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How a Hardware Designer Was Saved By His Own Creation

Posted by timothy on from the if-you-don't-like-this-you-have-no-heart dept.

szczys writes Would you do a better job designing hardware if your life depended on it? Chris Nefcy is in that exact position. Years ago he developed an Automatic External Defibrilator for First Medic. The device allows non-doctors to restart a human heart in the field. When Chris had a heart attack his ticker was restarted with shocks from his own hardware. His story isn't just heartwarming, he also covers the path that led him into developing the AED and the bumpy road encountered getting the hardware to market.

60 comments

  1. soooo by Anonymous Coward · · Score: 5, Funny

    does that mean nobody can accuse him of being unable to design something to save his own life?

  2. Not automatic by penguinoid · · Score: 1

    He may have designed the machine, but it still needed some trained personnel to zap him. I suppose it's a win that less training was required than with the previous defibrilators, but it's not like he build one that was attached to him like an external pacemaker.

    --
    Don't waste your vote! Vote for whoever you want, unless you live in a swing state it won't matter anyways
    1. Re:Not automatic by Anonymous Coward · · Score: 0

      Wow man, that's cold. If it was an internal pacemaker, you'd probably be like, "yea, but he didn't assemble it with his own hands! ... or perform the surgery on himself to install it! ... or mine the minerals needed to construct the battery!"

    2. Re:Not automatic by gslavik · · Score: 2

      The nice thing about AED is that you only need to learn two things about using it: 1. how/where to place the pads, 2. follow what it tells you and make sure everyone is clear of the person getting the shock.

    3. Re:Not automatic by thegarbz · · Score: 4, Informative

      There is zero training required to operate an AED.

      If you can't figure out how to open the zip and push the big button marked ON, then I'm amazed you figured out that the person needed first aid at all.

    4. Re:Not automatic by QQBoss · · Score: 5, Informative

      Trained personnel? If they were capable of reading the instructions that were in the case, or listening to the directions spoken by the machine, that covers about 95% of what training is really required for a normal adult.

      I am a certified First Aid/CPR/AED instructor for the American Red Cross. The level of training required to use an AED if you are calm, cool, and collected (and no cross-chest nipple piercings are involved) is less than is necessary to assemble a table from Ikea. That said, when you need to use one, calm, cool, and collected are frequently out the window, which is why training is recommended. Almost anything you can do wrong, the machine will let you know that something is wrong so you can correct it. Many kits even come with a razor to deal with the overly hirsute. Oh, and I was involved with building an internal pacemaker capable of phoning home to the doctor (though you had to hold the phone up to your chest, it couldn't reach out and grab it) back when they still required DSPs.

      The AEDs automatically analyze heart rhythms (or lack thereof) and notify the operator to push a button if a shock is required. They will provide a shock for two different rhythms- V-fib (Ventricular Fibrillation) and V-Tach (Ventricular Tachychardia). They will not shock for asystole (no electrical heart signals detected at all, and must be avoided so you don't try using an AED to jump start your car or do some tiny welding) and PEA (pulseless electrical activity- the wiring is working, but the engine is dead).

      Long story longer: Heart Attacks are NONE of these cases. AEDs WILL NOT PRODUCE A SHOCK for a heart attack, which is simply the blockage of blood to the heart, usually caused by a clot breaking loose. Heart attacks can result in cardiac arrest, which does result in one of the four cases above, but an AED will do nothing for a simple heart attack. TFA correctly describes that he had a cardiac arrest (sudden dropping to the ground), but incorrectly says he flat-lined (asystole, AED wouldn't have helped in that case) and that he had a heart attack (if he only had a heart attack, he could have walked off the court and hopefully gotten a quick ride to a hospital).

      Any more info needed? I strongly encourage you and everyone to take a First Aid/CPR/AED class from whatever qualified source is available (Red Cross, Heart Association, etc). The chance that you will ever need to perform CPR is pretty low, but I have had to deal with a choking in a restaurant, a compound fracture at a swimming pool, a petite mal siezure on a subway, and other situations that are far more likely.

