Medical Equipment AED Onboard

[GoingWalkabout]

Originally Posted by Therapy

I feel pretty senior a lot these days though I am not a doctor.

I have stopped and thought, and read others thoughts. I know one major reason. It is our longevity. Exponential growth in population has occurred in large part because of our technology.

And lots of "organic" foods are falsely labeled. They are tricking you into paying more for the same thing.

And how come with "the growing health awareness" we have more obesity than ever before?

Not using one does not "cause harm". But I understand what you are trying to say.

Ouch. I will confess I have not read any new "research" in the last 3 months. What is new? Anything that can't be partially traced back to someone selling the items in question?

If you have the belief that you will one day use one to save a life you can certainly do that. I am talking about the relative use of one on a cruising boat.

I will keep my belief that the cost doesn't justify the chance of using it successfully. Successfully means "happily ever after", not "made it to the hospital but died two days after discharge".

I will try to look up ya'lls 25%. Unless you would like to show me your "research" eh? Save me some time.

Nite nite.

Nite Nite. We all have good reasons for our views and we all try our best I think to do good. Even Doctors can have heated debates about the correct procedure. So I conceded O could be waiting my money but then I don't think so. Gave a good night.

[crazyoldboatguy]

Originally Posted by GoingWalkabout

So if you have an intracranial bleed miles from anywhere your prognosis is as good as dead. If you have a clot then you have a very good chance of surviving if you are immediately administered TPA. So I can see the clear logic of administering TPA because if you've got a serious bleed from a ruptured vessel your going to die anyway. Unless you have a good Neuro sailing with you and he/she brought along his cranial saw. Mind you, you could use your boat drill to relieve the pressure but its a little difficult to use a drill on a persons head in high mid Atlantic waves. Unless of course your on a cat.

Great point.

[MBWhite]

No need to get into the details, but I've been an EMT on a rural volunteer ambulance service for more years than I care to think about. I am not only an EMT instructor but also have been a CPR instructor.

Anyway, until last month I have never had a successful CPR outcome.

If you had asked me 2 months ago about having an AED onboard I would have been neutral about it, but goddam it is really a good feeling to bring someone back who had no pulse, and it certainly changes your outlook on AED's! I will probably never have one on my boat, but I would certainly never begrudge someone else choosing to keep one onboard.

I will have to confess that I was not aware how expensive the batteries are! If I were to carry one onboard, especially outside of the US, I would be disassembling that battery pack and finding replacement cells for it! Just for grins, I looked up the battery for a Phillips Heartstart and it is an "FR3" which has a rating of 12V and 4.7 AH. It is a Lithium manganese dioxide battery. I then looked up lithium CR123A cells, they are spec'd at 1550 MAH and 3V, so 12 of those would give you 12V and 4.65 AH. I wonder if you cracked open an expired FR3 battery if you'd find a dozen solder tabbed 123A batteries inside? Quality Lithium CR123A batteries are about $1.50 each online....

Anyway, at this point I'll view an AED like I would one of those emergency flotation bladders that you put in a boat that you have to unroll and fasten them fore and aft inside the cabin then inflate with a scuba bottle- pretty much a stowable expensive gimmick that you will most likely never ever ever ever use but IF you needed it AND it worked as designed, you'd be a lifelong convert wouldn't you?

[Leo Ticheli]

We use a rebuild service for our camera batteries, http://www.ritterbattery.com; the guy does excellent work with a very fast turn-around. Our engineer used to rebuild the batteries for us, but Ritter does it for close to the cost of the replacement cells, so we use him now. I don't know if he will work on the AED batteries, but I intend to give him a try when the time comes.

I do appreciate the willingness on the part of sailors to warn their fellows of potential problems or dangers, but I have to admit I'm quite puzzled by the strident tone and persistence from those apposed to certain safety equipment. I just don't understand the motivation.

Fair winds,
Leo

[weavis]

The question I answered was "would you use one?". A little different to "would you buy one?".

Would I buy one for my boat right now?............. no.

I dont a see thousand plus expenditure as a priority considering the other stuff that would be more useful to the boat and the welfare of its occupants. Every specialist item is useful when required, but I see an EPIRB as more useful risk wise, and I can get four for the cost of 1 EAD.

What are you going to do when taking an inland walk on an Island you visit... carry the EAD with you? Or one of you goes into a 3rd world rural town shopping and one stays on the vessel......who gets to take the EAD? Do you have to get two?

On a scale of 10 in emergency equiptment on a boat its about a 10.

Whats next, every house is required to have one because it take too long for an ambulance to get there?

Do I decry or vehemently denounce people for getting one? Heck no. Fill yer boots, Get three if it makes you happy. To be honest Kenomac and mrs O'mac are quite competent in using their skills and CPR knowledge to do a great job without one.....

