AED Automated External Defibrillator and Rural Fire Departments

   / AED Automated External Defibrillator and Rural Fire Departments
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#31  
Wedge40, excellent question! I have not had the training for the AED but will keep your question in mind.

My wife has taken ACLS for work and in her ACLS American Heart Association book goes over what to look for and says: "......The presence of an implanted defibrillator or pacemaker is not a contraindication to attaching and using an AED. Avoid placing the AED electrode pads directly over the device because the devices may interfere with each other ...... allow 30-60 seconds for the implanted defibrillator to complete the treatment before delivering a shock from the AED."

I also wonder if this is covered in basic AED Training.
 
   / AED Automated External Defibrillator and Rural Fire Departments #33  
Wedge40, excellent question! I have not had the training for the AED but will keep your question in mind.

My wife has taken ACLS for work and in her ACLS American Heart Association book goes over what to look for and says: "......The presence of an implanted defibrillator or pacemaker is not a contraindication to attaching and using an AED. Avoid placing the AED electrode pads directly over the device because the devices may interfere with each other ...... allow 30-60 seconds for the implanted defibrillator to complete the treatment before delivering a shock from the AED."

I also wonder if this is covered in basic AED Training.

AED usage with an implanted defib has been covered in every class I have taken since AED's were covered in our CPR class.

Later,
Dan
 
   / AED Automated External Defibrillator and Rural Fire Departments #34  
This is a very interesting thread, & as a volunteer RFS (Rural Fire Service) firefighter from the other side of the world (Australia), I find it interesting how much we share common challenges (like funding, medical first responder queries, equipment shortfalls, protocols ....etc.)

In our state NSW, all RFS vehicles carry an AED & comprehesive First Aid Kits, primarily because of the risk to firefighters in demanding operating environments (heat, stress, physical demands, injury/ trauma...etc.), with most of our RFS brigade crew qualified/certified in First Aid - whilst we are not designated medical first responders, because of distance & remoteness of incidents quite often the RFS brigade crew will be first on the scene for quite sometime & therefore need to initiate proactive care in a critical medical situation (often trauma from vehicle or farm accidents) including where required the use of a AED.

'BranchChipper' raises extremely valid points, however our local operating protocols/relationships allow us to work closer, rather than 'compete' with other agencies to improve response, & we actively deploy initiatives to develop our skills, inter-agency harmony & also raise our 'profile' to increase awareness/capability/funding in our area:-
1. Working with other local emergency services (EMS/Ambulance/Police & other paid fulltime agencies, & other emergency volunteer organisations like our SES - State Emergency Services) in training exercises/contingency emergency planning (fire/flood/evacuation..etc), convening joint incident debreifs & regularly supporting each others meetings/individual organisations training exercises
2. Community Engagement/Awareness
- Convening street meetings for community education (held on landowners properties for near neighbours to develop their 'plan')
- Assisting with individual property risk assessments/fire plans/hazard reductions..etc
- Activities in local schools, some brigades have 'cadet' programmes (for future recruits)
- Representation, displays & fund raising at all local fairs, fetes & elections..& a Xmas Santa fire truck run through the town...etc (a strategically placed fire truck draws attention anywhere !! ), & bi-annual RFS station open days
- Educating on what we do/how we can serve the community (e.g Fire, Flood, Disaster planning/recovery/Communications)
- Of our RFS skills/training: from the general public knowledge of Bush/Village firefighting to MVA/Incident & rescue response/Chainsaw use & Tree Felling/First Aid/BA qualifications to Communication/Mapping/Catering & Logistics .......etc
- Local Business: supporting their activities/trade days & public acknowledgment of their funding support & pledges..etc

All probably sounds like a lot, but somehow from our brigades c.20 members of which maybe 13 are regularly active, it gets done.

I'm unsure of how volunteer rural firefighting works in the US & other countries. Over here in NSW it is a state based organisation (currently funded fom state govenrment & insurance company contributions) that supplies the basic standard equipment like trucks/PPE/basic truck fitout & develops training competencies (deployed at a local zone level), there's also paid fulltime zone managers/coordinators/admin (whom I'm sure would like to think they add value....) , historically stations are mostly tin sheds having been funded locally (albiet with varying degrees of state contribution), & individual brigades raise funds for additional/ specific equipment locally.

As for the RFS volunteers, we're all unpaid/no oncall retainer/no tax concessions for out of pocket expenses...etc... so we do it free for community service.......& volunteer recruitment & retention is as challenging a securing sufficent regular funding(except after a major disaster when all the politicians try to cover their past oversights with "one off" cash injections...)

Apologies if some of this was a little off the subject, but hopefully of interest to others engaged in volunteer fire/emergency services

MBTRAC- Thanks very much for sharing your snapshot of fire services down under! We very much need some outside perspective- as you may have already guessed, the American fire service is kind of a jumbled mess. While there is a set of comprehensive national standards, they only become "law" when individual states adopt them (and usually it is only parts of them). In other words, it is every state for itself, and there is so much variety between different locales (even sometimes within the same state and/or county) that it can make your head spin. The same applies to funding, staffing, terminology and everything else.
I have cringed many times recently at press photos of Texas volunteers fighting fast-moving wildland fires in 20 or 30 year old structural PPEs (bunker gear). Without picking on Texas, that illustrates my point- not only is that a reflection of a lack of funds and lack of adherence to existing national standards, it puts those firefighters in immediate danger, from heat exhaustion, exposure to fire, etc. The same sorts of things happen all over the country every day.

Much of what you described in item 2 is Integrated Risk Management/Community Risk Reduction. It has been spectacularly successful in Oz and Britain in reducing risk while engaging firefighters with their communities, but it is is its infancy here. (Interestingly, the concept originated here in the 1970's) My reply to txdon didn't promote competition with their EMS providers, but rather promoted teamwork. If everyone's goal is the best patient care, for example, you get the best result by working together. The community wins.
In the Western US, EMS has been part of daily life for firefighters for many decades. So it is not a big stretch to incorporate other non-fire risk reduction tactics (like some that you describe) into their activities. In other regions, where EMS has always been done by "someone else," funds and activities are restricted to a very narrow fire response model. In those places, the public often thinks that their local FD is no more than a social club with expensive toys.
My point? Until all US firefighters begin speak with one voice (and stop the "we know what works best for our little corner of the world" mantra) the jumbled mess will persist, and communities will miss out on what could be a much better partnership.
We need to pay more attention to what the rest of the world's firefighters think and do, and stop hiding behind those closed apparatus bay doors.
 
   / AED Automated External Defibrillator and Rural Fire Departments #35  
Branchchipper- I empathise with your challenge & whilst there's been major progress over here, there's still plenty of "band aid" approaches & room for improvement(e.g we are issued with $150+ fire boots & about a $7.50 fire "hat" - most brigades elect to local fund something more substantial )...........unfortunately it took the catalyst of several bushfire disasters in the 1980's & early '90's where we lost many people for everyone to "wake up" & at least equip every RFS brigade with minimum & current standards of trucks/equipment/PPE...................prior to this I well remember the old days of the '80's fighting bushfires in overalls with c25yr old+ "clapped out" 4x2 & ex-army 6x6 trucks (including some Studebakers from WWII), not knowing if these petrol powered trucks would start, or stop from a vapour lock in the heat of a bushfire.........though it's still a sobering thought despite all the progress, equipment, communications & increases in resources in the face of a major bushfire like which occurred in February 2009 in Victoria (another Australian state) we lost 173people & over 2000homes.

Thought you might like this link for a few insights on our NSW RFS equipment, operations..etc.:-

Operations - NSW Rural Fire Service
 
 
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