The A in AED has to do with automatic detection of a rhythm needing a shock to reset the heart and let the natural pacemaker take over
Not to get to deep into this. But Trust me 😜 an AED can shock only 2 rhythms. V Fib or Vtach (pulseless).
Now the monitor that EMS carries however can cardiovert other rhythms as well as pace certain rhythms. But that does not require CPR. And is Totally different and takes more time to set up.
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So In saying all of this. If It was an AED that fired and CPR was performed than it is a certainty. That Jay Bouwmeester went into cardiac arrest. (Heart stopped completely and would be clinically dead). So good job by the medical team if so. However if CPR was performed only .... well it could mean they jumped on compressions while waiting for the AED. Again an AED is totally different than a cardiac monitor.
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His heart may not have stopped, the AED can be used to, say. reset a tachycardia
not an AED. We can manually defib tachycardias (vtach w/pulse, narrow complex tach/SVT, Afib RVR, polymorphic, etc), but AED's won't (or shouldn't). Technically Vtach is a tachycardia, but in an arrest its an arrest, you wouldn't be using an automated on a Vtach w/pulse.
Edit for clarity: if you don't see feel a pulse, that doesn't mean there isn't one, you can be profoundly hypotensive but still technically have cardiac output. In those cases its presumed to be arrest and you would use an AED appropriately and if its Vtach or Vfib it would deliver the dose of electricity. I was stating the above with the assumption that someone wouldn't hook an AED up to someone who is likely unstable but not in arrest (or as heart and stroke calls it, "signs of life"). We do things differently in EMS, because we are looking at what we are treating. I've had many Vtachs upright and talking to me that we just use medication on, conversely we have some who are unstable and we will use electricity, even if they're "awake".
Not to get to deep into this. But Trust me 😜 an AED can shock only 2 rhythms. V Fib or Vtach (pulseless).
Now the monitor that EMS carries however can cardiovert other rhythms as well as pace certain rhythms. But that does not require CPR. And is Totally different and takes more time to set up.
Fair enough. In the RVOT-VT example I cited, there was a cardioversion but it wasn’t with an arena AED
Then again, we don’t know what hockey team medical staff are equipped with and what actually happened
(AED is hearsay from some hockey fan, best I can tell, and I presume actually unlikely here)
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Fair enough. In the RVOT-VT example I cited, there was a cardioversion but it wasn’t with an arena AED
Then again, we don’t know what hockey team medical staff are equipped with and what actually happened
(AED is hearsay from some hockey fan, best I can tell, and I presume actually unlikely here)
Ya it’s hard to say. I would think they have paramedics at every game. But an AED could be closer to the players bench then EMS would be. Regardless whoever responded (Team doctor, trainer, ems etc.) and if this is confirmed later. They did a hell of a job and saved his life.
6:00 mark may help those of you with backgrounds in this. *Sound on*
__________________ "I think the eye test is still good, but analytics can sure give you confirmation: what you see...is that what you really believe?" Scotty Bowman, 0 NHL games played
6:00 mark may help those of you with backgrounds in this.
No signs of CPR or anything in this video. But I would’ve like to seen the actual event. EMS primarily doing patient care. God what a scary event that would be all around.
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The A in AED has to do with automatic detection of a rhythm needing a shock to reset the heart and let the natural pacemaker take over
Once again, I guess the distinction between an atrial and ventricular episode is important. During a case of atrial tach or fib, I believe blood is still being efficiently pumped, thus not typically a medical emergency requiring immediate shock- although many people may be shocked at a later point if other methods dont return the individual to a normal rhythm. A ventricular episode of both of those are absolutely emergencies and require an immediate shock and return to a normal sinus rhythm. All that said, I believe you can still pass out from episodes of atrial arrhythmia.
For those thinking the convo is getting a little bit carried away, probably true, but I guess my point is there are different types of arrhythmia, and an episode of A fib or so would have a considerably better outcome for Bouwmeester. The use of the AED suggests it wasnt.
