Transcript Using an AED

LESSON 9
AUTOMATED EXTERNAL
DEFIBRILLATION
© 2011 National Safety Council
9-1
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
© 2011 National Safety Council
9-2
AEDs, Medical
Direction and Laws
• Medical director oversees placement and use of AED
• Many AED units in public places and homes
• Safe to use by lay rescuers
• AED technology continues to evolve, making them
easier and safer to use
© 2011 National Safety Council
9-3
Heart’s Electrical System
© 2011 National Safety Council
9-4
Heart’s Electrical System
• System keeps contractions
of 4 chambers of heart
synchronized
• With heart attack (or other
problems), rhythmic
electrical control disrupted
© 2011 National Safety Council
9-5
(continued)
Ventricular Fibrillation
Ventricular Fibrillation (VF) is most common abnormal
heart rhythm
• Ventricles of heart quiver instead of beating
rhythmically
• In about ½ of cases of cardiac arrest, patient’s heart
is in VF
© 2011 National Safety Council
9-6
How AEDs Work
• Automatically checks
patient’s heart rhythm to
detect fibrillation
• Advises whether patient
needs a shock
• The shock (defibrillation)
may return heart to a
more normal rhythm
© 2011 National Safety Council
9-7
Time is Important
• AEDs are easy and simple to use but must be used
right away
• With every minute that goes by, chances for survival
drop by 10%
© 2011 National Safety Council
9-8
The AED Unit
• Contains a battery and is
portable
• Unit has 2 pads connected to
it with 1 or 2 cables
• Pads are placed on patient’s
chest (or as directed in an
infant or small child)
• Unit analyzes patient’s heart
and advises whether to give a
shock
© 2011 National Safety Council
9-9
Using an AED
• Whenever patient
suddenly collapses or is
found unresponsive,
consider possibility of
cardiac arrest  send
someone for AED
• 9-1-1 dispatcher may alert
rescuers to nearby AED
© 2011 National Safety Council
9-10
AED and CPR
• Check patient for normal breathing and a pulse
• Use AED as soon as available if patient is unresponsive,
not breathing normally and pulseless
• With two rescuers, one gives CPR and one sets up AED
• For non-breathing infant or child found unresponsive (not
observed to have collapsed suddenly), give 5 cycles of
CPR before using the AED
© 2011 National Safety Council
9-11
Attach AED to Patient
• Be sure patient is not in water or
in contact with metal
• Place AED near patient’s shoulder
and turn it on
• Attach pads to patient’s chest
- See diagram on pads
- On adult or large child:
• One on right side below collar bone
• One below and to left of left nipple
- On infant or small child:
• Apply as directed by unit’s diagram
© 2011 National Safety Council
9-12
Attach AED to Patient
(continued)
• Attach pads to patient only if patient is unresponsive, not
breathing normally and pulseless
• Expose patient’s chest and dry or shave it if needed
• Remove backing from pads and apply firmly on patient’s
chest (or chest and back in infant or small child)
• If required with AED model, plug pad cables into main
unit
© 2011 National Safety Council
9-13
Analyze and Shock
• Most AEDs automatically
analyze patient’s heart
rhythm
• Do not move or touch
patient while it is analyzing
• Unit will advise shock or to
resume CPR
• Follow unit’s prompts
© 2011 National Safety Council
9-14
Analyze and Shock
(continued)
• If shock advised:
- Be sure no one is touching patient
- Administer shock (or stay clear as unit automatically
gives the shock)
- Immediately resume 5 cycles CPR (~2 minutes)
- AED will analyze and advise again
© 2011 National Safety Council
9-15
Different AEDs May
Use Different Prompts
• Follow unit’s voice and visual prompts
• Some units are programmed to administer shock
automatically; follow unit’s prompts
• Some units provide feedback about CPR skills
between shocks
© 2011 National Safety Council
9-16
If the Patient Recovers
• Put unresponsive, breathing
patient in HAINES recovery
position if spinal injury is not
suspected
• Continue to monitor breathing
• Keep AED pads in place
because some patients return
to VF and require defibrillation
again
© 2011 National Safety Council
9-17
If the AED Says No Shock
• Patient’s heart will not benefit from defibrillation
• Immediately resume CPR
© 2011 National Safety Council
9-18
Skill: AED
© 2011 National Safety Council
9-19
1. Position patient away
from water and metal
2. Place unit by patient’s
shoulder and turn it on
© 2011 National Safety Council
9-20
3. Expose patient’s chest
4. Dry or shave pad
placement areas as
necessary
© 2011 National Safety Council
9-21
5. Apply pads to chest
© 2011 National Safety Council
9-22
6. Stand clear during
rhythm analysis
© 2011 National Safety Council
9-23
7. Follow prompts to:
- (1) give shock
- (2) stay clear during
automatic shock or
- (3) do not give shock
but resume CPR
© 2011 National Safety Council
9-24
8. Stand clear when AED prompts to analyze rhythm
again after 5 cycles of CPR (about two minutes)
- Continue until patient wakes up or more advanced help
arrives and takes over
- If patient begins breathing normally but is
unresponsive, put in recovery position (with pads in
place) and continue to monitor breathing and pulse
© 2011 National Safety Council
9-25
AED Alerts
• Remove any medication pads present with a gloved hand
• Avoid flammable materials, including oxygen flowing through
a mask
• Don’t use alcohol to wipe patient’s skin
• Don’t use AED when in motion
• Don’t use cell phone or two-way radio within 6 feet of AED
• Don’t touch patient while AED is analyzing the rhythm or
administering a shock  except as advised by the AED
© 2011 National Safety Council
9-26
AED Use in
Infants and Children
• Follow adult guidelines
for children >8 years
• Sudden cardiac arrest
can occur in infants and
children as result of:
- SIDS
- Poisoning
- Drowning
- Heart problems
© 2011 National Safety Council
9-27
AED Use in
Infants and Children (continued)
• Give infant or child two minutes of CPR before using
AED – unless witnessed that infant or child collapsed
suddenly
© 2011 National Safety Council
9-28
Pediatric AED Pads
• Use pediatric pads:
- Smaller
- Produce lower-energy shocks
- Follow diagram on pads for
placement
- Use adult pads if pediatric
pads are not available
• Pediatric pads should not be
used on adults
© 2011 National Safety Council
9-29
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
© 2011 National Safety Council
9-30
Special AED Considerations –
Internal Pacemaker or Defibrillator
• Vary AED placement if
there is an internal device
© 2011 National Safety Council
9-31
Special AED Considerations –
Medication Patches
• Remove medication
patches prior to pad
placement
© 2011 National Safety Council
9-32
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 patient
• Error message may indicate pads not firmly in contact
with patient’s skin
© 2011 National Safety Council
9-33
AED Maintenance
• AEDs require regular maintenance
• Check manufacturer’s manual
• Daily inspection ensures AED ready for use and
supplies are present
© 2011 National Safety Council
9-34