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(CBS New York)   Victim's family shocked that even though a gym is require to have defibrillator, and staff trained to use it, they don't actually have to use it   (newyork.cbslocal.com) divider line 147
    More: Stupid, Long Island, Jonathan Lippman, negligence, gyms, Appeals Court, automated external defibrillators  
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10231 clicks; posted to Main » on 09 Feb 2013 at 10:11 PM (1 year ago)   |  Favorite    |   share:  Share on Twitter share via Email Share on Facebook   more»



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2013-02-09 10:57:32 PM  

Britney Spear's Speculum: And that's why the court should throw this case out.  It will do more harm than good if they rule that the club was negligible.


What a negligible club might look like:

img22.imageshack.us

/it's negligent
 
2013-02-09 10:57:51 PM  
This is a shocking lawsuit
 
2013-02-09 10:58:00 PM  

Smgth: What's the point of mandating they carry the equipment and mandating they have someone to USE the equipment if you have zero intention of holding them to it's use?!!! Isn't the intention of the mandates to save lives? If you don't insist they ACTUALLY try and save lives, then you're just out to make sure gyms spend money.


Exactly. I would say the implied obligation is in the existence of the state mandate. Presumably, there is more backstory to the law than good lobbying. My state requires me to have working brakes on my car; I would probably not get away with failure to stop if I told the officer I didn't think the circumstances required me to use them.
 
2013-02-09 11:00:13 PM  
"Victim" *picture of Dr. Evil doing air quotes*
 
2013-02-09 11:00:25 PM  

BronyMedic: Notabunny: I'm ignorant. Will those things fire if the patient has a pulse?

There was a chance with the old ones that it would, but after what Cretinbob said I wonder if it's just kept in the guidelines as apopcryphia. I know our SOP with the Zoll PD1700s when I was a first responder said not to attach it if they had a pulse. it also has to do with the fact that those defib/pacer patches are about 150 bucks a pop, and they'd rather you not waste them. AEDs are useless if the patient had a pulse at any rate. Modern AEDs did away with the EKG monitoring screen (you can use the pads to monitor in Lead II) years ago because people realized they were added cost with no added value.

I do know that as of December 2012, a certain large nation-wide ambulance service I work for has in their guidelines that EMTs cannot use an AED while going down the road because of the risk of a false firing event. I've been monitoring patients on a Lifepak 12 that would literally look like they were in ventricular fibrillation when you go over some roads in Memphis, and the v.fib alarm would go off.

When you're dealing with BLS providers, namely First Responders and EMTs, you also have the issue of them performing a skill they are not legally allowed to perform - namely attempting manual cardioversion.


Something about that brings Orville Redenbacher to mind, but not in a happy way.
 
2013-02-09 11:00:46 PM  
Wait till the day comes when you all realize that even though police are armed with guns for protection, and are trained to be able to protect all of you, they aren't required or morally bound to actually do it either.
 
2013-02-09 11:01:04 PM  
If your only tool is a hammer...
 
2013-02-09 11:01:08 PM  

ZackDanger: OR

The guy had a pulse and respirations when the trainer first got there... but then deteriorated by the time the Doctor got next to him?


Maybe the doctor strangled him with a stethoscope just to be sure he didn't have a pulse.
 
2013-02-09 11:01:32 PM  

cretinbob: If he wasn't in a shockable rhythm, it wouldn't have mattered anyway.
AED's give a false sense of security.


Done in one. You can stick the pads on somebody, but the AED won't even let you shock if it's not appropriate.
 
2013-02-09 11:03:44 PM  

3StratMan: Wait till the day comes when you all realize that even though police are armed with guns for protection, and are trained to be able to protect all of you, they aren't required or morally bound to actually do it either.


[US Supreme Court] "Justices Rule Police Do Not Have a Constitutional Duty to Protect Someone"
 
2013-02-09 11:06:28 PM  

HMS_Blinkin: cretinbob: If he wasn't in a shockable rhythm, it wouldn't have mattered anyway.
AED's give a false sense of security.

Done in one. You can stick the pads on somebody, but the AED won't even let you shock if it's not appropriate.


