AED Training: Myths & Truths

This week, Doug Comstock provided an incredibly detailed training on how to use an AED machine (Automated External Defibrillator) for swimmers. Doug has 20+ years of experience with AEDs, and is also a marathon open water swimmer. He covers what causes a person to need an AED, what an AED is, why it's useful, and how it applies to our community.

https://video.wixstatic.com/video/7ad9b3_8eb8c1dc9a3c411793b61bb884910e88/1080p/mp4/file.mp4

If this video isn't loading correctly, or you'd like to view it through a different platform for closed captions, you can also access the recording via Google Drive: https://drive.google.com/file/d/1rcUk27Va9n6everWVxvUas1R4wj4SU0Q/view?usp=sharing

Here are my notes from the call:

• Heart Attack vs. Cardiac Arrest:

  • A heart attack is a "plumbing problem" where blood flow is restricted by a blockage in arteries. While there are often warning signs like pain or sweating, an AED will not deliver a shock because it cannot fix a physical blockage.

  • A cardiac arrest is an "electrical problem" where the heart's internal pacemaker (the SA node) malfunctions, causing the heart to beat too rapidly or erratically. This causes the heart to stop effectively pumping blood, meaning the person is clinically dead.

    
    

• The Importance of AEDs:

  • An AED is a "life-saving computer" designed to "reset" the heart's electrical system.

  • Crucial Rule: An AED will only deliver a shock if it detects a specific, fatal rhythm (Ventricular Fibrillation or Ventricular Tachycardia). It cannot shock someone who does not need it.

  • For every minute that passes after a cardiac arrest, the chance of survival drops by 10%. Having an AED nearby significantly increases survival odds from approximately 5% to over 70%.

• CPR and AED Collaboration:

  • CPR is a life-extending mechanism that moves oxygen-rich blood through the body when the heart cannot.

  • CPR should continue to be performed WHILE the AED is being prepared. ONLY once the AED is ready, it becomes the "boss" of the situation, though CPR MUST continue between analyses.

    
    

• How it applies to the swimming community:

  • AEDs are 100% safe to use in wet environments, such as on boats or at beaches. The primary reason to dry a patient's chest is to ensure the adhesive pads stick correctly, not out of fear of electrocution.

  • Non-professional responders should not check for a pulse, as they may feel their own pulse due to adrenaline or misinterpret a faint rhythm. Instead, they should only check if the person is responsive and breathing.

  • Maintenance is VITAL; pads and batteries must be checked regularly, as expired components are a common cause of AED failure at the point of rescue.

    • Batteries last 2-4 years, and the pads have an expiration date due to the adhesive no longer being viable.

    • Ensure the kit also contains critical accessories, such as clothing shears and a razor. A small towel may also be a valuable addition.

  
  

Operational Advice for Swimmers

• Confirm the safety plan: Before embarking on a swim, confirm what the safety plan for extraction and lifesaving care will be with your captain and crew. In an emergency, individuals often hesitate and panic, but having pre-determined positions and responsibilities, like the in-water responder, backboard user, CPR administrator, and AED manager can ensure each person knows can begin the emergency protocol without losing valuable seconds.

• Equipment: Verify and check what safety equipment is available on your boat (backboard, AED). There should also be a way to keep the AED within adhesive pad operating temps (above 32°F or below 122°F). An insulated cooler with warming or cooling contents to keep the AED within viable temp range may be needed for more extreme temperatures. Confirm with the owner of the equipment whether the equipment has been checked to be operational (AED batteries and pads especially).

• Environment: the AED analyzes, or attempts to analyze, electrical signals, as soon as the pads are attached and the machine is on. If there's significant movement, like the jostling of the boat that rocks the person the AED is attempting to get a read from, the AED may not be accurate. The boat captain and crew may need to try to reduce the boat movement and/or hold the person down as the AED analyzes the heart rhythm, then only remove their hands when the countdown to a shock starts.

The Bottom Line:

The AED can provide medical care that CPR cannot, and first responders can use the AED to provide guidance on how to continue live saving care. The AED can scan and obtain more information than any human first-responder could outside of a hospital or ambulance setting, so attaching the pads and using the AED as soon as possible in any rescue is the key for improving the chances of survival.

If you have questions about the training or would like to contact Doug directly, his email is dc@aedserviceamerica.com. If you'd like to obtain a copy of the recording for your own use, please email us. If you'd like to collaborate on creating open water equipment/safety gear lists or any other safety-adjacent topic as it pertains to open water swimming, please email me at hello@swimwildwaters.com.

Here's a link to Doug's company: https://www.aedserviceamerica.com/.