Medical Emergencies at Remote Cruising Destinations

[DumnMad]

I agree with Zeehag; Heart assoc and FDA are corrupted by the big legalised drug pushers and mass producers of high glycemic refined food.
The infamous FDA food pyramid is a classic example of grain industry influence.

When they start standardising drug success rates by measuring against alternatives such as scientifically proven successful excercise and diet regimes they may earn a little more credibility. But hey, wheres the profit and sponsership in that?

[GoingWalkabout]

Thank you. An amazing account of your heart stopping. And thanks for educating everyone about the benefit of an AED. I am mystified why anyone would try and talk any other person out of having a life saving device. It is so bizarre. Again thanks

[GoingWalkabout]

Originally Posted by zeehag

the american heart association lost its credibility with me, a cardiac care rn, when they allowed pfizer to build their brand new headquarters building just to be able to bribe the heart assoc into use as a first line drug, a poison named amiodarone, as a front line drug in acls. we had tested that , as did 3 other arrythmia centers in usa in 1986. we came to conclusion, as 10 out of 10 patients on that drug who went to surgery DIED because they could not be removed from ventilator. we studied this and found amiodarone, with its over 2 week half life was causing interstitial pulmonary fibrosis in all of the patients we sentenced to using it. very not a decent drug to use as a first line anti arrhythmic. to make this poison we deemed unusable for any but last ditch efforts to save a soul not able to survive without it. poison, no surgery after administering even a few doses.
and so WHAT do you think heart ass has to say about WHAT!!??? allowing a poison with 2 week plus as a half life, and because of BRIBE!!!--not appropriate for first line defense against v tach, sorry.
they lost me as an advocate with that murderous move'

Zeehag, I'm with you more than you you know. The industrial drug complex is dangerous. I know from my own experience. Five years ago I had surgery and got a bad dose of bacterial pneumonia. Suspected not cleaning the filter in the operating theatre between surgeries. Anyway 3 weeks in intensive care. O2 a lot around 80. Weeks later I could barely walk or breath but I got out of that hospital. Made back to my home and spent the next years battling pulmonary fibrosis, massive pulmonary ademas, and pneumonia caused interstitial autoimmune disease (similar to lupus) Five years on corticosteroids nearly destroyed my body. Damaged tendons and every time I tried to come off the drug I would have a massive inflammatory response throughout my body. No fun having every muscle in your body causing pain at the slightest movement and every joint swelling and causing crippling and painful arthritis. This is my fifth attempt at coming off corticosteroids. I have no muscle pain to date and only have swelling and pain in my left fingers. Although I'm still recovering from a very painful left shoulder ruptured ligaments. Not caused by trauma but by the side effects of corticosteroids.

I'm taking a lot of natural medicines including ginger and cinnamon capsules. And my body even after what it has gone through is a miraculous self healing organism. Even now my swelling in my left hand is improving. I was seriously concerned that I was going to be crippled. But thank GD my body is fighting back.

So I know first hand how "medicines" can help but also do major harm. I am as a result highly suspect all drug usage. But I also know that at times you have to take the path of accepting a lessor evil so you can stay alive to let's say live and fight another day.

So for me it's not a matter of rejecting medicine but being eyes wide open and very very careful.

Kind regards,
Chaya

[Paul L]

Originally Posted by GoingWalkabout

This is not the advice of the American Heart Association regarding defibrillators.

Can you show a link to where the AHA recommends a defib for remote medicine cases? I'd like to better understand their recommendations, if they made them.

[donradcliffe]

Here is what medical officer.net has to say;

Unfortunately, studies also show that CPR and defibrillation offers no improvement in survival rates outside of the reach of EMS and a hospital. The probability of successful defibrillation after more than 10 minutes of cardiac arrest is very low, but delayed defibrillation is only part of the problem. Reports of survival after defibrillation without early access to hospital care are notably absent from the literature.

Yet, in spite of the absolute lack of scientific or anecdotal evidence to support the idea, the manufacturers and distributors of AED’s continue to push them on offshore sailors, expedition medics, and other people operating well out of reach of sophisticated medical care. Statements like “The more remote the setting, the more critical it is to have an AED” permeate the advertising copy and are appearing in EMS and rescue magazine articles. This is an unsubstianted extrapolation of urban success to the wilderness context.

