Oahu Diver in critical condition.

[Desert_Diver]

I have one question...which I should know the answer to, but don't....so I will ask.

Do the AED computer interpretations distinguish flat line (asystole) from a fine V. fib?

and also...what do we know about the saline wet conditions of using these AED's on victims aboard boats?

The AED (keyword here is automtic) does distinguish between asystole, v fib and bradicardia. On the fully automatic defibs, asystole is not considered a shockable condition since you need to juice the victim with epinephrine to be effective. And be prepared to follow with lidocaine if (very probable), he goes into tachycardia. Depending on the local protocols, different level EMTs carry different types of defibs.

 

[Henryville]

well....anybody that dives long enough is going to have to handle seeing a death. And it is good to be in touch with reality. When I said "taking it hard"...It is normal to be affected by a death. People involved know this heart attack could have happened anywhere and that the man was doing what he loved.

There is an argument to be made that experience serves a purpose.

I don't think the man was "trying to bring on an event". I think he was living a full and happy life with people he wanted to be with and doing something very enjoyable. Having that outlook and comitting suicide are very different.

Absolutely, positively in now way was I implying anything about this particular incident, merely responding to the point being made.

I would like to express my opinion more fully but out of respect for friends and family of the lost diver I don't want to do so in this thread at the risk of being misinterpreted. I'm going to do a thread search and maybe start a new one on this topic.

 

[Cacia]

it's a good topic.

A great debate will ensue, you can be assured.

Thanks desert diver. Yes, the AED detected no shockable rythm, and the rather experienced rescuers felt no palpable pulse. I think judging from his initial color, they think his perfusion/ circulation had ceased abruptly.

I find myself wondering about the effects of a victim being wet and how that affects an AED, if at all. When I did my EFR instructor course, they were not really on dive boats yet and no one present seemed to know the answer to this.

 

[Thalassamania]

I get your point, but respectfully disagree. Here's why:



If one wanted to end it diving, went solo shore diving against a current to bring on an "event", tethered one's self to a fixed point in shallow water, and left a note with instructions, then maybe okay. Otherwise, doing so jeopardizes those who attempt a rescue or recovery, traumatizes those who are involved or are witnesses, and makes diving appear to be a more dangerous pursuit than it actually is, maybe in the end hurting all of us.

This of course is all responding to your hypothetical point and implies nothing about this incident, other than that the people who tried to rescue the stricken diver are adversely impacted.

Condolences to the family and friends of the diver, and respect to the divers and crew who tried to rescue him.

You're absolutely, 100%, right, I was thinking in rather more general terms and not paying close enough attention (my mother-in-law likely will not make it through the week, so I'm kind of preoccupied with the question).

 

[do it easy]

At the AED training I took, the instructors said that some water was not an issue and gave me the impression that you would have to have deep puddles to interfere with the AED.

 

[Henryville]

Opened a thread here:

http://www.scubaboard.com/showthread.php?t=168096

Should be a lively discussion.

 

[Wildcard]

The chest wall needs to be dried off some so the juice goes from paddle to paddle in a dirrect line and not across the skin. I have burned people in snow, water and mud and never had a problem.
BTW, I see he has died.
"
The AED (keyword here is automtic) does distinguish between asystole, v fib and bradicardia. On the fully automatic defibs, asystole is not considered a shockable condition since you need to juice the victim with epinephrine to be effective. And be prepared to follow with lidocaine if (very probable), he goes into tachycardia. Depending on the local protocols, different level EMTs carry different types of defibs."
Epi does not "juice" asystole into anything nor is lido used for tachycardia except Vtach.. BLS rigs usualy have AEDs and everyone else uses manual defib/monitor/pacers.

 

[bluemagoo]

...
I find myself wondering about the effects of a victim being wet and how that affects an AED, if at all. When I did my EFR instructor course, they were not really on dive boats yet and no one present seemed to know the answer to this.

This doesn't address salt water specifically but was quoted on a couple of sailing sites: Red Cross
I don't believe any special instructions are given to Honolulu City & County lifeguards; they'll do it on the beach but obviously safely out of drenching wet conditions. I'm not sure about the rescue boat; my guess is that they'll do manual CPR. I might be able to find out.

This 1-1/2 y.o. study found only one waterproof unit, the Zoll AED; there may be others:
AED procurement

 

[Desert_Diver]

"
The AED (keyword here is automtic) does distinguish between asystole, v fib and bradicardia. On the fully automatic defibs, asystole is not considered a shockable condition since you need to juice the victim with epinephrine to be effective. And be prepared to follow with lidocaine if (very probable), he goes into tachycardia. Depending on the local protocols, different level EMTs carry different types of defibs."

Epi does not "juice" asystole into anything nor is lido used for tachycardia except Vtach.. BLS rigs usualy have AEDs and everyone else uses manual defib/monitor/pacers.

The epinephrine makes the heart muscle more sensitive to the electrical shock. The epi does not, by itself, cause the asystole to convert to any other rythm. Because the heart muscle is more sensitive after introduction of epinephrine, protocols (that vary from state to state) usually specify that some drug be administered in the case of ventricular tachycardia resulting from the defib.

You quite often find AEDs now in shopping malls, airports, and industrial manufacturing locations in addition to BLS responders. The defibs that I have seen on dive boats are also AEDs.

I apologize for not being more specific. I was trying to answer the question in terms that non-medics would understand. I hadn't intended for this to be a CME class. I keep forgetting the pirhana lurking just out of sight on the board.

 

[Cacia]

he he.

WC = pirahana

down boys