CPR - CardioPulmonary Resuscitation

[Kettlewell]

Defibrillators save lives but they don’t keep them alive, unless you can get the afflicted to a hospital or higher care with in a short period of time (3hrs max) they will most likely tap out again if you can get them back.

It would be interesting to find out what the survival rate is for people who have heart attacks onboard, but then again I suspect having a heart attack onboard is a pretty rare occurrence. In my close to 50 years of boating I have never heard of one amongst anyone I have met, and even among my boating friends ashore I can only think of one heart attack. Even among those who had known heart problems. I think this might be one of those things we all worry too much about, and spend too much time and money on, when we could be doing something else that is more productive in extending our own lives. Like maybe cutting back on all that drinking going on...

[GordMay]

Originally Posted by Kettlewell

It would be interesting to find out what the survival rate is for people who have heart attacks onboard, but then again I suspect having a heart attack onboard is a pretty rare occurrence ...

Perhaps; but:
60,000 cardiac arrests occur, outside of a hospital, each year, in Canada*.
Heart & Stroke Foundation ➥ https://www.heartandstroke.ca/what-w...t/saving-lives

* Population 40,947,847 ➥ https://www150.statcan.gc.ca/n1/pub/...018005-eng.htm

[Hoodsail]

Originally Posted by Tom_F

Not to be pedantic, but CPR does not "restore someone's cardiac rhythm." What it does is circulate the blood through the circulatory system to keep somewhat oxygenated blood flowing to vital organs, especially the brain. It's why CPR should be performed for as long as possible once started - even if it is clear it is not restarting someone's heart. Also, an AED is not used when someone is asystole (has no heartbeat) or is in cardiac arrest. An AED is used when someone is suffering from fibrillation (I forget whether atrial fibrillation, ventricular fibrillation or both) - when the heart is beating so fast that it cannot fill with blood sufficiently to pump oxygenated blood throughout the body. An AED works by stopping the person's heart and hopefully resetting the electrical issue that is causing the fibrillation. The nonsense you see on TV and in movies where they use a defibrillator to save someone who has flatlined is just that - nonsense. Or at least so I was told in EMT class. You also have to be very careful when using an AED because it can also stop the heart of someone in contact with the victim. As sailors, we are often surrounded by water - both outside the boat and on wet surfaces in or the boat. Standing in a puddle in the cockpit and shocking someone who happens to be in the same puddle can kill the rescuer. Please make sure when using an AED that you are not in physical contact with the victim, whether by touching them directly or by being connected to the same conductive surface. They are great devices, but they require care and caution when using them.

That being said, AEDs and CPR both unquestionably save lives, and they are often used in combination. If ashore, the first step is always to alert emergency services personnel (usually by asking a bystander to call them). CPR is easy enough to learn and perform for most of us, so the advice above to take a class is good advice - especially for those of us who (and whose spouses, significant others and friends) are getting older. Classes are available many places for very modest cost. Stay safe.

Tom

to continue the pedantic....an AED can restore a pt's "regular" rhythm..converting ventricular fib/tach or other rhythms....When I was a member ofthe code blue team we didnt have automated defibrillators, just defibrillators.....so we did shock patients who were in asystole because the device was not limited by the patient's condition...did our best not to but....we were there, unresponsive pt, no EKG, "faint pulse" or not?...thanks

[Kettlewell]

Perhaps; but:
60,000 cardiac arrests occur, outside of a hospital, each year, in Canada*.
Heart & Stroke Foundation ➥ https://www.heartandstroke.ca/what-w...t/saving-lives

Sure, but the heart attack out of the blue is relatively rare. Most victims will have a history of cardiovascular problems, and I suspect many sailors would alter or maybe curtail their cruising plans to stay closer to medical care. Even when cruising close to home you can easily be many hours from a hospital. I still suspect heart attacks onboard are very rare.

[dannc]

Originally Posted by Kettlewell

It would be interesting to find out what the survival rate is for people who have heart attacks onboard, but then again I suspect having a heart attack onboard is a pretty rare occurrence. In my close to 50 years of boating I have never heard of one amongst anyone I have met, and even among my boating friends ashore I can only think of one heart attack. Even among those who had known heart problems. I think this might be one of those things we all worry too much about, and spend too much time and money on, when we could be doing something else that is more productive in extending our own lives. Like maybe cutting back on all that drinking going on...

