Defibrillators - how beneficial ?

www.bbc.co.uk/news/uk-england-leeds-58818589.amp

The more defibrillators there are around the better. You don't even have to know how to use it, it tells you what to do.

While not answering the question, our village with a population of around 4000, has 10 according the defib map. Some located within 100m of another.

just accept that although the chances of success may be small, a life saved is a life saved?

I did a first aid course for Scouts with a paramedic and he said that, if you've got to the point where you're doing CPR or using a defibrillator, the life is very unlikely to be saved anyway but it is, obviously, worth the go.

I'm sure qualified medical professionals will be along shortly, until then I'm medically trained, although nothing I could legally use in civvy street apart from basic CABCD, however I'm of the mind with defibs, better to have it and not need it than need it and not have it.

They're life saving bits of kit but have no idea on the rationale behind location.

As for CPR, you keep going until qualified medical aid arrives or you physically cannot continue.

The longest I've done is 45 mins in the back of a helicopter split between myself and a RAF EMT. We were ****ed and ultimately the guy passed.

We were **** and ultimately the guy passed.

Yeah, the other thing the guy said about CPR was that if you're not knackered after about three minutes, you're not doing it right

The sooner a defibrillator is used, the more likely there is to be a good outcome.

The idea that if you’re doing CPR and using a defibrillator that the person is screwed anyway, is more about getting people past bystander “analysis paralysis” preventing timely action, than a definitive analysis of the likely outcome.

 Can one of them do CPR while the other goes for the defib?

Yes, although CPR is more important. AED will only fire is your heart is in arrhythmia, and its not always.

How long is it realistic to do CPR?

Call 999 and keep going until they show up and tell you to stop, they may well ask you to carry on while they do other stuff, so don't stop until they tell you for sure and not when they just show up

At what point does there become a value in a defibrillator – proximity of kit, and availability of helpers?

Proximity really I guess, the kit will tell you what to do, so if you know where one is, send someone to go and get it, and use it, don't worry about how long its been, just make sure some-one is doing CPR all the time.

Yeah, the other thing the guy said about CPR was that if you’re not knackered after about three minutes, you’re not doing it right

Ruined my dude, absolutely ruined. The EMT was impressive to watch, I continued as we handed over to the hospital, he was ****ed and gave the most concise and clear handover.

There are some crazy compression machines about these days. Not seen one in the wild, just videos and they look brutal.

Has anyone here ever used one of these telephone box defibs, or had one used on them?

If you live by yourself they’re a bit pointless.

The ones that we have at work are completely autonomous with the exception of requiring someone to push the “shock” button. They won’t shock a heart that’s not in a shockable rhythm.

For me the most useful thing about them is that they will guide a user through effective CPR, giving feedback on compression rate and depth.

A population-based cohort study published in the Journal of the American College of Cardiology examined 13,769 out-of-hospital cardiac arrests documented between December 2005 and May 2007. The aim was to see how bystander CPR and AED shock therapy provided before EMS personnel arrived (if any) affected SCA survival rates to hospital discharge. This study did not document the length of time between collapse and the defibrillation shock.

Based on the available data, the researchers discovered that:

7% of cardiac arrest victims with no bystander CPR or defibrillation shock survived to hospital discharge.<br />9% of cardiac arrest victims with bystander CPR but no AED shock survived to hospital discharge.<br />38% of cardiac arrest victims with bystander CPR and an AED shock survived to hospital discharge.<br />Astoundingly, of 13,769 out-of-hospital cardiac arrests, only 32% of victims received bystander CPR and a mere 2.1% received an AED shock. By waiting for EMS personnel—who typically take between 4 and 10 minutes to arrive—the survival rates were much lower than they could have been.

https://www.aedleader.com/aed-survival-rates/

It's definitely better than nothing, but still needs to be used very quickly.  If not used within about 10 mins of arrest, the chances of survival drops to below 10% (from what I learned whilst renewing my first aid qualification a few weeks back).

Yes. Early defibrillation and CPR is what makes the difference.

I did a first aid course for Scouts with a paramedic and he said that, if you’ve got to the point where you’re doing CPR or using a defibrillator, the life is very unlikely to be saved anyway but it is, obviously, worth the go.

