Medical Equipment AED Onboard

[Wannabe-007]

There are many more qualified than me here, but for what its worth, here's my tuppence.

There is a strong relationship between speed of intervention and survival.

In the events we are concerned with, speed of intervention is not a problem. CPR can be started immediately to keep the life blood pumping while a third crew member (ideally) preps the AED.
The patient now has a chance of survival, and those chances are dramatically higher than if this had happened at your house and you'd called the paramedics.

My greatest fear is loosing my wife overboard and i'm about to invest in, among other things, a DSC, AIS, SART PLB to pin to her bikini or braid in her hair... If she needs it, I am likely to be the only chance she has. I'll break her ribs, follow the guiding voice on the AED and pray.

The likely scenarios are MOB and subsequent drowning, or electric shock.
People want to talk about fatality rates and chances of success.
If you really want to know about survival odds, we need to look at the right scenarios...
So the relevant question is: "How many boats, equipped with an AED and persons qualified to perform CPR have saved / lost lives in the even of heart 'failure' due to electric shock or drowning?"


At the end of the day, I know my chances are slim. If I lost the Admiral , or a crew memeber... my grief would be tempered by the knowledge that I had tried everything and there was nothing else I could have done.


How depressing - i'll lighten the mood with this handy icon of another CPR scenario...

[sailorboy1]

Originally Posted by Wannabe-007

How depressing - i'll lighten the mood with this handy icon of another CPR scenario...

sorry, didn't see it in time

the horse died

[Virginia Lee]

Was part of a team that revived an electrocution victim (on the hard) with regular CPR: he had a good outcome. (Burned fingers and toes aside.) Not that I would discourage AED; doing proper CPR on a boat would be quite difficult and I'm sure AED would be more likely to be effective.

Don't forget to have plenty of dry towels near your AED; I believe it will not work if the victim has water between electrode sites and/or under the electrode pads.

[Wannabe-007]

You revived him with CPR alone?
I thought the chances of actually reviving someone with CPR was slim-to-none.

Shows how much I know.

[Cheechako]

I'm CPR, FA, AED certified. The AED is the simplest of the three really. The unit wont let you shock someone unless it reads the right criteria.

[Suijin]

When I got my First Aid + CPR/AED certification, everyone in the room was a sailor as it was right before an ocean race and crews needed to have a certain percentage with the CPR/AED card.

The EMT teaching the class was adamant that having one of these units on board a cruising/racing boat was next to useless. His point was that yes they save lives but only if followed up within minutes by trauma care in a hospital.

If you've got the money, probably makes sense to go ahead and put one on the boat, but I think it's important to understand exactly how limited it's value might be.

[JRM]

I have been doing the EMS thing for a while, work for a place that's on the bleeding edge of CPR methodology (we call it CAM now for Cardiac Arrest Management) and I have done two full arrests in the last four days, one over a decade younger than myself.

I've done a lot of CPR. Only once have I ever seen a Hollywood style wake-up. Scared the heck out of us. Not even the guy's wife who witnessed the whole thing could convince him he'd been dead.

If it really makes you feel better, then by all means buy it. It's your money and you get to spend it how you like. But I'm having a hard time thinking of anything I'd put lower on my priority list. It's pretty much worthless beyond twenty minutes travel time to a hospital.

In the fancy lingo it's called ROSC. Return of spontaneous circulation. The problem is that it's much easier to restart the heart than to keep it going. Our current protocol actually involves continued compressions post shock without even a pulse check. The thought being that even if the heart does resume, it's not going to be pumping the volume required to sustain itself or the victim.

Someone above asked the question would you rather go into cardiac arrest on a boat that had an AED? It doesn't matter to me unless that boat is tied to a slip within about 15 minutes of a modern Emergency Department.

I carry a PLB in the pocket of my harness. I carry it to placate my mother, because we had a family friend fall off his boat. It's not going to do me any good on a passage, but I carry it anyway for her. I can't very well judge someone for spending dollars on a purely psychological net when I have done so myself. I just recognize it as such.

I'm not a doctor. I don't even play one on TV. But as someone familiar with the use of an AED my opinion is to skip it.

JRM


Sent from my SAMSUNG-SM-G900A using Cruisers Sailing Forum mobile app

[caradow]

A little bit of clarification is needed here:
If your "heart stops" an AED will not work and therefore will not save you.
That is called asystole and it is a NON SHOCKABLE RHYTHM!
It can however convert abnormal rhythms such as Ventricular Tachycardia and Ventricular Fibrillation that are life threatening into a normal sinus rhythm which is what we all hope for.
I would also state that if you have the money to afford one then maybe you could save a life. Ventricular arrhythmias are one of the leading causes of death in the early MI (heart attack) and shocking someone out of a lethal rhythm can save their life . I have seen many people shocked only once and they lived to tell about it. However if you are one of the lucky ones that live after getting shocked aboard a boat then I would lay very still and don't exert yourself for as long as possible. Having said that, dying of a cardiac arrhythmia is not such a bad way to go ......certainly better than falling off your boat and watching it sail away of getting eaten by a shark. I do hope this knowledge makes you guys more comfortable.

