Aed...

[psneeld]

Short and interesting front Heart Association on drowning....

Part 10.3: Drowning | Circulation

 

[Bigsfish]

Interesting topic. Now I'm confused. LMAO

 

[dannc]

This discussion has occurred in the past so a search might be useful though many of the same posters are already in the discussion.

My first CPR class was over 30+ years ago! Since then I have had two more classes for two jobs and get refresher training every other year. Plus First Responder training for those two jobs. In all of that time, and with all of that training, I have never done CPR BUT I have used the training in the CPR class to save my kid from choking to death.

Strangely, I have helped a woman who had a seizure at EPCOT. Twice. She seized one afternoon in the park and my training kicked in. I saw the lady go down and told my wife to call 911. Then I noticed a Cast Member and told my wife to talk to the Cast Member since I know they have quick communication to EMS.

Another couple heard me saying to call 911 and saw me move to the woman who had gone down. They turned out to be nurses. We stabilized the lady and found her MedAlert bracelet which mentioned seizures. She quickly came too as EMS arrived. Only took a few minutes for all of this to happen. EMS knew the lady.

Next day, we went back to EPCOT about the same time and saw a crowd near the bus stops. We could see it was that lady again. She was coming too as EMS was pulling in. I told the security guard that this had happened yesterday at the same time and that EMS likely knew her. He was kinda wigging out and needed to calm down a bit.

I mention all of this because CPR training is more than just compressions and you really do not know when the training will be needed. CPR classes cover AEDs but you don't really need training to use an AED. It is designed to work with untrained people.

You do CPR on a dead person and to buy time to allow for more advanced care to arrive. The odds of CPR helping to bring a person back to live is very small. AEDs increase the odds greatly compared to CPR but the odds of surviving are still small. But with no CPR or no AED, well, the dead are going to stay dead. Some chance is better than no chance.

If one is a hour or more from advanced life support, well, odds are pretty bad even with an AED.

The primary reason we would have an AED is to help others. My wife has some heart issues on her side of the family but most of her family have lived long lives. My family does not have heart issues that would affect me and we live to very old ages. The AED would almost certainly be for someone else. I would feel real bad if I was in a situation where an AED would have helped but I did not have one on the boat. The family of the victim would likely feel somewhat better knowing that everything that could be done was done. No playing the what if game in their head because and AED was not present.

Taking a CPR class is well worth the time. It is pretty danged easy and interesting. I have had the class at least a dozen times and I always learn something new. AEDs are covered in the class and AEDs are starting to appear in many places in the US. They are all over Disney World.

Later,
Dan

 

[Nightsky]

I had a heart attack May of '15, was cleared to go back fishing by end of June, so I bought one from St. John Ambulance, cost about $1700 CDN. I had my 3 deckhands take the CPR with AED course ( I already had training). I sold that boat last June but kept the AED which will go on trips with us on our new boat. Wife took the course too.

 

[Benthic2]

Another thing to think about....CPR is MUCH more effective with supplemetal Oxygen. All of my CPR experience is pre-AED, but I'd love to hear from the medical folk whether they thought an AED would be more effective than an Oxygen bottle.

 

[psneeld]

If you read my link, nothing in some cases is more important than oxygen...but if the person isn't breathing on their own, O2 straight isn't doing anything.

Rescue breathing has almost become separate from CPR in that without blood circulation, even O2 is worthless.

Read up on recent CPR....even basic training covers how old style CPR has evolved.

 

[menzies]

Yes.

Does a drowning victim go into defib?

 

[smitty477]

"Does a drowning victim go into defib?"


Try this link...


When Someone’s Drowning: 4 Resuscitation Tips. (Some May Surprise You.)

 

[Benthic2]

I'm not sure I would call "hands-only" CPR an evolution..... I think its merely a response to the germophobe culture that would rather watch a person die than risk catching something from trying CPR on a stranger....and if you're going to do the breathing portion of CPR, pure Oxygen has to be better than exhaled air. If I had my choice of keeling over next to a trained first responder with an AED, or an Oxygen bottle....I think I'd take the Oxygen.....if I was in a near drowning incident, I think I'd make the same choice....but as I've said previously.....I have no experience with AED's. I have seen firsthand that CPR with oxygen can be very effective.

 

[BruceK]

Benthic2, check the link in the post above yours, CPR has progressed. From memory the AED tells you when to do CPR and to suspend, even sets the CPR pace. Unless you have "air" moving via CPR, oxygen alone seems ineffective.

 

[Kaylic]

We had same issue. I'm 6 years out from my heart attack. We cruise full time. My cardiologist at Penn is very jealous. Asked him if it was a good idea to get an AED, "If something happened to either one of you, how would you feel if you didn't have one? Make your decision based on your answer."
We got a Phillips on Amazon during a sale. I have to admit, the sense of being able to handle that type of emergency is very reassuring, especially at 3:08am when all the monsters come out to play with your head! Hope never to need it but, like everything about cruising, knowing you do have another impeller when things go wrong...Priceless!!

