4 ms·

The article is about internal defibrillators. External ones are still the same as (good grief) 35 years ago (well maybe down from 300J to 200J). The only change

The article is about internal defibrillators. External ones are still the same as (good grief) 35 years ago (well maybe down from 300J to 200J). The only change I've noticed is moving from a gel for the pads to a gel pad (which feel like a frog, chuck one in your partners bed and let them find it!) which reduced the possibility of burning and odd smells in your ambulance. Fortunately my sense of smell wasn't great and often had a partner who smoked (and was allowed to in the olden days) in the ambulance to dull it. You kids don't know how it was having to actually manually read the trace instead of all this new-fangled automation that guides you through it.

breezeTrowel 2y ago
I think the biggest change with external defibrillators has been placement. It's now front and back instead of two on the front.
- wbl 2y ago
  I should redo my CPR then. Learned two on the front in high school in NJ. But also to read the instructions though I'm sure when seconds count you don't.
  - AndrewDavis 2y ago
    Modern AEDs have voice guidance telling the person what to do. So you can follow the instructions as you do it. Also, you should call the emergency number in your region and (at least in Australia) they'll transfer you to someone who can coach you through using the defib and performing CPR until professional help arrives. Don't let that stop anyone from getting their CPR up to date though. The more experience you have the better equipped you'll be if you need to use it
    - giantg2 2y ago
      I see AEDs at work. If I have a heart attack, I have no confidence in my team being able to use it. I've seen how they handle requirements and documentation in stories.
      - have_faith 2y ago
        > Not sure if we have time for learning CPR in the current sprint, let's put it in the backlog
        exe34 2y ago
        was going to say, you need to make sure to open a ticket and bring it to the refinement meeting.
- dx034 2y ago
  I just did a training course and for the ones we used it was still two on the front. Only for children it's front and back.
  - KineticLensman 2y ago
    Likewise in the UK, two on the front, at least for adults. Makes less disruption to CPR if you leave the patient on their back.
- h1fra 2y ago
  Well I thought it was one in the front and one close to the ribs
extraduder_ire 2y ago
AEDs are an amazing invention and I'm glad to see them dotted around the place. Initially in dedicated cabinets mounted to walls outdoors, and sometimes in repurposed telephone booths.
- giantg2 2y ago
  I see AEDs hanging on the wall at work. My only real thought is if I have a heart attack at work, just let me die. Clearly I'm not going to make it to retirement anyways if the stress nd stress eating from my job is giving me a heart attack.
  - retrac 2y ago
    Bit of a false dichotomy: some people survive a heart attack without intervention, but suffer crippling injuries as a result. It's entirely possible to develop arrhythmia, fall into a low-oxygen state where you get brain damage, and then have your stupid heart decide to start pumping again.
    - giantg2 2y ago
      That's fine. At least I'll be too brain damaged to go back to that hell hole.
      - abfan1127 2y ago
        you could leave now...
        giantg2 2y ago
        Not really. I have a family to support and no real alternatives.
        abfan1127 2y ago
        while I don't know the details of your situation. However, my experience says there's always an alternative. Sometimes it means networking yourself. Sometimes it means changing industries while still leveraging your skills. Sometimes it means getting some education/certifications (even at night). Good luck on your future.
westurner 2y ago
"New defib placement increases chance of surviving heart attack by 264%" (2024) https://newatlas.com/medical/defibrillator-pads-anterior-posterior-cardiac-arrest-survival/ https://newatlas.com/medical/defibrillator-pads-anterior-pos... : > Placing [AED,] defibrillator pads on the chest and back, rather than the usual method of putting two on the chest, increases the odds of surviving an out-of-hospital cardiac arrest by more than two-and-a-half times, according to a new study. "Initial Defibrillator Pad Position and Outcomes for Shockable Out-of-Hospital Cardiac Arrest" (2024) https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2823184 https://jamanetwork.com/journals/jamanetworkopen/fullarticle...
- devilbunny 2y ago
  I know article authors don't write their own headlines, but for all who read this: it's about out-of-hospital cardiac arrest, which can be caused by a heart attack, but is in no way the most likely presentation of a heart attack.
  - westurner 2y ago
    The AED should measure the rhythms before applying defibrillation. An emergency AED operator doesn't need to make that distinction (doesn't need to differentially diagnose a HA as a CA) , do they? You just put the AED pads on the patient and push the button if they're having a heart attack.
    - westurner 2y ago
      (and stand clear such that you are not a conductor to the ground or between the pads)
      - devilbunny 2y ago
        Grounding isn't an issue, as AED's are battery-powered once they are pulled off the wall. But they do pump out a lot of juice. If you're touching the patient, it will HURT.
fm2606 2y ago
As a former firefighter-paramedic of 14 years which I left in 2020, our LifePak monitors went up to 360J. We did use self adhesive pads and never once did I have any odd smells after "welding" someone. We used stacked sequence, starting out at 200J, 300J and 360J. Our LifePaks did have AED but very few people used that option, so yeah, medics and agencies still require to know how to read traces. To know which rhythms to shock and which ones not to isn't rocket science, nor are there that many. There are only two pulseless rhythms that get shocked. There are also a couple of reason to shock conscious people with rhythms that does require a bit more training and knowing when to give the shock but it isn't all that difficult to learn. Not sure why the "us kids" comment. How come you aren't boasting about not wearing gloves and PPE? I've heard about "back in the day" how it was a badge of honor to be covered in someone else's blood. That shit ain't cool at all, but it does occasionally happen where blood does get on unprotected skin, it has happened to me. Did we have to know as much as back in the 70s, 80s and 90s? No, not at all but that is advancement and not necessarily watering it down. If I have an out-of-hospital emergency I definitely would want street medics and firefighter there for help. I am still shocked how often I've seen doctors and nurses loose their shit because they aren't use to having to think on their own or they don't have a team of 10 or 15 people there to back them up. I've seen it in firefighters and medics as well, just not as often. Most nurses aren't allowed intubate in a well lit hospital room, let alone lying on the asphalt of a highway or floor of someones home.
- Johnny555 2y ago
  >Not sure why the "us kids" comment. >Did we have to know as much as back in the 70s, 80s and 90s? No, not at all but that is advancement and not necessarily watering it down. Sounds like you do understand the comment and agree with it, but still took offense.
  - 8338550bff96 2y ago
    Best of both worlds
- closewith 2y ago
  > Did we have to know as much as back in the 70s, 80s and 90s? No, not at all but that is advancement and not necessarily watering it down. We need to know much more now than ever before, as the number of treatments performed on scene has grown enormously. Not to mention survivability is orders of magnitude better.
aaron695 2y ago
[dead]
FireBeyond 2y ago
> having to actually manually read the trace instead of all this new-fangled automation that guides you through it. I never met a LifePak 12 that did not flag every 12 lead it saw as an "Abnormal ECG".
- _r2h 2y ago
  Zolls aren't any better. I managed a fleet of 70+ X-Series Advanced, and only read normal on young adults who were perfectly still and electrodes were placed perfectly. That being said, the rhythm and 12 lead interp algo on it was impressively accurate. It would very often pick up subtle very high lateral infarcts, usually only identified by clinicians familiar with the "south african flag sign."

