# Alternatives to defibrillators in a desperate situation? **URL:** \ **Category:** Factual Questions\ **Created:** [March 21, 2011, 8:27pm UTC](https://boards.straightdope.com/t/alternatives-to-defibrillators-in-a-desperate-situation/575511 "2011-03-21T20:27:03Z")\ **Posts on this page:** 13\ **Page:** 2
**Author:** ![Mark\_box](https://avatars.discourse-cdn.com/v4/letter/m/b5e925/32.png) [@Mark\_box](https://boards.straightdope.com/u/Mark_box)\ **Post date:** [December 22, 2016, 12:35am UTC](https://boards.straightdope.com/t/alternatives-to-defibrillators-in-a-desperate-situation/575511/21 "2016-12-22T00:35:39Z")
I retired as a fireman after 20 years of service. I have done CPR many times on pt and yes unfortunately yes the success rate is very low. It has many variables, at the top of the list is how fast CPR is started, 4 to 6 min is when brain death starts providing there is not a very cold climate the pt is exposed to. Another important factor can be age, providing it is a cardiac event. Believe it or not the older the better to a degree a 25 year old with a catastrophic heart blockage is almost hopeless, because his body depends on more blood flow, an older persons body becomes accustomed to partial blockage which in turn causes other veins, and capalaries to swell, therefor giving other avenues for blood when then the blockage happens. I dont know if ac electric would help or more importantly if its a family member your working, would hurt. I would suggest a cardiac thump especially if your working a sudden cardiac arrest with a very ypung pt and no access to diffribulation. Also we use a dfib on most codes, prividing we had a vfib rythem, meaning the heart is quivering and eletrical pulses in the heart are out of rythem. A dfib actually stops the heart and hopefully when it starts again it start in a normal rythem and starts moving blood again. All that said and it was my son and I was in the middle of nowhere and had worked him awhile I would try an electric fence a 120 volt cord or even better a 220 v, providing how desperate of a situation this would be, I would not leave any option on the table. ---
**Author:** ![WhyNot](https://avatars.discourse-cdn.com/v4/letter/w/c77e96/32.png) [@WhyNot](https://boards.straightdope.com/u/WhyNot)\ **Post date:** [December 22, 2016, 1:12am UTC](https://boards.straightdope.com/t/alternatives-to-defibrillators-in-a-desperate-situation/575511/22 "2016-12-22T01:12:30Z")
> [@robby](#): > > I just took a CPR course that included AED instruction. > > The short answer is that if you haven’t had a CPR course with AED instruction, you should leave the AED alone. This may have been good advice 5 years ago, but today’s AED’s are very nearly idiot proof. And first responders will have their own with them, so if you mess up the pads, they’ll use theirs. You still want to call 911 first, but if you have two or more people there, have someone get the AED while you’re doing chest compressions and give it a shot. It’s got voice prompts telling you what to do, and IKEA like diagrams on it showing you where to place the pads, and a big button that’s really the only thing to push, and it will not hurt someone if you try it and get it wrong. Pad placement really isn’t very critical anyway - just don’t let them touch. (If you have a small child, you can use adult AED pads by putting one on their back and one on their front so the pads aren’t touching.) But hey, for anyone reading this, might as well watch a video so you’ll know what to do. (This is a slightly older model where it tells you to press the button to deliver the shock. With newer ones, you don’t even have to do that, as \*\*robby \*\*said.) It’s just over 2 minutes of your time, and it might save a life: [https://www.youtube.com/watch?v=OO4z5bN2oNs](https://www.youtube.com/watch?v=OO4z5bN2oNs) I also have to agree with **Mark Box** - if a person’s already dead and there’s no AED, might as well get creative. Will a taser or stun gun or cattle prod or electric fence work? Probably not. But they aren’t getting any deader. And tasers HAVE been known to penetrate the chest wall and cause cardiac arrest when they weren’t supposed to\*, so it’s not entirely hopeless. \*[http://circ.ahajournals.org/content/129/1/101](http://circ.ahajournals.org/content/129/1/101) ---
**Author:** ![The\_Controvert](https://avatars.discourse-cdn.com/v4/letter/t/dec6dc/32.png) [@The\_Controvert](https://boards.straightdope.com/u/The_Controvert)\ **Post date:** [December 22, 2016, 1:40am UTC](https://boards.straightdope.com/t/alternatives-to-defibrillators-in-a-desperate-situation/575511/23 "2016-12-22T01:40:32Z")
> [@gotpasswords](#): > > Rather than count, just play Stayin’ Alive in your head and follow the beat. > [@Telemark](#): > > Or “Another One Bites the Dust” - same beat. Given the choice, I’d rather be “Stayin’ Alive” than “Another One Bites the Dust”… 😃 ---
