Automated External Defibrillator ?

[cal40john]

Originally Posted by speciald@ocens.

We carry one. My wife is a nurse anesthetist and ALS certified. I've had 2 heart attacks in the past. Two Winters ago, a friend of ours suffered a heart attack in the Bight at Norman Island. S he called on the VHF, and a cardiologist eating dinner ashore imediately came to the boat. Serch and rescue out of Roadtown also showed up quicky. He was defifbed with their AED, recieved CPR, and survived. He had no cardiac history. So - it does happen!

Is that out of order? I don't understand why you would do CPR after a successfull use of an AED.

Did he go to a hospital to receive treatment afterwards?

John

[Healer52]

Originally Posted by zeehag

realistically speaking--you are out in the middle of the pacific on way to nuku hiva from santa barbara or some other weird west coast locale---and --smack in the middle of 3000 miles of cean, omg--chest pain. --what ye gonna do--turn on the defib then? it doesnt work that way. by the time the lay person is aware of an impending fatal arrhythmia--YER DEAD!!!!!! ye gonna walk around on deck with the electrode patches in place for the defib to be used?/ how do ye kno wis gonna even happen?/ why waste of money that could be used on more functional items in the lockers or med kit???/ i am not understanding this--i have been icu and emergency room rn and triage rn for many many years----generally arrhythmias occur in sleep unless associated with mi -- is the individual sailing as a lay person--not a health care provider--going to know exactly what to do ??? NO!!!!! why buy ?? no reason to . oh yes, and the cpr being done in the middle of the blue sea--where are you going to find relief for the cpr giver as that individual sails the boat to the destination closest ?? good luck--doesnt work that way. why is everyone so in love with aed? to tell the truth--they dont even work all the time in hospitals--why bother!!!!!and--tell me how to save life in mid ocean with only you and the victim as sailors of the boat?? aint happening--do your best, but be real about it. aed is a useless added expense for the long distance short handed cruiser.

You don't even need to be that far out. The run from Long Island to Bermuda, or the Vineyard to Halifax or something very coastal can certainly put you out of range of help in time. If the weather is bad you could be on the hook at the Channel Islands and be too far away.

[Healer52]

Originally Posted by speciald@ocens.

We carry one. My wife is a nurse anesthetist and ALS certified. I've had 2 heart attacks in the past. Two Winters ago, a friend of ours suffered a heart attack in the Bight at Norman Island. S he called on the VHF, and a cardiologist eating dinner ashore imediately came to the boat. Serch and rescue out of Roadtown also showed up quicky. He was defifbed with their AED, recieved CPR, and survived. He had no cardiac history. So - it does happen!

Glad it worked out. Thats an extreme example of the situation I described where AED's are practical: With an EMS system that can deal with the problem in a timely manner. When it can't, the results can be quite different.

[sarafina]

what? it doesn't work like it did for James out in the casino parking lot?

I am SO disillusioned!

[Healer52]

Originally Posted by sarafina

what? it doesn't work like it did for James out in the casino parking lot?

I am SO disillusioned!

And you don't use an epi-pen for direct cardiac injection, either.....the needle isn't long enough, either.

[dgz3]

An AED onboard? Why not? If you want it, train on it, and can afford it...there is absolutely NO reason not to have it.
I am a retired firefighter/paramedic who rode rescue in Miami for 33 years. I have personally seen 3 people defibrillated with AED's applied by lay persons before EMS arrival. I have also seen a heart in Vfib restart spontaneously with just a few moments of CPR. Monitored. Saw it on the scope. Person regained conciousness before we got to the hosp. I have seen a 50 yo woman undergo CPR for an hour on scene during extensive rescusitation efforts and finally be successfully defibrillated. Granted, a truck full of drugs went into her, ten firemen took turns doing compressions, and she was shocked about 15 times; but good CPR can work. All of those people survived and were discharged from hospital.
Does it usually work? Of course not. In fact it rarely works. Less than one in ten in the field, in my experience. Maybe one in a hundred successfully discharged.
But there is NO reason not to try. Start CPR, apply the AED and hope for the best. In an MI, myocardial infarction, "heart attack", it is not the blockage that stops the heart. It is the electrical disturbance caused by the irritated heart cells down stream of the blockage, which may not be complete. A person defibrillated by an AED might live long enough to get a couple baby aspirins in them, get on some oxygen, and not experience that particular (R on T) electrical phenomenon again.
The incident is more likely to occur in an anchorage or marina than at sea, since most cruisers spend far more time on the hook than under sail.
Given the number of retired doctors, nurses and medics on cruising boats these days, it is not unlikely that competent help and good CPR may be only a panicked radio call away on the next boat.
In reality, your AED is far more likely to be used on someone else than on yourself or your crew.
If it works , someone will be mighty glad you were there..

[GordMay]

Originally Posted by dgz3

An AED onboard? Why not? If you want it, train on it, and can afford it...there is absolutely NO reason not to have it...
...If it works , someone will be mighty glad you were there..

Thanks for ALL of that, dgz!

[speciald@ocens.]