He’s talking shite

AIUI a defibrillator is a bit of kit that reboots your heart if it has got itself into an electrical tizz (refer to disclaimer above). It’s used after a person suffers a cardiac arrest. To keep them alive between the arrest and the reboot, it’s necessary to manually pump blood to their brain with CPR.

Its used when your heart is not beating properly but the sort of defib found on the streets is no use if your heart has completely stopped.  Technically I think its misleading to say CPR is to keep them alive.  Its to try and supply the brain with enough oxygen that there is some hope of being able to restore the heart rhythm itself.

In an environment where there is a defibrillator relatively nearby, and a number of people present to do the CPR, this may work, and it may be justification for installing a defibrillator in places like shopping centres, sports stadiums, whatever.

the argument for that - more people = more risk of an incident, and enough folk around to help.

But what about less favourable environments? If I live on my own on top of a hill, is there any value in there being a defibrillator. on the top of the next hill? I would say clearly not.

How far away is the next hill? who called the ambulance? etc.  In contrast, your shopping centre a paramedic might be able to get on scene as quickly as someone runs, finds defib, works out how to open the case, runs back, unpacks, follows instructions to set up etc...  in a rural setting you might have a much longer wait for professional help.

I can’t do CPR to myself and also run over and get the defib. Suppose I live with my wife? Wife and son? Can one of them do CPR while the other goes for the defib?

Yes (obviously depending on the age of son; but they may be able to run next door to get help too).  Not sure if you have local first responders - and if they carry a defib or collect from public source, but in some cases a 999 call will get you a local first aid trained person with a defib whilst they wait for "proper help" to get to you.

How long is it realistic to do CPR?

Its physically exhausting.  One fit person would struggle to do CPR for much over 30 minutes, especially if they are not used to it or have emotions running high.  Even then its probably becoming less effectively the more tired they get.  Professionals swap.  Specialise experts carry what are essentially CPR robots for prolonged CPR.  This is part of the reason why getting you defibrillated as quick as possible is important - the earlier the shock is delivered the better the chances.  Bystander CPR (rather than professional CPR isn't always very good either).

At what point does there become a value in a defibrillator – proximity of kit, and availability of helpers? Or is that the wrong way to look at it, and just accept that although the chances of success may be small, a life saved is a life saved?

There will be a formula for the cost benefit.  I'm sure some are installed in hindsight by loved ones saying "if only", but generally they can save lives, but also ensure that if a life is lost those who tried to help aren't left thinking "I could have done more" which I think is just as valuable.

I did a first aid course for Scouts with a paramedic and he said that, if you’ve got to the point where you’re doing CPR or using a defibrillator, the life is very unlikely to be saved anyway but it is, obviously, worth the go.

A colleague is only alive today because he happened to have a heart attack in front of a building with a defib...

He was super lucky, just come in from wind surfing in a lake and had a heart attack on the jetty...

As for CPR, you keep going until qualified medical aid arrives or you physically cannot continue

Yeah this. My mate had a cardiac arrest in his office. His work mate did CPR for 15mins which gave the paramedics time to get there. They revived him with a defibrillator, twice, then carted him off to hospital. Full recovery. Handily for the benefit of  everyone who was not there, the paramedics turned up with a channel 5 camera team in tow - can't remember the name of the show now... but anyway, the workmate was wrecked after 15minutes of CPR and the paramedics were saying he was owed a beer or 2 from my mate.  Amazing effort.

Warning: the linked video is of real-life CPR/defib use 

I was shown this on our first aid course, run by BASP, a few weeks ago.

Some of the main points it raised:

1. Having a good team of people who know CPR is awesome

2. Without a defib handy, the ambulance crew would probably not have managed to save the guy

3. The people involved here do this stuff all the time, so were incredibly calm.  If this was the first time you had ever had to deal with something like this, you would almost certainly make mistakes, such as possibly not calling for an ambulance immediately.

Our canteen guy had a cardiac arrest after doing couch to 5k. With prompt and vigorous CPR from a couple of people that knew what they were doing (for quite a long time) and a nearby AED he survived. It actually took ages for the paramedics to arrive so without one he would probably be dead.

You are screwed without an AED (CPR is keeping you functioning not bringing you back). And the graph of survival % Vs time to AED application is pretty grim beyond 10 mins. Very glad our slightly remote village has numerous AEDs.

