Originally Posted by caradow
Well I had deleted this thread after the cowboy comments on having TPA on a cruising boat.
However, probably due to the fact my environment
has become a frozen tundra here on the US east coast
, I dared to reopen the discussion.
I truly feel that Kenomac et al in their persistence have done a tremendous service
to the cruising community who took the time to read these threads. Several have stated they are now getting AEDs so hopefully more lives will be saved. Others will at least appreciate their potential and seek further training.
Many others here have made very valid statements. A lot has been discussed with some humor
along the way and that was good.
So I have a question and maybe Kenomac, Weavis and others would want to comment or even potentially get involved.
My question is, DO YOU THINK A SERVICE
IS NEEDED TO TEACH ADVANCED MEDICAL
CARE TO THE CRUISING COMMUNITY ? I know there are Wilderness Courses that are available but this would be geared to a boat.
Not only teach it but even help design advanced medical
kits that would supply the long range cruiser with knowledge and the tools (within reason) to go beyond normal first aid ? Also supply them with medications only an MD can provide?
The lectures would be set in various venues dependent on the level of interest. I think the cruising community as a whole yearns for more knowledge and after reading some of your statements on this forum it is certainly needed.
I do not want to offend any of you who may disagree with the statements I have personally made but they came from sincerity and a lot of experience.
I am an ex Special Forces Medic and Vietnam
Vet (68-69) who had to deal with many mass causality situations. Gained a tremendous amount of knowledge that eventually led me to go to medical school
and become an ED doctor. I have worked in a large inner city Trauma Center for over 20 years.
Ironically I have never used an AED but have personally shocked a great number of patients with regular defibrillators. I have seen some remarkable recoveries in those years outside the statistics stated in this thread. I have learned that that the only thing in medicine that is a 100% is death itself. By the way I started using TPA when it first came into being many years ago. Also I have taken time off from my regular job and worked in the Caribbean
on numerous occasions and have enjoyed that immensely. So I also have knowledge of what is available in areas without the technology that is available in the US and Europe
. Maybe this teaching is not for me personally to do but if these courses are already available certainly they are being underutilized.
So..... any of you think this would be a worthwhile venture ?
I don't think so. I don't think there is a need, nor is it practical. The reason being that the skills beyond first aid and BLS CPR are perishable. They wane rapidly without regular practice. That's why lots of county EMS agencies won't certify Paramedics unless they are employed with an ALS provider. Even EMT-1 requires CE hours. I took anatomy over ten years ago, and while I remember the basic stuff I use regularly in my day to day, I'd say a good 95% of that material has leaked from my brain. With the proliferation of SSB
and sat-phones, I can consult an M.D. for the pharmacology aspects without having to sit through years of training or remember what the suborbital foramen is.
A Wilderness EMT course is great, not just because of the skills that it teaches, but because of the mindset. The idea that YOU can help fix a problem, and that you can do it with what you have on hand. But the idea that the lay person is going to be doing hospital level work while isolated at sea is a stretch. I'm sure everyone can whip out some ancedotal incident, but it's by far the exception and not the rule
. But setting a fracture with an improvised splint, now that's a skill I'd like people on my boat to have. Maybe even starting an IV. But if I get appendicitis at sea, I'm probably going to die. That's just reality. Luckily the odds are exceptionally low. Low enough that most Doctors recommend against prophylactic appendectomy. The odds of post-surgical complications outweigh the odds of appendicitis.
Now, maybe gearing a Wilderness EMT course to be more marine
oriented, that would be something I'd be interested in just for the perspective. I spent a few years working down in the harbor station and I can tell you that just extricating a non-ambulatory patient from below decks in a sailboat is a real chore, and that's sitting in the slip with a full crew of responders to help.
To the person who can't understand why I feel an AED is a low priority. Here's an analogy:
We once had a sailboat wash up on the beach upside down. In the debris pile was a bunch of baby stuff, and one of the thinkers on scene felt we needed to access the interior
to make sure it was unoccupied. So we took a chainsaw to the hull
, made some holes, and made access.
I can make an argument that should I come upon a capsized boat at sea, a chainsaw is a really good piece of safety gear
to have, so that I can cut a hole in the hull
anyone who might be trapped inside. So in my hypothetical world, I jump on the forum and ask those smarter than I what they think of the shiny new Stihl I bought and put on the boat. I'm dumbfounded to discover that lots of people think I wasted my money. I don't get it? Wouldn't they feel bad if they came upon someone trapped in a capsized boat and they didn't have a chainsaw to save them? Isn't a human life worth the cost of the chainsaw? Would you
recommend that I keep the saw or return it and buy something more practical?
So, the answer to your question is that being familiar with the devices, their practical application, and the odds of successfully using one at sea, I consider them slightly more useful than the hypothetical chainsaw in the above example. It's your money, and if you want to buy one then feel free. I'm not saying that there is zero chance it could be useful. Like I said, I'm now looking into getting one for the house, because I have family
with a cardiac history
, and if I can find one for the same price
as Kenomac I'll buy it (although it may have to wait since the refit
is bankrupting me at the moment).