Originally Posted by Kenomac
You first need to fully understand the various reasons why a heart stoppage takes place before posting
an opinion so broad opposing the use of an AED. The opinion of the other poster claiming 100 percent success is way off, but so is 10%.
I have justed edited this reply, embarrassing amount of typos, in my initial post. I had surgery a couple of days ago on my forehead near one of my eyes and can't presently see very well, all puffed up. I apologize for my poor writing. Likely some errors still.
I have had AEDs utilized on me several times. Been there done that, thankfully. The first time as an emergency
immediately after entering cardiac arrest when I was an inpatient under the intense care of the cardiac care unit of a regional hospital having been in an atrial fibrillation for several days at the CCU, where they were trying to convert me back to normal pattern with the use of cardiac drug treatments; and the other times in a controlled basis at the hospital so as to convert my heart when I was in atrial fibrillation when the initial treatment by cardiac drugs was not resolving the situation promptly.
I can attest that the devices work well and are they are simple and quick to use. And they are now not very expensive.
I have not had the opportunity to utilize one on others, but would be readily willing to use it on myself if needed, if I was alone, or if the rest of the crew was reticent to "push the button" on me.
If any person on the boat is prone to arrhythmia or has an experience of heart disease, or is otherwise has an at risk profile, I would advocate that an AED be standard equipment
on board. If everyone on board is young and known to be cardiac healthy then it is a device which likely has little chance of being used and would seem to be an "optional" equipment
As always, evaluate those that will be on-board and equip appropriately for all personal issues they may have, allergic reactions, diabetes, depression, asthma, COPD, malaria, etc. Albeit my first incidence of atrial fibrillation, leading to ventricular tachycardia before arresting occurred when I was in my early twenties while still in undergraduate school
, but I had congenital heart disease and had two prior heart surgeries, at age five and again at sixteen, to repair a coarctation of the aorta so the development of an arrhythmia was not unexpected, let's say I was just such an at risk person.
Older cruisers are clearly at more risk, age is correlated to heart issues.
If someone is found to be in cardiac arrest, i.e., asystole, complete heart stoppage, the likelihood of successful AED response without concurrent CPR and cardiac stimulant drugs is considerably less than a person that is experiencing an arrhythmia which is treatable by AED.
A person in arrest, especially if located outside a hospital, is highly likely to die. Actually, technically an arrest is one of the typical defined states of death, so by restarting the heart one is actually bringing someone back from death, well at least as from one of the defined states of death. There being dead, and then being dead, dead.
It is best to use an AED, before the heart is arrested, while they are in arryhythmia, but if someone is arrested, and unless the person is known to have dictated "Do Not Resuscitate"[DNR], I for one would by all means give them a jump start, ASAP and also utilize cardiac pulmonary resuscitation, CPR. They will not typically complain to you later, if they are lucky enough to be revived. If they do complain later, I recommend return their gratitude, or lack there of and tie an anchor
to them and toss them overboard
, burial at sea.
FYI. I can't attest to the accuracy of the wiki information pasted below.
Automated external defibrillator
From Wikipedia, the free encyclopedia
An automated external defibrillator ready for use. Pads are pre-connected. This model is a semi-automatic due to the presence of a shock button.
An automated external defibrillator (AED) is a portable electronic device that automatically diagnoses the life-threatening cardiac arrhythmias of ventricular fibrillation and ventricular tachycardia in a patient, and is able to treat them through defibrillation, the application of electrical
therapy which stops the arrhythmia, allowing the heart to reestablish an effective rhythm.
With simple audio and visual commands, AEDs are designed to be simple to use for the layperson, and the use of AEDs is taught in many first aid, certified first responder, and basic life support (BLS) level cardiopulmonary resuscitation (CPR) classes
Conditions that the device treats
An automated external defibrillator is used in cases of life-threatening cardiac arrhythmias which lead to cardiac arrest. The rhythms that the device will treat are usually limited to:
Pulseless Ventricular tachycardia (shortened to VT or V-Tach)
Ventricular fibrillation (shortened to VF or V-Fib)
In each of these two types of shockable cardiac arrhythmia, the heart is electrically active, but in a dysfunctional pattern that does not allow it to pump and circulate blood. In ventricular tachycardia, the heart beats too fast to effectively pump blood. Ultimately, ventricular tachycardia leads to ventricular fibrillation. In ventricular fibrillation, the electrical
activity of the heart becomes chaotic, preventing the ventricle from effectively pumping blood. The fibrillation in the heart decreases over time, and will eventually reach asystole.
