Automated External Defibrillator ?

[Tampabayfireman]

Ok, question for those that are out here, or at least, planning on going... How many of you carry AEDs or considered it? And if not, how many have sent everyone onboard to learn CPR?

[Lodesman]

We've given it some thought. Certainly if it fits into the budget. We're still fairly young and don't have histories of heart trouble, so it's a pricey just-in-case thing to have on board. Will be more justified once we head offshore.

[DRS]

A very interesting question. Over the years of my first aid training I have seen a decline on the emphasis placed on CRP training. It's overall effectiveness does not appear to be as good as originally thought. The harsh reality is that, if you are doing CPR the person is dead and there is a very slim chance of recovery (sorry folks it's not like TV and the movies). I'll grant the the AED is a WAY BETTER option but you still require sophistiacted medical assistance very near by. If you are days out or even a few hours medivac out is it really worth the expense?

[Tampabayfireman]

believe it or not, the most survival type of use is electrical shock, or lightning strikes. And yes, 24 yrs as a paramedic, I know the odds, and have seen both types.. and the odds really show that CPR most likely is done on a family member or close friend... So place yourself in the position, surrounded by salt water, electric items and the occasional storm... hmmm

[DRS]

TBF. Im not arguing against the validity of the AED in a metropolitan area where advanced medical asistance is near by, however the chance of getting hit (and killed thus requiring CPR or a AED) by lightning is over 2 million to one and most boats run 12volt power (not likley to induce a heart attack) most of the time.
I would challange anyone to try and do single person CPR for over thirty minutes. It is physically demanding and even a fit person and well trained first responder will be pushed to their limit doing CPR for much longer not to mention the declining survival rate of the victim. AED's cost around $2000 I believe the money could be better spent elsewhere.
OK so now I am the coldest most callous person on the forum
Having said all that because of our jobs both my wife and I are CPR trained

[nautical62]

Yes, I have considered it. Given the demographics of who I sail with and other factors, I don't feel the negatives justify the potential positives at this time.

[duncan_ellison]

FWIW - I DO carry an AED on board. Bought on EBay at a reasonable price and given new batteries and pads, I feel it's a reasonable thing to do. Takes up more valuable locker space, but there you go.

My particular AED also has monitoring capabilities and thus could be used to relay a consious patient's condition to someone on shore.

Maybe I'm just paranoid about this stuff, but at 53 YO and a little bit overweight, I'm heading into the zone where this might just save my life one day, YMMV.

Duncan
S/Y TALISA

[Lodesman]

Originally Posted by DRS

TBF. Im not arguing against the validity of the AED in a metropolitan area where advanced medical asistance is near by,

I'm of the mind that CPR is only useful in a metropolitan area near advanced medical assistance, because as you pointed out, you can only do CPR for so long. An AED actually gives you the only reasonable chance of re-establishing a heartbeat. Sure the patient will be critical and will need to get to a hospital, but it might buy you enough time to get (to) help.

[Tampabayfireman]

A fair call as far as most people are concerned... Yes, i have in the past done CPR for 30 min plus, in a metropolitian area. I am also aware the typical survival rate is less than 19% in an ALS community. That being said, yes, I own one. Not from Ebay, but a national reseller for AEDs and a far less than 2k. (more like 250). Again, I have seen them work if applied in time, and given ideal conditions. As planning on cruising to areas that dont have ALS providers, the survival rate is 0 without one, so for me personally, yes, worth it. At 2k, would have been a lot farther down that list... And yes, it is just one part of a resonable idea of what I would take. Oh, and as far as 12v, not worried bout that, its that large generator of 240v that would be of more concern. YMMV, but like spare parts and first aid kits, peace of mind in far away places....makes one sleep better.... it was a question posed to see if other cruisers carried them, more than are they for everyone...

[maxingout]

During our circumnavigation, I never even thought about taking an AED along. One of my crew members during the last half of the circumnavigation was a physician assistant. She would have known how to make good use of an AED, but without any cardiac drugs and without an ICU on board, the chance that an AED would be useful is very low.

One of the things I like about cruising is the healthy positive lifestyle. I eat good, I exercise, and I don't worry about health issues. For me, an AED would be a constant reminder that the thread of life is thin, and is easily broken. It would give me the wrong focus. I am more interested in living than worrying about dying. But then, that's just the way I look at life.

[hummingway]

I had a job once that required me to learn CPR. I had never before and haven't since been faced with the situation that required me to use it but over the following three years I used it 3 times. Once the person died in the ambulance after it arrived and parametrics took over. The second time the person had a condition where their heart stopped and started and didn't really require assistance of that sort, although at the time I had no way of knowing. The third time I was unable to revive someone very close to me. It was one of the most difficult and devatasting things I've been through. I was alone with them doing CPR for what seem an eternity but was likely 45 minutes, until an emergency vehicle arrived.

That is the extent of my experience and I have no knowledge of what someone would generally expect to accomplish but I think for myself I will choose to live life as best I can and encourage those with me to do so as well. there may be some things that most of us are not going to be able to do anything about.

