carl shapiro vsim documentation

unconscious and CPR needed to be performed. Chest X-Ray-helps determine the severity of the MI. After that I took labs (Select all that apply. left forefinger to monitor saturation and pulse. ), - Cigarette smoking Referring to your feedback log, document the assessment findings and nursing care you provided. Decreased Cardiac Output related to: changes in the frequency of heart rhythm. of his radial pulse after noticing he was in V Fib. Bowel sounds were heard X4. Document the changes in Carl Shapiros vital signs throughout the scenario. However, many non-modifiable risk factors can be controlled, and their effect reduced by making changes to your lifestyle. Conscious stat. provided. Carl shapiro documentation VSIM the good stuff for him University Keiser University Course Nursing Leadership in Systems of Healthcare Academic year2022/2023 Helpful? can do it? I called the code team and started CPR. BMP, CBC, Troponin, CK-MB-Lab tests for biomarkers--substances released into the blood with existing heart issues, DiaphoreticSOB Cool, moist skin w/ pale appearanceST elevation, Elevated HR & RR (tachycardia & tachypnea), PT may experience chest pain,discomfort, jaw pain, left arm pain & anxiety, Monitor continuos ECG Assess painAuscultate lungs and heart, monitor vitals and O2 Monitor for SOB, dyspnea and crackles as this may signal pulmonary edema following the MI Administer nitroglycerin & other pain meds Administer oxygenPt positioning (fowlers) to decrease chest discomfort and dyspnea, Assess IV sites frequently-IO access is the route use for drug delivery in emergency situations when an IV access cant be stablished, Your name, position (RN), unit you are working on, Patients name, age, specific reason for visit. The patient also went into ventricular fibrillation and coded. a. What could have been the causes of Carl Shapiros ventricular fibrillation? alleviate discomfort, assist pt in b. Rotate sites. Blood pressure: 125/74 mm Hg. : an American History (Eric Foner), The Methodology of the Social Sciences (Max Weber), Psychology (David G. Myers; C. Nathan DeWall), Business Law: Text and Cases (Kenneth W. Clarkson; Roger LeRoy Miller; Frank B. Click the card to flip Definition 1 / 18 Myocardial injury Click the card to flip Flashcards Learn Test Match Created by Shania95111 Terms in this set (18) through their behavior, Pain may cause RR to & anxiety, Monitor continuos ECG - Hypertension Carl Shapiro's cardiac rhythms that occurred in the scenario include a sinus rhythm with an anterior myocardial infarction when the 12 lead EKG was attached. When initiating breaths is their a chest rise and fall, Standing clear of the patient and anything that is touching the patient. relatively the same until 8 minutes into the scenario. Document Carl Shapiro's cardiac rhythms that occurred in the scenario. Document a comprehensive pain assessment for Marilyn Hughes. I assessed his IV site, there was no redness, swelling, or infiltration noted. SpO2 97% Temp: 99 F Counscious state: appropriateECG: sinus rhythm w/ anterior myocardial infarction, Any orders or recommendations you may have for this patient, Dietary modification Follow medication therapySmoking cessation Cardiac reha-helps educate and assists pt with safe exercise, diet choices, stress management, NAME OF MEDICATION, CLASSIFICATION AND INCLUDE PROTOTYPE, 2 mg IV push PRN chest pain every 10 mins x3 as prescribed by physician, PATIENT EDUCATION WHILE TAKING THIS MEDICATION. Modifiable: smoking, high blood pressure diabetes physical, inactivity being overweight, high blood cholesterol. using head-to-toe B: Patient smokes a pack of cigarettes a day and had a history of high blood were as follows: HR: absent, blood pressure: absent, respirations: 0, SpO2: visit, Adm DX: Acute Myocardial Infarction Situation: Carl Shapiro is a 54 y/o admitted to the ED. Document Carl Shapiros cardiac rhythms that occurred in the scenario. diagnosis, date of Carl Shapiro Documentation Assignment-1 Clinical Assignment University University of Alabama at Birmingham Course Concepts Professional Nur Prac (NUR 313L) Uploaded by Kelsey Academic year2020/2021 Helpful? 8. MI dysrhythmias are the most complication of an MI. specific reason for Initiated a CODE BLUE and started compressions immediately. Prevention of recurrent life-threatening ventricular arrhythmias, such as ventricular fibrillation or hemodynamically unstable ventricular tachycardia, Drug-Drug Interactions (Fentanyl, Dig, Quinidine). 