Defibrillator onboard anyone?

[Franziska]

As many of us are older and many of us may have friends who had heart problems before we are considering to add a mobile semi automatic defibrillator to our medical kit.
There are professional refurbished ones available for 500€.
We also consider adding a blood thinner to the medical kit.

Both only to be used when out of range of immediate help and under extreme circumstances.
We will also get training and instructions as to when and under what circumstances to use it.

On a boat there are situations when fast outside help is not available and time is of the essence in case of heart failure and strokes.

I'm wondering, does anyone else have this onboard?

[C420sailor]

Not yet, but it’s something I’ve been considering.

Due to the price, I’m considering keeping it in our ‘boat bag’ at the house, instead of having one on the boat and one at home.

[Chotu]

Hello. Ha ha. I will be having these for sure.

The modern portable AED devices are really something. I had looked at them pre heart attack and they basically do an ekg/ecg, then determine if their use is warranted, then match their output to the correct jolt for the heart beat pattern they are sensing, then deliver the jolts as necessary. They tell the user how to use them and make all the medical calls for you.

As for blood thinners, aspirin and nitroglycerin are what EMS/EMTs use when bringing people in to the ER for cardiac problems. This will buy the person some time. My trip took 1 hour and 30 minutes to get to the ER by ambulance.

As I sat in my hospital bed looking at the helipad, I couldn’t help but to think that if I was 50 miles offshore I would have got to the hospital much faster. Ha ha. Aspirin and nitroglycerin combined with calling in a medical emergency on the radio for helicopter evacuation would have resulted in less heart damage than I got.

[Alan Mighty]

We do not carry a defibrillator.

As add-ons to the first aid kit and the tool kit, Led Myne carries:

* two electronic sphygmomanometers (models that can for two patients record systolic/diastolic, heart rate, and detect arrhythmia);

* a pulse oximeter (a model that can communicate to a laptop PC with the right software, so the readings can be displayed on the PC screen and saved to disk); and

* a handheld portable single-channel ECG.

The handheld portable single-channel ECGs (equivalent to the V4 antero-septal position of a standard 12-channel ECG) are no longer marketed or sold. The manufacturer had in mind selling them to GPs; the marketplace did not welcome them as enthusiastically as the manufacturer expected, so they were discontinued.

Most cardiologists regard them as toys, but some are prepared to at least look at the traces. The traces can be displayed on the ECG's own screen or can be stored on an SD card and displayed and printed via the right software on a PC.

[coopec43]

Chotu

They've made big advances with artificial hearts. My B.I.L (now deceased 78) holds the World Record of around ten years using an artificial heart.

[HankOnthewater]

Yes, I have a defibrillator that has an AED function (Zoll), I own one for professional reasons, but I never taken it on the boat, maybe I will in the future, but.......
Even if the AED can save a life (but not often does), one needs a real hospital soon, or a cathhlab. An AED can rectify certain arrhythmias (irregular heartbeats), but certainly not all, and when the heart stops beating, then an AED is useless. Only CPR and adrenaline/amiodarone might do the trick.

I would say if you stay close to shore and an ambulance with a hospital nearby, by all means carry one, if you are really going offshore, one will run out of time.

In regards to blood thinners, GTN is not a blood thinner, it dilates the peripheral bloodvessels, reducing the preload on the heart (and blood pressure) and sort of 'spares' the heart.

In regards to pulse oximeters and electronic blood pressure machines, that may or may not be connected to a computer..... yes, I have all these, but then again definitely not on a boat (IMO). I have on my boat a manual sphygmomanometer and a quality stethoscope. Very little to go wrong with these and..... much more accurate.

The above is not medical advise, just my opinion; what works for you might differ. I am a nurse, working in hospitals in management and critical care, and also freelance medic/nurse for various events.

[bstreep]

I asked my sister, who is a Red Cross Instructor, Instructor (she trains Instructors) about this a year or so ago. Her advice was NO. As Hank says above, unless you are within an hour or 2 of a hospital, it's for naught.

[GreenWave]

Originally Posted by bstreep

I asked my sister, who is a Red Cross Instructor, Instructor (she trains Instructors) about this a year or so ago. Her advice was NO. As Hank says above, unless you are within an hour or 2 of a hospital, it's for naught.

Agreed. Ethically, this is not good and an AED could do more harm than good by reviving someone to a vegetable state when they would have otherwise passed peacefully.

