Medical Equipment AED Onboard

[GoingWalkabout]

Originally Posted by GoingWalkabout

Yes I can understand how some can see modern day medical devices as somewhat Science fiction. Much of what was science fiction in the past is reality today. Good example is space travel itself and don't forget the Star Trek communicator... Looks a lot like the flip mobile phones. Outdated now but cutting edge a few years ago.

So getting to the point of your posting and that which disturbs me the most. You are so wrong in saying that an AED is only good in the hands of trained experts. The facts show you are seriously wrong. Even an untrained pedestrian using AED will have a higher success rate then if you waited for the EMS to arrive. Please do not spread ignorance on a subject that can cost lives. And on this point I am so very serious. If you want to stick your ill informed uneducated head in the sand than go ahead but I ask why are you going out of your way to talk other people out of having a known life saving device? Maybe some people can't afford an AED and are trying to rationalize why they don't have one. That's OK but please don't peddle your dangerous ignorance. Sorry but I take saving lives very seriously.

Sorry Weaves for saying your sticking your head in the sand. I don't mean any offence. I tried to go back and edit my post but I was to late. As I said the subject of saving lives is very serious to me. Have a nice day.

[weavis]

funnily enough, this afternoon, I had a person with nasty readings on the EKG......sent him in and they will be doing a triple bypass ASAP. No pain except when walking he had a tightening in the throat and jaw. If he arrested, I dont think anything would have saved him. 95% block.

Thanks for the apology, In between patients, I responded to your original statements and rather than edit it or spend time on it.. I will post it to you in PM as is. Im not irritated any more and as emergency medicine was my field, I agree the usefulness of certain tools. But you only need them when you need them, and I dont feel that to push them as a REQUIRED device is correct. The long PM will explain why.......

[Therapy]

Originally Posted by Leo Ticheli

We use a rebuild service for our camera batteries, http://www.ritterbattery.com; the guy does excellent work with a very fast turn-around. Our engineer used to rebuild the batteries for us, but Ritter does it for close to the cost of the replacement cells, so we use him now. I don't know if he will work on the AED batteries, but I intend to give him a try when the time comes.

I do appreciate the willingness on the part of sailors to warn their fellows of potential problems or dangers, but I have to admit I'm quite puzzled by the strident tone and persistence from those apposed to certain safety equipment. I just don't understand the motivation.

Fair winds,
Leo

It is because of the rationalization.

In the context of a cruising boat it borders on delusional. I mean really. There are multiple things to spend a grand on long before you reach the bottom of the list. Except maybe to the guy that said he, his wife and many friends have heart problems.......well, best of luck to you all. I would have one too if I KNEW that is what is probably going to take me out. At any minute!

The best I could find is a 20% increase in positive outcomes. But this is ONLY if time and training parameters are met.

The average response time for first responders once 911 is called is 8-12 minutes. (I don't know who got that number but I bet it is a little overly optomistic) It Certainly won't happen unless you are tied to the dock in a marina that is close to a "station" or, yep, you have an AED of your own.

For each minute defibrillation is delayed, the chance of survival is reduced approximately 10%. (this says defibrillation. Not getting things ready, assessing, hooking up, etc.)

So buy this one. Easy-peasy battery replacement.
The AED Plus is powered by 10 lithium batteries that can be purchased at any retail camera store

Automated External Defibrillator - AED Plus - AEDs for CPR - CPR Feedback

[Therapy]

This one will lead many to the wrong conclusion.

Fact VI: If an SCA victim receives defibrillation through an AED within the first minute, the survival rate is 90%.

Because it does not qualify the pt population or after care properly. This is necessary for the discussion about an AED on a cruising boat.

Bye all.

[JRM]

Originally Posted by socaldmax

The device has no idea if it's being powered by an original battery or a completely different battery, all it needs is the proper voltage and at least the same amount of ah rating.

I was thinking in terms of replacing it with a Lipo RC car battery rated at 12v and 5ah. It might actually perform better, because the Lipo can provide very high current draw if necessary. I already have a charger for it, and Lipos hold their charge very well, I wouldn't need to recharge it very often.

