Scout
Para-Noid
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Don't and you shouldn't, But whats the answer to the question? I'm not suggesting run out and try it.
safe AED usage on a drowning victim?
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Don't and you shouldn't, But whats the answer to the question? I'm not suggesting run out and try it.
medichopeful
Flight RN/Paramedic
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I think under certain circumstances it could:
http://www.azshare.gov/documents/curriculum.pdf
Look at page 2.
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Melclin
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It's not going too most of the time. The electricity will always follow the path of least resistance, and the vast majority of the time, if you've done everything right, that's going to be from one pad to the other. But like medichopeful said, there's no point in taking the risk that the stars have aligned in just the right way to create a less resistant path to ground that happens to involve a quick trip through you.
Wasn't there some talk a little while back about continuing compressions during defib? What was the deal with that?
Mountain Res-Q
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True story (second hand)... I know of some Firefighters that used an AED on a near drowning years ago, when AEDs were still novel locally. The patient was removed from the water and placed on the dock, where the EMTs started working the code. The dock was wooden and, of course, soaking wet after being used all day. The patient was laying on the drenched dock and the Firefighters all standing of kneeling next to the patient. They all felt the initial shock, but it was more of a tingling little jolt. In fact, a Firefighter that was standing ~20 feet away claimed to have felt a tingling running up his legs as well. Obviously they did not get the full force of the shock, nor could they have as the shock wants to travel between the two pads; but remember that water is a great conductor of electricity, which is why (despite the low likelihood of problems) you quickly pat the patient dry and remove them from water...
mycrofft
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Wayne Imahara could rig a remote trigger...
Falling back on evidence- based chase-cutting, with as many AED's incuding old retired ones lying about as there must be, we are not reading about nor seeing people dead from it.
Falling back on evidence- based chase-cutting, with as many AED's incuding old retired ones lying about as there must be, we are not reading about nor seeing people dead from it.
medichopeful
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Turns out this was wrong. Take patches off if they are anywhere on the chest.
Shishkabob
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Nope, only take off if they interfere with normal placement of the pads. If the patch is on their left shoulder, there is no need to touch.
medichopeful
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I left out a key work: nitroglycerin patches. According to my book, these should be removed if they are on the chest. Others, yes, if they interfere with the pads.
reaper
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If the patch is not in the way, you can leave it alone. A NTG patch may be removed, but it has nothing to do with the AED.
I have always been told to remove all patches too. Several reasons have been given, but in my engineering opinion; even if a patch is not under the defib pad, it could provide a lower resistance path across the surface of the chest than normal (especially foil backed patches), reducing the amount of current traveling through the chest where it should be. This is probably more likely in a small person where the pads are already close together.
If it only takes an extra 0.5 seconds to remove the patch, I'll do it.
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Brandon O
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I take off my patches when I shock so nobody can identify my service after I kill them <_<
medichopeful
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I think the key word here is "on the chest." If they are anywhere on the chest, I would take them off. If they are in the way of the pads, you MUST take them off. This is especially true for Nitro patches.
The thing is, electricity can actually melt the plastic on the patches, and it could probably melt other materials as well. I would say better safe than sorry.
But right, if it's on the arm or anything, I wouldn't really worry about it. It's not like you're going to do a full sweep of the body and remove every single patch you see. Instead, just remove the ones in the immediate area (in other words, the chest and possibly abdomen).
The thing is, electricity can actually melt the plastic on the patches, and it could probably melt other materials as well. I would say better safe than sorry.
But right, if it's on the arm or anything, I wouldn't really worry about it. It's not like you're going to do a full sweep of the body and remove every single patch you see. Instead, just remove the ones in the immediate area (in other words, the chest and possibly abdomen).
ruprgnant
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abdomen patches?
why remove patches on the abdomen?? i'm pretty sure no one is going to be putting the pads with a crosscurrent on the abdomen... and if they are... i'm less worried about the patches and more worried about the patients now fried stomach...
why remove patches on the abdomen?? i'm pretty sure no one is going to be putting the pads with a crosscurrent on the abdomen... and if they are... i'm less worried about the patches and more worried about the patients now fried stomach...
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MontanaEMT
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Especially Nitro patches, make sure you clean the spot very well since they can be explosive.
Explosive huh?
I guess.
But having seen a first year EM resident about 10 years back mistakenly put Nitro paste on manual defib paddles thinking it a tube of defib jel and the rest of the people in the code not figuring it out until after the fact, let me describe what happens.
When the electricity was applied there was big blue and white flash of light.
No sound, no shock wave. When it was over the patient had 2 paddle shaped full thickness burn marks on his torso and his chest hair was still on fire in several places. (if he wasn't dead prior, I am sure that didn't help)
The resident was standing there with a look of utter shock on his face and the rest of us were encouraging him to sit down. It was about then one of the nurses noticed the open tube of nitro paste.
After a very thorough workup by 2 highly respected attendings, the only injury was to his pride.
I wouldn't add his name here, but I will say at said facility, his story lives on eternally, retold to every incomming EM class even though the defib jel was replaced by orange defib pads.
But unlike so many stories of long ago, I actually witnessed this one first hand. I doubt I will ever forget his name.
Sorry to dissapoint, no "kaboom."
MontanaEMT
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No disapointment. . but as you saw causes some serious burns.. I have heard other stories where the nitro burned into the skin when they did not clean it off.
TransportJockey
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Vene, it's from the same myth I think that NTG IV infusion bottles will explode if they are dropped.
I've not heard that one before.
In order to have an explosion you need a rapid chemical reaction and containment.
It always seems that at least one of those 2 critical pieces is always missing in peoples' theories.
If memory serves me right, it has been a long time since fire/arson investigation school, a low order explosive can be set off by an ignition source or expanding gas and travels at <4081 feet per second.
High order requires both a shockwave and nitrogen at >4081 feet per second.
The practical difference being whether the shock wave pushes material or atomically disjoins it.
For the fire folk, a BLEVE is a low order explosion.
The explosion of the Murrah federal building is actually now a textbook example low order explosion. Though as demonstrated, they can be quite devastating despite their name.