Not really done in one since if he was in a shockable rhythm it very well have made a difference in the patient's outcome.  The lawsuit was correctly decided, however, since the trainer thought that the patient had a pulse and was breathing.
 
2013-02-09 11:10:46 PM  

felching pen: Exactly. I would say the implied obligation is in the existence of the state mandate. Presumably, there is more backstory to the law than good lobbying. My state requires me to have working brakes on my car; I would probably not get away with failure to stop if I told the officer I didn't think the circumstances required me to use them.


That's a little bit of a slippery slope there. The idea of the mandate is to have the equipment available to use appropriately by people trained to use it. The problem with creating a legal duty to respond in a case which would have otherwise been covered by the Good Samaritan statue is that you remove any protection people have for acting in good faith to aid another person, and open them up to medical malpractice and damage litigation. That is a POWERFUL motivator for people to not do anything but call 911.
 
2013-02-09 11:12:04 PM  

UsikFark: ZackDanger: OR

The guy had a pulse and respirations when the trainer first got there... but then deteriorated by the time the Doctor got next to him?

Maybe the doctor strangled him with a stethoscope just to be sure he didn't have a pulse.


Maybe the trainer accidentally checked the pulse on a guy lifting weights *next* to the victim... and then the doctor did CPR on a punching bag that was laying in the corner and THERE NEVER WAS A VICTIM.

The paramedics were just milk men.
 
2013-02-09 11:12:59 PM  

ZackDanger: UsikFark: ZackDanger: OR

The guy had a pulse and respirations when the trainer first got there... but then deteriorated by the time the Doctor got next to him?

Maybe the doctor strangled him with a stethoscope just to be sure he didn't have a pulse.

Maybe the trainer accidentally checked the pulse on a guy lifting weights *next* to the victim... and then the doctor did CPR on a punching bag that was laying in the corner and THERE NEVER WAS A VICTIM.

The paramedics were just milk men.


Maybe, just maybe, the reverse vampires actually set this up to murder him!
 
2013-02-09 11:14:28 PM  

ltdanman44: vygramul: cretinbob: If he wasn't in a shockable rhythm, it wouldn't have mattered anyway.
AED's give a false sense of security.

They treat a very small subset of shockable rhythms to begin with.  Like fewer than 20% of them.

the automated external defibrillator  can determine this. it just needs to be hooked up to the patient, and they did not do this.


No one said otherwise.
 
2013-02-09 11:14:52 PM  

BronyMedic: cretinbob: The AED won't fire if they have a pulse though, so there's no harm in applying the pads.

They can and will if they detect artifact and the software reads it as ventricular fibrillation.

[rtboardreview.com image 498x155]

That run of artifact there et al.....


Nice.
 
2013-02-09 11:16:28 PM  

BronyMedic: fusillade762: a trainer detected breathing and a pulse and didn't use the AED

Not a doctor, but do you use those things when someone still has a pulse? I thought they were supposed to re-start a stopped heart?

If they're breathing (laypeople don't check for a pulse), you don't apply it. You can actually cause an AED to deliver an improper shock by shaking the patient while it analyzes the rhythm - if they're having a seizure or shivvering violently, for example.

It's kind of useless to apply one to a conscious and/or breathing patient as a layperson. It will not do anything.

nmrsnr: This seems reasonable, they're gym staff, not doctors. They should know how to use the medical equipment on hand, but it's not like any time someone has a heart attack the defibrillator is the proper device to use, so if they missed the signs of proper use of the defibrillator and went with CPR instead, I don't think that's something they should be liable for.

Unless they were professional responders or healthcare professionals, they had no duty to act legally. Technically, they could do nothing and still be completely kosher for doing so.


And there it is, BronyMedic pretending to be an educator, when he's really just a pompous ass.  Yet again.  You'd think Bronny would eventually mature and grow out of it, and, yet,  after all this time, he continues to not do so.

Hint: Arrogant and condescending is a bad combination.  Maybe you could, you know, contribute and teach, instead of being your usual self. Oh wait, that's not in your union contract, is it.

/with all DUE respect.  (as in, none).
 
