Medical Equipment AED Onboard

[Albro359]

We have had an AED on board for several years now and actually used it 3 years ago. We also have a resus bag, pulse oximeter, blood pressure machine, manual suction gear, and a comprehensive professional offshore med kit with adrenalin, TPA, morphine and other drugs and equipment.

BTW in response to a previous poster an AED won't start a stopped heart. It is a "defibrillator" and that's what is does...defibrillates.
If the patient has ventricular fibrillation (disorganised and random cardiac electrical status) then application of a defib will deliver an electrical jolt that stops this disorganised rhythm in the hope that the heart will restart in an organised fashion.

This gear doesn't take up much room and I'd rather have it than not.

[Kenomac]

Originally Posted by Albro359

We have had an AED on board for several years now and actually used it 3 years ago. We also have a resus bag, pulse oximeter, blood pressure machine, manual suction gear, and a comprehensive professional offshore med kit with adrenalin, TPA, morphine and other drugs and equipment.

BTW in response to a previous poster an AED won't start a stopped heart. It is a "defibrillator" and that's what is does...defibrillates.
If the patient has ventricular fibrillation (disorganised and random cardiac electrical status) then application of a defib will deliver an electrical jolt that stops this disorganised rhythm in the hope that the heart will restart in an organised fashion.

This gear doesn't take up much room and I'd rather have it than not.

Thank you for explaining. We have a similar medical kit onboard including everything you mentioned except for the morphine, but including a complete suture kit and pharmaceuticals.

[sailorboy1]

I'm confused, what type of event would a AEC help with and what would be the likely cause of that event?

[Kenomac]

Drowning, arrhythmias, hypothermia and electric shock are several good examples. CPR along with an AED if done immediately usually have very good outcomes. If a person has a history of heart problems where the heart muscle has been damaged or the heart attack is the result of cardiac muscle damage or pulmonary embolism, the AED and or CPR won't be of any help.... Nothing will work.

For more information, wiki Automated External Defibrillator and/or cardiac arrest. Basically, if the heart is damaged or not receiving blood due to a blockage, there's really nothing that can be done to save the person. This is the situation in 50-70 percent of heart stoppages. But the remaining 30 percent of cases many of which include accidents and arrhythmia can be helped.

[sailorboy1]

In those 30%, what is the degree that an AED improves survival chances over CPR etc. especially if the event occurs in a remote location?

[Kenomac]

Contrary to what's seen on TV and what was taught in CPR classes over the years, CPR alone won't work to return the heart to a normal rhythm, CPR can only sustain a victim until the hospital or emergency medical staff can administer electric shock via an AED. So if you're in a remote location, your chance of survival would be statistically near zero without the AED. Greatly improved if you're one of the 30 percent who can be helped by the use and availability of an AED.

The proper use of an AED is now taught in CPR classes.

[Tayana42]

Kenomac and others, thanks for all of the useful information in this thread. You have changed my mind about having an AED onboard. I am now looking for one to add to our medical kit.


S/V B'Shert

[skipmac]

OK, here's the opinion straight from an EM doctor regarding an AED onboard.

I could imagine a very rare circumstance in which it might potentially be useful.

If you had a V fib arrest in the context of drowning or a heart attack or some other really bad event, an AED alone would likely not be enough to save you without other advanced medical care pretty quickly accessible.

If you had a V fib arrest as an isolated event from a primary electrical problem in your heart, an AED alone might save you. This would be extremely unusual and in my opinion not worth the big dollars you would have to spend for an AED.

However, as Kenomac points out, an AED can now be had for less than big dollars AND if you happened to be that one rare case then you would be pretty glad to see the AED on board.

Another thought. One could experience some form of cardiac trauma close to shore as easily as in the middle of the ocean. In that case medevac would probably be available and the advanced care needed could be there fast.

So my plan is to first focus on prevention; make sure all on board have had checkups prior to departure and follow good safety practices onboard to minimize the chance of accidents. Next put together an advanced first aid kit and maybe even a little training on how to use it. Then if time, space, budget and my training allow, the AED would be on the list.

[Kenomac]

Skip,

Excellent post. Our feelings and views are shared on the subject.

Most of our cruising is coastal, where valuable time would be wasted during a cardiac emergency due to language barrier, dinghy shuttle ride by rescuers, proximity of emergency services, etc. The AED can possibly buy us valuable time when used with CPR.


We view the AED much like a life raft. Would one prefer to be on a boat which has a life raft even though the likelihood of the boat sinking is very remote, or.... would one prefer to be on the boat without a life raft?


Very few boats actually sink, why do we feel the need to have life rafts?

[ntscout]

I notice other cruisers carry things like TPA and morphine. How does one obtain and carry these medications? At least in the US, they would require Rx and are quite expensive - at least TPA. Also, TPA needs to be delivered IV - that is something that may be beyond many cruisers skill set. Finally, what if a condition is misdiagnosed and TPA or AED or something like that is used - can more harm than good come of that?

I live in a remote cabin off grid and also cruise remote areas. An AED makes sense but I think I might buy a reconditioned unit with a warranty etc from a known vendor rather than eBay. Chinese counterfeits are rampant so it would really suck to fire up an AED in a emergency situation and find it is just a non-functional boat anchor.

[skipmac]

Originally Posted by Kenomac

We view the AED much like a life raft. Would one prefer to be on a boat which has a life raft even though the likelihood of the boat sinking is very remote, or.... would one prefer to be on the boat without a life raft?


