Review of: de Vries W, Bierens J, Maas M: “Moderate sea states do not influence the application of an AED in rigid inflatable boats.” Resuscitation. 70(2):247-253, 2006.

The Science
Some studies seem designed to bust myths as much as to answer a serious scientific question. The Royal Netherlands Sea Rescue Institution wanted to examine whether or not and how well various AEDs would operate in the event they were used at sea. They tested several models using three sizes of watercraft, including an open inflatable RIB design. While the seas were described as calm, the waves averaged about one foot. The authors used a manikin with a simulator and crossed the seas at various angles to introduce as much bounce in the boat as possible.

They discovered that all AEDs were able to recognize NSR and VT/VT and deliver a shock as indicated. All AEDs got wet to some degree and continued to function. The authors did find that some models were faster than others to analyze, charge and shock, and some makes had more easily understood voice prompts in the noisy environment.

The Street
Why do most service protocols require the ambulance to pull over to the side of the road when using the AED to analyze and defibrillate? Is this a holdover from the early AEDs that were more susceptible to motion artifact? Is it an unfounded fear in the possibility of defibrillating a rescuer?

If AEDs function properly in the bumpy ride of a fast moving boat at sea, they should work just as well in the back of an ambulance moving at a reasonable speed over paved roads. Perhaps it is time to do a similar study in the ambulance to prove this, so that we can stop the time wasting process of pulling over to the side of a road to defibrillate.