They sell the Lipo batteries in a variety of different shapes, I could probably find one that would fit inside the compartment with no modifications to the case.

I'll suggest keeping the battery case and replacing the cells. Our units have some wonky electronics in the batteries that respond to periodic self testing. That way it can alert us to a battery problem without having to open the case. Your fake battery would put our unit in failure mode. Might want to check what embedded gizmos the unit has before buying cells, or advising someone to do so.

It might seem odd, but our models power up on case opening, so every daily check was draining batteries. It also immediately starts recording all audio and its sensors and parameters for the eventual court case. We went to a weekly / after each use check sheet so it doesn't have to be opened every day.

Also, in addition to the battery expiration, the pads themselves expire as well. Probably not as a big a deal in the private setting where the likelihood of litigation isn't as looming, but the adhesives will eventually dry out.

There have been a lot of numbers about "survivability" thrown around in this thread, and while I can only comment on our own department's stats, I will say that survival rates in absence of neurological ratings are worthless. Here in our area they grade patients on a scale of 1 to 4, with 1 being the best or "insignificant lasting deficits." We only count Grade 1 and 2 in our survival rates, as 3 and 4 rarely ever leave the hospital even though technically they "survived."

JRM

Sent from my SAMSUNG-SM-G900A using Cruisers Sailing Forum mobile app

[JRM]

Although firmly in the "last on my list" group, I'm surprised no one has mentioned the utility of the implanted AED units yet. Lots of people with recurring arrhythmia get them. We see them pretty regularly, and they do work.

These things thump people immediately when they decide it's needed, with no warning. Lots of times the patients are asymptomatic, and it shocks them (sorry for the pun, I couldn't resist) when it goes off. I've seen them malfunction a few times, where they're continously shocking as soon as they charge. But even then they aren't damaging the patient, although it looks really bad.

The implanted AEDs probably save more lives more regularly than all the EMS and bystanders put together. Nothing beats "instant" in the brain death curve.

JRM

Sent from my SAMSUNG-SM-G900A using Cruisers Sailing Forum mobile app

[GoingWalkabout]

For the Doctors and Nurses you get to see mostly the other kinds of cases for which an AED would not work for. You don't get to see the sudden death cases that don't even make it to the ICU. The AED is for those who present with a sudden arrhythmia or heart stoppage for which a quick response in a short time of the event shock does save many lives.

Im not suggesting that it should be mandatory equipment on board every boat. I am not saying that everyone should have one in their home. These are personal decisions like having a fire extinguisher on your boat or for that matter in your kitchen at home if you do a lot of deep frying. :big grin:

From Doctors, Nurses too EMT's they arrive on the scene way too late to save the typical potential AED survivor. And yes AED's are will not work for everyone but will work for a lot.

Fussing around with the machine and loosing time while you locate it and open it and plug it in. This is silly. If you had the good sense to have one on board I am sure you and your partners will very much know where it is and how to quickly retrieve it and use it. By the way you don't have to go plug these new fangled contraptions into to a power outlet. They come with their own big battery.

The American Heart Foundation could be wrong. The Red Cross could be wrong. the 25% to 30% survivors after a sudden attack could be wrong in having even untrained members of the public save them. Yes they all could be wrong in thinking the AED's do save lives. After all the big hospital down the road who gets these heart patients all the time have such a low resuscitation and survival rate. Oh I forgot. They don't get to treat those who suddenly collapse and are dead inside of 6 yo 8 minutes if no AED is around.

[weavis]

Originally Posted by JRM

Although firmly in the "last on my list" group, I'm surprised no one has mentioned the utility of the implanted AED units yet. Lots of people with recurring arrhythmia get them. We see them pretty regularly, and they do work.

These things thump people immediately when they decide it's needed, with no warning. Lots of times the patients are asymptomatic, and it shocks them (sorry for the pun, I couldn't resist) when it goes off. I've seen them malfunction a few times, where they're continously shocking as soon as they charge. But even then they aren't damaging the patient, although it looks really bad.