I would think survival rates for heart attacks on board while offshore is close to zero since the time it will take to get the person to a hospital would take hours, if even if possible. A short handed crew, trying to perform CPR, use the radio, and sail the boat, is just not something that is going to end well.

Even coastal, the time it would take to get the person having a heart attack to a hospital is going to minimize survival rates. And the short handed crew problem is still present.

There have been a few AED on boat conversations on Trawler Forum. My two cents is that having an AED, after getting other safety equipment, is a good idea, if one has the budget. Having said that, it's use would be for when at a marina or moored/anchored so that the person could get to the hospital quickly.

A marina we have used quite a bit, has a fire station within a few hundred yards. There is a fire boat in the marina so the fire fighters and EMTs know their way around the place. A hospital is 5-10 minutes away. Having said that, someone having a heart attack in that marina, one will still loose many precious minutes waiting for the first responders to arrive. Some one knowing CPR and having an AED would increase the survival rate.

I can think of two heart attacks on boats. One was shown on a YouTube video channel whose name I can't remember. I think I randomly saw the video. A couple bought a nice catamaran and set sail to the Caribbean. They were anchored at some island with a bunch of other boats and the husband had a heart attack and did not survive though at least one cruising doctor responded. It seemed like a few people with CPR training responded to the boat. I THINK they had an AED but I can't remember for sure since I saw the video years ago. The couple had owned the boat less than a year. The wife said he was so happy during that time...

The other heart attack is a guess as to what killed the sailor. He was the man found in his drifting sail boat in the Pacific. He was found sitting at the navigation station appearing to have been trying to radio for help. I assume he had a heart attack based on how he was found. Being a solo sailor, and well away from anything, his chance of survival was zero.

CPR, even with an AED, can increase the survival rate a bit, but in some circumstances, no so much.

[sv Stella Maris]

Licensed Paramedic here with thousands of calls…

Good post and reminder. Only edit of note for lay-rescuers:

NEVER STOP COMPRESSIONS unless they inhibit AED pad placement, “analyzing”, or “shock advised”.

Rescue breaths have even been removed from lay-person CPR, since a full compression AND recoil of the chest acts as passive respiration.

Pulse Pressure developed from proper compressions takes minutes to build, but only SDCONDS TO LOSE…STAY ON THE CHEST, BREAK SOME RIBS, and DARE TO SAVE A LIFE.

Have a Blessed Day and hug someone you love !

[davil]

Originally Posted by sv Stella Maris

Licensed Paramedic here with thousands of calls…

Good post and reminder. Only edit of note for lay-rescuers:

NEVER STOP COMPRESSIONS unless they inhibit AED pad placement, “analyzing”, or “shock advised”.

Rescue breaths have even been removed from lay-person CPR, since a full compression AND recoil of the chest acts as passive respiration.

Pulse Pressure developed from proper compressions takes minutes to build, but only SDCONDS TO LOSE…STAY ON THE CHEST, BREAK SOME RIBS, and DARE TO SAVE A LIFE.

Have a Blessed Day and hug someone you love !

======================================

thanks
excellent update

[Reeve21]

The guy who taught my CPR class had been revived by it. He was very upfront about the low success rate-- this was a few years ago and I think he was talking in the 5 to 10 per cent range. He was a big proponent of AED.

[wsconner]

Appreciate reading this thread, as I am a survivor of a cardiac arrest (Vfib arrhythmia). Long story short, I came in from a run, talked to my family, and collapsed in the back hall. My wife (not a nurse) knew CPR and my kids did all the right things (911, etc). But the critical technique that saved my life was my wife doing (hard/violent) chest compressions for 10+ minutes along with aspirin under my tongue. Local police arrived first - AED not operable or user error. Local EMT arrived @ 10 min and I was flat-line when they initially hit me with with paddles. Second EMT arrived and got my heart started in the ambulance. Was in a coma for 36 hrs and ended up with 4CABG days later. I had four arteries between 30-70% blocked, but a "runners heart"! Doc's say I'm one in ten million at least in terms of survival. And even more miraculous was I remembered all my passwords, so zero brain or memory damage (but I swear I have those moments I chalk up to the breathing streak ending).