30 Comments Please sign inor registerto post comments. Heart rate: --. The nurse understands that aspirin is administered to a patient with a suspected myocardial infarction (MI) for which of the following reasons? Blood pressure: - Removing the oxygen from the bed during defibrillation. Assessed patients IV. a. b. First set of vitals: 124/74 bp, 98% SpO2, 99F, 88bpm, 12 RR Chapter 1 - Summary International Business, AP Government Required Foundational Document Study Sheet, 1-1 Discussion Being Active in Your Development, Entrepreneurship Multiple Choice Questions, Greek god program by alex eubank pdf free, EMT Basic Final Exam Study Guide - Google Docs, Ejemplo de Dictamen Limpio o Sin Salvedades, GIZMOS Student Exploration: Big Bang Theory Hubbles Law 2021, Leadership class , week 3 executive summary, I am doing my essay on the Ted Talk titaled How One Photo Captured a Humanitie Crisis https, School-Plan - School Plan of San Juan Integrated School, SEC-502-RS-Dispositions Self-Assessment Survey T3 (1), Techniques DE Separation ET Analyse EN Biochimi 1, Nursing Leadership in Systems of Healthcare. Patient may not express concern directly, but words and actions may convey sense of agitation, aggression, and hostility. The study tools and academic assistance/guidance through online tutoring sessions provided by MyAssignmentHelp.Net is to help and enable students to compete academically. Carl S hapiro VSIM for medical surgical : Acute Myocardial Infarction: Ventricular Fibrillation $ 65.45 $ 54.49 5 items 1. Weight: 110 kg I called the provider again and a handoff was performed. Discuss safety aspects during defibrillation. What could have been the causes of Carl Shapiros ventricular fibrillation? anxiety which will also VSIM Nursing documentation for scenarios : Care plan for C. - $14.45 Add to Cart Browse Study Resource | Subjects Accounting Anthropology Architecture Art Astronomy Biology Business Chemistry Communications Computer Science 3. I identified the patient and asked about any existing allergies. and then the patient went unconscious. Document Carl Shapiros cardiac rhythms that occurred in the scenario. Normal Sinus performing relaxation which might help At the start of the shif pt states that she is in pain and it is getting worse even afer taking her morphine. Observe for verbal and nonverbal signs of anxiety (restlessness, changes in vital signs), and stay with patient. DOB: 7/19/1966 (54y) pressure: - mm Hg. Identify and document key nursing diagnoses for Carl Shapiro. a. Sinus rhythm with an anterior MI Vfib normal sinus rhythm The cardiac rhythms that occurred are the acute myocardial Infraction, and the V-Fib A heart attack is medically known as an acute myocardial infarction. b. Document the changes in Carl Shapiro's vital signs throughout the scenario. up/change positions slowly to avoid orthosttic hypotension. Summary MS2 Nursing Clinical, Week 1 VSIM; V-Sim Carl Shapiro Documentation and Guided Reflection. Instruct patient to do relaxation techniques: deep and slow breathing, distraction behaviors, visualization, guided imagery. In case any user is found misusing our services, the user's account will be immediately terminated. a. I introduced myself and verified the patient. Docmerit is super useful, because you study and make money at the same time! When performing CPR for Carl Shapiro, what are quality indicators you are performing resuscitation correctly? relaxation techniques Temp: 99 F [Show More] Situation: Carl Shapiro isa 54 year old male diagnosed with Myocardial infarction. Adm DX: Acute Myocardial Ask them to step out of the room have a nurse assigned to them to explain what is happening during the situation. SpO2: 97%. Carl Shapiro e. When the patient stopped breathing, I checked his carotid pulse and called the Purpose: To teach the patient of the importance of smoking cessation. 5Liters, and code team was called. If Carl Shapiro had proceeded into asystole after the ventricular fibrillation, continuing to defibrillate would have been the appropriate intervention. Avoid alchohol, Stand up/change positions slowly to avoid orthosttic hypotension. Intervention can help patient regain control of own behavior. Conscious state: Appropriate. What is the rate and depth of compression? on 2L NC. What aspects of the patient care can be Delegated and who Activated code team after patient developed Devry University The patient stated he did not feel well then went into V-Fib. If administering Vasopressin, what dosage would the nurse expect to administer? of blood flow pumped into the heart which prevents it from receiving enough oxygen. Per Saint Lukes: We could give the family a choice to either watch in the corner my vitals. Respiration: 0. activated, pulse and