A new emergency procedure for cardiac arrests aims to save more lives
February 27, 2024 6:26 AM Subscribe
A new emergency procedure for cardiac arrests aims to save more lives – here’s how it works. New Zealand is just the second country to approve a novel defibrillation procedure for some patients. With current survival rates very low, it is hoped the new method will save many more lives.
Holy shit, that ambulance at the top of the article is the coolest looking thing.
posted by Halloween Jack at 7:27 AM on February 27
posted by Halloween Jack at 7:27 AM on February 27
From a total of 261 patients, 30.4% treated with this strategy survived, compared to 13.3% when standard resuscitation protocols were followed.
AMAZING. Great news! Thanks for sharing it! Survival rates for out-of-hospital cardiac arrests soar with the presence of a defibrillator -- even an automated unit used by an untrained bystander (previously) -- and having this new option for use by trained emergency medicine practitioners who could bring 2 defibrillators with them sounds super helpful!
posted by brainwane at 7:31 AM on February 27 [1 favorite]
AMAZING. Great news! Thanks for sharing it! Survival rates for out-of-hospital cardiac arrests soar with the presence of a defibrillator -- even an automated unit used by an untrained bystander (previously) -- and having this new option for use by trained emergency medicine practitioners who could bring 2 defibrillators with them sounds super helpful!
posted by brainwane at 7:31 AM on February 27 [1 favorite]
I am baffled at how you can do this in the back of an ambulance en route to a hospital. Prop up your patient and launch them back and forth between two defibrillators like two playground bullies with the hapless nerd in the middle?
posted by dr_dank at 7:45 AM on February 27 [1 favorite]
posted by dr_dank at 7:45 AM on February 27 [1 favorite]
Interesting! I wonder if they could make a 2 in 1 defibrillator which could be automated?
posted by rongorongo at 7:47 AM on February 27 [1 favorite]
posted by rongorongo at 7:47 AM on February 27 [1 favorite]
Interesting stuff, I'm curious to see if this makes its way into in-hospital arrest as well. Thanks for the post.
posted by Pantengliopoli at 7:51 AM on February 27 [1 favorite]
posted by Pantengliopoli at 7:51 AM on February 27 [1 favorite]
Holy shit, that ambulance at the top of the article is the coolest looking thing.
agreed, it whips ass
posted by dismas at 8:40 AM on February 27 [1 favorite]
agreed, it whips ass
posted by dismas at 8:40 AM on February 27 [1 favorite]
Prop up your patient and launch them back and forth between two defibrillators like two playground bullies with the hapless nerd in the middle?
From TFA:
From TFA:
The pads are attached in two different locations: one on the front and side of the chest, the other on the front and back.posted by joannemerriam at 8:48 AM on February 27 [1 favorite]
A single operator activates the defibrillators in sequence, with one hand moving from the first to the second.
Pads instead of paddles, makes sense. I remember in AED training in the office that the instructor said that the unit can only deliver so many shocks before needing a recharge. I’m assuming these are heavy duty units.
posted by dr_dank at 8:54 AM on February 27
posted by dr_dank at 8:54 AM on February 27
I keep pushing people to the Lifesaver (free! universally available!) online training developed by the Resuscitation Council UK. They spent a bucket of money writing effective scripts, using real actors, and creating genuinely emotionally fraught scenarios that test your ability to operate under some stress, even if it isn't real life stress. (You may consider the previous sentence a trigger warning. I know that every scenario in this gets me a little teary, even though nobody dies.)
The training doesn't cover the new technique, but it still may help you save a life. The first link shows you that both desktop and mobile versions are available, but here's a direct link to the defibrillator scenario designed for the desktop.
posted by maudlin at 10:18 AM on February 27 [5 favorites]
The training doesn't cover the new technique, but it still may help you save a life. The first link shows you that both desktop and mobile versions are available, but here's a direct link to the defibrillator scenario designed for the desktop.
posted by maudlin at 10:18 AM on February 27 [5 favorites]
I’m assuming these are heavy duty units.
Monitor/defib units in ambulances such as Lifepaks or Zollers are on charge when not actively in use, and they are both more robust than standard public AEDs and have manual and cardioversion modes, etc. The sticky pads are much the same though.
posted by Ardnamurchan at 10:31 AM on February 27 [1 favorite]
Monitor/defib units in ambulances such as Lifepaks or Zollers are on charge when not actively in use, and they are both more robust than standard public AEDs and have manual and cardioversion modes, etc. The sticky pads are much the same though.
posted by Ardnamurchan at 10:31 AM on February 27 [1 favorite]
That New Zealand ambulance looks like a mobile weed truck. I did not read the article but I'm assuming what happens is they get you extremely high in the ambulance on super dank NZ kush and you chill out a ton, until the cardiac arrest goes away. This makes sense to me from a scientific standpoint. I will not be reading any further on this but suffice to say I am glad to hear that THC once again proven to save lives.
posted by windbox at 11:55 AM on February 27 [6 favorites]
posted by windbox at 11:55 AM on February 27 [6 favorites]
I am somewhat entertained by the commentary on the ambulance - this is the new body layout brought in by the ex-UK top brass at St. John and is explicitly intended to be more similar to UK ambulances than to the classic 'box' type we used to have (many of which are still in service). It has not been uncontroversial.
