epndomain.txt

qDTDMsmVIRTMPmu8RnltsQ==

Philips HeartStart HOME and OnSite AED Accessories for HOME Installation

For whom have an AED or having thought to have one, I would love to suggest the Philips HeartStart Home / Onsite AED should be properly installed in home. Having an AED is good but unable to find it, is the worst case scenario. I’ve listed a few accessories that suitable to be installed in home, small office or maybe an observing post.

House provides security from theft and shelter form the unforgiving weather. Therefore Philips HeartStart Home / Onsite AED will be installed indoor and beyond reach of a child. Philips HeartStart Home / Onsite AED should also be installed near or side by side with the first aid kit in case you need both at one time – time cut short. Try to find a place where it is suitable where people can easily notice the AED even that is the first time they came to your house and installed the AED there.

You will need:

Philips Slim OnSite Carry CaseThis slim carry case is constructed with semi-rigid materials and covered in durable red cordura. The case holds the HeartStart OnSite Defibrillator and a pair of paramedic scissors. 9.5" (24 cm) W x 8.5" (21 cm) H x 4.8" (9cm) D

Stored in :

Philips HeartStart AED Wall Cabinet- BASIC
Cabinet for HeartStart AED. Basic audible siren alarm. No visual alarm. No connectivity to building’s security system. Dimensions:16.5" Wide by 15" High by 6" Deep

or Philips HeartStart AED Wall Mount Bracket
The Wall Mount Bracket is designed specifically for holding a Philips defibrillator and its accessories. The defibrillator's carrying case can be tethered to the Wall Mount Bracket with a breakaway Secure-Pull Seal (M3859A), to discourage tampering. A broken seal indicates that the defibrillator has been used or removed from the Wall Mount and accessories may need to be replenished. Size: (L) 10.6" (270 mm), (H) 8" (204 mm), (W) 5" (126 mm)

Optional:

Defibrillator Wall Sign
An AED Wall Sign hanging above a Wall Mount Bracket, or Cabinet, gives even greater visibility to the defibrillator. Plastic - Silk screened, double-sided sign. Size 7”x 10” 1 package = 1 sign with mounting bracket

Philips HeartStart HOME and OnSite AED

The Philips HeartStart HOME and OnSite Defibrillator with new AHA 2005 Guidelines are specifically designed to be use at home, office and public area such as airports, shopping mall and etc. Virtually anyone can use it to help save a life that may otherwise be lost to sudden cardiac arrest. The device is designed to deliver a life-saving shock, and in the process, provide calm and steady guidance to the person who must operate it.

Philips Heartstart OnSite Defibrillator Product Data Sheet
http://www.cpr-savers.com/pdf/philips-product-data-sheet.pdf

The Philips HeartStart HOME and OnSite Defibrillator includes: a battery, 1 SMART Pads Cartridge, Quick Start Poster, Quick Reference Guide, Owner's Manual, 5 year Manufacturer's warranty.

PHILIPS HOME and OnSite AED SMART replacement Electrode Pads Cartridge

Philips OnSite Adult and Philips OnSite Infant/Child Replacement SMART Electrode Pads Cartridge.

Philips HeartStart Adult SMART Pads Cartridge are appropriate for cardiac arrest victims 8 years and older, or weighing above 55 pounds or 25kg. For Children less than 8 years or weighing less than 55 pounds or 25 kg, including infants, should be treated using Philips HeartStart Infant/Child SMART Pads Cartridge. These pads instruct the defibrillator to reduce the energy of its shock from 150 to 50 Joules. The Philips HeartStart Infant/Child SMART Pads cartridge is marked with an indication of the appropriate weight and with a teddy bear icon for easy identification. Both Philips HeartStart Adult and Infant/Child SMART Pads are disposable and have to be replace every two years.

Philips OnSite AED Replacement Battery (last for 4-Years)
This battery is a disposable, lithium manganese dioxide, long-life battery that will typically last for four years with the defibrillator in standby mode.

Philips HeartStart Automated External Defibrillators Part 3 - Why choose Philips HeartStart Automated External Defibrillators or AED?

Philips HeartStart AED product approved by FDA. Philips Medical Systems begin selling its HeartStart automatic external defibrillator or AED directly to consumers following the FDA’s Sept. 16 decision to grant the device over-the-counter status (OTC). Removal of the physician prescription requirement makes HeartStart the first AED available directly to consumers.

