Cardiac Arrest

[bedouin]

But how many cases of you heard of recently where people have had to take to their liferafts in coastal waters? I am pretty confident that you are much more likely to have a heart attack on the boat than to have to use the liferaft.

A defibrillator will in increase your chance of survival following a cardiac arrest from 2% to 13%. I'm beginning to think that they might be more cost-effective than the liferaft!

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[dralex]

Even if you were shocked back into a rhythm, you'd probably be dead in a couple of hours anyway if you were that far from Western civilisation. I had the pleasure of trying to resuscitate a young Turkish fisherman last year. We were in Gocek. We had 3 UK doctors and the contents of a Turkish ambulance- worse than useless as they had all the kit but it wasn't serviced, no didn't work. This was a young fit man in ventricular fibrillation with a working defibrillator, intravenous access, drugs, and advanced airway techniques. The nearest. We had to declare him dead in the street after working for him for an hour. I also had to do mouth to mouth before the ambulance arrived- very unpleasnat, especially before dinner.

Point is- 3 UK docs- training in anaesthetics and intensice care, loads of kit and still dead.

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[dralex]

I think the key thing is that the defib is only the first step in resuscitation and you need access to more advanced medical care quickly. in Somewhere like the Solent, this may well happen. Perhaps it would be more cost effective than a liferaft in coastal waters- perhaps we should rethink all the safety kit we are encouraged to carry. I suppose it all boils down to personal assessment and perception of risk.

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[steve_cronin]

But do you deny that ones chances are better WITH than WITHOUT?

Sooner spend three grand on that than a daft high speed rib tender, for example.

Steve Cronin

<hr width=100% size=1>The above is, like any other post here, only a personal opinion

 

[dralex]

Can't deny it, but it's marginal in the situations we're talking about. Is it worth the money? I certainly wouldn't buy one.

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[Roberto]

that's very professional, I mean intervening on the spot:

A doctor friend of mine was coming back by plane with other *fifty* doctors from a convention, when the steward asked "is there a doctor on board, we have a problem with a passenger"

well, no one raised a hand, they had to ask four times..



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[bedouin]

The point is that the defib will stabilise things long enough for external help to arrive - again rather like a liferaft.

It's not something I've though about before but I'm sure prices will fall and it wouldn't surprise me if these didn't start becoming common in homes within 5-10 years

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[dralex]

Common in homes??? Hope not. That would be like keeping a dailysis machine in the garage in case your kidneys pack in. There is a lot of evidence which definately supports community defibs in saving lives. As you say, they may prolong things long enough for specialist medical intervention to arrive. Even when the paramedics arrive, that is still not definitive medical care and there is still the time taken in getting you to hospital. My argument is that when you're on a boat, how long will it take you to get to the definative medical care. Defibs definately have a role insociety, as the things they are good for become more difficult to reverse with progressing time. On a boat, it could be several hours and you need more intervention than just a defibrillator.

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[bruce]

Re: Red wine ..

defibs are in every state police car here in florida , even most state buildings have one, got my machine last month. if you are 'dead' they won't work, but if in fib state, they will bring you back. the basic one over here goes for about $1400, and is to be used by certified people, like me, but are simple enough for most anybody to use. they are almost automatic, they tell you to connect parts to body, then they check body to see if necessary, and if so will instruct you to push the button. them machine checks body and states whether repeat is necessary or not, if not, will not fire off another charge. believe what you want, but they DO work. just can't do it to yourself, need second person.

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[bedouin]

Why not? - we already have one in the office next to the coffee machine.

70% of heart attacks take place in the home - it is not unreasonable to assume that their cost will reduce to sub £1000 within a few years.

I am sure that I am thousands of times more likely to die of a cardiac arrest at home than use my liferaft - so in those terms it would represent much better value for money.

The point of the defibrillator is that if fibrillation starts you are likely to be dead in 10 mins, and only a defib can stop it. Once normal rythm is re-estabished there is a lot more time to get help - and a delay of a couple of hours getting to hospital is not likely to have a major impact on survival rates.


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[Allegro]

Interesting that as far as I can make out there are two medics in this thread - dralex and myself - and neither of us are very keen on the idea - we just don't seem to think it would make much difference. But then again maybe its just the cynisism that all doctors seem to have. When I first saw the title of the thread I though it was going to be about the very black comedy "Cardiac Arrest" that aired a few years ago. Very funny, and definitely very cynical!!

Cheers
Patrick

<hr width=100% size=1>Sailing a Victoire 25 on the Scottish West Coast

 

[jimi]

Erm ... think you'll find the eponymous Cutter is some sort of amateur sawbones as weel ..

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[MainlySteam]

Well learn something every day - now understand what dralex means - actually was trying to work out what SciFi story was a character in /forums/images/icons/blush.gif. Sorry Dr Alex.

Not knowing much more than about sticking plaster in the medical department I think I will stick with the Dr's and will not be rushing out to buy a defribrillator.

John

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[dralex]

The main argument is- would you spend your money on one and if so, what are your chances of having to use it. The initial part of the thread was about use on boats. It depends what you feel your chances are of having a sudden cardiac event- if you are fit and healthy, then it's very unlikely. If you are overweight, smoke, have high blood pressure, diabetes, previous cardiac problems then perhaps there may be an advantge in having one at home. It's a bit like having the new govenrment leaflet about terrorist attacks- you could go overboard preparing for such an event, but what are the chances of it actually happening where you live or work? It's about assessing the likelyhood of an event- media hype and portrayal these days makes people far more aware of very rare events, and therefore nervous of them happening to them.

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[dralex]

Cutter is far more enigmatic than dralex- it's just there were so many alex's and I didn't think to use my boat name before it was too late.

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[jimi]

Actually I thought the defrib was a spiffing on board lifesaving tool .. picture the scene .. you have sank in shark infested waters climbed aboard the liferaft with the trusty defrib when a couple of great whites scent supper ... as the charge towards you jaws agape you grab the defrib and clap a pad over each of their ears .. bang bang .. that's scared the buggers off ... couple of months later having eaten the emergency rations & the crew your on the point of starving to death when suddenly the trusty defrib comes to mind .. pads in the water one each side bang bang and suddenly there is a feast du mer floating beside you .. yes truly a life saver the defrib and no liferaft should be without one. I shall ensure that it becomes part of the Solas requirements

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[MainlySteam]

Actually in reflection I may have sold myself short in the medical knowledge department. I am reputed to be very good at non invasive frontal lobotomies - the kind along the lines of making uncooperative employees in organisations cooperative - chop, chop.

But that probably just goes to show that I have very little knowledge in the heart department.

John

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[bedouin]

I tend to agree with what you are saying - but the fact remains that you have a liferaft (as do I). You have yet to convince me that that is more likely to save your life that a defib (assuming coastal / channel sailing).


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[MainlySteam]

Oh my goodness Jimi, you just about sent me into convulsions to an extent nearly making me eat my words about not wanting a defribrillator. Very clever.

John

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[dralex]

I do agree with you, hence my point about assessing all emergency equipment that we're pressured to have. I'm not trying to argue that a liferaft is more likely to save you than a defib. They're both bits of kit that hopefully will never get used.

I think Jimis suggestion is a good one, certainly more useful IMHO. By the way Jimi- do you keep changing your picture or is it different Jimis?

<hr width=100% size=1>Life's too short- do it now./forums/images/icons/wink.gif