2013-02-09 11:17:54 PM  

BronyMedic: ZackDanger: UsikFark: ZackDanger: OR

The guy had a pulse and respirations when the trainer first got there... but then deteriorated by the time the Doctor got next to him?

Maybe the doctor strangled him with a stethoscope just to be sure he didn't have a pulse.

Maybe the trainer accidentally checked the pulse on a guy lifting weights *next* to the victim... and then the doctor did CPR on a punching bag that was laying in the corner and THERE NEVER WAS A VICTIM.

The paramedics were just milk men.

Maybe, just maybe, the reverse vampires actually set this up to murder him!


Maybe there was this guy in the midwest who invented a car that runs on water... and then the government decided to silence him... and they framed the trainer for the murder. But he was going to talk... so the government had to kill that random guy in the gym, so the trainer would mistakenly not do CPR (the government implanted into the gym guy, unbeknownst to him, during his sleep, a device in his blood stream to mimic a pulse), and then the trainer would be found negligent and sent to jail, and then when he was in jail his cell mate, tripping on government supplied acid, would murder the trainer, and then that other jail guy would fry in the electric chair.

All wrapped up nicely.
 
2013-02-09 11:21:18 PM  

djh0101010: BronyMedic: fusillade762: a trainer detected breathing and a pulse and didn't use the AED

Not a doctor, but do you use those things when someone still has a pulse? I thought they were supposed to re-start a stopped heart?

If they're breathing (laypeople don't check for a pulse), you don't apply it. You can actually cause an AED to deliver an improper shock by shaking the patient while it analyzes the rhythm - if they're having a seizure or shivvering violently, for example.

It's kind of useless to apply one to a conscious and/or breathing patient as a layperson. It will not do anything.

nmrsnr: This seems reasonable, they're gym staff, not doctors. They should know how to use the medical equipment on hand, but it's not like any time someone has a heart attack the defibrillator is the proper device to use, so if they missed the signs of proper use of the defibrillator and went with CPR instead, I don't think that's something they should be liable for.

Unless they were professional responders or healthcare professionals, they had no duty to act legally. Technically, they could do nothing and still be completely kosher for doing so.

And there it is, BronyMedic pretending to be an educator, when he's really just a pompous ass.  Yet again.  You'd think Bronny would eventually mature and grow out of it, and, yet,  after all this time, he continues to not do so.

Hint: Arrogant and condescending is a bad combination.  Maybe you could, you know, contribute and teach, instead of being your usual self. Oh wait, that's not in your union contract, is it.

/with all DUE respect.  (as in, none).


Wait... What?

What did you read? Because BronyMedic is right... there is no legal duty to act for non-proffessional responders.
 
2013-02-09 11:22:11 PM  
djh0101010:And there it is, BronyMedic pretending to be an educator, when he's really just a pompous ass.  Yet again.  You'd think Bronny would eventually mature and grow out of it, and, yet,  after all this time, he continues to not do so.

Hint: Arrogant and condescending is a bad combination.  Maybe you could, you know, contribute and teach, instead of being your usual self. Oh wait, that's not in your union contract, is it.

/with all DUE respect.  (as in, none).


Oh good, I was hoping the guy who was impersonating an EMT to troll would show up to cause his standard stupidity.

Actually, I'm an American Heart BLS-Healthcare Provider and an AAP Pediatric Education for Prehospital Provider Instructor. Nothing I've said has been arrogant or condescending in this thread. And I'm not even a member of a union, I work for a 403 Not for Profit Childrens Hospital.

What are you again, by the way? You never really answered which state the NREMT "licensed" you in?
 
2013-02-09 11:22:41 PM  

UsikFark: 3StratMan: Wait till the day comes when you all realize that even though police are armed with guns for protection, and are trained to be able to protect all of you, they aren't required or morally bound to actually do it either.

[US Supreme Court] "Justices Rule Police Do Not Have a Constitutional Duty to Protect Someone"


That ruling does not mean what you guys apparently think it means.
 
2013-02-09 11:23:55 PM  

BronyMedic: cretinbob: The AED won't fire if they have a pulse though, so there's no harm in applying the pads.

They can and will if they detect artifact and the software reads it as ventricular fibrillation.



