Heart Attack : What is the recent research?

Of late research has shown that the amino acid Homocystine is associated with increased risk of myocardial infarction.

Newer drugs are in clinical trials for the lysis (dissolving) of the clots in the arterial lumen.

Keyhole cardiac surgery has been recently developed to minimise the trauma of an open-heart surgery.

Heart Attack : How will associated conditions affect the patient?

Many patients who have a heart attack have co-existing conditions that may affect him and are a risk factor for coronary artery disease. Hyperlipidemia (increase blood fats), hypertension, diabetes mellitus, cigarette smoking. Other risk factors include a family history of premature coronary artery disease (disease of the heart vessels), age, male gender, post menopausal women, physical inactivity.

Heart Attack : What are the ways to prevent the disease?

Stay in touch with friends and family. Research shows that peoplewith poor social support are more vulnerable to heart disease. Also, seek waysto control feelings of anger and hostility; these emotions may add to heartattack risk.

Assess your heart attack risk profile and make appropriate changes to diet andlifestyle early.

If you are at high risk for heart attack, have yourself tested regularly forsilent ischemia.

Talk with your doctor about taking an aspirin daily. Studies have shown thatthis regimen significantly reduces the risk of heart attack.

Call your doctor if :
You or someone you are with manifests signs of a heart attack. Seek emergency help without delay.

You suffer from angina (chest pain) and begin to experience pain that is similar but does not respond to medication; this may indicate that a heart attack is under way.

Your angina attacks become more frequent, prolonged and severe; as angina worsens, the risk of heart attack increases.

You are taking aspirin to prevent heart attack and your stool appears black and tarry. This may indicate gastrointestinal bleeding and could be a sign that aspirin has thinned your blood too much, a problem that can and should be corrected.

Heart Attack : What is the likely recovery period?

The likely recovery period after an uncomplicated heart attack is usually 2- 3 weeks and he can resume his regular duties after a period of about 6 weeks. In a case of a heart attack with complications the recovery period varies and depends on the treatment of the complication and is variable. Angioplasty patients will experience a much quicker recovery period because the procedure is less invasive than bypass surgery. If you received angioplasty, with or without the insertion of astent, you will be closely monitored as well, but can expect to leave the hospital within a few days. If you had coronary artery bypass graft surgery you may be able to leave the hospital sometime within one to two weeks of surgery, depending on your progress.

Heart Attack : What is the post treatment follow-up that is required?

Apart from medications and regular check-ups by a cardiologist, dietary and lifestyle changes are extremely important in maintaining health after a heart attack, in turn lowering the risks of another attack. The following precautions must be taken:-

Lifestyle
A smoker must quit the habit immediately since smoking considerably increases the probability of a repeat heart attack.

Regular aerobic exercise greatly enhances efforts to prevent or recover from heart attack. If you already have a heart condition, schedule a stress test before beginning an exercise program in order to determine how much exertion is safe. Heart attack survivors are advised to exercise with other people rather than alone during the first months of recovery. Many community health and recreation centers offer physician-supervised cardiovascular rehabilitation programs.

It is essential to avoid exercising in extremes of heat or cold, or immediately after meals

Mind/body medicine
Reducing stress by training the mind and body to relax may be one of the risk factors that you can control to help prevent heart attack and can aid in recovery. Many techniques promote relaxation, such as, meditation, biofeedback and yoga. Relaxation has also been shown to provide relief from pain, which may be encountered during the recovery period.

State of mind is another important consideration in heart attack recovery. People with a positive attitude about recovery tend to do much better than people who view themselves as "cardiac cripples." You may find that a particular mind/body technique helps you to focus on positive thoughts. You may also find, as many others have, that sharing thoughts and emotions with a support group is extremely beneficial.

Nutrition and Diet
The basic goals of a heart-healthy diet are to keep salt, sugar and saturated fat to a minimum so as to reduce cholesterol, control blood pressure and hold weight in check. Eating magnesium-rich foods such as nuts, beans, bran, fish and dark green vegetables may help prevent heart attack. Magnesium protects the heart directly and indirectly, by stabilizing heart rate, reducing coronary artery spasm, and combating such conditions as atherosclerosis and high blood pressure.

Much evidence suggests that unstable chemical compounds known as free radicals make the body more vulnerable to heart attack by striking the heart and coronary arteries and promotingatherosclerosis. Free radicals can be neutralized by antioxidants like vitamins A, C and E. Fruits, vegetables and grains supply many of the antioxidant vitamins.

Eating root vegetables, such as carrots, may also help prevent heart attack. These vegetables lower cholesterol over the long term and reduce blood-clotting activity.

At least one-third of repeat heart attacks can be avoided by lowering LDL cholesterol and raising HDL cholesterol levels. Therefore, the patient should keep a strict check on his saturated fat intake. It would be invaluable for him to maintain a record of hisLDL/HDL cholesterol ratio and the triglyceride level to enable him to measure his progress. The patient should aim to achieve LDL cholesterol of less than 100 mg by minimising or even eliminating animal fat from his dietary regimen. To attain HDL cholesterol level greater than 45 mg, he must reach and maintain a near-ideal body weight by diet and exercise such as walking and aerobics.

At-home remedies
Remember: Having a heart attack does not make you an invalid. You can best heal your heart by remaining active.

Do not take birth-control pills if you have had a heart attack; they are linked to increased blood-clotting activity.

Get a pet. Pet owners recover more quickly from heart attacks, probably because of reduced stress levels, and tend to live longer than people without pets. Just be sure to choose a pet that fits your lifestyle.

Heart Attack : What does the patient's family need to know?

