savageseadog
Well-Known Member
One of my older crew has instructed me that if it's a vegetable job he's to become a "man overboard".
Heart attack procedures aboard
- Thread starter ianat182
- Start date
PilotWolf
Well-Known Member
In nearly 15 years as a (UK) paramedic, including the last 5 as a rapid response vehicle driver, I can probably count on one hand the number of patients I attended that survived a cardiac arrest outside of hospital.
Two of those were in the same street as the A&E department. Ironically one was on her way home from her cardiac clinic appointment!
No idea how many I attended but we averaged 8 - 10 calls, (of all types) per 12 hr shift.
W.
Two of those were in the same street as the A&E department. Ironically one was on her way home from her cardiac clinic appointment!
No idea how many I attended but we averaged 8 - 10 calls, (of all types) per 12 hr shift.
W.
Last edited:
D
Deleted member 36384
Guest
I was in charge of bring on hire a new floating drilling ship. We were on location and part of the safety set up was to test emergency response to medical conditions. The ship had a high tech ECG system that fed data real time to a hospital in Stavanger. We proceeded to get the fittest guy we had, some Nogy Viking who lived in the gym. Wired him up and and contacted the Hospital. They could recieve all the data and the real time thing was ticked off as accepted. We then got a call from the hospital, "You need to medivac the guy on the ECG machine!". We all start assuming he is pumping himself full of steroids or something, proceed to call off a helicopter and send him to hospital in Stavanger. Later that night, we get a call, you need to calibrate your ECG machine. Nogy Viking was allowed to rape and pillage for a few nights on full pay and expenses before the next scheduled chopper arrived back at the rig.
ballyabroad
Well-Known Member
Similar comments from a colleague of mine who was a paramedic for 20+ years, he knew of only 2 who survived a cardiac arrest that he attended in that time. After retiring 4 years ago he's had another 2 survive, just being a lay person but with good access to a defib and the casualty being lucky that he witnessed the collapse.
Of the 7 arrests I've been involved in (not a medical professional), only the most recent survived, the others would have died even if they'd been in hospital due to the nature of the medical conditions/trauma that caused the arrests. The 'lucky one' is only 2 years older than me, mid 40's, and decided he was going to have an MI in front of me. 112 call straight in, me doing effective CPR for 20+ mins before the medics arrived (country bumpkinland). Shocked 5 times on site, all of us working together until we could get him in to the helimed in a stable condition. The pilot made a good call to go to a more distant hospital, but downwind i.e. quicker. Another 10 or so shocks on the way and in theatre awaiting his stents.
Long and short, he popped in to see me the other week, off to New York with the kids on the proceeds of his critical illness insurance payout! Good on him. He could remember naff all about any of it, which is a good thing. So if the links in the chain are all present then there is a chance. In essence yes I bought him a little time until the medics could get there and do there bit, and as the surgeon told him prevented his heart and brain from being seriously damaged from hypoxia. Couldn't say the same about his ribs though, apparently they were a bit of a mess!
So do I carry a defib on board? Yep, one in the boot of the car, which usually goes on the boat. Most of my crew are proper candidates for a heart attack and I mainly sail coastal, so to me it makes sense that we'd stand a reasonable chance of keeping the 'unlucky one' ticking over until the surgeon can get hold. Yes I have a laminated prompt card, mainly in case it's me that hits the deck. For Offshore sailing, I probably wouldn't purchase a defib especially.
pmagowan
Well-Known Member
The rule is; treat the patient, not the ECG.
gjgm
Well-Known Member
And of course "survive" does not necesarily mean in pre-attack health. At all. Brain deprived of oxygen, sort of thing...
mjcoon
Well-Known Member
Anybody concerned about that should at least read the article on pages 30 & 31 of New Scientist of 2nd January 2016. It explores the unreliability of such diagnoses.
Mike.
mjcoon
Well-Known Member
Alan ashore
Well-Known Member
+many
D
Deleted member 36384
Guest
Yes, thats why he was medivaced ASAP. After he was found to be fit and well onshore at a regular hospital, the conclusion was that the new machine was not calibrated it was a false reading, the man was fit. Maybe I was too subtle, the man was fit, we medivaced him because the machine ....... oh never mind.
alant
Well-Known Member
Get it in writing.
laika
Well-Known Member
Nothing as relevant as Cardiac DIY. DIY ECT perhaps following some of my father's home electrical DIY and a conversation which went something like "Dad, isn't it a bit dodgy leaving these wires sticking out of the wall like this?" "Don't worry son, they're not live". Now admittedly I shouldn't have tried checking that he was right....
pmagowan
Well-Known Member
No, they treated the ECG. The man was fit, had no symptoms and I presume no cardiac history. If they treated the man, not the ecg they would have known that it was the ECG that was problematic in the first place. First thing to do, after taking a history to confirm that the man was not having a heart attack, is to stick another fit man in the machine and see what comes out. Could have saved a lot of time and money!
It is an old adage of cardiology that you should not rely on an ECG. ECG's can be wrong and technique is important. You ask the patient about their symptoms and even with a clear ecg you treat them according to the clinical picture....oh never mind!
D
Deleted member 36384
Guest
It's an oilfield story embellished for entertainment purposes but thanks for your comments anyway, educational.
pmagowan
Well-Known Member
Never let the facts get in the way of a good story!
The important point is to focus on the patient, not the technology. That goes for AEDs also. Just because the AED is happy does not mean the patient is so you still need to tend to their symptoms. Obviously it is not such a big problem when the machine says they are dead as they sip their cuppa tea!
D
Deleted member 36384
Guest
This is what actually happened. Noggy man, super fit, remote monitoring, hospital doctors contacting company doctor, man visiting specialist all true. Medivac, ECG calibration, nights on the raz, not true. What I believe happened is that the hospital saw something on the ECG that indicated a past heart issue or maybe a current heart issue, I don't really know what to say about the ECG, it was back in 2002. The company doctor was informed by the hospital and he advised the man that he should see a specialist. It turned out he had 'athletes heart', something to do with a big capacity, strong heart that has been developed as a result of excessive cardio training, this apparently may give certain indications that needs a test to eliminate a heart problem. The bloke was an Iron Man competitor and cycled stupid distances in his spare time. He turned out to be okay in the end.