Defibrillators

[rubberduck]

god it gets more complicated...

its one of those things, the more you know the less you know..

Isn't it just. Nicky is a first aider so will have chats & find out whats what.
Having been through years of Ill health, I'm not about to go down to something like that now things are hopefully going in the right direction. I don't intend to follow in the footsteps of Kieth Floyd, particularly after buying a new boat.
At work we have given all employees Bupa as a result of my experiences, so might as well follow up with a defib.
Makes them think we care

 

[MrB]

My friend lives in a small village in Devon and they clubbed in together to get one, it lives on the village pub wall. He was in the pub one day and collapsed with a big heart attack, the locals used it on him and got him back so they are worthwhile. It was only a year or two ago and was in the local papers.

 

[jrudge]

Not sure it is zero - we bought someone back and so did the machine in MrBs pub.

I dont doubt oxygen etc is preferable, but where do you stop ( or start) - especially as the machines are meant to work with nil training. Stick on the pads and the machine decides, and then talks to you as to what to do - which has to be better than nothing ( indeed as someone mentioned 1% to 10% is 10 times better odds!

They seem to give quite a lot of automated bang for buck, and of course they always work in the movies!

I have an app on my phone called ALERTER.

It tells you where all defibrillators are AND if you push the emergency button will summon local people who are registered ( they are never move than 300 mts away in London ) as able to assist in a medical emergency- so it is peer to peer medical as opposed to calling an ambulance.

I did wonder about my wifi sending out "I have a defibrillator on board" as a wifi name.

 

[Portofino]

There’s nothing in my post #17 I want to change when read in whole .
Just please revisit the 1 st sentence and the last sentence ( excluding ** )

Ok we can argue about the stats - we’ll any stats for that matter .

 

[MrB]

Porto makes some valid points in post #17 re: equipment. Medical grade O2 canisters look cheap enough on the BOC site, the resus bags and a portable suction device are also cheap so would be a good addition to the defib. A quick peak on the Ocean Safety site and it looks like they will supply the whole kit but i guess they will be more expensive.

 

[MrB]

I have an app on my phone called ALERTER.

It tells you where all defibrillators are AND if you push the emergency button will summon local people who are registered ( they are never move than 300 mts away in London ) as able to assist in a medical emergency- so it is peer to peer medical as opposed to calling an ambulance.

Is that just for Apple phones? I can't find it for android?

 

[Momac]

is this it
https://play.google.com/store/apps/details?id=com.goodsam.responder&hl=en

 

[Momac]

sorry . i thnk its this
https://play.google.com/store/apps/details?id=com.goodsam.alerter&hl=en

 

[MrB]

is this it
https://play.google.com/store/apps/details?id=com.goodsam.responder&hl=en

I did see that one but thought it was for doctors and nurses etc.

 

[MrB]

sorry . i thnk its this
https://play.google.com/store/apps/details?id=com.goodsam.alerter&hl=en

Ok cool thanks, it's a great idea. :encouragement:

 

[jrudge]

Thats it - same logo - different name.

 

[A1Sailor]

You need to be completely competent at CPR and quick to start CPR within say 1 min - and to do that take training on how to diagnose the unconscious none breathing no cardiac out put casualty.

Oxygenation is paramount to save brain death .
So you ideally need a pressurised 02 source and a bag to deliver it or at least assist with the breaths in CPR .
Just to be clear it’s CPR first and foremost .You never stop that ,the AED is not a magic wand .
An AED is usefully if it’s ready with in 5 mins of the collapse and fitted correctly.
Then there’s another issues gastric reflux to deal with .You ideally need a portable suction device to clear the oral cavity of the gastric contents that often reflux .
A post-mortem report of gastric contents forced into the bronchi does not make pleasing reading by the relatives .

My advice would be

Carry some GTN spray in your 1st aid box
If you want to go down the defibrillator route AEDs seek training in
CPR 1 st master that and keep up refresher courses
Carry pressurised O2 and a bag , **
Carry a portable suction device

Success rate of public CPR with or without a defibrillator is low single figure to zero %
Hospital CPR / defibrillator a bit better depending on which study 15 % is a fig banded about .

So why do we do it .?

Medico legal reasons —— so you can sit at a coroners inquest with the family present and look them in the eye and say you did everything you could .

