DBS, CPR, and AEDs

Neural network

The following blog is an edited version of a guest post I wrote in February 2013 for a now dissolved foundation, The Parkinson’s Assistance, Network, Directory, and Alliance and revised for The Parkinson’s Hub blog.  — Cyndee Williams Bowen, SLP

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I renewed my Cardio Pulmonary Resuscitation (CPR) certification recently, and much of the day’s training focused on the safe and proper use of Automatic Electronic Defibrilators (AEDs). It was interesting that the trainers talked quite specifically about cardiac pacemakers and the dangers of AED use near their subcutaneous battery packs, but they never mentioned people with Parkinson’s Disease and the impulse generators (IPG) used in Deep Brain Stimulation (DBS). So you know I asked!

The trainer responded to my question with an immediate and reasonably accurate answer; however, his body language shouted loud and clear that he had never really considered DBS and IPGs. I was very pleased when he said, Hold on. I want to confirm my answer. I am happy to say that when he returned he was more knowledgeable about DBS, CPR, and AEDs. I’d like to think that we all came away with a stronger awareness of an issue that is critically important for many people with Parkinson’s Disease.

In fact, the experience piqued my own interest and I did a little digging to “confirm his confirmation.” I quickly located the answer among the Frequently Asked Questions on the Parkinson’s Disease Foundation website. Here is what I found:

Aug 14 2008

Q: I am a CPR instructor for the Red Cross and I recently held a class with a trainee whose father had undergone deep brain stimulation for his Parkinson’s disease. The trainee asked if using the automatic electric defibrillator (AED) on a person with deep brain stimulation can be harmful. Can you help me answer this question? (anonymous).

A:The short answer is yes, AED (automatic electric defibrillator) can harm the pulse generator and the patient. But if one is attempting to save a life, the device should be used. It is suggested to use the lowest wattage, avoid having the current cross over the IPG (the stimulator) or its wires, and if possible, turn the IPG off while using the AED.

Copied from the Frequently Asked Questions page of the Parkinson’s Disease Foundation website on Monday, 2/18/2013.

This is important information for CPR certified individuals, people with Parkinson’s disease, and caregivers. The fact that I had to raise the question about DBS and the trainer had to leave the room to verify an answer indicates that responders are not universally familiar with this technology. My experience leads me to make two recommendations to people with PD who are receiving DBS treatment and their caregivers:

(1) Use a medical alert system, keep your information up to date, and be sure you are identified as a user of DBS with instructions on how to deactivate the unit, if possible.

(2) Have a “back up plan” in the form of written emergency instructions on hand at all times.

I know this topic doesn’t directly pertain to every person with PD. Still, I think it is important that those of us who are CPR certified be aware that there are special circumstances to consider when we are called upon to electronically defibrilate a person receiving DBS for Parkinson’s Disease. There may be more considerations that should be made. I have not provided an exhaustive list, so I highly recommend that people with DBS for PD who are reading this blog check with their medical professionals and/or the many wonderful foundations who provide exhaustive materials on such topics.

In fact, links already provided within this article can take you to more information. For something a little more casual and written in the voice of a person with DBS for PD, I recommend you visit the blog of my friend, Beverly Ribaudo. Bev writes Parkinson’s Humor in an easy-to-read-and-understand style. She includes a great explanation of DBS and several posts describing her journey with the treatment.

Thanks for reading my blog! Please feel free to comment. I always enjoy reading your thoughts and suggestions!

CyndeeBlue2

Cyndee Williams Bowen is a Speech-Language Pathologist and owner of Bowen Speech-Language Therapy, LLC in  Clearwater, FL.  She provides quality, creative, collaborative service to help clients achieve their
goals and an improved quality of life. Visit the Bowen Speech Website for more information.

5 thoughts on “DBS, CPR, and AEDs

  1. Update! I’ve just happened upon a medical alert solution to this problems. It is called Epic-ID, an affordable bracelet that stores important health info via USB port. You can learn more about it at http://www.touchofmodern.com. (Disclaimer: I am not affiliated with this company in any way whatsoever. I’m just happy to see affordable products like this becoming more available!) Cyndee

  2. American Heart Association CPR instructors are trained to cover the steps and precautions needed for implanted pacemaker/defibrillators. Unfortunately, IPGs are not part of the course material.
    The reply from the Parkinsons Disease Foundation was very helplful, but please keep in mind – Administering the lowest effective defibrillation dose will only apply to trained Advanced Life Support healthcare providers since they will most likely be using a manual defibrillator. Any lay provider will be using an Automatic External Defibrillator with no option to change the energy setting. In this case, the best practice, as stated in the blog, is being cautious to avoid placing the AED pads on the device or across the leads.
    Thank you for posting. This information will help in future classes when the subject comes up.

  3. Thank you so much for this information. My father has a DBS system for Parkinson’s and your blog post has helped me to be better informed in case we need to use an AED on him in the future.

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