Heart attack outside my office

[45dotACP]

AED as soon as possible and a 90 minute call to cath lab time is associated with better outcomes. Sorry about your colleague Glenn...heart attacks are never something that comes to mind....until you or someone you know has one.

[Sensei]

The few that came back?

When systems using the newer "pit crew" CPR training are seeing save rates in the high 30% range (or higher?), "the few that came back" is only evidence that the way we have done things in the past were shit-tastic, and not to be used as anything conclusive.

For you guys with organized gun clubs or some pull at your employment, I would seriously invest some time/money for a cheap AED to keep conspicuously about the premises. The most enthusiastic AED salesmen I ever met was a dude who suffered a cardiac arrest in a big-city gym at age 21, and everyone walked by him or continued their workout. At least encourage the training.

http://www.sca-aware.org/sca-news/ah...cardiac-arrest

The 2014 AHA statistics on out of hospital cardiac arrest show an overall survival to hospital discharge rate of 10%. The survival rate for witnessed VF/VT arrests where CPR and defibrillation were performed immediately is 30%, but VF/VF represent only 23% of the presenting rhythms. Some jurisdictions have reported exceptionally high survival in pre-hospital cardiac arrest studies using novel CPR techniques such as compression only CPR, thumper, negative pressure vest, etc. While some of these techniques may translate to small increases in survival, follow-up studies are inevitably less impressive or unable to replicate the benefit.

The bottom line is that the best survival outcomes are in people who have a witnessed VF/VT arrest event followed by immediate access to defibrillation. Bystander compression-only CPR is helpful if there is going to be a delay to defibrillator access but should not interrupt placement of pads or delivering a shock. If you have return of circulation without return of consciousness, prevention of hyperthermia and possibly cooling are helpful in maximizing neurological outcome. Cardiac cath is also probably a good idea on patients with a VF/VT arrest even if their ECG does not show a STEMI after return of circulation. ACLS medications such as epinephrine, vasopressin, amioderone, etc. have little to no effect on survival to discharge.

[SLG]

So what's the aed of choice these days?

[ST911]

So what's the aed of choice these days?

Using and liking the Philips FR3 and FRx.
http://www8.healthcare.philips.com/ems/Product/FR3.aspx
http://www.usa.philips.com/healthcar...tstart-frx-aed

I've had Zolls and Physios, they work fine too. The combined footprint, pricing, and customer support gave Philips the nod however.

Not an AED, but while we're talking about CPR... In the last couple of years, LUCAS devices are becoming common. We have a bunch around me. It will be a bit before there's a credible body of data, but so far the feedback is excellent.
http://www.lucas-cpr.com/en/lucas_cpr/lucas_cpr
https://www.youtube.com/watch?v=ox9XA_KzUF0

[Drifting Fate]

My mother is a retired nurse - started about the time the wheel was invented. She thinks CPR is cruel and useless unless someone is young and fit. Otherwise, leave the person to die in peace.

[ST911]

My mother is a retired nurse - started about the time the wheel was invented. She thinks CPR is cruel and useless unless someone is young and fit. Otherwise, leave the person to die in peace.

Her opinion is surely guided by the science, capabilities, and standards of care of the time and facilities in which she served. No doubt honorably, and no disrespect intended.

It might be likened to a Vietnam era medic's view of current TCCC guidelines.

[45dotACP]

Using and liking the Philips FR3 and FRx.
http://www8.healthcare.philips.com/ems/Product/FR3.aspx
http://www.usa.philips.com/healthcar...tstart-frx-aed

I've had Zolls and Physios, they work fine too. The combined footprint, pricing, and customer support gave Philips the nod however.

Not an AED, but while we're talking about CPR... In the last couple of years, LUCAS devices are becoming common. We have a bunch around me. It will be a bit before there's a credible body of data, but so far the feedback is excellent.
http://www.lucas-cpr.com/en/lucas_cpr/lucas_cpr
https://www.youtube.com/watch?v=ox9XA_KzUF0

Those LUCAS devices do look cool.

To standardize a CPR compression, my facility has a pad they put on the chest. Kind of like the Phillips Q-CPR...goes on fast, provides feedback...they seem to work well enough.

To prevent mortality in a cardiac event, I recommend knowing the signs...especially if you are diabetic, or not a man. Most women and diabetics will present with atypical symptoms, like back pain, indigestion, generally feeling crappy, and shortness of breath. Not all the classic hollywood heart attack symptoms, so some people just brush it off...and then they realize something is horribly wrong about the time they collapse...

[TGS]

Those LUCAS devices do look cool.

To standardize a CPR compression, my facility has a pad they put on the chest. Kind of like the Phillips Q-CPR...goes on fast, provides feedback...they seem to work well enough....

Like Skintop, both of these devices are being utilized more in my area.

Theyre excellent. None of the agencies have enough data on their own usage yet, but the crews feel their save rates are increasing significantly.

[John Hearne]

One of the more amusing (if you're twisted) scenes I was ever privy to was our first use of an AED in the field. The recipient was a drowning victim who had some electrical activity when we started to work him. Our AED was an early one that actually showed you the rhythm. We got the pads on and fired him up.

We shocked him into asystole (flat line). The look on everyone's face was like a bunch of guilty kids standing around a broken vase - "oh crap, we broke him....."

(In an example of cosmic justice, our drowning victim was a minor, drunk on stolen alcohol who couldn't swim but wanted to jump off the cliffs because all of his friends were doing it)

[WDW]

If you ain't in the Cath Lab getting PCI within 90 min after a STEMI, you probably gonna die. I work in the Cardiac Short Stay Unit & deal with these every day. It's amazing what they can do these days.