I think your Scout medical instructor needs to update his teaching.

I know of 2 people that have been saved with an AED .

Also on one First Aid course I attended a woman gave her Dad CPR successfully until the Paramedics arrived.

I did a first aid course for Scouts with a paramedic and he said that, if you’ve got to the point where you’re doing CPR or using a defibrillator, the life is very unlikely to be saved anyway but it is, obviously, worth the go.

Horseshit.

https://www.theguardian.com/football/2012/mar/25/muamba-collapse-minute-by-minute

Can the one thing we take away from this thread is tbat if you aren’t already qualified, go and do a decent 2-3 day First Aid course.

Volunteer to be a First Aider at work, or through a sports team or youth organisation or get a group of mates organised the next time you are down the pub and one of you says "we ought to do that".

Just do a course.

Are Defibs and CPR beneficial? In short, yes.

The BHF are doing a big push on both getting defibs installed and on CPR training at the moment. Further info here on how you can get a defib installed in your community and on free CPR training

https://www.bhf.org.uk/how-you-can-help/how-to-save-a-life/defibrillators/apply-for-a-free-defibrillator-for-your-community

https://www.bhf.org.uk/how-you-can-help/how-to-save-a-life

I think your Scout medical instructor needs to update his teaching.

Indeed. The survival percentage leap from having one available to not and just using CPR is massive. If you can get hold of one without neglecting the cpr its an absolute gamechanger.

I look after a defib provided to our rural area by Lucky2bhere. It's bolted on to my next door neighbour's house. At our last training session, the guy from lucky2bhere said that the longest he would be prepared to leave someone needing cpr to get a defib is one minute. The trouble is our local rural area has about 30 houses and the distance ever house is much more than a minutes and most are lived in by couples. So if one was having a heart attack the other would struggle to go to a neighbour to get help let alone drive 5 mins to ours. On the back of this we have an emergency whatsapp group - put in a group call on the whatsapp group and hopefully someone on the group will answer and come help via the box. The box has a map I've knocked up of everyone's house just in case someone gets flustered when the time comes.

In my time looked after the box it's twice been retrieved by someone at the instruction of 999 on the phone but neither time actually deployed. Long may it stay that way.

I know know a few mountain leaders who specialise in leading older folk who now carry the small AED you can buy. Virtually pencil case sized. Not cheap but amazing that that can now be a thing.

When your doing CPR on someone I can absolutely guarantee that you wish someone rocked up with a charged AED pronto.l

Has the mapping of where AEDs are improved or are there still multiple websites and resources that don't include all locations?

I know know a few mountain leaders who specialise in leading older folk who now carry the small AED you can buy. Virtually pencil case sized. Not cheap but amazing that that can now be a thing.

I think this is the future - a population heavily dotted with people carrying these things who know how to use them.

However, the next government's focus should also be on getting paramedic response times back down again - report out yesterday found that the average response to suspected heart attack and stroke was 38 minutes, which is not optimal for good outcomes for either. I know there is a 'golden hour' for the delivery of post-stroke treatment in many cases which can make all the difference in terms of quality of recovery.

I've been getting annual first aid training with St Andrew's First Aid (like St John's, but in Scotland) for work for quite a few years now and every time they emphasise that prompt use of an AED dramatically improves a casualty's chances of survival compared to CPR only.

The more there are,  the better the chances.  I've been doing first aid at work training this week and today we were told,  cpr alone success rate 1 in 10. Defib applied inside 2 mins success rate rises to about 7 in 10, it drops about 1 I n 10 every further 2 mins delay.   Hence why they need to be abundant. 

Also we were told website called the circuit has there their locations

I'm still amazed (and frankly horrified) by the level of confusion surrounding the difference between a heart attack and a cardiac arrest. I've seen numerous headlines "He died after  suffering a massive cardiac arrest."
Of course the former can precede and precipitate the latter but their only connection is the organ they affect.
AEDs are fantastic and offer a chance of survival that just wouldnt be there without them. Of course, they are of no use if the patient is in asystole but for those in VF (ventricular fibrillation or wobbly, ineffective heart rhythm) they are very good at restoring normal sinus rhythm. 
I'd rather have a 50% chance of survival than 0%.

