Automatic External Defibrillator Training

Ben Field

Didn't really know which Furom to put this in so...

Hi All,

Last night fellow Forum and club member Phil Siswick and I took part in an AED (Automatic External Defibrillator) course in London run by BSAC.

Some of you may already be aware of and trained on these but I've posted this here because I was impressed and would be comforted to know they where available on dive boats.

What we learnt was that AED's are easy to use tool for BLS (Basic Life Saving, (thats what we now call ) Think of them as the Ipod generations version of the big electro shock pads you see the staff using on
Casualty or ER.

To cut a long story short- you turn it on, its verbally tells you
what to do- through attaching pads to the victim, to actually talking
you through giving chest compressions and rescue breaths, if it deems
necessary it is capable of shocking the patient in an attempt to get
the heart out of fibrillation (not pumping properly.)

The course was only two and a half hours, which doesn't sound much
but it gave time for a practical review of BLS skills and knowledge (some people where alittle rusty of course) and then how to
give BLS with an AED assisting.

These are rather expensive machine to buy and maintain (about £1500
start up costs followed by consumables of about £150 every two years)
but I guess it could be considered as we consider the O2 kit, which
is relatively expensive to buy and maintain but performs a vital life saving function.

We agreed that in addition to the BSAC Dive Track device (due next
year) the AED should be on the shopping list of many dive clubs and boats, FWIW I've even reccomended they buy one at work (Far more chance of a
heart attack here!

Probably the best news was that unlike O2, once you've completed this
course you can use an AED in any situation, you are not limited to
the diving enviroment. (At least in the UK, laws where you live might be different)

No doubt the medically trained folk on here might be better
suited to give pros and cons of these devices but IMO they seem an
excellent tool.

PS- Although our club doesn't have one (yet) if people locally (see- hugsac online | Main / Hertfordshire Underwater Gogglers) are interested we could organise a course on one of our club nights, cost is about £15 for BSAC members, £45 for non-members)

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Beanie

Nice one was reading about these on the BBC the other day: BBC NEWS | England | Somerset | Villages get new heart machines

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deanc

You were taught (can you remember) the chance of reviving a stopped heart (without) and (with) the defibrillator?

The medico's will know this? It is a real siginificant improvement we were told over CPR alone.

Ben Field

If your heart is stopped its stopped, short of serious medication (Adrenaline and Atropine?) plus a shock I don't believe there is much that can be done outside of an ER.

Here (UK) the term CPR has been dropped because the chances of "resusitating" someone in VF or Flatline are low, really all you are trying to do is keep the organs oxygenated till a Doctor/Paramedics arrives, hence BLS (Basic Life Support) Basic being the operative word!

The defibrillator stands some chance of shocking and hence stopping the heart allowing its internal pacemaker (the bit in your heart that generates the electric signal to make it pump) to restart with the correct "beat" (IIRC)

What was stressed is that the time frame for successful defibrillation falls rapidly, having your own unit means you can target the first 5minutes or less (it takes about 30-40 seconds to setup) Even with good transport links Paramedics are 10-15minutes away when you'll be down to a 10%'ish chance of survival, which was pretty gloomy

Even if its not required to shock a patient straight away you will probably have only hooked someone up who is in a very bad way.
The AED's we tried periodically monitor the heart and revise their advice whether a shock is required, in between times they provide useful advice and assistance giving the chest compressions and breaths, something most people will be out of practice with I'd imagine. (It has a speaker and gives the correct frequency and count of compressions and timing for the breaths)

Like a Sat-nav the voicing is alittle amusing to begin with, less so once you realise the situation you might be listening to it under.

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h2odragon1

AED"s have a much higher survival rate than CPR alone. It is the electricity that improves survival rate, the sooner the better the survival.
I'm a nurse, and we have to keep our certification up to date.
Not all dive boats have these available. Perhaps a future regulation.

PhilSiswick

We were advised to refresh ours, with suitably supervised practice, annually.

Cheers,

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Phil (WSKD 0001)

I have always felt that the dive I am on is not nearly important as the dives I plan to be on the rest of my life. Tom Rose, 2007

The person who gets the farthest is generally the one who is willing to do and dare. The sure thing boat never gets far from shore. Charles A. Lindbergh

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Tom Rose

I strongly suggest having one. All 23 of my staff are trained on CPR, AED, and Oxygen delivery (DAN course at LDS). For over 3 years I had have an AED unit and oxygen supply at the office and one in my home that travels with me.

With an AED you increase the success rate of saving someone by more than an order of magnitude.

The AED CPR training does take a one day refresher annually but it is certainly worth it IMHO.

On the oxygen side, most of us have it available, pick up an extra tank on E-Bay and a regulator that will flow up to 15 liters per minute if you are not going to set up a little rebreather for the purpose, in that case an adjustable to 7 liter per minute regulator will do the job.

Having had the occasion to give my 14 month grandson CPR, not only scared the hell out of me as I held his little non breathing body in my arms, made me a believer. Beside me was my Daughter, Son, Son in Law and wife who were all trained. Everything worked out just fine because I was able to start in less than a minute.....By the time the paramedics arrived he was in his mommas arms crying and I was trying not to have a heart attack.

Just look around you at the people you love and you dive with....Its an easy decision.

Tom

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SteveJ

Well said and well done.

As a rural family doctor (GP), I have carried an AED for the past 10 years. It is hugely comforting to have in my car esp when it routinely takes 25 mins for the paramedics to arrive. It has been used on about 10 occasions. On the two occasions that the patient had a shockable rhythm (ventricular fibrillation or ventricular tachycardia) they were sucessfully cardioverted and lived to leave hospital. All of these were elderly folk with primary cardiac illness. The chances of success increase hugely in younger patients who arrest for non-cardiac causes, such as drowning and in those who are treated with BLS and a AED soon after the incident.

In summary, AED's on a hard boat will probably save lives and £2000 (US$4000) is a small price to pay.

Steve

Skipbreather

I’m not sure about other airlines, but at ours we carry them on EVERY aircraft (along w/ extensive medical kits- called ‘stat kits’ by the ER folks). We probably break out one a day somewhere in our system. All of our flight attendants receive refresher training as part of their annual recurrent training.

One advantage not yet noted is that some models, like the ones we carry, have what amounts to a rudimentary EKG readout on them. I remember several years ago on a San Francisco- Chicago flight we had a passenger in a really bad way. AEDs were pretty new then. A volunteer MD aboard was at first reluctant to let it be hooked up to the patient but when he saw the trace he had the info he needed to say no shock needed, but get him on the ground NOW. I delivered the passenger into the back of an ambulance in Omaha, NE, in 21 minutes from 100 miles away and 37,000 feet up. We were going about the speed of heat.

Ken

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Tom Rose

Under 2 grand in the US........

Tom

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The 50-50-90 rule: Anytime I have a 50-50 chance of getting something right, there's a 90% probability I'll get it wrong the first time.

www.atlimp.com