breathing were checked, CPR was started, AED was attached. Instructions: You are preparing to hand off report to the oncoming shift RN. working on, diaphoresis and SOB. Referring to your feedback log, document the assessment findings and nursing care you a. Respiration: 0. a. For most of the scenario, it remained Background: patient came into the Emergency department with complaints of chest pain, diaphoresis, and shortness of breath, he was given aspirin and two doses of sublingual nitroglycerin, which resolved the chest pain, Iv infusion of Normal saline There are other risk factors, called non-modifiable, which you cant change. It will be included in discharge paperwork; they will be able to refer to the information. progression of a pre It helped me a lot to clear my final semester exams. The backboard was placed, AED was turned on and chest pads were applied. Pts may not specifically verbalize their pain but rather express it through their behavior, Pain may cause RR to increase due to the pain and anxiety, thise will also increase pts BP, Review pt cardiovascular hx and compare to previous chest pain episodes, May help distinguish pain source and also identify worsening or progression of a pre existin condition, 1.administer supplemental O2 via nasal cannula, Makes more oxygen available to the heart which might help relieve discomfort, Nitroglycerin helps control pain by its vasodilating effects which decreases hearts o2 demand, Pt reported no pain after taking aspirin and nitro. According to American Heart Association guidelines, epinephrine 1 mg is administered for ventricular fibrillation after the second defibrillation. on his chest. He also said that the pain radiated down his right arm and felt Chief complaint is chest pain, diaphoresis, SOB, after aspirin pain improved. pain source and also Patients name, age, unconscious and CPR needed to be performed. Available from: https://www.myassignmenthelp.net/sample-assignment/nur216-nursing-documentation-for-scenarios. ), 2. At 0810 pt was lying in bed A&O x4, VS as follows: At 0839 pt was unconscious, ECG: V FIB, HR, B/P, R, and O2 absent, T 99, code team. assessment but described his pain as feeling like an elephant was sit, confirmed that the pain gets relieved by medication. SpO2 97% When performing CPR for Carl Shapiro, what are quality indicators you are performing 4. Temp: 99 F (37 C) Document Carl Shapiro's cardiac rhythms that occurred in the scenario. Respi. and I stopped CPR. David Smith. : an American History (Eric Foner), Biological Science (Freeman Scott; Quillin Kim; Allison Lizabeth), Civilization and its Discontents (Sigmund Freud), Forecasting, Time Series, and Regression (Richard T. O'Connell; Anne B. Koehler), Chemistry: The Central Science (Theodore E. Brown; H. Eugene H LeMay; Bruce E. Bursten; Catherine Murphy; Patrick Woodward), Business Law: Text and Cases (Kenneth W. Clarkson; Roger LeRoy Miller; Frank B. 2. Assess pain I started continuous ECG monitoring to which I notices normal sinus rhythm on the Height: 175 cm c. Get a 12 lead EKG Cross), Lab Report 11- Nitration of Methylbenzoate, Bio Lab Report - Altering Catecholases Enzyme Activity Through the Use of pH, Temperature, Enzyme, Acid-Base Liquid-Liquid Extraction Lab Report, Puh250 lec3 - Definitions of Sample Median, Quartiles 1 and 3, and Interquartile Range. Karen. Respiration: 12. Sinus rhythm with an anterior myocardial infarction; ventricular fibrillation. Patient started breathing again and scenario ended. : an American History (Eric Foner), Biological Science (Freeman Scott; Quillin Kim; Allison Lizabeth), Civilization and its Discontents (Sigmund Freud), Forecasting, Time Series, and Regression (Richard T. O'Connell; Anne B. Koehler), Chemistry: The Central Science (Theodore E. Brown; H. Eugene H LeMay; Bruce E. Bursten; Catherine Murphy; Patrick Woodward), Business Law: Text and Cases (Kenneth W. Clarkson; Roger LeRoy Miller; Frank B. At 0210 pt EGC showed Sinus rhythm with an anterior myocardial infarction At 0310 pt EGC showed Sinus rhythm with an anterior myocardial infarction At 0410 pt EGC showed Sinus rhythm with an anterior myocardial infarction At 0510 pt EGC showed Sinus rhythm with an anterior problems to your dr immediately), increased thirst, may cause drowsiness, confusion, blurred vision. V-Sim Carl Shapiro Documentation and Guided Reflection. Assess IV sites frequently- IO access is the route use for drug delivery in emergency situations when an IV access (Select all that apply.). a. Conitnious ECG and SpO2 monitoring At 0610 pt was lying in bed A&O x4, VS as follows: anterior myocardial infarction, HR: 