangerous fall in blood sugar for diabetics.
• Contraindications : People with aspirin allergies, bleeding stomach ulcers, anemia, high blood pressure, kidney disease, liver disease, gout, or hemophilia. Diabetics or people who have allergic sinusitis or asthma should contact physician prior to taking.

Tincture of Benzoin

• Ingredients : Benzoin, alcohol 80%
• Use : Use only as a topical solution on skin to provide a sticky surface for tape or moleskin to adhere to. Benzoin is not effected by wet or sweat. Not for internal use.
• Directions for Use : Clean and dry the area. Apply a thin coating and let air dry until tacky, then apply tape or moleskin.
• Precautions : Do not apply to open wounds. Do not take internally.

Diphenhydramine

• Common Name: Benadryl
• Use : Antihistamine, anti-allergy medication. Inactivates histamine produced by allergic reactions. Provides temporary relief of sneezing, watery and itchy eyes, and running nose due to allergies and hay fever. Also helps relieve upper respiratory allergies.
• Adult Dose : 25 - 50 mg every 4-5 hours.
• Precautions : May cause drowsiness. Avoid driving or hiking in dangerous terrain. Do not drink alcohol. Large doses may cause central nervous system depression or convulsions.
• Contraindications : Antihistamines add to the effects of alcohol and other central nervous system depressants such as sedatives, tranquilizers and sleeping pills. Consult your physician before taking an antihistamine with these other drugs. Consult your physician before taking if you have asthma, glaucoma, liver disease, or difficulty in urinating due to enlargement of the prostate gland.

Epinephrine

• Ingredient : Epinephrine 1:1000 solution (a synthetic form of adrenalin)
• Use : This drug is used for emergency treatment of severe allergic reactions that cause respiratory distress. It is a fast-acting bronchodilator that also reduces swelling in the throat to allow breathing. It also serves to constrict the capillary bed to restore the circulating blood volume. After injection, bronchodilation may occur within 5-10 minutes, with maximum effects within 20 minutes.
• Adult Dose : 0.5 ml. of epinephrine solution from the syringe in the kit, injected into the muscle of the shoulder (deltoid) or thigh. Dose may be repeated in 10–15 minutes as needed. See the kit itself for attached administration instructions.
• Adverse Effects : Increased heart rate, heart flutters, increased blood pressure, trembling, dizziness, anxiety, weakness, paleness, nausea, vomiting, and headache. Excessive doses cause very high blood pressure, and cardiac irregularities.
• Precautions : Use according to directions attached to the kit. Epinephrine is light sensitive and should be stored in the box provided. Store at room temperature. Periodically check contents of the syringe. The solution should be clear and colorless. If it appears brown or cloudy or contains a precipitate, do not use. The effects of epinephrine may be potentiated by tricyclic antidepressants or by some antihistamines.
• Contraindications : Must not be given intravenously! It must be given into the muscle only. It should not be used on individuals in shock from blood loss. Epinephrine is a powerful cardiac stimulant. Use may be contraindicated in persons with high blood pressure, diabetes, thyroid disease, or heart disease.

Hydrocortisone Cream

• Common Names : Cortaid, Lanacort
• Use : Relieve redness, swelling, itching of skin. Use on skin rashes and irritations caused by eczema, insects, poison ivy/oak/sumac, soaps, detergents, cosmetics, genital and anal itching.
• Dose : Apply cream to affected area not more than 3-4 times daily.
• Precautions : External use only. Do not bandage or wrap the skin being treated unless directed to by a physician. Occlusive dressings increase the amount of medicine absorbed through the skin. Avoid contact in eyes. Do not use it for skin problems that are not listed on the package label without checking with a physician. Discontinue use after 7 days if itching is still present, and contact a physician. Do not use for external feminine itching if there is a vaginal discharge.

Ibuprofen

• Common Names : Advil, Motrin
• Use: Mild pain reliever, muscle relaxant, anti-inflammatory,. Good for menstrual cramps.
• Adult Dose : 200 to 400 mg every 4–6 hours, as needed. Total daily non-prescription dose should not exceed 1,200 mg.
• Precautions : Ibuprofen can irritate the stomach; take with food or milk. It should not be taken if there is a history of ulcers or severe indigestion. Ibuprofen can also produce gastrointestinal ulceration and bleeding. Ibuprofen also has a tendency to cause fluid retention, so care should be used in situations where fluid retention is a problem (ex. acute mountain sickness or high altitude pulmonary edema). Pregnant women should not take Ibuprofen without consultation with a physician.
• Contraindications : Do not take if you are allergic to aspirin or salicylates.

