A few comments about the great discussion on Defibrillators (AED's). My daughter and I coordinated the purchase and installation of dozens of AED's for Puget Sound area Jr. and Sr. High schools, following the deaths of 5 students in 2000. Surprisingly there is an unknown risk to teenage kids as they become exposed to organized sports in schools. No one knows how many young kids die each year because of Sudden Cardiac Arrest (SCA), some estimates run into the thousands. This is a bit off topic, so I'll return to the scope of discussion, suffice to say if you have kids, nephews or nieces in Jr. or Sr. High School, go out and make sure they have AED's in their schools. www.la12.org and www.early-defib.org have much more info on this topic. Regarding the boating community, there is a subject that I don't think has gotten quite the attention it deserves, specifically for the cruising couple. The key to successful use of an AED is time. If the SCA isn't witnessed immediately, and corrective action taken within a very short period of time (4 min), the results are not going to be favorable. The stress of seeing a spouse or loved one in cardiac arrest is daunting, very few people are capable of dealing with it. All the commentary about training is crucial, but in the end you have to ask yourself if you or your partner have the psychological makeup to effect this kind of rescue. I think boaters in general are more apt to be able to perform, but in reality very few people initiate bystander CPR (less than 2%). Take some time, meet with local American Heart Association or Red Cross people that are knowledgeable in lay response, but aren't selling AED's, and then make a decision. It may be that the best use of that boat unit is upgrading to an automatic inflatable PFD, or getting an EPIRB. If you have all the other bases covered, and you get educated enough to feel this is a great decision, make sure you fly a banner identifying your boat as has having an AED aboard. Because if your moored near me, I'm going to buy you a bottle of wine, and make sure you know who I am, your the kind of person I want to know! - Somewhere between 1/3 and 1/2 of all "heart attacks" involve the electrical system of the heart, in a manor that an AED may be effective. - In most cases advanced life support following a cardiac arrest is crucial, but there are many instances where patients need little or no follow-up care. You must contact 911 (or equivalent) during or following use. - Portable AED's may not be as "powerful" as the hospital units with respect to the current delivered to effect rhythm conversion. Manual units may be able to deliver higher shocks, but by that time it may not be relevant to the lay rescuer. There are studies that suggest AED's are better at identifying convertible rhythms that EMS personal. -Young adults and children are capable of using AED's -You can't hurt someone with an AED, although because we are discussing using them in and around boats, you need to be cautious about water and electricity. Finally, AED's run between $1,200 and $2,300. Access Cardio Systems makes the least expensive unit I know of, but I really like the Medtronics CR Plus. Safe Boating, Scott

The majority of Cardiac arrests and recusitations I have seen did not require defribrilation in my 35 yrs in the field. CPR and stabilization of the airway were the most common.

There are HUGE misconceptions regarding CPR and defibrillation. I'm not sure where they come from or why they continue to exist in light of overwhelming evidence. To clear up a few: > The majority of Cardiac arrests and recusitations I have seen > did not require defribrilation in my 35 yrs in the field. > CPR and stabilization of the airway were the most common. Recent studies have shown CPR performed out-of-hospital results in only a 1 - 3% survival rate. A fairly large study (http://tinyurl.com/6d698) with tight parameters showed a 4.6% survival rate. CPR alone is effective for certain respiratory arrest conditions (drowning, etc.) and it can prolong the time available before defibrillation is applied. For the most part, you will die if you only receive CPR in a boating or cruising situation for cardiac arrest. In addition to many studies like this, there are multiple books written on this exact subject. I'd refer anyone to "Sudden Death and the Myth of CPR" which I have read (http://tinyurl.com/6w3lc). Go read the information on Amazon about this book. For heavens sake, just look at the title! [Please note my tinyurl use - thank you all for the suggestions] > Call me "low tech", but if I get to experience "the big one", > my plan is to take a handful of aspirin and call 911. > There something inherently dangerous about a scared girlfriend > and devices that produce a large amount of electricity. There are two widely believed misconceptions described by that. 1. A "heart attack" is different than cardiac arrest. There are many other things that can cause cardiac arrest, especially in boats! If you ever think you're having "the big one," issue a mayday before you run for your aspirin. By the way, the first sign of having "the big one" is...denial, so I doubt you'll ever run for the aspirin anyway. If you are ever actually in cardiac arrest, you won't be able to find the aspirin, open it, or swallow one, before you pass out. Additionally, aspirin will do nothing to convert you out of the deadly cardiac rhythm you are in. 2. AED's cannot hurt anyone unless they are swung around and banged into someone's head! They cannot shock a person unless the person is in a deadly cardiac rhythm. An AED is a combination of a cardiac monitor (ECG/EKG) and a defibrillator. The device takes your EKG and evaluates it. The shock can only be delivered if your rhythm falls into very narrow classifications, no matter how angry your girlfriend or wife is with you. The FDA and AAMI have very tight requirements before an AED can be put into the US market. While talking with my wife last night (an EMT and certified CPR instructor), we realized that we spent more than twice the amount of money of an AED on our life raft. The funny thing is that before we ever pull up our anchor, we make careful evaluations to decide whether it is safe to venture out. We check the weather. We check our boat. We do everything we can to avoid the need to use our life raft. By comparison, there is very little that we can do to prepare so that we won't become a cardiac arrest victim. Although we are fit and healthy, cardiac arrest can happen to anyone. It isn't the same thing as a heart attack! The number of athletes who die from cardiac arrest in their prime would astound you. By the way, Murray Archdekin's comments are right on the mark. An AED alone will do very little without the proper training. At a minimum, everyone should take a CPR course. Ask your instructors about AED's. Don't believe all of the hype and misinformation. Go find out for yourself... ================ Jeffrey Siegel M/V aCappella DeFever 53PH W1ACA/WDB4350 Castine, Maine