**Author:** ![Chronos](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/chronos/32/134_2.png) [@Chronos](https://boards.straightdope.com/u/Chronos)\ **Post date:** [December 22, 2016, 2:07am UTC](https://boards.straightdope.com/t/alternatives-to-defibrillators-in-a-desperate-situation/575511/24 "2016-12-22T02:07:25Z")
Yeah, the hardest part about using an AED is knowing just how easy it is to use it. I imagine that there are a lot of folks who _don’t_ know that, and so just leave it hanging on the wall instead of grabbing it, in an emergency. ---
**Author:** ![WhyNot](https://avatars.discourse-cdn.com/v4/letter/w/c77e96/32.png) [@WhyNot](https://boards.straightdope.com/u/WhyNot)\ **Post date:** [December 22, 2016, 3:44am UTC](https://boards.straightdope.com/t/alternatives-to-defibrillators-in-a-desperate-situation/575511/25 "2016-12-22T03:44:41Z")
> [@gotpasswords](#): > > The latest Red Cross guidelines for CPR could probably stand re-naming it to CR. Take out the “pulmonary” as now the recommendation is compressions only, at a rate of 100 per minute. Rather than count, just play [Stayin’ Alive](http://en.wikipedia.org/wiki/Stayin'_Alive#Medical_training) in your head and follow the beat. For the young whippersnappers who need to get off my lawn, here’s a sample of the song at [Amazon](http://www.amazon.com/Stayin-Alive/dp/B001KQE64E). > [@Telemark](#): > > Or “Another One Bites the Dust” - same beat. > [@The\_Controvert](#): > > Given the choice, I’d rather be “Stayin’ Alive” than “Another One Bites the Dust”… 😃 We really need to update those to something people under 40 know. 😃 Apparently, Usher’s “Yeah” works. This is not Usher’s “Yeah”: [https://www.youtube.com/watch?v=3JpaSjL7M-Q](https://www.youtube.com/watch?v=3JpaSjL7M-Q) ---
**Author:** ![Emergency911](https://avatars.discourse-cdn.com/v4/letter/e/43a26b/32.png) [@Emergency911](https://boards.straightdope.com/u/Emergency911)\ **Post date:** [December 22, 2016, 2:23pm UTC](https://boards.straightdope.com/t/alternatives-to-defibrillators-in-a-desperate-situation/575511/26 "2016-12-22T14:23:16Z")
The worst part about the above stated CPR statistics is that they don’t distinguish between what they call a “witnessed arrest”, which is where you actually watch the person go unconscious and start CPR immediately; versus a “non witnessed arrest”, which is when someone finds a person pulseless and starts CPR when they find them. The old adage “seconds saves lives” really does apply here. Survivability decreases dramatically every moment nothing happens. When someone is found pulseless, there is no way of knowing whether they have been down 1 minute or 10 minutes. While it is purely anecdotal, it has been my experience that if CPR is initiated immediately on a witnessed arrest, their chances of survival are better than the over all statistic of 5 to 10 percent. ---
**Author:** ![Omar\_Little](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/omar_little/32/269_2.png) [@Omar\_Little](https://boards.straightdope.com/u/Omar_Little)\ **Post date:** [December 22, 2016, 2:40pm UTC](https://boards.straightdope.com/t/alternatives-to-defibrillators-in-a-desperate-situation/575511/27 "2016-12-22T14:40:18Z")
If your choice is between just performing CPR and going MacGyver on me with a battery charger and tampon…just keep performing CPR. ---
**Author:** ![Archinist](https://avatars.discourse-cdn.com/v4/letter/a/b782af/32.png) [@Archinist](https://boards.straightdope.com/u/Archinist)\ **Post date:** [December 22, 2016, 2:48pm UTC](https://boards.straightdope.com/t/alternatives-to-defibrillators-in-a-desperate-situation/575511/28 "2016-12-22T14:48:33Z")
> [@WhyNot](#): > > I also have to agree with **Mark Box** - if a person’s already dead and there’s no AED, might as well get creative. Will a taser or stun gun or cattle prod or electric fence work? Probably not. But they aren’t getting any deader. And tasers HAVE been known to penetrate the chest wall and cause cardiac arrest when they weren’t supposed to\*, so it’s not entirely hopeless. Is it possible to manually circulate the blood around the body by sillier methods, such as spinning the body around in circles or manually taking the heart out and massaging the chambers with your fingers, or does the heart need to be pressurized in a special chamber or something? I mean if someone was careful enough and knew what they were doing, couldn’t they just make the heart work somewhat by digging it out and massaging it? ---
**Author:** ![WhyNot](https://avatars.discourse-cdn.com/v4/letter/w/c77e96/32.png) [@WhyNot](https://boards.straightdope.com/u/WhyNot)\ **Post date:** [December 22, 2016, 3:06pm UTC](https://boards.straightdope.com/t/alternatives-to-defibrillators-in-a-desperate-situation/575511/29 "2016-12-22T15:06:22Z")
> [@Archinist](#): > > Is it possible to manually circulate the blood around the body by sillier methods, such as spinning the body around in circles or manually taking the heart out and massaging the chambers with your fingers, or does the heart need to be pressurized in a special chamber or something? I mean if someone was careful enough and knew what they were doing, couldn’t they just make the heart work somewhat by digging it out and massaging it? That’s what chest compressions do. They