The implanted AEDs probably save more lives more regularly than all the EMS and bystanders put together. Nothing beats "instant" in the brain death curve.

JRM

Sent from my SAMSUNG-SM-G900A using Cruisers Sailing Forum mobile app

Possibly because we were not discussing after care. Its really a different topic... but you are right.... they are excellent

[GoingWalkabout]

Originally Posted by weavis

Possibly because we were not discussing after care. Its really a different topic... but you are right.... they are excellent

Love it. :big grin: I think we all should get one.. put in...

[weavis]

So we are all agreed then
Kenomac has our collective permission to get one.
They are not mandatory.
After 30 years of medical practice, 7 in Emergency work, I can now die happy that AEDs are around.

So glad thats settled...........

[hellosailor]

"well meaning, but untrained personnel using equipment and administering drugs."
Weavis, as a physician, surely you then carry an AED and TPA and all sorts of things in a big brown physician's bag, all the time, everyplace you go, including every trip on your boat?


What, you don't carry it all? So, you mean, if some untrained civilians on the next dock starting shouting "MEDIC! MEDIC!" or simply "Is there a doctor in the house?"


You wouldn't be better off if they already HAD equipment beyond what they were trained to use?


That's the reason we have AEDs in airports and stadiums, folks. Not so Bubba can play Marcus Welby, MD. But because there may be 10,000 people within shouting distance, and just one of them might be able to use the equipment properly. IF THE EQUIPMENT IS AROUND.


Besides, every time someone buys an AED, the sales volume goes up and the price goes down. Can't see that's gonna hurt, either.

[GoingWalkabout]

Originally Posted by weavis

So we are all agreed then
Kenomac has our collective permission to get one.
They are not mandatory.
After 30 years of medical practice, 7 in Emergency work, I can now die happy that AEDs are around.

So glad thats settled...........

And Weavis thank you for your service to humanity.

[weavis]

Originally Posted by hellosailor

"well meaning, but untrained personnel using equipment and administering drugs."
Weavis, as a physician, surely you then carry an AED and TPA and all sorts of things in a big brown physician's bag, all the time, everyplace you go, including every trip on your boat?


What, you don't carry it all? So, you mean, if some untrained civilians on the next dock starting shouting "MEDIC! MEDIC!" or simply "Is there a doctor in the house?"


You wouldn't be better off if they already HAD equipment beyond what they were trained to use?


That's the reason we have AEDs in airports and stadiums, folks. Not so Bubba can play Marcus Welby, MD. But because there may be 10,000 people within shouting distance, and just one of them might be able to use the equipment properly. IF THE EQUIPMENT IS AROUND.


Besides, every time someone buys an AED, the sales volume goes up and the price goes down. Can't see that's gonna hurt, either.

I have one. Its nice and shiny. It was a lot of money. Its in my clinic and available to be used the second it needs to be. All the staff can use it, I trained them, (nurses) even the cleaner and my nephew and my sister. They also know CPR.

I believe airports and and stadiums pay for their own.

Maybe you should talk to Marinas and tell them to get one. Anyone who wants one personally should go and buy one. I insist.

There is a great health service in USA and the UK.. The emergency vehicles carry everything. All paid for by our contributions. They will be there as quick as they can.

Life sucks. Sometimes I personally have to choose between an "either or" situation in buying equipment because, yes folks, Im paying for it. Currently Im purchasing Sterilising equipment and the price would make your eyes water...... it made mine bleed purple piss.

Im doing this because I want the best for patients. I did not have to invest so much but my experience with Ebola and rapid communicative diseases, made me aware that I could make my clinic a safer place by having the right equipment to prevent infection..... No case ever of MRSA and ........... never mind, you get the picture. I have a whole heap of things to take into consideration and not just the current flavour of the month....AEDs.

Did I mention I have one? Oh I did.

