Heart attack victim 'saved' by defibrillator delivery drone* An autonomous drone carrying a defibrillator helped save a 71-year-old man having a heart attack, a first in medical history, a Swedish search-and-rescue tech company has claimed. We're told the old boy was clearing snow from his driveway in Trollhättan, Sweden, on the morning of December 9 before he was struck by crippling …
And well done to the doctor.
I have to say, if it's winter, snow on the road, and I happen to be driving by and old man clearing his driveway who falls down, I don't think "heart attack" will be the first thing I think of.
I'm guessing I would have driven past, completely oblivious to the issue.
That scares me now.
Great story - shovelling snow is a classic way of getting a heart attck
https://health.clevelandclinic.org/snow-shoveling-a-real-risk-for-heart-attack/
and in many countries there is a legal duty to keep your pavement/ 'sidewalk' clear.
But two important points:
1. You don't have to be a doctor to do CPR and you don't need to do a training course.
You won't do any harm.
https://www.youtube.com/watch?v=3vXPo7lNYzk
2. We teach primary school kids to use the defibrillators : the defibrillators tell you exactly what to do - you don't need a lesson to use them.
You won't do any harm.
https://www.youtube.com/watch?v=UFvL7wTFzl0
If you watch these two videos you will be completely equipped to do what this doctor did.
You won't do any harm. You don't have to kiss the patient. JFDI !
[IAAD and teach CPR to medical students]
This was pretty much the gist of the course we did at work a while ago. See icon -->
There was even a JFDI section aimed at the men in the room saying to not be "hesitant" and to remove a woman's clothing including underwear before starting chest compressions. I assume that some poor women have not been resuscitated because of this or else we wouldn't have been told that :(
I have successfully performed CPR & AV on a woman for long enough for her to be conscious enough to be complaining about being cold when the doors were slammed shut on the Ambulance taking her to hospital after she'd mixed alcohol with whatever the heart medication is that causes a heart attack when you do that.
Even back in those days then we were told in training that it it might be worth considering legal insurance if we intended to help random members of the public in case they sued us. I have never found this an issue; if the person is unconscious then as long as you don't give your information to the ambulance crew then nobody has your name so it's practically impossible to sue you.
However, this was long before the era of ubiquitous mobile phone camera coverage, image recognition and online hate mobs of vigilantes. These days i'm given to understand that male First Aiders have been persecuted after removing a woman's bra and saving her life via CPR. Courts will of course throw out any case brought due to the "good samaritan" protections in the law, but that won't stop online hate mobs whispering campaigns messing up your life, or you paying out for legal representation to get that outcome.
All a First Aider gets for saving a life is a warm fuzzy feeling followed by some nightmares about what'd have happened if you twitched the wrong way at the wrong time. You don't tend to get any thanks, and faced with an unquantifiable risk of financial penalties and/or being persecuted by a hate mob that might destroy your life, as well as the risk of picking up transmittable diseases from doing mouth to mouth.
That really makes you wonder very, very hard if it's actually worthwhile stopping and helping just because morally it's the right thing to do.
Now could I actually just walk away in an emergency? I don't know. I haven't ever done so before and i'll only find out if i'm forced to make a choice. But face with that sort of risk/reward one has to wonder if it's actually worth getting involved. No good deed is left without consequences these days and that does have an impact.
A paramedic that I knew through volunteer emergency services told us about the time he was doing CPR on a young woman. He had removed the necessary clothes and was doing CPR and partner was setting up the Lifepack (fancy defib). Some old 'lady' came by and started hitting him around the head with her bag as she thought (if you can call it that) they were molesting the woman. They were in full uniform and had the ambulance there with lights on!
I once saw a guy stumbling down the road and thought to myself it was just another drunkard. Fortunately for the guy, another passer-by was an ER doctor and though otherwise, helped the men and asked me to call 112 (no one else around, but the 3 of us). Turns out the guy had just had a stroke and it was the doctor's intervention that most probably saved his life. I've never felt as inadequate as I did that day, but it was a real eye-opener for future situations.
Figures from BHF research show that 60% of the population would simply walk past. A large number might get their phones out and start livestreaming the person's last moments on Facebook Live, but most people would simply walk past.
It's the thing that leads to Schrödinger's corpse. You pass a body in a shop doorway covered by a sleeping bag. You have no idea if they are dead or alive and you won't go and check, so the person just lies there until someone calls the police to move them on. The Police will open the box and find out if its someone who needs moving on or if its another person who died a cold and lonely death huddled in a shop doorway as the world walked by oblivious.
