Emergency First Aid

[Billhook]

Just been on a very good first Aid course and we were discussing defibrillators.  I asked if it was possible to use a cattle electric fence unit in a dire emergency when you are literally out in the field and of course I was laughed at, with all sorts of reasons about different voltages and how it would be applied.  I thought that the 8000 volt low amps of the fencer would be very similar but again made to feel small and ridiculed by the instructor.

Found this on the web when I returned home.

 

https://www.google.com/amp/s/www.dailymail.co.uk/news/article-4459660/amp/New-Zealand-man-jump-starts-heart-electric-fence.html

[Acerforestry]

This is certainly not a daft idea, an elderly friend who is made of sterner stuff than most (he started up the big cat sanctuary down this way) suffers from arythmia and occasionally has touched his horse fencing when not feeling quite right to jolt things back to a normal...

Edited February 4, 2019 by Acerforestry
spelling

[Billhook]

On 04/02/2019 at 19:53, Acerforestry said:

This is certainly not a daft idea, an elderly friend who is made of sterner stuff than most (he started up the big cat sanctuary down this way) suffers from arythmia and occasionally has touched his horse fencing when not feeling quite right to jolt things back to a normal...

If you are miles from anywhere wihout a phone signal and the choice is either leaving someone to die or try anything, then it has to be worth a go.

[Big Jim]

The article describes a man with AF (Atrial Fibrillation) which is quite a common heart arrhythmia (especially in older people) where rogues cells within the Atria take over as the heart natural pacemaker, rather than the usual cluster of cells known as the Sinoatrial node (at the top of the right atrium).  Some people have AF permanently and drugs are used to control the rate/rhythm of the heart.  Some people have occasional bouts of AF - often due to stress, illness, excessive alcohol consumption etc and may experience palpitations, dizziness, shortness of breath etc.  It looks like the guy in the news article has had a bout of AF or maybe another arrhythmia and used the electric fence to 'cardio-vert' his heart.  He was not in cardiac arrest, which is what an automated defibrillator is used for, which is used when people in cardiac arrest are in VF (ventricular fibrillation) or VT (Ventricular Tachycardia), the defib delivers a set rate of Joules of charge across the heart to momentarily stop the heart in the hope the hope it will restart itself in a more normal rhythm.  People in cardiac arrest wont always be in VF or VT, in which case shocking does nothing.  The best thing to do is concentrate on calling 999 immediately and starting good quality CPR ie chest compressions asap and make sure you advise the 999 call handler how remote your location is and any access problems so they can send appropriate resource.   

Id advise against touching electric fences as a self treatment - I recall going to a young lad who had taken a jolt from a fence whilst dog walking and then felt 'weird' for the rest of the day.  When we did an ECG, he had extra heart beats (ectopics) all over the place. 

That said, the instructor belittling you for asking the question..... no need. He could have just explained why its probably not advisable. Perhaps he was just a first aid trainer and not a qualified medic a some are.  Early recognition that the person has arrested, good quality chest compressions and that rapid 999 call are the things to concentrate on.

Choose a different first aid training company next time. If you're anywhere near Derbyshire, I can recommend a very good one.

 

Jim

 

[Big Jim]

Oh, even if you have no phone signal, still dial 999 as emergency calls will be made on any network available, not just your own, so you may get through on another network.  Also you can send for help by text, again this is in case you have not enough phone signal to make calls, but you need to register your phone for this service to work.  See http://www.scottishambulance.com/UserFiles/file/TheService/About sending a text to 999 tracked changes 031013.pdf

[agrimog]

also, 112, when registred on your phone will work in areas of almost nill reception, and also when opened on smart phones allows gps tracking for emerghency trace

[john k]

112 is the pan-European emergency number and in the UK is exactly the same as calling 999.

Calling 112 or 999 does not give the emergency services your GPS coordinates although they may be able to get cell position information from the phone network.

On a smart phone it’s worth having an app that will give your location as an OS grid reference which you can pass to the emergency services if required.

[Billhook]

To be fair to the guy he did say that real life is not like the movies where nine times out of ten a victim of a heart attack seems to make a complete recovery with a couple of big electric shocks.

I am slightly confused still about the meaning of a cardiac arrest.  Does it mean that the heart has stopped beating altogether or that it is  just about beating erratically and causing a small amount of circulation but not enough for the victim to remain conscious?

If your victim is in the latter state and you have no phone and you are in a field miles from anywhere and there is an electric fence around the field, would you not give it a go if all else has failed?

[Haironyourchest]

Cardiac arrest is when the hearth starts fibrillating - which is to say, vibrating and rippling, as opposed to beating erratically. An erratic weak beat is still able to support life, but fibrillation is pretty much game over, unless caught in time - hence the defibrillator.

[Big Jim]

Billhook

 

Its very common that people get Heart Attack and Cardiac Arrest muddled up (and indeed heart attack and stroke, strokes being something that affects the brain).

 

A heart attack or myocardial infarction (MI) is an occlusion of the coronary arteries which are vessels that supply the heart muscle tissue with its own blood supply.  This loss of blood to a part of the heart causes death of the muscles tissue in part of the heart affected.  The person having an MI will usually be alert, breathing and have a pulse, but they will have chest pain, often described as crushing or heavy, which may radiate to the neck, jaw or arm(s).   They will usually look grey and clammy.  This is a 999 call immediately job and if there is a community defib nearby, send someone to get it as they could go into Cardiac Arrest at any moment and having the defib there before this happens could make a difference.

 

A cardiac arrest is basically no or insufficient output from the heart. It aint pumping properly and could be in one of several rhythms (eg Asytole, PEA, VF or VT).  They will be unconscious, not breathing and have no pulse and look very pale. 999 and get on that chest asap once you establish they are not breathing.  Don't worry about getting it wrong - if they aren't in cardiac arrest, the minute you get on their chest, they'll soon come round albeit with a few broken ribs, but better that than do nothing. If you have a 999 call handler on the phone, they will stay on the phone and talk you through CPR so have phone on speaker if you can, or just think Nelly the Elephant.  And if theres more than one of you.... swap over chest compressions every 2 mins between you (if the others are trained or feel happy to do so).  Doing cpr right is knackering and the longer you do it, the less effective your compressions will be, no matter how big and hard you think you are.  Swap every two mins (5 cycles of 30 compressions).  

Your instructor was right about it not being like on TV where people rush in with two big paddles, shock them and they sit up.  Out of hospital arrests have a very low success rate, less than1 in 10, though that will include many where you wouldn't expect to get them back like 80 year olds. Good cpr can make big difference though with younger people who usually will have a healthier heart and more likely to make a good recovery. This very much depends on the reason for the arrest in the first place though..... 

J