That run of artifact there can be read by an AED as V Fib, and shocked inappropraitely. It's why even EMTs have to pull over if they use an AED during a transport before they can analyze, but a PAramedic can make a manual reading of the EKG and determine if it's needed.

American Heart and Red Cross standards both state that you do not apply an AED to a patient who has signs of circulation. Lay Rescuers do not check for a pulse anymore, and have not since the 2005 standards were released. The only people who are legally covered if they do so are Advanced Life Support personel, i.e. Paramedics, Registered Nurses, and Doctors/Mid-Level Providers who do so in a peri-arrest situation where they anticipate a patient is about to code.

If you apply an AED to someone who you know has a pulse, you have just lost ANY coverage against lawsuits as a layperson or BLS Healthcare Provider, and could actually face professional and civil sanctions as one.

Ed Finnerty: And that is why paramedics are no longer allowed to participate in "Wear Your Favorite Halloween Mask to Work Day".

Not all arrest rhythms are shockable, and are only able to be treated by identifying the reversable causes and correcting them as quickly as possible. Some of those you can reverse in the field, some of those you can't. Even shockable rhythms can turn into an irreversable asystole depending on how long the patient has been down, and what's going on with them to cause it in the first place.


Oh boy a ricky rescue who tries to look smart every time something EMS related pops up. Prime example of why a little knowledge can be a bad thing.
 
2013-02-09 11:24:14 PM  

ZackDanger: Wait... What?

What did you read? Because BronyMedic is right... there is no legal duty to act for non-proffessional responders.


Just ignore him. He's a person who claims to have been an "EMT-Basic" who shows up to troll threads I post in. He's been doing it ever since I made an off color joke a few months ago and that apparantly rustled his jimmies. This is pretty par for the course for him.
 
2013-02-09 11:24:59 PM  
I'm Red Cross CPR trained.  I've attended several CPR classes for certification.

My takeaway is this:  I really shouldn't try.  I'll call 911, and let the pros handle it.
 
2013-02-09 11:25:02 PM  

JonPace: Oh boy a ricky rescue who tries to look smart every time something EMS related pops up. Prime example of why a little knowledge can be a bad thing.


Please point out what I've said that is wrong, or contrary to the AHA's 2010 guidelines for emergency cardiac care?
 
2013-02-09 11:25:38 PM  

djh0101010: BronyMedic: fusillade762: a trainer detected breathing and a pulse and didn't use the AED

Not a doctor, but do you use those things when someone still has a pulse? I thought they were supposed to re-start a stopped heart?

If they're breathing (laypeople don't check for a pulse), you don't apply it. You can actually cause an AED to deliver an improper shock by shaking the patient while it analyzes the rhythm - if they're having a seizure or shivvering violently, for example.

It's kind of useless to apply one to a conscious and/or breathing patient as a layperson. It will not do anything.

nmrsnr: This seems reasonable, they're gym staff, not doctors. They should know how to use the medical equipment on hand, but it's not like any time someone has a heart attack the defibrillator is the proper device to use, so if they missed the signs of proper use of the defibrillator and went with CPR instead, I don't think that's something they should be liable for.

Unless they were professional responders or healthcare professionals, they had no duty to act legally. Technically, they could do nothing and still be completely kosher for doing so.

And there it is, BronyMedic pretending to be an educator, when he's really just a pompous ass.  Yet again.  You'd think Bronny would eventually mature and grow out of it, and, yet,  after all this time, he continues to not do so.

Hint: Arrogant and condescending is a bad combination.  Maybe you could, you know, contribute and teach, instead of being your usual self. Oh wait, that's not in your union contract, is it.

/with all DUE respect.  (as in, none).


I used to be an EMT-D and learned why we were trained to pull over before using an AED from him now, fifteen years after I was first licensed, from him in this thread. Not sure why you have an issue with him, but he's educated at least one person here.
 
2013-02-09 11:31:18 PM  

davidphogan: I used to be an EMT-D and learned why we were trained to pull over before using an AED from him now, fifteen years after I was first licensed, from him in this thread. Not sure why you have an issue with him, but he's educated at least one person here.


