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Artificial automated defibrillator powerpoint presentation
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- 2. SUDDEN CARDIAC DEATH SUDDENCARDIAC DEATH “Sudden cardiac death (SCD) is one of the leading causes of death, striking more than 3,40,000 victims each year. SCD can happen to anyone, any age, anytime, anywhere and sometimes in extreme conditions and remote places. ”
- 3. Definition Definition “SCD is naturaldeath due to cardiac arrest causes, heralded by abrupt loss of consciousness within 1 hour of onset of symptoms in a person who may have pre existing heart disease but in whom time and mode of death are unexpected.”
- 4. SUDDEN CARDIAC DEATH SUDDENCARDIAC DEATH • INCIDENCE -3,40,000 deaths/ year -1 death / 33 sec -13% of all deaths - 50% of CAD deaths • AGE mid 30s - mid 40s
- 5. Mechanism of SuddenCardiac Mechanism of Sudden Cardiac Arrest Arrest • VF >80% (Heart twitches ineffectively) • Asystole • PEA • VT
- 6. Structural causes ofSCD Structural causes of SCD • Coronary heart disease Coronary Artery abnormalities Chr Atherosclerotic lesions Active lesions • MI Healed Acute • Myocardial Hypertrophy Secondary Cardiomyopathy
- 7. Structural causes ofSCD (Contd)_ Structural causes of SCD (Contd)_ • Inflammatory & infiltrative diseases • Volvular Heart disease • EP abnormalities WPW syndrome Congenital QT prolongation
- 8. Transient Functional Contributory TransientFunctional Contributory Factors Factors • Alteration of coronary flow Transient ischaemia Reperfusion following ischaemia • Systemic Metabolic Abnormalities Dyselectrolytaemia Hypoximea, Acidosis • Autonomic Fluctuations
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- 11. PRINCIPLES OF EARLY PRINCIPLESOF EARLY DEFIBRILLATION DEFIBRILLATION • VF - Most frequent rhythm 80% • Basic CPR unlikely to convert • Most effective Treatment of VF • Probability of successful defibrillation overtime (7-10% / min) • VF tends - Asystole • Early Defibrillation -High Priority Goal included in BLS
- 12. SURVIVAL RATE FROMVF SURVIVAL RATE FROM VF • <1 min 90% • 5 min 50% • 7 min 30% • 9-11 min 10%
- 14. CARDIAC CHAIN OFSURVIVAL CARDIAC CHAIN OF SURVIVAL Verify unresponsiveness • Step 1: Early Access to care (calling emergency number) • Step 2: Early CPR - limited effect • Step 3: Early Defibrillation -effective • Step 4: Early ACLS
- 15. CHAIN OF SURVIVAL CHAINOF SURVIVAL
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- 19. GOAL OF EARLY GOALOF EARLY DEFIBRILLATION DEFIBRILLATION • In Hospital < 3 min • Outside Hospital < 5 min
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- 21. ECG MONITOR CUM ECGMONITOR CUM DEFIBRILLATOR DEFIBRILLATOR
- 22. DISADVANTAGES OF DISADVANTAGES OF TRADITIONALDEFIBRILLATORS TRADITIONAL DEFIBRILLATORS • Bulky • Too cumbersome and complicated • Need authorized medical personnel to operate • Users have to be trained in interpreting ECG
- 23. DISADVANTAGES OF DISADVANTAGES OF TRADITIONALDEFIBRILLATOR TRADITIONAL DEFIBRILLATOR • Escalating joules • Monophasic • Too costly • Inaccessible
- 24. • In CCU/OT– Defibrillation possible immediately • Outside Hospital < 1 in 20 survive since effective Tt does not arrive IN TIME, < 5 min • Seconds count
- 25. AED AED • Since mid80s computerized defibrillator • Greatest advance since advent of CPR • EMS personnel could defibrillate- AEDs placed in BLS Amb • Survival rate – Out of hospital arrests • Challenge-Getting defibrillator to victim <10min • Police - Ist to arrive at emergency
- 27. Portable Defibrillators outside PortableDefibrillators outside Hospital Hospital
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- 29. ADVANTAGES OF AED ADVANTAGESOF AED • Small Portable 2.1 Kg, clean, uncluttered design • Simple - for lay persons • Trusted tool of professionals • Sophisticated • Has built in computer
- 30. ADVANTAGES OF AED ADVANTAGESOF AED • Audible and visual prompts-clear ,concise • Shock button activated during VF/VT • Can be configured for manual • Biphasic current • Rugged
- 31. ADVANTAGES OF AED ADVANTAGESOF AED • Detects movement • Filters • High resolution ECG Screen • Pads can be connected to ALS Manual defibrillators • Reusable 3 lead ECG module • Maintenance Free, Status indicator
- 32. BIPHASIC CURRENT BIPHASIC CURRENT •Less joules < 150 -170 J • Non escalating • Less damage to myocardium • Impedance compensating Biphasic Truncated Exponential (BTE)
- 33. • Place AEDwhen SCA confirmed • Avoid movement of patient • No interference by radio signal • Children < 8 years • No Water
- 35. PUBLIC ACCESS PUBLIC ACCESS DEFIBRILLATION DEFIBRILLATION •PAD -A MAJOR STEP In Early defibrillation • Community –CCU • Integration with EMS • New Recognition:- - Extremely easy - AHA Trg-4 hrs -In some states of US anyone with knowledge of AED can use
- 36. PAD RESCUERS PAD RESCUERS •Level 1: Non traditional responders • Level 2: Targeted / Citizen • Level 3 : To Patients
- 37. LOCATION OF AEDs LOCATIONOF AEDs • Airport, Airplane • Public buildings • Offices • Schools • During transfer of patients • Clinics • Police cars • Malls Condominiums
- 38. AED WALL SIGNS AEDWALL SIGNS • Strategic location <1.5 min • Directional information and Arrow • Mounted on a bracket
- 39. TRAINING IN AED TRAININGIN AED
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- 41. HOW TO OPERATEAED? HOW TO OPERATE AED? • Placed next to Tele • Position close to left ear • Only Knowledge - PRESS “ON” • AED speaks and actually guides operator through rest of procedure
- 42. PROMPTS PROMPTS Place adhesive electrodes Plugin Pads connector to AED Press Analyse (Stand clear) Press SHOCK button (Stand clear) (cluster of 3 Shocks)
- 43. PROMPTS PROMPTS Check Respiration andPulse (if shock indicated) Perform CPR 60 sec Press Analyse Press SHOCK button (cluster of 3 shocks) Repeat 3 times
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- 45. FUTURE OF DEFIBRILLATION FUTUREOF DEFIBRILLATION • Initially AEDs – EMS • Simple • Later restrictions - less stringent • Many states have PAD programs
- 46. FUTURE OF DEFIBRILLATION FUTUREOF DEFIBRILLATION • AED as common as Fire Extinguisher • Use by anyone in emergency • Today we are closure than ever in realizing this dream