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#185668 - 10/17/09 02:47 AM Re: AED Questions [Re: MDinana]
NobodySpecial Offline
Member

Registered: 03/03/09
Posts: 197
Originally Posted By: MDinana
My other pet peeve are news reports that show BLAH BLAH BLAH prevents X % of deaths

That's why I started smoking - the warning on the packet said 50% of smokers die. SO I reckoned I had a 1:2 chance of living forever!


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#185682 - 10/17/09 11:54 AM Re: AED Questions [Re: Polak187]
Desperado Offline
Veteran

Registered: 11/01/08
Posts: 1530
Loc: DFW, Texas
Thank you for your response.

These are the kinds of issues I wanted to hear.

I promise I am not a vigilante first responder.

The problem I face is working in an industry that often places the crews I am responsible for in very remote locations respective to Fire/Rescue/EMS services. We are often a minimum of an hour from the nearest town that might even have a volunteer FD, but often even farther.

Once assigned a job site, part of my initial survey is finding the two closest Fire/Rescue services and visiting them in person. I provide the FD with a map to the location, and the GPS coordinates. We also establish a helicopter LZ and set up to mark it day or night (FD/EMS apparatus road requirements are considered). If said LZ is "off site", I also provide the location info to the FD. Cell/Radio towers are notoriously dangerous places for helicopters due to guy wires and the proximity of power lines.

Then I ask them for their input as to what they need from me should we have an emergency. Usually they ask how we plan to rescue someone from the tower, as they are not trained/equipped for high angle work. ALL of our employees are trained and certified for high angle rescue, and we have to re-certify every six months. Several of my guys have become volunteers in their respective communities because they have this training and the VFD doesn't.

Generally in this line of work if something bad happens the victim is DRT, and there is not much going to change it except a time machine. I am just researching this as a means to help if a "normal" bad thing happens like sudden cardiac arrest.

Right now, the budget precludes any purchase. That is allowing me to research this with my lawyers and two of the MD's I built homes for (1 trauma knife and 1 Cardio/Thoracic cutter), and get more training before making any decisions.

I was set for what Red Cross call Professional CPR/AED to cap off my basic CPR, but the class didn't fill so that is delayed until next month.

Thanks again for the information.
_________________________
I do the things that I must, and really regret, are unfortunately necessary.

RIP OBG

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#185727 - 10/17/09 10:35 PM Re: AED Questions [Re: Desperado]
Polak187 Offline
Veteran

Registered: 05/23/02
Posts: 1403
Loc: Brooklyn, New York
I think that at the end of the day you have to think about this: what if the shock was succesful and now you got to manage post arrest... Everything else prior to the use of aed is nothing in comparison to what happens than. If you have a plan for that situation than you are golden. I've been a medic for a while now and only twice in my career pts were able to breathe on their own after defib and required almost no follow up care. Rest of them required massive drug support and managment otherwise they would arrest again.
_________________________
Matt
http://brunerdog.tripod.com/survival/index.html

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#185728 - 10/17/09 10:49 PM Re: AED Questions [Re: Polak187]
Desperado Offline
Veteran

Registered: 11/01/08
Posts: 1530
Loc: DFW, Texas
Hmm, I had not gotten that far down the road yet to think about meds. That one is way out of my level of experience and training....

More to think about.
_________________________
I do the things that I must, and really regret, are unfortunately necessary.

RIP OBG

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#185729 - 10/17/09 11:19 PM Re: AED Questions [Re: Polak187]
Arney Offline
Pooh-Bah

Registered: 09/15/05
Posts: 2485
Loc: California
Originally Posted By: Polak187
Rest of them required massive drug support and managment otherwise they would arrest again.

That's exactly the kind of information I was hoping to hear to the question in my first post. Using the AED is just the beginning, not the end, of a crisis. But, if you're going to go so far as to routinely set up a landing site for a medevac helicopter at your work sites, as you said, it could still tip the scales towards the AED if the response time is not too long.

Also, the kinds of cardiac situations you'd typically face on your job site may not reflect what an urban medic sees, so Polak's experience may not be 100% transferable to your situation in terms of how much post-AED care would typically be required.