'Waka manaaki' means basically 'care vehicle' for those unaware. Waka (the canoe) traditional craftspeople were consulted on the design - more here.
posted by ngaiotonga at 2:57 PM on February 27 [3 favorites]
'Waka manaaki' means basically 'care vehicle' for those unaware. Waka (the canoe) traditional craftspeople were consulted on the design - more here.
posted by ngaiotonga at 2:57 PM on February 27 [3 favorites]
ngaiotonga, that is BEAUTY
“'Waka’ means transport method and ‘Manaaki’ means to take care of. If we break 'Manaaki' down 'Mana' is one’s power 'aki' means to encourage or empower – which is essential for our patients.”
… The transformation of the design to a Waka Manaaki was underpinned by three concepts centred around care for all New Zealanders: Manaaki tangata, or care for individuals; Manaaki whānau, or care for families, communities and staff; and Manaaki hauora, care for all of our collective health and wellbeing.”
posted by rrrrrrrrrt at 6:30 PM on February 27
“'Waka’ means transport method and ‘Manaaki’ means to take care of. If we break 'Manaaki' down 'Mana' is one’s power 'aki' means to encourage or empower – which is essential for our patients.”
… The transformation of the design to a Waka Manaaki was underpinned by three concepts centred around care for all New Zealanders: Manaaki tangata, or care for individuals; Manaaki whānau, or care for families, communities and staff; and Manaaki hauora, care for all of our collective health and wellbeing.”
posted by rrrrrrrrrt at 6:30 PM on February 27
I am baffled at how you can do this in the back of an ambulance en route to a hospital. Prop up your patient and launch them back and forth between two defibrillators like two playground bullies with the hapless nerd in the middle?
Have you seen what AEDs look like? These are the more-or-less automatic ones that anybody can be trained to use in an hour, not the complex ones that paramedics use. Many ambulances have Basic EMTs, like me, and not higher-trained paramedics. All our main ambulances are staffed with paramedics, but if all our paramedics are out on call, someone like me can be sent out.
An AED is a flat box with two stickers on wires on it. Big stickers with glue that will rip off hair - the actual in-field standard for getting rid of chest hair if you can't get them to stick is to stick the first one, and just take the chest hair with it, then switch to the backup pair. AEDs in malls and offices have a little razor to shave the chest first; we are taught not to bother and just do it that way.
The point is, these stickers stick.
So they are saying, take one of those flat AED boxes with the stickers on wires, and put them in the normal position we always have done. Then take another flat AED box with another set of stickers on wires and put those ones in a different way.
Then activate the one, and then activate the other. The patient doesn't have to move.
The main challenge to implementing this, as I see it, is that AEDs are expensive. The average price of a new AED is, like, $1500. Used refurbished ones can be had for half that, but that's still not cheap.
Equipping an ambulance is expensive, and putting two AEDs on each truck isn't impossible, but I am sure there would be quite a bit of grousing. There are three main ways you get ambulances in the United States, and money isn't unlimited in any of them. Either you are in private for-profit EMS, which, y'know, "profit", and there already isn't much of that - for all that the United States has insanely high charges for ambulance rides, the ambulance companies themselves often barely break even - the money all goes to the insurance companies; you are in taxpayer-funded EMS, and nobody likes taxes (although "fire departments and ambulances" tend to be an easier sell than a lot of other things), or you are in a volunteer department, and you are paying for stuff yourself.
Still possible, and if it is more than doubling survival rates, I hope the Office of Emergency Medical Services investigates this immediately, and, if it holds up, makes this our protocol real soon.
posted by Xiphias Gladius at 5:44 AM on February 28 [1 favorite]
Have you seen what AEDs look like? These are the more-or-less automatic ones that anybody can be trained to use in an hour, not the complex ones that paramedics use. Many ambulances have Basic EMTs, like me, and not higher-trained paramedics. All our main ambulances are staffed with paramedics, but if all our paramedics are out on call, someone like me can be sent out.
An AED is a flat box with two stickers on wires on it. Big stickers with glue that will rip off hair - the actual in-field standard for getting rid of chest hair if you can't get them to stick is to stick the first one, and just take the chest hair with it, then switch to the backup pair. AEDs in malls and offices have a little razor to shave the chest first; we are taught not to bother and just do it that way.
The point is, these stickers stick.
So they are saying, take one of those flat AED boxes with the stickers on wires, and put them in the normal position we always have done. Then take another flat AED box with another set of stickers on wires and put those ones in a different way.
Then activate the one, and then activate the other. The patient doesn't have to move.
The main challenge to implementing this, as I see it, is that AEDs are expensive. The average price of a new AED is, like, $1500. Used refurbished ones can be had for half that, but that's still not cheap.
Equipping an ambulance is expensive, and putting two AEDs on each truck isn't impossible, but I am sure there would be quite a bit of grousing. There are three main ways you get ambulances in the United States, and money isn't unlimited in any of them. Either you are in private for-profit EMS, which, y'know, "profit", and there already isn't much of that - for all that the United States has insanely high charges for ambulance rides, the ambulance companies themselves often barely break even - the money all goes to the insurance companies; you are in taxpayer-funded EMS, and nobody likes taxes (although "fire departments and ambulances" tend to be an easier sell than a lot of other things), or you are in a volunteer department, and you are paying for stuff yourself.
Still possible, and if it is more than doubling survival rates, I hope the Office of Emergency Medical Services investigates this immediately, and, if it holds up, makes this our protocol real soon.
posted by Xiphias Gladius at 5:44 AM on February 28 [1 favorite]
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posted by rednikki at 7:19 AM on February 27 [1 favorite]