In the event of a cardiac arrest, a defibrillator is an essential piece of equipment that forms an indispensable link in the ‘chain of survival’. Approximately half of all cardiac arrests may be treated with prompt defibrillation. Defibrillators may be of particular use on boats that undertake substantial dive programs, where underwater accidents may result in relatively young people suffering a cardiac arrest through lack of oxygen.
Defibrillators are only one link in the chain of survival, the other links being prompt recognition of
cardiac arrest, rapid initiation of effective cardiac compressions, and an early call for help. Following successful defibrillation, a good supply of oxygen is required, together with rapid transfer to the nearest hospital for on-going support, if that is possible.
The defibrillator kit is based on a semi-automatic defibrillator. This defibrillator will automatically recognise what cardiac rhythm is present, and determine whether a defibrillation shock is appropriate. Actual delivery of the defibrillation shock is dependent on the boat medic pressing the large button located on the top of the defibrillator. This sequence of actions is so designed to safely prevent shocks being given to other crew who may be inadvertently in contact with the casualty. Voice commands ensure that timings for cycles of compressions and defibrillations are as accurate as possible.
The defibrillator is housed in a Pelicase, which ensures the unit stays in good operational condition in the harsh marine environment. It can stay in the case for several years without need for service, although an occasional health check on the battery is advisable. A soft bag version is also available.
The defibrillator pads supplied with the unit are configured in one piece, which covers the front of the chest. The pad incorporates a sensor which detects both the rate and depth of compressions, giving real- time feedback, facilitating effective life-saving chest compressions.
The defibrillator kit is not a stand-alone kit, but is designed solely for defibrillation of the casualty in the event of cardiopulmonary arrest. Vessels would normally also be equipped with commercial kits such as MCA kits, or non-commercial kits such as the Distant Ocean Medical Kit.
The defibrillator kit is recommended for use by boat crew who have received first aid training, with regular updates of cardiopulmonary resuscitation, and who ideally have telemedical support.