Emergency Life-Support Equipment - Oxygen and AED? - Who Carries on Dive Trips?

[lobbolt]

Hello ScubaBoard,

Thanks for making the forum here very welcoming and friendly, every time I posted with questions there were always helpful responses. It's truly appreciated.

I have another question regarding emergency preparedness. As we all hope our diving is as safe as possible, and an emergency is by definition an unplanned event.

My question is about carrying 2 forms emergency life support equipment readily available just in case.

First, do you carry a emergency oxygen kit (such as the DAN kits) during dive trips? Or, if you operate a commercial dive service, do you have a kit readily available whenever you have divers in the water?

Secondly, do you also have an AED (Automated External Defibrillator, a first-aid device that may replace CPR. Healthcare professionals can comment here) readily available on dive trips, in case needed?

Or, do you have both oxygen and an AED?

Currently, I personally have neither available, but will not be doing further diving until I purchase an oxygen kit.

Do you think also purchasing an AED, which units cost up to approximately $5,000, is wise for the amount of risk in (recreational) SCUBA diving? I will likely still purchase a unit after research.

 

[TSandM]

I couldn't answer the poll, because none of the answers fit. We have oxygen with us sometimes. Always when teaching, and always when doing any technical diving, but not always when we do simple shore diving. Many of our dive sites are within about five minutes of a major hospital with easy EMS access, which isn't an excuse for not taking the O2 kit when we have it, but the fact is that we don't.

I don't own an AED and don't plan to. A resuscitatable cardiac event is no more likely at a dive site than anywhere else (and I spend a great deal more time everywhere else) and I don't think most of us take AEDs to bike races, horse shows, or other events that involve exertion. I think it might be a reasonable investment for a large dive charter boat, which will be out of easy reach of EMS for long periods of time, but even then . . . I wonder how many boats have ever had a cardiac fatality occur?

 

[MXGratefulDiver]

I keep a DAN O2 kit and first aid kit in my car at all times ... so that when I dive they're always available.

But it depends on what you mean by "dive trips". I don't take them when I fly ... I suspect the airlines wouldn't look kindly on me packing an O2 bottle in my luggage.

I do not own an AED ...

... Bob (Grateful Diver)

 

[Wookie]

. . . I wonder how many boats have ever had a cardiac fatality occur?

Times 3, one survived (MI due to near drowning) and 2 didn't make it. AED not present for 1 fatality and 1 survivor, AED did not help 2nd fatality.

 

[MXGratefulDiver]

I wonder how many boats have ever had a cardiac fatality occur?

... our favorite south Sound dive charter had one not very many years ago ... as did a now-defunct dive charter out of Anacortes ...

... Bob (Grateful Diver)

 

[Tigerman]

I couldn't answer the poll, because none of the answers fit. We have oxygen with us sometimes. Always when teaching, and always when doing any technical diving, but not always when we do simple shore diving. Many of our dive sites are within about five minutes of a major hospital with easy EMS access, which isn't an excuse for not taking the O2 kit when we have it, but the fact is that we don't.

I don't own an AED and don't plan to. A resuscitatable cardiac event is no more likely at a dive site than anywhere else (and I spend a great deal more time everywhere else) and I don't think most of us take AEDs to bike races, horse shows, or other events that involve exertion. I think it might be a reasonable investment for a large dive charter boat, which will be out of easy reach of EMS for long periods of time, but even then . . . I wonder how many boats have ever had a cardiac fatality occur?

According to another active thread.. About 28% of all the boats that has had fatalities?

AEDs is becoming more common over here, but its more of a "buisness thing" as in hotels, shopping malls, sports arenas and such have one or more available if need should arise. Dont know anyone who carries one around "in their back pocket" though..