Laxatives

• Common Names : Ducolax
• Use : Stimulant laxative for prolonged constipation, to encourage bowel movements
• Dose : varies with specific preparation
• Precautions : Do not take if there is abdominal pain, nausea, or vomiting. Discontinue if rash appears, or if there is rectal bleeding. Do not use if there is a history of kidney disease. Continued use can cause a dependence upon laxatives.
• Contraindications : Do not use products with Bisacodyl if you are allergic to aspirin.

Triple Antibiotic Ointment

• Common Name : Neosporin ointment
• Active Ingredients : Polymyxin B sulfate, Bacitracin Zinc, Neomycin, in a white petrolatum base
• Use : to prevent skin infection in minor cuts, scrapes, and burns..
• Dose : apply a small amount (an amount equal to the surface area of a finger tip) on the area 1 to 3 times daily. To clear up the infection completely, use the medication for the full time of treatment (even if symptoms have disappeared).
• Precautions : For external use only. Do not use in the eyes or apply over large areas of the body. There is a separate product specifically designed for use in the eye. Stop use and consult a physician if the condition persists or gets worse, or if a rash or other allergic reaction develops. Do not use this product if you are allergic to any of the active ingredients. Do not use longer than 1 week unless directed by a physician. In case of ingestion, seek professional medical care on contact the nearest poison control center.

Pepto-bismol

• Use : Antacid, for upset stomach, heartburn, indigestion, nausea, and diarrhea. Neutralizes excess stomach acid and protects stomach lining. If you are having diarrhea, taking a dose before eating may help.
• Dose : 2 tablets chewed or dissolved in mouth every 1/2 to 1 hour, as needed, to a maximum of 8 doses in 24 hours. Best to take an hour after meals, and every 2-3 hours thereafter.
• Note : A darkened coating of the tongue or darkening of the stool may occur with use. Both conditions are harmless and temporary.
• Precautions : May prevent the absorption of other drugs, so avoid taking when on other medications. Do not take more than 16 tablets in 24 hours. Do not use maximum dosage for more than 2 weeks. Consult physician prior to giving Pepto-bismol to teenagers during or after recovery from flu or chickenpox. If diarrhea is accompanied by high fever or continues more than 2 days, evacuate and contact physician.
• Contraindication : Do not use this product if you are allergic to aspirin. Contact a physician prior to use if you are on anticoagulants (blood thinners), have diabetes, kidney disease, stomach ulcers, or gout.

Povidone-Iodine Solution and Ointment

• Common Name : Betadine
• Uses : Antiseptic (cleansing and sterilizing agent), topical antibiotic, water purification.
• For cleaning and irrigation : Flush wound with povidone-iodine solution.
• Mixing Solution : Mix about 1-1½ inches (2-4 centimeters) of povidone-iodine ointment with 1 liter of water (anywhere from 1:100 to 1:1000 concentration is acceptable). Allow to dissolve completely; wait 10-15 minutes. This solution can be safely stored in plastic bottles for extended periods, but may be slightly light sensitive.
• For skin disinfection : Apply ointment directly to skin, or to sterile dressing to be placed over a wound.
• Precautions : Individuals who are allergic to iodine. A chronic skin rash is the usual manifestation. Do not use directly in deep puncture wounds, on severe burns, and avoid contact with eyes.

Psuedoephedrine

• Common Name : Sudafed
• Use : Decongestant, for the common cold. Promotes sinus/nasal drainage. Relieves nasal congestion due to colds, hay fever, and upper respiratory allergies.
• Doses : 60 mg tablets every 4-6 hours. Do not exceed 240 mg in 24 hours.
• Adverse Effects : Acts as a mild stimulant and makes some individuals restless or jumpy, inhibiting restful sleep. Reducing dose of drug usually relieves these side effects. Taking the last dose of the day several hours before bedtime will help prevent trouble sleeping
• Precautions : Do not exceed recommended dosage because at higher doses nervousness, dizziness or sleeplessness may occur. Do not take this product if you are presently taking a prescription anti-hypertensive or anti-depressant without consulting a physician first.
• Contraindications: If you have high blood pressure, heart disease, diabetes, or thyroid disease consult your physician before taking this drug.

Sting Relief Swabs

• Common Name : Sting-Eze
• Use : Local immediate sting relief for non-allergic reactions
• Directions : Remove swab from packet, squeeze mini-vial between fingers, and apply using sponge end directly to sting site, spreading with your finger.
• Precautions : Do not use in eyes or nose. Not for prolonged use, or use over large areas of the body. If swelling or pain persists, discontinue use.

Zinc Oxide Ointment

• Use : Skin protectant (total sun block). Apply liberally to desired area (especially face).
• Precautions : Do not take internally. Avoid eye contact. Do not apply to open wounds.

[source : www.princeton.edu ]