[NSboatman]

I haven’t yet carried one on board, but I certainly plan to. They are the same cost now as a plb or good life jacket. The scenarios I see it as being most likely to provide a use are all near-shore or while moored/tied up- which, let’s face it, is the VAST majority of the time. Imagine being at a lovely sun-downer raft up, when a guest goes into fibrillation on one of the boats - for what ever reason. A shock, a fall, a reaction, over exertion in the water or on the beach, a sting; underlying conditions of some kind- you can’t say what the folks around you will be dealing with. Being able to stabilize and restore rhythm for that person while emergency care is on its way is worth every damn penny.

And let’s face it- the average age of most folks cruising is significantly advanced- and therefore much more likely to fall victim to these issues.

Seems like an easy thing to support to me.

[Topspin]

Hello all,
an AED is useful in the gap between an incident and the arrival of professional help to assist CPR (cardio pulmonal resuscitation). If you are in the circumstances that professional help can be at your place within 10-15 minutes, the AED as well as CPR is useful and can safe lifes. Talking about being in a marina, this might be the case in first world nations with perfect emergency help systems. If you are cruising in remote locations or bluewater, this is most definitely not be the case.

@Franziska: get a good first aid kit (look at the one from TransOcean) and an individual medical kit recommended by your GP. Get and renew the training for first aid (there are occasionally good courses for cruisers) and CPR and you are well prepared. All tools on top of that highly depend on additional training (f.e. I carry a suture kit).

Regards,

-Richard

[MikeHoncho]

Do not give nitro to someone who doesn’t have a rx for it. Given for the wrong type of cardiac event will kill them.

[sanibel sailor]

Not worthwhile.
I looked into the likelihood of actually using one when I was working. Someone in our office thought we should have one, "just in case."
Looking at data from malls, for instance, with many thousands of visitors a day, it might get used once every several years. Applying some generous assumptions to my work, saying a hundred people a day, 260 days a year, it would be used once every 50 years or so. On a boat, even continually occupied, with only a couple or handful of people- figure once every several hundred years.


I got one for the office anyway, even though it made no sense, realizing it was wasted money to allay someone's fears.

[Calif.Ted]

I've been trained and used defibrillators and AED's and they have a very limited use, they are only for Ventricular Fib and Ventricular tachycardia. Not for stroke or any other cardiac dysrhythmia. Not a "Jump Start", more a "Hard Reboot", you are stopping the heart in hopes one of it's major pacemakers will kick in on the reboot. It's effects when successful are short lived without other Advanced Cardiac Life Support. Oxygen, cardiac drugs etc., treatment for the underlying cause and the damage incurred.
Good to have in large group settings, but the odds of it being necessary decrease greatly among 4-6 people.

[slipaway]

This has pretty much been said, but here is another way to look at this issue. First, you are talking about an "AED". An automated external defibrillator. These are what are approved for use by lay people. They are easy to use and there are some at a price point where people might consider them. But it is important to remember that an AED is only one part of a chain of actions that can make a difference in sudden cardiac arrest. The first is CPR. So you need to ask, can you do CPR? Do you have the knowledge, strength, endurance? Do others on your boat? (in case you are the patient). Second is activation of the emergency medical system- on a boat that can be problematic depending on where you are, but presumably you can make a Mayday call or even a 911 cell call if inshore and then hope that there are rescue resources close enough to help. Then comes the AED and yes, it can be a lifesaver, but only in limited circumstances, that is, the heart has to be in a "shockable rhythm"- it has to be beating in a way that the electric charge will reset it back to normal. Many cardiac arrests are not shockable in which case the AED will not help. Then comes advanced resuscitation by Emergency Medical Services and other healthcare providers. Are you close enough to help to make a difference? Finally, if you were able to reset the person's heart rhythm can you get them to proper post-arrest care? Those are the 5 links that lead to A CHANCE of survival. While there are cases where you shock a person and they suddenly come back to life, those are mostly on television and even when they happen in real life the chance of "re-arresting" is high thus the need for advanced care (i.e. medications). In my time in EMS I have worked many cardiac arrests in environments that are much more conducive to survival then on a boat on the ocean and in most cases the patient does not make it. That all said, some do survive, and in most cases the AED made all the difference. So, as with many things, it is a very personal choice.

[coopec43]

"After recovering, Packer donated a large sum to the Ambulance Service of New South Wales to pay for equipping all NSW ambulances with a portable defibrillator"

Kerry Packer was a billionaire: did he wast his money? But I suppose they were for ambulances where there would be a big demand for this type of equipment (unlike a yacht)?