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One Beat CPR: Emergency Action Plans for Gyms

Subject: One Beat CPR: Emergency Action Plans for Gyms
See below.


Contact at 516 484 0055  Contact Roberta D.   
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[ALERT] Keep e-cigs away from students

From: American Heart Association <>
Subject: [ALERT] Keep e-cigs away from students

Friend, please urge your lawmakers to help pass the Tobacco to 21 Act.
American Heart Association Donate
URGE CONGRESS: Pass the Tobacco to 21 Act and Protect Our Students
take action
Dear Friend,

Students going back to school in the coming weeks can’t wait to spend time with friends again. Inevitably, as they get older, they’ll face a critical choice to try smoking or vaping.
did you know?
As adults, parents and guardians, we must all work to keep deadly tobacco products away from our youth. Today, 18 states, Washington, D.C., and hundreds of localities have raised their legal minimum sales age to 21. Congress has also responded, introducing the Tobacco to 21 Act (H.R. 2411/S. 1258) in an effort to make it national policy.

But it’s not enough. New products such as e-cigarettes have caused a rise in teen smoking. Nicotine causes lasting adverse effects on brain development, sets kids up for a lifetime of addiction and costs communities billions in medical care and lost productivity.

That’s why we’re reaching out to everyone who has supported the American Heart Association in the past. Can we count on you again today?

Friend, 75% of American adults favor raising the tobacco age of sale to 21, including 7 in 10 smokers. We need you to reach out to your representative today and ask them to protect our students by passing the Tobacco to 21 Act in the House immediately.
take action
Many thanks,
Bert Scott Bert Scott signature
Bert Scott
Chairman of the Board
Volunteer, 22 Years
American Heart Association – American Stroke Association
© 2019 American Heart Association Inc. – also known as the Heart Fund. All rights reserved.
Unauthorized use prohibited.The American Heart Association is a qualified 501(c)(3) tax-exempt organization.

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  1. the branch of medicine that deals with the provision and use of artificial devices such as splints and braces.
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If these signs are present CALL 9-1-1

Dial 9-1-1 Fast

Heart attack and stroke are life-and-death emergencies — every second counts. If you see or have any of the listed symptoms, immediately call 9-1-1 or your emergency response number. Not all these signs occur in every heart attack or stroke. Sometimes they go away and return. If some occur, get help fast! Today heart attack and stroke victims can benefit from new medications and treatments unavailable to patients in years past. For example, clot-busting drugs can stop some heart attacks and strokes in progress, reducing disability and saving lives. But to be effective, these drugs must be given relatively quickly after heart attack or stroke symptoms first appear. So again, don’t delay — get help right away!


More about heart attack
Some heart attacks are sudden and intense — the “movie heart attack,” where no one doubts what’s happening. But most heart attacks start slowly, with mild pain or discomfort. Often people affected aren’t sure what’s wrong and wait too long before getting help.Immediately call 9-1-1 or your emergency response number so an ambulance (ideally with advanced life support) can be sent for you. As with men, women’s most common heart attack symptom is chest pain or discomfort. But women are somewhat more likely than men to experience some of the other common symptoms, particularly shortness of breath, nausea/vomiting, and back or jaw pain. Learn more about heart attack symptoms in women.
Learn the signs, but remember this: Even if you’re not sure it’s a heart attack, have it checked out (tell a doctor about your symptoms). Minutes matter! Fast action can save lives — maybe your own. Call 9-1-1 or your emergency response number.Calling 9-1-1 is almost always the fastest way to get lifesaving treatment. Emergency medical services (EMS) staff can begin treatment when they arrive — up to an hour sooner than if someone gets to the hospital by car. EMS staff are also trained to revive someone whose heart has stopped. Patients with chest pain who arrive by ambulance usually receive faster treatment at the hospital, too. It is best to call EMS for rapid transport to the emergency room.Learn more about heart attack.
More about stroke
Immediately call 9-1-1 or the Emergency Medical Services (EMS) number so an ambulance can be sent.  Also, check the time so you’ll know when the first symptoms appeared. A clot-busting drug called tissue plasminogen activator (tPA) may improve the chances of getting better but only if you get them help right away.
A TIA or transient ischemic attack is a “warning stroke” or “mini-stroke” that produces stroke-like symptoms. TIA symptoms usually only last a few minutes but, if left untreated, people who have TIAs have a high risk of stroke. Recognizing and treating TIAs can reduce the risk of a major stroke.
Beyond F.A.S.T. – Other Symptoms You Should Know

  • Sudden numbness or weakness of the leg
  • Sudden confusion or trouble understanding 
  • Sudden trouble seeing in one or both eyes 
  • Sudden trouble walking, dizziness, loss of balance or coordination 
  • Sudden severe headache with no known cause

Learn more about stroke warning signs.

More about cardiac arrest
If these signs of cardiac arrest are present, tell someone to call 9-1-1 or your emergency response number and get an AED (if one is available) and you begin CPR immediately.If you are alone with an adult who has these signs of cardiac arrest, call 9-1-1 and get an AED (if one is available) before you begin CPR.

