Automated External Defibrillation

Lesson 10

10-1

Introduction
Many patients receiving CPR benefit from an AED Abnormal heart rhythm can be corrected with AED shock Use AED with unresponsive, non-breathing, and pulseless patients CPR keeps patient viable until AED shock restores normal heart rhythm

10-2

AEDs, Medical Direction, and Laws

Medical director oversees placement/use of AED Many AED units in homes/other settings Safe to use by lay rescuers

10-3

Hearts Electrical System

Hearts Electrical System

System keeps contractions of four chambers of heart synchronized With heart attack (or other problems), rhythmic electrical control disrupted

Ventricular Fibrillation (VF)

Most common abnormal heart rhythm Ventricles of heart are quivering instead of beating rhythmically In about of cases of cardiac arrest, victims heart is in VF

10-6

How AEDs Work

Automatically checks victims heart rhythm to detect fibrillation Advises whether victim needs a shock
The shock (defibrillation) may return heart to a more normal rhythm

10-7

Time is Important
AEDs are easy and simple to use but must be used right away With every minute that goes by, survival drops by 10%

10-8

The AED Unit

Contains a battery and is portable Unit has 2 pads connected to it with cables Pads are placed on victims chest Unit analyzes victims heart and advises whether to give a shock
10-9

Using an AED
Whenever patient suddenly collapses or is found unresponsive consider cardiac arrest

10-10

AED and CPR

Check patients ABCs Use AED if patient is unresponsive, not breathing, and pulseless With two rescuers, one gives CPR and one sets up AED For pulseless patient, use AED as soon as it is ready except: For pulseless child not observed to have collapsed suddenly For adult found pulseless on arrival and 4-5 minutes have passed since you were called to respond

10-11

Attach AED to Patient

Be sure patient not in water or in contact with metal Place AED near patients shoulder and turn it on Attach pads to patients chest See diagram on pads One on right side below collar bone, the other below and to left of left nipple

10-12

Attach AED to Patient continued

Attach pads to patient only if patient is unresponsive, not breathing, and pulseless. Expose patients chest and dry /shave it if needed Remove backing from pads and apply firmly on patients chest If required with AED model, plug pad cables into main unit

10-13

Analyze and Shock

Most AEDs automatically analyze patients heart rhythm Do not move or touch patient while it is analyzing Unit will advise shock or to continue CPR Follow units prompts

10-14

Analyze and Shock

If shock advised:
Be sure no one is touching patient Administer shock Immediately give 5 cycles CPR (~2 minutes) AED will analyze and advise again

10-15

Different AEDs May Use Different Prompts

Follow units voice and picture prompts Some units programmed to administer shock automatically; follow units prompts

10-16

If the Patient Recovers

Put unresponsive, breathing patient in recovery position Continue to monitor breathing Keep AED pads in place. Some patients return to VF and require defibrillation again

10-17

If The AED Says No Shock

Patients heart will not benefit from defibrillation Immediately continue CPR

10-18

Skill: AED

10-19

Position victim away from water and metal. Place unit by victims shoulder.

Expose victims chest. Dry or shave area as necessary.

10-21

Apply pads to chest.

Stand clear.

Follow prompts.

 Stand clear when AED prompts to analyze rhythm again after 5 cycles of CPR (about 2 minutes) Continue until patient moves or EMS arrives and takes over If patient recovers, check for breathing Put breathing unresponsive patient in recovery position (with pads in place) and continue to monitor breathing

10-25

AED Alerts
Avoid flammable materials, including oxygen flowing through a mask Dont use alcohol to wipe patients skin Dont use AED when in motion Dont use cell phone or 2-way radio within 6 feet of AED.

10-26

AED Use in Children

Follow adult guidelines for children > 8 years Sudden cardiac arrest can occur in younger children
SIDS Poisoning Drowning Heart problems

10-27

AED Use in Children

Give child 2 minutes of CPR before using AED
Unless witnessed that child collapsed suddenly

10-28

AED Use in Children

Use pediatric pads
Smaller Produce lower-energy shocks Follow diagram on pads for placement

Pediatric pads should not be used on adults

10-29

AED Age Recommendations

AED use recommended for adults and children ages 1 - 8 AED use for infants is not recommended

10-30

Changing AED Technology

AED technology continues to evolve Some units use same pads for all patients Have a separate switch on unit for pediatric patients Always follow AED prompts

10-31

Vary AED placement if there is an internal device

Remove medication patches prior to pad placement

10-33

Potential AED Problems

AED must be maintained regularly and have charged battery AED may prompt you to avoid problems
With low battery prompt, change battery before continuing May get prompt to avoid moving victim

10-34

AED Maintenance
AEDs require regular maintenance Check manufacturers manual Daily inspection ensures AED ready for use and supplies are present

10-35