I can’t stress how time is very important in diagnosing the none breathing zero cardiac output casualty then starting CPR along with oxygen infusion asap .

** intubation- go and learn how to do that and carry intubators 3 sizes

There’s nothing in my post #17 I want to change when read in whole .
Just please revisit the 1 st sentence and the last sentence ( excluding ** )

Ok we can argue about the stats - we’ll any stats for that matter .

The Resuscitation Council (UK) Guidelines for adult basic life support and AED don't recommend oxygen but it is in the advanced life support guidelines. Both are here: https://www.resus.org.uk/resuscitation-guidelines/
Edit: If your worry is "medico legal", these guidelines will be what a UK Coroner might expect you to have followed.

 

[NoviceRod]

Maybe NiviceRod will be able to comment further - I think he knows more about how it was acquired.

The Defibrillator was acquired through British Heart Foundation with a village project to raise the £400 to purchase it plus cost of suitable cabinet and signage. Our local retired GP carries out regular checks on the equipment.

The key point to note is that use of a defibrillator is only one part of the rescue procedure, with heart massage being the most important. Training is essential.

I guess such equipment would be of limited value on a boat unless there is someone else there to use it when needed. It is obviously not a DIY task!

 

[A1Sailor]

Really, almost zero chance of saving someone with a public defib?
If you get to someone within a couple of minutes with a public defib their chances are actually pretty good. Actually better than 50/50. Your odds of surviving if there's no defib and you wait for an ambulance are single figures so having one available is definitely worthwhile. The defib talks the operator through how to use it and it only shocks if it needs to.

There's some Scottish Out-of-Hospital Cardiac Arrest audit data here: http://www.gov.scot/Resource/0052/00523287.pdf
and in due course UK data here: https://warwick.ac.uk/fac/med/research/ctu/trials/ohcao

- 25.1% of the 91.1% patients in whom the rhythm was known had a "shockable rhythm" - VF or VT. This is similar to other audits apparently.
- males were more likely than females to be in a shockable rhythm - almost 30% vs less than 20%. Graph on page 15 (17/48) at http://www.gov.scot/Resource/0052/00523287.pdf
- 40% of cases were recorded as having had bystander CPR initiated before the arrival of paramedics
Outcomes:
Return of Spontaneous Circulation: 12.2 - 16.7%
Alive at 24 hours: 9.3 - 12.7%
Alive at 30 days: 6.2 - 8.4%
Alive at 1 year: 5.9 - 8.0%
The reason for there being 2 different numbers for each is explained in the report.
http://www.gov.scot/Resource/0052/00523287.pdf

Have you some data to support the assertion that chances (if a debrillator is available within 2 minutes) are better than 50/50?
Chances of what, exactly? And from what?

There was a Lounge thread here:
http://www.ybw.com/forums/showthread.php?490619-Defibrillators-really-do-work-!!

 

[adey]

This thread is about whether or not it's worth having a defib handy on a boat, a valid discussion given recent tragic events.
Porto's post is just wrong.
There's a very good chance of bringing someone back with a defib, even if the person using it has no training, as long as it's used within a few minutes of the attack. There's more than enough oxygen in the atmosphere, even after being breathed out of someone. Having an oxygen tank might be useful but probably best left to the paramedics. The NHS advice is not to give mouth to mouth if you don't want to. Just giving chest compressions is enough to improve their odds.
There was a commercial skipper locally whose life was saved at sea by a defib.
If you can afford it then why not?

 

[Nigelpickin]

This thread is about whether or not it's worth having a defib handy on a boat, a valid discussion given recent tragic events.
Porto's post is just wrong.
There's a very good chance of bringing someone back with a defib, even if the person using it has no training, as long as it's used within a few minutes of the attack. There's more than enough oxygen in the atmosphere, even after being breathed out of someone. Having an oxygen tank might be useful but probably best left to the paramedics. The NHS advice is not to give mouth to mouth if you don't want to. Just giving chest compressions is enough to improve their odds.
There was a commercial skipper locally whose life was saved at sea by a defib.
If you can afford it then why not?

+1

 

[adey]

There's some Scottish Out-of-Hospital Cardiac Arrest audit data here: http://www.gov.scot/Resource/0052/00523287.pdf
and in due course UK data here: https://warwick.ac.uk/fac/med/research/ctu/trials/ohcao

Have you some data to support the assertion that chances (if a debrillator is available within 2 minutes) are better than 50/50?
Chances of what, exactly? And from what?

