A good time to die?

This past Sunday saw the passing of a true waterman and a friend. Oin Cenal had an apparent heart attack 45 minutes into the mens molokai while steering the Waikiki Beach Boys. He will be missed. I do not know if he had to die this day. When he collapsed in the canoe his team mates started c.p.r. within seconds, he was transfered to the escort boat and the paramedics and doctor started their care within minutes. They did not have a defibrillator, a device that starts the heart after it has stopped. This is the most important tool in caring for a heart attack victim. It costs as little as $1200 and can be used by almost anyone. They even have them at walmart and airports on the wall for anyone to use in an emergency, they do not have doctors or paramedics at these places. Sending these professionals to care for a stopped heart without a defibrillator is like sending a worker to frame a house without a hammer.

Submitted by concerned on Mon, 10/10/2005 - 9:47pm



Oin was a good man; it was tragic that he wasn't given the opprotunity of a difib, especially in a sport in which he dedicated his life to. If this is a World Championship event, then lets be prepared to handle circumstances such as this. No brainer-When you have more than 1000 people pushing themselves beyond exhaustion for 5,6,7 plus hours-and that a good number of them are 50 plus years of age, the chances of problems go way up.
Take the time to educate yourself on a difribulater-
and CPR- both super easy to understand.For those who knew Oin, I share your pain; a beautiful man who took care of the underdog.


#1 Tue, 10/11/2005 - 1:59am


First off, for those of you who didn't know him, his name was Owen ... not Oin. And secondly, I'm sure there was a good reason for not having an AED (Automated External Defib.) on the escort boat. For those of you who have never used one, anyone who needs treatment must be dry and in a dry place, else you run the risk of shock towards others. Being in a boat in the middle of the ocean, sort of inhibits the safety of anyone using it to save a life. People can speculate all they want and try to place blame, but Owen is still gone, and with him, his knowledge of canoe making, his Pili paddles, and his love of perpetuating the ancient hawaiian tradition of paddling.


#2 Tue, 10/11/2005 - 7:21am


many dive boats, fire rescue, and city & county lifeguards perform using
Difibs out at sea. You are correct that victim should be out of standing water and preferebly in a dry place. However, once wet clothing is removed, this procedure can be performed. And by the way, its Oin,
or at least thats how he used to spell it.


#3 Tue, 10/11/2005 - 9:24am


His name was both "Owen" and "Oin." The legal spelling was "Owen" so that is what his family likes to use, although many people knew him as "Oin" as well.

It was a very tragic event that we all wish could have been avoided, but at least he was doing what he loved in the channel that he had crossed many times.

Several photos of this well respected and loved waterman are posted on the Waikiki Beachboys site in memorium.
http://www.waikikibeachboys.com


#4 Tue, 10/11/2005 - 10:06am


i work for the fire department and just want to make sure the facts are straight. our sog's (standard operating guidelines) prohibit use of aed in any wet environment (i.e. the ocean). i'm pretty sure lifeguards don't carry any while on the water either. yes, they do carry aed's, and i'm pretty sure their protocol, like ours, is to only administer them once on shore. if a cardiac arrest is reported out to sea, various agencies such as coastguard ships (not boats, there is a difference) or helicopters are dispatched to such emergencies and utilize their facilities where such dry enviroments allow proper use. i had known owen for about 10 years and he was a good friend and his passing is a great loss to the paddling communtiy.


#5 Tue, 10/11/2005 - 10:19am


I was in the escort boat and with Oin (Oin, himself, used both spellings of his name) on Sunday and want to clear up a couple of things.

