AED Use in Diving Emergencies

[Reck Diver]

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A ScubaBoard Staff Message...

This thread has been split off from an accident discussion in the A&I forum

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I can see where DD is coming from. For a Captain, it has to be an agonizing decision, that is to make the choice of risking the living at the very slim chance to save the dying.

Here are some interesting statistics from the AHA...
"It’s estimated that about 95 percent of sudden cardiac arrest victims die before reaching the hospital."

"Survival is directly linked to the amount of time between the onset of sudden cardiac arrest and defibrillation. If no bystander CPR is provided, a victim’s chances of survival are reduced by 7 to 10 percent with every minute of delay until defibrillation."

"The VF sudden cardiac arrest survival rate is only two to five percent if defibrillation is provided more than 12 minutes after collapse."

"In some cities with public access defibrillation or “community AED programs,” when bystanders provide immediate CPR and the first shock is delivered within 3 to 5 minutes, the reported survival rates from VF sudden cardiac arrest are as high as 48 to 74 percent."

So in the case of an MI, really the only real chance the for survival is to have an AED aboard the vessel. An AED seems like an essential piece of safety gear for a commercial dive op. For 2K, no commercial vessel should leave the dock with out one.

 

[jar546]

I can see where DD is coming from. For a Captain, it has to be an agonizing decision, that is to make the choice of risking the living at the very slim chance to save the dying.

Here are some interesting statistics from the AHA...
"It’s estimated that about 95 percent of sudden cardiac arrest victims die before reaching the hospital."

"Survival is directly linked to the amount of time between the onset of sudden cardiac arrest and defibrillation. If no bystander CPR is provided, a victim’s chances of survival are reduced by 7 to 10 percent with every minute of delay until defibrillation."

"The VF sudden cardiac arrest survival rate is only two to five percent if defibrillation is provided more than 12 minutes after collapse."

"In some cities with public access defibrillation or “community AED programs,” when bystanders provide immediate CPR and the first shock is delivered within 3 to 5 minutes, the reported survival rates from VF sudden cardiac arrest are as high as 48 to 74 percent."

So in the case of an MI, really the only real chance the for survival is to have an AED aboard the vessel. An AED seems like an essential piece of safety gear for a commercial dive op. For 2K, no commercial vessel should leave the dock with out one.

Yes, absolutely. The key to every person that I have ever pulled out of cardiac arrest was early defibrillation and effective CPR leading up to it. I would love to see AED's more widely spread in the diving community. It would be a help but is never a guaranteed fix.

 

[letterboy]

is using an AED on a dive boat a good idea? or does the sea water not conduct electricity?

 

[danvolker]

Yes, absolutely. The key to every person that I have ever pulled out of cardiac arrest was early defibrillation and effective CPR leading up to it. I would love to see AED's more widely spread in the diving community. It would be a help but is never a guaranteed fix.

Certainly would be a nice feature on any diveboat....If I had a friend with a heart condition, who was a diver, I would push them to buy their own AED and have it with them on all dive trips, just like a Nitrox analyzer....For that matter, they should have it with them where ever they were...it is "their" responsibility, as it is their condition.

 

[jar546]

is using an AED on a dive boat a good idea? or does the sea water not conduct electricity?

It is a great idea if the proper training is provide for the situation in which it will be used. Sort of like on the wet sand of a beach. I have defibrillated many people in multiple situations such as in the rain, wet floors of bathrooms, in pools of blood and vomit, etc. It all comes down to situational awareness and training. So yes, it is a great idea.

I myself have been defibrillated so I know the value. For you medical personnel like me, I had synchronized cardioversion for rapid A-fib due to Grave's disease.

 

[TSandM]

Dan, the problem with heart disease is that, for a significant number of people, the presenting symptom is sudden death. They don't KNOW they have heart disease prior to that. I remember taking care of a very nice man in his mid-60s who didn't have an ounce of extra weight, and swam every day. He had a cardiac arrest in the pool, survived it, and had a four vessel bypass. He had no idea he had heart disease, before he "died".

 

[danvolker]

Dan, the problem with heart disease is that, for a significant number of people, the presenting symptom is sudden death. They don't KNOW they have heart disease prior to that. I remember taking care of a very nice man in his mid-60s who didn't have an ounce of extra weight, and swam every day. He had a cardiac arrest in the pool, survived it, and had a four vessel bypass. He had no idea he had heart disease, before he "died".

That is kind of scary!
I have been hearing this of marathon runners as well...particularly at risk are athletes that do LSD ( long steady distance) training, as it is actually bad for the heart, prolonged Anaerobic threshold level racing apparently will cause scarring and damage( evidenced by the autopsies). The smart training with this knowledge, is doing intervals, and not competing in many long duration events.

But just imagine if every new business that wanted to open up, was going to be forced to pay 2K to buy an AED...I'm just not sure it is fair to the business owners.
I think when a business owner decides to spend the money, and have this as an available service, they should be praised for it....

With the Diveboats, certainly it would be a nice feature to acquaint their customer base with...I would hope the AED would be "Marinized"..replacing every 6 months would get expensive!

 

[Jim Lapenta]

One issue I'd like to see addressed with every boat, shop, and even instructor is some way to bring down the cost of having an AED. The technology is certainly not new. The cost of mfg one can't be too crazy now with all the different models. Last time I looked into getting one it was in the area of $1100.00. That's a nice chunk of change for many. Bring it down to around 300 or even 500 and you'd see more of them in more places.

 

[boulderjohn]

One issue I'd like to see addressed with every boat, shop, and even instructor is some way to bring down the cost of having an AED. The technology is certainly not new. The cost of mfg one can't be too crazy now with all the different models. Last time I looked into getting one it was in the area of $1100.00. That's a nice chunk of change for many. Bring it down to around 300 or even 500 and you'd see more of them in more places.

The problem is that just about all medical equipment is absurdly overpriced. In fact, I can't believe AEDs are as cheap as that. I have sleep apnea and use a C-PAP machine at night. I am supposed to replace the external parts--a 4-foot hose, a face mask, and the soft cover for it--every now and then. That's it. For that, my insurance company is charged $1,400. My co-pay is $400. I recently had an accident resulting in a lot of bills. The costs are simply ridiculous.

 

[Reck Diver]

One issue I'd like to see addressed with every boat, shop, and even instructor is some way to bring down the cost of having an AED. The technology is certainly not new. The cost of mfg one can't be too crazy now with all the different models. Last time I looked into getting one it was in the area of $1100.00. That's a nice chunk of change for many. Bring it down to around 300 or even 500 and you'd see more of them in more places.

Are they unable or unwilling? I find it difficult to believe a legitimate dive op can't afford 2k, for a device that could save the life of a passenger. If the ops margins are that tight, they are more than likely a failing business.

Look at the American Heart Association data. A heart attack victim has a 2-5% chance of survival if defibrillation begins more than 12 minutes after the event. That is every time on a dive boat in Palm Beach County. When bystanders provide immediate CPR and the first shock is delivered within 3 to 5 minutes, the reported survival rates from VF sudden cardiac arrest are as high as 48 to 74 percent.

An AED on a commercial dive op should be as common as VHF, or a Fire Extinguisher.

As far as the price coming down to $300.00.... it's not going to happen. That price barely covers the liability.