# Carrying a defibrillator in a group



## eytanm (Jul 31, 2021)

Have you seen an analysis of the probabilities of cardiac arrest while biking and of the survival rate after CPR and defibrillation?


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## EKram (Oct 30, 2020)

@eytanm What are we discussing? The probability data you suggest, can we have a link to what you saw?

Physical bicycle exertion I suppose could trigger a cardiac event. What about other triggers. Why would someone at cardiac risk be on a group ride. Does this person disclose this fact? Is it you?

The title in the post is about carrying a defibrillator in a group. Whoever is carrying it, are they competent in using it?


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## eytanm (Jul 31, 2021)

We are 15 bikers in the group, ages 70-85.
We are arguing if carrying a defibrillator may be of real benefit, or the probabilities of cardiac arrest and survival are too low to justify the logistics, training, weight...
I did not see any analysis, I hope to have your help in finding one.


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## EKram (Oct 30, 2020)

Surmising. The defibrillator carry is in the “just in case category”.

Many carry stuff on our bikes for contingencies. If one feels like any piece of contingency equipment is a might be needed item….

Analysis articles. No help my end.

Cheers


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## blueglide (Apr 23, 2020)

Seems a little extreme to me. Each person is responsible for their own health and should have some idea if bicycle riding is appropriate for their condition. You can't plan for all contingencies otherwise just have an ambulance follow you around.


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## nOOky (May 13, 2008)

I'd say no. What would happen in reality? Someone goes into cardiac distress, the defibrillator gets put on, they pop back up and continue the ride? Or is it a stop gap until said person gets transported to the hospital? Should someone that feels they really might have an event out on the trail be out on the trail in the first place? I can see carrying an epipen or nitro or a first aid kit, but a defibrillator is a very extreme just-in-case piece of equipment.


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## MSU Alum (Aug 8, 2009)

I don't know how hard it is to get medical workups where you live.
5 or 6 years ago, I decided I wanted a "calcium score". I called around and found a place to get it done for about $150 (U.S.) within 3 or 4 days. The test took less than a minute. I expect some insurance covers it, but I just paid out of pocket. It's basically the cost of 2 good tires.
Prior to that, I got a stress echo cardiogram. In that case, it was required by the FAA in the U.S. and was covered by insurance. Again, scheduling was not a problem.
I'd say that if you got those two tests, you'd have a very good estimation of the risk of a cardiac event in conjunction with exercise, though anything can happen, of course.
Additionally, a quick listen to your carotid artery (according to my doctor) is another good, easy way to get some data on vascular status.
I wouldn't be inclined to bring something like a defibrillator on a ride. But I think it makes sense to get some health data at your (our) age.
If you go to an FAA doctor, they have ECG gear, as an ECG is required yearly for certain licenses.


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## Dan Zulu (Jul 5, 2008)

Medical encounters, cardiac arrests and deaths during a 109 km community-based mass-participation cycling event: a 3-year study in 102 251 race starters-SAFER IX - PubMed


In a 109 km community-based mass-participation cycling event, medical encounters (moderate to severe) occurred in about 1 in 200 cyclists. Injury-related (1/300 cyclists) encounters were higher than illness-related medical encounters (1 in about 500). Serious life-threatening medical encounters...




pubmed.ncbi.nlm.nih.gov




There are some studies linked at the above website. Defibrillators are more commonplace now and give step-by-step verbal instructions, but I question the practicality of bringing one on a bicycle ride. For your group I'd think that if someone thought it was worth attaching a pannier and lugging it along then they can do so?


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## eytanm (Jul 31, 2021)

MSU Alum said:


> I don't know how hard it is to get medical workups where you live.
> 5 or 6 years ago, I decided I wanted a "calcium score". I called around and found a place to get it done for about $150 (U.S.) within 3 or 4 days. The test took less than a minute. I expect some insurance covers it, but I just paid out of pocket. It's basically the cost of 2 good tires.
> Prior to that, I got a stress echo cardiogram. In that case, it was required by the FAA in the U.S. and was covered by insurance. Again, scheduling was not a problem.
> I'd say that if you got those two tests, you'd have a very good estimation of the risk of a cardiac event in conjunction with exercise, though anything can happen, of course.
> ...


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## eytanm (Jul 31, 2021)

All of us are in quite good shape, biking together for 15 years, and taking good care of ourselves, including using the best available cardiac medicine and technology.
Nevertheless, cardiac arrests may happen. We are trying to estimate the potential risk, and not just act upon fear and emotions.