  1. To "noa14"... if it is unsafe to use a defibrilator on a boat then please tell that to the Coastguard because the first thing they did when they came aboard the escort boat to treat Oin was to try to re-start his heart with a portable defibrillator. The first thing the machine does is read the patient to detect whether a shock should be administered. If there is no activity in the heart, whatsoever, then the machine will advise, "no shock." In Oin's case, the machine advised that a shock should be delivered, and did so, safely to everyone involved. Unfortunately, it was too late. So for those that have asked why there was no defibrilator on any of the four medical boats, I don't know what that reason is. (But I'm not a doctor!)
  2. Many people have asked what happenned on the boat after Oin went down. I can honestly say that everyone involved, Dr. Foti, Oin's crew, the escort boat captain, and everyone on-site gave Oin every chance quickly and efficiently and with extreme love and care that they could have given. Oin was steering when it happenned and our paddler in seat five (thank goodness!) was a nurse. Treatment began immediately and professionally.

And for interested friends... service information will be posted on www.waikikibeachboys.com.

I won't pretend to know Oin or what his wishes would be at this time as well as some of you that knew him better but I do know that Oin was a peaceful man that put aloha before conflict and anger. He was described by someone as easy... easy to get to know, easy to talk to, easy to be with. I'm guessing that he'd want us all to use his passing as a way to make the art, sport and culture of canoe paddling safer, more accessible and more meaningful to everyone, as "konapaddler" said, easpecially to the underdog. And as "noa14" said, Oin's knowledge and love of this Hawaiian tradition was inspiring and a teaching tool to SO MANY of us. Oin will forever be a part of this tradition in all the people he touched!


#6 Tue, 10/11/2005 - 10:23am


"Oins" passing was a tragedy. Any passing of such a fine person is a tragedy. I knew Oin for many years and I will miss him. His presence around the ala wai is a loss, especially for the keiki he has coached and mentored.
I do not wish to place blame but I know Oin would have had a much better chance at survival if there was an a.e.d. on any of the medical boats. I was a pool lifeguard for many years. I was also an e.m.t. and a c.p.r. and a.e.d. instructor. You can use an a.e.d. on any dry torso while the victim is on a dry surface. ie; 60' coast guard cutter, 45' sport fisherman, 22' whaler, 9' avon dingy. Why should you wait almost an hour for a helicopter.
From what I have heard all persons involved in trying to save Oin performed admirably. However, they did not have the proper tools to save a life. They did not even have the proper drugs to help start a heart. In other words the medical staff could not help Oin any more than an individual trained in c.p.r. Maybe if the medical boats were called first aid boats we wouldn't expect medical care.


#7 Tue, 10/11/2005 - 10:25pm


Concerned and others: I am a Captain on one of many official boats that provide medical support for both channel races. I have been involved in escorting for the past 25 or so years. In the past 10, I, like many others on our team have accepted the immeasurable challenge of bringing all of you home from Molokai in one piece.

Many years ago, when I began assisting in Na Wahine and Molokai Hoe , we had nothing more than sea sick nurses and if we were lucky, a doctor or two aboard a few vessels scattered along the race course. No medical equipment and no plan. Thank God, our makeshift staff was never really challenged. Nine years ago, I asked a very close friend by the name of Mandy Shiraki to come along and provide medical care for the races. Mandy worked as an MICT (Medical Intensive Care Technician, not EMT) and EMS supervisor for the City and County of Honolulu.

Within hours of my call, Mandy had gathered an army of City and County Paramedics for both the Women's and Men's races. Since that day, all Molokai races have been served by a group of MICT's that are dedicated to providing participants the best medical care possible and they do it for free! The core group of MICT's understand and accept the challenge of providing you with the best care under extremely adverse conditions.

As for our physicians, one in particular pays his own airfare from Minnesota for every Molokai race, women's and men's. He also brings (as a performance award) 3 or 4 other physicians along at his own expense. His Orthopedic expertise has paid off several times in both Molokai races. Dr. Foti has always been the mainstay of both races and we should all hope he continues. His dedication to the sport is immeasurable and I personally guarantee you that any time he tends to a paddler on the race course, he treats the paddler as though they were his own kids.