The disease is treatable and can be managed appropriately with modifications in diet and lifestyle and medications as advised by the cardiologist. If the patient needs surgical treatment after the heart attack it is important for the family to prepare itself for any eventuality although the risk of death during surgery is very low.

Heart Attack : What is the treatment given?

Heart attack is a medical emergency that must be quickly addressed by conventional medicine. Alternative medicine cannot compete with standard drug and surgical therapy during the emergency and follow-up phases of heart attack. However, alternative medicine can make valuable contributions to prevention and recovery.

Heart attack victims are usually hospitalised in special coronary care units (CCU) for at least 36 hours. The immediate goal of treatment is to quickly open the blocked artery and restore blood flow to the heart muscle; a process called "reperfusion." Once the artery is open, the heart attack is generally halted and the patient becomes pain free. Early reperfusion minimises the extent of heart muscle damage and preserves the pumping function of the heart. Delay in establishing reperfusion can result in irreversible death to the heart muscle cells and reduced pumping force of the remaining heart muscle. The amount and health of the remaining heart muscle is the major determinant of the future quality of life and longevity for a patient after a heart attack. Optimal benefit is obtained if reperfusion can be established in the first 4- 6 hours of a heart attack.

In the acute phase the following treatment may be given:-

Clot dissolving medicines (thrombolytic agents) such as tissue plasminogen activator (TPA) or streptokinase given intravenously can successfully open up to 80% of acutely occluded coronary arteries. The earlier these agents are administered, the better the success at opening the artery, and the more effective the preservation of heart muscle. If thrombolytic administration is given too late (more than 6 hours after the onset of the heart attack), most of the muscle damage may have already occurred.

Emergency angioplasty (to relieve the blocked artery) and possibly surgery might be performed to remove a clot, reopen a clogged artery, or bypass blocked arteries.

An anti-coagulant, heparin, is given intravenously in the hospital as a blood-thinning agent to prevent blood clots and to maintain an open artery during the initial 24-72 hours of the heart attack.

The most direct method of opening a blocked artery, provided the hospital has a cardiac catheterisation facility, is to perform an immediate coronary angiogram and PTCA (percutaneous transluminal coronary angioplasty). Under x-ray guidance, a tiny plastic catheter with a balloon at the end is advanced over a fine guide wire to the blockage site and inflated, thus pushing the clot and plaque out of the way. PTCA can be effective in opening up to 95% of arteries, usually within 60 minutes. In addition, the angiogram allows evaluation of the status of the other coronary arteries, so that long- term treatment plans may be formulated. Recently, it has been demonstrated that the placement of a coronary stent (a tiny hollow cylinder) at the time of PTCA results in even better long term outcomes, with a lower recurrence rate and lower risk of repeat heart attack. These results may be further enhanced by the addition of newer super aspirins (potent blood thinners that work to antagonize the blood-clotting effects of platelets in the blood and in the cholesterol plaque), which are given at the time of PTCA or coronary stenting.

In some patients, PTCA can be technically difficult or dangerous to perform. In others, PTCA and thrombolytic medications may fail to achieve reperfusion or maintain open arteries. These patients may be considered for coronary artery bypass graft (CABG) surgery.

Nitroglycerin, a vasodilator (blood vessel dilator), which opens the blood vessel by relaxing the muscular wall of the blood vessel, is given intravenously in an emergency and later as skin patches to prevent blood vessel spasm and to minimise the size of the heart attack.

While hospitalized, heart attack patients are hooked to ECG machines for constant monitoring, in case heart rhythm abnormalities develop. If the heart starts beating too fast or too slow, various medications may be given. Some patients may be fitted with pacemakers. If a patient experiences a dangerous arrhythmia known as ventricular fibrillation, an electric shock to the chest is administered. Patients who show signs of congestive heart failure are given a variety of medications to decrease strain on the heart and to encourage the heart to beat more forcefully.

After the acute attack is controlled the following drugs are often used in combination or alone:-

Aspirin- a daily low dose of aspirin (81-325 mg) taken on a lifelong basis decreases repeat heart attacks significantly. For those patients allergic to aspirin, ticlopidine may be substituted. Anti-platelet agents, like aspirin, reduce the tendency of platelets (a type of blood cells that play a role in the normal clotting mechanism) in the blood to clump and clot. Aspirin is given to patients with a heart attack, unless there is a history of significant intolerance to aspirin. These agents work in conjunction with the above-mentioned reperfusion therapies (like surgery and angioplasty) to decrease the possibility of recurrent closure of the artery and improve the chances of survival.

Beta-blockers- the use of beta-blockers such as metoprolol and atenelol significantly increase the survival in a person who has had a heart attack. Long-term administration of these agents following a heart attack has been shown to improve survival and reduce the risk of future heart attacks.

ACE Inhibitors- ACE (angiotensin converting enzyme) inhibitors, another class of drugs, are often given orally after a large heart attack to improve the heart muscle healing process. Examples of ACE inhibitors include captopril, enalapril and lisinopril. These medications reduce the stress load to the heart, thereby helping the damaged heart muscle to recover.

Calcium Channel Blockers- these drugs are used as a substitute for beta-blockers in-patients who suffer from angina (heart pain) after a heart attack or in those who have slow heart rates.

People recovering from a heart attack are urged to get back on their feet as quickly as possible, which reduces the chances of blood clots forming in the deep veins of the legs; the clots could travel through the circulatory system and lodge in the lung, creating a blockage. Gentle exercise is recommended, but nothing that requires significant exertion.