Im a gadget guy so I love all the new technology. If I had a few dollars spare and could get one kitted with new batteries for the right money and if .......... at this point I stop and realise that with my experience of life, its not high on my list... for a boat.

Life happens. People die. Living is a high risk activity.

I have to leave it for personal choice. I dont want it to be "politically correct" that I am forced to carry one.

[GoingWalkabout]

Originally Posted by MBWhite

No need to get into the details, but I've been an EMT on a rural volunteer ambulance service for more years than I care to think about. I am not only an EMT instructor but also have been a CPR instructor.

Anyway, until last month I have never had a successful CPR outcome.

If you had asked me 2 months ago about having an AED onboard I would have been neutral about it, but goddam it is really a good feeling to bring someone back who had no pulse, and it certainly changes your outlook on AED's! I will probably never have one on my boat, but I would certainly never begrudge someone else choosing to keep one onboard.

I will have to confess that I was not aware how expensive the batteries are! If I were to carry one onboard, especially outside of the US, I would be disassembling that battery pack and finding replacement cells for it! Just for grins, I looked up the battery for a Phillips Heartstart and it is an "FR3" which has a rating of 12V and 4.7 AH. It is a Lithium manganese dioxide battery. I then looked up lithium CR123A cells, they are spec'd at 1550 MAH and 3V, so 12 of those would give you 12V and 4.65 AH. I wonder if you cracked open an expired FR3 battery if you'd find a dozen solder tabbed 123A batteries inside? Quality Lithium CR123A batteries are about $1.50 each online....

Anyway, at this point I'll view an AED like I would one of those emergency flotation bladders that you put in a boat that you have to unroll and fasten them fore and aft inside the cabin then inflate with a scuba bottle- pretty much a stowable expensive gimmick that you will most likely never ever ever ever use but IF you needed it AND it worked as designed, you'd be a lifelong convert wouldn't you?

I'm sorry but by the time you rock up to a patient lying prostrate on the ground from a cardiac event it would in all likelihood be at least 10 minutes to late. I am not surprised with your low resuscitation rate. This is the whole purpose of an AED. Immediate use without letting vital minutes go by with the usual subsequent brain damage.

[weavis]

Originally Posted by Going Walkabout

I'm sorry but by the time you rock up to a patient lying prostrate on the ground from a cardiac event it would in all likelihood be at least 10 minutes to late. I am not surprised with your low resuscitation rate. This is the whole purpose of an AED. Immediate use without letting vital minutes go by with the usual subsequent brain damage.

Its only as immediate as the ability of the responder to recognise the problem and use one. Most people call 999 or 911 and talk to the emergency services and wait for an ambulance.

I guess this is why medical people get training and why AEDs work best in hospital settings or from trained personnel right on the doorstep of an incident. Dont get carried away now, its not magical... It only works in the right circumstances and even then only a low % of the time as ONE of the initial help aids. Im not knocking it..... its just sum o' y'awl are descending into Star Trek territory.

[Kenomac]

Originally Posted by weavis

Dont get carried away now, its not magical... It only works in the right circumstances and even then only a low % of the time as ONE of the initial help aids. Im not knocking it..... its just sum o' y'awl are descending into Star Trek territory.

Kaptain Ken, star date 2015.2, from the log of Starship Orinoco,

I don't think Gary is saying the idea of obtaining a AED or "EAD" is a bad idea, he just places it further down on his list of priorities. We already have over a dozen fire extinguishers, 2 EPIRBs, life raft, AIS, Radar, extra everything onboard, so when I saw the opportunity to purchase a $1500 AED unit for $185 to add to our medical kit, it seemed like a no brainer.

The final evaluation of the unit I purchased. It is in fact the current Cardiac Science Powerheart G3 9030 fully automatic model with two years remaining on the original battery. I did buy a spare battery to keep on the shelf until this one dies. Mrs. O'Mac now wants a second AED for the house, if one can be had for the same price.

Personally, I see the unit being more practical for us on the boat since we are nearly always together onboard. At home, not so much... which is problematic. Also on the boat and at home, I live a lifestyle which seems to have a propensity towards accidents... like last season when I fell off the dinghy clutching my old mountain bike, which ended up with it on top of me under the RIB. So hopefully, she'll be around if and when the AED is needed.

[weavis]

Originally Posted by Kenomac

when I fell off the dinghy clutching my old mountain bike, which ended up with it on top of me under the RIB. So hopefully, she'll be around if and when the AED is needed.

Good Lord Ken!!

How is the bike?!!

[GoingWalkabout]

Here are some facts.

From the US Government OSHA website....