So the take away for me was be paranoid and prepared. I had heart history in family, went to dr's all the time, ate a healthy diet, ran 20-25 miles/wk and cholesterol never over 180. I actually passed a stress test 8 weeks before my incident and an annual physical three days prior. I should have insisted on been on a statin and asking for CAC or agatsan test. And we should have had an AED in the house.

Great thread here and nice departure from the normal banter. Like everything else having to do with the sea, being prepared and ready for the worst case scenario beats relying on luck 24x7x365.

[Lateral Hazard]

I agree with everyone. Learn CPR if you do not know how!
We went camping in SC. Came home and a week later I became ill. No big deal. Just the flu. Lasted a couple days and my wife insisted I go to Dr.
they did blood tests and immediately sent me to hospital.
Intensive care.
Next day my heart stops. Before they can bring in paddles etc. CPR brought me back, 3 hours later same thing, (I messed my self this time, very embarrassing),
Next morning same thing. It was a damn tick bite and it caused me to go septic with erlichiosis. A damn tick bite!
Point is, cruisers need to know CPR.

[s/v Jedi]

An AED is only useful when you are within 15 minutes of a fully equipped ambulance and not much more from a hospital.

For offshore and 3rd world cruising it is much more important to have aspirine aboard. And most boats I ask this don’t have it. Aspirine, from Bayer. You feel a heart problem, stick one in your mouth, lay down and either it works or you continue with the afterlife. But you won't have to live like a plant connected to a machine.

Speaking of medical gear, I have only met one or two boats that had a decent kit aboard and one was a retired MD.

[NRbar]

Frontier paramedic and emergency PA in rural hospitals. CPR and defibrillator success rate depends on the condition of the victim. Many people who experience heart attacks are not fit and or not medically healthy thus the poor CPR and defibrillator success rate. Do not forgo CPR or defibrillation even at sea. A fit and medically healthy person has an excellent chance of survival. I carry a defib on board. My kids have a congenital heart condition and can be saved from cardiac arrest with little effort. Think of young healthy athletes converted with no negative sequela. For medical old timers; I would use a precordial thump along with CPR if I did not have ready access to a defibrillator. Guidelines are that, guides. A few patients were converted with a timely thump.

[SeanPatrick]

I was leaving work one day [about ten years ago] when a co-worker pointed out a guy who appeared to be sleeping, sitting on the sidewalk with his back up against a soda machine. I walked over and said in a loud voice "Hey, man! You need to move along!" No response. So, I clapped my hands right in front of his face and repeated what I had said in an even louder voice. Still no response. I told my co-worker that I thought the guy might be dead and to go inside and get the manager on duty while I called emergency services.


The emergency dispatcher asked me if the guy was warm to the touch. I told her "He's not as warm as I'd expect." (It was a warm day and the guy still had a drop of sweat [I think] hanging from his nose.) She then asked me to place my hand just below his nostrils to see if I could feel him breathing. I told her I felt nothing. She told me to get him on his back immediately and start performing CPR. With the help of another co-worker, I got him safely on his back. The dispatcher instructed me on how to do chest compressions and said that she wanted me to count out loud with her as I did them. I did exactly what she told me to do.


After a couple of minutes, she asked if I would like to try giving him mouth-to-mouth or continue with chest compressions. This guy was relatively young. I'd say maybe in his late twenties to early thirties. Same age I was at the time. He had long, stringy brown hair and he was wearing a dark blue T-shirt, a pair of jeans and some black sneakers. He wasn't filthy or emaciated, but he was thin and looked like he could use a bath. There were no obvious signs of trauma. It looked like he just sat down to rest, nodded off and never woke up. There was a pack of cigarettes and a bottle of Pepsi next to him.


Following a brief hesitation, I blurted out "Compressions!". She continued to count. If I had my wits about me, I would have asked one of my co-workers to go inside and grab one of the CPR masks we had in our first aid kits. But this was the first time I had been in this kind of situation and I didn't know this guy from Adam.