I've used one. No way was the guy coming back to life but we did all we could. I don't think they're actually that useful but if they save a handful of lives then that's worth it.

I’d rather have a 50% chance of survival than 0%.

Likewise. I’d rather have 1% chance than 0%. But the original question was about understanding what real world situation corresponds to a 1% chance, a 10% chance etc. From what people have said, and the links provided, it looks like the chance of survival is actually better than I’d thought.

There's 5 24/7 public ones in my little town, plus at least 4 more that aren't so easy to access, and they're well spread... Ambulance should be reasonably quick here but it'd need luck for one to arrive before you could run for a defib. I especially like the one right outside the old man pub, maybe they should get a 2-pack there. All got to be a good thing.

IHN
Full Member

I did a first aid course for Scouts with a paramedic and he said that, if you’ve got to the point where you’re doing CPR or using a defibrillator, the life is very unlikely to be saved anyway but it is, obviously, worth the go.

My understanding is that this used to be somewhat true, just because of the sheer lack of people who could do CPR usefully and the rarity of defibs (and the earlier public ones weren't as good), but also that it was sometimes used as useful disinformation since so many people are quite understandably scared to get involved, afraid of making it worse. Even with training I really don't want to have to do any of it! And probably the more people understand that the defib won't let you shock someone inappropriately, the better, even if you use sketchy methods.

(But also that it's become less and less true over time, with more defibs and more and more people having either training or basic understandings of cpr)

BAck to the OP, even in the arse of nowhere, it could help. I "helped" with a walker who collapsed on the west highland way, a long time back- there were more qualified people to do the CPR so I never did that, just helped with scene management and looking after the people who were doing the interventions and with access and ambulance- but tbf the guy had very little chance, there was no helicopter available and it was over an hour for the ambulance to arrive. But now there's a defib at the drovers, we could have had it to him in about 10 minutes, or we could probably have got the one from crianlarich well before the ambulance arrived. And that was a guy who'd just dropped while walking, by luck there were people nearby and then other people less nearby but, that's how it works. Thing is, sure they're less useful the further away from population centres and people you are, thta's inevitable, but equally that usually means slower ambulances too.

I've experienced several relevant examples but this one is probably the best to mention.   In contrast to @munrobiker and their unpleasant experience, I have delivered a patient clearly beginning to have a heart attack at a big event in a wheelchair the short distance to the on-site resus bay ... where the patient promptly crashed during handover and was revived within two minutes by the AED which a colleague had been unpacking as soon as they saw the patient's face.

This patient left the site alive and chatting to the ambulance crew.

If you go to Murrayfield for the 6Nations or Edinburgh's Hogmanay street party, there are staff walking about in the crowd with AEDs. Commercial providers often now also have these really compact units, literally pocket mask sized.  Less kicks than a bigger unit but still more than adequate for a responder role.

Outwith working for that provider, I take several AEDs in my car to every event that I personally cover, often distributing them out among the team.  I encourage race directors to buy and deploy their own among the marshals too, so even if I'm not there, we have the resource and plenty of folk trained to use them.  At home, everyone on the farm where I live knows that I have these (and a lot of supporting kit) and I look after other units around this end of the county.  I've no hesitation in saying that it's hard to have too many units and equally better still if you have trained folk to work them.  Good CPR isn't easy to achieve and takes practice as well as confidence.

Technically, a defibrillator doesn't restart the heart, it stops it so that it can restart itself in the proper rhythm, rather than the fibrillation rhythm it was in. Hence the name.

If somebody has a heart attack, CPR can keep them in condition to restart once defibrillated. As I understand it, it's very rare for CPR alone to bring somebody back from a heart attack, if there's no defib available. BUT if their heart has stopped due to drowning, CPR can work without a defib, although you would always try the defib if you have one, particularly since a heart attack may have been the root cause of the drowning.

I don’t think they’re actually that useful but if they save a handful of lives then that’s worth it.

Funny I’ve found them to be extremely useful.

One of my neighbours survived a heart attack with prompt CPR and a defib machine. Prompt ambulance response as well. His collapse was totally out the blue. Ran for miles every day. No previous symptoms. Had the good luck to collapse on a road with passers by outside a golf clubhouse with a defib machine.

