The Case for Automated External Defibrillators (AEDs) Aboard Vessels.

Consider that most Sudden Cardiac Arrest (SCA) happen while on solid ground, a city, a home, an urban environment. When this happens, we have a rather good chance that Emergency Medical Services (EMS) will arrive in 4-10 minutes, so long as you are within an urban area. Now consider you are on the water when a SCA strikes a passenger aboard your vessel. Now how long before EMS will arrive? The chances are that if you are witness to a Sudden Cardiac Arrest on a lake, river, or even on a short cruise just a few miles off shore, the victim will not survive without the application of immediate first aid procedures.

Factors contributing to Out-of-Hospital survival following Sudden Cardiac Arrest have been described primarily in terms of the time-related Chain of Survival.

The Links in the Chain of Survival

(1) Early recognition and call for emergency medical services;

(2) Initiation of basic life support CPR;

(3) Defibrillation; and

(4) Advanced cardiac life support (EMS)

Survival depends on the availability of the link. Without intervention, survival following Sudden Cardiac Arrest decreases rapidly.

Several studies have reported that for each minute of untreated cardiac arrest, the probability of successful rhythm conversion decreases by 7% to 10%. (see chart)

First Aid – Less than the Cost of a Flat Screen

Being an avid boater and regular visitor to many vessels of all sizes, I am very surprised to see the enormous amount of money spent on expensive luxuries and very little on emergency preparedness, first aid being almost dismissed. By and large, a full complement of first aid preparedness aboard most small and larger recreational vessels I visit consist of a $10 first aid kit. I see more money spent on the flat screen TV, than is ever invested in first aid training, or first aid kits. A First Aid, CPR & AED class runs about $110.00, but most of the recreational boating public I speak to has never taken a class, or if they did, it was so long ago that they do not have the confidence to apply even the simplest of first aid procedures, or life saving techniques.

Most professional mariners are required to train for emergencies, recreational boaters have no such requirements. In fact many have never even taken a boating safety course.

Unlike land based medical emergencies, when you are on the water, 1 mile or 100 miles there is no pulling over to the side of the road, no 911. Time to Emergency Medical Services and immediate first aid are critical factors in determining the outcome of a cardiac medical emergency. Lack of training or simple life saving devices like a full BLS first aid kit and an AED will reduce the survivability of a Sudden Cardiac Arrest victim by 10% per minute. It doesn’t take a mathematician to realize that after 10 minutes of non-response the survivability drops to almost zero.

For a small investment of time, and less than the cost of that flat screen you can learn vital first aid skills that could someday save a life. For a few dollars more, you could invest in a life saving device such as a Heartsine or Phillips HeartStart and the value is priceless in a Sudden Cardiac Arrest.

Thomas Bliss