I'm really honored about that then. I didn't even know why they made you do that until I asked a Zoll Rep a few months back when eh was doing our initial training on the new ProPaqs we went to. We weren't taught the "why" we do a lot of things in school as EMT-Basics, just the how and when.

As far as djh0101010 goes, he's gone on several bizarre diatribes in which he uses improper and blatently wrong terminiology, incorrect assumptions that only someone who has never been in the EMS profession could make (like NREMT Licensure), and has constantly claimed to be better at, well - everything, since he's been a volunteer "EMT" for 10 years. I called him out as a fake in a thread a few weeks ago, and he abandoned ship.
 
2013-02-09 11:32:27 PM  
BronyMedic
If they're breathing (laypeople don't check for a pulse), you don't apply it. You can actually cause an AED to deliver an improper shock by shaking the patient while it analyzes the rhythm - if they're having a seizure or shivvering violently, for example.

It's kind of useless to apply one to a conscious and/or breathing patient as a layperson. It will not do anything.


OTOH, if they did CPR...I remember being told during some quickie first-aid course not to do CPR if someone is just unconscious, but still breathing normally.
So given that they thought CPR was necessary, shouldn't they also have tried the AED?
 
2013-02-09 11:33:38 PM  
davidphogan:
I used to be an EMT-D and learned why we were trained to pull over before using an AED from him now, fifteen years after I was first licensed, from him in this thread. Not sure why you have an issue with him, but he's educated at least one person here.

As a point of clarification from something posted earlier in the thread, I also want to point out that an AED can shock a person who is conscious, not in VFIB, and not even moving. AEDs are designed to shock a variety of rhythms, one of which can support life in some cases and thus it is not benign to put an AED on a person who is awake.

I've even heard of EMTs proactively placing electrode pads on someone who is awake and experiencing Chest Pain "just in case." Not only is this directly in contradiction to manufacturer's guidelines, it is very dangerous and potentially deadly.

Only ever place an AED on a person with "no signs of circulation."

blogs.laweekly.com
 
2013-02-09 11:35:00 PM  

CruiserTwelve: UsikFark: 3StratMan: Wait till the day comes when you all realize that even though police are armed with guns for protection, and are trained to be able to protect all of you, they aren't required or morally bound to actually do it either.

[US Supreme Court] "Justices Rule Police Do Not Have a Constitutional Duty to Protect Someone"

That ruling does not mean what you guys apparently think it means.


I'm pretty sure it means that the police are not obligated to protect you, and have quite a bit of discretion in that regard,and have it legally.

What do you think it means?
 
2013-02-09 11:36:25 PM  

ZackDanger: UsikFark: ZackDanger: OR

The guy had a pulse and respirations when the trainer first got there... but then deteriorated by the time the Doctor got next to him?

Maybe the doctor strangled him with a stethoscope just to be sure he didn't have a pulse.

Maybe the trainer accidentally checked the pulse on a guy lifting weights *next* to the victim... and then the doctor did CPR on a punching bag that was laying in the corner and THERE NEVER WAS A VICTIM.

The paramedics were just milk men.


I am the Milkman. My milk is delicious.
 
2013-02-09 11:36:35 PM  
79 posts and nobody has blamed this on OBAMACARE?!?!

Goddamn - you guys are getting sloppy.
 
2013-02-09 11:39:07 PM  

The Voice of Doom: BronyMedic
If they're breathing (laypeople don't check for a pulse), you don't apply it. You can actually cause an AED to deliver an improper shock by shaking the patient while it analyzes the rhythm - if they're having a seizure or shivvering violently, for example.

It's kind of useless to apply one to a conscious and/or breathing patient as a layperson. It will not do anything.

OTOH, if they did CPR...I remember being told during some quickie first-aid course not to do CPR if someone is just unconscious, but still breathing normally.
So given that they thought CPR was necessary, shouldn't they also have tried the AED?


It wouldn't be unreasonable to do CPR on someone who has a very slow pulse rate... If zero beats a minute is worthy of CPR.... what about 2 or 5?

There is also something called "agonal" respirations... which are the basically the last dying gasps of a person... an experienced healthcare provider would recognize this and understand these types of respirations as basically not counting as real ones.
 