Figures from BHF research show that 60% of the population would simply walk past. A large number might get their phones out and start livestreaming the person's last moments on Facebook Live, but most people would simply walk past.
As a reasonably experienced First Aider, your statistics are way off. Saying that 60% of the population who notice a situation will walk past is fairer, but presumably is judged on people stating if they would stop or not, rather than being based on the number that actually do stop at actual accidents.
Anybody who has ever been crouched over a body will tell you that the number of people who will notice things can be extremely, extremely low. Most people have utterly appalling situational awareness, especially if they are on a "routine" trip somewhere done on mental autopilot. And how many people stop in a car at the scene of an accident? It's certainly not anywhere near 6 in 10 and it varies depending if it's in a town or out in the country; out in the country with smaller and stronger communities despite much lower levels of footfall you rarely fail to have have several orders of magnitude more people stop.
Also people don't tend to livestream the persons last moments on Facebook live. This is typically a urban issue, and what you have is people taking a video and saving it to be able to sell it to the media which makes for some interesting issues; people will hold a phone and use it to video somebody dying instead of doing something beneficial such as you know, using the phone to call an ambulance.
And, as noted they get rewarded by being paid by whomever they sell the clip to. The person that actually saves the life or usefully contributes via phoning an ambulance typically gets nothing other than mental trauma, which leads to a morally perplexing reward distribution for particular types of behaviour.
I traveled for 20 years with a doctor, and continued to be amazed at her awareness of medical emergencies. Where I'd see a car pulled over at the side of the road, she'd recognize a heart attack: where I'd see a fender bender, she'd see a road injury.
To be fair, I was trained in the opposite strategy: only driving awareness is important, all else is irrelevant.
I think Sweden was the first place I saw an AED in public. As in inside a green cross box prominently located on a street. So wandered over to have a look, chuckled at the "Heartstarter" sign, and was reading the instructions when a couple of officers asked me if everything was OK. They explained they'd been around a few years, saved lives and the machines told people what to do. Plus opening the box would trigger an emergency response as well.
So seemed like a really good idea, and since seen similar in the UK as well.
There was a fundraising to put one on just about every street corner here.
I was sceptical, I thought they were only good for certain heart problems but people who watch TV think they save 100% of all heart attacks and the makers were definitely leaning into this while being very careful what they claimed
Here in Oz (at least in my part out bush) there are AEDs outside Post Offices as well as other well-frequented places such as some parks, in shopping centres, some major bus depots and the like.
Our various 'helping' orgs (such as Lions) oft times have fundraising for them.
Being isolated we then wait for one of these or a plane ----->
Yep, the Swedish one I saw was in central Stockholm, but the benefit scales with expected emergency response times. The part I liked is the way they're fairly foolproof. So hook up the patient and it'll tell helpers what to do. Curious if there's datalink potential for remote support, or if there'd be much benefit. Videos I've seen have them directing CPR, and guessing extra features like administering adrenaline would be risky.
Where I worked got one in the company some 18 years ago. We received instructions in the company time first aid course, I also think they spoke to us then, and they have built in check to prevent giving a jolt if there is regular pulse. You can't damage people with it.
One of my colleagues actually saved a third colleague that way. Probably didn't harm that we were 2km from one of the Danish heart centres.
They are quite widespread in Portugal now, incl schools, sport halls and shopping centres, but I think a lot of people don't know how simple they are to use.
I've done some training on AEDs as part of First Aid at Work training and I was shocked (pun intended) at how simple they are to use. I've not seen one with videos, but the diagrams on the pads make it easy to know where to put them and the device will tell you what to do.
Also, as far as CPR goes, if someone isn't breathing, you CANNOT make them worse by attempting CPR. At worst, their corpse might have a few broken ribs (common rule of thumb is "if you don't break a rib, you're not doing it hard enough), but they'd be dead anyway. At best, you'll keep their organs oxygenated long enough for medical attention. Bad CPR is better than no CPR.
"Bad CPR is better than no CPR."
Make sure their airway isn't blocked first - you don't really want to be doing the C bit of CPR on someone whose heart is fine, but they have choked and collapsed.
Whilst BAD CPR is better than no CPR, you will get plenty of support from emergency services dispatchers, and singing "Staying alive" could help you as well...
Basically - get first aid training when it's available.
A blocked airway (choking) can be cleared via CPR - the compressions push air out of the lungs as well as compress the heart and can dislodge an obstruction. It's why 'hook and look' got ditched (also - getting fingers bitten was considered a bad thing).
