The correct and secure operation of an automatic exterior defibrillator (AED) necessitates consciousness of things past the usual working process. These components should not all the time instantly obvious and require cautious consideration to make sure efficient defibrillation and decrease potential hurt to the affected person and responders. Failure to handle these can impede the effectiveness of the gadget or introduce new hazards.
Efficient use of a defibrillator is paramount within the administration of sudden cardiac arrest. Historic evaluation of resuscitation makes an attempt has recognized quite a few situations the place a disregard for distinctive circumstances compromised the intervention. Adherence to established protocols types a baseline, however recognizing and adapting to situational variables considerably will increase the probability of a optimistic end result. Cautious consideration of those variables can optimize the possibilities of survival for the person experiencing cardiac arrest.
A number of conditions warrant heightened consciousness. These embody the presence of water, implanted gadgets, treatment patches, and particular affected person populations, resembling youngsters or pregnant people. The next sections will element every of those circumstances, highlighting the precise protocols and precautions that needs to be noticed to maximise security and effectiveness throughout defibrillation.
1. Water
The presence of water throughout automated exterior defibrillator (AED) use presents a major electrical hazard, immediately impacting security and efficacy. Managing this danger is a key side when addressing components requiring cautious analysis.
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Conductivity of Water
Water’s inherent means to conduct electrical energy drastically will increase the chance of shock to each the affected person and responders. Any standing water or moisture on the affected person’s pores and skin, clothes, or the encircling atmosphere can create a pathway for {the electrical} present to deviate from its meant course by means of the affected person’s coronary heart. This deviation may end up in ineffective defibrillation, damage to bystanders, and probably deadly penalties for the consumer.
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Floor Moisture
Even seemingly insignificant quantities of moisture, resembling sweat or damp clothes, can pose a risk. Previous to making use of the AED pads, the affected person’s chest have to be totally dried. Consideration must also be given to the encircling atmosphere to make sure it’s free from any puddles or dampness. This precaution is essential for stopping unintended present leakage and making certain the AED delivers the meant therapeutic shock.
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Environmental Situations
Rescue situations occurring outside, significantly throughout rain or in proximity to our bodies of water, demand further vigilance. Relocating the affected person to a dry space is paramount. If relocation is unimaginable, makes an attempt needs to be made to defend the affected person and the AED from the weather. If situations are deemed too hazardous, prioritizing responder security and awaiting skilled help outfitted for aquatic rescue could also be vital.
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Gear Integrity
The AED itself needs to be inspected for any indicators of water injury prior to make use of. Compromised gear might malfunction, posing a extreme danger to each the affected person and the consumer. If water injury is suspected, an alternate AED needs to be sought. Constant upkeep and storage of the AED in a dry atmosphere are important preventative measures.
In abstract, the potential for electrical shock within the presence of water necessitates meticulous consideration and adherence to security protocols when utilizing an AED. Addressing this danger is a non-negotiable part of accountable defibrillation and considerably contributes to improved affected person outcomes and responder security.
2. Implanted gadgets
The presence of implanted gadgets, resembling pacemakers or implantable cardioverter-defibrillators (ICDs), necessitates cautious consideration to pad placement throughout automated exterior defibrillator (AED) use. This consideration is essential, as direct placement of AED pads over these gadgets can intervene with defibrillation efficacy and probably injury the implanted gadget, resulting in affected person hurt.
Implanted gadgets sometimes function a metallic casing, which may block or deflect {the electrical} present from the AED. This interference reduces the quantity of vitality delivered to the center muscle, probably rendering the defibrillation try ineffective. Moreover, the high-energy shock from the AED might injury the delicate digital circuitry throughout the implanted gadget, requiring subsequent gadget alternative and probably delaying or stopping wanted remedy from the implanted gadget itself. A typical instance includes people with a visual bulge underneath the pores and skin of the higher chest, indicating the presence of an implanted cardiac gadget. In such circumstances, pad placement have to be adjusted to keep away from direct contact.
