Cruisers Forum
 


Join CruisersForum Today

Reply
 
Thread Tools Rate Thread Display Modes
Old 13-09-2012, 16:47   #76
Senior Cruiser

Cruisers Forum Supporter

Join Date: Jul 2005
Boat: Outbound 44
Posts: 4,580
Re: Automated External Defibrillator ?

Quote:
Originally Posted by hellosailor View Post
...

But the numbers are basically 10/10. That is, ten percent of heart attack victims will die for every minute in the first ten minutes after an attack. If you can get an AED to someone within 3 minutes they've got a 70% chance of recovery. 5 minutes, they've now got a 50% chance of recovery. Eight miuntes? They're already down to 20% and after ten minutes, their odds range from slim to none.......
Don't those stats that you state also assume that you have direct hospital grade medical care directly afterword? That's seems like the rub in having an AED on a cruising boat.
__________________

__________________
Paul L
http://svjeorgia.blogspot.com
Paul L is offline   Reply With Quote
Old 13-09-2012, 16:53   #77
Senior Cruiser

Cruisers Forum Supporter

Join Date: Jul 2005
Boat: Outbound 44
Posts: 4,580
Re: Automated External Defibrillator ?

Quote:
Originally Posted by stinkboat View Post
....

Assuming that an AED necessarily implies sacrificing other useful measures only complicates the discussion needlessly. If buying an AED requires certain sacrifices, then factor those in as "costs".......
You began this re-awoken thread with the calculations based on cost and risk. So, yes it makes sense to look at all of the much more cost effective things that should be done before an AED - many that are not done on most cruising boats because they just haven't reached the top of the list yet. Adding expensive items that have very low chance of being effective in the cruising environment doesn't make sense for most cruising boats. If it makes sense for your environment then buy one. You don't need any validation from here.
__________________

__________________
Paul L
http://svjeorgia.blogspot.com
Paul L is offline   Reply With Quote
Old 13-09-2012, 19:37   #78
Registered User

Join Date: Sep 2010
Location: Halifax
Posts: 435
Re: Automated External Defibrillator ?

Quote:
Originally Posted by hellosailor View Post

But the numbers are basically 10/10. That is, tenpercent of heart attack victims will die for every minute in the first ten minutes after an attack. If you can get an AED to someone within 3 minutes they've got a 70% chance of recovery. 5 minutes, they've now got a 50% chance of recovery. Eight miuntes? They're already down to 20% and after ten minutes, their odds range from slim to none.

So says the guys who gave me training with one. Which, reassuringly, was the special "demo" unit which (ahem) refused to operate when they tried to get it going. So you might want to invest in two of them, if you really want one to work.
Just to clarify and be a grammar Nazi this should read Cardiac Arrest as opposed to heart attack (myocardial infarction), the former sometimes following the latter.

I would think that would be an interesting training course you took.
__________________
Brob2 is offline   Reply With Quote
Old 13-09-2012, 20:47   #79
cruiser

Join Date: Aug 2011
Location: Tampa Bay area
Boat: Hunter 31'
Posts: 5,731
Re: Automated External Defibrillator ?

Quote:
Originally Posted by Pblais View Post
You just won't get clinical trials to determine how well you survive without quick followup medical attention. No doctor in their right mind will suggest an AED to the heart and you are good to go. There usually is a reason you needed it and an AED won't ever cure that.

Bang for the buck a general Red Cross Basic First Aid course will cover CPR using and AED and other stuff that you could die from. The idea that you pick and choose what to study is pretty foolish when the basic stuff will in most cases get you to a port in the best shape possible. If you have done the Basic then the Red Cross offers a great deal more all the way through EMT training. It's as good as you get without being a physician. Even that isn't going to cure patients. It's just to get them stable until better medical assistance can be obtained. It's the best you can ever hope for.

I don't get the either/or thinking. You're fifty miles from the mainland. Someone has a heart attack. The AED works and gets him going. You call for help; he's airlifted off, and MAYBE ... he gets to see his grandchildren. If not, at least you tried.

If you can afford an AED, get one and pray you never need it, but I would suggest that burial at sea might not be the best idea. Someone did actually die a couple of years ago on the way to Isla Mujeres in a race. He was the captain, and the crew decided that he would not have wanted them to stop racing. They didn't bury him at sea ...
__________________
Rakuflames is offline   Reply With Quote
Old 13-09-2012, 21:11   #80
Senior Cruiser
 
bstreep's Avatar

Cruisers Forum Supporter

Join Date: Oct 2007
Location: San Antonio, TX/Port Aransas, TX
Boat: 1990 Macintosh 47, "Merlin"
Posts: 2,274
Re: Automated External Defibrillator ?