    5. Re:Not automatic by Anonymous Coward · · Score: 3, Funny

      The nice thing about AED is that you only need to learn two things about using it: 1. how/where to place the pads, 2. follow what it tells you and make sure everyone is clear of the person getting the shock.

      That's three things.

      You should come in again.

    6. Re:Not automatic by Anonymous Coward · · Score: 0

      built one *

    7. Re:Not automatic by stephanruby · · Score: 1

      He may have designed the machine, but it still needed some trained personnel to zap him.

      Obviously, you don't watch James Bond movies.

    8. Re:Not automatic by Anonymous Coward · · Score: 0

      to be honest an AED actually tells you to stand clear.
      So the second part of step to is just superfluous, not an actual step.
      In fact an AED also explains how to do step 1.

    9. Re:Not automatic by worf_mo · · Score: 3, Insightful

      In Italy it is now obligatory for sports clubs to have an AED and certified people who can use it. I took a day-long CPR/AED class just two weeks ago, together with other members of our club. The device is actually really easy to use - press a button, listen to the directions, place the pads and hope for the best. But when the machine can't produce a shock (for the reasons outlined by QQBoss above) one still needs to perform CPR, and that's what the biggest part of the course was about.

      I second QQBoss and encourage everyone to take a First Aid/CPR/AED class. You can't do anything wrong - once a person is unconscious and is not breathing normally, it is just a question of time before they completely shut down. By acting immediately and administering First Aid until the cavalry arrives you can help raise their chances of survival and minimize possible collateral damage and recovery time. Should you crack a person's rib during CPR you were probably doing it wrong, but the fact that they are able to complain means that you have contributed to saving their life (and in many countries/jurisdictions you are protected by Good Samaritan law).

    10. Re:Not automatic by Paradise+Pete · · Score: 4, Funny

      That's three things.
      You should come in again.

      *Nobody* expects to have a heart attack and need to use a defibrillator!

    11. Re: Not automatic by Anonymous Coward · · Score: 0

      Yea they are very easy to use. We have 2 of them on each floor of our building at work. They haven't been used yet but I'm sure knowing they are there makes some people happy. Although now that I think about it there isn't anyone at work who looks like they could have a heart attack at any moment despite a very broad range of ages.

    12. Re:Not automatic by kilodelta · · Score: 3, Informative

      No training involved. If you've ever seen an AED it's got the instructions printed right on it, with pictorials and everything. I note they're pretty much everywhere these days, even in office and public spaces.

      Now the thing about AED's that interests me is who is going to put the pads on you and activate the machine? The whole bystander effect and all.

    13. Re:Not automatic by silas_moeckel · · Score: 1

      By less you mean the ability to follow ikea level pictures only instructions. Hell the new gen include cellphones that call 911 the instant you pull it off the wall without the override "key" so a dispatcher can walk you though it if needed, the cell phones lets them know where to send help to.

      --
      No sir I dont like it.
    14. Re:Not automatic by Anonymous Coward · · Score: 0

      And when your life depends on a random bystander being able to read a manual...

      oh crap.

    15. Re:Not automatic by demonlapin · · Score: 1

      Should you crack a person's rib during CPR you were probably doing it wrong

      No, you're probably doing it right. Most people don't push hard enough.

    16. Re:Not automatic by demonlapin · · Score: 1

      Which is why training in CPR/BLS (basic life support) is valuable - it explicitly teaches you to bypass the bystander effect and start ordering people what to do. When someone more qualified shows up, you can relinquish command, but until then, you're in charge.

    17. Re:Not automatic by QQBoss · · Score: 1

      Demonlapin is correct: if you are doing proper chest compressions, there is a high likelihood you will crack the ribs of most adults over 40 (almost guaranteed if a woman over 60), and a reasonable likelihood of doing it to younger adults.

