boating with elderly folks in remote areas

[ksanders]

We occasionally boat with our father in law, and we often have our mother in law over for extended periods of time. Both are in their late 70's.

Where we boat and live is remote. Realistically medical help while boating is a minimum of an hour by helicopter away and probably longer.

At home help is a minimum of 30 minutes and probably closer to an hour away. In our neighborhood of mostly older folks we've lost two to heart attack in the last couple of years.

What do you guys think about AED's? At work we have them everywhere. In town the police have them and use them to save lives all the time.

I'm just thinking that I would not want to someday be thinking that I could have saved someone on my boat or at my home because I didn't want to spend the $1200 a AED costs.

 

[BruceK]

I invited a paramedic member of my Club to deliver a medical safety talk one meeting. I was unaware he sold defibrillators as a sideline, a good part of his talk was about them. They seem easy to use, virtually talking you through the procedure, and greatly improve prospects of survival.
The device was introduced maybe 30 years ago on all emergency ambulances, donated by the late media mogul Kerry Packer after his life was saved by one. These days they are everywhere, though not yet on my boat, and I guess I`m a candidate.

 

[JDCAVE]

I think it's an excellent idea. I have considered getting one for our boat.


Jim
Sent from my iPad using Trawler Forum

 

[rochepoint]

Kevin
At our yacht club we have two AED's, one in the clubhouse and one in the cruise bag that attends every cruise. We have been very fortunate that we have not had to use them yet, but glad we have them available. We also hold CPR/AED courses three times a year put on by our local Fire Department training officers and have trained over 100 members. I also have one at our office and a couple of trained staff members.

They are becoming more common everywhere and the price is coming down all the time. With your remote location and time to assistance it sounds like a good move and if you do get one make sure you put the notification plaque that come with them where other can see your vessel is equipped outside on your boat.

Now you have me thinking about our boat as the Admiral and myself are not spring chickens anymore.......

 

[souzaham]

AED is a life saver

The AED is a wonderful life saving tool in the event of a cardiac incident. Early intervention during a heart attack with the employment of the automatic electronic defibrillator will give the person a much better chance of survival. A short class in CPR and AED operations will give you peace of mind.
Bob Souza, retired Fire Chief and EMT

 

[O C Diver]

Certainly a worthwhile tool to have on the boat provided you and your wife get and maintain training and proficiency for the unit. When someone has an incident is not the time to learn how to use the unit.

Would also consider adding an oxygen kit with a 3 hour supply to the boat. Also take the very simple oxygen provider course. Oxygen is far more commonly used in medical emergencies than an AED and is a fraction of the cost.

Ted

 

[dannc]

I have had a CPR certification for decades, and for many years, AEDs have been part of the CPR classes.

AED are pretty idiot proof and they are designed to be used by people with no training.

If we manage to get a boat, it will have an AED. Not so much to be used on us, but for use on other people. There is a long discussion on TF a year or two back about AEDs that had some useful information.

AED's are not miracle devices but they have a better success rate than CPR. Well, ok they are pretty danged magical if you think about it, but they are not perfect. CPR success rates are pretty bad and not like what is shown in the media. Flip side is that some chance is better than no chance.

If one is in a remote area, CPR and an AED may well be worthless since the time to get to a hospital might be too great to have a successful outcome. However, if I did NOT have an AED on board, and needed it, I don't think I could forgive myself.

We have elderly family members in poor health that live 45-60 minutes from a hospital and about that far from EMS. Ironically, this year we were talking about taking care of those family members, when one was having a heart attack. We worried that when a heart attack happened, they would not react quickly and just deny what was happening. Thankfully, they did not take a trip on the river De Nile and quickly called 911. That quick call certainly prevented a death.

An AED might bring someone back from the dead and buy them some time to get to an ER. It is a low chance but better than no chance.

CPR classes now days teach three things, CPR, AED usage and choking response. I would guess most people are for more likely to have a choking incident, the choking techniques work really well, and you don't have to buy any equipment.

Later,
Dan

 

[psneeld]

I have had a CPR certification for decades, and for many years, AEDs have been part of the CPR classes.

AED are pretty idiot proof and they are designed to be used by people with no training.

If we manage to get a boat, it will have an AED. Not so much to be used on us, but for use on other people. There is a long discussion on TF a year or two back about AEDs that had some useful information.

AED's are not miracle devices but they have a better success rate than CPR. Well, ok they are pretty danged magical if you think about it, but they are not perfect. CPR success rates are pretty bad and not like what is shown in the media. Flip side is that some chance is better than no chance.