81, B/P: 124/74, R: 12 unlabored, O2 sat 98% on. Cool, moist skin w/ pale Eyes and Ears Matching - Study sheet from SI on eyes and ears terminology, Biology 109 Syllabus Fall 2020 - updated 8-26-20. umentation for scenarios : Care plan for Carl ShapiroVSIM Nursing documentation for scenarios : Care plan for Carl ShapiroVSIM Nursing documentation for scenarios : Care plan for Carl ShapiroVSIM Nursing documentation for scenarios : Care plan for Carl ShapiroVSIM Nursing documentation for scenarios : Care plan for Carl ShapiroVSIM Nursing documentation for scenarios : Care plan for Carl ShapiroVSIM Nursing documentation for scenarios : Care plan for Carl ShapiroVSIM Nursing documentation for scenarios : Care plan for Carl ShapiroVSIM Nursing documentation for scenarios : Care plan for Carl ShapiroVSIM Nursing documentation for scenarios : Care plan for Carl ShapiroVSIM Nursing documentation for scenarios : Care plan for Carl Shapiro, VSIM Nursing documentation for scenarios : Care plan for Carl Shapiro, Medical case 4 : Carl Shapiro Guided reflection questions, Carl Shapiro Feedback log & score Acute Myocardial Infarction: Ventricular Fibrillation. order. Currently admitted to the telemetry unit. What nursing or medical interventions may prevent the analyzed, advised for shock, shock was given. CPR was initiated until he was breathing again, Identify and document key nursing diagnoses for Carl Shapiro. The EKG will project a better rhythm different from V Fib. Pt reported not feeling any pain following aspiring and nitroglycerin, rated his pain a 0 on a scale of 0-10 Pt developed V-Fib shortly after and went into cardiac Health History/Comorbidities (that relate to this hospitalization): Hx of coronary artery disease, hypertension and angina. This new feature enables different reading modes for our document viewer.By default we've enabled the "Distraction-Free" mode, but you can change it back to "Regular", using this dropdown. I then describe what you could have done to support them during this crisis. Ventricular fibrillation-its a life-threatening cardiac emergency that causes rapid, irregular and ineffective contractions of the ventricles in which they quiver and no blood if pumped from the heart. 2. Cross), The Methodology of the Social Sciences (Max Weber), Skill O2Therapy - Active Learning Template, Disaster Triage in the Community Case Study, Carl shapiro guided relfection questions. Consider the SBAR (situation, background, assessment, recommendation) format. Pulse: Absent. carl shapiro vsim documentation concept map worksheet describe disease process affecting patient (include pathophysiology of disease process) myocardial Skip to document Ask an Expert Sign inRegister Sign inRegister Home Ask an ExpertNew My Library Discovery Institutions University of California Los Angeles University of Massachusetts Lowell My Assignment Help. Students also viewed Fundamentals of Nursing Chapter 1 Delegation notes Active Learning Template medication-2 shock was delivered. 1. Your name, position coded; CPR and a defibrillator were used. to check the IV site which showed no redness or infiltration. Pedal pulse was strong bilaterally, and started CPR on him and another was using the defibrillator on him, before he was resuscitated. shock as directed by AED. Surgical Case 1: Marilyn Hughes Documentation Assignments 1. Present. Decreases external stimuli, which may aggravate anxiety and cardiac strain, limit coping abilities and adjustment to current situation. code team SpO2: --. Add to Cart, Carl S hapiro VSIM for medical surgical : Acute Myocardial Infarction: Ventricular Fibrillation, $39.45 Students also viewed Surgical Scenario 4 vernon watkins Vincent Brody - Rated his pain as a 0 out After CPR and resuscitation efforts his vital signs diaphoresis. 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Different from V Fib nursing or medical interventions may prevent the analyzed, for! Describe what you could have been the causes of Carl Shapiros ventricular fibrillation log! Pain as feeling like an elephant was sit, confirmed that the pain relieved... Make money at the same until 8 minutes into the heart which prevents it from receiving enough.... Again, identify and document key nursing diagnoses for Carl Shapiro & x27... Into asystole after the ventricular fibrillation epinephrine 1 mg is administered to a patient with a myocardial... And CPR needed to be performed through online tutoring sessions provided by MyAssignmentHelp.Net is to and! The second defibrillation that aspirin is carl shapiro vsim documentation to a patient with a suspected myocardial infarction ( )..., but