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## MSU Alum (Aug 8, 2009)

eytanm said:


> All of us are in quite good shape, biking together for 15 years, and taking good care of ourselves, including using the best available cardiac medicine and technology.
> Nevertheless, cardiac arrests may happen. We are trying to estimate the potential risk, and not just act upon fear and emotions.


Given this, I'd say your risk is low at the 70 year old end, but if I were the 85 year old, I'd consider an ebike. Maybe stick his tongue against the electrodes if he has an event.

OTOH:


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## spaightlabs (Dec 3, 2011)

eytanm said:


> We are 15 bikers in the group, ages 70-85.
> We are arguing if carrying a defibrillator may be of real benefit, or the probabilities of cardiac arrest and survival are too low to justify the logistics, training, weight...
> I did not see any analysis, I hope to have your help in finding one.


Ya gotta die sometime. You guys have all had good runs - if the good lord is calling, answer the call and head toward the light.


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## d365 (Jun 13, 2006)

Defib paddles could be a new e-bike accessory. Just plug them in to the accessory port, and zap.

Seriously though, there have been several fatal heart attacks on the trails around us over the years. And some were younger than your group. I've scared myself a few times when the chest gets to thumping too hard on a climb.


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## Jayem (Jul 16, 2005)

EKram said:


> Surmising. The defibrillator carry is in the "just in case category".
> 
> Many carry stuff on our bikes for contingencies. If one feels like any piece of contingency equipment is a might be needed item&#8230;.
> 
> ...


While true, it would then reason that one has performed a risk analysis and is carrying the gear most appropriate to the most frequent or likely situation to be encountered. Like, you would want a 406mhz PLB before a lot of other things. Extra water/shelter or filter, etc.


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## eytanm (Jul 31, 2021)

Dan Zulu said:


> Medical encounters, cardiac arrests and deaths during a 109 km community-based mass-participation cycling event: a 3-year study in 102 251 race starters-SAFER IX - PubMed
> 
> 
> In a 109 km community-based mass-participation cycling event, medical encounters (moderate to severe) occurred in about 1 in 200 cyclists. Injury-related (1/300 cyclists) encounters were higher than illness-related medical encounters (1 in about 500). Serious life-threatening medical encounters...
> ...





Dan Zulu said:


> Medical encounters, cardiac arrests and deaths during a 109 km community-based mass-participation cycling event: a 3-year study in 102 251 race starters-SAFER IX - PubMed
> 
> 
> In a 109 km community-based mass-participation cycling event, medical encounters (moderate to severe) occurred in about 1 in 200 cyclists. Injury-related (1/300 cyclists) encounters were higher than illness-related medical encounters (1 in about 500). Serious life-threatening medical encounters...
> ...


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## eytanm (Jul 31, 2021)

Thanks you Dan for the very relevant reference. 
3 cardiac arrests per 100,000 riders of 109km race, gives you some ball park for the risk involved. Although it is not trivial how to account for the many differences in age, race difficulty, etc.
I will look into the other references.


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## Nat (Dec 30, 2003)

It would not likely matter if you had a defibrillator out on the trail or not. You'd likely die either way. Cardiac arrest survival rate is something like 10%-12% unless it occurs inside a hospital, and even if you get the AED on you it's still less than 40%. Of course, if someone crumps out on the trail if paramedics can get there within a few minutes _maybe_ they'd survive but the chances of having emergency personnel within a few minutes away is super low. Therefore, I wouldn't bother hauling the AED around. Your group sounds like you're in good shape so I'd just make my peace with the idea of dying doing something you enjoy.



https://www.heart.org/idc/groups/heart-public/


@wcm/@ADV/documents/downloadable/ucm_301646.pdf


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## eytanm (Jul 31, 2021)

Nat said:


> It would not likely matter if you had a defibrillator out on the trail or not. You'd likely die either way. Cardiac arrest survival rate is something like 10%-12% unless it occurs inside a hospital, and even if you get the AED on you it's still less than 40%. Of course, if someone crumps out on the trail if paramedics can get there within a few minutes _maybe_ they'd survive but the chances of having emergency personnel within a few minutes away is super low. Therefore, I wouldn't bother hauling the AED around. Your group sounds like you're in good shape so I'd just make my peace with the idea of dying doing something you enjoy.
> 
> 
> 
> ...


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## eytanm (Jul 31, 2021)

How do I download the document you have linked?


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## Nat (Dec 30, 2003)

eytanm said:


> How do I download the document you have linked?


It was just a flyer from the American Heart Association.

Google search "cardiac arrest survival rate with AED" to get the link directly. I'll also add screenshots.


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## Nat (Dec 30, 2003)




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## eytanm (Jul 31, 2021)

Found your reference.
Another interesting fact: "Statistics shows that 23% of out-of-hospital cardiac arrests are "shockable" arrhythmias, or those that respond to a shock from an AED".