Not going to read ALL of this, but I asked my sister two weekends ago for her opinion:

1) She's considered one of the top EMT/Para instructors in the country - people travel from all over just for her classes. In other words, she knows what she's talking about.

2) She's been a paramedic for many, many years (she's in her 60s), and an instructor for over 20 years.

3) AED's are between $500-700.

4) She says putting one on a cruising boat is a waste of money - without followup care - usually within 1 hour - it's pretty much worthless.
__________________
Bill Streep
San Antonio/Port Aransas, TX
bstreep is offline   Reply With Quote
Old 13-09-2012, 22:48   #81
JRM
Registered User

Join Date: Aug 2009
Location: Santa Barbara
Boat: Valiant 40
Posts: 416
Images: 2
Re: Automated External Defibrillator ?

Quote:
Originally Posted by Rakuflames View Post
I don't get the either/or thinking. You're fifty miles from the mainland. Someone has a heart attack. The AED works and gets him going. You call for help; he's airlifted off, and MAYBE ... he gets to see his grandchildren. If not, at least you tried.

If you can afford an AED, get one and pray you never need it, but I would suggest that burial at sea might not be the best idea. Someone did actually die a couple of years ago on the way to Isla Mujeres in a race. He was the captain, and the crew decided that he would not have wanted them to stop racing. They didn't bury him at sea ...
Heh, I'm too lazy to read the rest of the thread, besides, I participated in it earlier. This is oddly coincidental, as I just had to sit through the in-service training on our new AED units this afternoon. And, since we run more Cardiac Arrest calls than the entire rest of the county, we're up again on another CPR trial, this time a completely different paradigm.

The idea of an AED on a cruising boat is so mindboggling odd, I don't even know where to start. OK, that's not entirely true. There is an entire class of individual who would benefit immensely from having one, but odds are if they're still breathing they already have one implanted. If they don't already have one, you'll run out of batteries in yours before you get them ALS care anyway.

I wrote about three pages of reply that I just deleted, because it was really bad. It's pointless, this really. If you're willing to trust the people in the know, you won't bother with the AED. If you watch a lot of TV like the person I've quoted above, then buy one for your own peace of mind. Otherwise, just apply a modicum of common sense and put that money to better use elsewhere.

JRM
__________________
JRM is offline   Reply With Quote
Old 14-09-2012, 02:10   #82
Registered User
 
resilientg's Avatar

Join Date: Jul 2012
Location: Townsville, Qld, Australia
Boat: William Bollard, Gypsy Wave, 28'
Posts: 144
Re: Automated External Defibrillator ?

Your all mad, why use an expensive AED, we all have generators and big dc battery banks on board, jumper cable to the nuts or nipple region and one to the neck or ear and ZZAAAPPPO, seems to me that you end up with the same percentage chance of saving someone and you didnt spend any extra to get it, as a side benifit it would be a cracker to watch and you could tone it done to a lower voltage at those drunken partys.

Matthew
__________________
Do but once what others say you cant, and you will never be judged by their limitations again.
resilientg is offline   Reply With Quote
Old 22-09-2012, 16:34   #83
Registered User
 
foxfire's Avatar

Join Date: Apr 2011
Location: Toronto
Boat: Chartercats SA, Jaguar 36
Posts: 28
Quote:
Originally Posted by resilientg
Your all mad, why use an expensive AED, we all have generators and big dc battery banks on board, jumper cable to the nuts or nipple region and one to the neck or ear and ZZAAAPPPO, seems to me that you end up with the same percentage chance of saving someone and you didnt spend any extra to get it, as a side benifit it would be a cracker to watch and you could tone it done to a lower voltage at those drunken partys.

Matthew
What entertainment! But seriously folks, spend the money on something with a higher probability of return. I purchased one for a passenger vessel 5 years ago, and in over 25 years of carrying passengers aboard it, roughly more than a half million passengers carried in that time, two persons dropped unconscious for non alcohol related reasons. Oddly both occurred at the dock while they were in the que. one died, it was a stroke, the other lived . Crew administered CPR, with questionable benefit. In both cases ems were on scene within minutes . In the last 5 years no need for the defib, now time to change the pads and batteries again That's 100 000 passengers cruising for 4 hours per cruise. With ems immediately available. Where I choose to sail, no ems, no airlifts, no chance for a fibrillating sailor. I will replace the battery for the passenger boat though.
__________________
foxfire is offline   Reply With Quote
Old 25-10-2012, 16:23   #84
Registered User

Join Date: Mar 2008
Location: Boat is in Maine, anchor is in Colorado
Boat: Cape Dory 33 Sloop
Posts: 13
Images: 2
Re: Automated External Defibrillator ?