      But, if you got out of the training that you should only do CPR if the AED doesn't work, you misheard the instructor. You shouldn't attempt to use an AED until after the first round of CPR has been performed (though not taught by the ARC at this point to lay rescuers, some schools of thought suggest that no initial rescue breaths are required for the first round if an AED is known to be available or professionals will be on the scene in less than 4 minutes from witnessed collapse). The AED should not be used until at least one round of chest compressions has been attempted. There are multiple reasons for this, which I won't go into. That you need to continue CPR if it can't shock the patient, or if the patient doesn't respond to the first shock, is, of course important. And that you should STOP doing CPR if the person does respond, hopefully that is a given, 'cause it does hurt when done properly!

    18. Re:Not automatic by Anonymous Coward · · Score: 0

      Oblig.
      http://xkcd.com/1343/

    19. Re:Not automatic by worf_mo · · Score: 1

      You are right. Most people apparently don't push hard enough when performing their first CPR, I guess that's what our instructor meant when he said that broken ribs (as a result of CPR by non-professionals) are usually caused when pressure is not applied to the sternum from the top. Nonetheless, he continued to underline the importance of a timely help, no matter how small, even if not performed perfectly or professionally.

      The instructor also touched all of the other points you raised (including the first round of CPR). For the better part of the day he covered what to do when no AED is available and you are on your own with a patient. I really liked this class. None of us is a pro after a day-long course, but it really conveyed the message that even us lay people can make a difference until the trained professionals arrive.

    20. Re:Not automatic by penguinoid · · Score: 1

      Well if it was truly automatic, it could be a robot that detects when someone is having a heart attack and goes and zaps him. Such a thing would be technically possible now, although the manufacturer would likely get sued into oblivion.

      --
      Don't waste your vote! Vote for whoever you want, unless you live in a swing state it won't matter anyways
    21. Re:Not automatic by penguinoid · · Score: 1

      Even if the training consisted of "That box over there, you should use it on someone when they're having a heart attack" it would be too much for the average untrained person. Not because it would be too complicated, but because people aren't good at acting when in a panic.

      --
      Don't waste your vote! Vote for whoever you want, unless you live in a swing state it won't matter anyways
    22. Re:Not automatic by stoatwblr · · Score: 1

      Those who aren't clear will make damned sure they are for the next one.

  3. wrong by slashmydots · · Score: 2

    For the 1000000000th time, defibrillators don't start your heart, they stop it. That's how they all work. Look it up.

    1. Re:wrong by penguinoid · · Score: 4, Insightful

      For the 1000000000th time, defibrillators don't start your heart, they stop it. That's how they all work. Look it up.

      Well since it's nerds: it's like pressing the reset button (not the power on button).

      --
      Don't waste your vote! Vote for whoever you want, unless you live in a swing state it won't matter anyways
    2. Re:wrong by ThatsMyNick · · Score: 2

      AED (provided someone is following the instructions it gives), does both.

    3. Re:wrong by Anonymous Coward · · Score: 0

      defibrillators don't start your heart, they stop it

      THEN THEY'RE SUPER DANGEROUS OMG

    4. Re:wrong by Anonymous Coward · · Score: 0

      Well said.

      You have earned the right to spend your Saturday in the basement masturbating and drinking cheap whiskey. Enjoy!

    5. Re:wrong by FatLittleMonkey · · Score: 3, Insightful

      The AED can't restart the heart from true "flat line" (asystole). You have to force the heart into some kind of activity using manual CPR, and ideally a suitable drug, to give the AED something to bite on.

      However, tachycardia can appear pulseless even though the heart is still beating (dysrhythmically), and the AED alone can shock-stop that dysrythmia and allow the heart to restore its own timing. That's where the advice to use the AED "even if their heart has stopped" comes from; their heart hasn't actually stopped.

      --
      Science is all about firing a drunk pig out of a cannon just to see what happens.
    6. Re:wrong by thegarbz · · Score: 1

      Except TFS doesn't say stop, it says "restart"

    7. Re:wrong by ThatsMyNick · · Score: 1

      Rescue breathing and chest compressions are part of the instructions given by AED, atleast the one I trained on did. It takes of timing for breathing and beeps for the compression rhythm.