 

[Benthic2]

The link didn't have anything new.....when you apply Oxygen its with a bag that inflates and is then forced into the victim similar to how you'd do it with your own lungs....but its pure Oxygen. I don't know what the oxygen content of exhaled air is, but its less than 21 %....pushing 100% Oxygen into a victims lungs is vastly better than that....it has to be!! My point was that in a situation where CPR is needed..an AED would be helpful sometimes...but oxygen would be helpful every time....so that might be a better use of limited resources...of course...if you can afford both...even better.

 

[psneeld]

How do you force the oxygen into the lungs?

Oxygen setups with the small bag I thought had the bag to show the patient was breathing.

Now whether you put oxygen into the bag that you squeeze might help, but I was always taught there is plenty of oxygen in air to keep someone alive though more is good for recovery.

Any paramedics familiar with "bagging" that can comment whether oxygen is used in conjunction now?

 

[Gabe n Em]

Benthic, Exhaled air is 15-16% if memory serves.

We've taken CPR with AED training. Seeing as how we're not yet 30 and moderately athletic we will wait a while to get an AED.

We do a lot of scuba diving and we'd really like to get an o2 bottle but theres weird restrictions in the state of Georgia on getting one re-filled....

After AED training and O2 administration training - it does't seem that o2 is a real substitute for an AED. probably couldn't hurt though. It is, like everyone else has said, REALLY tiring to continue CPR beyond 10 minutes or so without someone to trade with you.

 

[Gabe n Em]

How do you force the oxygen into the lungs?

Just an bottle doesnt.....it's not like a breathing machine in a hospital.

They actually showed us this in our O2 admin class - SOME kits come with what I think is called a demand valve respirator that acts very similarly to a 2nd stage on a scuba tank and you can press the button on the back when it has an oronasal attachment to seal over the mouth and nose. you must be careful to not give the person an embolism.

I am not a doctor nor have I played one on TV. do not act on or use any of my advise. GET PROPER TRAINING

 

[Peter B]

Effective cardiac compressions shift enough air in and out of the lungs to adequately ventilate a collapsed person, just by the spring in the chest wall, which is why mouth to mouth resuscitation is no longer mandatory, and the air is 21% oxygen so sufficient. (This being a real advance, as having to do mouth to mouth was a huge turnoff to most, me included, and why most folk were not keen to get involved, and who could blame them..? Ok, if you have bottled O2 and a suitable mask as well, that's better, but not unless you are resuscitating effectively, or the person is breathing on their own and with an adequate pulse. But this is getting way too complicated. I suggest rereading my post 13, P1.
PS. I am a CPR training MD.

 

[Benthic2]

 

[Benthic2]

I've always used something like that when doing CPR....are they not still in use ?

 

[dhays]

Effective cardiac compressions shift enough air in and out of the lungs to adequately ventilate a collapsed person, just by the spring in the chest wall, which is why mouth to mouth resuscitation is no longer mandatory, and the air is 21% oxygen so sufficient. (This being a real advance, as having to do mouth to mouth was a huge turnoff to most, me included, and why most folk were not keen to get involved, and who could blame them..? Ok, if you have bottled O2 and a suitable mask as well, that's better, but not unless you are resuscitating effectively, or the person is breathing on their own and with an adequate pulse. But this is getting way too complicated. I suggest rereading my post 13, P1.
PS. I am a CPR training MD.

I get CPR training every year. It is required. I have never had to use it. Over the years, the protocol has changed significantly.

As Peter points out, current training concentrates on the compressions. The message I got last year was "don't bother with the rescue breathing unless you have lots of CPR trained folks around so one person can do the breathing". The compressions will provide enough O2 exchange all by themselves. An O2 bottle makes no sense to me. An AED would be great, but I don't have one and likely won't get one.

 

[eyschulman]

Effective cardiac compressions shift enough air in and out of the lungs to adequately ventilate a collapsed person, just by the spring in the chest wall, which is why mouth to mouth resuscitation is no longer mandatory, and the air is 21% oxygen so sufficient. (This being a real advance, as having to do mouth to mouth was a huge turnoff to most, me included, and why most folk were not keen to get involved, and who could blame them..? Ok, if you have bottled O2 and a suitable mask as well, that's better, but not unless you are resuscitating effectively, or the person is breathing on their own and with an adequate pulse. But this is getting way too complicated. I suggest rereading my post 13, P1.
PS. I am a CPR training MD.

Totally agree CPR trained annually also an MD.

 

[Benthic2]

as an MD....if someone close to you needed CPR...I know you'd be doing the breathing as well. They took out the breathing component so that more people will be willing to attempt CPR if they don't have a pocket mask, because compressions alone are better than nothing.....but compressions and breaths are better than compresions alone.

 

[Xsbank]

My wife and I did CPR on a neighbour who had probably been collapsed by about 5 minutes before we got to her? We worked on her for ages (was probably 10 minutes before we got help) and we were both exhausted by the process and the stress. She was pronounced by the paramedics.