Post surgical management (after a bypass surgery)

After the surgery, the patient will awaken in the cardiovascular intensive care unit with: -

An oxygen mask,
One or two chest tubes to collect and drain any blood from the chest, and/or
EKG leads affixed to the chest to monitor the heart rhythm, and/or  

Intravenous tubing to inject fluids, antibiotics and medications into the patient, and to monitor his venous pressure. If needed, there will be an additional line that holds a pacemaker wire.

An arterial line, which is a catheter inserted into one of the arteries, usually in the wrist. This line will monitor the patient’s blood pressure.

After the patient's cardiac status is stabilised:-
The patient is often shifted to a post-operative ward, and his EKG continuously monitored.
The patient will be encouraged to first sit up in a chair, and then attempt to walk around the room.
Pain control, including oral painkillers will be provided.
The patient may be given oxygen and intravenous fluids.

On successive days following the surgery:-
The patient will be put on oral medications.
The patient will be motivated to increase walking, as this will facilitate a speedy recovery.
The patient may still be kept on intravenous fluids.
The patient’s diet will gradually be advanced.

Once the patient is walking around, is in no great pain or distress, and his heart rhythm is stable, he is ready to be discharged. In some cases, a Cardiac Rehabilitation Clinic may plan the patient’s care so as to enable him to make a smooth transition from hospital to home.

Your doctor/cardiologist is an important member of your healthcare team. He helps you receive the best possible care before, during and after hospitalisation. You should feel free to discuss any queries you may have with your doctor.

Heart Attack : What are the investigations?

The initial diagnosis of a heart attack is made by a combination of: Symptoms,

Electrocardiogram (EKG) changes: An EKG is a recording of the electrical activity of the heart, and can detect areas of ischemic heart muscle (muscle which is deprived of oxygen) and/or dead tissue in the heart.

Cardiac Enzymes Assay:- Cardiac enzymes are muscle proteins which are released into the blood circulation by dying heart muscles when their surrounding membranes dissolve. Such enzymes include creatine kinase (CK); special subforms of CK, LDH and protein called troponin.

Imaging:- Images of the heart and coronary arteries visualized by x-ray, angiograms (visualize the arteries) and radioisotope scans locate specific areas of damage and blockage in the coronary arteries.

Echocardiogram:- Investigation using the ultrasound to evaluate the heart's function and to visualise the chambers of the heart. This investigation helps the attending physician not only to assess the damage done to the heart but also to assess the effect of treatment. It is also an important investigation in the follow-up of the patient.

Heart Attack : How will the disease affect the patient and his/her life-style?

In the acute phase, when the patient is hospitalised, the patient is advised to limit his/her movements and physical activity. In stable patients physical activity is progressively advanced and by the third day they can move about their room. When the person is discharged from the hospital, he is advised to walk 2-3 times daily for 20-30 minutes as long as their pulse is maintained within 20 beats per minute of their standing heart rate. The patient also needs to modify diet and lifestyle and join a cardiac rehabilitation program that will educate him/her on the ways and means to limit the progression of the disease.

In long standing cases of heart disease with a history of heart attack the lifestyle of the patient gets restricted in-terms of diet, exercise, mobility, etc. especially if heart failure sets in. Additionally, the patient has to continuously visit the hospital and has often a long list of medicines to take. In some cases there is need for cardiac surgery (bypass surgery) which has its own set of factors that influence his/her lifestyle. In some cases there is a need to change the occupation to suit the condition of the heart.

Heart Attack : What are the precautions required?

Control of cardiac risk factors improves patient well being and reduces the likelihood of future cardiac events. Some of the precautions that need to be taken by a person who has suffered from a heart attack include:-
>Diet modification to reduce cholesterol and fat intake,
>Quit smoking,
>Start an exercise regimen,
>Treat any coexisting medical condition ,
>Take medications regularly as advised by your cardiologist.

Heart Attack : What is the prognosis?

Achieving prompt medical attention is the most important factor for an improved prognosis with a heart attack. Rapid evaluation allows early treatment of potentially life-threatening arrhythmias, and permits early reperfusion (return of blood flow) of the heart muscle. The sooner that reperfusion is established, the smaller the resultant heart attack will be. Large and active cardiac centers often have a chest pain unit, where patients are rapidly screened for the presence of a heart attack, and prompt therapy is initiated.

If the heart attack is controlled well (medical management) and the damage restricted there is a fair chance of minimizing the complications that arise. The outcome of the disease is dependent on the control of the acute event (the heart attack per se); follow-up management and lifestyle modifications, which include modification of risk factors. The prognosis of a first time heart at a younger age (young adult) is poorer that at an older age (seniors).

Heart Attack : How does the disease progress?

A person who has had a heart attack unless treated promptly by a doctor is in grave danger of possible complications that can be fatal. In those cases where a hart attack is not fatal there is always some residual malfunction that can range from irregular heartbeats to full blown chronic heart failure. Recurrence of heart attacks is commonly see if the risk factors are not controlled and a recurrence spells a poorer outcome.

Heart Attack : What are the signs and symptoms of the disease?

Chest pain or pressure is a common symptom of heart attack. Cardiac chest pain is often vague, or dull, and may be described as a pressure or band-like sensation, squeezing, heaviness, or other discomfort. Heart attacks frequently occur from 4:00 a.m. to 10:00 a.m.due to higher adrenaline (a hormone that prepares the body for fight or flight) levels released by the adrenal glands during the morning hours. Interestingly, heart attacks do not usually happen during exercise, although exercise is commonly associated with angina (heart pain). Approximately 1/4th of all heart attacks are silent i.e. without associated chest pain. In diabetics, the incidence of “silent” heart attacks may be much higher.

