Medical Director Update – BC Ambulance AEDs reconfiguration

BC Ambulance AEDs

A recent memo was circulated by the Director of First Responder Services Randy Shaw regarding the reconfiguration of the BC Ambulance AEDs. In part this memo outlines the following. The BCAS AEDs are being reset to eliminate the “charge‐up whine” when a shockable rhythm is detected and instead prompt the responders to resume CPR – See appendix 1 for the complete memo.

This AED reconfiguration is being done to encourage crews to continue chest compressions during the charge‐up phase of the AED and is one more step in maximizing time on the chest.

Although I am in agreement in principle with this initiative, it has come to my attention that there may be a considerable cost for some Fire Service AEDs to be reconfigured. This cost depends on the software version installed in the AED. In discussions with BCAS and the Emergency Health Services Commission, the following is recommended based on the model of AED and the software version:

lp500/1000

1. LP 1000s with software version 2.42
Recommend – reconfigure as these units contain the same software as BCAS AEDS (no costs incurred)

2. LP 1000’s with software versions older than version 2.42
Recommend – reconfigure not required ‐ The cost to upgrade ($700.00 per unit) does not justify the benefit

3. LP 500
Recommend – reconfigure not required ‐ The cost to upgrade ($300.00 per unit)does not justify the benefit

For those units where there is a recommendation not to reconfigure, the same benefit (chest compressions during charge‐up) can be obtained by reminding crews that chest compressions should continue throughout the “charge‐up whine”.

Best regards,
Allan Holmes
Medical Director, Iridia Medical

Appendix 1

TO ALL FIRST RESPONDER AGENCIES, SENT ON BEHALF OF RANDY SHAW, DIRECTOR, FIRST RESPONDER SERVICES

This note is to advise you that effective this week BC Ambulance Service (BCAS) AEDs will begin to undergo a minor reconfiguration. The AEDs are being reset to eliminate the “charge‐up whine” when a shockable rhythm is detected and instead prompt the responders to resume CPR.

If a shockable rhythm was detected on analysis, the AED will begin to charge and a 15 second timer will show in the display window. At 12 seconds, the AED will warn the responders that a shock is advised and at 15 seconds, prompt the responders to stand clear and to push the shock button.

There is no change in the procedures for CPR.

As you know, we teach that chest compressions are to resume during the charge‐up phase. This change in AED configuration is purely intended to support the re‐establishment of chest compressions during that phase. Please notify your first responder agencies accordingly both so that they are aware of the BCAS AED change and so that first responder agency medical oversight may consider the change with their own AEDs if similarly configurable.

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