Approximately seven minutes later, the paramedics arrived. An amazingly quick response time. I continued with the compressions until the paramedics took over. They continued with compressions and ventilation.


Sadly, it wasn't enough. I told one of the paramedics that I was sorry I didn't administer mouth-to-mouth. He said "Don't be sorry. Most people wouldn't have even done the compressions." That statement shocked me. I wondered if I had been in his situation, would anyone even try to help me?


Cheers!
SeanPatrick

[Brob2]

I'm a bit shocked with the confusing of some posters (and perhaps readers) of a heart attack with cardiac arrest- they are vastly different things. A heart attack may cause cardiac arrest but they generally don't unless the underlying issue is left untreated. This thread is about cardiac arrest.

In my family cohort of N=1 family study, my father went into cardiac arrest in hospital and was resuscitated by chest compressions. He lived and sailed for 16 more years. Albeit with sore ribs for a while. He looked like George Foreman used his torso for sparring.

CPR is worth learning- you will never know if the guy who collapses near you is one of the 20% who will respond to it.

[Pete7]

Originally Posted by dannc

Even coastal, the time it would take to get the person having a heart attack to a hospital is going to minimize survival rates. And the short handed crew problem is still present.

Well, there is some good news occasionally. I and a class of students saved a fellow yachties life 25 years ago.

Saturday afternoon in August on a boat handling course for divers. Morning spent doing theory, lunchtime spent loading up mine and the clubs dive ribs, including all the accessories we would normally take with us. That included first aid kits and oxygen sets. Launched the boats and motored 100 yrds over to the marina were they would be kept in the water overnight ready for an early start on Sunday morning with practical skills and drills.

Under the low bridge we saw a 25ft yacht drifting about in the channel, then the old man trying to wave and say something. His grey complexion an instant give away. Full throttle to close the gap, we came along side. Crew grabbed the yacht with lots of hands and we pushed it into the nearest empty marina berth with the rib.

Now this is were it gets interesting and all the stars lined up that day. The crew consisted of me, another instructor and serving Warrant Officer in the RN, a fit young RN rating and Sarah a serving nurse instructor who taught intensive care to NHS nurses.

Boat and rib tied up, Sarah moves aboard the yacht and is passed the commercial standard first aid kit and O2 set in 30 seconds. I send young lad to the marina office saying we need an ambulance now! Boy did he run fast.
Other instructor had the O2 set fitted and working, Sarah doing CC.

Ambulance turned up 10 minutes later, and two young crew slowly wandered down the jetty. Sarah said she needed the Defib now and I ordered the crew to run back to the ambulance with me. I grabbed the ambulance 02 set at the same time. Sarah prepped the Defib and then stood back checking before removing the patients arm from the guard rail and asking the rest of us not to touch anything metal on the yacht. Other instructor reported the ambulance 02 set empty and the crew gave me a blank look when I asked if it had been checked on the start of their watch. More blank looks when I asked if there was a spare on the ambulance. We resigned to continue to use my 02 set.

Defib worked heart started. Just then the marina manager appeared so I briefed him only for him to tell me the mans wife was walking down the pontoon. I glanced at the scene before me, mans shirt open, blood from the nose bleed everywhere, first aid and Defit kit plastic rappers everywhere and Sarah still working on him. Not a pretty scene.

Since the pontoon was narrow, I asked the manager to stand shoulder to shoulder with me blocking the wife's view whilst I explained to her what had happened who we all were and what we were doing. She seemed calmed by this. Eventually Sarah agreed to move the patient to hospital and accompanied him in the ambulance. We cleaned up the yacht.

Gentleman survived and on the anniversary of that day sent Sarah flowers for some years afterwards.
________________________________

Take away from this.

1. Don't give up, even if the odds aren't good, but be aware that if the body has suffered a major trauma sufficient to stop a heart or breathing, even your best efforts may be in vain.
2. The defibs as mentioned above could cause serious injury to others on a wet deck.
3. Depending on the type of attack, high blood pressure possible leading to extensive nose bleeds etc. Ignore and just carry on.