Automated External Defibrillators

1. Automated External Defibrillators • Saving Cardiac Arrest Victims

2. Early Advanced Care Early Defibrillation Early Access Early CPR Chain of Survival

3. Early Defibrillation • Early defibrillation is the single most important factor in determining cardiac arrest survival!!!

4. What is sudden cardiac arrest? • The cessation of cardiac function where the patient presents with • NO responsiveness, • NO breathing, and • NO pulse (signs of life) • Most sudden cardiac arrest victims experience ventricular fibrillation

5. What is ventricular fibrillation? • The heart’s electrical signal, which normally induces a coordinated heartbeat, suddenly becomes chaotic (disorganized) • Resulting in quivering of the heart’s ventricles = no or poor blood flow = decreased oxygenation to the tissues

6. What is ventricular fibrillation? • Another condition, Ventricular Tachydardia If seen, it would look like the heart is quivering, something like a bowl of Jell-O does not allow the chambers to fill with enough blood between beats to produce sufficient blood flow to meet the body’s need, especially the brain

7. Non-Shockable Rhythms(defibrillation won’t help these patients) • Pulseless electrical activity (PEA) • 15-20% of all cardiac arrests • Heart muscle fails, but the electrical activity continues • Asystole (Flat line) • 20-50% of all cardiac arrests • The heart has ceased generating electrical impulses altogether • Remember the longer you go without defibrillation, the lower the patient’s chance of survival

8. Why is the AED so important? • CPR alone will NOT reverse ventricular fibrillation • Remember, CPR only provides ≈ 30% of the normal blood flow to the brain • EARLY defibrillation is the single most important factor in survival from sudden cardiac arrest caused by ventricular fibrillation!!!!!

9. How an AED works • Contains a microprocessor and a computer program • Distinguishes the electrical activity of the heart • Intended to disrupt the abnormal electrical activity of V-fib and V-tach long enough to allow the heart to spontaneously develop an effective rhythm on it own • Used for victims in cardiac arrest ONLY!!!

10. Types of AEDs • Semiautomatic • Requires the rescuer to shock the victim • Fully automatic • Shocks automatically

11. AED Maintenance • AED’s do not require a high degree of maintenance • Usually will indicate when service is required

12. When To Use An AED • Victim must meet four conditions • Unresponsive • No breathing • No pulse • Chest dry (if not, wipe dry)

13. Special Situations • Care should be taken with individuals wearing medication patches or those with pacemakers or defibrillators • Adequately dry the chest; if in a wet environment, try to keep as dry as possible • If an implantable device is used, do not place the AED pads directly on the device, rather move them accordingly • If the victim is hypothermic, check for signs of life for 30-45 s. Do not delay CPR or defibrillation to re-warm the victim • If a victim has suffered a trauma, the AED may still be used; however, the AED should be used according to the local protocols • If pediatric pads are not available, you may use adult pads

14. Pad Placement • Remember you have adult and pediatric pads • Remove the pads from the packaging and connect cables from the AED to the pads or the cables to the AED • Wipe the victim’s chest dry • Peel away protective plastic backing from the pads • Place one pad (white) on the upper-right side of the victim’s chest, above the nipple and below the collarbone • Place other pad (red) around the lower-left side of the victim’s chest, below the nipple

15. Using the AED • Confirm cardiac arrest, check the victim for signs of life for no more than 10 seconds • Turn on the AED; follow the unit’s directions • Let the AED analyze the heart rhythm by pushing the analyze button • Advise rescuers to “stand clear” • Deliver the shock by pushing the shock button when indicated

16. After the first shock is delivered, begin CPR immediately Continue with CPR for 2 minutes if the shock delivered does not resuscitate the victim Analyze after two minutes of care Using the AED

17. AED Precautions • Don’t touch the victim while the AED is analyzing/defibrillating • Don’t use alcohol to wipe the victim’s chest dry or use an AED around other flammable materials • Don’t use around flammable materials, such as gas or flowing oxygen • Don’t use an AED in a moving vehicle • Don’t use an AED on a victim lying on a conductive surface • Don’t use an AED on a victim wearing a nitroglycerin patch or other patch on the chest • Don’t use a cellular phone or radio transmitter with 6 feet of the AED • Use age-appropriate pads when available

18. References • National Safety Council. (2001). First aid and CPR (4th ed.). Boston: Jones and Bartlett Publishing. • Limmer, D., O’Keefe, M. F., Grant, H. D., Murray, R. H., & Bergeron, J. D. (2001). Emergency care (9th ed). Upper Saddle River, NJ: Prentice Hall. • American Red Cross. (2001). Emergency response. Boston: The American National Red Cross. • American Heart Association (2001). Fact sheet: Community Access to Emergency Defibrillation Act of 2001. [Online]. Available at: http://www.amhrt.org/downloadable/heart/1016547403803community%20AED.pdf