"Approximately 450,000 people die each year from sudden cardiac arrest in the United States. Throughout the years, ArvinMeritor's various facilities reported five sudden cardiac arrests. Early defibrillation is the only definitive treatment for sudden cardiac arrest. The best “save” rates have been reported when the electric shock is delivered within three minutes of the patient's collapse. The average response time for emergency services, however, is 10 to 12 minutes, which may not be fast enough for the patient to survive. Response time is a particular concern at the many ArvinMeritor facilities located in remote areas, where emergency services are further away."

"Survival is directly linked to the amount of time between the onset of sudden cardiac arrest and defibrillation. If no bystander CPR is provided, a victim’s chances of survival are reduced by 7 to 10 percent with every minute of delay until defibrillation."

"The VF sudden cardiac arrest survival rate is only two to five percent if defibrillation is provided more than 12 minutes after collapse."

"In some cities with public access defibrillation or “community AED programs,” when bystanders provide immediate CPR and the first shock is delivered within 3 to 5 minutes, the reported survival rates from VF sudden cardiac arrest are as high as 48 to 74 percent."



The findings were presented here at the American Heart Association (AHA) 2007 Scientific Sessions.

A review of out-of-hospital cardiac arrests in 11 cities in the United States and Canada participating in the Resuscitation Outcomes Consortium (ROC) shows an increase in survivors with the public availability of automated external defibrillators (AEDs).

"Contemporary bystander AED programs appear to improve survival from cardiac arrest greater than 2-fold over solely EMS-based defibrillation," Myron L. Weisfeldt, MD, from Johns Hopkins University School of Medicine, in Baltimore, Maryland, told attendees.


The Public Access Defibrillation (PAD) trial showed that training and equipping lay volunteers to use an AED in community settings doubled the number of survivors after an out-of-hospital cardiac arrest compared with training in cardiopulmonary resuscitation (CPR) alone, from 15% to 30% survival to hospital discharge (Hallstrom AP et al. N Engl J Med. 2004;351:637-646).
The current study examined the use of AEDs in the community to see what effect the recent increase in publicly available AEDs has had on survival after an out-of-hospital cardiac arrest. It was a population-based cohort study in 11 US and Canadian urban and rural sites participating in the ROC, a prehospital emergency-care trials network.



Patients were included if they experienced a nontraumatic out-of-hospital cardiac arrest between December 1, 2005 and November 30, 2006, were evaluated by organized emergency medical services (EMS) personnel, and received attempted defibrillation before or after EMS arrival or chest compressions by EMS.

A total of 10,663 patients were included; most were men, and the average age was about 60 years, typical of these patients.

The bystanders who applied the AED were mostly either untrained lay bystanders or healthcare workers.

If the bystander had an AED and placed it on the patient, whether or not it ultimately delivered a shock, survival increased to 23%, and if an AED was placed and a shock given, the survival rate was 36%.

For patients who received bystander CPR followed by defibrillation by the EMS services, survival was 15%.


Interestingly, the survival rate was 32% when the EMS personnel were called to the scene for a patient who was in distress but not yet in cardiac arrest, witnessed the arrest, and provided defibrillation. "Their survival rate was no better than the bystander doing it," Dr. Weisfeldt pointed out.


AED's can dramatically increase the chances of survival of many cardiac arrest victims. Consider these statistics from the American Heart Association:

• Less than 8% of people who suffer cardiac arrest outside the hospital survive. 1 In many communities this can be because the time interval from activation of EMS to arrival of these medical personnel may be 7 to 8 minutes or longer. 2
  
  
• Effective bystander CPR, provided immediately after sudden cardiac arrest, can double or triple (approximately 15 - 24%) a victim’s chance of survival. 1
  
  
• In places where widespread first responder CPR training has been provided (eg, as part of community lay rescuer AED programs), survival rates from witnessed sudden cardiac arrest associated with ventricular fibrillation have been reported to be as high as 49% to 74%. 2Other studies suggest that when AED's are used to deliver a shock within the first minute, that the patient's heart can be restarted and be beating on its own again before EMS arrives in as high as 90% of the cases. 3
  
  
• Brain death and permanent death start to occur in just 4 to 6 minutes after someone experiences cardiac arrest. Cardiac arrest can be reversed if it's treated within a few minutes with an electric shock to the heart to restore a normal heartbeat. This process is called defibrillation. A victim's chances of survival are reduced by 7 to 10 percent with every minute that passes without CPR and defibrillation. Few attempts at resuscitation succeed after 10 minutes. 4

MORE FACTS

Fact I: Sudden cardiac arrest (SCA) is a leading cause of death in the United States, killing nearly 300,000 every year.

Fact II: SCA can strike persons of any age, gender, race and health.