Had he collpased 2 minutes earlier in a quieter location who knows?

https://www.bbc.co.uk/news/uk-scotland-67715220

Hmm I’d rather there was one close to hand in the event that I need one 🙂

YMMV.

Bloke dropped down in the middle of a jog luckily right in front of my office gates. A very quick thinking security guard saw it on cctv, grabbed a defib ran at least 500m to the scene with a colleague and performed cpr till the defib was ready and saved the runner.  Was in the local paper n everything. <br /><br />

so with that example and loads of others on this thread I simply don’t understand why posters are still persisting with the ‘ain’t much use’ theme. Clearly alone on a deserted island that is true but otherwise….

One of our running club collapsed and died on our hash just the other week, I don't know if a defib would have helped or not 😢 my niece owes her life to someone knowing to continue CPR despite lack of signs of life & the ambulance driver knowing which hospital to take a very young drowning victim. If you are thinking of doing a first aid course get on it.

GP friend of mine was out jogging with a pal, running through tiny village. Pal dropped to the ground, my friend grabbed the AED from the village hall about 5m away. Pads on within one minute and CPR given. Ambulance was 15 min to arrival and the guy was out running again 6 months later.  

Always used to have a giggle with the GP as I was a fit midlifer but tbh it means nothing as it’s a lottery,you could smoke 100 fags a day and eat a fry up every day and outlive a super fit jogger with a super healthy lifestyle, it’s all hedging your bets 🙂

Some people's knowledge is shocking.

I like the fact that there's a defib on every Coop funeral directors wall. One last chance.. .

I don’t think they’re actually that useful but if they save a handful of lives then that’s worth it.

In which case, you’re an idiot

drac: Funny I’ve found them to be extremely useful.

I’m sure, but I’d be interested to know your experience of how people in rural locations managed during the time before you showed up.

 <br />I like the fact that there’s a defib on every Coop funeral directors wall.

Like hypothermia where you're not dead until you're warm and dead. You don't go in the box until you've been shocked and declared dead!

We were out riding one morning and my friend Stef dropped mid sentence.  We thought he was p1ssing about.

Stef didn't make it.

There "was" a defib about 300m away. But the batteries had expired and not been replaced.

Would a defib have saved Stef, in his case probably not.  But I would have used it until they stopped me.

Get trained, fund raise, get more defibs.

Just to widen awareness, here's the resuscitation council's flowchart for if someone collapses:

For the best chance of survival, a defib is a key link in the chain, and I have been involved in their use through my job on plenty of occasions to see the remarkable survival stories that can happen.

https://www.bhf.org.uk/how-you-can-help/how-to-save-a-life/defibrillators/apply-for-a-free-defibrillator-for-your-community#whatsincluded

Some very humbling reading and information in this thread.

In which case, you’re an idiot

Harsh.

I’m sure, but I’d be interested to know your experience of how people in rural locations managed during the time before you showed up.

Of course it depends on the individuals but if they are able to give good quality CPR, there is more than one person then reasonably Ok but not great. Add in an AED that can be accessed quickly and it’s an incredible difference, either the shock/s they give it can work or at least give us a better chance of having success with drugs. The figures provided earlier for the ratios of success are accurate, the survival rate without CPR plus early shock are tiny. 

They are absolutely worth having and should be provided by the government and no rely on charities. 

On the subject of AEDs and mention above about batteries needing replacing, Shere council in Surrey are raising funds to replace theirs in their villages, Shere, Gomshall, Peaslake and Holmbury St. Mary.

Reason being that they get out of date, can't get replacement parts to keep them maintained, and council doesn't have the funds to replace them.

This is vital to help saving lives especially in rural environments full of mountain bikers, walkers and runners.

Given someone died recently on BKB, heart attack or cardiac arrest (not sure which), and while these may not have helped, maybe it will help the next one.

Despite a few of us posting this on a number of popular groups it's not had much attention so far.

https://www.justgiving.com/crowdfunding/ShereParishCouncilAEDs?utm_term=RD9vpnMY5

I remember an idle chat with one of the other dads at an event a couple of years back. Went along the lines of
How are you
I can't lift things at the minute
Oh done your back?
No had heart surgery after a cardiac arrest at work.
Sounds bad
If they'd not had a defibrillator I'd be dead
Oh!
Three kids iirc all of school age.  We covered their use on a First Aid course a year or two back.  Basically no magic bullet but significant difference to survival rates and the machines are really well designed. Gets my vote.