AEDs, like all defibrillators, are not designed to shock asystole ('flat line' patterns) as this will not have a positive clinical outcome. The asystolic patient only has a chance of survival if, through a combination of CPR and cardiac stimulant drugs, one of the shockable rhythms can be established, which makes it imperative for CPR to be carried out prior to the arrival of a defibrillator.
A personal note: It is rather interesting to awaken to having persons performing CPR on you. As I recall
, after having been converted to normal heart action, I was attempting to speak to them with a single
word between each of there pulses while being "bagged" to inflate my lungs and squished on my chest to pump my heart that, "I . . . am . . . O . . . kay . . . please . . . get . . . off . . . of . . . me." all along the medical team was paying no attention to me and likely not even hearing me speak as the doctor was relaying orders and the nurses and hospitalists were busy preparing and pushing drugs. I had to punch the nurse that was compressing my chest to get the team to quit and to take notice that I was fine.
Prior to being revived from arrest, I had become feeling ill while lying in my bed
in the CCU and vomited into the little tray they had at my disposal at bed
side and I pushed the call button to have the nurse come so as to dispose of the vomit filled tray. When she arrived at the door she asked me, "What's the matter, Dan?" Just then I felt my heart stop, so I answered her calmly with a clear voice that, "My heart has stopped." Her eyes grew wide open, we both looked toward the heart monitor
and sure enough it changed to a flat line and the alarm
sounded. With one hand she pushed the Code Blue button just inside the doorway, and with her other hand she grabbed the crash cart that was located just outside my CCU room, prepositioned so as to be readily available just in case I was in need of such equipment and stimulant drugs.
After the medical team stopped the CPR, and the nurse was able to pick herself up from the floor having fallen from receiving my upper cut blow to her chin, she was able to tell the medical team about my having called for her assistance and my self-diagnosis that "My heart has stopped". The doctor said that he wished he had been there to hear that, and said to the medical team, "As I have told you before, don't be afraid to ask the patient what they perceive the medical issue is as they often can provide you with guidance as to what needs to be treated." Later he said that my self-diagnosis was likely the best that there ever was or could be. I agreed with him stating "Well it was the best that I could give at the moment."
In later incidents of arrhythmias, I have taken to instructing the doctors at the ER, which drugs to provide me, which not to give me, in what amounts and in what rate and in what sequence which is not something that an emergency room cardiologist is used to receiving from a patient. They follow orders very well, but do discuss and debate the options with me, but I make the ultimate decision taking into account their perspective and recommendations, it being my body, not theirs.
By the way, when your heart stops, or at least as to my heart stopping, I felt no pain and remained cognizant for about 8 to 10 seconds before lapsing. My vision just went gray, just before I passed out and was not aware of anything until awakening with the CPR occurring. Did not feel the shock treatment, but did have an itchy chest for a few days after, kind of like having a rash on the inside of the muscles. The use of proscribed Novicane numbing jell eased the itching considerably. I suspect the blast of current
fried the nerves in my chest muscles a bit and caused the itchy symptoms.
Effect of delayed treatment
Uncorrected, these cardiac conditions (ventricular tachycardia, ventricular fibrillation, asystole) rapidly lead to irreversible brain damage and death, once cardiac arrest takes place. After approximately three to five minutes in cardiac arrest, irreversible brain/tissue damage may begin to occur. For every minute that a person in cardiac arrest goes without being successfully treated (by defibrillation), the chance of survival decreases by 7 percent per minute in the first 3 minutes, and decreases by 10 percent per minute as time advances beyond ~3 minutes.
Requirements for use
AEDs are designed to be used by laypersons who ideally should have received AED training. However, sixth-grade students have been reported to begin defibrillation within 90 seconds, as opposed to a trained operator beginning within 67 seconds. This is in contrast to more sophisticated manual and semi-automatic defibrillators used by health professionals, which can act as a pacemaker if the heart rate is too slow (bradycardia) and perform other functions which require a skilled operator able to read electrocardiograms.
Bras with a metal underwire and piercings on the torso must be removed before using the AED on someone to avoid interference
. American TV show Mythbusters found evidence that use of a defibrillator on a woman wearing an underwire bra can lead to arcing or fire but only in unusual and unlikely circumstances.
A study analyzed the effects of having AEDs immediately present during Chicago's Heart Start program over a two-year period. Of 22 individuals 18 were in a cardiac arrhythmia which AEDs can treat (Vfib or Vtach). Of these 18, 11 survived. Of these 11 patients, 6 were treated by bystanders with absolutely no previous training in AED use.