My standard answer to cruising sailors who ask about purchasing an AED goes something like this: "If you already have the best life raft, survival suits, collision bulkheads, running lights, MOB recovery, radios, EPIRB, fire suppression, floatation devices, CO detector, first aid kit, drug kit, medical training, and survival training that money can buy and you STILL have money left over, buy an AED. Please write to me if it saves a life on a small boat offshore because it will be the first ever recorded."

Almost any other piece of safety equipment has a better chance of saving a life aboard your boat. Automatic External Defibrillators do have a place in near shore rescue and perhaps aboard cruise ships and ferries that can provide early access to advanced life support and a hospital. But offshore, an AED should not occupy space or consume funds that could be used to much better effect elsewhere.
__________________
Jeff

www.medofficer.net
Woodstock is offline   Reply With Quote
Old 25-10-2012, 16:45   #85
cat herder, extreme blacksheep
 
zeehag's Avatar

Cruisers Forum Supporter

Join Date: Jul 2008
Location: furycame alley , tropics, mexico for now
Boat: 1976 FORMOSA yankee clipper 41
Posts: 17,770
Images: 56
Send a message via Yahoo to zeehag Send a message via Skype™ to zeehag
Re: Automated External Defibrillator ?

would make a great taser, tho.....
zeehag is online now   Reply With Quote
Old 25-10-2012, 16:56   #86
cruiser

Join Date: Aug 2011
Location: Tampa Bay area
Boat: Hunter 31'
Posts: 5,731
Re: Automated External Defibrillator ?

Quote:
Originally Posted by Paul L View Post
You began this re-awoken thread with the calculations based on cost and risk. So, yes it makes sense to look at all of the much more cost effective things that should be done before an AED - many that are not done on most cruising boats because they just haven't reached the top of the list yet. Adding expensive items that have very low chance of being effective in the cruising environment doesn't make sense for most cruising boats. If it makes sense for your environment then buy one. You don't need any validation from here.

I wish we had one in our clubhouse as we have a lot of older members, but a few powerful people are adamantly opposed, convinced that it will *increase* our liability. Personally I think that's a terrible mistake. We're surrounded by excellent hospitals. It really *could* save a life at the clubhouse and the price of them has really come down.
__________________
Rakuflames is offline   Reply With Quote
Old 25-10-2012, 17:03   #87
cat herder, extreme blacksheep
 
zeehag's Avatar

Cruisers Forum Supporter

Join Date: Jul 2008
Location: furycame alley , tropics, mexico for now
Boat: 1976 FORMOSA yankee clipper 41
Posts: 17,770
Images: 56
Send a message via Yahoo to zeehag Send a message via Skype™ to zeehag
Re: Automated External Defibrillator ?

having an aed on siteDOES increase liability, a syou have to add insurance for the individual administering the aed treatment, not to mention, PAY for the individual who is going to use it,what, one time every 5 years??
would do better to use the thing as a taser.

(lemme see what you find to argue with me on this, raku--do i need to present my credentials as an emergency and post anes and intensive care registered nurse certified specially in arhythmias as well as other subspecialties in intensive care medicine??)
zeehag is online now   Reply With Quote
Old 25-10-2012, 17:04   #88
Senior Cruiser

Cruisers Forum Supporter

Join Date: Jul 2005
Boat: Outbound 44
Posts: 4,580
Re: Automated External Defibrillator ?

Quote:
Originally Posted by Woodstock View Post
My standard answer to cruising sailors who ask about purchasing an AED goes something like this: "If you already have the best life raft, survival suits, collision bulkheads, running lights, MOB recovery, radios, EPIRB, fire suppression, floatation devices, CO detector, first aid kit, drug kit, medical training, and survival training that money can buy and you STILL have money left over, buy an AED. Please write to me if it saves a life on a small boat offshore because it will be the first ever recorded."