[MarkJ]

I thought I'd chime into this secret language you guys are using. This being an international forum and that. Not everyone knows abbreviations (or initializations for the pedantics).

AED = automated external defibrillator?

Maybe a Mod could change the subject box so we can find this important discussion in the future.

We are a little young for a defibrillator for heart condition use. And there doesnt seem much value for the few dollars we have for extras.
That, of course, could change as I get older.

If we did have a spare $300 I would be getting a Penthrox Inhailer which is a very strong analgesic in a tube somewhat like a long whistle. A badly injured person can suck on this whistle and have pain relief for about 20 minutes. They can self regulate the amount of drug simply by sucking or not.

The particular use I thought in long distance cruising was if someone is injured on deck, say a broken leg, and they need to be brought below using a halyard and winch etc, then while that fun bit is happening the injured can be in the land of bliss.
Also for setting fractures etc.

I think it is not legal to buy in the USA. The quoted cost in a chemist in Australia was, I think, AUD$325 = USD$275

As a general note to follow up Dave's thought of healthy lifestyle, we have heard of very few injuries in our 2 years floating around the world. I always have skin off in a few locations and the supply of band-aids is always being restocked. (I went into a sharp bit of curved SS the other day that would have had 5 stitches at a hospital, and banged my bloody head the next day in a scar-leaving dispute with another bit of metal). I guess most cruisers have a bit of skin off from time to time. Many bumped heads too, noting some of the coments on CF

Cruisers are a pretty fit lot, till they get to a point where they know its time to slow down and have a few more marina days, more motoring and less straining on halyards and sheets.

The only medical induced death we've encountered was suicide from low budget. I kid you not.

That being the general state then I think our Senior First Aid certificates and our Remote Area First Aid are probably spot on for our circumstances.

As for CPR we always carry a CPR face mask, but find them extremely difficult to buy when the wallet one gets too old. I find that quite odd!

I would like to do refresher courses often but if they are available at all the cost is out of our budget. The argument of money V's saving lifes doent work as we have many things on the to buy list that are essential for that, including a new dinghy so we don't sink in the middle of nowhere! So I would like to see a person jump on the VHF and say: "Hey folks, I'm a paramedic (or doctor) and we're doing a CPR practice session on the beach at 1100."


But please take note: I'm the only one that gives Nicolle the kiss of life!


Mark

[Albro359]

Penthrox is not universally available in Australia...only in the state of Victoria. Its use is banned in most other parts of the world becuase it is too dangerous...the fact that a previous medical adviser to the Victorian ambulance service had a company that was the agent for this product probably explains a lot !

I have an AED on board and all crew are instructed in its use (its pretty damn simple).

There seems to be some confusion between CPR and AED use...CPR is necessary to keep blood flow to the brain until the AED is applied...and the CPR has to be done properly...if you don't think you're going to break his ribs you're not doing it hard enough.....even then the AED will only work if the patient is in VF (Ventricular fibrillation) or high rate VT (ventricular tachycardia)...a defibrillator doesn't start the heart (in contrast to one devices brand name) it actually stops it suddenly and the hope is that the conductive pathways of the heart will re=establish a normal rhythm.

Thats why it doesn't work if the patient is flat-lined..ie no electrical activity...as you see the BS in ER and other programs where there is a flat line and they apply the defib...and wow...patient comes back to life...BS...doesn't happen 99% of the time

regarding physicians on board using them...I would say from my experience a well trained lay person or a paramedic would do a better job...once the patient's heart is beating in an organised rhythm, then let the physicain ahve a go...too often they don't appreciate the absolut urgency and the need to follow a strict protocol which has been proven to work

As well as the AED we also carry a bag mask resuscitator, guedal airways, adrenalin etc

[Tampabayfireman]

Sorry about not spelling out AED, bad habit being a paramedic for over 25 yrs now. Yes, if you are under 45, i am quite sure I wouldnt spend the money for an AED. Also, you tend to find more people over 45 esp from the US that have CAD(Coronary Artery Disease), or lay terms, blockages of the arteries of the heart from Lifestyle, food, etc.. the AED works as above, with the understanding that it typically works the best on the sudden collapse from a heart attack. It is designed to work best if used in the first min of collapse. (age 45-60) Over 60 you tend to develope collateral circulation, or added veins/arteries that help prevent the sudden collapse syndrome that is seen in the younger crowds. ( yea sucks that the old ones have better chance of survival...) They develope the typical chest pain, breathing problems, etc.. where the cardiac meds and such work. Yes a little long winded, but background. As I plan to take off cruising in the next 2-3 yrs, puts me in the middle where it would work, (well unless gf kills me first...) so yea, I will carry one.

[Paul L]

Originally Posted by maxingout

..... but without any cardiac drugs and without an ICU on board, the chance that an AED would be useful is very low....

I think this is the real issue for a cruising boat. When the AED is used on TV the miraculous recovery is always followed by a quick trip to the ICU -- often from the ER. This isn't going to happen in most cruising scenarios. So you will have a near dead or dieing patient onboard with little likelihood of a good outcome. It would probably be more cost effective if you spent the AED money on 2 years of gym memebrship (and used it) before you left.

Paul L