squish the heart and cause it to squeeze blood out one end and in the other end, and circulate the blood around the body. Yes, you can open the chest wall and manually massage the heart to circulate blood, but only if “you” are a “doctor”. It’s called _open-chest cardiac massage_, and only doctors do it, and only doctors who also have lots of drugs and a defibrillator (not an AED, but a full defibrillator with sterile paddles that make contact directly with the heart through that opening you’ve made in the chest) at hand as well. [https://www.mdguidelines.com/open-chest-cardiac-massage](https://www.mdguidelines.com/open-chest-cardiac-massage) If you’re not a doctor, not only are you unlikely to do it correctly (it’s a lot harder than chest compressions) but you’re unlikely to be able to open the chest wall and get at the heart. You have to cut the tough connective tissue in between two of the ribs and then spread them apart, which is not as easy as it sounds. Doctors have a special metal tool called, unimaginatively enough, a “[rib spreader](http://austos.com/wp-content/uploads/2014/01/ae-fb800r-tuffier-rib-spreader-blades-43x53-mm.jpg)”, to do this. If a person’s ribcage is already ripped open and their heart isn’t beating…well, again, they’re dead, so nothing you do will make them any deader, but at that point, open-chest cardiac massage from a layperson is probably not going to help, and will likely traumatize everyone watching. ---
**Author:** ![Telemark](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/telemark/32/372_2.png) [@Telemark](https://boards.straightdope.com/u/Telemark)\ **Post date:** [December 22, 2016, 3:14pm UTC](https://boards.straightdope.com/t/alternatives-to-defibrillators-in-a-desperate-situation/575511/30 "2016-12-22T15:14:13Z")
> [@Omar\_Little](#): > > If your choice is between just performing CPR and going MacGyver on me with a battery charger and tampon…just keep performing CPR. Agreed, the chances of success by jury rigging an AED with a cattle prod, two brillo pads, and some barbed wire are much less than the chance of injuring someone else with your contraption and creating another victim. ---
**Author:** ![Dr\_Paprika](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/dr_paprika/32/3042_2.png) [@Dr\_Paprika](https://boards.straightdope.com/u/Dr_Paprika)\ **Post date:** [December 22, 2016, 5:20pm UTC](https://boards.straightdope.com/t/alternatives-to-defibrillators-in-a-desperate-situation/575511/31 "2016-12-22T17:20:31Z")
The answer to the question is a precordial thump, as mentioned. If you need to do it, you are at a stage where you aren’t too worried about a broken rib. Automatic defibrillators tell you what to do, and are designed for ease of use. CPR provides oxygen to the tissues, and buys some time. I have seen direct cardiac massage (cut the chest and squeeze the heart) used in very desperate and essentially futile situations. Cardioversion (a shock which is timed to avoid making things worse, q.v “R on T phonomenon”) helps atrial dysrhythmia which is unstable or causing severe symptoms. Defibrillation is similar and is useful for ventricular fibrillation or many unstable ventricular tachycardias. Shocks are not useful for pulseless electrical activity. or asystole and the AED would not shock these rhythms. One of the first things in treating others is to avoid killing yourself. I’d be careful with a random electric shock but understand sometimes things are desperate. Calling for help early and continuing CPR are important, if an AED is handy so much the better. I have shocked and saved many hundreds of people. If you arrest in hospital your odds or somewhat better. ---
**Author:** ![Hari\_Seldon](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/hari_seldon/32/5173_2.png) [@Hari\_Seldon](https://boards.straightdope.com/u/Hari_Seldon)\ **Post date:** [December 22, 2016, 8:54pm UTC](https://boards.straightdope.com/t/alternatives-to-defibrillators-in-a-desperate-situation/575511/32 "2016-12-22T20:54:08Z")
> [@Dickerman](#): > > This is not accurate. A defibrillator can be used to in an attempt to convert atrial fibrillation, in which case the procedure is called cardioversion. > > Defibrillators are used to treat ventricular fibrillation/ventricular tachycardia. Untreated ventricular fibrillation leads to death, rather quickly. There are a lot of people walking around in atrial fibrillation. Me, for example, and for about a dozen years so far. ---
**Author:** ![Yllaria](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/yllaria/32/3452_2.png) [@Yllaria](https://boards.straightdope.com/u/Yllaria)\ **Post date:** [December 22, 2016, 9:06pm UTC](https://boards.straightdope.com/t/alternatives-to-defibrillators-in-a-desperate-situation/575511/33 "2016-12-22T21:06:22Z")
> [@Telemark](#): > > Or “Another One Bites the Dust” - same beat. I recently saw a post saying that “The Imperial March” from Star Wars works, too. Harder to sing along to, though. [Previous page](https://boards.straightdope.com/t/alternatives-to-defibrillators-in-a-desperate-situation/575511.md?page=1)