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## cyclelicious (Oct 7, 2008)

spaightlabs said:


> Ya gotta die sometime. You guys have all had good runs - if the good lord is calling, answer the call and head toward the light.


I agree. It's best to die doing something you love like mtb or having sex or doing something heroic like saving someone from a bear attack or on the battlefield

BTW Maybe it's easier to learn to do CPR than to carry a defibulator. Does everyone in your group have their First Aid?


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## 749800 (Jul 14, 2013)

A good compromise might be to have one or two competent and capable people trained in CPR. Then you don't have to carry anything (although my kid has some sort of light-weight protection device that they gave him in life-guard training).


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## Nat (Dec 30, 2003)

Even with CPR the chances of coming out of the event intact is slim. If you survive you're likely to have sequelae. Take-home message: take care of your health in the first place to decrease the risk of heart disease, make peace with your mortality, cherish every day.






Complications of Myocardial Infarction: Overview, Arrhythmic Complications of MI, Arrhythmic Complications: Supraventricular Tachyarrhythmias


Myocardial infarction (MI) due to coronary artery disease is a leading cause of death in the United States, where more than 1 million people have acute myocardial infarctions (AMIs) each year. The advent of coronary care units and early reperfusion therapy (lytic or percutaneous coronary...



emedicine.medscape.com


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## k2rider1964 (Apr 29, 2010)

A mountain biking full blown heart attack while riding survival story!!

April 8, 2017 San Clemente Singletracks Orange County, CA

We were on a group ride in the area know as San Clemente Singletracks aka The Weed Patch aka The Dog Pound on a average, relatively mild, sunny day in SoCal. There were 7 of us in the group including a newcomer, Chris, who was a friend of another rider in the group. I had Matt lead us out as he knew the area the best and although he had been struggling the past couple months with what his doctors said was some sort of esophagus irritation that they couldn't nail down, he was on fire that day. I'm usually 2nd or 3rd in the conga line but couldn't hold on and fell back, probably 1/4 mile back in the end as I just wasn't feeling it. On the way back, there is a long, windy singletrack climb that can gas you on your best day. Myself and another ride, Tom, opted to take a longer but easier way out. We would meet the rest of the group up at the trucks. By the top of that climb, Matt had fallen off to the back himself but a fun, flow section called Blue Chair was coming up so nobody was worried. 

Here's where the miracles start to kick in....for some unknown reason, the group stopped after less than a 1/2 mile and realized Matt wasn't with them. Normally, we would assume he took a phone call, a bathroom break or had a mechanical. It would be the norm to wait a solid 5-10 minutes before backtracking but Chris, who had never Matt before this day, went back after about two minutes and found Matt unconscious next to his bike. He yelled for everybody to come back. Darren, a school teacher checked for a pulse and wasn't sure if he felt one. He immediately started CPR while someone else called 911. John, an off-duty police officer who also knew CPR, stepped in when Darren got tired. As they continued to do this, an off duty ER nurse walking her dog came up. She told them they weren't compressing hard enough and stepped in to take over. She promptly broke 8 of Matt's ribs and the process continued for 45 minutes. The nurse later told us that she NEVER walks that way but her dog pulled her that way so she decided to go with it. 

Matt had fallen directly under some power lines so Life Flight was unable to land. The OC Sheriff's ended up lowering down a paramedic who was able to get a tube down Matt's throat after a pulse had been established. Paramedics in an ambulance eventually had to come down a service road used by the electric company. Matt was transported to a trauma center where we were told he had about a 4-11% chance of survival. They lowered his body temperature and put him in a coma. After several days they did a brain scan and we received the good news that there was brain activity. He underwent surgery for a blocked artery as well and after another 4-5 days, another brain scan was done since he wasn't coming out of the coma as quickly as they had hoped. Once again, good news and the next day he was awake. He couldn't communicate, didn't know where he was and didn't even know most of the people in the room. He actually looked scared. This went on for 5-6 days before things started to improve. Needless to say, he had a few months of rehab ahead of him but in September, he was back on a bike and by Halloween, he was full blown mountain biking. 

Sometimes there are happy endings!!! Ride on...


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## tjhspapa (Nov 29, 2010)

MSU Alum said:


> View attachment 1941190


Do you know of any studies regarding the risks and benefits of wearing a bullet proof vest while riding to protect oneself from said possum?


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## MSU Alum (Aug 8, 2009)

tjhspapa said:


> Do you know of any studies regarding the risks and benefits of wearing a bullet proof vest while riding to protect oneself from said possum?