Product Name:
HeartStart Home Defibrillator (model number M5068A)
Manufacturer:
Philips Medical Systems
Address:
2301 5th Avenue, Suite 200, Seattle, WA 98121
Clearance Date:
September 16, 2004
Clearance Letter:
http://www.fda.gov/cdrh/pdf4/k040904.pdf
Details:
http://www.fda.gov/cdrh/mda/docs/k040904.html

The Design
Philips HeartStart AED was designed to be compact, easy-to-carry unit that demands little of the user. The device prompts every step, has pictographs showing proper placement or technique, and performs its own diagnostics automatically. It is a simple, effective piece of equipment that can save lives.

Teaching Others - how to use.
There are also Philips HeartStart AED Simulator or Trainer which replicate the actual Philips HeartStart AED. With this product available, learning process will become easier and more effective.

Philips HeartStart AED Support Programs.
Successful early defibrillation program requires more than just defibrillators. Philips offers a complete solution that helps us manage the entire spectrum of our AED program, including site assessment, training, data management, regulatory support, medical direction, risk mitigation, and more. With Philips HeartStart Essentials, currently available in the U.S. only, you can rely on a dedicated team of program management specialists to help ensure that your program details are in place and that your organization is prepared in case a sudden cardiac arrest event should occur.

Philips HeartStart Automated External Defibrillators Part 2 - Different Types defibrillator

Different Types defibrillator

Manual external defibrillator

The units are used in conjunction with or more often have inbuilt electrocardiogram readers, which the clinician uses to diagnose a cardiac condition most often fibrillation or tachycardia although there are some other rhythms which can be treated by different shocks. The clinician will then decide what charge to use which is measured in joules, based on their prior knowledge and experience, and will deliver the shock through paddles or pads on the patient's chest. As they require detailed medical knowledge, these units are generally only found in hospitals and on some ambulances. In the United States, paramedics are trained to recognize lethal arrhythmias and deliver appropriate electrical therapy with a manual defibrillator, when appropriate.

Manual internal defibrillator

Manual internal defibrillator are virtually identical to the external version, except that the charge is delivered through internal paddles in direct contact with the heart. These are almost exclusively found in operating theatres, where the chest is likely to be open, or can be opened quickly by a surgeon.

Above Picture - Manual internal defibrillator paddles

Automated external defibrillator or AED

These simple to use units are based on computer technology which is designed to analyze the heart rhythm itself, and then advise whether a shock is required. They are designed to be used by lay persons, who require little training. They are usually limited in their interventions to delivering high joule shocks for VF and VT (ventricular tachycardia) rhythms, making them generally limiting for use by health professionals, who could diagnose and treat a wider range of problems with a manual or semi-automatic unit.

The automatic units also take time generally 10-20 seconds to diagnose the rhythm, where a professional could diagnose and treat the condition far quicker with a manual unit. These time intervals for analysis, which require stopping chest compressions, have been shown in a number of studies to have a significant negative effect on shock success. This effect led to the recent change in the AHA defibrillation guideline (calling for two minutes of CPR after each shock without analyzing the cardiac rhythm) and a statement in the ACLS Provider Manual that AEDs should not be used when manual defibrillators and trained operators are available.

Automated external defibrillators are generally either held by trained personnel who will attend incidents, or are public access units which can be found in places including corporate and government offices, shopping centres, airports, restaurants, casinos, hotels, sports stadiums, schools and universities, community centres, fitness centres and health clubs.

The locating of a public access AED should take in to account where large groups of people gather, and the risk category associated with these people, to ascertain whether the risk of a sudden cardiac arrest incident is high. For example, a centre for teenage children is a particularly low risk category (as children very rarely enter heart rhythms such as VF(Ventricular Fibrillation or VT(Ventricular Tachycardia), being generally young and fit, and the most common cause of paediatric cardiac arrest is trauma - where the heart is more likely to enter asystole or PEA, where an AED is of no use), whereas a large office building with a high ratio of males over 50 is a very high risk environment.

In many areas, emergency services vehicles are likely to carry AEDs, with some Ambulances carrying an AED in addition to a manual unit. In addition, some police or fire service vehicles carry an AED for first responder use. Some areas have dedicated community first responders, who are volunteers tasking with keeping an AED and taking it to any victims in their area. It is also increasingly common to find AEDs on transport such as commercial airlines and cruise ships.

