Both horse and rider are subject to cardiac stress during many competitive activities. Event organizers are recognizing the importance of on-hand emergency equipment to provide first aid and assistance for horse and rider in the case of a medical emergency. This article reviews the latest technology in defibrillation, a life saving technology that is increasingly available outside of the hospital.
What is defibrillation?
Advances in defibrillator technology provide lifesaving equipment that is user-friendly.New window.
Defibrillation, an intensive medical treatment that introduces a therapeutic round of electrical energy to an affected heart, aims to correct lift-threatening conditions, such as ventricular fibrillation, cardiac arrhythmias, and ventricular tachycardia with a special device called a defibrillator. This treatment counteracts the cardiac arrhythmia by depolarizing the heart muscle's critical mass, thus re-establishing a normal sinus rhythm within the body's natural pacemaker.
Defibrillators come in different types and sizes, including external, trans-venous, and implanted devices. Each defibrillator requires some training to operate the machine effectively with the exception of automated external defibrillators (AEDs), which are designed to diagnose treatable rhythms automatically.
When used in conjunction with electrocardiogram readers, manual external defibrillators diagnose and treat a cardiac condition, such as fibrillation or tachycardia, through use of a therapeutic dose of electrical shock. A patient's healthcare provider will decide and then administer the intensity of the electrical charge based on authoritative guidelines and general work experience through coated paddles or pads placed on the patient's chest. Manual external defibrillators can only be found in medical environments, such as a hospital or ambulance, where paramedics and technicians can effectively use the devices to treat lethal arrhythmias.
- Implantable Cardioverter Defibrillators (ICDs)
- Implantable Cardioverter Defibrillators for Arrhythmias
Automated External Defibrillators bring defibrillation technology outside the hospital
Portable devices monitor the patient, and automate settings for accurate application.
Automated external defibrillators (AED), user-friendly units based on technological advancements, analyze an individual's heart rhythm and then provide the necessary feedback as to whether an electrical shock is needed to regain normalcy. These devices are designed to be used by inexperienced workers with little training; however, the simplicity of these defibrillators limit the range of application for more serious conditions. For instance, health professionals may need to use a manual or semi-automatic unit to diagnose conditions for ventricular fibrillation or ventricular tachycardia. The automatic units require more time to assess a cardiac rhythm, while as a trained professional could diagnose and perform a treatment in a lesser time frame with a manual unit. This makes AEDs less than ideal for emergency situations where an immediate intervention is required to stop chest compressions.
Automated external defibrillators are generally offered in public for easy access, such as in government offices, community, fitness, and health clubs, casinos, hotels, airports, and sports stadiums. These units are usually found where large gatherings occur and where the risk of sudden cardiac arrest is high. Emergency services vehicles do carry automatic external defibrillators, despite their less than adequate response. In fact, some ambulances will have an AED equipped with a manual defibrillator to assure a rapid response in the event either device fails. Automatic external defibrillators are useful in emergency situations where a qualified medical professional cannot get to site to perform a manual assessment.
- Advances in the Treatment of Arrhythmias: Implantable Cardioverter-Defibrillators
- Biventricular Pacing Implantable Defibrillator
Automated external devices come in two different subtypes, including fully and semi-automated models. A semi-automated external defibrillator automatically diagnoses an individual's cardiac rhythms and then advises the user to push a button in order to administer the electrical shock. A fully automated external defibrillator does the exact same process with the exception of performing the electrical shock on default. Some AEDs will have features that allow the user to perform a manual override or display an ECG screen.
Public access AEDs are mounted in brightly colored cases near a building's entrance. An alarm will sound when an AED becomes activated and removed in an emergency situation. Public access AEDs do not automatically summon emergency services, despite the setting off an alarm. Therefore, automated external defibrillator operators should call for an ambulance if a situation calls for using the device. Typically, emergency situations involving an AED means the patient lays unconscious, which requires emergency services automatically in any case.
- Automated External Defibrillators (AEDs)
- PUBLIC HEALTH(410 ILCS 4/) Automated External Defibrillator Act
Internal cardiac monitors and defibrillators for high-risk individuals
Implantable devices allow otherwise healthy individuals to live securely away from medical care.New window.