Civil war era = good. M61 20mm.....mmmmm....not so good!
I'm sure I read that somewhere.


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## eytanm (Jul 31, 2021)

Statistics shows that


k2rider1964 said:


> A mountain biking full blown heart attack while riding survival story!!
> 
> April 8, 2017 San Clemente Singletracks Orange County, CA
> 
> ...


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## eytanm (Jul 31, 2021)

I guess this was not a cardiac arrest and a defibrillator wouldn't help anyway.
If it was, the guy wouldn't survive without immediate defibrillator shocks.


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## spaightlabs (Dec 3, 2011)

Maybe get a cardiac surgeon in your group and have him bring along a full surgical kit too?


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## FLYINW (Apr 26, 2016)

A defibrillator is for when the heart gets out of sinus rhythm and not effective on a heart attack or cardiac arrest.


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## rod9301 (Oct 30, 2004)

eytanm said:


> We are 15 bikers in the group, ages 70-85.
> We are arguing if carrying a defibrillator may be of real benefit, or the probabilities of cardiac arrest and survival are too low to justify the logistics, training, weight...
> I did not see any analysis, I hope to have your help in finding one.


I'm 72, and I'm amazed how old people want to hang on, more the older they get.

You'd think a young person should be more motivated not to die, because they have so many more years ahead of them.

Sent from my Redmi Note 8 Pro using Tapatalk


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## Sanchofula (Dec 30, 2007)

My wife and I talk about the folks we see who are the “worried well”. They worry about getting sick, being sick, and dying; but they're neither sick nor dying

So you wanna carry a portable defibrillator while mountain biking. How about when you travel, commute to work, go out to dinner and a movie, or when you’re sleeping

Your risk of having a cardiac event while mountain biking is lower than your risk of dying from an MVA on the way to the trail head.

This is definitely a worried well scenario…


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## jbhaji (Oct 9, 2019)

If you guys are healthy enough to ride I wouldn’t bother with a defibrillator.
They aren’t light and there’s a lot more to a code than just shocking the patients.
I would recommend taking a CPR course and if you are particularly concerned about yourself talk to a provider to see if you need a cardiac workup (stress test).


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## upstateSC-rider (Dec 25, 2003)

Hopefully there are many more good endings than bad but, locally, we did have a cardiac event with one of our local riders on a group ride a few years ago. I wasn't on the ride itself so I feel I can't really speak on specifics but I do know if it's a widow-maker experience, it doesn't matter if you're on the trail 10 miles in or at the corridor of the world's leading cardiac unit ...When it's your time, it's your time, carrying a defrib won't make a difference, like our favorite Canadian said, know current CPR guidelines.
RIP Mike Cox


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## Shark (Feb 4, 2006)

If it makes you or your group feel better, then do it. Take turns carrying it.

Personally I think it's a very slim chance that it would be helpful, but you never know.

I'd be more worried about a wreck/broken bone, or even getting hit by a car on the way to the trailhead.

Sent from my SM-G960U using Tapatalk


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## Smiles for miles (Feb 26, 2021)

I don't have anything useful to add but gotta say I'd rather die on a choice piece of singletrack than in a traffic jam somewhere!


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## Jayem (Jul 16, 2005)

And isn't a defib requiring an AED only one kind of heart attack?


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## Jayem (Jul 16, 2005)

FLYINW said:


> A defibrillator is for when the heart gets out of sinus rhythm and not effective on a heart attack or cardiac arrest.


This.


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## mudflap (Feb 23, 2004)

k2rider, that is a great survival story, Matt beat the odds in a huge way!

As a emergency responder for twenty years, I worked my share of code blues. Not ever pleasant, but if your patient survives, it's the best day of your life.

To begin with, if a cardiac arrest is witnessed, your odds of surviving begin to go up. If the person witnessing can activate 911, they go up even more. If said person knows CPR, well, they continue to climb. If an AED is available, your odds continue up. But survival rate, even for witnessed codes, are minimal.

Since AEDs aren't compact or light, I don't see the advantage of hauling one around on a bike "just in case." It would be better to attain a degree of health that would prevent the possibility of a heart attack before heading out on a bike. But that said, the exception does happen, and cardiac arrest can strike even the most fit person, however extremely rare.

As for a group of riders witnessing or coming across a person in dire straights, the first thing to do is confirm their airway isn't obstructed and that they are breathing - head tilt helps to open an obstructed airway. Put your cheek down by their nose/mouth and sense whether they are exchanging air. While doing this, try and get a pulse by palpating their carotid artery.

If pulse but no air, give mouth to mouth if possible.

