drac: Funny I’ve found them to be extremely useful.
I’m sure, but I’d be interested to know your experience of how people in rural locations managed during the time before you showed up.
<br />I like the fact that there’s a defib on every Coop funeral directors wall.
Like hypothermia where you're not dead until you're warm and dead. You don't go in the box until you've been shocked and declared dead!
We were out riding one morning and my friend Stef dropped mid sentence. We thought he was p1ssing about.
Stef didn't make it.
There "was" a defib about 300m away. But the batteries had expired and not been replaced.
Would a defib have saved Stef, in his case probably not. But I would have used it until they stopped me.
Get trained, fund raise, get more defibs.
Just to widen awareness, here's the resuscitation council's flowchart for if someone collapses:
For the best chance of survival, a defib is a key link in the chain, and I have been involved in their use through my job on plenty of occasions to see the remarkable survival stories that can happen.
Some very humbling reading and information in this thread.
In which case, you’re an idiot
Harsh.
I’m sure, but I’d be interested to know your experience of how people in rural locations managed during the time before you showed up.
Of course it depends on the individuals but if they are able to give good quality CPR, there is more than one person then reasonably Ok but not great. Add in an AED that can be accessed quickly and it’s an incredible difference, either the shock/s they give it can work or at least give us a better chance of having success with drugs. The figures provided earlier for the ratios of success are accurate, the survival rate without CPR plus early shock are tiny.
They are absolutely worth having and should be provided by the government and no rely on charities.
On the subject of AEDs and mention above about batteries needing replacing, Shere council in Surrey are raising funds to replace theirs in their villages, Shere, Gomshall, Peaslake and Holmbury St. Mary.
Reason being that they get out of date, can't get replacement parts to keep them maintained, and council doesn't have the funds to replace them.
This is vital to help saving lives especially in rural environments full of mountain bikers, walkers and runners.
Given someone died recently on BKB, heart attack or cardiac arrest (not sure which), and while these may not have helped, maybe it will help the next one.
Despite a few of us posting this on a number of popular groups it's not had much attention so far.
https://www.justgiving.com/crowdfunding/ShereParishCouncilAEDs?utm_term=RD9vpnMY5
I remember an idle chat with one of the other dads at an event a couple of years back. Went along the lines of
How are you
I can't lift things at the minute
Oh done your back?
No had heart surgery after a cardiac arrest at work.
Sounds bad
If they'd not had a defibrillator I'd be dead
Oh!
Three kids iirc all of school age. We covered their use on a First Aid course a year or two back. Basically no magic bullet but significant difference to survival rates and the machines are really well designed. Gets my vote.
I think that a lot more people should be trained on them, although they are incredibly easy to use, it's more that people are ill-informed and often think it's like the movies where you can shock somebody's stopped heart back into life with one. They do not operate unless it finds a pulse, but also won't work on someone with a healthy heart beat.
Interesting info here:
research has shown that the chances of survival for an out of hospital (community) cardiac arrest are only about 6%. If you can get the pads onto the patient’s chest within 3 minutes and they are in a shockable rhythm, the chances of survival jump to 74%. This drops by 10% for every minute’s delay in using the machine.
https://firstaidforlife.org.uk/8-common-myths-about-defibrillators-and-why-they-save-lives/
Push for your work to get one but store it outside the building and have it added to the defib location app/website. This way more people would be able to access it.
In which case, you’re an idiot
This thread is the first time I've heard of anyone first hand saying that a community defibrillator has saved the life of someone they were treating. Everyone I know who's used one, including me, has had the patient die on them. I suspect it's different for Drac, who is likely to be there at the right time and know what they're doing. I'm sure some of them do save lives, so we obviously need them, but to think they will be the ultimate lifesaver is probably optimistic.
Nothing can make matters worse and the success rate for CPR is lower than you might think. About 5% out of healthcare and double that in healthcare settings. I’ve given CPR but not had access to a defibrillator. It would not have mattered in that instance. If one had been to hand Id have used it. They don’t sadly repair a broken neck though.
We've got a few in our offices now and I've passed a few phone box conversions out in the villages on bike rides with mates.
I can't see the harm in them becoming more and more common, as for choosing where they go? I suppose anywhere there's lots of footfall?
Are there many heart attack hotspots? Places with an elderly population? At the top of big hills? Chip shops? Feels like one for the statisticians...
I'm afraid that i can add myself to the number of people who have knackered themselves giving CPR to an already dead man.
In a situation where i'm unconvinced a defib would've made much of a difference.
TBF we were half way between Seven Springs and the Stepping Stones, so not exactly in the thick of it - eventually we had three of us in rotation giving CPR, the Air Ambulance hovered but couldn't land, the ground Ambulance crew took over, but had come on foot from something like 500m away, and all three of us were spent by the time they got to us. Chap didn't make it.
Time is of the essence - if the defib is close to where people might need it, it might help, but being close to an Ambulance to get to you will always be better.
My wife was incredibly to survive a cardiac arrest 18 years ago.
It was a quiet sunday on a ride down our street. When she collapsed, cars were stopping immediately to help. Someone ran to get an ER doctor who lived around the corner, who took over CPR.
The roads weren't busy, so the ambulance got there quickly. My flatmate was a trainee on that very ambo on the day as well.
I wasn't much help because I was a blithering mess.
but to think they will be the ultimate lifesaver is probably optimistic.
Which I'm not sure anyone has claimed.
We have three in our village, sensibly located at three of the four corners (its essentially a square road layout).
They asked us to have one on the wall of our Scout hut in the next village, and we refused - the hut is hidden down an unlit lane on the edge of the village, a lot of resudents don't know its even there. Much better to put it on the football pavilion, slap bang in the middle of the village
I suspect it’s different for Drac, who is likely to be there at the right time and know what they’re doing. <br /><br />
Not different at all, I’m a first aider without my equipment. An early shock is what massively increases your chances. Can’t do that without a defib.
https://www.defibfinder.uk/ shows you the nearest defib location and there are apps that you can download to your phone.
When I did a St John course on them, they didn't mention patches, but it is good practice to remove any patches before sticking on the pads (there have been cases where a nitroglycerine patch exploded).
IMHO it always worth trying CPR / Defib, even if the patient doesn't make it, the relatives at least know that somebody cared enough to try.
Drac
Not different at all, I’m a first aider without my equipment. An early shock is what massively increases your chances. Can’t do that without a defib.
Couldn't agree more. In my fire service career, I reckon I gave CPR to about ten people & the successful outcomes from those that I remember were a couple of incidents that happened outside our station so we had AED/CPR going within a couple of minutes.
The more AED units out there in the community, combined with public awareness, the better.
Most Screwfix branches have an AED in store.
It's also always going to be charged up as it's part of our monthly management checks.
Will be behind the counter , and there should be a sticker on the customer facing side to aid collection
I have no training beyond basic first aid and no experience using them, so no comment on that front. But I have been involved in fund raising for and siting one in our village. As above, we really just looked for the most visible place that was as central as possible to as many people as possible. It ended up on the fence outside the school, very visible and I guess near enough everyone knows where it is. Ultimately though there was no professional influence on its siting and it just came down to a community decision. The procurement of it came down to same. It was notable that most offerings essentially provided 4 years of renting/provision, rather than you buying the AED, after which in theory we'd be in for buying it all again. Talking to the ambulance service we ended up just buying one and adding it to their system. It cost a lot less all in and it isn't a limited time thing. We have to source batteries and pads though of course. The consumables expire quite quickly (a year or two for pads IIRC). But I think even with the other offerings someone in the community would've had to have the same responsibility.
Another notable thing about the process was the call from various parties for it to be locked in case of vandalism, in a leafy little Devon village with no real history of vandalism of anything much. Sure you get the combo from 999 and all the rest of it but are there any seconds in your life more valuable than those precious ones as you make that extra call and then get the number wrong in your panic? I'm happy to stand corrected but the idea of locking up something like this seems absurd to me. We won the debate easily and ours isn't locked, but I've seen loads of locked ones in similarly unlikely to see trouble places.
I’m happy to stand corrected but the idea of locking up something like this seems absurd to me. We won the debate easily and ours isn’t locked, but I’ve seen loads of locked ones in similarly unlikely to see trouble places.
The number of defib's that get damaged/vandalised/stolen is incredibly small. The British Heart Foundation ask that defib's be placed in unlocked cabinets which are accessible 24/7.
With the BHF's current offer for funding for community defib's, one of the conditions of funding is that they are kept in accessible, unlocked cabinets.
I don't know about other areas of the country but in London the ambulance service are throwing a huge amount of money in to teaching bystander CPR at the moment. They have a five year plan to teach every year 8 child in London how to perform CPR and how to use a defibrillator.
One of the best places in the country for out of hospital cardiac arrest survival was Heathrow Airport, the reason for the high survival rate was twofold. There's a huge number of staff there who are CPR trained who crack on and start CPR as soon as they witness people collapsing and there's also around 250 publicly accessible defib's that can be used when required.
Haven't read the thread but an anecdote that stands on its own:
On a very long local beach a young man had a heart attack in the water. He was dragged out with no heart beat and someone who knew how to started a heart massage. Meanwhile another ran the not inconsiderable distance to where he knew there was a defibrillator. He ran back to where the victim was still being given a heart massage and used the machine - the heart was restarted, long before the rescue services arrived.
Edit: there are so many press reports of people being saved by surfers/passers by/life guards using defibrillateurs on local beaches I can't find the case I've related above. Another stat came up in my searches: 1480 drownings in France in 2021 of which only 27% were fatal - it's always worth having a go and the chances of saving people are pretty good.
They're also useful as a risk mitigation asset; had an old boy have a nasty dismount from his folding bike due to a pothole this past summer whilst we were walking the hound, the 999 operator gave us the location and code for a AED nearby just in case his condition deteriorated. Me and another passerby kept him comfortable while Ms. RM fetched the AED.
Thankfully the ambulance crew arrived earlier than first stated. But it was good to have it nearby in case things went sideways.
My son's school has a defib. For some reason it's kept in the PE dept office so only accessible 0830-1530 mon-fri and when there's a teacher there to unlock the office.
School is next to footpath and cyclepath and is a sports centre at evenings and weekends. If you're not a pupil you do not have a hope of finding the defib.
So rather than move the defib to somewhere more accessible / visible the school are fundraising to buy a 2nd defib to put on the outside of school next to the front door!!
If you suspect a cardiac arrest (collapsed and unresponsive) then start effective CPR immediately and call 999. The call handler will talk you through the compression ratio etc and you keep going until you cant physically continue or told to stop by a medic.
Note it is effective CPR that must be performed and that's why some first aid training or knowledge can be invaluable. As stated earlier there are only two heart rhythms that can be treated by shocking - pulseless VT ( ultra fast heartbeat with no pulse) and VF ( heart is wobbling like a jelly but not pumping) The classic scene in movies and TV when a patient “flatlines” and is shocked back to life is just a myth.
If a defib is available the 999 call handler can advise ( in my trust area) where the nearest is. Defibs are not always miracle makers but can be invaluable. They are simple to use and if the rhythm is shockable (VF/VT) the device will tell you how and when to shock. It will not allow you to shock unless appropriate. The device will also, as stated earlier, provide instructions regarding CPR.
When medics arrive they will tell you to carry on giving compressions and will attach their own defib device which has more functionality. They will also supplement CPR with maintaining a viable airway and administration of appropriate drugs ( adrenaline mainly)
They will perform Advanced Life Support ( drugs, airways, shocks etc) for at least 30 minutes ( much longer with children) until either ceasing efforts or transporting to hospital if we achieve a return to spontaneous circulation (ROSC)
It can feel like forever but medics will respond to a cardiac arrest with the highest priority and by calling 999 and initiating effective CPR you are giving the patient the best chance of survival. It is worth noting that CPR requires a lot of force and can seem brutal but please don’t hesitate to start compressions.
It is not always a successful outcome but well worth the effort. Somebody will thank you.
Somebody will thank you.
<br />It was the last thing the paramedic did when I left the scene after nearly an hour on a cold March evening wearing lycra. Can see it like it was yesterday.
Did one get used at Bournemouth vs Luton today?
Thankfully the ambulance crew arrived earlier than first stated. But it was good to have it nearby in case things went sideways.
this well worth considering
Defibs are amazing, the more of them we have available the better.
I’ve personally performed CPR on approx. 15 people under a range of circumstances from overdoses, car crashes, medical problems, hangings and stabbings to name just a few. Unfortunately as a police officer I have very limited medical training. On all occasions due to the nature of my job a defib has been available and on scene within 5 minutes of CPR starting.
On all but 2 occasions the defibrillators advised “no shock” be performed. On 4 occasions the patients heart has started again either from the defib or specialist ambulance equipment (including a specialist team cutting open a chest cavity and massaging a heart with their hands at the roadside). Only 2 regained full consciousness and survived.
Defibrillators are brilliant and have saved countless lives but the point is once somebody is under cardiac arrest there’s often very little that can be done
One thing people don’t tell you is how physically difficult CPR is, they also never mention if you’re first to perform the CPR you’ll feel breaking ribs as you’ve got to compress 1/3rd of the body depth. Ambulance teams often cary LUCAS chest compression machines which do the job for them freeing them up to perform other critical functions but it’s a brutal thing to witness.
including a specialist team cutting open a chest cavity and massaging a heart with their hands at the roadside
😲
and bump -
https://www.justgiving.com/crowdfunding/ShereParishCouncilAEDs?utm_term=RD9vpnMY5Come on. Tonnes of us ride Surrey Hills and pay nothing to ride there (also reminder to donate to The Friends of the Hurtwood). Mountain biking tends to trigger heart conditions (as said, tragic one just the other week). The AEDs there need replacing.
I have done CPR a few timers and never seen a successful outcome. I have also seen folk with hypoxic brain damage post arrest ( heart restarted but too late). I have also seen or heard of dead folk getting worked on for ages - hardly a dignified death. I know of one person who found a neighbour dead and the 999 call handler tried to get them to do CPR on a corpse
Tends to colour my view somewhat but I note Dracs different experiences
Defibs and CPR save lives. The more rural you are the more important community AEDs and first responder schemes are. There might only be one ambulance in a small town or village and if it's already attending a call the next nearest could half an hour away or more. The first few minutes of a cardiac arrest are crucial. With each minute that passes your chance of survival are reduced. Good CPR will increase the chances that defibrillation will be successful. There will always be situations where no matter how good the resuscitation is it won't be successful. I have seen AEDs used successfully on several occasions. The Scottish Ambulance Service are trying get all the AEDs registered so when someone calls 999 they can be directed to the nearest one. It's never the wrong decision to start CPR, if it turns out to futile there's no harm done, but do start.
The more rural you are the more important community AEDs and first responder schemes are
This was the thought that motivated my initial post - community help may be all you have, as the ambulance is miles away waiting to offload a patient into a packed A&E. What I still don't really understand is how many times, in practice, community action is successful, in a circumstance where help is not immediately on hand, and an AED has to be fetched from somewhere. I'm not suggesting that installing them is pointless, or that we should give up - just trying to get a realistic idea of the situation. Maybe there isn't an answer beyond "it depends".
Survival rates are low anyway. A defib greatly increases the chances of a successful outcome but its still low. the most important thing however is knowledge
Doing CPR is not easy - its both tiring and mentally hard
In witnessed VF arrests survival rates have been as high as 50% in Scotland and higher in Scandinavian countries where CPR is widely taught. That's survival to discharge with good neurological outcome. The key thing here is the arrests were witnessed and therefore more likely to get bystander CPR. When looking at the numbers it's worth differentiating between the 50 year old sudden collapse on the golf course from MI which is a reversible cause and the the elderly person with multiple comorbidities who dies as a result of those where there's no reversible cause.
which is a small subset
overall survival rates post arrest outside of healthcare settings is much smaller Much smaller. the key thing with witnessed events is that CPR is started straight away
VF is one of the few things that are shockable where defibs make a real differnce
One thing people don’t tell you is how physically difficult CPR is, they also never mention if you’re first to perform the CPR you’ll feel breaking ribs as you’ve got to compress 1/3rd of the body depth.
This very fact is one of the many reasons i'm grateful for the quality and realism of the training I received over the course of my career from a variety of trained and experienced clinical professionals, who were also unrelenting in their assessment standards.
From my recent exposure to civilian FA courses, experiences absolutely do vary and thus so does the quality of aid.
From the various 1st Aid Courses I've had to do it seems like they are best placed where they have the best chance of beinig needed.
Also, on their effectiveness, treat them like a fire extinguisher. The sooner you can use one the better, the outcome for the patient is massively improved. They won't fix the problem, but it means your CPR will have a better chance of keeping them alive.
All the ones I've had use of (training scenarios only thankfully), have been very intuitive, and simple to use. They analyse the patient and decide what type of shock is needed, if at all.
I think they are a very good idea in principal.
But I'm concerened it may be a waste of money as they will require a high quality battery...
...for example if one was afixed next to a Canal or something like that... how often would they be serviced?
I'm not an expert in these matters, but common sence would suggest they would need regular battery maintenence/replacement.
And of course they might/will be vandalised or misappropriated, so there is a long term 'sunk' service cost there.
In the OP's village setting I imagine it is very unlikely they will get damaged. In our village there are five and they never get touched. Our previous (bigger / rougher) village had one accessible (never touched) but many others stupidly locked in buildings / cupboards for "fear" of damage without any supporting evidence.
Batteries have a clear replacement date. I'd hope whichever group went to the effort of placing the AED then keeps a note of it (it is usually parish council, village hall, church, school, football club committee etc and there will always be someone on it that loves a bit of admin).
Also don't forget or underestimate the power of a shout for help. If I found someone in the village, I'd probably start CPR whilst yelling for help. I'd bet within a minute there would be people to call paramedics, get the AED and assist with CPR. It is more out MTBing or walking that we are really on our own and tough decisions need to be made.
And for some facts behind the anecdotes, here is Darren from my work who would be dead without an AED in a Chorley park. He thinks he is the only dead guy to have completed an Ironman (there are others but they died / revived on the operating table).
The lack of awareness a frightening, this is why organisations like the BHF fight so hard to change knowledge and opinion.
I work for an airline - mulitiple members of the public have been kept alive through CPR and AED use at 36000ft
Indeed a fellow member of staff who looked 'a bit peaky' and went for a 20 min nap in the van was kept alive by his recently first aid trained colleagues who realised that a bit peaky was actually 'massive heart attack' and wouldn't let him leave on his own. Would have been found dead in his van later that day for sure.