If one is in a remote area, CPR and an AED may well be worthless since the time to get to a hospital might be too great to have a successful outcome. However, if I did NOT have an AED on board, and needed it, I don't think I could forgive myself.

We have elderly family members in poor health that live 45-60 minutes from a hospital and about that far from EMS. Ironically, this year we were talking about taking care of those family members, when one was having a heart attack. We worried that when a heart attack happened, they would not react quickly and just deny what was happening. Thankfully, they did not take a trip on the river De Nile and quickly called 911. That quick call certainly prevented a death.

An AED might bring someone back from the dead and buy them some time to get to an ER. It is a low chance but better than no chance.

CPR classes now days teach three things, CPR, AED usage and choking response. I would guess most people are for more likely to have a choking incident, the choking techniques work really well, and you don't have to buy any equipment.

Later,
Dan

I started to write something pretty similar based on my nearly 40 years of responding to boating emergencies....but one bad button hit and the post was gone...kinda like what we are talking about but with lives not lost posts...

Few emergencies in my experience were ones where an AED or O2 would have made the difference...but if you can afford them and know how to use them...a great addition to the first aid kit. They were both very valuable for the many dive emergencies I have been involved with so OCDiver knows....

Even for those doing the loop...all those crowded and seemingly safe shore towns with first aid squads every few miles....in my experience it can still take over an hour to get to para-medic level support at times due to volume and poor coordination between rescue agencies.


Be prepared...but that also means for the emergency you cant resolve and accept that so you can enjoy yor time n the water.

 

[HeadMistress]

We occasionally boat with our father in law, and we often have our mother in law over for extended periods of time. Both are in their late 70's....In our neighborhood of mostly older folks we've lost two to heart attack in the last couple of years. What do you guys think about AED's? At work we have them everywhere. In town the police have them and use them to save lives all the time.

As one who's approaching my mid-70s, I can tell you that we're NOT all that "elderly" any more! For most of us it is true: 70s are the new 50s...and by extension, late 70s are the new late 50s, but better 'cuz we get senior discounts.

So age shouldn't be the driving factor in your decisions. What matters are your in-laws' weight, stamina and agility, and any known health issues.

As for whether to invest in an AED...whether it's likely to be needed in your own household/family or not, it's good insurance that could--along with CPR training-make a life or death difference to anyone any time...as the aspirin commercial says, heart attacks don't always come with a warning.

 

[psneeld]

There is a twist that scares most people...


In waterborne emergencies...the captain is often removed from the first aid portion of what is going on.


Sometimes vessel issues and the stress they cause also account for the medical emergency.


The captains role is save the vessel, the vessel will save the crew.


While sometimes there is no connection...even the USCG while requiring CPR/First Aid for initial qualification for lower level mariner licenses, it is not required for renewals. The thought is on a smaller boat, a captain needs to focus on everyones safety...not the one .....necessarily.


So as long as everyone on board also feels confident using all the equipment and application....great...then again... it might be something that isn't used when necessary or in time ...just because.


So few rescues go so neatly that all works out according to plan...but that is not a reason not to have the equipment....it is just that even with it....things happen.


When I am openly honest about survival at sea...many people get upset.


But compare it to the experiences or stories we have all had where the average skipper loses a perfectly seaworthy boat...why???? Because things don't always follow the rules and it is best to be prepared for those not so pleasant outcomes. The guy who loses a family after sinking a perfectly seaworthy boat is pissed...but at who is the question. All the emergency equipment and resources internal and external in the world don't matter sometimes...best if captain and crew are mentally prepared for that.


So these "additional" first aid items should add a "touch" of comfort....but in reality...its only a few percent of being more prepared. Making sure your crew is well prepared to help is as much a benefit as the actual hardware.

 

[SCOTTEDAVIS]

O2 is a great item to carry but know when to not use it, for example it can shut down the respiratory drive in a person with acute COPD, as their breathing is dependent on a low O2 level not the normal building up of CO2. Breathing concentrated O2 will repress their breathing.

Tools are great, training is key. Rather have two trained providers working good quality CPR on me then four spectators with a case full of AED's

 

[BandB]

We are both qualified as Medical Officers in Charge and carry a very extensive medical kit designed for long range cruising. We also have access to onshore support if needed.

We know many would consider us to have overdone what was needed but I couldn't deal with the thought of losing a life on board simply because I wasn't trained or equipped.

