Defibrillators for resuscitations - all talk and no action

It would seem that gyms and sporting facilities, and also parks, are not regulated in anyway with respect to the provision of resuscitative equipment. It's pretty much NATO - no action all talk only. Everybody wants to run CPR training cos they get money for course attendances, but when it comes to actually installing the equipment, it's pretty much dependent on organizationsto want to play ball.

The Singapore Heart Foundation just recently published lists of all the organizations and places where automated external defibrillators are installed. A consolidated list of places can be found here. My gym isn't on the list. Neither is the East Coast Park. Nor is the Prince George's Park Residence gym.

So there.

Maybe I can encourage you to speak to your gym, or sports facilities and pressure them to install appropriate resuscitative equipment. Perhaps you can also write in to National Parks and persuade them to be a bit more civic conscious and install appropriate resuscitative equipment in adequate quantities and in readily accessible locations. Their email is: NPARKS_MAILBOX@NPARKS.GOV.SGThis e-mail address is being protected from spambots. You need JavaScript enabled to view it

H1N1 vaccine toxicity?

The recent flurry of reports about side effects resulting from the recent H1N1 vaccines have caused many people to go into a flap.

The HSA reported a series of 27 cases, with one particularly problematic case of Sweet's Syndrome.

Canada reported high frequencies of unusual adverse reactions and some deaths, which resulted in cessation of the vaccinations, and withdrawal of the GSK vaccine.

Earlier China had reported 2 deaths, but evidence later discounted their relationship to the vaccine.

But actually, despite the fact that they are all H1N1 vaccines, they are all essentially different products. The China vaccine is China's own special product. The Singapore vaccine, I believe is pretty much the CSL version at the moment, while the Canadian vaccine is a GSK product manufactured in Canada.

It's interesting that the Canadian product is called Arepanrix and the Singapore GSK version is called Pandemrix. According to the GSK website, the difference is that Arepanrix is translucent and has particles..... Hmmmm...... poor manufacturing giving rise to allergies? We'll wait for the werdict.

Sudden death in the gym - adequate CPR support?

The recent fatal collapse of an NUS lecturer in the Prince George's Park Residences gym raised a number of concerns for me.

First of all is, whether there are adequate support for cardiopulmonary resuscitation to be done?

Although it was reported that CPR was started but was unsuccessful, I really question if proper CPR was at all possible. I can't imagine that there would be trained gym instructors at a hostel gym. Furthermore I really doubt if proper CPR equipment was available; don't even mention a defibrillator!

Which was a tragic shame....because in a young man with cardiac arrest, CPR/defibrillation could be life saving.

Which raised in my mind, a second question - how many gyms in Singapore are properly equipped for CPR? At the gym in the club I frequent, I discretely asked the instructor if there was any CPR equipment available. He stammered a bit and insisted there was. When I asked where, he stammered a bit more and said he didn't know.... perhaps it was out of order and sent for repairs. Then he said it was in the store room. Who had the key? That question really got him. I didn't want to embarass him further so I left it there. Bottom line was that even if there were CPR equipment it was not accessible in any way should an hapless auntie collapse from coronary insufficiency.

Then I thought a bit more..... what about at our parks? When I was at the East Coast Park the other weekend, I couldn't help marvelling at the thousands of weekend warriors who flock there every Sunday. If someone collapses, how does one do CPR? Does anyone know if there is a defibrillator anywhere? Why can't the park have well signposted CPR stations at regular intervals?

Hmmm....

I wonder who is responsbile for ensuring there is adequate support for public cardiopulmonary resuscitation in Singapore? Or is everyone wishing someone else would do it?

Rising sea levels - what is the impact on Singapore's coastline?? #2

The WWF report's estimate of sea level change comes on the back of previous estimates from :

a] the IPCC (Intergovernmental Panel on Climate Change 4th Assessment Report) which predicted a range of possibilities based on various scenarios. The worst case scenario being 26-59 cm for the 21st century; and

b] a report by Siddall et al, Nature Geoscience 2, 571 - 575 (2009), projecting a rise of 7-82 cm rise in sea levels; and

c] a report by Grinsted et al,Climate Dynamics 2009, forecasting a meter rise in sea levels.

How will Singapore be affected?

It's hard to tell for sure since there is very little in terms of survey data out there. But I came across this cool website put up by some NUS students called 'Mapping Potential Sea Level Rise in Singapore' with some simulations and projections done using the 2001 IPCC Report.

The 2 figures below show projections based on an 82cm and 120cm increase in sea levels. For more info please go to their website.

Rising sea levels - what is the impact on Singapore's coastline??

The WWF recently released its Final Tipping Points Report, in which it suggested that the global warming was likely to increase beyond 2-3degC. Correspondingly by 2050 (which is not that far away) sea levels could well rise by more than 0.5m threatening many coastal cities.

"Global temperatures have already risen by at least 0.7 degrees Celsius. Global warming above 2-3 degrees in the second half of the century is likely unless strong extremely radical and determined efforts towards deep cuts in emissions are put in place before 2015.

The melting of the Greenland (GIS) and the West Antarctic Ice Shield (WAIS) could lead to a Tipping Point scenario, possibly a sea level rise of up to 0.5 meters by 2050. This is estimated to increase the value of assets at threat in all 136 global port mega-cities by around 25.000 billion USD.

On the North-eastern coast of the USA and due to a localized anomaly, the sea level could rise up to 0.65 meters, increasing the asset exposure from 1.350 to about 7.400 billion USD. "

The gahment should tell us explicitly what they are doing to mitigate the effect of this rising sea level. If they have done any geographical surveys and modelling, they should let us know what the impact is on our coastlines, and the risks of flooding should sea levels rise by 0.5m.

We have a right to know.

NKF to dip into reserves

I wasn't quite sure what to make about the recent report about how the NKF suffered "one of its worst financial results in years". It ran into a deficit of some $900,000 and had to dip into its reserves.

I was tempted to feel sorry for it until I was reminded of the whopping size of its reserves. $270 million!!! This pretty much the same as when it ran into the TT Durai scandal in 2005. I couldn't help thinking that even if the charity couldn't ever do better than this recession year, and had to dip into into its reserves to the same degree for the next 100 years, there would still be a sizeable pile of cash in the bank.

By comparison, the Community Chest in 2007/8 raised $52 million and disbursed $49 million.
Annual Report 2007/2008

Chemotherapy errors - medical device regulation

There are now two versions of the story:
a] Only one type of pump capable of being programmed for hourly or daily delivery rates. The mistake was in the programming.
b] Two similar looking pumps - one for hourly delivery and the other for daily delivery. The mistake was in the wrong pump being used.

I really have no way of establishing which of these stories are true. We'll wait for the BOI to release their findings....if they ever. But in both of these scenarios, the design of the pump is also important in minimizing the risks of operator error.

By the way, these pumps are actually regulated by the HSA as 'medical devices'. I wonder if they these design problems into consideration when they approve these pumps? Or just look at the brochures?