2013-02-09 11:39:50 PM  

The Voice of Doom: OTOH, if they did CPR...I remember being told during some quickie first-aid course not to do CPR if someone is just unconscious, but still breathing normally.
So given that they thought CPR was necessary, shouldn't they also have tried the AED?


That's what's not adding up here.

You have two people who would, at the very least, be considered professional rescuers who have ascertained the person had no pulse, and required CPR. At that instant, yes you would. It's the exact situation the AED was designed for.

On the other hand, you have two laypeople, who are NOT trained to check for a pulse, who claim the guy had a pulse and that's why they didn't apply the AED. However, since they did NOT have a duty to act, they're still covered under the good samaritan act for not attaching it. If they had actually said they still attached it and thought that, IANAL but it would seem like their protection under the act would then go out the window, as they willingly commited a negligent act.
 
2013-02-09 11:40:13 PM  

CruiserTwelve: UsikFark: 3StratMan: Wait till the day comes when you all realize that even though police are armed with guns for protection, and are trained to be able to protect all of you, they aren't required or morally bound to actually do it either.

[US Supreme Court] "Justices Rule Police Do Not Have a Constitutional Duty to Protect Someone"

That ruling does not mean what you guys apparently think it means.


Please, by all means, explain to us, with a full dose of overcomplicated hyperbabble, exactly what it means.
 
2013-02-09 11:42:12 PM  
ZackDanger: OR
 
The guy had a pulse and respirations when the trainer first got there... but then deteriorated by the time the Doctor got next to him?

That was my first thought.
 
2013-02-09 11:43:39 PM  

ZackDanger: As a point of clarification from something posted earlier in the thread, I also want to point out that an AED can shock a person who is conscious, not in VFIB, and not even moving. AEDs are designed to shock a variety of rhythms, one of which can support life in some cases and thus it is not benign to put an AED on a person who is awake.

I've even heard of EMTs proactively placing electrode pads on someone who is awake and experiencing Chest Pain "just in case." Not only is this directly in contradiction to manufacturer's guidelines, it is very dangerous and potentially deadly.


THIS.

Not only that, if someone reports an EMT for doing that, they can lose their license for practicing outside of their scope of practice, and open themselves up to a lawsuit.

All the AED sees is this: Ventricular Tachycardia.

media.tumblr.com

The AED cannot determine if it has a pulse or not with it. It is quite possible to be in V.Tach and have a perfusing blood pressure at the same time (I had a patient the other day who was refractory to adenosine, amioderone and synchronized cardioversion, and lidocaine was contraindicated), and you WILL kill them by delivering an unsynchronized shock.

This is why EMT-Basics are taught NOT to apply an AED to a patient with a pulse and a rapid heart rate.
 
2013-02-09 11:45:13 PM  

Winston Smith '84: 79 posts and nobody has blamed this on OBAMACARE?!?!

Goddamn - you guys are getting sloppy.


heh, I was actually thinking that was a good sign.  Whatever.
 
2013-02-09 11:45:29 PM  

BronyMedic: The Voice of Doom: OTOH, if they did CPR...I remember being told during some quickie first-aid course not to do CPR if someone is just unconscious, but still breathing normally.
So given that they thought CPR was necessary, shouldn't they also have tried the AED?

That's what's not adding up here.

You have two people who would, at the very least, be considered professional rescuers who have ascertained the person had no pulse, and required CPR. At that instant, yes you would. It's the exact situation the AED was designed for.

On the other hand, you have two laypeople, who are NOT trained to check for a pulse, who claim the guy had a pulse and that's why they didn't apply the AED. However, since they did NOT have a duty to act, they're still covered under the good samaritan act for not attaching it. If they had actually said they still attached it and thought that, IANAL but it would seem like their protection under the act would then go out the window, as they willingly commited a negligent act.


VTac with a Pulse (and unresponsive) and profound bradycardia (and unresponsive) are two situations where an experienced medical provider may decide, in the field, to initiate CPR... or at least chest compressions... but *not* apply an AED.

That said, I still have no idea if this is what happened in this situation.
 