I dont have Epirbs on one boat. The statistics for people going in the water and being found quicker seem to be better odds than someone having a heart attack on my boat. You want me to make that choice with a heavy politically correct emphasis on getting an AED because Im a physician? LOL

Ive contributed.

Go to the government and demand that EVERYONE has to have one.....In a nation of 38 million people, where 300K die of heart attacks.

And then: Tobacco use remains the single largest preventable cause of death and disease in the United States. Cigarette smoking kills more than 480,000 Americans each year, with more than 41,000 of these deaths from exposure to secondhand smoke. In addition, smoking-related illness in the United States costs more than $289 billion a year, including at least $133 billion in direct medical care for adults and $156 billion in lost productivity.

How many of those who have heart attacks smoke? Wouldnt it be better to accept that there is a lot wrong with Society and that I, and others have to deal with far more than heart attacks in order to diminish the need for urgent care? Heart attacks can be congenital and also smoking and also poor diet and also obesity and also.........

There is only so much I personally can do. I deal with each situation as it arises the best I can. I see other things for "safety" and "just in case", more of a priority on my vessel than a AED. Thats my call. If my passengers drown because I dont have a liferaft, what am I gonna say..... " oh I had to buy an AED?!"

Despite ALL that you believe or read, Drs have been saving peoples lives with good quality CPR and rapid response units for a long time. I dont deny AEDs do a good job, they do..... Its just in their wisdom, governments have set up the rapid response unit as the way to go.

We do our best. Today I will have worked 16 hours and I have one call to do on the way home, and its 1:36 am. I havent dealt with one heart attack all day.. but I have dealt with diabetes, Kidney problems, Influenza and a host of other things.

Its a bugger when someone invests in an AED and then is allergic to an insect bite offshore and dies because there was no Adrenaline shot.......

Y' just cant win.

[Cuttyhunk]

Even with all the sidetracks, I've found this thread compelling. In 1992, when I was anchored in Luperon harbor, in the Dominican Republic, a man on another boat died of cardiac arrest. There were medical people on other boats who came to his wife's assistance, but they couldn't do anything. He had been working on his engine and they weren't sure if he'd had a heart attack or had been electrocuted by something he was working on.

They put his body in the freezer in the Comandante's boat and it stayed there for several days until arrangements could be made to get it home.

I've never forgotten that and as AEDs became more common, I've thought of Luperon and wondered if an AED could have brought that man back, especially if it was an electrocution. I have priced them on Amazon, and before reading this thread definitely had one on my list. I can see, however, that the odds of it being useful are not that high and so it's less of a sure thing for me to buy one at this point. I have been trained in their use -- it was mandatory in the university athletic department where I worked for some years -- but I learned some interesting things from you all that make me think it would make more sense to have one in our summer house instead of the boat. Our yacht club has one in the clubhouse and they have just started offering classes so that the members know how to use it.

Anyway, thanks, Kenomac, for starting this thread.

[Nicholson58]

Originally Posted by caradow

I wish you well with your "new" AED
What year was it made?
Battery technology in the AED's have changed dramatically in the last 5 years.
Did you ever question why you were able to buy one so cheap?
With hospital constraints on costs here in the US makes me a little suspicious of such a good deal.
I am not advocating not having one, I commend you on your thirst for safety but you want it to work if you ever need it. The extra money for a state of the art one would be money worth spent. Didn't you pay that much for your life raft, SSB, Sat Phone etc ?

All valid points, however, many places Auto upgrade devices that are nearly new. Some places replace when the battery is expired. A good check might be to consult the Red Cross or EMT techs regarding your unit. As I mentioned before, ours was purchased new from an EMT/dealer who does our CPR training. We paid about 650. 5-year battery and free annual check by the seller. It comes with a set of child's pads & auto-set-up for children or adults. These things will evaluate a patient and will only shock if it calculates the need. This means dead is dead; it is a DEFIB - not a resurrection machine. BTW, in addition to a new battery, you probably need new sticky pads. Again, the EMT guys can tell you what you need & lead you to the correct attrition parts.