Bureaucracy gone mad

[QUOTE=Garry] They state that 80% of cardiac arrest cases are venticular fibrillation and this can be treated with a defibrillator
[=QUOTE]

To the best of my knowledge this is true of you count all cardiac arrests. The bizzare thing is that the majority of these take place in a coronary care unit, when the patient is being monitored after a heart attack or during a period of unstable angina. In these cases it is absolutely true that prompt and competent use of a defib will massively increase your chances of survival! These cardiac arrests will almost all be due to ischaemic heart disease.

There are two problems with applying this logic to a watersports environmet:     

1) People who are out doing watersports are at low risk of a cardiac arrest from ischaemic heart disease (compared to the general population), because they are actually doing some exercise, and it is reasonable to assume that they do not suffer from exertional angina (otherwise they wouldn't be out there in a boat!). Therefore the actual risks of someone who participates in a sporting activity have an arrest are smaller that the general population. This may not be true for the spectators / non-active participants.         ; ;         

2) The most likely type of heart attack in someone reasonably young and fit who has been sailing / windsurfing is going to be an 'EMD' arrest, brought on by hypothermia or drowning. An automatic defibrillator (AED) won't let you shock an EMD rythmn. But here is the scary bit: if you try to resussitate someone with a core temp below 28 deg you can precipitate a VF arrest, at which point the AED will try to shock the subject. Defibrillation will not be successful until the core temp is >30deg, but of course you can't effectively re-warm someone if you have their chest exposed to deliver shocks.

In otherwords: a complete nightmare, and very confusing / frightening for anyone trying to decide what to do.

Garry is right that defibrillotors CAN save lives but this only applies if your heart starts beating in two of three abnormal rythmns and if you see the person collapse and deliver the shock within a few seconds / minutes. Even in a specialist hospital unit, with the patients monitored all the time to detect the abnormal rythmns the chances of saving someone are less than 30%.

If someone had a cardiac arrest due to sailing it is most likely to be due to hypothermia or hypoxia (lack of oxygen e.g. due to drowning). In these cases using a defibrillator is more likely to kill the person than help them.

As far as the risks to the first-aiders and by-standers are concerned even in a hosiptal, where everyone is trained to use them, we see near misses and actual injuries every few months. I have never been to a sailing club with a dry enough floor where I would be happy to use a defib.

I am all in favour of clubs sending members on first aid courses, and I am certainly in favour of people making their own minds up about the risks of taking part in a sport. But I also think it is really important for those in charge to think long and hard about the very real risks involved with some 'safety measures'.

The sailing club in question decided not to get a defibrillator, not because it could not afford one but because it felt the risks were far greater than the potential benefits. 

     Gary is either:

     a.) h&s officer

     b.) a member of goverment

     c.) a pr representative in some big buisiness.

For a start you can't expect that all clubs can raise the thousands of pounds to buy one of these, that would be a nice little addition to the club membership fee wouldn't it, and also as far as spending more time on the shore, what the....?

I have one that is worse: a club that will remain nameless was advised by health and safety that they aught to have a defibrillator (medical device that delivers 360 volt shocks to the heart if you have had a heart attack).

What no-one had thought through was that the people operating the deviceand  the victim were very likely to be soaking wet (this is a water sport after all). Given that water is a great conductor of electricity, any attempt to shock someone would almost certainly result in a awful lot of dead / shocked bystanders