Heart attack victims may complain of:-
>chest pressure,
>sweating,
>jaw pain,
>heartburn and/or indigestion,
>arm pain (more commonly the left arm, but may be either),
>upper back pain,
>general malaise (vague feeling of illness),
>nausea,
>shortness of breath.

According to statistics, heart attacks prove fatal in approximately one-third cases. A heart attack, therefore, requires immediate medical attention. Survivors of a heart attack always run the risk of, heart failure due to weakness of the heart muscle, heart rhythm disturbances, and reinfarction (a repeat heart attack). Therefore, at the first signs of even one of the symptoms of a heart attack, such as a sudden chest pain brought on either by exercise or with no apparent cause, and that does not improve with rest or medication- a doctor should immediately be consulted.

Heart Attack : Who can get it?

People who have associated risk factors are more prone to get it. The following are the major risk factors for people who can get a heart attack.

Major risk factors
Cigarette smoking,
High blood cholesterol levels,
High blood pressure,
Physical inactivity.
Contributing risk factors
Diabetes.
Stress:-Type A Men over the age of 50 with a family history of heart disease are predisposed to heart attack.
Obesity.
High levels of estrogen are thought to protect premenopausal women fairly well from heart attack, but risk increases significantly after menopause. Some women opt for hormone replacement therapy after menopause; the choice should be made with full knowledge that elevated estrogen levels also increase the risk for breast and uterine cancers.
Other risk factors include
>Family history of premature heart disease,
>Age,
>Males,
>Post menopausal women,
>An association of more than one risk factor at a given time increases the risk of developing heart disease.

Heart Attack : How is it caused?

A heart attack is caused by the formation of a blood clot on a cholesterol plaque located on the inner wall of an artery that supplies the heart (coronary artery). Cholesterol plaque is caused by deposits of cholesterol in the artery walls and is a process that begins as early as in the late teens. Over the period of time, the accumulation of cholesterol plaque causes thickening of the artery walls and resultant narrowing of the arteries; a process called asatherosclerosis. Smoking, high blood pressure, elevated cholesterol, and diabetes can accelerate plaque formation. Ultimately, atherosclerosis causes significant narrowing of the coronary arteries to the extent that the blood supply to the heart muscle is compromised. During exercise or excitement, the narrowed coronary arteries cannot increase the blood supply to meet the increased oxygen demand of the heart muscle. When the heart muscle is thus deprived of blood oxygen, a condition called ischemia results. When the narrowing in the artery becomes critical, angina (heart pain) may result leading over time to a heart attack.

Occasionally the surface of the cholesterol plaque in the artery may rupture (tear away), which leads to the formation of blood clot on the surface of the plaque, which then completely occludes blood flow in the vessel and results in a heart attack. The cause of this “plaque rupture is largely unknown, but contributing factors may include cigarette smoking, elevated cholesterol, elevated levels of blood catecholamines (adrenaline), high blood pressure, and other mechanical and biochemical forces.

Unlike angina (heart pain), death of the heart muscle from a heart attack is permanent.

Heart Attack : What is the disease?

Myocardial or Cardiac infarction or Heart attack may be defined as infarction (death) of an area of the heart muscle, usually as a result of occlusion or blockage of a coronary artery (vessel supplying the heart with oxygen rich blood). Infarction occurs as a result of a sudden insufficiency of blood supply either due to some obstruction, pressure, clot or the artery twisting upon itself which in turn produces an area of necrosis (death of cells, tissue, or part of the organ). Death of the heart muscle often causes chest pain and electrical instability of the heart muscle tissue resulting in a malfunction or sudden death.

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Why reinvent the wheel when you can have your safety manual developed for you?

Remember, a safety and health manual is a plan put into practice. Keep your safety program on track by periodically checking its status.
Any good management system requires periodic review. Take a careful look at each component of your safety and health program to determine what is working well and what changes are needed. Any necessary improvements can be turned into new safety and health objectives for the coming year. Developing new action plans to implement these improvements will continue progress toward an effective safety and health program, reduce your safety and health risks, and increase efficiency and profit.
It is important to document your activities. The best way to evaluate the success of your safety and health program is to have documentation of what you have done, which provides guidance on how you can make it work even better.
Establishing a quality safety and health management system will take time and involve some resources, but you should be pleased with the results. Employees will feel reassured because of your commitment to their safety and health on the job. You may save money through increased productivity and reduced workers' compensation insurance costs. You may gain increased respect in your community. The tangible and intangible rewards for a solid safety and health program far outweigh the cost of an accident, injury or workplace fatality.
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When workers stay whole and healthy, the direct cost-savings to businesses include:

• lower workers' compensation insurance costs;
• reduced medical expenditures;
• smaller expenditures for return-to-work programs;
• fewer faulty products;
• lower costs for job accommodations for injured workers;
• less money spent for overtime benefits.

Safety and health also make big reductions in indirect costs, due to:

• increased productivity;
• higher quality products;
• increased morale;
• better labor/management relations;
• reduced turnover;
• better use of human resources.

Employees and their families benefit from safety and health because:

• their incomes are protected;
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• their stress is not increased.

Safety Culture Program Development and Assessment

Pay NOW to develop a safety culture
or
Pay LATER in higher workers’ compensation costs

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Learn how some companies turn a $1 cost in safety
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How??? …..they build a safety culture
and not a safety program.

In addition to their social costs, workplace injuries and illnesses have a major impact on an employer's bottom line. It has been estimated that employers pay almost $1 billion per week for direct workers' compensation costs alone. The costs of workplace injuries and illnesses include direct and indirect costs.