If you are trained, you just get to it. The stress happens later.

 

[BandB]

My wife and I did CPR on a neighbour who had probably been collapsed by about 5 minutes before we got to her? We worked on her for ages (was probably 10 minutes before we got help) and we were both exhausted by the process and the stress. She was pronounced by the paramedics.

If you are trained, you just get to it. The stress happens later.

First, I applaud you both for being trained and for doing all you could. I can only imagine the physical and mental exhaustion of the entire process and I imagine it was tough for a few days.

Since you are the one who started this thread, I have to ask this, did you ever wonder if the neighbor might have been saved had you had an AED? Did that horrible event have anything to do with starting this thread?

 

[AusCan]

I used to have annual CPR training for 20 years or more when working with hydrogen sulphide. I had to use it on several occasions. In the early 80's, we were trained to use oxy-viva resuscitators such as this. They don't seem to be used by non-professionals any more for whatever reason. I know I saved at least one life with them.

 

[Xsbank]

B and B not really, it's that everyone I know is aging, I lost a friend last week to cancer and we try to have a well-equipped first aid kit just like I have a fire pump on board. With the cost, I thought it best to ask the assembled masses what they thought of adding it to the kit.

One evening after dinner, we had had a bit of snow and I could hear a car that sounded stuck. However, it didn't stop so I went out on the road with a flashlight to see what was going on. There was a parked Honda with the engine revving up and slowing down, not moving. I could see someone in the driver's seat so I opened the door, she was slumped back in the seat, unresponsive. Her foot was on the gas and the engine was hitting the rev limiter. I shut off the engine, removed her seatbelt and lifted her down to the road, my wife called 911 and I started chest compressions while My wife spelled me off. We did the breathing thing too. You could hear the ambulance a long way off and when they arrived, they pulled out a stretcher, put her in the ambulance while we waited. They came out and told us no joy, that was it. I think she put her belt on, started the car and dropped dead. Strangely, she was visiting next door and I never heard anything from her friends or family about what got her...that was it. An AED might have saved her, but I'll never know.

 

[Benthic2]

Can an EMT or Paramedic decide someone is dead or aren't they supposed to keep trying until they can hand the person off to a doctor, who can then declare a person dead ? CPR can keep a person viable for a long time. I've seen people survive after 40 minutes of CPR and make complete recoveries....and that was a heart attack and near drowning.

 

[psneeld]

Can an EMT or Paramedic decide someone is dead or aren't they supposed to keep trying until tfhey can hand the person off to a doctor, who can then declare a person dead ? CPR can keep a person viable for a long time. I've seen people survive after 40 minutes of CPR and make complete recoveries....and that was a heart attack and near drowning.

In the rarest occasion someone might make a complete recovery...but every medical pro I have discussed this with has said more than 4 to 5 minutes on basic CPR, unless there is some partial rscovery...and the chances are the person wont make it or be all but hrain dead.

Cold water and hypothermia does some strange things with what we called the mammalian dive reflex.....where once the face came out of cold water CPR better commence, but immersed and the body practically shuts down and the need for oxygen and blood flow is greatly reduced. But that is the only exception I know of to the 4 to 5 minute rule.

And believe me this was a heavily debated topic in search and rescue the entire 23 years I was in the USCG.

We were taught to go as long as you could as only a doc could pronounce death except in Alaska where I was told state troopers could also.

 

[ddalme]

I have a defib built into my pace maker. BUT, it only works on me.

 

[Benthic2]

I'm familiar with the Mammalian Dive Reflex but I don't think it was a factor, as most of my CPR experience was with people snorkeling in Nassau and the water there wasn't cold enough to ellicit that reflex. I was a first responder on a cruise ship as well as the manager of the snorkeling program. We had much better success with CPR on snorkelers than we did on people who collapsed on board the ship. I've always attributed that to it being easier to bring someone back from a drowning than a heart attack, rather than the diving reflex, but that's just an uneducated assumption based a few dozen applications of CPR.

 

[dennismckim]

An anecdote re: extended CPR:
I am a retired RN, and was a CPR Instructor Trainer. That is, I taught others how to be CPR Instructors.
After leaving nursing and moving out of state to care for my father, I took several different jobs until I was eligible for Medicare. One of those jobs was as an office assistant in a family-run commercial plumbing business. One day, the owner of the business was in the front office when he turned purple and lost consciousness. I pulled him out of the chair and to the floor, assessed for pulse and respirations, and initiated solo CPR while his wife called 911.
Through a series of unfortunate events, the EMTs were delayed in getting to the office, and it was only after they did arrive and took over, that they told me that I had performed solo CPR for 23 minutes. Buck survived, with only a couple of cracked ribs and some bruises. I'll admit I was exhausted. Were it not for my own size (6'6" and 230 pounds), I would not have been able to be successful.
Several days later, as Buck had a pacemaker implanted, I realized he had been in V-fib, and I dearly wished there had been an AED in the office that day.