Almost any other piece of safety equipment has a better chance of saving a life aboard your boat. Automatic External Defibrillators do have a place in near shore rescue and perhaps aboard cruise ships and ferries that can provide early access to advanced life support and a hospital. But offshore, an AED should not occupy space or consume funds that could be used to much better effect elsewhere.
Jeff
From your web site it is clear you have some experience in tbe subject. As I stated above I agree with your thoughts on the AED for cruisers. You didn't really state why you take this position. I suspect you have some good stats that support it. Care to share some?
__________________
Paul L
http://svjeorgia.blogspot.com
Paul L is offline   Reply With Quote
Old 29-10-2012, 14:44   #89
Registered User

Join Date: Mar 2008
Location: Boat is in Maine, anchor is in Colorado
Boat: Cape Dory 33 Sloop
Posts: 13
Images: 2
Re: Automated External Defibrillator ?

Quote:
Originally Posted by Paul L View Post
Jeff
From your web site it is clear you have some experience in tbe subject. As I stated above I agree with your thoughts on the AED for cruisers. You didn't really state why you take this position. I suspect you have some good stats that support it. Care to share some?
Paul - With the use of AED's in remote settings, it more a case of lack of validating data. There are no case reports or clinical trials that support AED deployment. The industry is inappropriately extrapolating urban success to the back country and marine environment. As a result we have seen many units deployed in remote places, including cruising boats and sail training ships, but have yet to see a real save. The only shipboard one that I know of was a guy who was electrocuted while using a power tool aboard a boat alongside a dock in Italy. He was successfully defibrillated by an ambulance crew.

A salesman from one of the marine suppliers once challenged my lack of enthusiasm by asking "...even if there is only a one in a hundred thousand chance, isn't it worth it?" This helped me formulate my standard answer; if you already have everything else and still have money left over, etc. For me it will be when defibrillation becomes a $5 smartphone app. Who knows? Maybe it will. I never thought my iphone would become a chart plotter.

The stats are fun to follow. It all depends on where you draw the line of success. If it is drawn at the restoration of a pulse in any case of cardiac arrest, the AED looks OK. If it is drawn at the restoration of a pulse in patients experience ventricular fibrillation on whom the device was applied within 5 minutes, the AED looks downright miraculous. These are the stats the salesmen like to quote.

If you consider success to be a living patient walking out of the hospital, the results are not so great but still better than nothing in areas with rapid access to hospital care. Without the hospital, we're still at zero.

I am sure that somebody somewhere someday aboard a small boat at sea will be defibrillated and live to tell about it. It still will not change the math. It will still be fewer than seaman who claim to have been saved by dolphins. Your safety and survival budget will be much better spent elsewhere.
__________________
Jeff

www.medofficer.net
Woodstock is offline   Reply With Quote
Old 29-10-2012, 14:56   #90
Senior Cruiser

Cruisers Forum Supporter

Join Date: Jul 2005
Boat: Outbound 44
Posts: 4,580
Re: Automated External Defibrillator ?

Quote:
Originally Posted by Woodstock View Post
.......

I am sure that somebody somewhere someday aboard a small boat at sea will be defibrillated and live to tell about it. It still will not change the math. It will still be fewer than seaman who claim to have been saved by dolphins. Your safety and survival budget will be much better spent elsewhere.
Jeff
You're gonna piss off the dolphin lobby if you don't watch out.

Well put.
__________________

__________________
Paul L
http://svjeorgia.blogspot.com
Paul L is offline   Reply With Quote
Reply

Thread Tools
Display Modes Rate This Thread
Rate This Thread:

Posting Rules
You may not post new threads
You may not post replies
You may not post attachments
You may not edit your posts

BB code is On
Smilies are On
[IMG] code is On
HTML code is Off
Trackbacks are Off
Pingbacks are Off
Refbacks are Off


Similar Threads
Thread Thread Starter Forum Replies Last Post
Halyards - External to Internal skipmac Deck hardware: Rigging, Sails & Hoisting 9 18-05-2010 07:30
External Regulator davevancat Electrical: Batteries, Generators & Solar 1 16-09-2009 09:41
What external fan to use to cool Alternator Ram Electrical: Batteries, Generators & Solar 16 28-10-2008 09:51
Automated Main Sail Limpet Deck hardware: Rigging, Sails & Hoisting 22 08-05-2007 09:51
External Ground Plate Kai Nui Electrical: Batteries, Generators & Solar 2 09-10-2005 03:14



Copyright 2002- Social Knowledge, LLC All Rights Reserved.

All times are GMT -7. The time now is 10:49.


Google+
Powered by vBulletin® Version 3.8.8 Beta 1
Copyright ©2000 - 2017, vBulletin Solutions, Inc.
Social Knowledge Networks
Powered by vBulletin® Version 3.8.8 Beta 1
Copyright ©2000 - 2017, vBulletin Solutions, Inc.

ShowCase vBulletin Plugins by Drive Thru Online, Inc.