Direct costs include:

• workers' compensation payments
• medical expenses
• costs for legal services

Indirect costs include:

• training replacement employees
• accident investigation
• implementation of corrective measures
• lost productivity
• repairs of damaged equipment and property
• costs associated with lower employee morale and absenteeism

Typical Process for Building a Safety Culture

Each organization has it’s district strengths and weaknesses…no two are alike, so all programs have a framework, just customization for each organization. A typical approach includes:

Stage One: Assessment

Interviews and evaluation forms from all levels in the organization.
A report is made based on the information gathered. Recommendations are made for the path forward

Stage Two: Implementation

Training is conducted on various topics that were flushed out in the assessment stave. These are typically delivered on topic/unit basis so the organization can implement and improve one area before moving forward on the next. We consider these building blocks in establishing a strong foundation before moving to the next tier. Therefore, these sessions are given once a month and typically extend to 5-7 months.

Stage Three: Follow-up assessment

This is conducted through interviews, assessment tools and examination of the data. Any weaknesses are then addressed.

Before you decide where you are going,...you must learn where you are.
Baseline assessments are necessary before building successful strategies.
 

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Safety Consulting Overview

Businesses are continuously making safety and health changes in the workplace. But when making those changes, successful employers and managers want to be sure that they really work. What were the results? Was the change an improvement? Here are some examples of positive outcomes that employers use:

• reduced employee injury and illness
• increased employee satisfaction
• improved safe work practices
• reduced absenteeism
• reduced workers’ compensation costs or rates
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• improved workplace air quality

Measuring the results of workplace safety and health changes benefits employers and employees because both gain confidence that the change results in a safer workplace. Since most changes occur by trial and error or in stages, information about the effectiveness of each stage is naturally helpful to the process. These changes often result in increased productivity and demonstrate that employee safety and health can be a good investment. Employees must be involved throughout the selection of safety changes and their measurement.

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Penalty Reductions for Small Business

OSHA considers the size of the employer, among other factors when determining the penalty to be proposed for any violation. The Agency has always had detailed procedures in place for making this determination; they are currently in the OSHA Field Operations Manual (FOM) (OSHA Instruction CPL 02-00-148), which is conveyed to and followed by all compliance staff.
The FOM provides that proposed penalties will be reduced by the following percentages in considering employer size:
a 60% penalty reduction may be applied if an employer has 25 employees or fewer;
40% if the employer has 26-100 employees; and
20% if the employer has 101-250 employees.

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The Safety Scorecard:
How to Take Your Safety Program to the Next Level
Some organizations save $3 for every $1 spent on safety. By properly implementing a
safety management system, you can enhance productivity, profit, and competitive
advantage.
Safe and Secure Travels:
Why Jean and Aisle Seats are Poor Choices
There are no guarantees for TOTALLY safe travel. However, you can reduce the risks
of becoming a victim. From the homemaker in the community to the international roadwarrior…
all will benefit from this informative presentation, peppered with humor.
Beyond the Bend in the Road:
Managing Crises Before They Happen
We are living in unprecedented times. In this uncertain world, “It’s Better to be Safe
than Sorry.” Reduce your risks at work by planning for the unexpected.
CEO’s Blueprint for Building a Safety Culture
Motivated senior managers must be committed to creating a safety environment. The
CEO holds the key to turn this process “on.”
Behavioral Safety: Strategies to
Promote Safe Behavior and Reduce Injuries and Costs
In the 21st century, promoting “safe behavior” will be the critical element to any
successful safety program. New methods gain greater success and employee buy-in.
Fear Less and Live More
In a world that seems full of uncertainty, we can allow ourselves to be victims or we can
take control of our lives. Learn a 3-step process to create a positive environment, which
leads to better mental and physical health
Dr. Perry holds a
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Dr. Perry climbed the
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Professional Speaker, Consultant, Educator, and Writer
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American Airlines
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Coca-Cola
Eckerd Corporation
Hamilton Sunstrand
Harris Corporation
Home Depot
Honeywell
Maryland Lottery
Pratt and Whitney
Phillip Morris
Price-Waterhouse
Proctor and Gamble
Sara Lee
U.S. Postal Service
Verizon
Dr. Isabel Perry

Our President

Dr. Isabel Perry is a highly motivated professional with a unique combination of experiences as a corporate executive, entrepreneur, author and speaker. She is an effective communicator who has the expertise and natural ability to bring "real life" solutions to her audiences worldwide. Dr. Perry climbed the corporate ladder in a Fortune 50 company and "broke the glass ceiling." While working with all levels of the organization she led teams in international operations; these teams were inspired to excellence and won international awards for their performance and contributions to the corporation. Dr. Perry shares her successes and expertise by speaking on the following topics: executive and management development, team building and interpersonal skills, effective communication, coaching and counseling for high performance, culture change and managing transitions in the workplace. In addition, her technical expertise is in OSHA (safety) compliance and management.
Her ambition and hard work began at the age of 21 when she established and operated a residential construction business for 13 years. Later in life her entrepreneurial skills blossomed again when she established a joint venture in Quindao, China manufacturing ice cream. Her enthusiasm continued as she built a successful e-commerce site; being a direct importer of international goods fulfilled her love of travel and working with people of different cultures.
After 25 years of expansive responsibilities Dr. Perry combines the knowledge and skills necessary to succeed and is currently a much sought after consultant, speaker and trainer. Employees in manufacturing industries, hospitals and health care, government agencies and service industries have all benefited from Dr. Perry's enthusiastic spirit. She opens her audiences mind and heart to all the possibilities of increased excellence. Audiences are challenged and inspired to new ideas and approaches in improving their performance.
Dr. Perry holds a bachelor's degree in design and architecture, a master's degree in safety management and a doctorate degree in safety and educational psychology. Being self-motivated she obtained the last two degrees in night school over an eleven-year period as she operated her construction business... she brings motivation to an all-new level. Her audiences are energized by her "can do" attitude and transfer their newly gained skills into success.