In order to make them highly visible, public access AEDs often are brightly coloured, and are mounted in protective cases near the entrance of a building. When these protective cases are opened, and the defibrillator removed, some will sound a buzzer to alert nearby staff to their removal but do not necessarily summon emergency services. All trained AED operators should also know to phone for an ambulance when sending for or using an AED, as the patient will be unconscious, which always requires ambulance attendance.

Semi-automated external defibrillators

These units are a compromise between a full manual unit and an automated unit. They are mostly used by pre-hospital care professionals such as paramedics and emergency medical technicians. These units have the automated capabilities of the AED but also feature an ECG display, and a manual override, where the clinician can make their own decision, either before or instead of the computer. Some of these units are also able to act as a pacemaker if the heart rate is too slow (bradycardia) and perform other functions which require a skilled operator.

Implantable Cardioverter-defibrillator or ICD

Also known as automatic internal cardiac defibrillator (AICD). These devices are implants, similar to pacemakers (and many can also perform the pacemaking function). They constantly monitor the patient's heart rhythm, and automatically administer shocks for various life threatening arrhythmias, according to the device's programming. Many modern devices can distinguish between ventricular fibrillation, ventricular tachycardia, and more benign arrhythmias like supraventricular tachycardia and atrial fibrillation. Some devices may attempt overdrive pacing prior to synchronised cardioversion. When the life threatening arrhythmia is ventricular fibrillation, the device is programmed to proceed immediately to an unsynchronized shock.

There are cases where the patient's ICD may fire constantly or inappropriately This is considered a medical emergency, as it depletes the device's battery life, causes significant discomfort and anxiety to the patient, and in some cases may actually trigger life threatening arrhythmias. Some emergency medical services personnel are now equipped with a ring magnet to place over the device, which effectively disables the shock function of the device while still allowing the pacemaker to function (if the device is so equipped). If the device is shocking frequently, but appropriately, EMS personnel may administer sedation.

Modeling Defibrillation

The efficacy of a cardiac defibrillator is highly dependent on the position of its electrodes. Most internal defibrillators are implanted in octogenarians, but a few children need the devices. Implanting defibrillators in kids is particularly difficult because children are small, will grow over time, and possess cardiac anatomy that differs from that of adults. Recently, researchers were able to create a software modeling system capable of mapping an individual’s thorax and determining the optimal position for an external or internal cardiac defibrillator.

With the help of pre-existing surgical planning applications, the software uses myocardial voltage gradients to predict the likelihood of successful defibrillation. According to the critical mass hypothesis, defibrillation is effective only if it produces a threshold voltage gradient in a large fraction of the myocardial mass. Usually, a gradient of three to five volts per centimeter is needed in 95 % of the heart. Voltage gradients of over 60 V/cm can damage tissue. The modeling software seeks to obtain safe voltage gradients above the defibrillation threshold.

Early simulations using the software suggest that small changes in electrode positioning can have large effects on defibrillation, and despite engineering hurdles that remain, the modeling system promises to help guide the placement of implanted defibrillators in children and adults.
Interface with the patient

The most well-known type of electrode is the traditional metal paddle with an insulated handle. This type must be held in place on the patient's skin while a shock or a series of shocks is delivered. Before the paddle is used, a gel must be applied to the patient's skin, in order to ensure a good connection and to minimize electrical resistance, also called chest impedance (despite the DC discharge). These are generally only found on the manual external units.

Another type of resuscitation electrode is designed as an adhesive pad. When a patient has been admitted due to heart problems, and the physician or nurse has determined that he or she is at risk of arrhythmia, they may apply adhesive electrodes to the patient in anticipation of any problems that may arise. These electrodes are left connected to a defibrillator. If defibrillation is required, the machine is charged, and the shock is delivered, without any need to apply any gel or to retrieve and place any paddles. These adhesive pads are found on most automated and semi-automated units.

Both solid- and wet-gel adhesive electrodes are available. Solid-gel electrodes are more convenient, because there is no need to clean the patient's skin after removing the electrodes. However, the use of solid-gel electrodes presents a higher risk of burns during defibrillation, since wet-gel electrodes more evenly conduct electricity into the body.
Adhesive electrodes are designed to be used not only for defibrillation, but also for non-invasive pacing and electrical cardioversion.