2013-02-09 11:55:10 PM  

3StratMan: CruiserTwelve: UsikFark: 3StratMan: Wait till the day comes when you all realize that even though police are armed with guns for protection, and are trained to be able to protect all of you, they aren't required or morally bound to actually do it either.

[US Supreme Court] "Justices Rule Police Do Not Have a Constitutional Duty to Protect Someone"

That ruling does not mean what you guys apparently think it means.

Please, by all means, explain to us, with a full dose of overcomplicated hyperbabble, exactly what it means.


It means get a weapon and learn how to safely and properly defend yourself.
 
2013-02-10 12:01:18 AM  
If I ever find someone who is down without a pulse (check the neck), I'm doing CPR until someone with better training tells me to stop, or I stop due to exhaustion, or someone else tags in to help.

If someone wants to use an AED I'll give them a chance, and then when nothing happens, will continue CPR.

/pretty much just CPR for a stopped heart
 
2013-02-10 12:06:11 AM  

Kraftwerk Orange: I'm Red Cross CPR trained.  I've attended several CPR classes for certification.

My takeaway is this:  I really shouldn't try.  I'll call 911, and let the pros handle it.


Please, please don't do this.

I'm begging you not to be the person who calls 911, and doesn't act when you have the training to do so. If that person needs CPR, and you just call 911 and don't do anything else, you're signing their death warrant. Even in cities with rapid EMS response, like Seattle or Wake County, NC (Two of the areas that are considered the gold standard in ECC in the United States), by the time EMS gets there they won't be viable. AHA studies have shown that less than 4% of out of hospital arrests will have a return of circulation, and less than one percent will leave the hosptial neurologically intact.

We're getting better with things like the Dr. ICE/Therapeutic Hypothermia protocols, better CPR training and real-time feedback, and mechanical CPR aids like the Lucas and Autopulse, but all that means nothing if you can't get someone to intervene in the meantime.

zoll.com

If one link is broken, the other links won't pull.
 
2013-02-10 12:10:19 AM  

studebaker hoch: If I ever find someone who is down without a pulse (check the neck), I'm doing CPR until someone with better training tells me to stop, or I stop due to exhaustion, or someone else tags in to help.

If someone wants to use an AED I'll give them a chance, and then when nothing happens, will continue CPR.

/pretty much just CPR for a stopped heart


The purpose of CPR is to keep heart tissue alive and maintain a rhythm long enough for an AED to arrive and make the difference.

For cardiac arrest, CPR will not solve the problem alone. The AED is essential. You shouldn't just be "giving [the aed] a chance"... you should be demanding someone brings you one.
 
2013-02-10 12:10:47 AM  

studebaker hoch: If I ever find someone who is down without a pulse (check the neck), I'm doing CPR until someone with better training tells me to stop, or I stop due to exhaustion, or someone else tags in to help.

If someone wants to use an AED I'll give them a chance, and then when nothing happens, will continue CPR.

/pretty much just CPR for a stopped heart


This is my understanding. 1 person should always do CPR, period. If two people are capable of assistance, one person should do CPR while the other gets the AED ready and verifies that it's the correct time to use. But CPR is first and foremost.

I review a lot of safety plans for construction work and I really think modern AEDs are quite good and relatively cheap, so every job site should consider having them available, but there's just no replacement for having two CPR basics trained people on every job.
 
2013-02-10 12:11:12 AM  

3StratMan: Please, by all means, explain to us, with a full dose of overcomplicated hyperbabble, exactly what it means.


It means the police do not have a legal obligation to protect individual people. Example: Let's say the cops are legally required to protect each individual person. You get robbed and murdered. Your family could sue the police for failing to protect you. Every crime victim would have a case against the government for failing to protect them from the criminal.

Note that I said a "legal" obligation. The police still have a moral and ethical obligation to uphold the law, and they still have a legal obligation to enforce the law within the confines of the constitution.

You can also sue the police for failing to act. This occurs when the police know there is a violation and fail to take action when they have the immediate ability to do so. Let's say the cops see you getting your ass kicked by another person and they stand there and watch without taking action. You have a case against them.