Better to let them die with dignity.

[jackdale]

Originally Posted by donradcliffe

Here is what medical officer.net has to say;

Unfortunately, studies also show that CPR and defibrillation offers no improvement in survival rates outside of the reach of EMS and a hospital. The probability of successful defibrillation after more than 10 minutes of cardiac arrest is very low, but delayed defibrillation is only part of the problem. Reports of survival after defibrillation without early access to hospital care are notably absent from the literature.

Yet, in spite of the absolute lack of scientific or anecdotal evidence to support the idea, the manufacturers and distributors of AED’s continue to push them on offshore sailors, expedition medics, and other people operating well out of reach of sophisticated medical care. Statements like “The more remote the setting, the more critical it is to have an AED” permeate the advertising copy and are appearing in EMS and rescue magazine articles. This is an unsubstianted extrapolation of urban success to the wilderness context.

Better to let them die with dignity.

In my Adventure Medic courses, I was told the best place to have a cardiac arrest was Seattle as all EMS had advanced life support. Even the chance of survival was about 4%. (Working from memory on the percentage.)

[Kenomac]

Originally Posted by donradcliffe

Here is what medical officer.net has to say;

Unfortunately, studies also show that CPR and defibrillation offers no improvement in survival rates outside of the reach of EMS and a hospital. The probability of successful defibrillation after more than 10 minutes of cardiac arrest is very low, but delayed defibrillation is only part of the problem. Reports of survival after defibrillation without early access to hospital care are notably absent from the literature.

Yet, in spite of the absolute lack of scientific or anecdotal evidence to support the idea, the manufacturers and distributors of AED’s continue to push them on offshore sailors, expedition medics, and other people operating well out of reach of sophisticated medical care. Statements like “The more remote the setting, the more critical it is to have an AED” permeate the advertising copy and are appearing in EMS and rescue magazine articles. This is an unsubstianted extrapolation of urban success to the wilderness context.

Better to let them die with dignity.

I don't agree. There are some cases where a heart simply needs to be shocked back into a rhythm. Think in terms of a pacemaker with a built in defibrillator. We have an AED onboard for this sort of circumstance. I agree that a complete heart stoppage caused by a blockage cannot be revived using an AED. But how does one know ahead of time which type of heart attack someone plans to have onboard your boat?

Sounds like you plan to allow someone who can easily be saved "to die with dignity" onboard your vessel instead of trying to do much of anything. Bravo.

I happen to know of several people who've been saved using an AED. One is a fellow registered nurse who essentially died at age 32 but was brought back to life five minutes later by emergency services using their brand new AED. She's still a nurse and doing just fine now at age 49.

How would she have done on your boat? Burial at sea ... I suppose?

[Muckle Flugga]

Originally Posted by Kenomac

I don't agree. There are some cases where a heart simply needs to be shocked back into a rhythm. Think in terms of a pacemaker with a built in defibrillator. We have an AED onboard for this sort of circumstance. I agree that a complete heart stoppage caused by a blockage cannot be revived using an AED. But how does one know ahead of time which type of heart attack someone plans to have onboard your boat?

Sounds like you plan to allow someone who can easily be saved "to die with dignity" onboard your vessel instead of trying to do much of anything. Bravo.

I happen to know of several people who've been saved using an AED. One is a fellow registered nurse who essentially died at age 32 but was brought back to life five minutes later by emergency services using their brand new AED. She's still a nurse and doing just fine now at age 49.

How would she have done on your boat? Burial at sea ... I suppose?

Did any of these cases happen in remote areas with no subsequent acute support? I am agnostic about the carrying and use of AEDs for remote medical assistance, and if you have money and space for one, then I suppose why not? However recent MCA Ship Captain's Medical First Aid and Medical Care Aboard Ship do not recommend the carrying of AEDs in circumstances wherein immediate evacuation to an acute care facility is not likely, as it is stated that the chances of survival of an event requiring such a device without subsequent support are essentially nil (again just going by what I was taught by ambulance service/MCA training, which is not infallible). Of course a lot of the time one may be within such reach (especially as you sail in the Med) so this is rather a different situation.