Optimum pad placement includes positioning the AED pads both to the facet of the implanted gadget, making certain no less than one inch of separation, or in an anterior-posterior configuration. The anterior-posterior placement includes inserting one pad on the entrance of the chest (anterior) and the opposite on the again (posterior), which generally is a appropriate various when lateral placement will not be possible. Consciousness of this consideration, coupled with diligent visible evaluation of the affected person’s chest, is paramount for optimizing the effectiveness of defibrillation and stopping issues associated to implanted gadgets. A profitable resuscitation usually hinges on these seemingly small, however essential, changes to straightforward AED protocols.
3. Remedy patches
The crucial to take away treatment patches earlier than deploying an automatic exterior defibrillator (AED) is a essential part of making certain efficient and secure defibrillation. The presence of those patches, significantly these containing metallic backings or gels, presents a major impedance to electrical present move. This interference can divert the present away from the center, decreasing the probability of profitable defibrillation. Contemplate, for instance, a affected person sporting a nitroglycerin patch for angina; the metallic backing, meant for managed treatment launch, inadvertently acts as a barrier to the AED’s electrical impulse. Failure to take away such a patch leads to a diminished shock delivered to the myocardium, thereby reducing the likelihood of restoring a perfusing rhythm. This motion can also be essential as a result of some patches include energetic substances that, when subjected to {the electrical} discharge, may trigger localized burns to the affected person’s pores and skin.
The sensible implications of this step are substantial. In emergency conditions, responders should shortly assess the affected person’s chest for treatment patches and take away them previous to pad placement. This may occasionally contain visually scanning the chest space and palpating for any hid patches. Frequent places embody the higher chest, again, and higher arms. It’s also very important to take away patches with gloves to guard the responder from absorbing any treatment. Eradicating the patch requires just a few seconds, which generally is a small worth to pay for security and elevated effectiveness. The patches needs to be moved away from the affected person and the responder to stop unintended contact.
In abstract, the elimination of treatment patches earlier than utilizing an AED will not be merely a procedural advice however a basic security and efficacy consideration. Ignoring this step compromises the effectiveness of the defibrillation try and probably harms the affected person. A short evaluation and elimination course of can vastly enhance outcomes in cardiac arrest situations, linking on to the broader goal of maximizing survival charges. Incorporating this protocol into coaching and emergency response procedures is crucial for all potential AED customers.
4. Chest hair
Extreme chest hair can considerably impede the efficient supply of {an electrical} shock from an automatic exterior defibrillator (AED), forming a essential level within the context of things necessitating particular protocols. The presence of dense hair creates an insulating barrier between the AED pads and the pores and skin, stopping enough contact. This diminished contact reduces the quantity {of electrical} present reaching the center muscle, thereby lessening the probability of profitable defibrillation. For instance, if a big quantity of hair covers the chest, it may create air gaps between the AED pad and the pores and skin, resulting in electrical energy arcing throughout these gaps as a substitute of passing effectively by means of the affected person’s chest. This arcing generates warmth and might probably trigger pores and skin burns, additional complicating the emergency.
Subsequently, quickly shaving the world the place the AED pads will likely be positioned turns into an important step within the rapid response protocol. Most AED kits embody a disposable razor for this categorical goal. The aim is to take away sufficient hair to make sure agency, direct contact between the AED pads and the pores and skin. Whereas velocity is of the essence, care have to be taken to keep away from inflicting pores and skin abrasions, as these may introduce further issues. In circumstances the place a razor is unavailable, firmly urgent the AED pads onto the chest might present a brief answer, though the effectiveness will seemingly be compromised. Some superior AED pads are designed with stronger adhesives meant to penetrate by means of chest hair, however shaving stays the optimum method. The precedence is to beat the insulation impact and allow the total electrical dose to be delivered to the center.
In conclusion, the seemingly easy act of shortly shaving chest hair types an integral hyperlink within the chain of actions vital for profitable defibrillation. Overlooking this step reduces the effectiveness of the AED and probably endangers the affected person. Integrating this consideration into AED coaching packages and emergency protocols is essential for maximizing survival charges in circumstances of sudden cardiac arrest. The power to shortly acknowledge and handle this issue highlights the significance of complete preparation and consciousness in emergency medical response.
