Accidents. Resuscitation. AED. Should AED be mandatory on diving boats?

[Radoo]

Nobody can sue you for broken ribs during CPR - it’s like suing a surgeon for cutting your skin while doing your surgery. Trained or untrained to deliver CPR you will invariably crack some ribs and/or the sternum and retrospective studies show an incidence of broken ribs up to 97%: Skeletal chest injuries secondary to cardiopulmonary resuscitation. - PubMed - NCBI More likely to cause some if you deliver good quality CPR. If someone needs it go ahead and deliver it without being afraid of any broken bones.

 

[Rred]

'Nobody can sue you for broken ribs during CPR'
Perhaps not in the UK, but here in the US anyone can sue anyone for anything.
Including cracked ribs during CPR.

Now, they might not be able to successfully sue you, but they can file the suit, require you to hire counsel and go through pre-trial depositions and meetings, and rack up an easy ten grand in expenses, before it even goes to court. When and if it goes to court and the judge *maybe* throws it out, you might be able to counterclaim for your expenses and other damages. But you can have a couple of years (long trial calendars, very low priority for something like this) of worries and legal bills in the meantime. And if you were out of town on vacation at the time, or the suit is brought in a court district that not local to you...lots of travel expenses too.

Yes, legal matters can be that bad here. Yes, there are many attorneys who should be disbarred. Yes, there are lawsuits dismissed as "frivolous" and "bad faith" every day or week. But you still have grabbed a tar baby, and once you're caught up in it...there's no easy way to get free.

 

[happy-diver]

If you want one, yes
If you can't use it in the water, no
If you can't use it on yourself, no
If you have to pay for it, no

 

[Radoo]

Don’t know what to say, maybe it’s my personality but I would prefer to crack all your ribs and restart your heart. You can sue me after, at least I can go asleep peacefully knowing that I did everything to save your life. And I would do that on a diving site or in the street.

 

[TeamBubbles]

Rred, perhaps regulation is too strong of a word. NYS certainly requires that it's hoops have been jumped through. For the most part, at least with AEDs/PAD, if you're willing to jump through them, they're going to let you put the AED in service. Much as there's no scuba police, there's no AED police (yet - it is NY). Where there might be an issue is if someone gets hurt or a resuscitation doesn't have a good outcome. Plaintiff's attorneys love it when you haven't complied with a State reg/policy/procedure/etc.

I have personally broken a LOT of ribs doing CPR. It's a recognized complication of the procedure and one that should not dissuade anyone from attempting CPR.

 

[Pat.D]

A few comments from someone who does CPR/defib often, sadly not proper peer reviewed info just anecdotes from +25y on the job.

First of all I'm firmly in the camp of having AED's in all locations where they may do some good: public buildings, golf courses, gyms, arenas... and yes dive boats too. They are not that expensive and personally have saved a few of my patients before we even arrived on scene.

I've done CPR on pool drowning victims over the years and never had one with a shockable rhythm, in every case they were flat line. As mentioned by others, the reality on a dive boat is that some divers are not in the best shape. So even if it's less likely (but not impossible) an AED would help in the case of a diving accident, it is quite likely it would help in other cardiac events.

I don't know what the official statistics are but day to day I'd say only around 10-20% (if that much) of all of our heart arrest PT's have a shockable VF or VT rhythm. So that's lots of compressions and async BVM/Combitube ventilations but not many zap-zap's. The majority of our PT's are over 55 and their heart is often not very healthy so that likely plays in those numbers.

For those of you wondering about breaking ribs, take it from me... you will break ribs. If your patient is 40 of above, it's likely and over 65 almost a 100% certainty. Kids have rubber bones, teens and 20's generally don't break and have a good resistance. You know when you break ribs, you feel it. My last PT was 3 days ago, in his/her 90's and all the ribs went crunch on my first compression.

Can't speak for other countries, but here in Canada as a civilian (or a health/rescue professional not on duty) you are protected by the Good Samaritain laws and cannot be sued. Even a person with zero training doing compressions following instructions from the 911 dispatcher is safe here.

(ref: FF and very basic EMT in a large dept. we do first response on prio-1 medical calls but no transport. ambulances are a separate gov. entity and they have paramedics).

 

[Rred]

I can't cite you a source, but about 15-20 years ago while reading up on hypothermia and cold water shock, I came across a statement along the lines that for a 50+ year old male, simply jumping into 50F water was enough "cold shock" to cause heart arrhythmia, and cautioned about that. So, that would be a very "shockable" situation, where a diver enters typical north eastern waters in the not-so-sunny season and gets a rude surprise.

Not that I'm entirely convinced it is the right way to allocate limited funds, but I'll concede the situation is there. Heck, on my checkout dive, in a pond, I think the water was under 40F. I needed to find my lips with one hand in order to put my regulator back into them when buddy breathing.

 

[SapphireMind]

Even with kids, you'll break ribs. Broken quite a few in my career so far, will break more as it is needed.

And cold shock arrhythmia I would think if you're getting that, you are not properly dressed for the water! No, this is all very interesting for me.

I definitely don't think it is a bad idea to have AEDs - I just don't think they'll be a cure-all.

 

[tursiops]

But for non-professionals, for the general public, RESCUE BREATHING IS NO LONGER TAUGHT OR REQUIRED.

This is simply not true.
I'm happy to provide references if you'd like, or you can look it up yourself rather than just spouting off something you may have read in a newspaper somewhere.

 

[Wookie]

This is simply not true.
I'm happy to provide references if you'd like, or you can look it up yourself rather than just spouting off something you may have read in a newspaper somewhere.

I teach 6-10 first aid courses a year. Compression-only CPR has been the standard for 2 years now. Rescue breaths get a mention, but no practice.