Use an AED as soon as it arrives.

For more information, visit our cardiac arrest website.

Hands-Only CPR

Hands-Only CPR can be as effective as CPR with breaths. Watch the demo video and learn how to save a life in 60 seconds.

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Most heart attacks involve discomfort in the center of the chest that lasts more than a few minutes, or that goes away and comes back. It can feel like uncomfortable pressure, squeezing, fullness or pain.




Learn more about heart attack


Spot a stroke F.A.S.T.:

Face Drooping Does one side of the face droop or is it numb? Ask the person to smile.

Arm Weakness Is one arm weak or numb? Ask the person to raise both arms. Does one arm drift downward?

Speech Difficulty Is speech slurred, are they unable to speak, or are they hard to understand? Ask the person to repeat a simple sentence, like “the sky is blue.” Is the sentence repeated correctly?

Time to call 9-1-1 If the person shows any of these symptoms, even if the symptoms go away, call 9-1-1 and get them to the hospital immediately.

Learn more about stroke



No response to tapping on shoulders.


Learn more about cardiac arrest

If these signs are present CALL 9-1-1

Come back next week to read our update

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Planter Fasciitis in Runners

Plantar fasciitis:
Clinical considerations in runners


By Patricia Pande, MClScPT, CSCS, CPed

Sponsored by an educational grant from Medi USA.

Running is a hugely popular form of exercise due to its low-cost investment, accessibility of appropriate environments, and obvious health benefits. As running has become mainstream, so has the prevalence of plantar fasciitis or fasciopathy. The incidence of lower extremity injuries in runners is estimated to range from 4.5% to 10% and the prevalence from 5.2% to 17.5%.1

Taunton et al2 and Lopes et al1 have noted the absence of prospective studies of running populations; Taunton et al, however, observed that a higher number of male runners (54%) than female runners (46%) injure the plantar fascia. In fact, plantar fascia injury is the third-most frequent complaint of runners visiting sports medicine clinics. Unfortunately many relevant studies have not uniformly defined running injuries or running populations.3

Anatomy and diagnosis

The fascia divides into medial, central, and lateral bands that attach to the abductor hallucis, flexor abducto brevis, and abductor digiti minimi. The windlass mechanism transfers tension from the proximal attachment of the fascia to its insertion on the calcaneus, which causes the calcaneus to invert and turns the foot into a rigid lever.4-7 The plantar fascia may become inflamed from repetitive stress or undergo degenerative changes, commonly called fasciosis.

Plantar fasciitis presents as pain in the plantar heel at the medial calcaneal tubercle and is most noticeable with the first step in the morning. This pain intensifies with long periods of standing and may be exacerbated with plantar fascia stretching. Although the two may coexist, plantar fasciitis (or fasciopathy) should be differentiated from plantar fat pad atrophy (FPA), which presents as increased pain with weightbearing and compression over the center of the heel.8

Plantar fasciitis in runners

The literature cites a number of causes of plantar fasciitis in runners, including long plantar arch alterations, rearfoot pronation, and magnitude of plantar loads.2,9-12 Plantar fasciitis in runners can also be associated with fasciosis.13-15

Muscle atrophy. Several studies suggest an association between plantar fasciitis and muscle atrophy, particularly of the intrinsic foot muscles. Chang et al found that forefoot muscle volume, assessed using magnetic resonance imaging (MRI), was significantly lower in the affected limbs of patients with unilateral plantar fasciitis than in the healthy limbs.16 In another MRI study, Cheung et al found that rearfoot intrinsic muscle volume was lower in experienced runners with chronic plantar fasciitis than in healthy runners, while forefoot muscle volume was similar between groups.17 Kibler et al also found that runners with plantar fasciitis had significantly worse ankle plantar flexion strength than healthy runners;18 this weakness could be related to muscle atrophy or to reflex inhibition with increased load on the plantar fascia.

Although these studies do not confirm muscle atrophy as the cause of plantar fasciitis or that strengthening exercises will relieve symptoms, research does suggest that intrinsic muscle activation from forefoot contact to toe off may reinforce ligamentous structures.19 Further studies are needed to evaluate the effectiveness of exercises to improve muscle activity and orthotic interventions to support the foot for generation of muscle power.

Plantar loads. Recently, Ribeiro et al found lower loading rates in runners with acute plantar fasciitis (pain for more than four months) than in chronic cases (diagnosed a mean of 1.5 years earlier, presenting with fascial abnormalities but no acute inflammation or pain). However, loading rates in all runners with plantar fasciitis were higher than in healthy runners.20 The authors hypothesized that the lower loading rates in the symptomatic runners than in the chronic group were due to a pain-avoidance response, and that higher loading rates in the chronic plantar fasciitis group were due to the loss of a protective mechanism against pain in the degenerated tissue, as well as a reduced ability to attenuate shock.