Edit- im quoting you deluxemoustache, but guessing you probably know all this
Last edited by Flabbibulin; 02-11-2020 at 10:45 PM.
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I don't think they would be doing compressions if his heart didn't stop. Sounds like a heart attack.
heart attack and cardiac arrest are not the same thing. Not throwing shade in this thread, just walking around educating
Heart attack is the layperson word for ACS/AMI, which is acute coronary syndrome, or acute myocardial infarction. Those are injurious events to heart tissue caused by ischemia due to lack of blood flow or hypoxia. Depending on the specific coronary vessel that is affected and at what level, it definitely can lead to dysrhythmias, or if high enough on the aortic root can cause cardiac arrest, but those that follow that disease path don't resuscitate well because the occlusion remains.
Exercise can induce either angina, ischemic chest pains, all the way to ACS if worked hard and long enough, and ultimately can lead to cardiac arrest. Exercise induced cardiac arrest could be a result of electrolyte imbalance (and resultant dysrhythmias), just plain exertional tachycardias, QT issues, WPW, etc.
Once again, I guess the distinction between an atrial and ventricular episode is important. During a case of atrial tach or fib, I believe blood is still being efficiently pumped, thus not typically a medical emergency requiring immediate shock- although many people may be shocked at a later point if other methods dont return the individual to a normal rhythm. A ventricular episode of both of those are absolutely emergencies and require an immediate shock and return to a normal sinus rhythm. All that said, I believe you can still pass out from episodes of atrial arrhythmia.
For those thinking the convo is getting a little bit carried away, probably true, but I guess my point is there are different types of arrhythmia, and an episode of A fib or so would have a considerably better outcome for Bouwmeester. The use of the AED suggests it wasnt.
Edit- im quoting you deluxemoustache, but guessing you probably know all this
Thanks. I have some reasonable knowledge based on, well, what I have been able to learn, but there are people here who obviously have additional knowledge and I am grateful for the opportunity to learn more
(And certainly if I have misunderstandings or assumptions that are pointing the wrong way, glad to get a better handle)
No signs of CPR or anything in this video. But I would’ve like to seen the actual event. EMS primarily doing patient care. God what a scary event that would be all around.
I think there's been a statement out now where there was CPR for a "cardiac episode" and a shock delivered, but around 4:40, where the clip changes to the other broadcasting team, there is clearly CPR being performed (inbetween the frames freezing) as well as the defib pads coming out. It doesn't seem to last long (CPR I mean) and they don't appear to be doing it as the pads come out which is a bit odd unless they perceived circulation to have returned. Normally you wouldn't pause CPR until the pads are on and the machine is checking the cardiac rhythm so it's unclear to me why they stopped CPR, especially since it was likely an AED and as others have mentioned, it's only giving a shock for two specific rhythms. Now if it was the EMS defibs, I suppose they could have started CPR for pulselessness, got cardiac output back, slapped the pads on and found a dangerous arrhythmia which needed to be shocked back to a normal rhythm, but really it's all speculation at this point.
All unimportant really as the main thing is that hopefully Bouwmeester is doing alright and the fact that potentially, the expert and quick medical intervention saved his life.
Edit: You can also see the CPR happening right at the very beginning of the video.
Last edited by FusionX; 02-11-2020 at 11:34 PM.
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Glad to hear Bouwmeester is okay. CBC Marketplace had an episode on AEDs and how they aren't, but need to be more accessible in public areas. I can't remember which city it was but there's a city that actually has regulations to ensure that AEDs are located in most locations (not sure the exact regulation). I also learned from that episode that if you ever need an AED, if you call 911 and provide them with your location, they can tell you the nearest one. The problem with this is that the AED must be registered with 911 which the investigation also found isn't always done.
Man that is scary stuff. Bouw was the first player I ever got on a Flames jersey. Sounds like the paramedics and doctors did a fantastic job. Really hope this turns out okay for him. Glad to hear he was alert.
