As a former firefighter-paramedic of 14 years which I left in 2020, our LifePak monitors went up to 360J. We did use self adhesive pads and never once did I have any odd smells after "welding" someone. We used stacked sequence, starting out at 200J, 300J and 360J. Our LifePaks did have AED but very few people used that option, so yeah, medics and agencies still require to know how to read traces. To know which rhythms to shock and which ones not to isn't rocket science, nor are there that many. There are only two pulseless rhythms that get shocked. There are also a couple of reason to shock conscious people with rhythms that does require a bit more training and knowing when to give the shock but it isn't all that difficult to learn.

Not sure why the "us kids" comment. How come you aren't boasting about not wearing gloves and PPE? I've heard about "back in the day" how it was a badge of honor to be covered in someone else's blood. That shit ain't cool at all, but it does occasionally happen where blood does get on unprotected skin, it has happened to me.

Did we have to know as much as back in the 70s, 80s and 90s? No, not at all but that is advancement and not necessarily watering it down.

If I have an out-of-hospital emergency I definitely would want street medics and firefighter there for help. I am still shocked how often I've seen doctors and nurses loose their shit because they aren't use to having to think on their own or they don't have a team of 10 or 15 people there to back them up. I've seen it in firefighters and medics as well, just not as often. Most nurses aren't allowed intubate in a well lit hospital room, let alone lying on the asphalt of a highway or floor of someones home.

AEDs are an amazing invention and I'm glad to see them dotted around the place. Initially in dedicated cabinets mounted to walls outdoors, and sometimes in repurposed telephone booths.

"New defib placement increases chance of surviving heart attack by 264%" (2024) https://newatlas.com/medical/defibrillator-pads-anterior-pos... :

> Placing [AED,] defibrillator pads on the chest and back, rather than the usual method of putting two on the chest, increases the odds of surviving an out-of-hospital cardiac arrest by more than two-and-a-half times, according to a new study.

"Initial Defibrillator Pad Position and Outcomes for Shockable Out-of-Hospital Cardiac Arrest" (2024) https://jamanetwork.com/journals/jamanetworkopen/fullarticle...

I think the biggest change with external defibrillators has been placement. It's now front and back instead of two on the front.

> having to actually manually read the trace instead of all this new-fangled automation that guides you through it.

I never met a LifePak 12 that did not flag every 12 lead it saw as an "Abnormal ECG".

[dead]

I survived an out-of-hospital cardiac arrest (previously undiagnosed ventricular fibrillation). Luckily I was in a building about 20 yards from where they kept the defibrillator, and they started CPR within a couple of minutes of me going down, with defibrillation as soon as they had got the device ready. I was already sitting up and talking when the air ambulance arrived but I still got the helicopter ride.

When I had an ICD implanted a few days later the surgical team stressed how massively lucky I'd been. They all stopped what they were doing and stared at me when the lead person read out my case history.

I don't think I had significant neurological issues as a result. Perhaps I should check my HN comment history to see if my rate of karma accrual changed around the date of the event.

My father survived this. No brain damage. Lived a few more years, until 74. The heart wasn't pumping at normal rates because of damage. Do to hip problems (arthritis) also had problems walking. Eventually Developed a blood clot in a leg. Initially survived the blood clot. But the medication given to thin out the blood clot caused bleeding on his liver. Somehow the Hospital missed the bleeding until it was too late. The operating room was also busy (Canada), so no intervention could be performed. Wasn't allowed to see him because of covid rules. Possibly been able to advocate for him if I was in his room, and saw his worsening condition.

They can save your life in a hospital, but just as easily kill you by mistake or side effect of whatever intervention they are doing. Also, walking (or being able to walk) is very important for longevity.

But the speed of the first response of the cardiac arrest is what matters. Since the brain is without oxygen. Assuming the person makes it to a hospital alive, they'll cool off the body to prevent brain damage. For every minute you survive, your odds get better.

When I was attending a first aid & CPR class, one of the first things the instructor explained was that the chance of successful CPR is very, very low, but not attempting CPR obviously reduces the odds even more. Not to discourage anyone, but rather to prevent us from beating ourselves up over it if things didn't go well.

If you don't know CPR, you might want to consider learning.

OHCA survivor now with an ICD here. I just want to say I'm grateful for this technology and grateful that people still work on this and attempt rescue even if only 10% of people survive. I'm one of those 10%.

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> This appears to be a simulation study done in 2d.

Yes. The paper says

>> In this study, a simple two-dimensional numerical model of atrial tissue containing anatomical heterogeneities – the essential ingredient responsible for the emergence of virtual electrodes – was used to explore ultra-low-energy defibrillation.

> no one had managed to translate them to application.

Yes. The paper itself has the following statements in its conclusion:

>> The approach considered here is impractical – it requires an accurate mathematical model of the tissue as well as complete knowledge of the state of the tissue at the initial time. Furthermore, computation of a defibrillating electrical field cannot be performed in real time.

> They’re already commercializing this.

My ICD is an Abbott Ellipse VR [0] and is 2 x 2.5 x 0.5 inches in size. It doesn't make too much of a bump under my skin. It was implanted in 2021 and I don't think was new then.

[0] https://www.cardiovascular.abbott/int/en/hcp/products/cardia...

[Edit]

> They’re already commercializing this.

Sorry to disappoint, and unfortunately, no. See other comments elsewhere. This study is based on a theoretical study of 2D simulated tissues. The original paper itself contains the disclaimer...

>> "The approach considered here is impractical – it requires an accurate mathematical model of the tissue as well as complete knowledge of the state of the tissue at the initial time. Furthermore, computation of a defibrillating electrical field cannot be performed in real time."

This is more about implanted defibrillators than AEDs. In implanted devices, the size of the battery absolutely does matter.

Powder Game: https://dan-ball.jp/en/javagame/dust/

Powder Game 2: https://dan-ball.jp/en/javagame/dust2/

Emoji Simulator: https://ncase.me/sim/?s=bz

Less than low energy antitachycardia pacing (LEAP), which is itself a lower-energy alternative to the typical 1-shock defibrillation. Their "1000 times less" means three orders of magnitude. From the abstract of the paper:

We find that, rather counter-intuitively, a single, properly timed, biphasic pulse can be more effective in defibrillating the tissue than low energy antitachycardia pacing (LEAP), which employs a sequence of such pulses, succeeding where the latter approach fails. Furthermore, we show that, with the help of adjoint optimization, it is possible to reduce the energy required for defibrillation even further, making it three orders of magnitude lower than that required by LEAP

Important to note that the study uses:

"an electrophysiological computer model of the heart's electrical circuits "

and

"a simple two-dimensional model of cardiac tissue"

Seeing this phrasing more and more, and I don't like it.

"...using 0.1% as much electricity" feels far more proper.

I assume it means 1/1000th because the phrase makes zero sense.

Why the harsh words and insults? I understand the headline immediately, so as a smart person you probably did too.

Though this phrase has a literal translation to my native language. Maybe the person who wrote this is not a native speaker? But definitely not illiterate, come on.

Than other defibrillation devices, is my default interpretation, because I know they use electricity and there are no other subjects in the sentence.

So: reading comprehension and common knowledge.