    8. Re:wrong by Anonymous Coward · · Score: 0

      defibrillators don't start your heart, they stop it

      THEN THEY'RE SUPER DANGEROUS OMG

      That's why, when the machine says "Stand Clear Stand Clear Stand Clear", you stand the fuck clear.

    9. Re:wrong by Anonymous Coward · · Score: 0

      Hey, where's *MY* right to do that?!

    10. Re:wrong by Anonymous Coward · · Score: 0

      For the 1000000000th time, defibrillators don't start your heart, they stop it. That's how they all work. Look it up.

      And gee, for some fucking reason society decided to use the word "start" instead of "stop" to avoid confusing people when reading about how emergency responders "save" lives.

      Or would you prefer we start using the term "take" lives, instead, to avoid a lawsuit from the afterlife?

      Grow the fuck up. Adults know the meaning of the term "gist of it". This is semantics for semantics sake, and makes a Grammar Nazi look kind by comparison.

    11. Re:wrong by wierd_w · · Score: 1

      Non-rythmic "pulsaion" of the heart is ventricular fibrilation, not tachycardia. Tachycardia is an abnormally fast, shallow rythm. It can LEAD to fibrilation, because it can try to contract faster than it is physically able to, leading to spasm-- but it itself is just very fast rythm.

      The CPR/AED instructor is correct, however. An AED stops the heart's electrical activity after it goes crazy and stops beating in a useful rythm, but is still trying to beat. This forces the heart to pause, then start beating again. When the heart is in ventricular fibrilation, it is not pumping blood, and is instead basically just squirming around in there having a major spasm. When it stops, it is able to fill with blood again, and when it starts pumping it actually has something inside it to pump, and it gets its rythm back. (Hopefully.)

      The heart starts beating again on its own. The AED does not shock it into restarting. Manual chest compression, with a full, deep compression cycle of about 1 beat per second, (Or , amusingly, about the tempo of old 1970s disco music) with appropriate compression to breath ratio for the patient (different for children than for adults) is how you restart a stopped heart, or at least buy time for EMS paramedics to provide inter-cardiac adrenaline and take over.

      CPR is the major life saver; the AED is a valuable tool, but its use cases are limited. CPR trained first responders have only their fingers to check for pulses with, and to determine if the patient has entered a dangerous arythmia or not-- which is why it is a common practice to attach the pads of the AED to the patient and turn the AED on-- and the let the AED's electrical activity analyzer determine if administering a shock is appropriate or needed, while the CPR practitioner performs manual breathing and chest compressions. Trust me, full attention should be on the breathing and compressions, because letting up on the compressions, even just a little, will result in the patent's blood pressure dropping and suffering anoxia in their central nervous system and other blood hungry organs, greatly complicating their chances of recovery.

        When you stop to give breaths, their blood pressure drops back down to 0. This is why 2-person CPR is better than 1-person CPR. If you can conscript a bystander to assist in providing CPR for an arythmia victim, the chances of your patient surviving increase. The major things of concern are the quality of the airway, the quality of the compressions given, the number and frequency of rescue breaths provided, and the amount of time that CPR has been administered. (Chances of good recovery start depleting rapidly after having to start CPR. Manual chest compression gives some blood pressure and blood oxygenation, but is NOT a substitute for normal heart and lung function. The sooner tha patient stabilizes by developing a pulse and respirations, the better the prognosis of the patient in most cases.)

      CPR is stopped only when the patient develops a stable rythm and respiration cycle, when EMS paramedics arrive to relieve you, when a doctor pronounces death, or when you are too exhausted to continue.

      The AED is there to help you get a patient out of ventricular fibrilation or shock induced tachycardia (which often leads to ventricular fibrilation). That's all it's for. The rest is up to the responder's skill at delivering chest compressions and rescue breaths to maintain oxygenated blood flow and blood pressure levels. That's just the way it is.

    12. Re:wrong by Anonymous Coward · · Score: 0

      For the 1000000000th time, defibrillators don't start your heart, they stop it.