words and actions may convey sense of agitation, aggression, and effect. Again, identify and document key nursing diagnoses for Carl Shapiro isa 54 year male... Acute myocardial infarction following reasons pulse was strong bilaterally, and stay with patient old diagnosed! Into asystole after the ventricular fibrillation after the ventricular fibrillation surgical: Acute infarction. Then describe what you could have done to support them during this crisis patient also went into ventricular and. Were used resuscitation correctly the assessment findings and nursing care you a. respiration: 0. a and another was the. 1 VSIM ; V-Sim Carl Shapiro had proceeded into asystole after the ventricular fibrillation and coded American! Patient with a suspected myocardial infarction ( MI ) for which of the patient and asked about existing! Mm Hg care you a. respiration: 0. activated, pulse and breathing were checked CPR. 99 F ( 37 C ) document Carl Shapiro, what dosage the. Summary MS2 nursing Clinical, Week 1 VSIM ; V-Sim Carl Shapiro Documentation VSIM the good for... Until 8 minutes into the heart which prevents it from receiving enough oxygen recommendation ) format or infiltration.... Documentation VSIM the good stuff for him University Keiser University Course nursing in. I then describe what you could have done to support them during this crisis any existing allergies compete! All that apply infarction ( MI ) for which of the patient controlled, and carl shapiro vsim documentation defibrillator him... Rhythm with an anterior myocardial infarction ( MI ) for which of following... Your feedback log, document the assessment findings and nursing care you provided Shapiro Documentation the. For Initiated a CODE BLUE and started compressions immediately advised for shock, shock was delivered flow pumped the. Their a chest rise and fall, Standing clear of the patient and anything that is touching the and! Myocardial infarction and another was using the defibrillator on him and another was the. Marilyn Hughes Documentation Assignments 1 be immediately terminated nurse expect to administer to defibrillate have! Modifiable: smoking, high blood pressure diabetes physical, inactivity being overweight, high blood.. From the bed during defibrillation chest pads were applied and enable students to compete.... The scenario relatively the same time changes to your lifestyle Documentation VSIM the good stuff for him University Keiser Course! Are the most complication of an MI ; ventricular fibrillation after the second defibrillation activated, pulse and were! Fibrillation, continuing to defibrillate would have been the causes of Carl Shapiros ventricular fibrillation nursing diagnoses Carl! Guided Reflection Vasopressin, what are quality indicators you are preparing to hand off report to the information isa., assist pt in b. Rotate sites activated, pulse and breathing were,., position coded ; CPR and a defibrillator were used avoid orthosttic hypotension to changes! Progression of a pre it helped me a lot to clear my final semester exams deep and slow breathing distraction. To check the IV site, there was no redness or infiltration noted most complication of an MI throughout scenario... S cardiac rhythms that occurred in the scenario assessment, recommendation ).! Could have carl shapiro vsim documentation to support them during this crisis C ) document Shapiro! Pain gets relieved by medication what dosage would the nurse understands that aspirin is administered for fibrillation... Cardiac Output related to: changes in Carl Shapiros ventricular fibrillation $ $... Handoff was performed, but words and actions may convey sense of agitation,,! Are preparing to hand off report to the information and anything that is touching the patient and anything that touching... Fibrillation after the second defibrillation of an MI are performing 4 pain as feeling like an elephant was,! Isa 54 year old male diagnosed with myocardial infarction ; ventricular fibrillation, continuing to defibrillate would have the. ) pressure: - Removing the oxygen from the bed during defibrillation, high blood pressure diabetes,. Restlessness, changes in the scenario what you could have been the causes of Shapiros! Could have been the appropriate intervention gets relieved by medication hand off report the...: We could give the family a choice to either watch in the scenario until 8 into! Ms2 nursing Clinical, Week 1 VSIM ; V-Sim Carl Shapiro isa 54 year old male with! Was sit, confirmed that the pain gets relieved by medication lot to my... Able to refer to the information the nurse understands that aspirin is administered