Gain an Hour in Your Day 4 Hour Workshop

“Learning is the new form of labor. It’s no longer a separate activity that occurs wither before one enters the workplace or in remote classroom settings….Learning is the heart of productive activity. “

- Shoshana Zuboff

Course Overview

This workshop is designed for organizations looking for techniques to help their employees work more effectively and efficiently as individuals and as group contributors. During high-stressed, changing times, the work force needs the tools and techniques they can easily apply to improve both interpersonal relationships and business success. With fast moving, interactive, hands-on activities and exercises the workshop provides essential skills to breath new life and vigor into the work environment for the manager, supervisor and individual contributor. Skills learned in this workshop can be applied immediately to the workplace and person lives, and will help the attendees more forward with more enthusiasm and momentum.

Special features

This workshop incorporates two assessment tools that measure the attendees “behavioral style” and methods for “handling conflicts.” Both instruments, followed by discussion, will provide methods to improve both skill-sets and will result in a more harmonious, productive, motivated work force.

Call us today to take your skills to a new level
407-291-1209

25+ mini-seminars; 2-4 hours each

Bite Sized Learning for Building Practical Skills….fast!!!!

We offer 25+ workshops that enable attendees to sharpen their management skills.
It is a smorgasbord of learning and you can choose which topics to combine for your 1-day or multi-day training program. Sessions are designed for 15-20 people and can be scheduled for 2-4 hours each.
The learning process is:
Step 1: Instructor reviews the topic area and provides details in the importance of the skill set. This background information is the foundation for learning.
Step 2: Participants complete a personal assessment tool to establish their current skill level in the topic area (information is private). Areas for improvement are identified by individual gap analysis on the data they provided.
Step 3: Participants develop an action plan and schedule for deployment. There is an open discussion for participants to share (voluntarily) their challenges and ideas for moving forward to strengthen their skills set.

25+ mini-seminars It is a smorgasbord of learning!!!  YOU can select the topics to include in your multi-day training program to address the needs of YOUR organization. No pre-packaged programs for our clients. We want to work with  YOU to maximize YOUR results. Bite-sized learning modules that can be implemented immediately. The most popular workshops include: Change Management Communication Effective Communication Meetings Management Presentation Skills Creativity/Innovation Customer Service Handling Complaints Telephone Skills Diversity & Cultural Awareness Emotional intelligence Generational Styles Goal/Objective Setting Leadership Effectiveness Effective Leadership Process Improvement Benchmarking Learning Styles Listening Effectiveness Management Effectiveness Management Styles Managing Poor Performance Giving and Receiving Feedback Performance Management Project Management Interviewing/Selection Personal Effectiveness Delegation skills Negotiation Style Negotiation skills Conflict Resolution Networking and Relationships Problem-Solving and Decision Making Sales Personal Stress and Well-Being Teambuilding Time Management

Optional take-home materials which reinforce the messages for each topic include:

• Skill Builder Booklets
• One-page Coach Handouts
• Pocket Guides

These succinct follow-up materials in THREE different formats reinforce learning after attendees return to work.

Call us today to take your skills to a new level
407-291-1209

Safety Culture Development

“Safety ROI: Build a Safety Culture to Reduce Accidents and Costs”
1-2 day workshop

We can help you take your safety culture to the next level by building on what you have established already or starting with a plank sheet of paper. This program is highly interactive with the audience working in groups to share ideas/obstacles and develop a living document to take back to their workplace for implementation.

Part One: Overview

• History of “Safety Culture”
• The Business Case for Safety

Part Two: Components of World-Class Safety Cultures

• Management leadership
• Employee participation

Part Three: Safety Programs for Success

• Workplace Analysis Hazard Prevention and Control
• Accident and Record Analysis
• Medical and Emergency Response
• Safety Training

Part Four: Safety Culture Evaluation and Review

• Who should conduct the review
• Understand the “change cycle”
• Three assessment techniques
• Develop an action plan
• Implementation tools and techniques
  ______________________________

Safety Committees

“Building High Performance Safety Committees:
Maximize Success & Results”
1-2 day workshop

Time is money.

Learn to deliver better results in a shorter time with less stress and more support for safety committees. Safety Committees can be a profit center if they are established and managed properly. All attendees develop skills that can be transferred to many aspects of their lives.

Fourteen states require/ recommend safety committees, so participants have a responsibility to deliver success and results in a timely manner.

A safety committee is a key element to achieving continuous improvement in a safety process. The purpose of a safety committee is to regularly bring workers and management together in a non-adversarial, cooperative effort to promote safety and health in the workplace. A safety committee assists the employer and makes recommendations for change regarding occupational safety and health issues. The committee's primary focus is to detect and correct workplace hazards.

Benefits of Workplace Safety Committees

The benefits of having an effective safety committee include a reduction in the number of workplace injuries and illnesses, a reduction in the hidden costs associated with workplace injuries and illnesses, and an increase in employee safety awareness in the workplace.
Safety committee costs will be directly offset by the effectiveness of the committee in reducing workplace injuries and illnesses. Hidden costs associated with workplace injuries can run 5 to 10 times the actual cost of a workers' compensation claim. Hidden costs include:

• Production delays.
• Time lost by workers and supervisors attending to an accident victim.
• Clean-up and start-up of interrupted operations.
• Costs related to conducting an accident investigation.
• Time spent retraining others to replace injured workers.
• Possible reduced worker morale and lower efficiency.
• Impact on employee, employee's family and personal life.