While the paddles on a monitor/defibrillator may be quicker than using the patches, adhesive patches are superior due to their ability to provide appropriate EKG tracing without the artifact visible from human interference with the paddles. Adhesive electrodes are also inherently safer than the paddles for the operator of the defibrillator to use, as they minimize the risk of the operator coming into physical (and thus electrical) contact with the patient as the shock is delivered, by allowing the operator to stand several feet away. Another inconvenience of the paddles is the requirement of around 25 lb of pressure to be applied while defibrillating.

Placement

Resuscitation electrodes are placed according to one of two schemes. The anterior-posterior scheme is the preferred scheme for long-term electrode placement. One electrode is placed over the left precordium (the lower part of the chest, in front of the heart). The other electrode is placed on the back, behind the heart in the region between the scapula. This placement is preferred because it is best for non-invasive pacing.

Picture Above: Anterio-apical placement of external defibrillator electrodes (When defibrillation is unsuccessful, anterio-posterior placement is also sometimes attempted)

The anterior-apex scheme can be used when the anterior-posterior scheme is inconvenient or unnecessary. In this scheme, the anterior electrode is placed on the right, below the clavicle. The apex electrode is applied to the left side of the patient, just below and to the left of the pectoral muscle. This scheme works well for defibrillation and cardioversion, as well as for monitoring an ECG.

Source - http://www.wikipedia.org

Philips HeartStart Automated External Defibrillators Part 1 - Defibrillator

Each year, more than 250,000 Americans die from sudden cardiac arrest. As per medical experts, it is vital to have a chain of sustaining events, which includes cardiopulmonary resuscitation. With recent technological advances, a portable lifesaving device called the automated external defibrillator has been invented. It is an important life saving device, and has saved many a cardiac patient's life.

Defibrillation - defibrillator

Defibrillation is the definitive treatment for the life-threatening cardiac arrhythmias, ventricular fibrillation and ventricular tachycardia. Defibrillation consists of delivering a therapeutic dose of electrical energy to the affected heart with a device called a defibrillator. This depolarizes a critical mass of the heart muscle, terminates the arrhythmia, and allows normal sinus rhythm to be reestablished by the body's natural pacemaker, in the sinoatrial node of the heart.
Defibrillators can be external, transvenous, or implanted, depending on the type of device used. Some external units, known as automated external defibrillators or AED , automate the diagnosis of treatable rhythms, meaning that lay responders or bystanders are able to use them successfully with little, or in some cases no, training.

Cardiac arrhythmia

Cardiac arrhythmia also known as dysrhythmia is a term for any of a large and heterogeneous group of conditions in which there is abnormal electrical activity in the heart. The heart beat may be too fast or too slow, and may be regular or irregular.

Some arrhythmias are life-threatening medical emergencies that can result in cardiac arrest and sudden death. Others cause aggravating symptoms such as an abnormal awareness of heart beat or palpitations, and may be merely annoying. Others may not be associated with any symptoms at all, but pre-dispose toward potentially life threatening stroke or embolus.

Some arrhythmias are very minor and can be regarded as normal variants. In fact, most people will sometimes feel their heart skip a beat, or give an occasional extra strong beat - neither of which is usually a cause for alarm.

The term sinus arrhythmia refers to a normal phenomenon of mild acceleration and slowing of the heart rate that occurs with breathing in and out. It is usually quite pronounced in children, and steadily lessens with age. This can also present during meditation breathing exercises that involve deep inhalings and breath holdings patterns.

Ventricular fibrillation

Ventricular fibrillation or V-fib or VF is a condition in which there is uncoordinated contraction of the cardiac muscle of the ventricles in the heart, making them tremble rather than contract properly. Ventricular fibrillation is a medical emergency. If the arrhythmia continues for more than a few seconds, blood circulation will cease, and death may occur in a matter of minutes.

Ventricular tachycardia

Ventricular tachycardia or V-tach or VT is a tachycardia, or fast heart rhythm that originates in one of the ventricles of the heart. This is a potentially life-threatening arrhythmia because it may lead to ventricular fibrillation and sudden death. Less commonly, however, some forms of this arrhythmia appear benign, especially in young individuals.

