Using AED's

There are specific times when an AED machine should be used. When a lay rescuer treats sudden cardiac arrest for a patient, they must be able to integrate rapidly between CPR and the use of a Defibrillator. To give the patient the best chance of survival, three actions must occur within the first few moments of a cardiac arrest.

1. Emergency Medical Services must be activated; If you are at work, this could mean activating your specific emergency response system

2. Lay rescuers must provide CPR; The recommended method is to Push Hard and Push Fast

3. Whenever available, rescuers must use AED's as early as possible; Defibrillators are principally automatic and not difficult to use. A shock delivered from an Automated Defibrillator should be administered as soon as it is available.

AED Use Authorization & Criteria

AED Training usually results in the user learning the skills that are necessary to operate an Automated External Defibrillator. However, only having the skills may not be enough if you choose to own a home defibrillator. In some areas, the purchase and the use of AED's comes under the supervision of a designated official or medical physician. In the United States, for example, AED's are regulated by the Food and Drug Administration (FDA) and require a prescription for some models.

Most countries have a different legislation specific to AED use so it's important to be familiar with the protocols outlined by public facilities and work environments in your area. These protocols should be met before you use an AED machine in a life-threatening emergency.

If you decide to attach the defibrillator device to the patient, they must be unresponsive and must not be breathing, coughing or moving. Once the unit is turned on and attached to the patient, it will analyze the patient's heart rhythm and assess whether the rhythm is shockable. Some rhythms are not shockable but still benefit from CPR until more advanced care is available. Follow the simple steps for shocking a patient in cardiac arrest that is prompted to the user by the AED device.

Follow the AED Prompts (audible & visible)

As you move towards the patient, assess the scene and make sure that it is safe for you to approach. Check for hazards that may have caused the patient to collapse. Look for bystanders that may be able to assist you in activating the EMS, retrieve an AED, help with CPR or direct the EMS to the patient's location. Put on your personal barriers and give the responder statement 'Introduce yourself as a trained responder and ask for permission to help'.

Open the patient's airway using the 'head tilt - chin lift' method and check for breathing for 5 to 10 seconds.

If the patient is non-responsive, not breathing normally and you do not suspect an obstructed airway, immediately apply the AED before you begin CPR. If you have another rescuer present, one can start CPR while the other prepares and attaches the Defib to the patient. If there is no AED available, begin a combination of 30 chest compressions and 2 rescue breaths until one arrives.

Using an Automated Defibrillator

Step 1. Turn on the AED Unit

Most automated defibrillators have a power button to switch on the device although some units automatically turn on when you open the lid. A voice prompt then talks you through each step.

Step 2. Attach the Chest Pads

Expose the patient's chest allowing you to place and secure the defibrillator electrodes. Undergarments covering the chest should be removed and you may need to cut off clothing to facilitate defibrillation. Excessive body hair or damp skin may interfere with adhesion and conduction of the electrode pads and it's not uncommon to find a razor included with the AED's if you need to shave body hair. Use a towel to dry the wet skin before attaching the pads.

Remove the backing from the adhesive pads (electrodes) and firmly apply the pads to the patient's chest skin as shown. One pad is placed to the right of the patient's breastbone just below the collarbone at the shoulder and above the right nipple. Place the other pad to the left of the patient's left nipple with the electrode on the side of the chest, above the lower rib margin and under the left arm. Next, plug in the cable connector to the AED if your device requires this step.

Step 3. Stay Clear of the Victim

Take Note icon A modern AED automatically analyzes the patient's electrical activity and heart rhythm. Make sure no person is touching the patient.

During this process, the device will either instruct you to deliver a shock if needed or some machines do so automatically. If the AED analysis shows that a shock is needed, make sure that no one is touching the patient or any materials that are in contact with the patient.

Step 4. Follow the Voice Prompts

If prompted to do so, stay clear of the patient and push the shock button to deliver one shock. Start CPR immediately, beginning with chest compressions. The first shock eliminates ventricular fibrillation more than 85% of the time. In cases where the first shock fails to do so, or even when a shock eliminates ventricular fibrillation, the resumption of CPR delivers oxygen and sources of energy to the heart which may increase the likelihood that the heart will pump blood effectively after a second shock.

After giving five to six cycles of 30 compressions and 2 breaths (approx 2 minutes of CPR) check the patient's heart rhythm again. Look, listen and feel for signs of breathing. If breathing is still absent use the defibrillator to deliver another shock if prompted to do so, and follow the shock with CPR. Allow the machine to check the patient's rhythm every two minutes.

Continue to give single shocks and five cycles of 30 compressions and 2 breaths until one of the following occurs;

AED Information

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