These refer to people's chances of surviving a heart attack outside of hospital and indeed your chances are less than 10% The reports are nothing to do with public AEDs.
A quick Google of 'Public defibrillator survival rates' gives these pages...

https://www.defibshop.co.uk/facts-and-figures
"If a defibrillator is used and effective CPR is performed within 3-5 minutes of cardiac arrest, their chance of survival increases from 6% to 74%"

https://firstaidforlife.org.uk/why-defibrillators-save-lives/
"If a defibrillator is used within 3-5 minutes of cardiac arrest, survival rates jump from 6 per cent to 74 per cent"

http://circ.ahajournals.org/content/136/10/954
"Despite recent advances, the average survival after out-of-hospital cardiac arrest (OHCA) remains <10%. Early defibrillation by an automated external defibrillator is the most important intervention for patients with OHCA, showing survival proportions >50%. "

https://discover.dc.nihr.ac.uk/port...ed-to-out-of-hospital-cardiac-arrest-survival
"The UK survival rate is around 8%, which is lower than in other developed countries. This review found that bystander assistance through cardiopulmonary resuscitation and attaching a defibrillator increased it to 32%, compared to 12% for police or firefighters. Survival rates were even higher for people who had a rhythm that could be treated by a shock from the defibrillator, at 53% following intervention by bystanders. The higher survival rate seen following bystander assistance was probably due to the shorter time response time"

 

[A1Sailor]

These refer to people's chances of surviving a heart attack outside of hospital and indeed your chances are less than 10% The reports are nothing to do with public AEDs.
A quick Google of 'Public defibrillator survival rates' gives these pages...

https://www.defibshop.co.uk/facts-and-figures
"If a defibrillator is used and effective CPR is performed within 3-5 minutes of cardiac arrest, their chance of survival increases from 6% to 74%"

https://firstaidforlife.org.uk/why-defibrillators-save-lives/
"If a defibrillator is used within 3-5 minutes of cardiac arrest, survival rates jump from 6 per cent to 74 per cent"

http://circ.ahajournals.org/content/136/10/954
"Despite recent advances, the average survival after out-of-hospital cardiac arrest (OHCA) remains <10%. Early defibrillation by an automated external defibrillator is the most important intervention for patients with OHCA, showing survival proportions >50%. "

https://discover.dc.nihr.ac.uk/port...ed-to-out-of-hospital-cardiac-arrest-survival
"The UK survival rate is around 8%, which is lower than in other developed countries. This review found that bystander assistance through cardiopulmonary resuscitation and attaching a defibrillator increased it to 32%, compared to 12% for police or firefighters. Survival rates were even higher for people who had a rhythm that could be treated by a shock from the defibrillator, at 53% following intervention by bystanders. The higher survival rate seen following bystander assistance was probably due to the shorter time response time"

Thanks - it certainly adds to the debate.:encouragement:

 

[henryf]

A very worthwhile post and one that might genuinely save someone's life.

It's one of those things where you could argue until the cows come home but ultimately if the time ever came to get involved surely something is better than nothing if you feel you can afford it. I do agree with Pete that from our own perspective the first thing to do is strip off, stand in front of the mirror and ask if like looks like a heart attack waiting to happen. I suspect we are all smack bang in the middle of the target zone so shedding weight and getting your heart working again in a controlled manner will pay dividends.

The recent news was horrible and most tragic. If anything good can come out of it, whether through investment in hardware or ourselves it would go some small way to redressing the balance.

Henry.

 

[MrB]

A very worthwhile post and one that might genuinely save someone's life.

It's one of those things where you could argue until the cows come home but ultimately if the time ever came to get involved surely something is better than nothing if you feel you can afford it. I do agree with Pete that from our own perspective the first thing to do is strip off, stand in front of the mirror and ask if like looks like a heart attack waiting to happen. I suspect we are all smack bang in the middle of the target zone so shedding weight and getting your heart working again in a controlled manner will pay dividends.

The recent news was horrible and most tragic. If anything good can come out of it, whether through investment in hardware or ourselves it would go some small way to redressing the balance.

Henry.

Well said as usual :encouragement: