> If it can't detect a treatable condition it doesn't just blat you with electricity for the sake of it
I was taught how to use one on a course where the instructor said he used to enjoy teaching students this fact by allowing them to take turns attempting to use a live defibrillator on him.
He got away with it for many years until his boss found out and put a stop to it because the company insurance wouldn't cover the company (despite clear witnessed consent being given by the instructor).
On the plus side, the company didn't ban his teaching method of NPA (Nasopharyngeal Airway) insertion. ;-)
> manual CPR which had kept my brain supplied with oxygen
Manual CPR done correctly is critical, and yes if done correctly you WILL end up with broken ribs. Mouth-to-mouth is not deemed particularly necessary these days (since the act of correct CPR will draw oxygen in anyway), better to focus on proper CPR and wait for the ambulance to turn up with high-flow oxygen from a tank.
> If I had been a 20 minute walk away, I would be dead (or brain damaged)
Yes. The most effective time for defib use is in the first 5 minutes. That's not to say you should not have a go after that time, but its effectiveness does drop away quite quickly.
> Mouth-to-mouth is not deemed particularly necessary these days (since the act of correct CPR will draw oxygen in anyway), better to focus on proper CPR and wait for the ambulance to turn up with high-flow oxygen from a tank.
Mouth-to-mouth isn't critical, but clearing the airway is. I remember one story from a first-aid refresher a few year, the guy doing it said he arrived at a car crash (doing a stint on an ambulance). A girl had been hit and was lying on the floor. Nobody had touched her in case they broke her neck or something.
She wasn't breathing. The ambulance had arrived within about 5 minutes, which was too late. Tilting her head back would likely have saved her life.
> Mouth-to-mouth isn't critical, but clearing the airway is.
Sure, but that goes without saying. Anybody who's been taught DRSABCD should know that.
Its also the reason why the FIRST thing you do when someone is choking is call for an ambulance (ideally on loudspeaker so you can get on with it at the same time, or, preferably get someone else to, if available). Even if you are successful in dislodging the item, they will still need a once-over by a trained medic because if you did it by the book it comes with side-risks.... so whichever way you won't be wasting the ambulance's time.
If you start trying things on choking and find you're not getting very far and then call an ambulance .... it'll probably be too late.
(Goes without saying that for heart issues, ambulance is also a high priority, but choking is far more time critical in the grand scheme of things).
Clearly not for the average person at that accident scene where the girl died, and indeed I believe that for most people - especially in a crowd - the first and last action is "shock". Maybe someone will phone for help.
My first aid training comes from hostile environments, where catastrophic bleeding fits in before airway. Unlikely to find someone with a missing limb down the high street, but there's not much point in CPR if the blood you pump is gushing out of the femoral artery.
I remember reading of one--kid ran behind the car that was backing out. *Minor* injuries, but fatal because the people were afraid to mess with a head wound. The kid was knocked unconscious and had a nosebleed--he drowned on the sidewalk.
> Yes. The most effective time for defib use is in the first 5 minutes. That's not to say you should not have a go after that time
Totally! After my experience I booked myself on a defibrillator training course, and looking back now, the main thing I remember from the course was the instructor's key learning point that you should get the defib out as soon as you can and let it take over. It pretty much can't make things worse than doing nothing.
Exactly. Hollywood always gets it wrong--shocking a non-beating heart does nothing (in fact, the whole purpose of the machine is to *stop* the heart!). The machines look for improper, useless beating and will not fire unless they see it. It's still possible to get the pads sufficiently wrong that the shock is wasted, but there's no way to shock someone who doesn't need it.
For a non-beating heart the only treatment is CPR until the docs can deal with whatever caused it not to beat in the first place.
When I was 3 years old my older brother tried to kill me and very nearly succeeded. As best anyone can recon, I was no breath no pulse for about 10 minutes. My life was saved by an EMT doing CPR. These people are incredible, and deserve every bit of praise and validation we can give them.
> Mouth-to-mouth is not deemed particularly necessary these days (since the act of correct CPR will draw oxygen in anyway), better to focus on proper CPR and wait for the ambulance to turn up with high-flow oxygen from a tank.
Not exactly. More precisely, for the “average” out of hospital cardiac arrest in an adult, chest compressions are more important than expired air resuscitation (mouth to mouth). The guidance to the public was watered down because there was recognition that members of the public were not enthusiastic about starting mouth to mouth resuscitation with a stranger. Mouth to mouth definitely helps.
You need a patent airway for any type of CPR to have any chance of working. Chin lift and jaw thrust are important for both compressions only and compression with breaths.
Source: I’m an attending anaesthesiologist and have resuscitated more people than I would like to count.
I was taught how to use one on a course where the instructor said he used to enjoy teaching students this fact by allowing them to take turns attempting to use a live defibrillator on him.
He got away with it for many years until his boss found out and put a stop to it because the company insurance wouldn't cover the company (despite clear witnessed consent being given by the instructor).
On the plus side, the company didn't ban his teaching method of NPA (Nasopharyngeal Airway) insertion. ;-)
> manual CPR which had kept my brain supplied with oxygen
Manual CPR done correctly is critical, and yes if done correctly you WILL end up with broken ribs. Mouth-to-mouth is not deemed particularly necessary these days (since the act of correct CPR will draw oxygen in anyway), better to focus on proper CPR and wait for the ambulance to turn up with high-flow oxygen from a tank.
> If I had been a 20 minute walk away, I would be dead (or brain damaged)
Yes. The most effective time for defib use is in the first 5 minutes. That's not to say you should not have a go after that time, but its effectiveness does drop away quite quickly.