He arrested twice and was shocked back. He was then taken to the ICU on Tortola (it used to be a closet), evacuated to Puerto Rico, then to Miami where he underwent by-pass surgery, then back home to Canada. Which brings up another point - air evacuation insurance. His insurance paid for private air ambulance transport. Some high end credit cards provide this insurance in their package (such as Mastercard Global Elite) or it can be purchased for about 3-4 hundred dollars a year. Don't leave home without it.

[Jetexas]

There is some misconception here about what a defribrillator does. It attempts to shock an already beating heart back into sinus rythm. It does NOT restart a heart that is not beating.

For the past four years the CPR certifications I've recieved through my office have included use of AEDs. They will not shock someone with no heartbeat.

It is up to the first responder to restart the heart with CPR. However, the heart may end up fluttering or not beating in the correct rhythm once it has restarted. Then and only then is the AED useful.

If I was cruising with someone who has a history of heart problems or needs a pacemaker, I would keep one on board. Otherwise, it's doubtful it would ever be of any use.

[Lodesman]

Originally Posted by Jetexas

Otherwise, it's doubtful it would ever be of any use.

What's the verdict on learning CPR then? We all know it rarely works, so why should any of us bother to get trained at it?

[Healer52]

Originally Posted by Lodesman

What's the verdict on learning CPR then? We all know it rarely works, so why should any of us bother to get trained at it?

It's quick and easy to learn. Why not? Who knows, you might be somewhere that has a decent EMS system.

[Lodesman]

Originally Posted by Healer52

It's quick and easy to learn. Why not? Who knows, you might be somewhere that has a decent EMS system.

Same argument could be made for having the AED.

[Healer52]

Originally Posted by Lodesman

Same argument could be made for having the AED.

An AED costs around a grand, requires updates and maintenance, and is vulnerable to failure. CPR costs nothing, the last full class I took was two hours long. I doubt that the 5-year updates in protocol really make a lot of difference (and most cruisers won't stay current in CPR certification if they;re away from home), and has the same success rate (without an EMS system) as an AED.

Most people can find better uses for that grand. If you have the room, the cash, and the understanding that it's not a magic device, go for it.

[dgz3]

Jetexas, Sorry to cut across your bow, but this is too serious a subject to let it pass. You are dead wrong about how the AED works. It analylizes the heart's electrical output, the electrocardiogram, looking for the electrical signature of ventricular fibrillation, or vfib. It will not shock ANY rhythm other than vfib. If applied to someone with a heart beat, it will say, "shock not advised." For anyone interested there is an excellent explanation of all this at

GEMS - Automatic External Defibrillation

CPR is performed to perfuse the brain and heart muscle until someone arrives with an AED or EMS arrives with a monitor/defibrillator. And on rare occasions with a very "fresh" heart, as occurs in a "witnessed arrest," the act of mechanically compressing the heart with CPR can generate enough of an electrical impulse in the heart to restart it all by itself. It's rare, but it can and does happen.

So CPR is always worth a try. Should you learn it? Why not? Drowning victims are often resuscitated with just CPR. Should you ever experience the horror of finding one of your grandchildren on the bottom of the pool, you'll wish you knew it. CPR training also includes the Heimlich manuever. Another useful thing to know.

Of note is the fact that a significant percentage of men in their 40's and 50's die suddenly during their first heart attack with no prior history, symptoms, or warning at all. Their last words are often, "Honey, I don't feel good. Somethings wrong." Then they keel over. These are exactly the people that rapid application of an AED might very likely save.

[Healer52]

Originally Posted by dgz3

Jetexas, Sorry to cut across your bow, but this is too serious a subject to let it pass. You are dead wrong about how the AED works. It analylizes the heart's electrical output, the electrocardiogram, looking for the electrical signature of ventricular fibrillation, or vfib. It will not shock ANY rhythm other than vfib. If applied to someone with a heart beat, it will say, "shock not advised." For anyone interested there is an excellent explanation of all this at

GEMS - Automatic External Defibrillation

CPR is performed to perfuse the brain and heart muscle until someone arrives with an AED or EMS arrives with a monitor/defibrillator. And on rare occasions with a very "fresh" heart, as occurs in a "witnessed arrest," the act of mechanically compressing the heart with CPR can generate enough of an electrical impulse in the heart to restart it all by itself. It's rare, but it can and does happen.

So CPR is always worth a try. Should you learn it? Why not? Drowning victims are often resuscitated with just CPR. Should you ever experience the horror of finding one of your grandchildren on the bottom of the pool, you'll wish you knew it. CPR training also includes the Heimlich manuever. Another useful thing to know.

Of note is the fact that a significant percentage of men in their 40's and 50's die suddenly during their first heart attack with no prior history, symptoms, or warning at all. Their last words are often, "Honey, I don't feel good. Somethings wrong." Then they keel over. These are exactly the people that rapid application of an AED might very likely save.

All true, except that an AED will (at least should) shock V-tach as well. And in 80% of the cases, even with the full gamut of ACLS, the results of that first MI is death.