Automatic internal cardiac defibrillators are implantable devices that constantly monitor a patient's heart rhythms in the event life-threatening arrhythmias occur. These devices function similarly to artificial pacemakers. Implantable defibrillators distinguish between ventricular fibrillation and ventricular tachycardia and may prevent benign arrhythmias like atrial fibrillation and supra-ventricular fibrillation using a process known as synchronized cardioversion. If the situation poses a more life-threatening condition, then the program will default into an unsynchronized mode. Some implantable defibrillators will actually misfire or constantly send inappropriate shock waves, which could potentially trigger life-threatening arrhythmias. Due to this problem, some emergency medical services are equipped with magnets that will disable the shock function and allow intervention to re-stabilize the device.
Manual internal defibrillators, identical to the automated external defibrillators, allow the administration of electrical shock treatment through internal paddles that come in direct contact with the patient's heart. These are usually inserted during surgical operations where the chest cavity is already open. A wearable external defibrillator, another derivation of the automatic internal cardiac defibrillator, implies an external unit that is worn like a vest around the chest. The device monitors the patient around the clock and will deliver a two-phase shock in the event a cardiac condition arises. Medical professionals mainly use this transitory device until an implantable defibrillator can be administered to the patient.
- Automated External Defibrillator Arrhythmia Detection in a Model of Cardiac Arrest Due to Commotio Cordis.
- Advances in the Treatment of Arrhythmias: Implantable Cardioverter-Defibrillators
A medical professional establishes the connection between the patient and the defibrillator through a pair of electrodes conduced with a specialty gel in order to minimize chest impedance, which would result in severe burns for the patient. This electrical conductive gel comes in a wet, liquid form or a solid, gel-like state. Solid electrical gel provides more convenience for the medical professional because of simplicity of not having to clean the excess gel off the patient's skin after defibrillation. Solid electrical gel poses higher risk for burns, however, because wet gel provides more conductivity into the body. Self-adhesive electrodes have gel pre-applied before usage for expedient administration.
- ICD (Defibrillator) Implantation
- Algorithm for Exterior Defibrillators That Correctly Identifies Both Adult and Child Arrhythmias
Principles, techniques and equipment used in defibrillators
Paddle electrodes are the most commonly known defibrillator that establishes connection with a metal paddle and insulated handle. This metal paddle is applied to the patient's skin with at least twenty five pounds of pressure to secure a solid connection with the patient's body. Paddles offer several advantages over self-adhesive electrodes, including re-usability and faster conductivity. Manual defibrillators are generally equipped with paddles.
- Basic Principles and Technique of Cardioversion and Defibrillation
- Algorithm for Exterior Defibrillators That Correctly Both Adult and Child Arrhythmias
Self-adhesive electrodes are designed with an adhesive pad with solid or wet gel. The user simply peels off the backing and then applies the electrodes to the patient's chest. The user connects the electrodes to the defibrillator and then charges the machine to administer shock treatment. Self-adhesive pads are generally found on automated units. These electrodes are primarily found in non-hospital settings, unless the self-adhesive pads are used prophylactically.
- Automated External Defibrillators: Do You Need an AED?
- Automated External Defibrillator Public Access Defibrillation
Pads offer advantages for the untrained user and medics working in less than optimal conditions. Pads do not require extra equipment for monitoring, and they do not require force to deliver shock treatment. Therefore, self-adhesive electrodes play a safer role for inexperienced users. Self-adhesive electrodes can only be used once; however, they may be used several times in a single course of treatment. Self-adhesive pads are immediately replaced after the administration is discontinued.
About the author
Gina Papetti is an avid horse trail rider who loves to share horse health information through her writing for EquiMed.
Gina has to her credit a number of equine related articles in the United States and Italy. She has successfully logged over 1000 hours of riding her favorite horse, Abbey, on trail rides in the Southern California area.
Gina is married to Robert, who is a practicing Chiropractor. Gina has two grown children, three dogs, a cat, and her beloved Abbey (Arabian QH mix).