Talk of The Villages Florida - Neighborhood AED Costs

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Quote:

Originally Posted by Blueblaze (Post 2429930)

It seems a scam to me. When we moved in, the guy down the street with the AED in his yard showed up immediately to collect his $100 and we never heard from him again.

Three years later, my wife had an apparent heart attack (which turned out to be a blood cot). Even though the fire department is less two blocks away and the AED guy half a block, it took 20 minutes for an ambulance to get there (and not the one from the nearby fire station). Nobody ever showed up with an AED. Thank God it wasn't a real heart attack!

When the EMT's moved her to the Ambulance, the clot moved to her brain and caused a stroke. They recommended HCA Ocala as the best stroke center. It took them half an hour to get there. It took me 45 minutes. In the emergency room, I asked the receptionist to buzz me in the door. She glared at me and ordered me to sit down and wait my turn. A few minutes later, a face appeared in the window, saw me there and called my name. I found my wife somewhat more coherent than when last I'd seen her, but still stroking out. A guy came up to me and asked permission to administer a clot buster. I said "they didn't do that in the ambulance"? He said no, they were worried about a brain bleed. I asked if they'd scanned for a bleed. They said yes, no bleed , and they could see the clot. I asked them, "Then what the hell are you waiting for!". He said they needed my permission (to save my wife's life!). So I signed a paper and they gave her the clot buster. The effect was almost immediate. And amazingly, she somehow survived an hour or more with a clot in her brain, with no apparent damage today. I credit divine intervention. It certainly had nothing to do with Florida healthcare. WORST I HAVE EVER SEEN in all my 71 years!

But I'm sure that guy with the AED in his yard, paid for by his neighbors, will have a much different story to report, on the day of his heart attack

I’m sorry to hear of your wife’s experience but an AED would have done her no good. An AED is only used for sudden cardiac arrest. The neighborhood AED program wouldn’t have even been notified of your wife’s condition unless you told the dispatcher that your wife wasn’t breathing. The D in AED stands for defibrillator. It will only deliver a shock to stop ventricular fibrillation.

Quote:

Originally Posted by MandoMan (Post 2429100)

IF the AED volunteer arrives and uses the equipment before the pros arrive, the chances of surviving to the point of leaving the hospital alive double, from 7% to 14%. However, the percentage who have heart attacks and need AED has decreased in the past twenty years from 70% to 80% to 10% to 30%. Trying to defibrillate someone who doesn’t need it is not helpful. In probably most cases, the local volunteers trained can’t get there in time anyway.

Leaving the hospital alive does NOT mean returning home happy and healthy. Many more of the survivors then go to rehab hospitals or nursing home. Or they go home but have significant memory loss and perhaps can’t drive again, much less play golf again. I really don’t like those odds. It is NOT the way it is shown on TV.

“Survival After Application of Automatic External Defibrillators Before Arrival of the Emergency Medical System”
“ Of 13,769 out-of-hospital cardiac arrests, 4,403 (32.0%) received bystander cardiopulmonary resuscitation but had no AED applied before EMS arrival, and 289 (2.1%) had an AED applied before EMS arrival. The AED was applied by health care workers (32%), lay volunteers (35%), police (26%), or unknown (7%). Overall survival to hospital discharge was 7%. Survival was 9% (382 of 4,403) with bystander cardiopulmonary resuscitation but no AED, 24% (69 of 289) with AED application, and 38% (64 of 170) with AED shock delivered. In multivariable analyses adjusting for: 1) age and sex; 2) bystander cardiopulmonary resuscitation performed; 3) location of arrest (public or private); 4) EMS response interval; 5) arrest witnessed; 6) initial shockable or not shockable rhythm; and 7) study site, AED application was associated with greater likelihood of survival (odds ratio: 1.75; 95% confidence interval: 1.23 to 2.50; p < 0.002). Extrapolating this greater survival from the ROC EMS population base (21 million) to the population of the U.S. and Canada (330 million), AED application by bystanders seems to save 474 lives/year.”
“ In recent years, emergency medical services (EMS) recordings of initial cardiac arrest rhythms show a striking decline in the incidence of ventricular tachycardia (VT) or ventricular fibrillation (VF) that may benefit from AED use. Initial VT/VF rhythms accounted for 70% to 80% of cardiac arrests 20 years ago (25), but now constitute only 10% to 30% of arrests (8,25,26). Non-VT/VF arrests (asystole and pulseless electrical rhythms) do not benefit from AEDs, and furthermore, their use may delay life-saving measures such as bystander CPR in such patients.”
Article from National Library of Medicine: Survival After Application of Automatic External Defibrillators Before Arrival of the Emergency Medical System: Evaluation in the Resuscitation Outcomes Consortium Population of 21 Million - PMC

The AED will only shock a shockable rhythm. The AED is dummy proof and that's the reason anyone can use them. Never leave someone to get an AED, start CPR and call 911. Or 911 and CPR.