As most of you know, Mandy was killed in an air ambulance crash last year but one of his many legacies lives on. This year was no exception. On the men's course we had seven MICT'S and three physicians. One MICT and Federal Firefighter that tended to Owen, is home on leave from Iraq. He planned his 10 day leave so that he could be at Molokai Hoe. They were well capable of, and well prepared for what happened. They also administered all of the drugs under C&C protocol and provided care with the limited amount of resources available and the adverse conditions that the channel provides. In this case, except for immediate use of an A.E.D. Interestingly enough, we had discussed leasing or purchasing one or two but the jury was still out on the use in and around salt water where constant splashing can occur. While some say their use on boats is somewhat safe, others by far disagree. Eleven people aboard a 22 foot vessel with metal trim thru ought provides adequate safety concerns. It is also important to understand that two of the four EMS A.E.D. instructors for all of Oahu were part of our medical team on Sunday. They were part of many vigorous debates as to whether or not OHCRA should purchase units. Logistically, as in this years women’s race, when the course is four miles long and four miles wide, the number of units required to effect a timely response is also questionable. Also probably important to note that the survival rate after use of an A.E.D. is extremely low.

A few other things you need to understand. During the course of attending to Owen, many people were either put on or taken off of the vessel. All of them were wet or splashed water back on to the vessel when they jumped off. And the ocean conditions in that particular area were not the best. The paramedics, in anticipation of the arrival of the USCG chopper and A.E.D. say that it took them that long to dry Owen and the surrounding area. One thing that no one expected was that the Coast Guard chopper required refueling because of an early morning search and rescue mission on Oahu.

Just a few more points. Everyone should understand that the crew aboard the Escort vessel did an awesome job in a very stressful situation. The crew, along with at least one paddler who both have medical backgrounds began CPR immediately. After my arrival at the scene, CPR techniques that I witnessed in my opinion, were perfect. Intubation, IV and drug administering were all performed in a timely manner. None of which is considered basic first aid.

While A.E.D.’s are fully automatic and will defribulate when the machine deems necessary or viable, the Coast Guard diver’s transmission that I heard asked the pilot to position the chopper for transportation. He stated that he believed the A.E.D. was activated by the vibration of the escort vessels engine.

My condolences also go out to the rest of Owen’s crew aboard the canoe. I give you all a great deal of credit for bringing the boat home safely. I know that was a long ride across the channel.

I Know that this will not quell all questions, there are many more to ask. I will be the first to state that everything did not go exactly as planned but I am proud of the timely response of the officials and medical staff in adverse conditions and the medical care provided. We all need to continue working together towards the common goal of improving paddling safety at all times and at any expense. I would also ask that you, as paddlers recognize these professionals who provide medical care on a volunteer basis.

Interestingly enough, on the night before the race, we conduct a medical meeting in Kaunakakai. On this past Saturday, as Paramedics and Physicians reviewed our plan of a possible medical problem that would require helicopter transport (over and over again I might add), Owen visited the vessel next door. He was the coach of one of our official boat captains sons and stopped by to say hello. Although I didn't know him, it’s obvious that he was a great man and a legacy in paddling for an immeasurable number of people. Please understand that coming home without each and every paddler is something we never planned to accept and this is as hard for the officials and medical staff as it is for each of you.

We will constantly strive to improve paddler safety and our ability to respond to all emergencies. I'm sure there will be many more and all will provide different challenges and responses. For Concerned, as well as others, I would encourage you to get involved. We welcome any and all assistance.


#8 Thu, 10/13/2005 - 8:52am


Thank you, Bigfish, for your comments. No one up to this point has been able to provide an inkling of what the possible downsides of having an AED truly are. An AED is a scary and difficult to understand piece of machinery to the layperson (like myself!). However, I am still finding it even more difficult to believe that the risks outweigh the potential benefits. Here are some of the things I’ve learned via Red Cross CPR training, via Phillips (one of the leading AED manufacturers), and via the Red Cross of Hawaii AED specialist.