5. Pediatric pads
The supply and utility of pediatric pads represents a key side when addressing components that require cautious analysis throughout automated exterior defibrillator (AED) use. The connection stems immediately from the physiological variations between youngsters and adults, significantly in coronary heart measurement and the quantity {of electrical} vitality required for efficient defibrillation. When available, using pediatric pads throughout a sudden cardiac arrest occasion involving a baby is paramount to delivering an applicable and secure electrical shock. Failing to take action and making use of customary grownup pads to a baby may end up in extreme electrical vitality being delivered to the smaller coronary heart. This could trigger myocardial injury, burns, and different issues that cut back the possibilities of profitable resuscitation. For instance, making use of grownup pads, which ship a considerably larger dose of electrical energy, to an toddler may end up in iatrogenic hurt, negating any potential profit from the defibrillation try. The strategic deployment of pediatric pads, subsequently, contributes on to the security and efficacy of pediatric defibrillation.
The applying of pediatric pads sometimes includes a diminished vitality dose in comparison with grownup pads, aligning with the decrease vitality necessities of smaller our bodies. Most AEDs, when related to pediatric pads, mechanically attenuate {the electrical} present delivered. In conditions the place specialised pads are unavailable, some skilled tips recommend utilizing the grownup pads whereas making certain they’re positioned in order that they don’t contact one another, thereby minimizing the floor space of contact and the quantity of electrical energy delivered. It stays paramount to observe the precise tips supplied by the AED producer and cling to present resuscitation protocols. Coaching packages centered on emergency medical response should emphasize the right identification of pediatric sufferers and the significance of using applicable gear, together with pediatric pads, to make sure a tailor-made and efficient intervention.
In abstract, the right utilization of pediatric pads, when accessible, constitutes a essential factor within the complete method to AED utilization. This motion minimizes potential hurt and maximizes the probability of profitable resuscitation in pediatric sufferers. The supply and proper utility of those specialised pads underscore the need of preparedness and adherence to age-specific tips throughout emergency conditions involving youngsters. Integration of this information into common coaching ensures that first responders are outfitted to supply applicable care in a variety of situations, finally enhancing the general effectiveness of emergency medical interventions.
6. Being pregnant
The consideration of being pregnant throughout automated exterior defibrillator (AED) use is important, primarily as a result of being pregnant is not a contraindication to defibrillation. This precept signifies that the potential advantages of defibrillation for the pregnant particular person experiencing cardiac arrest outweigh the dangers to each the mom and the fetus. A failure to defibrillate as a consequence of considerations about being pregnant would successfully deny the mom probably life-saving therapy. Cardiac arrest in a pregnant lady necessitates the identical rapid response as in a non-pregnant particular person, prioritizing the restoration of maternal circulation. The physiological modifications related to being pregnant can, in actual fact, make the pregnant individual extra susceptible to sudden cardiac arrest, making immediate intervention all of the extra essential. Delaying therapy based mostly on being pregnant standing can result in irreversible maternal and fetal injury, as each rely upon the mom’s circulatory perform.
Whereas being pregnant itself doesn’t preclude using an AED, there are sensible implications to concentrate on when deploying the gadget. The anatomical modifications of being pregnant, significantly in later trimesters, might necessitate minor changes in pad placement. Uterine displacement could also be thought-about to enhance venous return after defibrillation, however shouldn’t delay the applying of the AED. Fetal monitoring, if obtainable, needs to be initiated as quickly as potential after maternal stabilization, to evaluate fetal well-being. Nevertheless, this could not delay the supply of {the electrical} shock. Moreover, the crew managing the pregnant affected person needs to be ready to carry out resuscitative measures tailor-made to each the mom and the potential supply of the fetus, which can be vital if maternal resuscitation is unsuccessful.
In abstract, being pregnant represents a scenario requiring consciousness however not hesitation within the context of AED use. The first goal stays restoring maternal cardiac perform, as this immediately impacts fetal viability. Whereas steps resembling monitoring fetal standing and contemplating uterine displacement are related, they’re secondary to making sure well timed and efficient defibrillation. Overcoming any reluctance to make use of an AED in a pregnant affected person as a consequence of perceived dangers is essential, as the shortage of intervention carries a far higher danger of mortality and morbidity for each the mom and the fetus. Coaching packages ought to explicitly handle this side to make sure that responders are assured and ready to behave decisively when confronted with a pregnant particular person in cardiac arrest.
