how to defib

1. AUTOMATED
EXTERNAL
DEFIBRILLATION
LESSON
10

2. 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

3. 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

4. HEART’S ELECTRICAL SYSTEM

5. HEART’S ELECTRICAL SYSTEM
System keeps contractions of four chambers
of heart synchronized
With heart attack (or other problems), rhythmic
electrical control disrupted

6. VENTRICULAR FIBRILLATION (VF)
Most common abnormal heart rhythm
Ventricles of heart are quivering instead of
beating rhythmically
In about ½ of cases of cardiac arrest, victim’s
heart is in VF

7. HOW AEDS WORK
Automatically checks victim’s heart rhythm
to detect fibrillation
Advises whether victim needs a shock
 The shock (defibrillation) may return heart to
a more normal rhythm

8. 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%

9. THE AED UNIT
Contains a battery and is portable
Unit has 2 pads connected to it with cables
Pads are placed on victim’s chest
Unit analyzes victim’s heart and advises whether
to give a shock

10. USING AN AED
Whenever patient suddenly collapses or is
found unresponsive consider cardiac arrest

11. AED AND CPR
Check patient’s 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

12. ATTACH AED TO
PATIENT
Be sure patient 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
One on right side below collar bone,
the other below and to left of left
nipple

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

14. 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 continue CPR
Follow unit’s prompts

15. 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

16. DIFFERENT AEDS MAY USE
DIFFERENT PROMPTS
Follow unit’s voice and picture prompts
Some units programmed to administer
shock automatically; follow unit’s
prompts

17. 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

18. IF THE AED SAYS NO SHOCK
Patient’s heart will not benefit from
defibrillation
Immediately continue CPR

20. Position victim away from water and metal.
Place unit by victim’s shoulder.

21. Expose victim’s chest.
Dry or shave area as necessary.

22. Apply pads to chest.

23. Stand clear.

24. Follow prompts.

25. 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

26. AED ALERTS
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 2-way radio within
6 feet of AED.

27. AED USE IN CHILDREN
Follow adult guidelines for children > 8
years
Sudden cardiac arrest can occur in
younger children
SIDS
Poisoning
Drowning
Heart problems

28. AED USE IN CHILDREN
Give child 2 minutes of CPR before using AED
 Unless witnessed that child collapsed suddenly

29. 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

30. AED AGE RECOMMENDATIONS
AED use recommended for adults and
children ages 1 - 8
AED use for infants is not recommended

31. 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

32. VARY AED PLACEMENT IF THERE
IS AN INTERNAL DEVICE

33. REMOVE MEDICATION PATCHES
PRIOR TO PAD PLACEMENT

34. 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

35. AED MAINTENANCE
AEDs require regular maintenance
Check manufacturer’s manual
Daily inspection ensures AED ready for use and supplies are present