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#185732 - 10/18/09 01:01 AM Re: AED Questions [Re: Arney]
dweste Offline
Pooh-Bah

Registered: 02/16/08
Posts: 2463
Loc: Central California
Today I went through American Heart Association basic First Aid, CPR, and AED training put on by the local fire department. I was suprised to learn that, because of the varied causes of collapse in breathing and heartbeat, CPR allows fewer than about 5% of victims to live, and that for infants the number is even lower. We were told that if the cause of collapse was ventral fibrillation that the general CPR numbers applied but with both CPR and AED the survival rate jumped to 40% plus.

Sobering.

Perhaps the most difficult technique for me to do properly was using the right amount of force to strike infants on the back to try to help them survive a choking incident - it felt like child abuse.

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#185734 - 10/18/09 01:26 AM Re: AED Questions [Re: dweste]
Desperado Offline
Veteran

Registered: 11/01/08
Posts: 1530
Loc: DFW, Texas
Originally Posted By: dweste


Perhaps the most difficult technique for me to do properly was using the right amount of force to strike infants on the back to try to help them survive a choking incident - it felt like child abuse.


dweste

That is one I have had to do in real life on an infant of a family I know.

The bad feelings go away when you hear the baby start crying. It is also nice when they invite you to their high school graduation too.....
_________________________
I do the things that I must, and really regret, are unfortunately necessary.

RIP OBG

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#185735 - 10/18/09 01:30 AM Re: AED Questions [Re: dweste]
JohnE Offline
Addict

Registered: 06/10/08
Posts: 601
Loc: Southern Cal
I'd be very suspect about that 40 % statistic. Doesn't jibe with any of the stats I've seen regarding the survival rate of patients where CPR and an AED was used.

A lot of stats are tossed around when it comes to things like survival rates, the reality is that unless the event is witnessed and CPR and an AED are used properly with additional medical treatment the survival rate hovers around 4-5 %. Those numbers go up to around 10% in some studies.


_________________________
JohnE

"and all the lousy little poets
comin round
tryin' to sound like Charlie Manson"

The Future/Leonard Cohen


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#185736 - 10/18/09 01:30 AM Re: AED Questions [Re: Arney]
Desperado Offline
Veteran

Registered: 11/01/08
Posts: 1530
Loc: DFW, Texas
Originally Posted By: Arney
Originally Posted By: Polak187
Rest of them required massive drug support and managment otherwise they would arrest again.

That's exactly the kind of information I was hoping to hear to the question in my first post. Using the AED is just the beginning, not the end, of a crisis. But, if you're going to go so far as to routinely set up a landing site for a medevac helicopter at your work sites, as you said, it could still tip the scales towards the AED if the response time is not too long.

Also, the kinds of cardiac situations you'd typically face on your job site may not reflect what an urban medic sees, so Polak's experience may not be 100% transferable to your situation in terms of how much post-AED care would typically be required.


It is not like we are painting the grass or anything, we just ensure there is an area that will safely accept any size rotor cone, has clear approach/departure paths, prepared to mark (day & night), and is accessible with FD or EMS apparatus. (rolling stretchers are not ATV's)
_________________________
I do the things that I must, and really regret, are unfortunately necessary.

RIP OBG

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#185738 - 10/18/09 01:37 AM Re: AED Questions [Re: JohnE]
dweste Offline
Pooh-Bah

Registered: 02/16/08
Posts: 2463
Loc: Central California
Originally Posted By: JohnE
I'd be very suspect about that 40 % statistic. Doesn't jibe with any of the stats I've seen regarding the survival rate of patients where CPR and an AED was used.

A lot of stats are tossed around when it comes to things like survival rates, the reality is that unless the event is witnessed and CPR and an AED are used properly with additional medical treatment the survival rate hovers around 4-5 %. Those numbers go up to around 10% in some studies.


You are right. I forgot that the 40%+ was for witnessed collapses and prompt use of CPR plus AED on victims suffering from ventricular fibrillation. Thanks for the correction!

P.S. CPR is hard work!


Edited by dweste (10/18/09 01:43 AM)

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