I think that a lot more people should be trained on them, although they are incredibly easy to use, it's more that people are ill-informed and often think it's like the movies where you can shock somebody's stopped heart back into life with one. They do not operate unless it finds a pulse, but also won't work on someone with a healthy heart beat.

Interesting info here:

research has shown that the chances of survival for an out of hospital (community) cardiac arrest are only about 6%. If you can get the pads onto the patient’s chest within 3 minutes and they are in a shockable rhythm, the chances of survival jump to 74%. This drops by 10% for every minute’s delay in using the machine.

https://firstaidforlife.org.uk/8-common-myths-about-defibrillators-and-why-they-save-lives/

Push for your work to get one but store it outside the building and have it added to the defib location app/website. This way more people would be able to access it. 

In which case, you’re an idiot

This thread is the first time I've heard of anyone first hand saying that a community defibrillator has saved the life of someone they were treating. Everyone I know who's used one, including me, has had the patient die on them. I suspect it's different for Drac, who is likely to be there at the right time and know what they're doing. I'm sure some of them do save lives, so we obviously need them, but to think they will be the ultimate lifesaver is probably optimistic.

Nothing can make matters worse and the success rate for CPR is lower than you might think. About 5% out of healthcare and double that in healthcare settings. I’ve given CPR but not had access to a defibrillator. It would not have mattered in that instance. If one had been to hand Id have used it. They don’t sadly repair a broken neck though.

We've got a few in our offices now and I've passed a few phone box conversions out in the villages on bike rides with mates.

I can't see the harm in them becoming more and more common, as for choosing where they go? I suppose anywhere there's lots of footfall?

Are there many heart attack hotspots? Places with an elderly population? At the top of big hills? Chip shops? Feels like one for the statisticians...

I'm afraid that i can add myself to the number of people who have knackered themselves giving CPR to an already dead man.

In a situation where i'm unconvinced a defib would've made much of a difference.

TBF we were half way between Seven Springs and the Stepping Stones, so not exactly in the thick of it - eventually we had three of us in rotation giving CPR, the Air Ambulance hovered but couldn't land, the ground Ambulance crew took over, but had come on foot from something like 500m away, and all three of us were spent by the time they got to us. Chap didn't make it.

Time is of the essence - if the defib is close to where people might need it, it might help, but being close to an Ambulance to get to you will always be better.

My wife was incredibly to survive a cardiac arrest 18 years ago.
It was a quiet sunday on a ride down our street. When she collapsed, cars were stopping immediately to help. Someone ran to get an ER doctor who lived around the corner, who took over CPR.
The roads weren't busy, so the ambulance got there quickly. My flatmate was a trainee on that very ambo on the day as well.
I wasn't much help because I was a blithering mess.

but to think they will be the ultimate lifesaver is probably optimistic.

Which I'm not sure anyone has claimed.

We have three in our village, sensibly located at three of the four corners (its essentially a square road layout).

They asked us to have one on the wall of our Scout hut in the next village, and we refused - the hut is hidden down an unlit lane on the edge of the village, a lot of resudents don't know its even there. Much better to put it on the football pavilion, slap bang in the middle of the village

I suspect it’s different for Drac, who is likely to be there at the right time and know what they’re doing. <br /><br />

Not different at all, I’m a first aider without my equipment. An early shock is what massively increases your chances. Can’t do that without a defib. 

https://www.defibfinder.uk/ shows you the nearest defib location and there are apps that you can download to your phone.

When I did a St John course on them, they didn't mention patches, but it is  good practice to remove any patches before sticking on the pads (there have been cases where a nitroglycerine patch exploded).

IMHO it always worth trying CPR / Defib, even if the patient doesn't make it, the relatives at least know that somebody cared enough to try.

Drac
Not different at all, I’m a first aider without my equipment. An early shock is what massively increases your chances. Can’t do that without a defib.

Couldn't agree more. In my fire service career, I reckon I gave CPR to about ten people & the successful outcomes from those that I remember were a couple of incidents that happened outside our station so we had AED/CPR going within a couple of minutes.