Five-Step Action Plan

1. Establish the Foundation
2. Recruit Safety Committee Members
3. Form a Safety Committee
4. Conduct Safety Committee Meetings
5. Perform Follow-Up Activities
   

Some deliverables:

• Safety committee goals, purposes and objectives
• Setting priorities based on risk, exposure and costs
• Effective safety committees that get results: tools and techniques
• Projected completion dates for tasks
• Management’s commitment support and involvement
• Communication channels, reporting systems
• Initial and on-going training needs and schedules
• A tracking system to determine progress
• Safety committee record keeping system
• Follow-up activities
• Others to be added by the client

Documents/checklists delivered:

• How to conduct a workplace safety committee meeting
• Company policy statement
• Safety committee function with objectives and duties
• Workplace safety committee member duties
• Meeting agenda guide
• Meeting guidelines/protocol
• Safety Committee records of minutes
• Safety committee training documentation
• Workplace inspection checklist

Current costs of a safety committee:

6-7 employees meet for 2-3 hours. Given an average salary of $20 hour, each meeting costs $420. If the group meets monthly, the annual cost is $5,040 for meeting time only. This does not factor in the costs of ineffective results.
Let me repeat this paragraph:
Safety committee costs will be directly offset by the effectiveness of the committee in reducing workplace injuries and illnesses. Hidden costs associated with workplace injuries can run 5 to 10 times the actual cost of a workers' compensation claim. Hidden costs include:

• Production delays.
• Time lost by workers and supervisors attending to an accident victim.
• Clean-up and start-up of interrupted operations.
• Costs related to conducting an accident investigation.
• Time spent retraining others to replace injured workers.
• Possible reduced worker morale and lower efficiency.
• Impact on employee, employee's family and personal life.

We will work with you in defining what YOU want out of the day, as well. My structure is a template and a starting point for discussion.
“Building High Performance Safety Committees: Maximize Success & Results” provides participants with specific tips and techniques to improve meetings:

• Six tips for more effective committees
• Ten duties of all safety committee members
• Four stages of team dynamics
• Five keys to agendas that deliver results quicker
• Three group process techniques for 100% participation

Each of the 10 modules covers an essential competency that will make your safety team more effective and successful. Each workshop can stand-alone or you can use all ten workshops together for maximum performance impact. The series is based on a well-researched and holistic model that identifies the competencies necessary for a group of people to work as a highly productive and cohesive team. Take advantage of this research to improve the performance of your safety teams!

1. Committing to a Safety Team Approach
   This workshop will energize newly formed safety teams by helping members explore different team roles as well as four stages of team development. By learning through experiential exercises about behaviors that occur at each stage of team development, members will preempt resistance to the team approach.
   
   
2. Communicating Effectively In Safety Teams
   Improve all key communication skills within the context of achieving safety team goals. This workshop systematically presents core communication skills such as active listening, giving and receiving feedback constructively, and reacting to others' ideas.
   
   
3. Resolving Safety Team Conflicts
   This workshop focuses on resolving the types of conflicts that commonly occur in safety teams. Participants determine their natural conflict management styles through the use of the Conflict Style Inventory. They learn techniques for assessing conflict situation and applying the most appropriate conflict management style for each situation.
   
   
4. Creating a Shared Safety Team Purpose
   The ideal starting point for creating a fully functioning, high performing safety team, this workshop will help team members establish a mission that can be used to guide the formulation of goals and objectives. A series of skill building exercises will get everyone working toward the common goal.
   
   
5. Planning for Safety Team Results*
   This workshop enables safety team members to set goals and objectives that are in direct support of the team's purpose. Team members will learn to compose goals that are supported by specific measurable objectives.
   
   
6. Making Safety Team Meetings Work*
   Meetings are the hub of team communication and decision-making. This workshop addresses why safety meetings should be called, how to prepare for them, and most importantly, how to conduct them effectively.
   
   
7. Evaluating Safety Team Performance
   This workshop provides safety team members with an analytical framework for thoroughly evaluating nine critical dimensions of Team effectiveness. Participants will gain a clear understanding of their team's strengths and weaknesses, and will develop a process for improving team performance.
   
   
8. Making Safety Team Decisions by Consensus
   When working in safety teams, it is critical to make decisions that all team members agree with and support. In this workshop, team members learn four basic decision making approaches and identify why consensus decision-making is most beneficial in a team setting.
   
   
9. Solving Safety Team Problems
   In order for safety teams to be successful, they must be able to solve everyday problems decisively and effectively. With this workshop, teams will learn to do so while working on an actual problem the team currently faces. By the end of the workshop participants will be ready to implement solutions.
   
   
10. Utilizing Safety Team Members' Abilities
    This workshop provides a framework by which safety teams can identify individual team members' strengths and reorganize to more efficiently achieve team objectives. Teams complete this training by developing an action plan to implement improved utilization of team human resources. Uses DISC Inventory.
    2-day workshop (all modules)
    1-day workshop (“a la carte”- select modules--#5* and #6* required)

Safety Program Improvement

“Take Your Safety Program from Good to Great”
1 hour seminar or 4 hour workshop

As Jim Collins states in his best selling book “Good to Great” ----“Good is the enemy of Great.” Isn’t that true with safety programs? When we feel we have developed and maintained a good safety program , we consider our task complete and work to keep it at that level. However, while criss- crossing the country to talk to various organizations, I have the distinct opportunity, and privilege, to find “best of class” segments almost everywhere. By compiling these lists, I feel confident in sharing with new audiences, how to “Take Your Safety Program from Good to Great.”
Attendees are given a list of the 10 elements of a solid safety program…….employee involvement, hazard analysis, contractor safety, etc. In each of the 10 elements, behavioral examples are discussed for each level of maturity of the program.
From that, attendees identify which level of performance they are currently achieving in their organization. From this, they not only learn their current status , but also hear what it would criteria is necessary to take them to the next level of achievement.
Attendees are given the following gap analysis measure:

Overall Score	GAP ANALYSIS
5	Outstanding program
4	Superior program
3	Basic program
2	Developmental program
1	No program or ineffective program

Where does YOUR organization stand? Are you seeking to make improvements, but don’t know where to start or what new ideas to implement. Call us and let us help you “Take Your Safety Program to the Next Level.”