Similarly, Pohl et al found that maximum instantaneous load rate was significantly higher in female runners with a history of plantar fasciitis than in control runners.9 Changes in tissue stiffness and fat pad atrophy may contribute to higher loads and may further complicate treatment by reducing lubrication and shock absorption.8 Furthermore, loads related to the running surface may also contribute to plantar fasciitis.21

Running pace and volume. There is conflicting information about the impact of running pace and volume on the risk of injuries, including plantar fasciitis.22 A study by Knobloch et al23 found that marathon runners have a lower risk of plantar fasciitis than runners of shorter distances, which suggests faster pace may be a risk factor and higher volume may be protective. However, other prospective studies have linked lower extremity injuries, including plantar fasciitis, to higher running volume.24 Whether due to pace or volume, the resulting stress may overload tissue.22

Structural variables. Thickening of the plantar fascia has been associated with plantar fasciitis, and may arise from a combination of bending, compression, and shearing forces from muscle weakness or from degenerative thickening.12 Wearing et al found that thicker fascial structures were associated with a lower arch in patients with plantar fasciitis but not in healthy controls;12 it is still not clear whether this finding suggests that having a low arch causes the disability or results from gait adaptation.

Root’s theory25 that foot type contributes to plantar fasciitis remains controversial. The fact that the spectrum of foot types does not form a bell-shaped curve complicates the argument, as does the prevalence of subject-specific kinematic variations.3,26 Additionally, the connection between foot structure and plantar fasciitis is unclear.27  Some researchers found a lower arch index with increased range of dorsiflexion in female runners with plantar fasciitis than in their healthy counterparts,13 but others suggest this relationship is not easily defined due to the foot’s adaptability to prevent injury.32 Nielsen et al found no increased risk of running-related injury in novice runners with moderately pronated feet.28 Additional well-controlled randomized prospective studies of homogenous running groups are critical to furthering our understanding of these factors.

Biomechanics. Kinematics and kinetics during walking in individuals with plantar fasciitis differ from healthy volunteers,29 and clinicians should consider the possibility that these or related differences may extend to running. The coupling mechanisms between the hindfoot, tibia, and arch during running are well-documented, but the relationship between segments of the foot is not clearly understood.6,30,31 Still, it is important for clinicians to be aware that treatments or interventions focused on a single aspect of the foot can also affect other aspects of the kinetic chain.

Clinical applications

1medi-iStock48636328The American Physical Therapy Association’s clinical practice guidelines for treatment of plantar fasciitis combine stretching, activity limitation, iontophoresis, night splints, and prefabricated or custom inserts.32 The American College of Foot and Ankle Surgeons recommends initial treatment with ice, stretching, ergonomics, off-the-shelf arch supports, nonsteroidal anti-inflammatory drugs, and corticosteroid injections, with progression to custom foot orthoses and physical therapy if little or no improvement after six months.33

Inserts must be able to absorb ground reaction forces, particularly in runners. Prefabricated and customized EVA (ethylene vinyl acetate) orthotic devices were associated with similar levels of pain relief in patients with noncomplicated plantar fasciitis after eight weeks.34Interestingly, another study found reduction of plantar pressures at the heel associated with two types of EVA sham orthoses (flat and contoured) were similar to those associated with custom foot orthoses—a finding the authors attributed to the attenuating and pressure-redistributing properties of EVA.35 The findings of Pfefffer et al also support the use of less rigid orthotic devices in this patient population; felt and silicone or rubber were more likely to be associated with symptom relief than more rigid devices.36

The use of orthoses to control or supplement motions has been the traditional mainstay of treating runners and nonrunners with plantar fasciitis. Research has demonstrated that orthotic devices are associated with kinetic and kinematic effects in healthy runners. One study showed a decrease in forefoot to rearfoot coupling angles with the use of foot orthoses,37 and another showed a change in rearfoot eversion angle and eversion velocity in female distance runners.38 Mündermann et al found that molded foot orthoses and molded and posted foot orthoses both reduced vertical loading rates and ankle inversion moments in healthy runners.39 However, researchers have not yet determined whether similar biomechanical effects can be expected in runners with plantar fasciitis, or to what extent those changes might affect patient symptoms.

Recent studies in which workload or strain causes pain in connective and muscular tissue support interventions to reduce kinetic effects on such tissue.40 Nigg’s Preferred Movement Pathway theory stresses force reduction and advocates self-selection based on comfort;3,41 however, this and other similar theories need vigorous scientific inquiry.

Conclusions and recommendations

Clinicians should advocate for the cost-effective, judicious use of foot orthoses for runners with plantar fasciitis, in accordance with the present body of knowledge, which suggests such devices should:

  • be comfortable42
  • provide shock absorption35,36
  • not increase torque at other lower extremity joints43
  • fit well in the shoe without hindering use of the toe flexors and intrinsic muscles44
  • be semicustomizable for patient comfort; and
  • address any compensatory adaptations.

Future studies should continue to assess the kinematic causes and effects of plantar fasciitis in the running population, along with factors that predict positive response to treatment.

Patricia Pande, MClScPT, CSCS, CPed, is a physical therapist, pedorthist, strength and conditioning specialist, and founder of FootCentric, an online continuing education company dedicated to comprehensive, multidisciplinary foot treatment.