Quote:

Originally Posted by Kenswing (Post 2429948)

Not true just because wife was breathing doesn’t mean she wasn’t on the verge of Cardiac arrest. Unless you are expressing that each caller needs to professionally diagnose exactly what the event, is. And the AED program instructs volunteers to make diagnoses telepathically.
Did OP state “My wife is having a Stroke? “ not a Cardiac Event, most likely not.

The Only Time an AED Volunteer should not be called is If the 911 caller Tells Dispatch “Do Not Notify”. Dispatch should also Not make the determination if a volunteer AED is needed. A non professional especially one that is emotionally involved isn’t going to refuse help.

All Three times I have used 911. I stated “Do Not Activate AED” volunteers. Of course not all Dispatch, will abide by the request.

AED volunteer notification is automatic...

Quote:

Originally Posted by thelegges (Post 2429972)

The 911 operator does not have the capability to activate or not, AED volunteers. If the person calling 911 indicates "not breathing", "not responsive", or something similar the 911 operator enters the code defining the type of emergency. The computer system automatically dispatches the nearest available emergency response unit(s) and notifies the volunteer responders subscribed to PulsePoint and ReadyAlert. Again the 911 operator has NO control over the response notification system.

Quote:

Originally Posted by TedfromGA (Post 2430053)

So when the 911 responsed for non breathing event, to my request he was incorrect..3 times.

The caller needs to diagnose, breath or non viable. Then if breath stops, after exchange, does the code change to alert a different code, that breath has ceased? 911 stays online until caller disconnects, is there a default to change the code?

In our mandatory 911 training, years ago, information sent automatically to local station, while continuing to advise CPR, choking, wound, or drowning information. Sometimes the caller had no idea if breath could be detected, or not capable of communicating information. I don’t know was common, especially in the young or elderly.

Quote:

Originally Posted by Kenswing (Post 2429948)

OF COURSE IT WOULD HAVE DONE NO GOOD! And thank heavens for that! If it had been an actual heart attack, SHE'D BE DEAD because NOBODY EVER SHOWED UP when I called 911 and TOLD THEM MY WIFE WAS HAVING A HEART ATTACK!

The only guy benefiting from the AED that my entire neighborhood paid for is the guy with the AED in his front yard.

If the closest ambulance is out on another call, or for any reason no ambulance available at the closest EMT, they will alert the next closest. This could add 5 minutes to response time. The trained neighbors would be at the scene first and already doing CPR.

Quote:

Originally Posted by thelegges (Post 2429972)

That's not how our system works. They will not activate if someone is "on the verge" of anything. If you state to the 911 operator that someone is not breathing and/or has no pulse that's the only time the neighborhood AED team will get toned out.

Should you be the one that an AED saves, then that $100, $475, or even $1000 for that matter is money happily spent.

As others have said, an AED will only shock a patient for whom a shock is required. The shock defibrillates the heart. Stops the heart from fibrillating (becoming a quivering mass of uselessness). Essentially what that means is that it stops a heart that is quivering in order for it to restart in a regular, sustainable rhythm. It's a reset button for the heart. If the heart isn't quivering, a shock (aka reset) is not useful.

The best thing is immediate CPR, but there are caveats. Forget about the mouth-to-mouth for now, that is secondary.

The purpose of the CPR is to manually circulate blood to the organs, especially the brain. That requires about 100 compressions per minute and they must be deep (adult = 2 to 2.5 inches) enough to be effective.

Of course, that depth will also crack ribs and tear cartilage from the rib cage. It is a sickening sound, but is required for CPR to be effective. The most important thing for CPR is to be continual, the blood pressure must be kept up or else it is useless.

Now, you try pressing 2.5 inches into your sofa cushion 100 times per minute and tell me how many minutes you last. If you last more than 5, I'd be shocked. It is exhausting even after 1 minute. That is the effort required for high success ratios.

Quote:

Originally Posted by Blueblaze (Post 2430118)

A heart attack and cardiac arrest are two different things. A heart attack is generally muscular or circulatory in nature. In other words it's muscle damage or a blockage. Cardiac arrest is electrical. The brain has basically lost control of the heart's rhythm. You can have a heart attack and still be conscious and breathing. If you're in cardiac arrest you're basically dead. CPR is used to keep oxygenated blood flowing to the brain to keep it alive long enough for the defibrillator to do its job.

Now if you're saying that the Fire Department didn't show up when you called, that's a problem. If you're saying that the neighborhood AED team didn't show up, they weren't supposed to.