The more AED units out there in the community, combined with public awareness, the better.

Most Screwfix branches have an AED in store.
It's also always going to be charged up as it's part of our monthly management checks.
Will be behind the counter , and there should be a sticker on the customer facing side to aid collection

I have no training beyond basic first aid and no experience using them, so no comment on that front. But I have been involved in fund raising for and siting one in our village. As above, we really just looked for the most visible place that was as central as possible to as many people as possible. It ended up on the fence outside the school, very visible and I guess near enough everyone knows where it is. Ultimately though there was no professional influence on its siting and it just came down to a community decision. The procurement of it came down to same. It was notable that most offerings essentially provided 4 years of renting/provision, rather than you buying the AED, after which in theory we'd be in for buying it all again. Talking to the ambulance service we ended up just buying one and adding it to their system. It cost a lot less all in and it isn't a limited time thing. We have to source batteries and pads though of course. The consumables expire quite quickly (a year or two for pads IIRC). But I think even with the other offerings someone in the community would've had to have the same responsibility.

Another notable thing about the process was the call from various parties for it to be locked in case of vandalism, in a leafy little Devon village with no real history of vandalism of anything much. Sure you get the combo from 999 and all the rest of it but are there any seconds in your life more valuable than those precious ones as you make that extra call and then get the number wrong in your panic? I'm happy to stand corrected but the idea of locking up something like this seems absurd to me. We won the debate easily and ours isn't locked, but I've seen loads of locked ones in similarly unlikely to see trouble places.

I’m happy to stand corrected but the idea of locking up something like this seems absurd to me. We won the debate easily and ours isn’t locked, but I’ve seen loads of locked ones in similarly unlikely to see trouble places.

The number of defib's that get damaged/vandalised/stolen is incredibly small. The British Heart Foundation ask that defib's be placed in unlocked cabinets which are accessible 24/7.

With the BHF's current offer for funding for community defib's, one of the conditions of funding is that they are kept in accessible, unlocked cabinets.

I don't know about other areas of the country but in London the ambulance service are throwing a huge amount of money in to teaching bystander CPR at the moment. They have a five year plan to teach every year 8 child in London how to perform CPR and how to use a defibrillator.

One of the best places in the country for out of hospital cardiac arrest survival was Heathrow Airport, the reason for the high survival rate was twofold. There's a huge number of staff there who are CPR trained who crack on and start CPR as soon as they witness people collapsing and there's also around 250 publicly accessible defib's that can be used when required. 

Haven't read the thread but an anecdote that stands on its own:
On a very long local beach a young man had a heart attack in the water. He was dragged out with no heart beat and someone who knew how to started a heart massage. Meanwhile another ran the not inconsiderable distance to where he knew there was a defibrillator. He ran back to where the victim was still being given a heart massage and used the machine - the heart was restarted, long before the rescue services arrived.

Edit: there are so many press reports of people being saved by surfers/passers by/life guards using defibrillateurs on local beaches I can't find the case I've related above. Another stat came up in my searches: 1480 drownings in France in 2021 of which only 27% were fatal - it's always worth having a go and the chances of saving people are pretty good.

They're also useful as a risk mitigation asset; had an old boy have a nasty dismount from his folding bike due to a pothole this past summer whilst we were walking the hound, the 999 operator gave us the location and code for a AED nearby just in case his condition deteriorated. Me and another passerby kept him comfortable while Ms. RM fetched the AED. 

Thankfully the ambulance crew arrived earlier than first stated. But it was good to have it nearby in case things went sideways. 

My son's school has a defib.  For some reason it's kept in the PE dept office so only accessible 0830-1530 mon-fri and when there's a teacher there to unlock the office.

School is next to footpath and cyclepath and is a sports centre at evenings and weekends.  If you're not a pupil you do not have a hope of finding the defib.

So rather than move the defib to somewhere more accessible / visible the school are fundraising to buy a 2nd defib to put on the outside of school next to the front door!!

If you suspect a cardiac arrest (collapsed and unresponsive) then start effective CPR immediately and call 999. The call handler will talk you through the compression ratio etc and you keep going until you cant physically continue or told to stop by a medic.

