In the day to day functions of your vessel, the defibrillator lies in the back of a closet or under the helm station. If the crew is diligent and safety minded, it’s on a checklist and gets a cursory inspection from time to time. Hopefully once or twice a year, when the medical supplies are reviewed, it gets a closer look.
The defibrillator is deserving of so much more respect and attention. In a recent press release from a leading defibrillator manufacturer, the Royal Caribbean cruise ship,“Oasis of the Seas” used their defibrillator on a passenger who collapsed with “Sudden Cardiac Arrest or SCA. Fortunately, a doctor was close by, started CPR and called for the defibrillator. Two shocks were delivered and the passenger was transported to a local hospital where they underwent cardiac surgery and recovered.
The ship had multiple defibrillator units strategically placed throughout the vessel. Their particular device was designed to be so easy to use that even minimally trained persons could successfully respond to a cardiac arrest scenario.
Sadly, only 5% of SCA victims survive, in part because a defibrillator was not available, no one knew CPR or the victim was too far away from medical care. Make sure you get CPR training with a defibrillator and keep it updated regularly.
Every few years the American and European Heart Associations review the protocols for CPR and make recommendations for changes. I know for many of us it seems there are changes every year!
The CPR changes in 2010 were very dramatic. The rescue breath was eliminated, at least in the first few minutes of CPR. The pace of compressions became faster (100-120/minute) and depth of compressions was deeper.
This also meant that many defibrillators, set to the old protocols, required updating. Many defibrillators need to be sent back to the factory for updates. This will mean taking your defibrillator out of service and the update will be at your expense. Ask for a loaner until your unit is returned to ensure you always have one available in an emergency. This might also be the best time to consider updating to a new defibrillator.
There are several defibrillators on the market, including the device used on the cruise ship, that are reprogrammable by using a computer with a free download. That means you will have a defibrillator that is always current and never needs to be removed from service.
The newer devices are so easy to use that untrained people, and even children, can use them. They calmly talk you through all of the actions of CPR and some devices actually tell you when you are doing compressions deep enough and fast enough to be effective.
The devices use lithium batteries and have a long shelf life before replacing batteries and electrodes. In recent years, there have been reports of lithium batteries overheating and causing fires. This has lead to
restrictions on shipping by air, any lithium battery replacements. For this reason, make sure you keep spare batteries in stock before you travel to remote areas where the batteries are not available.
Not all defibrillators are meant to be used in a marine environment. So, if considering a new defibrillator purchase, look for a water ingress rating of 55 or better.
To recap:
- Inspect the defibrillator, check battery and electrode expiration dates and replace if needed
- Place the defibrillator in an easily accessible, central location
- Familiarise everyone to defibrillators location
- Check the manufacturer’s website for updates or or recalls
- Get a quote for a new device if your current defibrillator was manufactured before 2005
- Get CPR trained or have your training updated every 2-3 years and ask the instructor to use your defibrillator brand in your training
By Rebecca Castellano, RN
Medical Support Offshore Sales Manager US/Caribbean