breezeTrowel 2y ago

I think the biggest change with external defibrillators has been placement. It's now front and back instead of two on the front.

wbl 2y ago
I should redo my CPR then. Learned two on the front in high school in NJ. But also to read the instructions though I'm sure when seconds count you don't.
- AndrewDavis 2y ago
  Modern AEDs have voice guidance telling the person what to do. So you can follow the instructions as you do it. Also, you should call the emergency number in your region and (at least in Australia) they'll transfer you to someone who can coach you through using the defib and performing CPR until professional help arrives. Don't let that stop anyone from getting their CPR up to date though. The more experience you have the better equipped you'll be if you need to use it
  - giantg2 2y ago
    I see AEDs at work. If I have a heart attack, I have no confidence in my team being able to use it. I've seen how they handle requirements and documentation in stories.
    - have_faith 2y ago
      > Not sure if we have time for learning CPR in the current sprint, let's put it in the backlog
      - exe34 2y ago
        was going to say, you need to make sure to open a ticket and bring it to the refinement meeting.
dx034 2y ago
I just did a training course and for the ones we used it was still two on the front. Only for children it's front and back.
- KineticLensman 2y ago
  Likewise in the UK, two on the front, at least for adults. Makes less disruption to CPR if you leave the patient on their back.
h1fra 2y ago
Well I thought it was one in the front and one close to the ribs

extraduder_ire 2y ago

AEDs are an amazing invention and I'm glad to see them dotted around the place. Initially in dedicated cabinets mounted to walls outdoors, and sometimes in repurposed telephone booths.

