There's a New CPR

[medic45]

For the purposes of ACLS ventricular fibrillation and pulseless ventricular tachycardia are treated the same.

 

[MedicStudent]

Ya apparently it's the only rhythm that it shocks, and it's the one that more closest and I guess easiest to being achieved after compressions. Hence... I guess that's why laymens get a defib for only 1 rhythm.

That's what's been taught to me maybe not the laymen's parts... and that's what I've been teaching my students. 

medic45 is correct on the fact that AEDs will recognize V-fib and V-tach. The use of an AED is indicated in a patient who is unconscious and not breathing "normally" when used by a lay responder now though so it's not just for pulseless anymore technically (although we sure hope that they are).

Since the AED will recognize V-tach it is extremely important to pay attention to the prompts on your machine so that you don't miss when it tells you to stop CPR as it begins the analysis. Much like being in a moving vehicle can look like V-fib, having compressions done create artifact that looks like V-tach.

 

[ArmyGuy99]

MedTech,

You were right, I misread my notes, the AED's for Civi and most other uses only shocks V-Fib, but V-fib is not the only shockable rythym, just that the others are for ALS and Doctors to take care of.  Either way, I'm glad it's in our tool box to use. 

 

[medaid]

MedTech,

You were right, I misread my notes, the AED's for Civi and most other uses only shocks V-Fib, but V-fib is not the only shockable rythym, just that the others are for ALS and Doctors to take care of.  Either way, I'm glad it's in our tool box to use. 

Hahaha I'm glad I wasn't completely out to lunch, if I was I would've handed my cert. back in disgrace...

 

[MedicStudent]

MedTech,

You were right, I misread my notes, the AED's for Civi and most other uses only shocks V-Fib, but V-fib is not the only shockable rythym, just that the others are for ALS and Doctors to take care of.  Either way, I'm glad it's in our tool box to use. 

I can't speak in regards to the AEDs that you were taught on, but current AEDs will shock both V-fib and V-tach. A popular model for use by the public is the Zoll AED Plus (http://www.zoll.com/product.aspx?id=75). From their technical sheet on the device (http://www.zoll.com/uploadedFiles/Products/AED_Plus/9656-0158_0706AEDPlusTA.pdf):

Defibrillation Advisory:
Evaluates electrode connection and patient ECG to determine
if defibrillation is required. Shockable Rhythms: Ventricular
fibrillation with average amplitude >100 microvolts and
wide complex ventricular tachycardia with rates greater than
150 BPM for adults, 200 BPM for pediatrics.

 

[X Royal]

Back in Ontario anyone can use the AED's now, thanks to superb stupid proofing of these devices.  The ont gov't changed the legislation a few years back, and now there is an AED at every school, pool, museum, places of work etc........

In Ontario the use of an AED is still a delegated medical act requiring a doctors authority for the user. There has been talk of deregulating the use of the AED in Ontario but it still has not happened. Currently now if your authority to use an AED is for your workplace you are not covered to take the AED off the company property to help some across the road.
As for AED's being at every school, pool, museum, place of work ect.. , thats still a long way off. Although some places of work do now have them, far many more do not. As for schools and recreational places it is up to the local authorities if they wish to spend the money on the equipment and training. Unless AED's are mandated by law they will never be in all the listed places. Some places will install them, while others will not or can not afford the cost.

 

[MedicStudent]

In Ontario the use of an AED is still a delegated medical act requiring a doctors authority for the user. There has been talk of deregulating the use of the AED in Ontario but it still has not happened. Currently now if your authority to use an AED is for your workplace you are not covered to take the AED off the company property to help some across the road.
As for AED's being at every school, pool, museum, place of work ect.. , thats still a long way off. Although some places of work do now have them, far many more do not. As for schools and recreational places it is up to the local authorities if they wish to spend the money on the equipment and training. Unless AED's are mandated by law they will never be in all the listed places. Some places will install them, while others will not or can not afford the cost.

In regards to AEDs being a controlled act in Ontario, it depends on how you interpret the current legislation. From my interpretation, it is quite clear that when used as first aid in an emergency situation (i.e. someone who is in cardiac arrest), it is not a controlled act. The Heart and Stroke Foundation is also of the opinion that it is not a controlled act.

If it were then who would be allowed to use the public access defibs that are in places like airports?

 

[X Royal]

In regards to AEDs being a controlled act in Ontario, it depends on how you interpret the current legislation. From my interpretation, it is quite clear that when used as first aid in an emergency situation (i.e. someone who is in cardiac arrest), it is not a controlled act. The Heart and Stroke Foundation is also of the opinion that it is not a controlled act.

If it were then who would be allowed to use the public access defibs that are in places like airports?

The Chase McEachern Act (Ont.) was passed on 04 Jun 07, but to the best of my knowledge it is yet to receive Royal Ascent. This act in Ontario will protect those from liability who attempt to use an AED during a life threating situation while in a place with a public accessible AED. It will also protect the provider of the AED as long as the AED has been properly looked after.
It is generally thought that AED's without training are of little use(see studies published on the Ont. Ministry of Health web site).
This protection is not guaranteed within the private workplace or for someone to buy their own AED & carry it around. Proper training is & med. authority are still needed. The Ont. Ministry of Health web site is a good resource for info for Ontario. Every place that I'm aware of that have AED's available have also taken the time & expense to train the people most likely to use them.

 

[sonardork]

I just finished my First Aid and CPR today in Victoria. According to BC laws, AEDs are not to be used by untrained/uncertified people. We had a demo, and from what I understand it is not designed for "starting" a heart rather to "stop" it from abnormal rhythms followed by chest compressions when prompted allowing you to "prime the pump" for starting on it's own. Our instructor said a 2 hr SJA course will certify you to use it (in BC) however the CF Surgeon General has yet to sign off on any policy for the CF. From the demo (and SJA video) it seems like a dead simple piece of kit to use [no pun intended]. Those SJA videos, and CF ones for that matter, always make me laugh though....such great acting