If you read the case that brought about this ruling, you can see why the ruling was made as it was. Had the court ruled that the police were at fault for not enforcing a restraining order when they did not have the immediate ability to act, it would have meant anytime a person violated a restraining order the police would be liable. That's an impossible responsibility.
 
2013-02-10 12:14:47 AM  
AEDs at gyms give people a false sense of security, he said, because nowhere in the U.S. are they mandated to use them.

Defibrillators do not give me a false sense of security. There is nothing about a publicly available defibrillator that says "it's ok if I have a heart attack here." The only place I feel safe having a heart attack is in a bed in a hospital room with a cardiologist and surgeon in the room.
 
2013-02-10 12:17:08 AM  
Just to clarify one data point for folks.  Defibrillators do not 'jumpstart' a heart.  They erase all electrical activity in the heart in the slight hope that when the heart re-polarizes on it's own afterwards that it will have a normal or better rhythm again.  In fact if one is asystolic and arythmic, defibrillators don't do much.  It's all drugs and CPR in that situation.
 
2013-02-10 12:28:13 AM  

BronyMedic: UsikFark: BronyMedic: It will not do anything. But, but, but, DO SOMETHING! Save Grandpa!

QUICK! GO BOIL WATER! AND I NEED TOWELS. LOTS OF TOWELS!

ltdanman44: the automated external defibrillator  can determine this. it just needs to be hooked up to the patient, and they did not do this.

This is what's not adding up. You have two healthcare providers insisting the person does not have a pulse and to attach the AED, and you have two laypeople - who are not trained nor are supposed to check for a pulse, only signs of circulation - insisting this person DID have a pulse.


Oo! I know the answer to this one: The laypersons were using their thumbs to check for the pulse. Betcha dollars to donuts. Alternatively, the "healthcare providers" were LVNs or RNs and not emergency room personnel and were used to checking wrists, but not carotids--and it was the LAYPERSONS who were finding a pulse (in the neck) where the "healthcare providers" were not.

CSS--we had an incident when I still worked for The Mouse, a friend of mine was "just a security guard" but a paramedic in real life. Disney had just gotten AEDs but only the nurses were allowed to use them. DL nurses are mostly RNs and LVNs and not ER nurses. So a train engineer drops from a heart attack one night, the other engineers start CPR, the fire dept. is called but are 10 minutes out. Our useless nurse shows up with her AED...but won't use it because although she knows how, she isn't "signed off" on the damn thing and is afraid to use it because liability.

My friend rolls up and sees the ambulance crew standing there, the nurse standing there, security standing there, all watching the engineers doing CPR on their buddy who is probably dead by now, and the AED dangling from the nurse's hand. HE, certainly, isn't supposed to use the AED, being just a security guard; but he's also a medic (and an asshole) and says to the nurse, "give me the damn defibrillator", tells the EMTs to get him an airway started, takes over the scene, and gets a rhythm shocked into the engineer before the medics get there. Guy walks out of the hospital 72 hours later.

My friend gets a 10-day suspension and a permanent disciplinary letter put into his personnel file which is only removed after Michael Eisner writes him a personal letter and orders that the disciplinary letter be torn out. And THAT is why nobody is ever going to help you out in the gym locker room, even if they've all been trained and have the equipment handy.
 
2013-02-10 12:34:04 AM  

fusillade762: a trainer detected breathing and a pulse and didn't use the AED

Not a doctor, but do you use those things when someone still has a pulse? I thought they were supposed to re-start a stopped heart?


Opposite. They actually stop a heart that's beating incorrectly, creating a stable rhythm (flat, actually) and allowing the heart to begin to beat properly (normal rhythm) again. They will not re-start a heart that has stopped beating (dead guy) because they are incapable. If that's what you're looking for (television and movies), you need to be paging Dr. Frankenstein and setting up a lightning rod.

Fun fact: shock at the wrong time and you can kill someone rather than helping the heart restore normal rhythm.
 
2013-02-10 12:37:25 AM  

Aigoo: Fun fact: shock at the wrong time and you can kill someone rather than helping the heart restore normal rhythm.


It's nothing a few hundred thousand volts won't fix, Aigoo. To be honest, the human body's one big potato clock.

images2.wikia.nocookie.net
 
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