About the use of AEDs with an engine operating... the word from the Red Cross AED specialist is that an engine is not a concern for the performance of an AED. According to the Phillips technician, it is possible that such vibrations will register with the AED. However, it will register as “artifact.” If there is too much artifact noise, the AED will state that there is too much noise and that the noise must be eliminated (meaning, stop the ambulance, engine, etc.). AEDs are routinely used on airplanes, in ambulances, and on boats. The frequency of an engine is much higher than that of a heartbeat and would not mis-register as such. The only possible danger of a mis-detection by an AED would be if the AED somehow decided to deliver a shock to a heart that was beating normally and didn't require defibrillation. With a doctor onboard administering the shock, I don't know what the statistics here are, but I can bet that between the mind and observations of the doctor and the technology of the AED, the risk of delivering a shock to a healthily beating heart are negligible.

About the use of an AED around water… it is not to be used with the patient in standing water. Splashing or a wet surface is not a problem. It is true that with technology as it was 10 yrs ago, the American Heart Association did not recommend use near water. The energy is now delivered in such a way that the energy is smaller and safer (this part got a bit technical for me to translate the reasoning behind, something about the energy now being “biphasic” so it’s of a lesser intensity). Electricity wants to travel in the shortest, easiest path between two points, those points being the pads of the AED. Even if you touch a patient while a shock is delivered it will not cause damage to you though you will “feel” it. However, it would be dangerous to come between the two pads on the patient. There have been tests done with a simulated patient on a wet surface using salt water (which is a better conductor than freshwater) and these tests have shown the activity to be safe. Many AEDs are made for such environments and are available for around $2000.

There also is the measure of human awareness and judgment to factor in. With a doctor, lifeguard, MICT, etc. involved, this caliber of responder would also have the benefit of experience and training-enhanced judgment available to them to determine whether the use of any type of care is safe to all those involved. This is one of the first things responders (including the basic CPR-trained citizen) are taught in their training.

I’ve gathered all this information just as a layperson. For those involved with race course safety, if you’re interested, I can give you the name and number of the Red Cross Hawaii AED specialist and for the Phillips technical specialist. You can contact me for that with a private msg on this website. Another good source of knowledge may also be the Coastguard. Hopefully this will help in making a decision one way or the other for future races.

So, I still have a hard time swallowing the statements, “While some say their use on boats is somewhat safe, others by far disagree. Eleven people aboard a 22 foot vessel with metal trim thru ought provides adequate safety concerns,” I appreciate hearing both sides. I think we all agree on the reality of the risks and we all want to continue to make this sport as safe as possible for all involved. It seems though that with the technology where it is now... the potential benefits tip the scales against risk.

And we definitely ALL agree that the medical personnel and crew responded wonderfully. I thanked Dr. Foti and all involved with Sunday's attempts personally and I will thank them here, again, publicly… MAHALO! Without you we could not participate in something we love so much. Thank you for minimizing the risks that we all acknowledge every time we pick up a paddle, let alone, when we attempt to cross the Kaiwi Channel! Also, to race directors, medical coordinators, etc… thank you for your efforts, too. I know we all have the same goal for the Molokai Hoe and Na Wahine O Ke Kai!


#9 Thu, 10/13/2005 - 5:30pm


A heart attack is most of the time facilitated by underlying heart disease, ' blockage of the bloodvessels of the heart '.
When such a blockage goes from partial to total, and this happens suddenly, no blood goes to parts of the heart and the situation is extremely critical.
I some cases a defibrillator can help in this situation, ideally used during the first 60 seconds ! Shortly after that, the success rate with a defibrillator goes down dramatically.

Besides the thoughts about the AED, it is very important to keep your heart healthy during the year lifestyle, food. It may even be a good idea to do a treadmill before you go into the extreme challenge of long distance paddling, certainly if you have reached some age, are at risk, and mostly if you have any chest pains/symptoms that you cannot explain well. A treadmill test is a good basic tool to find out about your heart health.
Please think about this.
May Owen's soul rest in peace.


#10 Fri, 10/14/2005 - 11:13pm


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