UKH

I was reminded of this topic on another post. 

Do you know where your nearest one is? 

Do you know how it works?  

Links to follow.  

I don't know about nearest, but know where the one in our local shopping centre is. I try to take note when I see them

http://www.heartsafe.org.uk/AED-Locations

Call 999 as usual, send someone to get the defibrillator,  they may need also to call 999 for the code to open the box if you can't give it to them before they leave. 

Instructions for use are given by the machine and also by the 999 call handlers.  

More lists here by area.

https://www.docdefib.com/where-is-your-nearest-defibrillator/

There’s one on the wall of Langton outdoor centre in Hartsop.

Unfortunately there’s often no mobile signal in this area and nobody in the centre itself.

I suppose one could always try breaking into the cabinet in an emergency.

I guess that’s part of the risk of enjoying the great outdoors.

Thanks for publicising this important topic.

The beauty is they will usually tell you how to operate themselves. I was surprised they are now covered in first aid courses

That's how I know as it happens, my first aid renewal covered it.  Surprisingly straightforward, but if you don't know that then you might not try so this is why I thought I'd mention it. 

I know where there a couple near me, 999 callhandlers will only direct you to them if you are close by, as in 200m, but if you have a runner and know where the closest AEDs are it's best to get them to head to one if it's a bit further away anyway as if it reduces the time between an arrest and shock being delivered then it doesn't not help.

The AEDs themselves are virtually idiot proof.

Even if your phone shows “no signal”, a 999 call may go through as they’re automatically carried by any network, not just the one you use and the status of which your phone displays.  Some phones will display “Emergency calls only” in such situations.

There is also the 999 text service but you need to register 

There are three in our fairly rural location, two of the ones you need to call 999 and get in to,  but our nearest is in an old phone box that we purchased ourselves via fundraising. This isn't  locked, and the non profit organisation that supplied it and provided a training session said that theft or vandalism is incredibly rare, even in urban areas.

Thanks for that.

Two of the local ones are in locked boxes with the call 999 instructions, and a third is in a community centre, but that isn't open all of the time. They are certainly a great lifesaving tool to have in the area.

FTFY

A couple of points that came up when I did training on their use:

- they are indeed pretty much idiot proof, they talk you through the process

- if you are 'taking charge' then point to a specific person or pair of people to go get it, don't just shout "someone go get the defib!". Same advice applies to telling someone to call 999 if you are doing CPR. Obviously make sure they have a phone so they can get the code.

- unless it's really cold get the casualty's chest exposed in advance of the defib arriving, ideally in the moments while someone is doing rescue breaths so you don't have to delay chest compressions.

- get the pads on simultaneously with CPR

- as soon as it has administered the shock/said that the rhythm is unshockable you can restart CPR, you don't have to wait for it to tell you to restart.

In general the aim is to minimise time spent not doing CPR, but if in doubt follow the spoken instructions.

To add to your points:

- AEDs don't work if you're not at skin level. Inside the pack is a pair of shears for removing clothing and underwear - underwiring in bras can cause nasty burns. There is also a razor for people with especially hairy chests. At all times, respect the dignity of the casualty, as far as is possible in the circumstances.

On the wall of our village hall, 250m away. Covered using one on last first aid course (Oct 2018). It was very straightforward. We are getting one at our school too. It could easily take 30 to 40 minutes for an ambulance to reach us so it will be reassuring to have one on site.

Outside the pub up the road, I think it gives you instructions when you turn it on - or something like that I hope. Meant to be idiot proof. 

Interested to know how many times public ones are used?

Just to add to that, on my last first aid course earlier this summer, an intense three day course run by a paramedic, we were told, unless you have pure oxygen and a bag valve mask, not to give rescue breaths and just do chest compressions when giving CPR.

The thinking being that you're outgoing breath will have less oxygen than the surrounding air, and that the squeezing of the lungs when doing chest compressions actually draws in more oxygen than mouth to mouth.

You'd be surprised!

At a recent practice session, it was pointed out to us that we'd have probably joined the unconscious victim flat out on the beach. If you apply the defibrillator to a wet canoeist, if you're equally soggy and don't stand well enough clear, you'll share the shock with the original victim. Apparently it's wise to dry the victim off before using the defib.

None of my previous first aid courses had mentioned this factor. And it's not just paddlers: walkers and climbers are likely to be outdoors, so what if it's raining heavily?

Not sure how accurate that advice is. It was certainly stressed on my course that you need to dry the chest as far as possible to ensure the pads stick to deliver the shock across the heart rather than across the chest.

IIRC modern AEDs have pretty sophisticated diagnostics that prevent them shocking if there's a safety issue. Plus they tend to get used a lot on people who've gone into the water (and in the rain in the UK).

Any experts in the house?

I pass four that are visible on the way to work and then there's one in the office. I've been on 3 or 4 3 day FAW courses and have picked a few things up from this thread which weren't covered already! The main thing I took away from cpr training was they're probably not going to survive whatever you do but if there's a defib then do what you can to get it in use asap as it raises their chances of survival from next to nothing to minimal.

The last FAW course I went on was run by a lev 5 kayak coach and at the time our paddle sports technical advisor. IIRC they said it was fine to use in the rain but dry their chest enough for the pads to stick.

