Bzzzzztttttt......KERPOW!!!

[Captain Deco]

Just a quick question:

Having recently been certified by an ALS instructor in the dark arts of Defib use etc, we both wondered how to deal with someone that you would want to defib if they are wearing a wetsuit, and have just come out of the water. Surely:

Electricity + Drippy wet water = Certain and sudden death?

Any experten out there care to enlighten me?

[Adrian Kelland]

Sounds like one for Odin, and not for his god like nature either.

Was this kind of thing not covered in the course? Just thinging about uses in a very rainly day for example.

Adrian

[dlegros]

Dry the chest as best you can before applying the pads (they won't stick to wet skin very well anyway).

Ensure that the casualty is not in a puddle of water, and especially that you are not connected to the casualty by water if you administer a shock.

HTH

[paramedic paul]

Defibs and water do not mix, end of story!!! Get the toughcuts out get them out of suit and dry off as much as possible and move well away from water!

I went to a cardiac arrest at a local swimming pool earlier in year, lifeguards had fetched patient out of pool and had attached the defib pads at the side of the pool and were about to press the big green button. You've never heard me shout so loud, bearing in mind there were about 6 members of staff gathered around the patient, if he had pressed the button we would be attending a major incident and not a single casualty situation!!!

If you cannot move the patient away from waters edge then get a bench or mat or something similar underneath them. Either that or, at the precise moment you press the button JUMP!

[The Purist]

I've been unfortunate enough to be involved when we pulled a friend out of the pool after a heart attack. The pool staff & ambulance crew both used a defib on the poolside, but made very sure that everyone not wearing shoes was up in the seats beforehand. The defib still packed a punch, but sadly not enough.

[Captain Deco]

Thanks for the advice on this one. I couldnt recall if it was covered because the course I was taught defib on does not refer to diving, and I have never been on a boat or an inland site where they have defibs. Wearing a drysuit - no drama, but wetsuits were what posed the question. When seconds count I didnt think it would be right to start wasting scant seconds with scissors and a towel. CPR until my assistant (should I have one) has desuited and dried the patient.

[Rod]

Just give their chest a wipe then zap 'em, just make sure you are not in a pool of standing water.

I have used a defib on a two people that have been soaking wet (swimming pool and straight out of the river Thames). Both survived.

[paramedic paul]

If you are on your own cpr is pretty much the only thing you can do until someone else arrives to deal with clothing etc, as the mantra goes Airway, Breathing, Circulation! Without air going in asap it won't matter how many times the patient is "shocked" the outcome won't be good.

[dlegros]

Except the 2005 guidelines seem to be going CAB now, with this big push for compressions first and even the options for compression only CPR in the lay-person algorithms!

Barstewards! Every time I get my head round them the go and pull the rug out from under me.

[purple vonny]

Originally Posted by scubajay

but wetsuits were what posed the question. When seconds count I didnt think it would be right to start wasting scant seconds with scissors and a towel. CPR until my assistant (should I have one) has desuited and dried the patient.

Yes, and as answers above say, airway, breathing, circulation comes first. But if the patient has no heartbeat, they would not have a dicky sinus rhythm, so CPR would probably be the most appropriate action to oxygenate the blood and get it pumping around the body.

I know that in hospital situations (and medical dramas) when someone "flat-lines" they get "shocked", but..... and I am prepared to stand corrected here, in the case of a lay person helping in an emergency, a defibrillator is appropriate for those with an abnormal heart rhythm (atrial fibrillation) and the machine restores normal rhythm. In order to find out whether this was the case, you would have to dry the patient in order for the electrodes to be attached so the machine could tell you whether to defibrilate or not.

I think......