By Eric Douglas
(First appeared September 2001 – DAN Alert Diver magazine)
Sudden cardiac arrest kills more than 1,000 people daily.
After drowning, heart problems constitute the second most common cause of death among divers.
These facts underscore the drive with which DAN has developed the Automated External Defibrillators (AEDs) for Scuba Diving course.
Cardiovascular disease is one cause of sudden cardiac arrest (SCA). Sudden cardiac arrest occurs when the heart stops beating and begins to fibrillate, or move with the absence of rhythm. When the heart begins to quiver, no blood moves throughout the body.
Cardiopulmonary resuscitation (CPR) helps the pumping action of the heart to circulate oxygenated blood in a breathing patient to body tissues. This may delay the onset of brain damage and prevent a death. However, CPR cannot reset a heart that is in fibrillation; only a defibrillator can do that.
According to the American Heart Association’s Guidelines 2000 for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care, "CPR appears to prolong VF (ventricular fibrillation) and preserve the heart and brain function. However, it is unlikely CPR will convert VF to a normal heart rhythm."
Survival rates from SCA decrease 7 to 10 percent for every minute defibrillation is delayed. After 10 to 12 minutes, the chance of survival is low.
AEDs and Divers
As the present diving population ages, and older people enter the sport, the risk increases for cardiovascular disease to contribute to a diving emergency.
When Dr. James Caruso, a DAN on-call physician, examined the dive fatality statistics DAN collects, he discovered that in 66 (12 percent) of the 549 fatalities from 1990 to 1995, cardiovascular disease was listed as the cause of death or as a major contributor. Cardiovascular disease was a factor in 26 percent of the fatalities in divers over 35.
What is a Defibrillator?
Defibrillators are designed to send an electric shock across the heart muscle. Advancements in technology, software and hardware have made defibrillators something virtually anyone can use almost anywhere. Medical experts agree that widespread access to defibrillators will likely save lives: they can help reduce the time the heartbeat is stopped, raising chances for a full recovery.
Time Delays and Using AEDs
Consider that before the EMS can even go to the ambulance and head to a scene, the rescuer must first recognize that a person is having a cardiovascular problem, determine what can initially be done to aid that person, and then get to a phone to call for EMS assistance.
Now place the person on a dive boat. If someone experiences sudden cardiac arrest in the water, add the time it takes to get the diver back to the boat. One has little or no access to EMS personnel within 10 minutes. The conclusion: for timely results, divers need AEDs on dive boats and at local shore-based dive sites.
Training Divers to Use AEDs
By participating in the DAN Automated External Defibrillators (AEDs) for Scuba Diving course, you will acquire the training to provide potentially lifesaving assistance to someone with SCA. You will still need to get the medical direction – in the form of a prescription from a local doctor – that will enable you to buy an AED and have it at your dive site.
DAN recently began a training program to teach divers to use AEDs. Similar in scope and content to the Oxygen First Aid for Scuba Diving Injuries and First Aid for Hazardous Marine Life Injuries courses, DAN Instructors will be able to teach divers to use the units. There will also be a DAN Services version of the AED course for Aquatic Emergencies, similar to the Oxygen First Aid for Aquatic Emergencies course that takes DAN’s first aid expertise and applies it to the pool, swimming and boating venues.
AEDs are simple devices: one needn’t know a lot about the units to use them. Turn the unit on, and you receive verbal and visual cues from the machine.
Q: If it’s so simple, why offer a training course?
A: Time is critical.
Divers trained to use AED units should respond more confidently in setting up the unit; and they’re able to apply their training more appropriately to the injured diver. They’ll recognize the signs of sudden cardiac arrest and realize the need for the AED.
This familiarity with the process and the confidence it brings can make all the difference when minutes count.