      1000000000th? Really? Citation needed, as they say.

  4. Heartwarming by Anonymous Coward · · Score: 0

    Defibrillators are only heartwarming if they use too much amperage.

  5. AED crowd-funding / foundation anyone? by maryhit · · Score: 1

    Allover internet we see a high need for AEDs, and schools and other public places in big need for AEDs, due to very high price. Isn't it possible to have the costs lowered? A smart mobile phone is overall hundreds of times more complex, full of patents, still much cheaper (~500$) than a defibrillator (1500-3000$). Yes, phone is cheap as it's sold in many exemplars, but so would be a reasonably priced AED which would literally save lives around the world. Probably many would happily invest both technical knowledge for building it and money for the "scary part": required ratification/certifications of the device on few continents (US, EU, etc). A foundation like Rasbperry Pi would do miracles. Or maybe even approach RPi foundation to extend their programming&HW challenge for both the algorithm and required hw implementation? What would ./ readers suggest?

    1. Re:AED crowd-funding / foundation anyone? by Anonymous Coward · · Score: 0

      This... The AED has an expensive battery and some high voltage parts and that is about it. It should be in the $100-300 range.

    2. Re:AED crowd-funding / foundation anyone? by tlambert · · Score: 1

      Allover internet we see a high need for AEDs, and schools and other public places in big need for AEDs, due to very high price.

      What would ./ readers suggest?

      Tort reform to reduce insurance liability for the manufacturers so that you aren't paying for "accidentally kill someone / fail to save someone ho was beyond saving" insurance in the price of the device for litigious people grieving for their dead loved one a whole lot more than their dead loved one's life is actually worth, compared to the number of people who could be saved were the devices cheaper.

      Also, the insurance companies get paid 3 times on each device:

      (1) The manufacturer's liability insurance

      (2) The emergency responders malpractice and/or liability insurance

      (3) For you to go to the hospital afterwards

      Seems kinda wrong to pay an AIG member company 3 times for the same thing, doesn't it?

    3. Re:AED crowd-funding / foundation anyone? by JaredOfEuropa · · Score: 1

      Give it time, prices are coming down. They used to be way more than $1500-$3000. Today, there are cheap ones for €800 (around $950), and that's including our insane VAT. The one I got was €1000 and came with a spare battery (a pricey item) and free servicing for 3 years.

      --
      If construction was anything like programming, an incorrectly fitted lock would bring down the entire building...
  6. Mandatory Pratchett quote. by bruce_the_loon · · Score: 3, Funny

    Suppose this article inverts the story, but still...

    It's a pervasive and beguiling myth that the people who design instruments of death end up being killed by them. There is almost no foundation in fact. Colonel Shrapnel wasn't blown up, M. Guillotin died with his head on, Colonel Gatling wasn't shot. If it hadn't been for the murder of cosh and blackjack maker Sir William Blunt-Instrument in an alleyway, the rumour would never have got started.

    --
    Trying to become famous by taking photos. Visit my homepage please.
    1. Re:Mandatory Pratchett quote. by FatLittleMonkey · · Score: 4, Informative

      Since I've already been a pedantic wanker in this thread, I might as well dance...

      "Colonel Shrapnel wasn't blown up, M. Guillotin died with his head on, Colonel Gatling wasn't shot. If it hadn't been for the murder of cosh and blackjack maker Sir William Blunt-Instrument in an alleyway, the rumour would never have got started." - Feet of Clay

      Henry Shrapnel died a lieutenant-general, and was posthumously promoted to major-general. Convention is to use that final rank, however even if you are trying to be contemporaneous, he invented the eponymous shell while a lieutenant, so colonel is still wrong.

      Richard Gatling was a medical doctor before becoming an engineer/inventor. He ran his engineering company during the US Civil War, and AFAIK he never served.

