HOW TO USE AN AED

HOW TO USE AN AED

When the heart stops, a cardiac arrest has occurred. The most common cause is an abnormal rhythm of the heart, known as ventricular fibrillation. This abnormal rhythm can occur when the heart muscle is damaged as a result of a heart attack or when insufficient oxygen reaches the heart. A machine called an automated external defibrillator (AED) can be used to correct the heart rhythm by one or more electric “shocks’. AEDs are available in many public places, including shopping centres, railway stations and airports. The machine analyses the casualty’s heart rhythm and shows with visual prompts – or tells you by voice prompts – what action to take at each stage. You should be trained in its use and be able to carry you CPR )



In most cases when and AED is called for, you will have already started CPR. When the AED is brought, continue with CPR while the machine is prepared and the pads are attached to the casualty.

POSITIONING THE PADS

1 Switch on the AED and take the pads out of the sealed pack. Remove or cut through clothing and wipe away sweat from the chest.
2 Remove the backing paper and attach the pads to the casualty’s chest in the positions indicated. Place the first pad on the casualty’s upper right side, just below his collarbone.
3 Place the second pad on the casualty’s left side, just below his armpt (inset). Make sure the pad has its long axis along the head-to-toe axis of the casualty’s body.
4 The AED will start analyzing the heart rhythm. Ensure that no one is touching the casualty. Follow the aural and/or visual prompts given by the machine (opposite).



SEQUENCE OF AED INSTRUCTIONS
The AED will start to give you a series of visual and verbal prompts as soon as it is switched on. There are several different AED models available, each of which has different voice prompts. You should always follow the prompts given the AED that you are using until advanced emergency care is available.

Switch AED on.
Attach pads to casualty’s chest.

AED gets ready to analyse the casualty’s heart rhythm. It may state “Stand clear, analyzing now” or “Analysing”. Make sure that no-one is touching the casualty.
Is a shock advised?


YES
AED advises that a shock is needed.The machine charges up.

AED instructs you to deliver the shock.
- Make sure everyone is clear of the casualty.
- Push the shock button.
-
AED deliver’s the shock. The casualty will appear to “jump” with each shock. This is quite normal.

AED instructs you to carry out chest compressions and rescue breaths (CPR) 30:2 for two minutes before it re-analyses.
The AED re-analyses heart rhythm.
- If at any time the casualty starts breathing normally, place him in the recovery position (pp.64-65). Leave the AED attached to the casualty.

NO
AED advises that no shock is needed.

AED instructs you to carry out chest compressions and rescue breaths (CPR) 30:2 for two minutes before it re-analyses heart rhythm.

The AED re-analyses heart rhythm.


CONSIDERATIONS WHEN USING AN AED

- CLOTHING AND JEWELLERY
Any clothing or jewellery that could interfere with pads should be removed or cut away. Normal amounts of chest hair are not a problem, but if it prevents good contact between the skin and the pads, it should be shaved off. Ensure any metal is removed from the area where the pads will be attached. Remove clothing containing metal, such as an underwired bra.

- EXTERNAL FACTORS
Water or excessive sweat on the chest can reduce the effectiveness of the shock so the chest should be dry. If a casualty is rescued from water, dry the chest before applying the AED pads.

If the casualty is unconscious following an electric shock, start CPR immediately the contact with electricity is broken. The electric current may cause muscle paralysis, which can make rescue breaths and chest compressions more difficult to perform, however, it will not affect the use of the AED.

- MEDICAL CONDITIONS
Some casualties with heart conditions have a pacemaker or an implantable cardioverter defibrillator (ICD). This should not stop you using an AED. However, if you can see or feel a device under the chest skin, do not place the pad directly over it. If a casualty has a patch such as a glyceryl trubutrate (GTN) patch on the chest, remove it before you apply the AED.

- PREGNANT CASUALTIES
There are no contra-indications to using an AED during pregnancy; however, the increased breast size may present some problems. Therefore, to place the AED pads correctly, you may need to move one or both breasts. This must be carried out with respect and dignity.



POSITIONING AED PADS ON CHILDREN

- POSITIONING PAEDIATRIC AED PADS
Place one pad in the centre of the child’s back. Then place the second upper pad over the centre of the child’s chest. Make sure both pads are vertical. Connect the pads to the AED and proceed as described.

- USING AED PADS ON A LARGER CHILD
Place the pads on the child’s chest as for an adult – one on the child’s upper right side, just below his collarbone, and the second pad on the child’s left side, just below the armpit. Make sure the pad has its long axis along the head-to-toe axis of the child’s body.