[roland stockham]

I see you point about electric shock etc. Can also see a good rational if cruising in coastal waters (within helecopter range) which many people spend most of there time doing. A 1-2hr delay getting to ICU can be OK but min's count for defib'.
I considered this and asked the local SAR people. They don't carry them and the issue seem to be about the safety considerations for the operator. I think that they where concerned that in a damp salty environment the operator could get shocked as well. There may be an issues with charge control for the same reason. Don't have details but might be something you want to look into. The med in summer would also be very different to the irish sea in winter which is where the SAR teem operated.

[caradow]

sorry, thats "or" getting eaten by a shark in the above post.
anyway as far as "meds to take with you" i would pick wisely and would discourage most to stay away because it is very easy to kill someone as opposed to letting them die on their own. The human body can be very resilient.
Remember what good old Hippocrates said "First Do No Harm"
Especially the person on this post that mentioned TPA. That is absolutely scary to think of administering this drug without proper monitoring and training. I have seen too many people die from TPA alone even in the best of circumstances. Also it is a very ugly sight when it occurs.
Even Nitroglycerin pills given to the wrong kind of heart attack can be lethal.
Taking an advanced course in survival medicine bent toward the nautical environment would be a great thing for all sailors to take. Sort of a Safety at Sea on Steroids.

[Nicholson58]

Originally Posted by Kenomac

Believe it or not... I purchased ours brand new on ebay for around $250. So I'd say the price range is between $250-$1600 depending on the age of the unit and how much instruction and automation is wanted. The more expensive units will even give CPR instructions during the actual emergency along with administering the shocks.

We've had one now for a year. Totally Automatic. It talks etc. The EMT that does CPR training where I work sells them so we get a discount.

We have told our marina mates its on board & while we are not on the boat it is still available by a retrieving line through a small port under the Bimini.

At sea, this may give you a bit of time but a victim still needs immediate evac & help.

[Kenomac]

AED update:

My "new" Cardiac Science Powerheart G3 unit arrived today, and I quickly figured out that it's going to cost a little more money to make it as "good as new." Although the unit itself has never been used and has probably just sat on a shelf somewhere collecting dust, it will require a new battery. So far, I've spent $220 on the unit and will need to spend another $200 in order to make it as good as new. Everything is working properly but as I've discovered, the batteries are not chargeable and need replacement.

But still, at $450 or so... that's a very good price for a unit which sells new for $1,100. It looks like there's quite a few of these available online because most institutions seem to trade in their old models when they expire for new ones. So basically, you just need to buy a used unit and replace the very expensive battery to give it new life. The useful battery life is about 5 years.

[Kenomac]

Originally Posted by 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...

Please comment, you won't make an enemies. I welcome your input, and no we don't have any TPA onboard, nor do we plan to.


I'm at the point where I can still return the unit for a full refund if I change my mind. I agree with your not going to hurt a dead person with CPR or the use of an AED comment, I use the same expression myself. Fire away...

[caradow]

I wish you well with your "new" AED
What year was it made?
Battery technology in the AED's have changed dramatically in the last 5 years.
Did you ever question why you were able to buy one so cheap?
With hospital constraints on costs here in the US makes me a little suspicious of such a good deal.
I am not advocating not having one, I commend you on your thirst for safety but you want it to work if you ever need it. The extra money for a state of the art one would be money worth spent. Didn't you pay that much for your life raft, SSB, Sat Phone etc ?

[Kenomac]

Originally Posted by caradow

I wish you well with your "new" AED
What year was it made?..................
The extra money for a state of the art one would be money worth spent. Didn't you pay that much for your life raft, SSB, Sat Phone etc ?

Since taking my most recent required CPR course, I decided that if I could buy an AED unit at the right price, I'd get one. So I looked at the exact model being used in the Hospital facility where I now work which is a Powerheart G3 and noticed the expiration date on the battery of May 2016.

So... if I purchase a new battery with an expiration date of March 2020, wouldn't the used unit I just bought be in better shape than the one next to the nursing station where I work? Keep in mind, the only difference is the remaining battery life.

Priced below $500, I think it's worth having. At $1500.... maybe I'm not as motivated to buy one.