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  #1  
Old 06-10-2008
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Gadget: Flashlight combined with CPR spoken instructions:

bookofjoe: BehindTheMedspeak: Talking CPR Flashlight

Interesting gadget...
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Old 06-10-2008
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Cute....but....

One thing that often gets overlooked, or intentionally ignored (depending on how cynical one is) by the manufacturers of these products and their sales teams. CPR, or for that matter defibrillation is just one step in a chain of survival (to paraphrase American Heart Association).

In the middle of a city with a well designed and staffed EMS service and hospitals close by, CPR and early defibrillation can increase survival. There is absolutely a role for AED's in public buildings. However, the marketing of AED's/CPR reminder devices etc. to lay people with the intent to use offshore, or in the wilderness etc... is IMO (not so humble in this case....pretty much a pet peeve of mine here), is downright dishonest. It plays on peoples fears and promises false hope.

With the exception of certain cold water immersions in which case the person is not actually in arrest and lightning strikes; the fact is if someone suffers a cardiac arrest more than 10 mins from defibrillation and 30 mins from Advanced Life Support..the chance of survival is miniscule (I'd say 0% but I'm sure there is a case out there I haven't found. Sorry to get off on a rant but the marketing of these items really bugs me some days. And today is one of those days.
Michael
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Old 06-10-2008
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TXlnghrn-

The voice of sanity... there's a lot of gimmicky junk out there that is marketed in what I consider an almost criminal fashion. As you said, CPR is not all that useful if you're more than a few minutes from help.
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Old 06-10-2008
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Sanity?

Be careful calling me sane SD. People with long white coats and butterfly nets will put you in a "special" jacket with extra long sleeves that tie in the back
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Old 06-10-2008
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I disagree a bit, I think your chance of survival is 0% without CPR and maybe .1% with CPR. Why wouldn't you do CPR, even if it only increases chances by a minuscule amount? If you don't try, you'll never know and that can stay with you forever.

A flashlight like this, yeah it's a bit gimmicky, but it's not that expensive and it can really help keep people on track if they are freaking out (likely to be happening).
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Old 06-10-2008
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My Rant

Merlin,
My rant was less directed at this particular $40 item, than the $5000 "offshore" AED's being sold as life saving. If you will bear with me for a minute, I will try and explain a little further:

Survival in a cardiac arrest is dependent on a "chain of survival" It requires all the steps to be in place or it is 0%. The hard work comes in a resucitation after the return of a pulse. The chain involves:
Immediate recognition of the arrest and the start of effective CPR within 1-2 mins
Defibrillation within 10 mins (but far better within 5 mins)
ALS (meaning IV's, multiple IV medications) immediately upon return of a spontaneous pulse (and in many cases necessary to help the heart restart).
Extensive ICU level support within 30 mins (possibly out to 1 hour).

When these things don't exist the chance of survival is 0% with the exceptions I mentioned in my prior post:
Hypothermia - Survival cases are most likely those in which the heart is slowed to a point and blood is shunted away from the skin so as to make a pulse undetectable - but not a true cardiac arrest. Actually CPR can be harmful in these cases.
Lightning strikes - The heart has automaticity, meaning after it gets short circuited by a lightning strike it can self-reboot in which case support for circulation through properly performed CPR for a few mins can allow this to happen, Respiratory support is likely to be needed afterwards for quite a while and hospital support will be needed in a very short time.

So buy one and keep it in your car, take a CPR class and practice, practice, practice....You may one day save a life, I just wanted to prevent people from spending money on items with the expectation that if we push on their chest and shock them a few times two hours from the marina all will be okay.

Yes 0.1% chance is better than 0% and if it were my wife, I would do CPR if it wouldn't endager the rest of the people on the boat. But I would also know when it was time to stop and that is the hardest call to make.

Not trying to get everyone off in a bad mood today, but we (meaning sailors as a whole) seem able to talk about the realities of MOB, sinking and other emergencies at sea, but shy away from the realities of medical emergencies.
Michael
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Old 06-10-2008
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Michael,

Excellent, well thought out, post. I am guessing that you have some background in this feild (I do not, and appreciate the detail above).

I'd give you a rep point but....


-Ed
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Old 06-10-2008
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Micahel does make an excellent point. It is key to remember that there is a greater than 0% chance of recovery outside of the ideal chain of care. Back in the days prior to AEDs I had a CPR instructor that told a story of saving someone in the backwoods. I don't remember the details but he was 1+ hours from civilization hiking in the woods. Companion collapsed (not trauma) he started CPR (mind you he is an expert) and continued for 20+ minutes until another group of hikers came along the trail. One of the new hikers set out to hike back to summon help while the other one stayed to spell the first on CPR. They continued this until rescuers arrived (>2hrs total). The stricken hiker survived. His point in relating this tale was to illustrate that CPR will generally not revive a person and that you may be doing it for a long time until rescuers get there that can help.

What this means to me - CPR in a costal/lake environment makes sense, offshore maybe, transoceanic doubtful or just for a short while as Michael described.

An AED makes good sense in an auditorium/shopping center/airport where there are 100's/1000's of people, makes little sense in a home or boat.
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An AED makes sense in a home or a boat, provided the home or boat is in a relatively civilized and populated area, where access to first responders is relatively easy.
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Old 06-10-2008
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The reason I found it interesting - just how many people do you know that actually know the steps to perform CPR? Formal education (I am Red Cross certified) is the best but for lack of any experience for those who do not know - its a gadget that may well at worst be a toy to learn the basics in the cockpit... and secondly in the event one does need to, knowing you do not know how to it may just as well be a item that can walk through the steps...The fact is - one never knows when they have to use any of the emergency procedures and quite often it is usually the last safety item concerns most people have in reality....

Thats why I think its an interesting gadget...as for the other "marketing despise" of the product - I politely dis-agree, because its not being marketed to save lives - its just another tool to learn from....
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