Very few boats actually sink, why do we feel the need to have life rafts?

I was thinking about a very similar analogy.

First step, prevention: medical checkup and safety awareness on board vs. well prepared boat and safety awareness to stay afloat.

Next level: have a good basic first aid kit and training vs. have a life raft, EPIRB, etc and training.

Advanced: Add the AED and/or other more advanced first aid resources vs. emergency water makers and/or other more advanced abandon ship resources.

All this reminds me, I have not had a CPR refresher class in years. Need to put that on my list.

[brantleychuck]

With all the CPR and shocking done on tv it us not surprising many folks think these procedures bring most people back. The reality out in the real world is very different. I started working EMS a few years ago for retirement fun. In that time I have been involved in maybe 12 full arrests. Almost all of those were basically dead on arrival at the ER, the ER staff just going through protocols before calling it. The rest either in the ambulance or at the ER got some kind of heart beat back long enough for family to gather and say good bye. I have never been on a call where a AED was used before we arrived on scene.
CPR is a pretty violent act. You must press hard, I mean real hard for it to be effective. I'm a pretty strong guy in good shape. I can do high quality compressions for maybe 2 minutes before I start to feel the burn. When you first start compressions you will feel a lot of crunching as you break ribs etc. Hard and fast ! I have come up with a saying, " we will not let you die till we break your ribs and stuff a tube down your throat" it's not pretty .
If you want to buy a AED, go for it. They are easy to use and are getting pretty affordable. It most cases it will not advise a shock, and in the few times it will the patient will in almost all cases not survive. A way better plan is to not be overweight and work that muscle that keeps us alive. In other words put down the fork and exercise. Control your cholesterol .

My biggest medical type fears I worry about when far from hospitals are infection and pain. I have had a couple of tooth aches during my life that were totally debilitating, frightening pain. I have seen kidney stones turn grown men into sobbing on the floor writhing in pain babies. Regular prescription Norco did almost nothing. I think some hard core narcotic pain relievers would be first on my list, then what ever you normally take antibiotic and some kind of big gun antibiotic. It would be nice to be able to revive a unconscious low blood sugar diabetic but that would mean injecting medication. My 2 cents


Sent from my iPad using Cruisers Sailing Forum

[skipmac]

Originally Posted by brantleychuck

With all the CPR and shocking done on tv it us not surprising many folks think these procedures bring most people back. The reality out in the real world is very different. I started working EMS a few years ago for retirement fun. In that time I have been involved in maybe 12 full arrests. Almost all of those were basically dead on arrival at the ER, the ER staff just going through protocols before calling it. The rest either in the ambulance or at the ER got some kind of heart beat back long enough for family to gather and say good bye. I have never been on a call where a AED was used before we arrived on scene.
CPR is a pretty violent act. You must press hard, I mean real hard for it to be effective. I'm a pretty strong guy in good shape. I can do high quality compressions for maybe 2 minutes before I start to feel the burn. When you first start compressions you will feel a lot of crunching as you break ribs etc. Hard and fast ! I have come up with a saying, " we will not let you die till we break your ribs and stuff a tube down your throat" it's not pretty .
If you want to buy a AED, go for it. They are easy to use and are getting pretty affordable. It most cases it will not advise a shock, and in the few times it will the patient will in almost all cases not survive. A way better plan is to not be overweight and work that muscle that keeps us alive. In other words put down the fork and exercise. Control your cholesterol .

My biggest medical type fears I worry about when far from hospitals are infection and pain. I have had a couple of tooth aches during my life that were totally debilitating, frightening pain. I have seen kidney stones turn grown men into sobbing on the floor writhing in pain babies. Regular prescription Norco did almost nothing. I think some hard core narcotic pain relievers would be first on my list, then what ever you normally take antibiotic and some kind of big gun antibiotic. It would be nice to be able to revive a unconscious low blood sugar diabetic but that would mean injecting medication. My 2 cents


Sent from my iPad using Cruisers Sailing Forum

Thanks Chuck. Some excellent information from someone that has been there, done that.

I have heard the same about CPR, basically if you are breaking ribs you aren't doing it right.

Also have the same reports on the success rate of reviving patients after a major event.

On the other hand I had a good friend save a strangers life doing CPR in the back of a taxi so it can happen. Took EMTs over 20 minutes to get there during Atlanta rush hour and they told my friend without the CPR the guy would have died. My friend did learn the guy survived and was discharged from the ER.

Similar happened to my father in law. Had a heart attack and stopped breathing while he was talking to an friend that was a retired MD who immediately started CPR. F-i-L made it to the ER and lived another 10 years.

So the message I take from this, always give it a try and never give up if there is the slightest chance.

[Cheechako]

In Georgetown Bahamas a boat maybe 200 yards away from us, owner had a heart attack. By the time people got over there ( a Doctor was anchored nearby) He was gone.

[farmall.dude]

Being a Critical Care nurse, I was very tempted to comment on some responses. Instead I decided not to make enemies of strangers and just congratulate the OP for thinking about safety. Having an AED aboard certainly can't hurt anything! All the ones I'm familiar with are Idiot Proof. A trained chimp could operate one. If someone's dead on deck, using an AED won't make them deadder if it doesn't work. If it does work, well... they'll be glad you had it handy.
TPA? That's another story... Oops, I wasn't going to write that...