I would certainly suggest that having an AED aboard but not carrying oxygen, nitrolingual, morphine and aspirin is putting the cart before the horse. Not suggesting this is your own case, though.

[Kenomac]

Originally Posted by Muckle Flugga

Did any of these cases happen in remote areas with no subsequent acute support? I am agnostic about the carrying and use of AEDs for remote medical assistance, and if you have money and space for one, then I suppose why not? However recent MCA Ship Captain's Medical First Aid and Medical Care Aboard Ship do not recommend the carrying of AEDs in circumstances wherein immediate evacuation to an acute care facility is not likely, as it is stated that the chances of survival of an event requiring such a device without subsequent support are essentially nil (again just going by what I was taught by ambulance service/MCA training, which is not infallible). Of course a lot of the time one may be within such reach (especially as you sail in the Med) so this is rather a different situation.

I would certainly suggest that having an AED aboard but not carrying oxygen, nitrolingual, morphine and aspirin is putting the cart before the horse. Not suggesting this is your own case, though.

Mike,

My response was to the rather broad statement made by the other post, basically giving the impression that an AED is useless and to allow victims to "die with dignity." Yes we sail in the Med and have the device onboard to give a potential victim the extra hour or so for medical personnel to get to our boat. We live at anchorages in the Med., usually within an hour of emergency services.

[Muckle Flugga]

Originally Posted by Kenomac

Mike,

My response was to the rather broad statement made by the other post, basically giving the impression that an AED is useless and to allow victims to "die with dignity." Yes we sail in the Med and have the device onboard to give a potential victim the extra hour or so for medical personnel to get to our boat. We live at anchorages in the Med., usually within an hour of emergency services.

Well in that kind of case I do think it is worthwhile.

Oh, and it's Steve

[mcarling]

Originally Posted by Muckle Flugga

Also my Ship Captain's Medical and Medical Care Aboard Ship training (UK MCA) would have me agreeing with you about defibrillation in remote areas. The advice is to carry nitroglycerine (nitrolingual), morphine, aspirin and antiemetics for acute cardiac care, but defibrillators are considered essentially pointless if no chance of arrival at a well equipped hospital.

That's contrary to what I was taught at my last Ship Captain's Medical and Medical Care Aboard Ship training (UK MCA) in 2013. We were advised to use the defibrillator even if days away from a hospital.

[JPA Cate]

Originally Posted by mcarling

That's contrary to what I was taught at my last Ship Captain's Medical and Medical Care Aboard Ship training (UK MCA) in 2013. We were advised to use the defibrillator even if days away from a hospital.

Yes, but was that for demonstrating that you did all that was possible for the courts? or was it for the infinitesimal chance it might save someone's life?

[Muckle Flugga]

Originally Posted by mcarling

That's contrary to what I was taught at my last Ship Captain's Medical and Medical Care Aboard Ship training (UK MCA) in 2013. We were advised to use the defibrillator even if days away from a hospital.

To be fair I am due for my update this year (5 years) so this advice may have changed.

[mcarling]

Originally Posted by Ann T. Cate

Yes, but was that for demonstrating that you did all that was possible for the courts? or was it for the infinitesimal chance it might save someone's life?

I don't recall any mention of legal liability as a reason, but my memory is not what it used to be. Certainly there are some causes of heart stoppage that will result in death without timely hospitalization that a defibrillator will not prevent, but there are others for which defibrillation will suffice.

In the 1970s, I saved a choking victim using CPR. That was before defibrillators were used outside hospitals. Hospitalization was not required. A defibrillator might have saved the victim several broken ribs and reduced the extent to which the brain suffered from lack of oxygen.

I don't believe the chance that a defibrillator might save someone's life at sea is necessarily infinitesimal. I would be infinitesimal if the cause is arterial blockage, but not for other some causes.

Another point is that defibrillators have improved a lot in recent years. They now have much better auto-diagnostic capabilities than they had 5-10 years ago.

[Kenomac]

Originally Posted by Muckle Flugga

Well in that kind of case I do think it is worthwhile.

Oh, and it's Steve

Every time I glance at your forum name without my reading glasses I see Michael Fuggle. LOL

Mr. Fuggle, here is your "'55 Sloop" located at present?