If no pulse, start CPR compressions immediately, but activate 911 first if possible.

As stated above, an AED detects heart rhythm: Wikipedia - "An automated external defibrillator is a portable electronic device that automatically diagnoses the life-threatening cardiac arrhythmias of ventricular fibrillation and pulseless ventricular tachycardia..."

AEDs are meant to shock the heart back into a viable rhythm, but can sometimes stop the heart completely, and that's where CPR is most effective. CPR isn't nearly as effective when the heart is out of rhythm, so the point of defibrillating is to re-establish the hearts natural rhythm. Once re-established, CPR is more effective.

If the heart has completely stopped, CPR can be effective until paramedics arrive and are able to administer drugs, usually epinephrine (adrenaline,) and sometimes CPR can even re-establish a natural rhythm.

In twenty years of service, the survival rate of my patients was around <5%, and that was with an AED and paramedics on hand.

I'm not a doctor, was just a first responder, so what I've written above is open to discussion, based on my memory, and experiences that ended ten years ago when I retired.

Bottom line: learn and practice CPR, it's something you can take with you everywhere.


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## eytanm (Jul 31, 2021)

Thanks Mudflap for sharing your valued experience.
Comment: AEDs currently weigh about half of the water you carry, for instance: SAM 360P is 2.4 lbs. This is not a big deal.
Question: With your experience, have you met or heard about bikers group carrying a defibrillator?


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## MSU Alum (Aug 8, 2009)

eytanm said:


> Thanks Mudflap for sharing your valued experience.
> Comment: AEDs currently weigh about half of the water you carry, for instance: SAM 360P is 2.4 lbs. This is not a big deal.
> Question: With your experience, have you met or heard about bikers group carrying a defibrillator?


You really want to carry one, obviously.
Just do it!


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## Harold (Dec 23, 2003)

eytanm said:


> Question: With your experience, have you met or heard about bikers group carrying a defibrillator?


no. I am also a professional guide, and NONE of us carry them (for any activity, not just biking). I have Wilderness First Aid certs (will probably upgrade to WFR this winter, as I'm due to recert), and work with others who have Wilderness First Responder certs. Again, none of us carry them. We carry pretty hefty first aid kits, too.


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## fredcook (Apr 2, 2009)

cyclelicious said:


> BTW Maybe it's easier to learn to do CPR than to carry a defibulator. Does everyone in your group have their First Aid?


👍


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## fredcook (Apr 2, 2009)

Of the things I _might_ consider for older age mountain bike protection, I think I'd go with a riding suit/vest with airbags (like those for motorcycling) before hauling a defibrillator. I think it is far more likely to break something than suffering cardiac arrest.


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## Nat (Dec 30, 2003)

mudflap said:


> In twenty years of service, the survival rate of my patients was around <5%, and that was with an AED and paramedics on hand.
> 
> I'm not a doctor, was just a first responder, so what I've written above is open to discussion, based on my memory, and experiences that ended ten years ago when I retired.


The survival rate that you experienced reflects what the data shows (it's a bit worse, actually). Survivability is very low, anecdotes of success aside. Everyone should know how to do CPR anyway, just because there's that chance...

Back in undergrad I was a diener in a morgue and >90% of the post-mortem exams that I assisted on had died from heart disease. The arteries were totally clogged up with plaque. Heart disease is a serial killer.


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## Nat (Dec 30, 2003)

fredcook said:


> Of the things I _might_ consider for older age mountain bike protection, I think I'd go with a riding suit/vest with airbags (like those for motorcycling) before hauling a defibrillator. I think it is far more likely to break something than suffering cardiac arrest.


DH biking armor (including torso protection) is readily available.


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## eytanm (Jul 31, 2021)

MSU Alum said:


> You really want to carry one, obviously.
> Just do it!


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## eytanm (Jul 31, 2021)

No, I am just studying the issue. Not at all decided yet.


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## Nat (Dec 30, 2003)

eytanm said:


> No, I am just studying the issue. Not at all decided yet.


What additional info would sway you one way or the other?


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## eytanm (Jul 31, 2021)

Nat said:


> What additional info would sway you one way or the other?


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## eytanm (Jul 31, 2021)

Data regarding the frequency of cardiac arrest while biking, for instance:# cases per million hours of biking.
Data regarding the success of using a defibrillator and CPR on the trail: Survival rates up to the hospital, after a year, brain/ cognition...etc.
Real world, day to day experience in carrying a AED in a biking group: responsibilities, location in the line, communication...


