Originally Posted by oarboatman
As far as I know the only two rhythms it shocks are vf/vt. So I'm not sure how it wold help in afib, svt, or a tach. I have a redicillous first aid kit that takes up 2 small watersheds and you won't find any welding equipment, (aed) or advanced airway equipment is my kit. This is because the chance of "saving" someone in a code in the backcountry is so low that I would rather have to make the call to family than deliver a vegetable to an ER.
A would suggest spending your money on medical training in ems or the ER rather than buying toys that your probably never going to get anything but a law suit out of.
A note to the a fibers, and svters. Talk to your cardiogist about a pacer/ aicd. These devices are Very effective at welding you with the correct intervention very quickly. It would even work in the water and is truly idiot proof. Most devises run an algorithm that will try to overdrive pace a person out of a fast rhythm. Most people find this a much less violent event.
You would also want to have a magnet to deactivate the device if it malfunctions and delivers an unneeded scock. I've taken care of people that have been welded 15 to 20 times and they don't look very happy.
Also a note to TL 's. I always make a list of trip participants with an emergency contact # and medical alergies. This way if something happens you have all the info I one spot.
Have a happy and safe winter season
You can shock any unstable rhythm or non-chemically manageable rhythm. We shocked a full term mom the other day who was in Afib on the L&D floor that became unstable with a rate over 220 and a bp of 70/40. SVT would be better Adenosine but you can shock it. On a side note, I highly doubt anyone would be able to pick out a specific rhythm other than A fib without an EKG.
I know several anesthesia doctors that don't carry airway management gear for the sole reason that if they decided to actually do it they would now be responsible for the entire process and would be doing so outside of the ER, OR, etc where all of our tools reside. What happens if you intubate this guy and he has fluid below the cords or the irritation to the pharynx causes him to drop his pressure and code. Even worse, lets say he has a laryngospasm from not being paralyzed/unresponsive and he suffocates from that. Tubes seem like a good idea, but in practice may be more of a liability...
LMA might work though for the wilderness setting in the event of a non-drowning.