History of Defibrillation and defibrillator

Defibrillation was first demonstrated in 1899 by Prevost and Batelli, two physiologists from University of Geneva, Switzerland. They discovered that small electric shocks could induce ventricular fibrillation in dogs, and that larger charges would reverse the condition.

The first use on a human was in 1947 by Claude Beck, professor of surgery at Case Western Reserve University. Beck's theory was that ventricular fibrillation often occurred in hearts which were fundamentally healthy, in his terms "Heart too good to die", and that there must be a way of saving them. Beck first used the technique successfully on a 14 year old boy who was being operated on for a congenital chest defect. The boy's chest was surgically opened, and manual cardiac massage was undertaken for 45 minutes until the arrival of the defibrillator. Beck used internal paddles on either side of the heart, along with procaine amide, a heart drug, and achieved return of normal sinus rhythm.

These early defibrillators used the alternating current from a power socket, transformed from the 110-240 volts available in the line, up to between 300 and 1000 volts, to the exposed heart by way of 'paddle' type electrodes. The technique was often ineffective in reverting VF while morphological studies showed damage to the cells of the heart muscle post mortem. The nature of the AC machine with a large transformer also made these units very hard to transport, and they tended to be large units on wheels.

Closed-chest method

Until the early 1950s, defibrillation of the heart was possible only when the chest cavity was open during surgery. The technique used an alternating current from a 300 or greater volt source delivered to the sides of the exposed heart by 'paddle' electrodes where each electrode was a flat or slightly concave metal plate of about 40 mm diameter. The closed-chest defibrillator device which applied an alternating current of greater than 1000 volts, conducted by means of externally applied electrodes through the chest cage to the heart, was pioneered by Dr V. Eskin with assistance by A. Klimov in Frunze, USSR in mid 1950s.

Move to direct current

In 1959 Bernard Lown commenced research into an alternative technique which involved charging of a bank of capacitors to approximately 1000 volts with an energy content of 100-200 joules then delivering the charge through an inductance such as to produce a heavily damped sinusoidal wave of finite duration (~5 milliseconds) to the heart by way of 'paddle' electrodes. The work of Lown was taken to clinical application by engineer Barouh Berkovits with his "cardioverter".

The Lown waveform, as it was known, was the standard for defibrillation until the late 1980s when numerous studies showed that a biphasic truncated waveform (BTE) was equally efficacious while requiring the delivery of lower levels of energy to produce defibrillation. A side effect was a significant reduction in weight of the machine. The BTE waveform, combined with automatic measurement of transthoracic impedance is the basis for modern defibrillators.
Portable units become available

A major breakthrough was the introduction of portable defibrillators in ambulances. This was pioneered in the early 1960s by Prof. Frank Pantridge in Belfast. Today portable defibrillators are one of the most important tools carried by ambulances. They are the only proven way to resuscitate a person who has had a cardiac arrest unwitnessed by EMS who is still in persistent ventricular fibrillation or ventricular tachycardia at the arrival of pre-hospital providers.

Gradual improvements in the design of defibrillators, and partly based on the work developing implanted versions have lead to the availability of Automated External Defibrillators, which can analyse the heart rhythm by themselves, diagnosing the shockable rhythms, and then charging to treat. This means that no clinical skill is required in their use, allowing lay people to respond to emergencies effectively.

Change to a biphasic waveform

Until the late 1980s, external defibrillators delivered a Lown type waveform which was a heavily damped sinusoidal impulse having a mainly uniphasic characteristic. Biphasic defibrillation, however, alternates the direction of the pulses, completing one cycle in approximately 10 milliseconds. Biphasic defibrillation was originally developed and used for implantable cardioverter-defibrillators. When applied to external defibrillators, biphasic defibrillation significantly decreases the energy level necessary for successful defibrillation. This, in turn, decreases risk of burns and myocardial damage.

Ventricular fibrillation (VF) could be returned to normal sinus rhythm in 60% of cardiac arrest patients treated with a single shock from a monophasic defibrillator. Most biphasic defibrillators have a first shock success rate of greater than 90%.

Implantable devices

A further development in defibrillation came with the invention of the implantable device, known as an implantable cardioverter-defibrillator or ICD. This was pioneered at Sinai Hospital in Baltimore by a team including Stephen Heilman, Alois Langer, Morton Mower, Michel Mirowski, and Mir Imran, with the help of industrial collaborator Intec Systems of Pittsburgh. Mirowski teamed up with Mower and Staewen, and together they commenced their research in 1969 but it was 11 years before they treated their first patient. Similar developmental work was carried out by Schuder and colleagues at the University of Missouri.