giantg2 2y ago
I see AEDs hanging on the wall at work. My only real thought is if I have a heart attack at work, just let me die. Clearly I'm not going to make it to retirement anyways if the stress nd stress eating from my job is giving me a heart attack.
- retrac 2y ago
  Bit of a false dichotomy: some people survive a heart attack without intervention, but suffer crippling injuries as a result. It's entirely possible to develop arrhythmia, fall into a low-oxygen state where you get brain damage, and then have your stupid heart decide to start pumping again.
  - giantg2 2y ago
    That's fine. At least I'll be too brain damaged to go back to that hell hole.
    - abfan1127 2y ago
      you could leave now...
      - giantg2 2y ago
        Not really. I have a family to support and no real alternatives.
        abfan1127 2y ago
        while I don't know the details of your situation. However, my experience says there's always an alternative. Sometimes it means networking yourself. Sometimes it means changing industries while still leveraging your skills. Sometimes it means getting some education/certifications (even at night). Good luck on your future.

westurner 2y ago

"New defib placement increases chance of surviving heart attack by 264%" (2024) https://newatlas.com/medical/defibrillator-pads-anterior-posterior-cardiac-arrest-survival/ https://newatlas.com/medical/defibrillator-pads-anterior-pos... : > Placing [AED,] defibrillator pads on the chest and back, rather than the usual method of putting two on the chest, increases the odds of surviving an out-of-hospital cardiac arrest by more than two-and-a-half times, according to a new study. "Initial Defibrillator Pad Position and Outcomes for Shockable Out-of-Hospital Cardiac Arrest" (2024) https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2823184 https://jamanetwork.com/journals/jamanetworkopen/fullarticle...

devilbunny 2y ago
I know article authors don't write their own headlines, but for all who read this: it's about out-of-hospital cardiac arrest, which can be caused by a heart attack, but is in no way the most likely presentation of a heart attack.
- westurner 2y ago
  The AED should measure the rhythms before applying defibrillation. An emergency AED operator doesn't need to make that distinction (doesn't need to differentially diagnose a HA as a CA) , do they? You just put the AED pads on the patient and push the button if they're having a heart attack.
  - westurner 2y ago
    (and stand clear such that you are not a conductor to the ground or between the pads)
    - devilbunny 2y ago
      Grounding isn't an issue, as AED's are battery-powered once they are pulled off the wall. But they do pump out a lot of juice. If you're touching the patient, it will HURT.

fm2606 2y ago

As a former firefighter-paramedic of 14 years which I left in 2020, our LifePak monitors went up to 360J. We did use self adhesive pads and never once did I have any odd smells after "welding" someone. We used stacked sequence, starting out at 200J, 300J and 360J. Our LifePaks did have AED but very few people used that option, so yeah, medics and agencies still require to know how to read traces. To know which rhythms to shock and which ones not to isn't rocket science, nor are there that many. There are only two pulseless rhythms that get shocked. There are also a couple of reason to shock conscious people with rhythms that does require a bit more training and knowing when to give the shock but it isn't all that difficult to learn. Not sure why the "us kids" comment. How come you aren't boasting about not wearing gloves and PPE? I've heard about "back in the day" how it was a badge of honor to be covered in someone else's blood. That shit ain't cool at all, but it does occasionally happen where blood does get on unprotected skin, it has happened to me. Did we have to know as much as back in the 70s, 80s and 90s? No, not at all but that is advancement and not necessarily watering it down. If I have an out-of-hospital emergency I definitely would want street medics and firefighter there for help. I am still shocked how often I've seen doctors and nurses loose their shit because they aren't use to having to think on their own or they don't have a team of 10 or 15 people there to back them up. I've seen it in firefighters and medics as well, just not as often. Most nurses aren't allowed intubate in a well lit hospital room, let alone lying on the asphalt of a highway or floor of someones home.

Johnny555 2y ago
>Not sure why the "us kids" comment. >Did we have to know as much as back in the 70s, 80s and 90s? No, not at all but that is advancement and not necessarily watering it down. Sounds like you do understand the comment and agree with it, but still took offense.
- 8338550bff96 2y ago
  Best of both worlds
closewith 2y ago
> Did we have to know as much as back in the 70s, 80s and 90s? No, not at all but that is advancement and not necessarily watering it down. We need to know much more now than ever before, as the number of treatments performed on scene has grown enormously. Not to mention survivability is orders of magnitude better.

aaron695 2y ago

[dead]

FireBeyond 2y ago

> having to actually manually read the trace instead of all this new-fangled automation that guides you through it. I never met a LifePak 12 that did not flag every 12 lead it saw as an "Abnormal ECG".

_r2h 2y ago
Zolls aren't any better. I managed a fleet of 70+ X-Series Advanced, and only read normal on young adults who were perfectly still and electrodes were placed perfectly. That being said, the rhythm and 12 lead interp algo on it was impressively accurate. It would very often pick up subtle very high lateral infarcts, usually only identified by clinicians familiar with the "south african flag sign."