Note it is effective CPR that must be performed and that's why some first aid training or knowledge can be invaluable. As stated earlier there are only two heart rhythms that can be treated by shocking - pulseless VT  ( ultra fast heartbeat with no pulse) and VF ( heart is wobbling like a jelly but not pumping) The classic scene in movies and TV when a patient “flatlines” and is shocked back to life is just a myth. 

If a defib is available the 999 call handler can advise ( in my trust area) where the nearest is. Defibs are not  always miracle makers but can be invaluable. They are simple to use and if the rhythm is shockable (VF/VT) the device will tell you how and when to shock. It will not allow you to shock unless appropriate. The device will also, as stated earlier, provide instructions regarding CPR. 

When medics arrive they will tell you to carry on giving compressions and will attach their own defib device which has more functionality. They will also supplement CPR with maintaining a viable airway and administration of appropriate drugs ( adrenaline mainly)

They will perform Advanced Life Support ( drugs, airways, shocks etc) for at least 30 minutes ( much longer with children) until either ceasing efforts or transporting to hospital if we achieve a return to spontaneous circulation (ROSC) 

It can feel like forever but medics will respond to a cardiac arrest with the highest priority and by calling 999 and initiating effective CPR you are giving the patient the best chance of survival. It is worth noting that CPR requires a lot of force and can seem brutal but please don’t hesitate  to start compressions.  

It is not always a successful outcome but well worth the effort. Somebody will thank you.

Somebody will thank you.

<br />It was the last thing the paramedic did when I left the scene after nearly an hour on a cold March evening wearing lycra. Can see it like it was yesterday.

Did one get used at Bournemouth vs Luton today?

Thankfully the ambulance crew arrived earlier than first stated. But it was good to have it nearby in case things went sideways.

this well worth considering

Defibs are amazing, the more of them we have available the better.

I’ve personally performed CPR on approx. 15 people under a range of circumstances from overdoses, car crashes, medical problems, hangings and stabbings to name just a few. Unfortunately as a police officer I have very limited medical training. On all occasions due to the nature of my job a defib has been available and on scene within 5 minutes of CPR starting.

On all but 2 occasions the defibrillators advised “no shock” be performed. On 4 occasions the patients heart has started again either from the defib or specialist ambulance equipment (including a specialist team cutting open a chest cavity and massaging a heart with their hands at the roadside). Only 2 regained full consciousness and survived.

Defibrillators are brilliant and have saved countless lives but the point is once somebody is under cardiac arrest there’s often very little that can be done

One thing people don’t tell you is how physically difficult CPR is, they also never mention if you’re first to perform the CPR you’ll feel breaking ribs as you’ve got to compress 1/3rd of the body depth. Ambulance teams often cary LUCAS chest compression machines which do the job for them freeing them up to perform other critical functions but it’s a brutal thing to witness.

including a specialist team cutting open a chest cavity and massaging a heart with their hands at the roadside

😲

and bump -
https://www.justgiving.com/crowdfunding/ShereParishCouncilAEDs?utm_term=RD9vpnMY5Come on. Tonnes of us ride Surrey Hills and pay nothing to ride there (also reminder to donate to The Friends of the Hurtwood). Mountain biking tends to trigger heart conditions (as said, tragic one just the other week). The AEDs there need replacing.

I have done CPR a few timers and never seen a successful outcome.  I have also seen folk with hypoxic brain damage post arrest ( heart restarted but too late).  I have also seen or heard of dead folk getting worked on for ages - hardly a dignified death.  I know of one person who found a neighbour dead and the 999 call handler tried to get them to do CPR on a corpse

Tends to colour my view somewhat but I note Dracs different experiences

Defibs and CPR save lives. The more rural you are the more important community AEDs and first responder schemes are. There might only be one ambulance in a small town or village and if it's already attending a call the next nearest could half an hour away or more. The first few minutes of a cardiac arrest are crucial. With each minute that passes your chance of survival are reduced. Good CPR will increase the chances that defibrillation will be successful. There will always be situations where no matter how good the resuscitation is it won't be successful. I have seen AEDs used successfully on several occasions. The Scottish Ambulance Service are trying get all the AEDs registered so when someone calls 999 they can be directed to the nearest one. It's never the wrong decision to start CPR, if it turns out to futile there's no harm done, but do start.