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## MSU Alum (Aug 8, 2009)

eytanm said:


> Data regarding the frequency of cardiac arrest while biking, for instance:# cases per million hours of biking.
> Data regarding the success of using a defibrillator and CPR on the trail: Survival rates up to the hospital, after a year, brain/ cognition...etc.
> Real world, day to day experience in carrying a AED in a biking group: responsibilities, location in the line, communication...


You are waay too needy!


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## Harold (Dec 23, 2003)

eytanm said:


> Data regarding the frequency of cardiac arrest while biking, for instance:# cases per million hours of biking.
> Data regarding the success of using a defibrillator and CPR on the trail: Survival rates up to the hospital, after a year, brain/ cognition...etc.
> Real world, day to day experience in carrying a AED in a biking group: responsibilities, location in the line, communication...


have you considered that the scholarly research is what you should be searching instead of mtbr? Google Scholar is a pretty respectable aggregator these days, but it's not the only one. A good university library can set you up with other excellent search engines and search terms to find what you want. Reference librarians are actually professionals at finding the kinds of things you're seeking.


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## jimPacNW (Feb 26, 2013)

Good advice to get checked out to make sure you're not an accident waiting to happen: a friend of ours died at age 40 from a 'heart attack' while riding his mtb deer hunting. He had undiagnosed heart disease, but was active and appeared to be quite healthy.


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## mudflap (Feb 23, 2004)

eytanm said:


> Thanks Mudflap for sharing your valued experience.
> Comment: AEDs currently weigh about half of the water you carry, for instance: SAM 360P is 2.4 lbs. This is not a big deal.
> Question: With your experience, have you met or heard about bikers group carrying a defibrillator?


I had no idea they had been minimized to that degree. If you feel the need to pack one of those around, by all means, go for it. But remember, AED's don't save lives on their own. CPR with high flow O2 administered with AMBU (bag valve mask) are crucial for best results, not to mention intubation for more effective administering of O2. Then come the drugs.

So all in all, the AED is a small part of the package, critical as it is with v-fib or tachycardia. CPR works even if v-fib or tachycardia are occurring. I should add that CPR is only a halfway measure, keeping the brain viable until advanced life support measures are available, one of which is an AED.

In dealing with our code blues, the first thing we did was determine a lack of pulse. Next was compressions, then came O2, then AED.

And the breaking of ribs, that's for real on every CPR patient, usually ribs separating from sternum, and typically happens on the first compression. CPR hand placement is over the sternum and uses it to compress the heart.

Best of luck out on the trail, hoping you never have to deal with a life threatening medical emergency again.

Never heard of bikers packing AEDs.


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## 749800 (Jul 14, 2013)

The overall survival rate is about 10%.


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## Nat (Dec 30, 2003)

eytanm said:


> Data regarding the frequency of cardiac arrest while biking, for instance:# cases per million hours of biking.
> Data regarding the success of using a defibrillator and CPR on the trail: Survival rates up to the hospital, after a year, brain/ cognition...etc.
> Real world, day to day experience in carrying a AED in a biking group: responsibilities, location in the line, communication...


Yeah okay forget it. I'm not about to dig all of that up for you. Best of luck.


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## Jayem (Jul 16, 2005)

mudflap said:


> I had no idea they had been minimized to that degree. If you feel the need to pack one of those around, by all means, go for it. But remember, AED's don't save lives on their own. CPR with high flow O2 administered with AMBU (bag valve mask) are crucial for best results, not to mention intubation for more effective administering of O2. Then come the drugs.
> 
> So all in all, the AED is a small part of the package, critical as it is with v-fib or tachycardia. CPR works even if v-fib or tachycardia are occurring.
> 
> ...


The question I have is:

If you are considering lugging this around, why would you pass up other gear and safety equipment in it's place that would be far more likely to be used/useful in an emergency situation?


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## DrDon (Sep 25, 2004)

eytanm said:


> Data regarding the frequency of cardiac arrest while biking, for instance:# cases per million hours of biking.
> Data regarding the success of using a defibrillator and CPR on the trail: Survival rates up to the hospital, after a year, brain/ cognition...etc.
> Real world, day to day experience in carrying a AED in a biking group: responsibilities, location in the line, communication...


If you have a provider contact and if they are willing, the librarian in the medical library will do a literature search. I doubt there's much information. Not having crunched the numbers I suspect there's little utility. As others have mentioned few survive and if they do often there is brain damage. I don't know of any physician that would carry a AED on a group ride. Large events with the possibility of trauma or individuals with bad health, yes, but a few years ago the data didn't support one in our office. We have them now. Let us know if you find anything different.

Sent from my iPad using Tapatalk Pro


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## fredcook (Apr 2, 2009)

Jayem said:


> The question I have is:
> 
> If you are considering lugging this around, why would you pass up other gear and safety equipment in it's place that would be far more likely to be used/useful in an emergency situation?