I'm not sure that's quite right. CPR is not going to revive them, but it does not mean they won't survive. Prompt CPR keeps the brain tissues oxygenated so that when the correct medical help does arrive they have a greater chance of being revived. 

Defibs increase those chances a lot

I hate to disagree with a professional* but that is not consistent with any of the training that I have been given or with official guidance for first aiders. Some organisations teach compression only CPR because many untrained people are unwilling to do rescue breaths (not unreasonably) and so might not do CPR at all if they think it requires the breaths.

Breaths are most important (and you should start with them) with children and drowning victims.

https://www.resus.org.uk/faqs/faqs-cpr/

http://www.sja.org.uk/sja/first-aid-advice/first-aid-techniques/resuscitati...

*It does appear to be true that for an adult without water in their lungs the odds are equal for traditional CPR and compression only. The numbers are scarily low though - so send someone to find that defibrillator!

Survival rates without cpr =0%

With high quality CPR ONLY = about 4%

Out of hospital cpr and defib about 20%

In hospital cpr with defib is slightly lower (they are usually more ill) 

RNLI Lifeguards about 60% last time I was given the figures... They are on screens quickly, trained and have good equipment) 

Why the difference? 

In general, we can see that cpr extends brain and heart function until a defib is available, but there are occasional situations where cpr only can be effective. For a defib to work there must be a shock able rhythm. If there is not one, cpr can introduce one. 

Defibs and the wet. The defib works by passing a current through the heart with a particular wave form. A wet chest can inhibit the pads sticking and also provide lower resistance path for the current to flow, so it goes over the skin rather than thru the chest. This can reduce the quantity resetting the heart. In puddles the advice has changed in the last few years. Used to be a big no no, now less important... Damp sand ok, puddles probably not helpful. remember most defibs are not waterproof, so you could risk damage to the unit. 

Re rescue breaths. First aid is always a compromise between skill level, equipment and current capacity.  Rescue breaths are vital for drowning casualty. It's a o2 problem they have. It is possible to have respiratory arrest and not cardiac arrest.  Ventilation may restart autonomous ventilation before cardiac arrest accurs. Or If both have occurred, there is no point pushing round blood low in o2. Similarly with children, it tends to be respiratory arrest before cardiac arrest, hence rescue breaths before chest compression. Dry adults generally cardiac arrest occurs first. 

So why not rescue breaths? Lack of skill and infection control. Chest compressions increase pressure in the chest cavity and build blood pressure and then circulation . Stopping them let's blood pressure drop off. Stopping for more than about 10 seconds means it's harder to get the circulation going again, as the pressure has dropped sufficient to stop effective blood flow. However, chest compression by itself does not have sufficient tidal flow in the lungs to reoxiginate blood to maintain high l evels. Hence rescue breaths in under 10 seconds. If you aren't practiced enough to du it in 10, the balance between increasing o2 and circulation, tends to favour the compresions. Different methods of delivering the rescue breaths have different efficiency. Bag valve and mask, and igel are very good (upwards or 90%, pure o2) , o2 fed into pocket Mask less so (just under 30%) expired air less so again(15-16%). 

All the time you are balancing o2 in the blood v circulation. Hands only becomes much less effective over time. So why do it? If the ambulance or first responder is only a few minutes away, it's good enough. And avoid s issues of infection from mouth to mouth or mouth to nose contact. If you have protective equipment these should be more avoidable. 

Hope this helps. 

SLSGB trainer assesor

I would like to see numbers about how often they are used and how effective they  are. 

A few years ago someone I knew well collapsed in front of me at work, we called the works emergency medical team who arrived within a couple of minutes, I watched as they applied a defib to his bare chest, it didn't revive him.

Now due to a  heart problem I have my own personal defib fitted, it probably saved my life last year. This works within seconds of detecting a problem and is programmed to suit my individual problem. It is also remotely monitored from the hospital who can see what is happening at all times.

I see plenty of public defibs but seriously wonder how effective they are in the hands of an untrained member of the public, OK if they have saved just one persons life they are worthwhile.  But it would be nice to see some actual numbers on their usage.

John Gresty

Here you go:

https://www.resus.org.uk/research/research-funded-by-rc-uk/national-databas...

39% of casualties resuscitated on scence with 26% discharged from hospital (fixed AEDs in public places)

10% resuscitated with 2.9% discharged from hospital for mobile AEDs. These are the type carried by community first responders, so the casualty may well not have had any CPR  before the responder arrived and may well have been dead anyway.

Pretty good sucess rate, and certainly much more that 'just one life'

Note the figures here are from 2008, so the situation will have changed a bit since then. 

I got quite close with my 2/3rd remembered figures...

Thanks, those figures are really interesting (if old). Note especially how the vast majority of times a fixed defib was used it actually administered a shock, indicating that people were able to get to the defib and apply it to the casualty fast enough for there still to be heart activity.

Interesting that there were more instances of mobile AEDs being used, with much lower success rate. I suspect that this sort of data will have led to the explosion of fixed AEDs that we see around the country.

Thanks for the link. I'm surprised that the success rate is that high.

John