7. Steel surfaces
Direct or oblique contact with metallic surfaces throughout automated exterior defibrillator (AED) use poses a major electrical hazard, underscoring its important position throughout the broader scope of concerns. It is because metallic is a extremely conductive materials, readily transmitting electrical present. If the affected person or a responder is involved with metallic throughout defibrillation, {the electrical} present may be diverted away from the affected person’s coronary heart, decreasing the effectiveness of the shock and probably inflicting unintended electrical burns or shock to anybody involved with the metallic. For instance, a affected person mendacity on a metallic stretcher or sporting metallic jewellery may create an alternate pathway for the present, diminishing the therapeutic profit and exposing the responder to hazard. Avoiding such contact is subsequently paramount for each affected person and responder security.
The sensible implications of this consideration demand cautious evaluation of the encircling atmosphere previous to AED deployment. Metallic objects resembling stretchers, wheelchairs, metallic flooring, jewellery, and even metallic mattress frames have to be recognized and mitigated. Shifting the affected person to a non-conductive floor, resembling a picket board or a dry blanket, is the optimum technique. Elimination of metallic jewellery, resembling necklaces or bracelets, can also be really helpful. If transferring the affected person will not be possible, making certain that neither the affected person nor any responder comes into contact with the metallic is essential. Responder gloves supply minimal safety in opposition to the excessive voltage delivered by an AED; subsequently, bodily separation from metallic objects is the one dependable safeguard. Constant coaching and consciousness of this hazard are very important elements of any complete AED program.
In abstract, avoiding contact with metallic surfaces represents a essential, non-negotiable side of secure and efficient AED utilization. The danger {of electrical} diversion and potential hurt necessitates thorough environmental evaluation and implementation of preventative measures. This consideration immediately helps the overarching aim of maximizing affected person survival whereas minimizing dangers to responders, reinforcing its significance throughout the complete framework of greatest practices for AED deployment. Neglecting this seemingly easy precaution can undermine the whole resuscitation effort, highlighting its substantial influence on affected person outcomes.
8. Oxygen proximity
The need of sustaining a secure distance from oxygen sources throughout automated exterior defibrillator (AED) use constitutes a essential security precaution. This requirement addresses the numerous danger of fireplace related to the mix of concentrated oxygen and electrical arcing, a possible consequence of defibrillation. Making certain adequate separation mitigates this hazard, safeguarding each the affected person and responders.
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Combustibility of Oxygen
Supplemental oxygen, whereas important for resuscitation, dramatically will increase the flammability of the encircling atmosphere. Oxygen-enriched atmospheres readily help combustion, which means that even a small spark can ignite close by supplies. The high-energy electrical discharge from an AED can generate such sparks, making a critical hearth danger if oxygen is in shut proximity. This precept applies to each compressed oxygen cylinders and oxygen supply gadgets resembling nasal cannulas and masks. The danger is amplified in enclosed areas.
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Secure Distance Parameters
A minimal distance of no less than one meter (roughly three toes) is mostly really helpful between the AED and any supply of supplemental oxygen throughout defibrillation. This distance is designed to cut back the focus of oxygen within the rapid neighborhood of {the electrical} discharge, minimizing the potential for ignition. It’s essential to confirm that oxygen supply gadgets are eliminated or quickly turned off and moved away from the affected person’s chest earlier than initiating defibrillation. The particular suggestions might range based mostly on native protocols and the kind of gear getting used, reinforcing the necessity for adherence to established tips.
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Oxygen Supply Gear
Specific consideration have to be paid to the position and situation of oxygen supply gear. Nasal cannulas, masks, and bag-valve-mask gadgets needs to be moved away from the affected person’s chest to stop oxygen accumulation close to the AED pads. Making certain that these gadgets should not leaking or malfunctioning can also be essential to attenuate the chance of oxygen enrichment within the space. After defibrillation, oxygen remedy needs to be resumed as shortly as applicable, however solely after the chance {of electrical} arcing has been eradicated.
