There was a very interesting and extensive thread detailing the pros and
cons of AEDs at boathouses on the rowing master's newsgroup.

http://sports.groups.yahoo.com/group/rowingmasters

I found this particular post to be very enlightening (yes, it is geared
towards older rowers, but also addresses younger athletes):

Re: Boathouse AEDs

As a cardiologist and long time competitive masters oar, I need to weigh
in on
this issue.
This topic is immensely complex and must not be reduced to the issue of "AED
or no AED", or "Which AED?" or "Where to place the AED."
The issue is: "How best to minimize the extremely small risk of having, or
dying of, a cardiac event associated with the effort of training, racing, or
rowing."
First, no one (myself included, and I have diligently sought such data
for 11
years) can give a precise answer as to how small this risk is. The reason is
that your national governing organization, USRowing, has never even tried to
establish a data base, much less an investigation, of cardiac events (or
deaths)
associated with rowing. If you ask USRowing (or anyone else) the simplest
question: "how many people have died associated with rowing events?"
they cannot
answer. The information is simply not there. Period. (There may be such
a data
base and answer available in Italy, by the way.)
Second, the risk of cardiac event or death associated with exercise is
heterogeneous, and falls into 2 groups: congenital problems, usually
manifest in
athletes <35 years old (this age cutoff is arbitrary); and coronary
problems,
usually in athletes > 35. This is not absolute: Sergei Grinkov died of
coronary
disease at 27.
Third, even under ideal circumstances, the successful resuscitation rate for
cardiac arrest is dismal. "Ideal circumstances" does not by the way include
"collapse in a narrow shell surrounded by water" or "collapse on a beach
in an
isolated area". "Successful resuscitation" is defined as a person
surviving an
event with good neurological function, i.e., without significant brain
damage.
While I agree that CPR training and AED instruction and/or availability is
useful in an ideal world, the reality is that once an arrest-event
begins, you
are about 2 lengths down with 300 meters to go. You are going to run out
of lake
before you make up the deficit. After approximately 3-4 minutes of CPR in an
arrest event, the likelihood of severe brain damage is extremely high. This
includes giving CPR in stable hospital beds and on firm concrete
sidewalks,both
of which I have done several times, not giving CPR in, say, bow seat of
an 8.
Fourth, The only key to minimizing risk of sudden death, or heart attack
(these are completely different entities), is primary prevention. The
object of
the game is to prevent having to initiate CPR, or deploy an AED. And on
statistical grounds, this type of prevention, especially in a population
such as
ours, is fabulously difficult. Should rowers all have a treadmill test? or a
'coronary calcium study'? or an EKG? or a cholesterol study? or a
physical exam?
The answers are no, no, no, no, and no. Why? The reason is that weasel-word
'all.' There is simply no one-size-fits-all approach to primary
risk-reduction.
Screening 20-year-olds with a treadmill test is preposterous. Screening
50-year-olds with an echocardiogram is equally preposterous.
This information is not meant to be depressing or nihilistic. I wish to
point
out to my fellow oars (or, by the way, coaches or judge-refs) that
prevention is
neither simple, free, nor cookbook.
A reasonable approach is something like this: in younger oars, try to
exclude
congenital problems. Consider using the Bethesda conference
recommendations for
a thorough symptom-and-family-history related questionnaire, and possibly an
EKG.
In older oars, try to exclude dangerous coronary disease. Do global
risk-assessment, with regard to family history, cholsterol issues, prior
smoking
history, and diabetes.
I have a very low threshhold for initiating cholesterol treatment with
statin
therapy. The reason for this is that in approximately 12--15 multicenter
controlled trials, involving now >100,000 patients, there is between a
25%--45%
event reduction in the treatment group, depending on underlying risk. If
your
LDL is >100, your HDL is <40, or your triglycerides are >150, have a
chat with
your doctor. (I am perfectly aware of current NCEP-3 recommendations. I am
equally aware that cardiovascular disease kills 1 in 3 Americans,
regardless of
gender.)
Above all--and this is the take-home message for this whole post: if
there are
warning symptoms of coronary ischemia, do not ignore them. In the events
I have
personally investigated, which are by now numerous, the majority had warning
signs. These warning signs include classic angina (effort-related squeezing,
pressing, aching, 'heartburn' in the upper chest, with or without jaw or arm
pain. Or it may include unusual shortness of breath with effort (yes, I know
perfectly well the audience I am addressing. I pull an 18.44 5K.) Or it may
include a single episode of frank passing-out after exertion. If something
happens that worries you, do not keep it to yourself.
Good luck. Row hard.
John Rudoff, M. D., FACC


John Rudoff, M. D., FACCConsultative, Diagnostic, and Invasive
Cardiology6475 S.
W. Borland Road, Suite L, Tualatin, OR 97062 (Meridian Park)Also: 9155 S.W.
Barnes Road, # 933, Portland, OR 97225 (St. Vincent)Phone:
(503)-238-8333 (Note:
Pacific Time); Fax: (503)-885-9033
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