AEDs in the Wild?

  1. Recently, a poster on a boating forum I frequent has advocated purchasing an AED for use on off-shore passages (think in the middle of the Pacific Ocean, three weeks from land). The reasoning is that "simply jump-starting the heart could save a life, and I'd rather do something than nothing." The poster goes on to say that they and their spouse are nurses, and know what they're talking about. They advocate purchasing an AED for personal use because they can save lives in drowning or scuba diving accidents, electrical accidents and when someone onboard has an MI.

    I really can't see advocating that boaters (or hikers, or backpackers or river rafters or anyone who engages in activity far from civilization, ambulances and hospitals) spend money and use the weight for an AED. Their usefulness is limited and without proper follow-up, the person is likely to die anyway. It's not like a Tom Cruise movie where you allow yourself to be electrocuted fall on a convenient defibrillator and get shocked back to life.

    What do others think?
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  2. 29 Comments

  3. by   Pixie.RN
    I think they might be more useful for a drowning or electrocution vs. an MI — if someone having an MI is that far from the beaten path, the defib might be only a temporary help and not enough to get them to where they need to be. But I do know you can get a "home" AED for about $1K on Amazon. Hmmmmmm. Interesting topic!
  4. by   offlabel
    What do you do after you've defibrillated? Mask ventilate? Intubate? Start an epi infusion?
  5. by   Susie2310
    My suggestion would be to begin by researching state law as it applies to AED use.
  6. by   blondy2061h
    Can boaters three weeks off shore call the air force for transport to a hospital? A defibrillator could be useful in a very specific situation where the person was otherwise fairly healthy and arrested with a shockable rhythm and a cause that's easily reversible on the boat (an obstructed airway causing hypoxia?) or the ability to get to a higher level of care in a timely fashion. The likelihood of any boater encountering that is slim.

    To be honest, when I see AEDs in grocery stores, churches, schools, and parks around the area I live in I wonder how often any of these get used. Like across the US. I live in a wealthy suburban area with an average EMS response time <5 minutes. By the time someone finds, gets, and assembles the AED at a grocery store EMS is there. But I bet the grocery store spends good money on replacement pads. And it just takes one feel-good news story about a saved life to re-vamp the popularity.

    I'm not berating AEDs by any means. I just think the situations they're most useful in is when ems will be there soon but not very soon.
  7. by   Penelope_Pitstop
    When encountering AEDs that have not been domesticated, remember that they will attack if feeling threatened. If you're traveling to an area native to AEDs, be prepared. Ensure that your food is hidden and covered at all times. Consider wearing something to mask your natural scent. And please, don't approach them.
  8. by   cleback
    Quote from Penelope_Pitstop
    When encountering AEDs that have not been domesticated, remember that they will attack if feeling threatened. If you're traveling to an area native to AEDs, be prepared. Ensure that your food is hidden and covered at all times. Consider wearing something to mask your natural scent. And please, don't approach them.
    Too funny.

    I've heard that most successful layperson aed use is in the airport... maybe it has to do with the availability of them everywhere. I also know of running groups keeping one on hand.

    In one of the immunization clinics I worked for, they would describe people who want certain immunizations even if the risk of catching that disease/benefitting from immunization is low as "risk adverse" and "desiring maximal preparation". In the case of aeds, if people have the money to spend, it's no skin off my back.
  9. by   That Guy
    early shocks save lives. the more there are available I'm for it.
  10. by   Ruby Vee
    Quote from Pixie.RN
    I think they might be more useful for a drowning or electrocution vs. an MI — if someone having an MI is that far from the beaten path, the defib might be only a temporary help and not enough to get them to where they need to be. But I do know you can get a "home" AED for about $1K on Amazon. Hmmmmmm. Interesting topic!
    My experience has been in CCU and cardiac surgery ICU. The ACLS scenerio for drowning (at least the last few times I've certified) specifies a non-shockable rhythm, so I'm wondering how common it would be for drowning to result in a shockable rhythm? I would think it would be PEA, asystole or extreme bradycardia resulting from hypoxia.

    A home AED -- for one's home on land and only a 911 call away from an ambulance ride to the nearby hospital -- makes more sense to me. I just don't understand the efficacy of shocking someone who is hours or days away from a hospital. Perhaps I've overlooked something?
  11. by   Ruby Vee
    Quote from Susie2310
    My suggestion would be to begin by researching state law as it applies to AED use.
    I'm sorry, I don't understand your post. Is there a state law applying to private use of AEDs, and if there is, what difference would it make to an offshore sailor? A climber ascending Mt. Everest? Or even a camper in a campground 40 miles from the nearest EMS? Could you clarify your thinking please?
  12. by   Ruby Vee
    Quote from blondy2061h
    Can boaters three weeks off shore call the air force for transport to a hospital? A defibrillator could be useful in a very specific situation where the person was otherwise fairly healthy and arrested with a shockable rhythm and a cause that's easily reversible on the boat (an obstructed airway causing hypoxia?) or the ability to get to a higher level of care in a timely fashion. The likelihood of any boater encountering that is slim.

    To be honest, when I see AEDs in grocery stores, churches, schools, and parks around the area I live in I wonder how often any of these get used. Like across the US. I live in a wealthy suburban area with an average EMS response time <5 minutes. By the time someone finds, gets, and assembles the AED at a grocery store EMS is there. But I bet the grocery store spends good money on replacement pads. And it just takes one feel-good news story about a saved life to re-vamp the popularity.

    I'm not berating AEDs by any means. I just think the situations they're most useful in is when ems will be there soon but not very soon.
    A boater three weeks off shore is out of luck unless there's a boat in the area (a cruise ship maybe? a vessel from someone's navy?) with a doctor and some equipment willing to go out of their way to attempt a rescue. The Coast Guard might try to get to someone who was within the US coastal waters or even a reasonable distance outside them, but you're on your own in the middle of the Pacific. Or Atlantic.

    I make it a point to look for AEDs when I'm in the airport and I've seen them in museums and large, expensive and crowded theme parks. But those places aren't far from EMS. It isn't like the movies -- people don't just get up and go on to commit heroic feats after being successfully defibrillated or even cardioverted.
  13. by   Ruby Vee
    Quote from Penelope_Pitstop
    When encountering AEDs that have not been domesticated, remember that they will attack if feeling threatened. If you're traveling to an area native to AEDs, be prepared. Ensure that your food is hidden and covered at all times. Consider wearing something to mask your natural scent. And please, don't approach them.
    Beverage alert!
  14. by   Ruby Vee
    Quote from cleback
    Too funny.

    I've heard that most successful layperson aed use is in the airport... maybe it has to do with the availability of them everywhere. I also know of running groups keeping one on hand.

    In one of the immunization clinics I worked for, they would describe people who want certain immunizations even if the risk of catching that disease/benefitting from immunization is low as "risk adverse" and "desiring maximal preparation". In the case of aeds, if people have the money to spend, it's no skin off my back.
    You're right -- if someone has the money to burn, it's no skin off my nose. The guy on the boat next to ours has an AED on board. He's a physician. When he takes the boat out, he's usually alone but I can see how it would come in handy if DH or I DFO'd on the dock . . . someone would just have to run to the gate to let the EMS through afterward!

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