That was my thought as well. Since we're talking about older riders, I'd forgo an AED for something like protective gear with airbags (as used in motorcycle racing) to protect our older bones. Far more likely to break something than suffer cardiac arrest... I think.


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## Antimatter (Jan 3, 2018)

I'd recommend seeing a doctor about doing rides that might put anyone at risk of cardiac arrest on the trails. Some kinds of activities are simply too high of a risk for certain kinds of medical conditions.


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## Harold (Dec 23, 2003)

DrDon said:


> Large events with the possibility of trauma or individuals with bad health, yes...


Pretty sure they still wouldn't have a rider actually carry one. Big events usually have first responders on standby, and THEY will have the ability (plus they'll have drugs and O2 and such). AFAIK, the folks out on the course usually just have big first aid kits for wound care and other more likely problems, and a radio to call for the professionals when more advanced care is necessary.



Jayem said:


> If you are considering lugging this around, why would you pass up other gear and safety equipment in it's place that would be far more likely to be used/useful in an emergency situation?


Exactly. I mean, okay, a couple pounds for an AED isn't actually too bad. But there's a whole lot of stuff that should be in your first aid kit and your training before you start thinking about an AED such that the whole package is going to weigh a whole lot more than just a couple pounds (and probably more importantly, be very bulky).


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## nOOky (May 13, 2008)

I suppose certain countries would install an implantable defibrillator for you if you have enough cash. I've heard it's like being kicked in the chest when it goes off to restore normal rhythm. Might interrupt the ride on flowing smooth downhill, or pedaling hard on the way up.

I've been defibrillated more than 7 times, but I was under every time. I've seen videos of people having it done, it does not look pleasant lol


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## shadowsports (May 10, 2009)

I'm not exactly young and super spry any longer, but if my health was in that level of question, I wouldn't need a Defib. since I wouldn't be going on the ride.

Either hire a pace vehicle or biker, or leave that equipment where it belongs. At home or in the hands of medical professionals. I think nitro pills are alright to carry, but the defib. unit is going a bit overboard unless again you have a designated person, med professional or EMT. Not sure if this is supported by data, but it is for sure supported by common sense.


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## chuckha62 (Jul 11, 2006)

I've had the "cardiac arrest while riding" discussion with my doc on more than one occasion and have come away feeling my chances of dying while riding are exceedingly low. We discussed situations which we both know of, where local "healthy" riders suddenly dropped dead on their bikes, in the last couple of years. His contention is/was that there were warning signs which, had they not been ignored, the guys would be alive today. 

In one case, I knew the guy and after speaking with his close friends, it turns out the guy had been having shortness of breath and chest tightness for a couple of weeks. He ignored his family's advice to go get checked out and rode anyway. 

Now, as for the AED... I work in an office where 80% of us are over 60 years old (I'm 59) and we decided that an AED was a good investment for us to have hanging on the wall. As for trying to lug one around on a bike, I think not.


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## DrDon (Sep 25, 2004)

Harold said:


> Pretty sure they still wouldn't have a rider actually carry one. Big events usually have first responders on standby, and THEY will have the ability (plus they'll have drugs and O2 and such). AFAIK, the folks out on the course usually just have big first aid kits for wound care and other more likely problems, and a radio to call for the professionals when more advanced care is necessary.
> 
> Exactly. I mean, okay, a couple pounds for an AED isn't actually too bad. But there's a whole lot of stuff that should be in your first aid kit and your training before you start thinking about an AED such that the whole package is going to weigh a whole lot more than just a couple pounds (and probably more importantly, be very bulky).


Didn't make myself clear. You are correct.

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## Gadi B (Jul 31, 2021)