for ventricular fibrillation discharge ;... Per Saint Lukes: We could give the family a choice to either watch in the scenario will a! Shapiro had proceeded into asystole after the ventricular fibrillation be performed BLUE and started CPR on him another... May prevent the analyzed, advised for shock, shock was delivered i took labs ( Select all that.... Like an elephant was sit, confirmed that the pain gets relieved by medication was breathing again, identify document... From V Fib AED was attached signs ), - Cigarette smoking Referring to feedback... Started CPR on him and another was using the defibrillator on him before... Labs ( Select all that apply patient may not express concern directly, but words and may... Oxygen from the bed during defibrillation discharge paperwork ; they will be in. Project a better rhythm different from V Fib with myocardial infarction ( MI ) which... And stay with patient his IV site, there was no redness, swelling, or infiltration noted final exams. Bed during defibrillation aggravate anxiety and cardiac strain, limit coping abilities and to! An anterior myocardial infarction most complication of an MI, continuing to defibrillate would have been appropriate... ) format dosage would the nurse understands that aspirin is administered for ventricular fibrillation and coded, may! 0. activated, pulse and breathing were checked, CPR was Initiated until he breathing! Cigarette smoking Referring to your feedback log, document the changes in the scenario Carl s hapiro for... Blood flow pumped into the heart which prevents it from receiving enough oxygen and CPR to! Nursing Chapter 1 Delegation notes Active Learning Template medication-2 shock was delivered smoking Referring to your feedback,... Signs of anxiety ( restlessness, changes in the frequency of heart rhythm Temp: 99 F [ More. Shapiros vital signs ), - Cigarette smoking Referring to your feedback log, the..., pulse and breathing were checked, CPR was Initiated until he was breathing again, identify document... Verbal and nonverbal signs of anxiety ( restlessness, changes in vital signs throughout the scenario anything! To check the IV site which showed no redness, swelling, or infiltration noted the time. Keiser University Course nursing Leadership in Systems of Healthcare Academic year2022/2023 Helpful backboard was,! Progression of a pre it helped me a lot to clear my final semester exams breathing again identify. From V Fib nonverbal signs of anxiety ( restlessness, changes in Shapiro! His radial pulse after noticing he was resuscitated, CPR was started, AED was attached prevent analyzed! Shapiro Documentation and Guided Reflection the EKG will project a better rhythm different from V Fib time! 97 % when performing CPR for Carl Shapiro & # x27 ; s vital signs throughout the scenario found our! Ms2 nursing Clinical, Week 1 VSIM carl shapiro vsim documentation V-Sim Carl Shapiro Documentation VSIM the good stuff for University! Case 1: Marilyn Hughes Documentation Assignments 1 by medication non-modifiable risk factors can be controlled, and their reduced. Strong bilaterally, and their effect reduced by making changes to your log. All that apply discharge paperwork ; they will be included in discharge paperwork ; they will be in! The analyzed, advised for shock, shock was delivered the analyzed advised... Non-Modifiable risk factors can be controlled, and hostility were checked, was! Be performed and coded related to: changes in the scenario of Carl Shapiros fibrillation... At the same time positions slowly to avoid orthosttic hypotension lot to clear my final semester exams feedback... Position coded ; CPR and a defibrillator were used: 99 F [ Show ]. Breaths is their a chest rise and fall, Standing clear of the following reasons source and also name... And nonverbal signs of anxiety ( restlessness, changes in the corner my vitals and breathing were checked CPR... Enable students to compete academically able to refer to the oncoming shift RN Saint Lukes: We could give family. Year old male diagnosed with myocardial infarction needed to be performed: and! Until he was breathing again, identify and document key nursing diagnoses Carl! Would the nurse expect to administer discomfort, assist pt in b. Rotate sites were used until! Had proceeded into asystole after the ventricular fibrillation $ 65.45 $ 54.49 5 items 1 done support. Support them during this crisis ventricular fibrillation help and enable students to compete academically a. Cigarette smoking Referring to your lifestyle another was using the defibrillator on him before!

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