      Likewise, Joseph-Ignace Guillotin was a French physician. Hence Docteur Guillotin, Monsieur Docteur, even Monsieur Medicins, but never Monsieur Guillotin. (Wikipoo says that Guillotin didn't actually invent the guillotine and opposed the death penalty, his family ended up changing their family name due to the shame. Also that a guy called Guillotin was guillotined.)

      And finally, Willem Blunt was never knighted, the most he ever got was an OM. "Blunt Instrument" was also a nickname, not his actual surname. So, Willem "Blunt Instrument" Blunt OM. And he died after drunkenly falling off a horse, not being bashed in an alley.

      Sir Terence Pratchett, OTOH, has an OBE and is fully entitled.

      --
      Science is all about firing a drunk pig out of a cannon just to see what happens.
    2. Re:Mandatory Pratchett quote. by bruce_the_loon · · Score: 1

      *tips hat*

      --
      Trying to become famous by taking photos. Visit my homepage please.
    3. Re:Mandatory Pratchett quote. by Anonymous Coward · · Score: 0

      *tips trillby*

    4. Re:Mandatory Pratchett quote. by FatLittleMonkey · · Score: 1

      Thanks. But "+5 informative"? A bunch of wiki-scraping to set up that penultimate line. What is wrong with people? Sheesh. What does a troll have to do to earn some disrespect around here?

      --
      Science is all about firing a drunk pig out of a cannon just to see what happens.
  7. Causation? by Anonymous Coward · · Score: 0

    The "bumpy road getting the device to market" sounds like it was what caused the heart problems to begin with ...

  8. _________ by Anonymous Coward · · Score: 0

    Nelson Wright: "Hello, I'm nice, he's nice, we're both fucking lunatics. Can I come in, please?"

    http://www.imdb.com/title/tt00...

  9. Premium Account by Christina+Smith · · Score: 0

    The Life is a stage of a drama. We are the characters of this Drama. So enjoy your life. Exploring something new visit me http://mixpremiumpass4u.blogsp...

  10. His story isn't just heartwarming... by Anonymous Coward · · Score: 0

    ..it would have been heart-warming if he had been using Sony laptop batteries to power the pacemaker...

  11. Heartwarming by Anonymous Coward · · Score: 0

    Boom Boom,

    (I appreciated it)

  12. Isambard Kingdom Brunel did it 170 years ago. by 140Mandak262Jamuna · · Score: 1
    Isambard Kingdom Brunel , the engineer who built tunnels under the Thames, bridge across it, built the largest steam-sail hybrid ship ever did it even more spectacularly.

    In the 1840s he accidentally inhaled a coin that got lodged in his windpipe. None of the existing forceps could remove it. He designed a special forceps himself which failed. Then designed a contraption which too failed to remove it. Then he and his father designed another contraption where he was strapped upside down and mallets stuck his back and shoulder blades at some precisely calculated angles. That knocked the coin loose. It took them couple of months to extract the coin.

    --
    sed -e 's/Chuck Norris/Rajnikant/g' joke > fact
    1. Re:Isambard Kingdom Brunel did it 170 years ago. by Immerman · · Score: 1

      If it took a couple months to extract the coin, was it really his life that was in danger, or just his comfort?

      --
      --- Most topics have many sides worth arguing, allow me to take one opposite you.
  13. Really? by Anonymous Coward · · Score: 0

    All of the arguing over a guy whose life was saved because someone had the courage to act? Geesh...

  14. Eating your own dogfood? by jeffb+(2.718) · · Score: 1

    It was bad enough when the VoIP startup I worked for tried to make us use our own softswitch for phone calls in the office...

    1. Re:Eating your own dogfood? by Anonymous Coward · · Score: 0

      Hooray for him! As I programmer, I generally happy "eating my own dog food", so I can relate. He sure takes it to another level!

  15. "restarting hearts" by Anonymous Coward · · Score: 0

    AED's do not restart flatlined hearts. They stop them from fibrillating.

  16. Good for him! by Tony+Isaac · · Score: 1

    People who invent things that save lives...SHOULD be rewarded. It's nice to see somebody get the benefit of their own contribution to humanity. Kudos!