However: DR ABC is a good approach (Danger>Response>Airway>Breathing>Circulation). Someone screaming in pain has a clear airway and a pumping heart. When they stop screaming, however...
(If you want to know more about DR ABC, there are a variety of courses out there that will teach you : They tend to be listed as first aid course :p )
As to the drone dropping off an AED: They're not that large, nor that heavy. One I was carrying a few months back was less than 12" across and weighed a few lb's. I've a larger and heavier one in the office - and that one is several years old (and kept in good condition - never know when you might need it!)
It's funny you should say that but I just looked it and it took 3 minutes to see exactly how to use one. They are pretty much fully automatic and really simple to use. Not only that but the AED actually talks you through what you need to do as well as analysing the patient to decide whether a shock is actually needed. Look it up, you never know if one day it could come in useful.
In the UK many communities have purchased defibrillators.
In the summer there was an obvious Myocardial Infarction (heart attack) in the village and I went to help (I was walking down the other side of the street). I sent the other helper off to ring for an Ambulance and then get the defibrillator from approx. 120m away.
The Ambulance arrived 18 minutes later, the defibrillator, over an hour later - no-one knew the code to get into the storage box!
(The lady was fine after a few days rest in Hospital.)
> The Ambulance arrived 18 minutes later, the defibrillator, over an hour later - no-one knew the code to get into the storage box!
Isn't that something that the 999 operator is supposed to give you?
Hopefully this near miss will mean the situation is resolved before someone needs it again.
The Ambulance arrived 18 minutes later, the defibrillator, over an hour later - no-one knew the code to get into the storage box!
Isn't that something that the 999 operator is supposed to give you?
Yes, but... Actually the Ambulance Dispatcher, not the "999 operator", but this only works when the 999 call is made from beside the defibrillator enclosure, so that the caller can give the correct (previously agreed) description of the location, which IIRC is also displayed. Without that the dispatcher has no idea which code to give the caller.
"Yes, but... Actually the Ambulance Dispatcher, not the "999 operator", but this only works when the 999 call is made from beside the defibrillator enclosure, so that the caller can give the correct (previously agreed) description of the location, which IIRC is also displayed. Without that the dispatcher has no idea which code to give the caller."
Also along the same lines (UK again), if you call via a mobile you could get routed to an operator anywhere in the country and they won't know where 'outside the chip shop in Newport high street' is. They won't even know which Newport you are talking about. That is one of the benefits of things like What3Words. (In the olden days of landlines / phone boxes you'd get routed to your local call centre).
How was it an obvious MI?
In a sense it doesn't matter. A defibrillator will not administer a shock to a heart that is generating a normal pulse; neither will it give a shock if it cannot detect a "shockable rhythm" in the casualty.
When fibrillating the heart muscles stop working with their correct rhythm and sequence leaving a residual rather chaotic series of small ineffective "trembles" and if the defibrillator cannot detect the basis of a working rhythm then it will advise that chest compressions should be continued in the hope that the external pumping will restore enough of a normal rhythm for a shock to be worthwhile.
That;s why I'm asking, as you clearly appreciate a defib isn't the golden bullet folk often think (especially in an MI case). I am assuming the MI presented itself with classic signs and symptoms and the patient was conscious throughout.
As I am guessing you'll know many folk don't even know that a defib is not a replacement for CPR but I blame how the training is often relieved nowadays. Incidentally I assume the ambulance was a resource without kit or transport if the defib took an age after they arrived?
That as my objection to the sales pitch to our town council.
The maker's presentation was full of scary stats about how many people died of heart attack, and how long an ambulance takes to our rural location - but they were careful to never say the AED would cure heart attacks.
Any medic want to chime in on exactly how often these things are useful?
AEDs do not 'cure heart attacks', they shock an irregular heart rhythm back into a normal rhythm, keeping the victim alive longer until proper medical attention can be delivered. Sadly the scary statistics are true:
Fewer than 1 in 10 people survive an out of hospital cardiac arrest.
Around 7–8% of people in whom resuscitation is attempted survive to hospital discharge.
Immediate initiation of CPR can double or quadruple survival from out hospital cardiac arrest.
Only 40% of people receive bystander CPR in the UK.
Defibrillation within 3–5 minutes of collapse can produce survival rates up to 50–70%.
Each minute of delay reduces the probability of survival to hospital discharge by 10%.
