Accidents. Resuscitation. AED. Should AED be mandatory on diving boats?

[Radoo]

Haha, we don’t like regulations but we love regulators.

Hypoxia it is indeed the most common aethiological factor but hypoxia leads to cardiac arrhythmia. On top of that you’ll have hypothermia and electrolytes abnormalities which can also lead to arrhythmia. My point was that you can treat hypoxia with O2 or rescue breaths (21% is better that 0%) but you can’t replace a shock delivered by an AED with anything. That of course if the victim have a shockable rhythm.

Someone was saying about cost effectiveness. You can use QALY (quality adjusted life year) to calculate this. It was deemed to be cost effective to have an AED in a plane: http://ai.stanford.edu/~iliu/my_papers/Groeneveld.pdf . Why not have one on a boat?

It’s true that 30% success rate for AED use is high compared to general population but they define “success” as return of breathing and consciousness. Most resuscitation bodies will define success as survival followed by home discharge. And the rate is <10%.

 

[BlueTrin]

Well your points beg the question of "If only one life is saved with the AED, wasn't it worth the expense and effort?"

It depends if the same amount of money could save more lives by being deployed differently ?

Which is the hardest part of the question

 

[Protondecay123]

It depends if the same amount of money could save more lives by being deployed differently ?

Which is the hardest part of the question

If it was your life do you think it would be worth it?

 

[BlueTrin]

If it was your life do you think it would be worth it?

That’s the wrong question though.

Once you know 100% it will save your life the price of an AED is probably worth it.

The question is: is it worthwhile to make all divers pay for the maintenance for an AED.

I do not know the answer as I do not have enough data: I suspect it is probably yes because it must be fairly low cost and end up having to increase the price per dive probably by a pound or so. But it’s hard to answer this question without figures. There are plenty of things people can pay to reduce their chance of dying but some may not be worth it statistically.

 

[Radoo]

Don’t know how much a boat costs but not having an AED because it’s expensive feels like having a Ferrari and not affording to get an air freshener for it.

 

[BlueTrin]

Don’t know how much a boat costs but not having an AED because it’s expensive feels like having a Ferrari and not affording to get an air freshener for it.

Yea intuitively I think it’s probably not very expensive per dive. But I don’t know how many lives this would save.

 

[BlueTrin]

Haha, we don’t like regulations but we love regulators.

Hypoxia it is indeed the most common aethiological factor but hypoxia leads to cardiac arrhythmia. On top of that you’ll have hypothermia and electrolytes abnormalities which can also lead to arrhythmia. My point was that you can treat hypoxia with O2 or rescue breaths (21% is better that 0%) but you can’t replace a shock delivered by an AED with anything. That of course if the victim have a shockable rhythm.

Someone was saying about cost effectiveness. You can use QALY (quality adjusted life year) to calculate this. It was deemed to be cost effective to have an AED in a plane: http://ai.stanford.edu/~iliu/my_papers/Groeneveld.pdf . Why not have one on a boat?

It’s true that 30% success rate for AED use is high compared to general population but they define “success” as return of breathing and consciousness. Most resuscitation bodies will define success as survival followed by home discharge. And the rate is <10%.

That’s interesting, if someone wants to adjust these figures by statistics reported in diving accidents he can then answer the question and pass th research to regulators

 

[GJC]

I don't think it's a terrible idea, but I also don't think it will impact fatalities much. AEDs help with a cardiac-based cause of collapse, but when it is a cessation of heartrate because of a lack of oxygen/ventilation, it won't really help, only establishing breathing will, and the HR typically comes back naturally with that.

I work with babies and their causes of cardiac arrest are almost always respiratory in nature, so I can count on one hand the number of babies I've seen needing defibrillation, additionally, unlike what they show in TV shows, defib will not restart a heart. Epinephrine will.

Since many causes of cardiac arrest in diving I think are respiratory in etiology, I wouldn't think it would make a huge difference. Additionally, the time it's going to take to get to an advanced care facility, if your primary pathology is cardiac, is going to be pretty prohibitive. It's unfortunate, but if you have a serious arrhythmia somewhere far from advanced medical care, your outcome is unlikely to be good.

BSAC data from the original post shows the success rate when AED is used is almost twice that of when only CPR is provided.

DAN data shows that drowning is the number 1 cause of diving fatalities with pre-existing medical conditions being number 2. A large number of the pre-existing medical conditions were cardiac related. This is the group that most likely would benefit from AEDs being immediately available.

 

[BlueTrin]

This is a bit interesting as well:
Cardiac Health & Your Risk of Death While Diving | The Heart & Diving - DAN Health & Diving

 

[GJC]

From an economist point of view, it’s one of these things people could be globally better off if it was mandatory but unlikely to happen without regulation or marketing/education.

It’s hard to tell without looking at the figures: i.e. number of lifes saved if every boat was carrying an AED vs cost of doing so.

Before to decide whether it is worth it, one has to determine what is the next most efficient use of money: if AED wouldn’t make enough of a difference there may be something the same cost or cheaper which would save even more lifes.

The cost of an AED is about $600-800. Most have an expiration date of 5 years before they have to be serviced or replaced. This puts the cost per year below $160. I think most boat operators can afford that without impacting their profit significantly.

I haven't seen any data on global cost/benefit.