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Environmental Consciousness
Past direct oxygen supply, think about the broader atmosphere. Confined areas, resembling ambulances or small rooms, might accumulate larger concentrations of oxygen. Air flow is essential to dissipate any extra oxygen within the air. Pay attention to any potential sources of flammable supplies, resembling alcohol-based pores and skin preparations or flammable materials, and guarantee they’re additionally evaded the defibrillation website. A scientific method to danger evaluation is crucial for sustaining a secure resuscitation atmosphere.
These concerns spotlight the integral hyperlink between oxygen proximity and total security throughout AED use. Whereas delivering life-saving electrical remedy, it’s essential to stay cognizant of potential hazards. By sustaining a secure distance from oxygen sources, responders can decrease the chance of fireplace and make sure the focus stays on efficient affected person care. Addressing this issue reinforces the overarching precept that profitable resuscitation includes not solely technical competence but in addition a eager consciousness of environmental security concerns.
9. Environmental hazards
The need of assessing the encircling atmosphere for potential hazards previous to and through automated exterior defibrillator (AED) deployment constitutes a essential part of secure and efficient resuscitation. This evaluation immediately aligns with the broader vary of things necessitating cautious analysis. Environmental hazards, if unaddressed, can compromise the efficacy of defibrillation, endanger the affected person and responders, and introduce authorized liabilities. The absence of a correct evaluation can remodel a probably life-saving intervention right into a hazardous scenario. For instance, a cardiac arrest occurring close to a busy roadway presents the rapid hazard of vehicular visitors. Deploying an AED with out first securing the scene may result in secondary accidents or fatalities, immediately undermining the resuscitation effort.
A complete analysis contains, however will not be restricted to, figuring out potential sources {of electrical} hazards (downed energy strains), unstable constructions (danger of collapse), hazardous supplies (chemical spills), and different rapid threats (on-going violence). The presence of those hazards dictates modifications to the usual AED protocol. This may occasionally necessitate relocating the affected person to a safer space, making a protecting perimeter, or, in excessive circumstances, delaying intervention till the atmosphere may be secured by educated professionals. Consideration should even be given to climate situations, as rain or snow can enhance the chance {of electrical} shock, necessitating further precautions. The authorized and moral implications of neglecting environmental hazards are important, as responders have an obligation to supply care in a way that minimizes hurt.
In abstract, the proactive evaluation of environmental hazards will not be merely a supplemental step however an integral side of accountable AED utilization. This evaluation contributes on to affected person and responder security, mitigates potential authorized liabilities, and maximizes the probability of profitable resuscitation. The failure to handle these concerns undermines the whole intervention and might result in unintended penalties. Integrating this precept into AED coaching packages is crucial for making certain that responders are outfitted to navigate complicated and probably harmful environments successfully.
Incessantly Requested Questions
This part addresses regularly requested questions concerning very important components impacting automated exterior defibrillator (AED) use. Adherence to those concerns optimizes effectiveness and affected person security throughout defibrillation.
Query 1: Why is it important to make sure the affected person and surrounding space are dry earlier than utilizing an AED?
Water conducts electrical energy, posing a major shock hazard to each the affected person and responders. Moisture compromises the AED’s effectiveness and elevates the chance of damage. Totally drying the affected person’s chest and surrounding space is a compulsory security precaution.
Query 2: How does the presence of implanted gadgets have an effect on AED pad placement?
Implanted gadgets, resembling pacemakers or ICDs, can intervene with the AED’s electrical present. Direct pad placement over these gadgets might cut back defibrillation efficacy and injury the implanted gadget. Pads have to be positioned both to the facet of the gadget, sustaining no less than one inch of separation, or in an anterior-posterior configuration.
Query 3: Why should treatment patches be eliminated earlier than utilizing an AED?
Remedy patches, significantly these with metallic backings, impede the move {of electrical} present. This interference reduces the quantity of vitality delivered to the center and probably causes localized burns. Previous to pad placement, all treatment patches have to be faraway from the affected person’s chest.
Query 4: What’s the rationale behind shaving chest hair previous to AED use?
Extreme chest hair creates an insulating barrier between the AED pads and the pores and skin, diminishing contact and decreasing the quantity {of electrical} present reaching the center. Shaving the world ensures agency, direct pad contact, maximizing the effectiveness of defibrillation.