The work was commenced, despite doubts amongst leading experts in the field of arrhythmias and sudden death. There was doubt that their ideas would ever become a clinical reality. In 1972 Bernard Lown, the inventor of the external defibrillator, stated in the journal Circulation - "The very rare patient who has frequent bouts of ventricular fibrillation is best treated in a coronary care unit and is better served by an effective antiarrhythmic program or surgical correction of inadequate coronary blood flow or ventricular malfunction. In fact, the implanted defibrillator system represents an imperfect solution in search of a plausible and practical application."

The problems to be overcome were the design of a system which would allow detection of ventricular fibrillation or ventricular tachycardia. Despite the lack of financial backing and grants, they persisted and the first device was implanted in February 1980 at Johns Hopkins Hospital by Dr. Levi Watkins, Jr. Modern ICDs do not require a thoracotomy and possess pacing, cardioversion, and defibrillation capabilities.

The invention of implantable units is invaluable to some regular sufferers of heart problems, although they are generally only given to those people who have already had a cardiac episode.

Source - http://www.wikipedia.org

Cardiopulmonary Resuscitation CPR - Watch, Learn and Help Part 1

Cardiopulmonary resuscitation or CPR is an emergency medical procedure for a victim of cardiac arrest or, in some circumstances, respiratory arrest. CPR is performed in hospital or in the community by laypersons or by emergency response professionals.

For 50 years CPR has consisted of the combination of artificial blood circulation with artificial respiration i.e., chest compressions and lung ventilation. However, in March 2008 the American Heart Association and the European Resuscitation Council, in a reversal of policy, endorsed the effectiveness of chest compressions alone without artificial respiration for adult victims who collapse suddenly in cardiac arrest. CPR is generally continued, usually in the presence of advanced life support, until the patient regains a heart beat called "return of spontaneous circulation" or "ROSC" or is declared dead.

CPR is unlikely to restart the heart, but rather its purpose is to maintain a flow of oxygenated blood to the brain and the heart, thereby delaying tissue death and extending the brief window of opportunity for a successful resuscitation without permanent brain damage. Defibrillation and advanced life support are usually needed to restart the heart.

With the birth of AED combine with CPR, victim has greater chances of surviving the attack. Automated External Defibrillator or AED is a portable electronic device that automatically diagnoses the potentially life threatening cardiac arrhythmias of ventricular fibrillation and ventricular tachycardia in a patient, and is able to treat them through defibrillation, the application of electrical therapy which stops the arrhythmia, allowing the heart to reestablish an effective rhythm.

Philips Automated External Defibrillator - Philips HeartStart Home AED - Philips HeartStart Onsite AED

Philips is a known global leader and trusted choice in defibrillator technology. Philips offer a complete line of manual and automated defibrillators that are safe, easy to use and designed to help improve survival outcomes wherever and whenever sudden cardiac arrest occurs. Philips HeartStart AED Home

Cardiopulmonary Resuscitation (CPR) - 01 - Assesment
http://www.youtube.com/watch?v=wj19Nekz0k8




Cardiopulmonary Resuscitation (CPR) - 02 - Adult CPR
http://www.youtube.com/watch?v=Dfcy4pQHyV0



Cardiopulmonary Resuscitation (CPR) - 03 - AED defibrillatio
http://www.youtube.com/watch?v=_DKXorQ47GU




Cardiopulmonary Resuscitation (CPR) - 04 - Barrier Devices
http://www.youtube.com/watch?v=7uYA8QecPbI




Cardiopulmonary Resuscitation (CPR) - 05 - Spinal injury
http://www.youtube.com/watch?v=b8V_tqmoiiU




Cardiopulmonary Resuscitation (CPR) - 06 -Airway obstruction
http://www.youtube.com/watch?v=Q-kzlyUsYac




Cardiopulmonary Resuscitation(CPR)-07-Obstruction
http://www.youtube.com/watch?v=SERmoMackDE




Cardiopulmonary Resuscitation(CPR)-08-child cpr
http://www.youtube.com/watch?v=pHVu311kuDs