We also do require anyone accompanying us on a long trip to provide medical information.

I can assure you the lab training in a hospital emergency room was extremely difficult for me. I've never been fond of the sight of blood or any of the other things you see there. However, it was also good for me as I had to know if I could handle it and be sure I wouldn't panic or freeze when a need arose.

 

[timjet]

With unlimited funds an AED is a great idea. But most of us don't have unlimited funds so a balance of cost vs necessity comes into play. Do your in-laws or other folks visiting the boat have a history of heart issues? You do mention you are in a remote area so that fact may influence your decision as well.

Keep us posted as to your decision.

 

[psneeld]

My biggest flying award was for MEDEVACing the ships doctor off a Russian freighter.


Even the best laid plans have glitches....


Seriously though....if you have greater probabilities of needing medical care while boating, staying closer to shoreside facilities is advisable.


Also often forgotten by boaters, the minute rescue conditions start to deteriorate, the time of rescue can start to go up exponentially.


I have always advised people that boating, even in populated areas can be and often is like wilderness camping. Calling the USCG (or any rescue operation) or 911 doesn't mean help comes fast.


Anything that helps is great...but often administering CPR, AED, First aid, ...etc...etc takes additional crew as the skipper is busy with the vessel and or rescue communications.


Make sure if you are short handed, having a mobile radio or sat phone, allows you to be closer to the patient but still split between two important activities.


Reality is for many boaters, planning is as important as the medical care. In many cases boaters are torn and frustrated between helping the injured yet still trying to aid in rescue operations. Know that...be at peace with that.

 

[BandB]

Seriously though....if you have greater probabilities of needing medical care while boating, staying closer to shoreside facilities is advisable.

As Captain or owner, you must know when to say "no." A bit to both ends of the spectrum in seniors and kids. We know a couple in their 80's who had to stop boating. They don't leave home often although we've had them to our home a couple of times. However, we did take them out once. Never left the ICW. Never were more than 5 minutes from a dock. They had a great time though as they'd assumed they'd had their final time on a boat before. We did it on a weekday too to avoid a lot of weekend recreational boaters.

You have a responsibility as the one in charge. We won't take a woman 8 1/2 months pregnant and we won't take one pregnant at all beyond quick access to medical care. Simple Risk Avoidance.

 

[psneeld]

Heck...babies born in helicopters are no big deal....there might still be a Bahamian or 2 with Sikorsky in their name someplace....

Helo landing pads on boats aren't absolutely necessary....just handy...

 

[BandB]

Heck...babies born in helicopters are no big deal....there might still be a Bahamian or 2 with Sikorsky in their name someplace....

Helo landing pads on boats aren't absolutely necessary....just handy...

Probably in most cases, babies born on boats aren't a big deal, but we sure don't want one born on our boat. And sure don't want pregnancy complications at 8 1/2 months. Our scope of medical support we intend to provide does not included C-Section's or Premature Babies.

 

[markpierce]

Guest a few months pregnant with three of her four children on board in view. Fortunately, just a day cruise! (Love the railings.)

 

[dannc]

Guest a few months pregnant with three of her four children on board in view. Fortunately, just a day cruise! (Love the railings.)

Yeah, Bill puts some really nice HIGH railing on the boats! You feel really secure on those boats. Flip side, we were on a Coot being built and there was not railing yet. Nice to see the boat being built though.

Later,
Dan

 

[funangler]

I would rather die at sea with family, friends, and fresh air then in a nursing home. We are born to die make the most out of the time we have and don't fuss to much about the what could happen! I work in emergency department I know the difference between quantity and quality of life.

 

[psneeld]

I would rather die at sea with family, friends, and fresh air then in a nursing home. We are born to die make the most out of the time we have and don't fuss to much about the what could happen! I work in emergency department I know the difference between quantity and quality of life.

I don't necessarily want to go early...But I have made that peace....guessing I have come close a few too many times.

As I get older...extrapolation of the fewer fun things on the plate often makes me wonder what the minimum will be....not sure after a lifetime of adventure, a porch bound rocking chair will cut it. Maybe the 15 minute, sunset canoe paddle, followed by napping in that rocker may be OK...but when the canoe ride ceases....not sure what mental adventures will make up for the real ones.

 

[BandB]

I would rather die at sea with family, friends, and fresh air then in a nursing home. We are born to die make the most out of the time we have and don't fuss to much about the what could happen! I work in emergency department I know the difference between quantity and quality of life.

I have my first choice as how to die and it involves my wife and goes beyond appropriate content for this site, but what a way to go out.