Query 5: When are pediatric AED pads vital?
Pediatric pads are important when defibrillating youngsters. These pads ship a diminished vitality dose applicable for smaller our bodies, minimizing the chance of myocardial injury. If pediatric pads are unavailable, observe established tips for modified grownup pad placement to cut back the delivered vitality.
Query 6: Does being pregnant contraindicate using an AED?
No, being pregnant will not be a contraindication to defibrillation. The potential advantages of defibrillation for the pregnant particular person experiencing cardiac arrest outweigh the dangers to each mom and fetus. Normal AED protocols needs to be adopted, with consideration given to potential uterine displacement to enhance venous return after defibrillation.
Consciousness of those essential components is paramount for efficient AED deployment. Prioritizing security and adhering to established tips optimizes the probability of profitable resuscitation and minimizes potential hurt to each the affected person and responders.
The next part will handle related authorized and moral concerns surrounding using automated exterior defibrillators.
Important AED Utilization Suggestions
The next suggestions emphasize key concerns for optimizing automated exterior defibrillator (AED) effectiveness and making certain responder security. Adhering to those tips enhances the probability of optimistic affected person outcomes throughout cardiac arrest occasions.
Tip 1: Prioritize Environmental Security: Earlier than approaching a affected person, assess the encircling atmosphere for potential hazards resembling visitors, unstable constructions, or hazardous supplies. Take away the affected person from rapid hazard or safe the world to stop additional hurt.
Tip 2: Guarantee a Dry Surroundings: Water conducts electrical energy. Totally dry the affected person’s chest and surrounding space to attenuate the chance {of electrical} shock to each the affected person and responders. Keep away from AED use in standing water or throughout inclement climate if potential.
Tip 3: Regulate for Implanted Gadgets: Establish any implanted gadgets, resembling pacemakers or ICDs. Place AED pads no less than one inch away from these gadgets to stop interference with the AED’s performance and potential injury to the implanted gadget.
Tip 4: Take away Remedy Patches: Transdermal treatment patches, particularly these with metallic backings, impede electrical conductivity. Take away all patches from the affected person’s chest earlier than making use of AED pads to make sure correct present supply.
Tip 5: Handle Chest Hair: Extreme chest hair can create an insulating barrier. Shortly shave the world the place AED pads will likely be positioned to make sure direct contact with the pores and skin, maximizing the effectiveness of {the electrical} shock.
Tip 6: Contemplate Pediatric Pads: When obtainable, make the most of pediatric AED pads for youngsters. These pads ship a decrease, age-appropriate dose of electrical energy, minimizing the chance of hurt. If pediatric pads are unavailable, observe tips for modified grownup pad placement.
Tip 7: Keep Oxygen Security: Supplemental oxygen enhances flammability. Guarantee a secure distance (no less than one meter) between the AED and any oxygen supply to stop the chance of fireplace throughout defibrillation. Briefly discontinue oxygen supply throughout the shock.
Adherence to those suggestions supplies a structured method to essential decision-making throughout emergency conditions, enhancing the security and effectiveness of AED interventions.
The following part will delve into the authorized and moral framework governing AED utilization, offering a complete understanding of responder duties and potential liabilities.
Conclusion
The previous dialogue comprehensively explored components necessitating cautious analysis throughout automated exterior defibrillator (AED) utilization. Key concerns embody environmental hazards, presence of water, implanted gadgets, treatment patches, chest hair, age of the affected person, being pregnant, proximity to metallic and oxygen, and different associated points. Addressing these components will not be optionally available however integral to making sure each affected person security and the efficacy of the defibrillation process. Correct implementation of the practices outlined immediately interprets right into a higher probability of profitable resuscitation outcomes throughout cardiac arrest occasions.
The knowledge conveyed serves as a name to motion for steady training and coaching amongst potential AED customers. Proficiency in primary AED operation is inadequate; understanding these nuances is crucial for accountable and efficient intervention. Continued analysis and updates to greatest practices warrant ongoing consideration, additional contributing to the development of survival charges from sudden cardiac arrest. Recognizing that what are some particular concerns when utilizing an aed, can enhance the chance to offer one other individual an opportunity to stay.