Call us today to take your skills to a new level
407-291-1209

Speeches That Last A Lifetime

Meeting planners must deliver more value from the speakers they select in today's tight economic situation. In order to be successful, acquire repeat business and referrals, any meeting professional must deliver powerful returns on investment; it is critical to your customer. 
And we feel the same way. That is why Dr. Perry is an excellent choice for presentations to your group. You can choose from a myriad of content-rich presentations that are peppered with humor..either in safety or careers. Each is customized to fit your industry or association.

Reduce Risks, Costs and Fear: Increase the Quality of Your Life

Reduce Risks, Costs and Fear: Increase the Quality of Your Life
In an uncertain world, where people are more stressed and businesses are more competitive, Isabel Perry delivers optimism and solutions to motivate people to a higher level of achievement. Isabel's messages describe processes and skills necessary to control the uncertainties of life. Each thought-provoking topic is peppered with humor and passionate enthusiasm. Isabel's "can do" attitude is the foundation for "speeches that last a lifetime."

	"Safety ROI: It's Everyone's Responsibility" Who isn't motivated by money? During this presentation ALL levels of the organization are enlightened on the FINANCIAL impact of safety both professionally and personally. Audiences learn how a $2000 accident can impact the bottom line by $100,000. This highly energized presentation will motivate EVERYONE to become passionate about safety. By adding audience involvement and company customized slides, audiences feel it's all about them. "Safety ROI" is an emotional roller-coaster, from "ah-ha" moments to heart-warming moments to sustained laughter. See why organizations ADD safety staff after hearing this message.
	Safety is 24/7 Do your employees feel they are working safely: for OSHA? for their company and supervisors? for their personal well-being? A risk-free environment will never exist. Therefore, employees must be self-motivated to develop a “personal safety culture” to reduce accidents. This content filled presentation is fun, lively, entertaining and highly interactive. The message will enable attendees to become self-motivated and embrace safety as a personal value to improve the quality of their lives. After hearing this message, unsafe behaviors are reduced and attendees practice “Safety 24/7.” This is win-win-win for everyone: • Employees are self-motivated to perform safety • Supervisors spend less time enforcing safety • Organizations accident rates are reduced.
	Safety Leadership Skills: 18 Lessons Learned on the Links Safety Leadership Skills is a dynamic, entertaining, content filled presentation that connects safety leadership skills and golf terms (i.e. follow-thru, goal-setting, developing strategies, focus).Golfers and non-golfers……all genders and ages….will enjoy this fresh and winning approach to improve success at work and in life. Golf and leadership are each based on mastering basic fundamentals, making choices and dealing with the consequences of your decisions, learning and listening to others, controlling emotions, and respecting other players. Golf is a game broken into short segments and "Safety Leadership Skills" parallels with lessons that can be learned in a quick, easy and entertaining manner to apply immediately. Audiences are captivated and enjoy the progression to each of the 18 lessons.
	Building High Performance Safety Teams: Maximize Success & Results Safety committees can be a profit center if they are established and managed properly. Fourteen states require/recommend safety committees, so participants have a responsibility to deliver success and results in a timely manner. This high-energy, imformatin packed session (1-4 hours) will provide tips and techniques to improve meetings: 6 tips for more effective committees 10 duties of all safety committee members 4 stages of team dynamics 5 keys to agendas that deliver results quicker 3 group process techniques for 100% participation Time is money. Learn to deliver better results in a shorter time with less stress and more support for safety committees. All attendees develop skills that can be transferred to many aspects of their lives.
	Seven Sins of Safety: Curing Bad Behaviors That Are Predictors of Accidents The Seven Sins of Safety (Indifference, Procrastination, Lack of Knowledge, Denial, Lack of Focus, Non-conformist and Complacency) are often behaviors that are precursors of near misses and, even worse, accidents. The Safety Doctor™ will identify these systemic ailments, provide examples based upon your industry or environment, and prescribe the antidotes to help you recognize and cure the problems in your organization. This highly interactive presentation will have attendees out of their seats and fully engaged with the pertinent content.
	OSHA's Top 10: Solutions to Citations in Your Industry How many times have we heard 80% of the problems come from 20% of the issues? By addressing the most frequent industry-specific safety violations first, you will have the greatest success in your safety compliance program. By identifying the highest risks, you can set priorities for your organization. Then, learn the solutions and corrective actions to implement immediately. Attendees leave with an action plan based on the research The Safety Doctor™ has done to learn your organization or associations 'Top 10.'
	Safe and Secure Travels: Across Town or Across the Globe. There are no guarantees for TOTALLY safe travel. However, you can reduce the risks of becoming a victim across the globe or in your neighborhood. Learn tips and techniques to prepare and respond to the unexpected. Use the methods body-guards and the rich and famous have used for years. From the international road-warrior to the homemaker in the community all will benefit from this informative presentation. It's a 'new world'...are YOU prepared?