Fact III: An automated external defibrillator (AED) is a device used to administer an electric shock and restore the heart's normal rhythm.

Fact IV: Ventricular fibrillation (VF) is the abnormal heart rhythm that most often leads to sudden cardiac arrest. It is treatable with an AED.

Fact V:The survival rate for SCA is less than 5%. This is due to limited AED accessibility.

Fact VI: If an SCA victim receives defibrillation through an AED within the first minute, the survival rate is 90%.

Fact VII: For every minute that passes without defibrillation, survival decreases by 7 - 10%.

Fact VIII: 30% - 50% of SCA victims would survive if AEDs were used within five minutes.

Fact IX: If the AED determines the victim's heart is in VF, the AED will recommend a defibrillating shock.

Fact X: If a person does not need an AED shock, the AED will not deliver.

Fact XI: All AED devices have voice prompts, enabling untrained bystanders to easily administer therapy with an AED.

Fact XII: If defibrillation is delayed by more than ten minutes, the survival rate is less than 5%.

Fact XIII: 20% of police cars carry an AED or defibrillator.


Fact XIV: SCA occurs most often in the home (57% - 75%), which are often unequipped with an AED.

Fact XV: AED electrodes collect information about the heart's rhythm and deliver the shock for the AED.

[weavis]

Go get one.
Problem solved.

[Kenomac]

Originally Posted by weavis

Good Lord Ken!!

How is the bike?!!

Ugly.

The next day the bottom bracket was seized up along with all the cables, but I got it working, rode down to the bike shop and a very nice Spaniard switched out all the cables and tuned it up for only 10 euros after we exchanged some photos of both of us racing bikes. His cycling shop is in Garrucha at the east end of town.

[weavis]

Originally Posted by Kenomac

Ugly.

The next day the bottom bracket was seized up along with all the cables, but I got it working, rode down to the bike shop and a very nice Spaniard switched out all the cables and tuned it up for only 10 euros after we exchanged some photos of both of us racing bikes. His cycling shop is in Garrucha and there's another excellent shop just east of Palma along the coastal road.

LOL..
you know better than that..... I know Palma well but as I found out the other day, only by proximity to tapas bars........

[GoingWalkabout]

Originally Posted by weavis

Its only as immediate as the ability of the responder to recognise the problem and use one. Most people call 999 or 911 and talk to the emergency services and wait for an ambulance.

I guess this is why medical people get training and why AEDs work best in hospital settings or from trained personnel right on the doorstep of an incident. Dont get carried away now, its not magical... It only works in the right circumstances and even then only a low % of the time as ONE of the initial help aids. Im not knocking it..... its just sum o' y'awl are descending into Star Trek territory.

Yes I can understand how some can see modern day medical devices as somewhat Science fiction. Much of what was science fiction in the past is reality today. Good example is space travel itself and don't forget the Star Trek communicator... Looks a lot like the flip mobile phones. Outdated now but cutting edge a few years ago.

So getting to the point of your posting and that which disturbs me the most. You are so wrong in saying that an AED is only good in the hands of trained experts. The facts show you are seriously wrong. Even an untrained pedestrian using AED will have a higher success rate then if you waited for the EMS to arrive. Please do not spread ignorance on a subject that can cost lives. And on this point I am so very serious. If you want to stick your ill informed uneducated head in the sand than go ahead but I ask why are you going out of your way to talk other people out of having a known life saving device? Maybe some people can't afford an AED and are trying to rationalize why they don't have one. That's OK but please don't peddle your dangerous ignorance. Sorry but I take saving lives very seriously.

[socaldmax]

Originally Posted by Leo Ticheli

We use a rebuild service for our camera batteries, http://www.ritterbattery.com; the guy does excellent work with a very fast turn-around. Our engineer used to rebuild the batteries for us, but Ritter does it for close to the cost of the replacement cells, so we use him now. I don't know if he will work on the AED batteries, but I intend to give him a try when the time comes.

I do appreciate the willingness on the part of sailors to warn their fellows of potential problems or dangers, but I have to admit I'm quite puzzled by the strident tone and persistence from those apposed to certain safety equipment. I just don't understand the motivation.

Fair winds,
Leo

The device has no idea if it's being powered by an original battery or a completely different battery, all it needs is the proper voltage and at least the same amount of ah rating.

I was thinking in terms of replacing it with a Lipo RC car battery rated at 12v and 5ah. It might actually perform better, because the Lipo can provide very high current draw if necessary. I already have a charger for it, and Lipos hold their charge very well, I wouldn't need to recharge it very often.

They sell the Lipo batteries in a variety of different shapes, I could probably find one that would fit inside the compartment with no modifications to the case.