Biphasic should replace Monophasic Defibrillators

1. Studies cited by me vs. studies cited by my opponent The study I cited in my R1 argument refers to external defibrillation in an emergency setting using the existing technologies of biphasic defibrillators vs. monophasic defibrillators. These are the only two types of defibrillators commercially available in hospitals, and the only ones addressed in the study as they are the only two waveform types approved for use by the FDA. Biphasic and Monophasic defibrillators are currently Class II (approved for market) type devices. The study my opponent cites does not refer to any device approved for market by the FDA. The study was experimental, and used devices made in a lab setting and controlled by a computer that is not approved for control of cardiovertive devices (Macintosh Computer). Triphasic defibrillators exist only as Automatic Implantable Cardioverter-defibrillators (ICD's). The significance of the difference between an ICD and an external defibrillator, or simply, defibrillators is that ICD's are used on ONE patient, and the implanting of such a device would be exclusive to that patient, and would be at the cost of that patient. Understand- the studies DO NOT refer to the same devices. This is like debating semi-trucks and mentioning motorcycles based on their similarities as "vehicles". (http://en.wikipedia.org...) If my opponent wishes to question the reliability of my Wikipedia source, I would ask that he first check the sources cited within the Wikipedia article before discrediting my source simply for being from Wikipedia. I would also note that the Wikipedia source cites sources cited by my opponent's posted study. ICD's are clearly not the devices I am referring to in this debate, and they are clearly the devices referred to by my opponent's source. My opponent's reference to manufacturing costs is ridiculous. He cannot possibly cite a source detailing the manufacturing costs of a biphasic defibrillator vs. a monophasic defibrillator. The cost of a brand new defibrillator has remained constant- anywhere from $9,000- $15,000 depending on the options purchased with the defibrillator (monitoring capabilities, 3-lead, 5-lead, or 12-lead ECG capabilities, pacing, SPO2, etc.). A monophasic defibrillator at the time of purchase would cost the same as a biphasic defibrillator costs today. For a hospital to replace a similar device it would be a tax write off that balances their budget. It is also in the hospital's interest to meet Joint Commission Sentinel Alerts like their recent alert regarding keeping up with new technology. 2. Existing Technology What I said were available in hospitals are triphasic ICD's- NOT external defibrillators. There is a big difference, and it would behoove my opponent to educate himself on the difference, as I pointed out there was a difference in my last round and he completely ignored my argument. My opponent does not understand the logic of why some hospitals have monophasic defibrillators as well as biphasics, and attempts to justify a similarity between adults and their vehicles. I assure you there is not a similarity in that hospital departments operate on individual budgets, yet many hospitals provide defibrillators based on an Emergency Department budget. If the hospital provides leniency of choice to the directors of the individual departments, there is not always uniformity, and that is the root of my argument. Many department heads have their own arguments as to why they will not replace monophasic defibrillators, and the argument is usually they are used to the operation of that particular defibrillator and are not comfortable with new technology. My argument stems from the fact that biphasics are more efficient, and being afraid of new technology is not a good argument because it is a Joint Commission standard to keep up with new technology- both in availability and in training. My opponent's argument makes no sense. My argument on availability of technology is based on commercial availability. In other words, using my opponent's analogy of replacing a vehicle- it would be ridiculous for a husband to want to replace his old vehicle with a flying vehicle knowing full well that vehicle is not available. If he were serious about replacing his old vehicle with newer technology, he would go to a dealership and purchase something that is available. It would be delusional for the man to request a flying Hummer that runs on solar power because they don't exist. 3. Converting Biphasics to Triphasics My opponent claims that he has cited a source, and I accept that. The problem is I understand the technology cited in the source, and he does not. An ICD can be converted into a triphasic (at the time there were no triphasic ICD's) defibrillator using the tiny switches the small device had available, and that is what led to the development through legal means of triphasic ICD's. My opponent, however, cannot cite how the ICD's were converted, and much less can he cite how a biphasic external defibrillator can be converted into a triphasic external defibrillator. If you cite a source, it should be as reference otherwise you are committing a logical fallacy of appealing to authority. If I argue that you can convert a diesel engine into a biodiesel engine and I cite a source, it should explain how it can be done- not simply that it can be done, otherwise the statement is simply hearsay. I am not saying the statement within the article is hearsay, rather that my opponent does not understand the differences between the technology cited in the study- ICD's- and the technology I am referring to- external defibrillators. 4. Converting Biphasics to Triphasics My opponent claims that this argument is about what "should" happen. The evaluative "should" in this debate is whether biphasic defibrillators should replace monophasic defibrillators- both technologies commercially available to hospitals. My opponent presents an evaluative "should" that is not compatible with my premise, and is not an opposition to my premise. His evaluative "should" is hypothetical- triphasic waveforms should be used because they have been proven superior. The problem is that a triphasic defibrillator has not been developed and is not commercially available to hospitals. Should this line of argument be opened up, the debate would convert entirely to quadriphasic waveforms, which are superior to mono, bi, AND triphasic waveforms, BUT there is not existing device called a quadriphasic defibrillator just as there is no triphasic defibrillators. I contend that hospitals should replace and outdated technology with an existing superior technology- monophasic vs. biphasic defibrillators. My opponents "lastly" paragraph makes no sense. Biphasic defibrillators are already in production and being sold. The fact that hospitals would buy them to replace existing monophasic defibrillators will not require any manufacturing on the part of hospitals. He, again, claims that biphasic defibrillator possess the hardware and software necessary to operate as triphasics. I will again point out that his source does not reference biphasic defibrillators that existed at the time- in fact, it was those studies that led to the development of the first biphasic external defibrillators in 1996, and triphasic ICD's a little later. I never claimed quadriphasic defibrillators are better than triphasics- I said quadriphasic WAVEFORMS are more efficient than triphasic waveforms. The devices to deliver them do not exist as commercially available devices, just as triphasic external defibrillators do not exist. Monophasic defibrillators exist, and so do biphasic defibrillators. My opponent should either concede the debate, or educate himself on the subject if he is to continue. Thank you. http://www.ncbi.nlm.nih.gov...