Eytanm raised a week ago the question of carrying a defibrillator in a biking group. His question followed a recent post in my son's Ittai Facebook re a successful CPR I have performed while mountain biking using a defibrillator. The post became viral in Israel and many biking groups decided to purchace and carry a defibrillator. This is my son's post:
"This is my father, Gadi Bar-Joseph, holding the device (Automatic External Defibrillator - AED) with which he saved the life of Eitan, a member of his cycling group, last Monday.
It all started over 4 years ago when Gadi, a retired intensive care physician, went to comfort the family of a 50-year-old cyclist who died of a heart attack while riding. In that case there was a doctor in the riding group who immediately started resuscitation attempts, an intensive care unit arrived relatively quickly, the man was taken to a hospital but the doctors were unable to save his life. Gadi's conclusion was that if the riding group had a defibrillator available immediately, there was a good chance of saving the man's life, as this is the only means that can restore cardiac action in case of cardiac arrest due to ventricular fibrillation.
When Gadi returned home , he announced on the WhatsApp of his cycling group that he had decided to purchase an AED and anyone who wanted to participate in the funding is invited. He purchased the smallest model that was on the market at the time, a device weighing 1,100 grams , placed easily in the riding backpack. The group members underwent a short training in operating the device and since then it has been with them on every ride, usually on Gadi's back
Then came Monday 7.6.21.
The group was nearing the end of a light ride in pleasant weather in the oak hills near Tivon, when suddenly Gadi's phone rang. On the line was his teammate Orly: "Come quickly ... Eithan collapsed ... defibrillator." The time was 9:33. Since Eithan was in the rearguard, Gadi galloped back up the single, meeting Malki, a nurse by profession, on the way. They reached Eithan who was had no pulse and no breathing. Malki started immediately chest compressions, Gadi pulled the defibrillator out of the bag, pressed the green button and the device started talking (literally!) giving clear operating instructions: "Pull the green tab ... Continue chest compressions ... stick pads ... stay away ... giving an electric shock .. Continue compressions" and so on.
After one electric shock and another minute of chest compressions, Eithan's heart restarted, he had regained strong pulse and spontaneous breathing quite soon.
After 6-7 more minutes, an mobile intensive care unit arrived from the station in Yokneam, the team continued to stabilize Eithan's condition and evacuated him to Rambam's Cardiac intensive care unit. Eithan was "cooled" (induced hypothermia) for 24 hours, has regained full consciousness, underwent bypass surgery and is recovering with no neurologica sequella.
I decided to write this post about the miracle that saved Eitan's life. "Miracle" is my word. Gadi, who had run Rambam's Pediatric Intensive Care Unit for about 30 years, hates the use of this word in medical contexts - "There is no such thing as a medical miracle. There is knowledge, there is resourcefulness and yes, sometimes you need a little bit of luck. "
And why is it important to Gadi that this story be told?
Gadi estimates that Eithan's heart stopped beating around 9:32, shortly before Orly called him at 9:33. He activated the defibrillator at 9:37 (this is documented in the AED's software). These are the "critical minutes". Chest compressions are of vital importance, but the most critical factor that determines whether the heart can restart is the time period from cessation of its action until the first electric shock is given. Being (biking) on the open countryside, there hardly exists any chance that an advanced resuscitation team (with a defibrillator) will reach the scene soon enough to rescue a person who has suffered a cardiac arrest. Only the presence of an immediately available defibrillator can bring the heart back in such a case.
Thousands of women and men in Israel currently bike in various amateur and half-professional settings. Many of them are 45-60 years old, the main risk group for cardiac arrest. It should be stressed - cardiac arrest is not unusual in perfectly healthy people, including in young and sturdy athletes. Therefore, in Gadi's opinion, every riding group, of all ages, should carry an AED. Most of these devices are small and light, almost no training is required to operate them and they cost a few thousand shekels. The amounts that riders invest in bicycles and accompanying equipment are immeasurably higher.
** It is important for me to clearly state - my father, Gadi Bar-Joseph (or me), has no business relationship with companies that manufacture or sell AED's, and has nothing to gain other than the knowledge that other people's lives may be saved by increasing awareness of among bikers (and other sporting groups). ** "

I continue carrying the AED on my back...Yes. it add's some weight and I don't ride electric bikes. Any comments?


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## MSU Alum (Aug 8, 2009)

Gadi B said:


> I continue carrying the AED on my back...Yes. it add's some weight and I don't ride electric bikes. Any comments?


Only that if you want to carry one, do so.
Maybe everyone should carry an epipen too just in case.
Might as well add in one of these: Stop the Bleed Kit - Personal | Red Cross Store


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## Nat (Dec 30, 2003)

Gadi B said:


> On the line was his teammate Orly


ORLY! LOL. NVM. JK.

Everyone should feel free to carry as much safety equipment as they'd like: AED, epipen, saline, sutures, fracture splint, etc.


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## mtbdudex (Jan 13, 2020)

MSU Alum said:


> Only that if you want to carry one, do so.
> Maybe everyone should carry an epipen too just in case.
> Might as well add in one of these: Stop the Bleed Kit - Personal | Red Cross Store


Came across this thread , just yesterday I posted in our local Facebook group "what's in your camelback ?" Pict below 
3 things related to wellness not in mine but others: epi-pen, bandaids, sugar tablets. 
I'll add bandaids to my stuff.
Fwiw, I'm 59.









I'm curious what the OP and group of 15 take on their rides now.

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