 

[TSandM]

The greatest utility of an AED is in a pure arrhythmic arrest. The problem with arrhythmias that occur as a result of incidents like drowning are that, unless you can reverse the other issues (eg. hypoxia) that caused the problem, you are unlikely to be successful in correct the arrhythmia for any sustained period of time. That said, the greatest survival from cardiac arrest IS with immediate shock, and if you have no machine at hand to do that, you can't deliver the most effective treatment. AEDs make great sense in areas where large numbers of people congregate -- airports, malls, sports arenas, etc. -- but the economics become more and more dubious as you start to deal with smaller numbers of people. However, there is really no downside to having one, except expense, and there is probably some advantage in our litigious society to not having to defend the decision not to provide one on a dive boat.

Still, I'm not going to invest in one for my car.

 

[Hawkwood]

... . . I wonder how many boats have ever had a cardiac fatality occur?

Happened February a couple of years ago on a trip to Vancouver Island. It was not a drowning incident.

To answer the OP's question, I take my DAN O2 kit on all local dives, teaching or not.

Bill

 

[DaleC]

I have a 1/2 hour supply of O2 which I feel would bridge the gap before EMS arrived to most dive sites within the lower mainland. No AED for me.

Also, I don't think an AED should be thought of in terms of replacing CPR.

Yes it's a useful tool true, but I have some cynicism regarding their popularity. My experience with primary emergency care over the years has jaded me to the level of competency expected from those attending classes and being certified. Recognition of vital signs and CPR are very valuable skills but they require understanding and practice. The complete lack of emphasis in this area seems to be being filled by a machine that does the thinking for you. But, because most people have/will never use one in anger, they probably wouldn't be able to successfully operate one in a crisis anyways.

Unbelievably, in my last recert HCP CPR course I was told the new standard is not to even check for a pulse because it's "too hard to do". We were shown an AED, the instructions for it, and told it would do the diagnosing for us - just follow the prompts. Uggh.

And, as stated, it's only useful for monitoring and cardioversion. An AED does not facilitate respiration or circulation which I still feel is more important overall.

My priority list would be:
Well trained and practiced in CPR
O2
AED

 

[Wookie]

I have a 1/2 hour supply of O2 which I feel would bridge the gap before EMS arrived to most dive sites within the lower mainland. No AED for me.

Also, I don't think an AED should be thought of in terms of replacing CPR.

Yes it's a useful tool true, but I have some cynicism regarding their popularity. My experience with primary emergency care over the years has jaded me to the level of competency expected from those attending classes and being certified. Recognition of vital signs and CPR are very valuable skills but they require understanding and practice. The complete lack of emphasis in this area seems to be being filled by a machine that does the thinking for you. But, because most people have/will never use one in anger, they probably wouldn't be able to successfully operate one in a crisis anyways.

Unbelievably, in my last recert HCP CPR course I was told the new standard is not to even check for a pulse because it's "too hard to do". We were shown an AED, the instructions for it, and told it would do the diagnosing for us - just follow the prompts. Uggh.

And, as stated, it's only useful for monitoring and cardioversion. An AED does not facilitate respiration or circulation which I still feel is more important overall.

My priority list would be:
Well trained and practiced in CPR
O2
AED

While I agree with you in the "more training is better" curmudgeonly sense, I have to disagree somewhat in the practical side of things. Our fatality with an EAD present involved a person who had their MI at 95 feet. The victims instructors immediately started the ascent with the victim, but the lights went out of the victims eyes at 25 feet of depth. When I recovered the victim on deck at 13 minutes after the MI occured, the victim was blue, unresponsive, and lungs were full of water and fluid, of course. I started CPR as trained and shouted for the AED even though it seemed near impossible to revive a victim in this condition. When the AED arrived, I placed the AED properly on the victim and no shock was advised. The no shock advised allowed me to stop resuscitation attempts and start to deal with the rest of the passengers, as well as the secondary victims (the MI victim's instructors were bent from the rapid ascent in deco).

Just having a tool in the toolbox that may allow you to free up personnel may be (in and of itself) helpful in dealing with a situation when limited resources are present.