Fewer than 2% of people have an automated external defibrillator (AED) deployed before the ambulance arrives.
https://cks.nice.org.uk/topics/cardiac-arrest-out-of-hospital-care/background-information/prognosis/
Exactly why I asked about it being an obvious MI; for that to be obvious the chances are the AED would be of sweet FA use, especially if the patient went into EMD as a result of this (or a CT of course). I was trying to be polite an dnice about ascertaining the effecitveness of the AED and how the 'ambulance' was not able to transport te patient or even carried one. Communityreposnders usually have these in their car so it seems a strange resource to despatch.
I know more about this than the typical guy on the street but am used to folk doing a first aid course or somesuch telling me what I don't know.
I also know more than most about the collapsing 999 responses being caused by a combination of factors including automated triage and a deluge od inept 111 calls requesting an ambulance for often chronic or mid/long term conditions flaring up. The exmapleof the nosebleedis a great one as it highlights the challeneges faced, yet no-one seems to think it's true.
Yet eveyrtime this topic come along on the boards the downvotes come aplenty against most posts trying to talk sense. It seems to be one of those subjects where everyone is an expert...
You don't use AEDs for heart attacks! They are completely different from cardiac arrests.
https://www.aedleader.com/when-not-to-use-defibrillator/
The Person is Suffering From a Heart Attack
It’s common to confuse a heart attack with cardiac arrest, but these are completely different conditions with different protocols. A heart attack is a plumbing issue while cardiac arrest is an electrical issue. An automated external defibrillator will not help a heart attack victim; on the contrary, it may put them in greater danger.
The good news is that it’s easy to tell the difference between a heart attack and cardiac arrest. If the person is in pain but still breathing and responsive, it’s most likely a heart attack. If the person is unresponsive and not breathing, you’re probably dealing with cardiac arrest.
Yes that was my question. They shock certain bad heart rhythms back into shape. But are all cardiac arrests => suitable bad rhythms? So do they work for all cardiac arrests or only a small percentage that are due to bad rhythms ?
What triggered my suspicious sales pitch detector was something like:
Slide 1, BIG scary number of people die of cardiac arrest before ambulance arrive
Slide 2, SMALL number of people have access to a AED before ambulance arrives
Slide 3, Therefore you should have lots of AEDs
But they were very careful no to say 2 would solve 1
Well based on
Defibrillation within 3–5 minutes of collapse can produce survival rates up to 50–70%.
Each minute of delay reduces the probability of survival to hospital discharge by 10%.
If only 8%% of cardiac arrest victims survive to hospital discharge without AEDs being used but an AED increases survival rates up to 70% I think that suggests that most cardiac arrests are the 'right sort of arrest'. If your heart doesn't have a shockable rhythm then you are technically dead anyway.
This is also why looked at the instructions on the AED box. I guess the ideal way is to start CPR while someone grabs the AED and attaches the leads. Then just do what the AED tells you, which might be to continue CPR. Ones I've seen in the UK presumably manage lock codes by simply having the location on the box.
Yes but are you seeing the 'unspecified' C1 emergencies due to a nosebleed causing breathing difficulties, and the automated triage appointing them top priority?
I know of one instance locally where a fractured femur lay at the bottom of the stairs (patient in her 80s) and waited six hours for a resource. In the meantime dispatch were prioritised jobs far less serious as that's the triage process determines it.
I have personally seen 40 minutes wait for unconscious man in the middle of the road (he had gone over the handlebars of his bike when the front wheel collapsed after hitting a deep pothole full of rain water, so I was not going to move him and the road was blocked.)
A friend was playing football (on the Race Course in Northampton) and his team mate suffered a compound fracture of the leg. There was a 3 hour wait for the Ambulance to take him less than a mile to the hospital. All the football games were abandoned and there was insistence of future attendance at all league matches by St Johns.
The story has nice technical El Reg parts - I just see it as an excellent explanation of why it's always best to trust a doctor (icon)). I always trust doctors, I work with them a lot of times and so I know they can not be 100% correct all the time but they work so much harder at it then everyone else and much better than I can do.
A news report from about three weeks ago announced a cheap AED for home use for about $300 AUD (or $210 US or 160 UK neglecting VAT). It appears to be single use only as you have to tear the packaging open to use it, but how many strokes or MIs do you expect in the same household?
https://thenewdaily.com.au/finance/2021/12/12/australian-develops-personal-defibrillator-home-use/
...but how many strokes or MIs do you expect in the same household?
I hope I don't have to reply on you for any first aid. I cannot for the life of me imagine what good a defibrillator will do for a casualty who has suffered a stroke. Please do tell...
See earlier posts about MIs.
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