4 ms·

Glad you were unscathed (assuming). Excellent point about CPR and blindness as well.

by kposehn 13y ago

rdl 13y ago
Seems like an excellent argument for having an AED available. (I'm really torn; it's just at the price point where buying one without any particular risk factors seems crazy, but EMS in the east bay tends to suck.) (except, I just checked on eBay; a surprising number of decent machines for <$500, allegedly pulls from gyms or hospitals. I wonder how hard it is to test and recertify, and also how hard it is to figure out how many of them have just been stolen.)
- MartinCron 13y ago
  The idea of a sub $500 AED from eBay makes me feel very nervous.
  - shabble 13y ago
    Assuming it hasn't been opened and screwed with (which should hopefully be apparent from tamper-evident case construction), it should have a fairly comprehensive self-test built in. There's a pretty in-depth tear-down of one on youtube[1] that describes some of the test aspects. Assuming it does pass, it's probably better than none at all, although in the worst case the person trying to use it is wasting time with it when they could be giving you CPR. Definitely a tough call. [1] https://www.youtube.com/watch?v=pn-Wv9YAfv0 https://www.youtube.com/watch?v=pn-Wv9YAfv0
    - rdl 13y ago
      A working AED for "guided CPR" is pretty nice even when you're doing CPR, especially if you don't do CPR all that frequently, too.
    - JshWright 13y ago
      If you have an AED, then you're not 'wasting time' getting it set up. CPR won't restart the heart. An AED _might_. If the person has been down for several minutes, then a few rounds of CPR is a good thing, but if it's less that 2-3 minutes, go right to the AED, don't bother with compressions.
      - Dylan16807 13y ago
        >CPR won't restart the heart. An AED _might_. Do you have a source on this? We're talking about a healthy but traumatized heart, right? And are we talking about totally stopped, arrhythmia, or either?
        rdl 13y ago
        I think by "restart", he meant the useful shorthand of "restore a useful rhythm, restart the heart as a pump instead of a tasty snack", and only in the case where the heart was in ventricular fibrillation or tachycardia. AEDs won't turn a "dead" heart into anything but slightly-cooked meat. (I think you can use them in full manual mode with open chest and electrodes to treat a few more weird rhythms, along with cardiac massage (open-chest or regular CPR), but probably not happening on a paramedic call-out, more likely in a hospital setting. Normally you use CPR + drugs and then try the AED again. I'm not really sure of the details of the limits of dealing with asystole in a hospital setting, but I suspect in an OR they have some extra options vs. other places.)
        JshWright 13y ago
        You can _try_ using a defibrillator to transcutaneously pace an asystolic heart, but I've never seen that work.
        rdl 13y ago
        I wonder if the next step would be being able to deliver drugs (atropine?) in a more targeted way (maybe tiny doses highly localized and recurring? I'm not sure exactly how it works) along with electrical or manual stimulation. I guess another option might be a rapid way to put someone on heart/lung bypass, either in the field or at least in the ER, rather than only in the OR. Or rapid chilling, or both. I suppose if we either had long-term useful artificial hearts, or a more efficient/effective organ transplant regime, this might be more of an issue.
- paul_f 13y ago
  Or go back out in the storm and get hit again, that should do it, right? :-)

Glad you were unscathed (assuming). Excellent point about CPR and blindness as well.

by kposehn 13y ago

Glad you were unscathed (assuming). Excellent point about CPR and blindness as well.

rdl 13y ago

Seems like an excellent argument for having an AED available. (I'm really torn; it's just at the price point where buying one without any particular risk factors seems crazy, but EMS in the east bay tends to suck.) (except, I just checked on eBay; a surprising number of decent machines for <$500, allegedly pulls from gyms or hospitals. I wonder how hard it is to test and recertify, and also how hard it is to figure out how many of them have just been stolen.)

MartinCron 13y ago
The idea of a sub $500 AED from eBay makes me feel very nervous.
- shabble 13y ago
  Assuming it hasn't been opened and screwed with (which should hopefully be apparent from tamper-evident case construction), it should have a fairly comprehensive self-test built in. There's a pretty in-depth tear-down of one on youtube[1] that describes some of the test aspects. Assuming it does pass, it's probably better than none at all, although in the worst case the person trying to use it is wasting time with it when they could be giving you CPR. Definitely a tough call. [1] https://www.youtube.com/watch?v=pn-Wv9YAfv0 https://www.youtube.com/watch?v=pn-Wv9YAfv0
  - rdl 13y ago
    A working AED for "guided CPR" is pretty nice even when you're doing CPR, especially if you don't do CPR all that frequently, too.
  - JshWright 13y ago
    If you have an AED, then you're not 'wasting time' getting it set up. CPR won't restart the heart. An AED _might_. If the person has been down for several minutes, then a few rounds of CPR is a good thing, but if it's less that 2-3 minutes, go right to the AED, don't bother with compressions.
    - Dylan16807 13y ago
      >CPR won't restart the heart. An AED _might_. Do you have a source on this? We're talking about a healthy but traumatized heart, right? And are we talking about totally stopped, arrhythmia, or either?
      - rdl 13y ago
        I think by "restart", he meant the useful shorthand of "restore a useful rhythm, restart the heart as a pump instead of a tasty snack", and only in the case where the heart was in ventricular fibrillation or tachycardia. AEDs won't turn a "dead" heart into anything but slightly-cooked meat. (I think you can use them in full manual mode with open chest and electrodes to treat a few more weird rhythms, along with cardiac massage (open-chest or regular CPR), but probably not happening on a paramedic call-out, more likely in a hospital setting. Normally you use CPR + drugs and then try the AED again. I'm not really sure of the details of the limits of dealing with asystole in a hospital setting, but I suspect in an OR they have some extra options vs. other places.)
        JshWright 13y ago
        You can _try_ using a defibrillator to transcutaneously pace an asystolic heart, but I've never seen that work.
        rdl 13y ago
        I wonder if the next step would be being able to deliver drugs (atropine?) in a more targeted way (maybe tiny doses highly localized and recurring? I'm not sure exactly how it works) along with electrical or manual stimulation. I guess another option might be a rapid way to put someone on heart/lung bypass, either in the field or at least in the ER, rather than only in the OR. Or rapid chilling, or both. I suppose if we either had long-term useful artificial hearts, or a more efficient/effective organ transplant regime, this might be more of an issue.
paul_f 13y ago
Or go back out in the storm and get hit again, that should do it, right? :-)