 

[BandB]

I don't necessarily want to go early...But I have made that peace....guessing I have come close a few too many times.

As I get older...extrapolation of the fewer fun things on the plate often makes me wonder what the minimum will be....not sure after a lifetime of adventure, a porch bound rocking chair will cut it. Maybe the 15 minute, sunset canoe paddle, followed by napping in that rocker may be OK...but when the canoe ride ceases....not sure what mental adventures will make up for the real ones.

We traveled virtually before we were able to cruise. I suspect we'd do that when we could no longer cruise as we do. Friends, family and laughter. Music.

 

[psneeld]

Adrenaline is a powerful drug......once adicted, hard to kick.....

 

[angus99]

I have my first choice as how to die and it involves my wife and goes beyond appropriate content for this site, but what a way to go out.

My wife has instructions to put my remains on our boat along with my dog, my guitars and my fly rod. Then she is to don a diaphanous gown, set fire to the boat, push it away from shore and--at the last moment--jump aboard to accompany me on my journey to the after-life. I know she will do this because, when we discussed it, her exact words were "whatever you'd like, sweetheart."

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[mbevins]

My wife has instructions to put my remains on our boat along with my dog, my guitars and my fly rod. Then she is to don a diaphanous gown, set fire to the boat, push it away from shore and--at the last moment--jump aboard to accompany me on my journey to the after-life. I know she will do this because, when we discussed it, her exact words were "whatever you'd like, sweetheart."

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Did you ask the dog his opinion of this wonderful way to go?

 

[THD]

Interesting and prescient topic. We have given a lot of thought to adding an AED and when we head south from the PNW for the last time in a few years, we will have one on board if not before. On older persons on board in general, my MinLaw is 93 and we take her out for an afternoon or dinner cruise fairly regularly. We have done one overnight with her and she did just fine. of course, she is in pretty good health for 93! Her dream since she has lived out here is to visit Victoria BC. We are planning a trip there with her next month. She is excited about taking the trip.

Like most here, the inactivity at life's end is anathema to me. My preference would be to die at sea and be given a proper sailor's burial at sea. More likely, cremated and ashes spread over whatever water we happen to be near at the time.

 

[angus99]

Did you ask the dog his opinion of this wonderful way to go?

Sadly, that's not an option, as of two weeks ago.

 

[Donsan]

Interesting and prescient topic. We have given a lot of thought to adding an AED and when we head south from the PNW for the last time in a few years, we will have one on board if not before. On older persons on board in general, my MinLaw is 93 and we take her out for an afternoon or dinner cruise fairly regularly. We have done one overnight with her and she did just fine. of course, she is in pretty good health for 93! Her dream since she has lived out here is to visit Victoria BC. We are planning a trip there with her next month. She is excited about taking the trip.

Been waiting for someone with a medical background (which I do not have) to chime in on this but from my experience with folks about 90, I would have some concern about using an AED on them. I looked on the web for something on age use of AEDs without much success. Even in good health, someone 90 years old is going to be significant weaker than they would be at 60. Not saying having an AED on a boat isn't a good thing but the older the patient, I would guess the less likelihood of a successful outcome from its use.

 

[psneeld]

Been waiting for someone with a medical background (which I do not have) to chime in on this but from my experience with folks about 90, I would have some concern about using an AED on them. I looked on the web for something on age use of AEDs without much success. Even in good health, someone 90 years old is going to be significant weaker than they would be at 60. Not saying having an AED on a boat isn't a good thing but the older the patient, I would guess the less likelihood of a successful outcome from its use.

The success rates of AEDS and CPR in and out of hospitals/minutes from higher medical care (paramedic and above with medicines) and out in the wilderness/on boats is pretty drastic from my experience.

We discussed putting AEDS on USCG helos at great length back around 1999 when they first came out. Because of metal and lots of salt water involved....they were not adopted at the time. Too much risk for low outcome of success.

I thint they are carrived now..but I believe the guiding principle still stands...unless a pretty high level of care is rapidly available, or the AED does a simple correction in a short amount of time, or CPR is only needed for a few minutes...survival rates are still pretty low.

So absolutely general health is a factor in survival and recovery and how the body handles recovery.

Again AEDS and CPR are great tools....but not miracles all the time...and seemingly in the boating world less than preferred.

Plus remember AEDS are more for sudden cardiac arrest than generic arterey blocked heart atracks....thus some confusion on surrival statistics ...at least what I gathered from flight surgeon input.