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

[tursiops]

I teach 6-10 first aid courses a year. Compression-only CPR has been the standard for 2 years now. Rescue breaths get a mention, but no practice.

Both DAN and EFR recommend maintaining rescue breaths for drowning situations. The idea is that there may not be enough O2 in the lungs/blood to bother pumping it around. Non-scuba related courses still have that caveat, as does the research that produced the stuff that gets misquoted.

Added:
Have limits changed, or have I mis-remembered?

 

[Wookie]

Perhaps. I teach for neither agency. I teach MFA, RedCross, and ASAHI.

 

[kafkaland]

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

There is a standard in the regulatory world for this. They extrapolate the premium that jobs with higher risks command to 100% chance of death. The number is something like 13million, if I remember correctly. And when new regulations are made, let's say, for stricter emission standards, that would cost the industry $130M, they would have to show that at least ten lives are saved by the regulation.

 

[tursiops]

Perhaps. I teach for neither agency. I teach MFA, RedCross, and ASAHI.

That's my point. Those are not diving-related agencies. Frank, take a look at the original research that motivated the hands-only approach. Some quotes from https://www.sciencedirect.com/science/article/pii/S0300957217306755:

"One study examined the influence of nationwide dissemination of compression-only CPR recommendations for lay rescuers and showed that, although bystander CPR rates and nationwide survival improved, patients who received compression-only CPR had lower survival compared with patients who received chest compressions and ventilations at a CV ratio of 30:2"

"Knowledge Gaps
Several knowledge gaps were identified in the review of this topic. A more comprehensive list has been posted on the ILCOR website.10 The BLS Task Force ranked the knowledge gaps in priority order, and the top 3 are listed here:
1.The effect of delayed ventilation versus 30:2 high-quality CPR.
2.The impact of continuous chest compressions on outcomes for cardiac arrests from noncardiac causes such as drowning, trauma, or asphyxia in adult and paediatric patients.
3.The ability of bystanders to perform correct mouth-to-mouth ventilations."

 

[Wookie]

That's my point. Those are not diving-related agencies. Frank, take a look at the original research that motivated the hands-only approach. Some quotes from https://www.sciencedirect.com/science/article/pii/S0300957217306755:

"One study examined the influence of nationwide dissemination of compression-only CPR recommendations for lay rescuers and showed that, although bystander CPR rates and nationwide survival improved, patients who received compression-only CPR had lower survival compared with patients who received chest compressions and ventilations at a CV ratio of 30:2"

"Knowledge Gaps
Several knowledge gaps were identified in the review of this topic. A more comprehensive list has been posted on the ILCOR website.10 The BLS Task Force ranked the knowledge gaps in priority order, and the top 3 are listed here:
1.The effect of delayed ventilation versus 30:2 high-quality CPR.
2.The impact of continuous chest compressions on outcomes for cardiac arrests from noncardiac causes such as drowning, trauma, or asphyxia in adult and paediatric patients.
3.The ability of bystanders to perform correct mouth-to-mouth ventilations."

Do you think that diving laypeople are likely to do a better job than non diving laypeople? I have 2 rescues to my name. I have 2 failures. In both rescues, rescue breathing was not necessary as once hit with an AED they resumed breathing on their own. In the case of one failure, it was 25 minutes before we could get to him with the AED, and the other, his coronary artery was toast.

IMO we need to do a better job teaching what a successful rescue looks like, as we were 200 miles from a helo and had to care for him for 24 hours.

 

[tursiops]

Do you think that diving laypeople are likely to do a better job than non diving laypeople? I have 2 rescues to my name. I have 2 failures. In both rescues, rescue breathing was not necessary as once hit with an AED they resumed breathing on their own. In the case of one failure, it was 25 minutes before we could get to him with the AED, and the other, his coronary artery was toast.

IMO we need to do a better job teaching what a successful rescue looks like, as we were 200 miles from a helo and had to care for him for 24 hours.

I'd like to think that diving laypeople have more incentive to do a decent job. But, truthfully, the odds aren't good no matter how well you do. You are at 50% success, which is WAY above expectations. Congratulation on the two good ones; and thanks for trying on the the other two.

 

[TMHeimer]

Apparently I was somewhat correct according to Wookie's report that 2 non-diving related CPR organizations' standards are compressions only. Maybe that's where I read it before. Yet tursiops is correct in that diving CPR orgs. still teach to do rescue breaths due to their help with drowning.
There is also the discussion as to whether doing less is easier for the "lay person" and is a good trade off in that the lay person will have less to remember and at least attempt something (my 2009 EFR instructor alluded to that). Same idea as when they made compressions to rescue breaths the same for both adults and children a while back. I thought that anyone taking CPR seriously shouldn't have trouble memorizing two different ratios--if it is important.

Some of this explains my frustration with CPR courses over the years and why I just skim a page of my old EFR manual daily.

 

[tursiops]

Some of this explains my frustration with CPR courses over the years and why I just skim a page of my old EFR manual daily.

You should get a copy of the newest EFR manual and scan that daily instead. Things have changed. This assumes you'd really like to do your best for someone in need.

 

[Wookie]

Apparently I was somewhat correct according to Wookie's report that 2 non-diving related CPR organizations' standards are compressions only. Maybe that's where I read it before. Yet tursiops is correct in that diving CPR orgs. still teach to do rescue breaths due to their help with drowning.
There is also the discussion as to whether doing less is easier for the "lay person" and is a good trade off in that the lay person will have less to remember and at least attempt something (my 2009 EFR instructor alluded to that). Same idea as when they made compressions to rescue breaths the same for both adults and children a while back. I thought that anyone taking CPR seriously shouldn't have trouble memorizing two different ratios--if it is important.

Some of this explains my frustration with CPR courses over the years and why I just skim a page of my old EFR manual daily.

It’s amazing how helpless you feel. I had a deckhand on the boat go into insulin shock Wednesday. I knew exactly what to do, but his berthing area was a pit. He was conscious and unresponsive, and I couldn’t find his glucose anywhere. I found his insulin, his glucose meter was out of strips, his teeth were clenched, and there was nothing I could do for him aside from keep him from hurting himself until EMS showed up. EMS cannot give glucose to someone unless they consent.

I am under no such restrictions. It’s amazing how fast he came around.

 

[caydiver]

Wookie well done. I have never personally had to deal with a like situation. Have so many friends and family members who have. I don’t know how you do it. Could say so much about “the friendly advice” that is so freely offered. Until you have been there or to such a lessor level no one can ever know what it is like to let a life go even if it is already gone.