Dive incident in Cozumel March 27, 2015

[DandyDon]

OK....Don's logic has beaten me down.

I'll concede carrying an AED in the woods when you're all alone might be counterproductive.


Again, apples and oranges....

It's fruit salad to you, but looking at how much time I spend in the wild under various condition, I am more likely to find need on land. I may well not be alone, but carrying one around and hoping others would quickly use it - questionable.

Still, a good idea for a boat to carry one - any boat with passengers or divers. So many reject so many good ideas, but having the AED mounted on the bulkhead would be a good show for business. Even better if they ever need it and it works.

 

[kwinter]

My question wasn't about the safety of their usage on a boat...more about their durability in corrosive conditions. Anyone with experience in this area?

Maybe stick the box in a dry bag with some DampRid?


iPhone. iTypo. iApologize.

 

[lowviz]

Marg,

As you know, AED is only half of the story. An AED will do nothing for someone without a heartbeat. That is where the CPR part comes in.

I had to maintain a valid CPR "cert" at the last company I worked for. Big company, trainer on-site every month. One of the instructors casually mentioned that the fun courses (she liked to teach) are those for professional rescuers and health care professionals. I asked why it was fun. "Different breed of individuals" So I asked why the ARC doesn't teach the same course to people like me.

No prob. The ARC doesn't care. Just sign up. She said you guys are here just to get recertified and get back to work. That is where I started taking the "other" course off-site. And, damn, if she wasn't right!

 

[bilsant]

It's fruit salad to you, but looking at how much time I spend in the wild under various condition, I am more likely to find need on land. I may well not be alone, but carrying one around and hoping others would quickly use it - questionable.

Still, a good idea for a boat to carry one - any boat with passengers or divers. So many reject so many good ideas, but having the AED mounted on the bulkhead would be a good show for business. Even better if they ever need it and it works.

I'm glad we agree.

 

[Kmart4321]

Marg,

An AED will do nothing for someone without a heartbeat.

Sorry, just need to interject here. This statement is categorically wrong. An AED is a lifesaving device that should be applied without delay to anyone not displaying signs of life, is pulseless or agonal respirations. The hope is that the patient is in a arrhythmia that the AED will recognize the arrhythmia and terminate it with a shock through the myocardium allowing the heart's pacemakers to initiate a normal rhythm. An AED should only be applied to a person with no heartbeat because the machine can only assess the electrical activity of the heart, it can not determine if there is a pulse or if the person is conscious.
In the case of Ventricular Tachycardia, one of the two arrhythmias that the AED will deliver a shock to, the other being Ventricular Fibrillation, a person can have a pulse, be awake and talking to you despite the arrhythmia. Delivering an unsynchronized shock to this individual will have the potential to make the situation much much worse.

 

[uncfnp]

Fyi, I was leaning on a stretcher attempting to intubate once when an overzealous partner lit the pt up once back in the old days of stacked monophasic shocks. 360 J zipped through him (and me to a lesser degree) with no lasting ill effects that I know of......although I do tend to twitch when the microwave starts[emoji12]

During a recent presentation, an ER physician discussed the risk to personnel doing chest compression (wearing gloves) during cardioversion/defibrillation. He stressed the importance of uninterrupted compressions and made a decision for himself not to clear before biphasic defibrillation. He is still doing presentations.

 

[Kmart4321]

During a recent presentation, an ER physician discussed the risk to personnel doing chest compression (wearing gloves) during cardioversion/defibrillation. He stressed the importance of uninterrupted compressions and made a decision for himself not to clear before biphasic defibrillation. He is still doing presentations.

I can not endorse that. Lol. The new biphasic machines do deliver energy in a superier fashion while only delivering what rnergy is necessary based on impedance sensed by pads on the skin.

I felt like I been hit in the forearms lightly as they were both in contact with aluminum stretcher. Different feeling than touching 110 volt wires....
But both get your attention

 

[Basking Ridge Diver]

Marg,

As you know, AED is only half of the story. An AED will do nothing for someone without a heartbeat. That is where the CPR part comes in.

Sorry, just need to interject here. This statement is categorically wrong. An AED is a lifesaving device that should be applied without delay to anyone not displaying signs of life, is pulseless or agonal respirations. The hope is that the patient is in a arrhythmia that the AED will recognize the arrhythmia and terminate it with a shock through the myocardium allowing the heart's pacemakers to initiate a normal rhythm. An AED should only be applied to a person with no heartbeat because the machine can only assess the electrical activity of the heart, it can not determine if there is a pulse or if the person is conscious.
In the case of Ventricular Tachycardia, one of the two arrhythmias that the AED will deliver a shock to, the other being Ventricular Fibrillation, a person can have a pulse, be awake and talking to you despite the arrhythmia. Delivering an unsynchronized shock to this individual will have the potential to make the situation much much worse.

From what I understand - please correct me - You should engage the AED every time you think you will be performing CPR to bring the heart back - BUT if there is no heart beat the AED will NOT deliver a shock - SO the above statement is technically true by lowviz....

 

[Kmart4321]

From what I understand - please correct me - You should engage the AED every time you think you will be performing CPR to bring the heart back - BUT if there is no heart beat the AED will NOT deliver a shock - SO the above statement is technically true by lowviz....

Incorrect. The machine can and will detect v tach which can be producing a pulse. That is why rescuers need to look for signs of life before applying.
An AED should be activated early on. It is one of the staples in the Chain of Survival.

The AED is simply a computer that can sense electrical activity of muscle fibers.
The algorithm built into the units looks for two arrhythmia, v fib and vtach.

You will not produce a pulse with v fib. The ventricles are contracting 300- 400 times per minute, way too fast to allow filling of the chambers of the heart and ejection of blood into the pulmonary or systemic circulation system. These patients do NOT have a pulse and they only thing that has any chance of saving them is an AED.
V tach can perfusing or nonperfusing. If left in perfusing v tach long enough, it will usually progress to nonperfusing v tach and then v fib.
If a pt is unresponsive without signs of life, start cpr, get an AED and use it. Survivability drops 10% each minute care is delayed during sudden cardiac arrest

 

[lowviz]

... An AED is a lifesaving device that should be applied without delay to anyone not displaying signs of life, is pulseless or agonal respirations. ...

I agree completely. With or without a heartbeat, you apply the AED. It gets to choose. You can "ask" for a shock by pressing the shock button. The unit alone will decide, act, and then inform you as to its decision.

BRD saw where I was going with that.

The point I was making was that, with no heartbeat or electrical activity, the unit will not deliver a shock. It appears that this statement was confusing as it seems to imply that one should not bother applying an AED to someone without a heartbeat. That is completely incorrect. My intent was to highlight the CPR half of the equation as the CPR part seems to be getting lost in the AED discussion. Ideally, CPR and AED work in unison. Anyone who has taken the course knows the proper procedure.