Using An AED
What is Sudden Cardiac Arrest (SCA)?
Sudden cardiac arrest (SCA) means that an electrical disturbance in the heart has caused it to unexpectedly & abruptly stop beating. This is often due to an abnormal heart rhythm called ventricular fibrillation (VF).
Is Sudden Cardiac Arrest the same as a heart attack?
No, a sudden cardiac arrest (SCA) and a heart attack are not the same. However, heart attacks are serious and sometimes will lead to SCA.
Heart Attack: Is a condition in which the blood supply to the heart muscle becomes heavily restricted or blocked, resulting in the death of the heart muscle. Heart attack victims usually (but not always) experience chest pain and remain conscious.
Sudden Cardiac Arrest (SCA): Is when the heart unexpectedly & abruptly stops beating. SCA may occur independently from a heart attack and without warning signs. SCA results in death if not treated immediately.
Who is at risk for Sudden Cardiac Arrest?
SCA is not restricted to any age or gender; it can strike anyone, anywhere, anytime. However, it is more common in the elderly, unfit and those with known heart complications.
What is ventricular fibrillation (VF)?
VF is often seen in SCA victims and is defined as an abnormal heart rhythm. This rhythm is created by an electrical abnormality in the heart causing it to beat very fast, prohibiting the heart from effectively pumping blood. During VF the heart just quivers and cannot effectively pump blood. VF is short lived and will deteriorate to asystole (flat line) if not treated promptly.
How is ventricular fibrillation (VF)? Treated?
An electrical shock via a defibrillation is the only effective treatment for VF. Defibrillation involves passing a specialized electrical current passes through the heart with the intent of stopping the VF, giving the victim an opportunity to regain normal heart function. An automated external defibrillator (AED) can provide VF victims with defibrillation; helping the heart to reorganize the electrical activity so it can pump blood again.
What is an AED?
AED stands for automated external defibrillator and is intended help restore normal heart function to those who suffer heart beat abnormalities. An AED has 3 main capabilities:
- Read heart beat and analyze for shockable heart rhythm.
- Alert rescuers of the need for defibrillation.
- Provide defibrillation if needed.
Can an AED cause further harm to a victim?
The AED is extremely safe to use on people who are unresponsive and not breathing. The AED is capable of analyzing heart beat rhythms to make shock delivery decisions, and will only defibrillate a shockable rhythm.
Should I perform CPR before or after applying electrode pads from the AED?
Perform CPR only until the AED arrives on site. Immediately apply the electrode pads to the victim's bare chest and follow the directions given by the AED. It will tell you when to resume CPR.
If defibrillation is important, why do I need CPR?
The intent of CPR is to provide some circulation of oxygen rich blood to the victim's heart and brain. Without oxygen cells in the heart and brain will begin to die. CPR helps delay this process giving a greater chance of recovery. CPR has also been shown to make the heart more likely to respond to defibrillation.
Can I be in legal trouble for using an AED?
Most states have passed “Good Samaritan” legislation protecting the lay rescuer from lawsuits. Please review you local laws to confirm liability.
Can I accidentally shock another rescuer or myself?
When used correctly AED’s are extremely safe. The AED is programmed to deliver an electrical shock from one electrode pad to another through the victim's chest. Following basic safety precautions, such as verbally warning others to stand clear and visually checking the area before and during the shock will help to ensure the safety of rescuers.
What if the victim has a medication patch on or EKG electrodes on the chest?
AED electrode pads should NEVER be placed directly on top of medication patches, such as nitroglycerin, or EKG patches. Patches should always be removed and skin wiped dry, prior to placing electrode pads on the skin.
Do I need to remove the electrode pads before performing CPR?
No. You do not need to remove the pads prior to performing CPR and is recommended you leave them in place to save time, thus increasing the victim’s chance of survival. It is recommended that you leave the electrode pads in place throughout the resuscitation and until the victim is transferred to advanced care providers such as the paramedics. When placed in the correct location on the victim's chest, the pads will not interfere with proper hand placement or compressions required for CPR.
Should I use the AED if the victim has a pacemaker or is pregnant?
Yes, you should NEVER withhold AED use from a person with SCA, as they are likely to die without immediate treatment.
Can I defibrillate on a wet surface?
Yes, you can defibrillate on a wet surface as long as the usual safety rules are observed. Always ensure the victim's chest is wiped dry and keep the electrode pads away from damp or conductive surfaces.
Can I defibrillate on or near a metal surface?
Yes, you can defibrillate on or near metal surfaces as long as the usual safety rules are observed. Keep the electrode pads away from damp or conductive surfaces. Don’t allow anyone to touch the victim while a shock is delivered.
How much of the victim's clothing should be removed to carry out defibrillation?
The victim’s chest should be exposed to allow correct placement of the electrode pads. For women this usually means the bra must be removed. Clothes may need to be cut off.
Why is it important to ensure the electrode pads are firmly adhered to a clean, dry chest?
In order for successful defibrillation to occur, electricity must flow from one electrode pad to the other through the chest. If the electrode pads are not firmly adhered to the chest or there is sweat or another conductive material between the electrode pads, the electricity will be more likely to flow across the chest rather than through it.
Is it okay to place the electrode pads directly on a hairy chest?
Electrode pads are required to make direct skin contact in order for successful defibrillation to occur. In an emergency situation where the chest hair is so excessive as to prevent good adhesion of the electrode pad, the hair must be removed quickly.
What if I have a child victim?
If you have a child victim you should use the specialized pediatric electrode pads. These pads are designed to carry a lower charge for treating children with SCA.
After successfully defibrillating the victim, do I keep the electrode pads on?
Yes. It is recommended that you leave the electrode pads in place throughout the resuscitation and until the victim is transferred to advanced care providers such as the paramedics. Even after a victim has been successfully defibrillated, they are still at risk of developing VF again. The AED will continually monitor the victim’s heart rhythm for the return of VF. If VF is suspected, the AED will automatically begin to analyze victim after two minutes of CPR is complete.
What if the victim regains a pulse but is not breathing or is breathing slowly?
If the victim regains a pulse but is not breathing or breathing slowly you should give rescue breaths at a rate of 1 every 5 seconds or 12 per minute.
I used an AED on a SCA victim and the AED always prompted “No Shock Advised”. Even with CPR the victim did not survive. Why didn't the AED shock this victim?
The AED is designed to only shock a victim that matches a VF (ventricular fibrillation) or VT (ventricular tachycardia). Although VF is the most common rhythm in cardiac arrest, it is not the only one. Other forms of SCA are not treated with defibrillation shocks. A “no shock advised” message doesn't mean the victim's heart rhythm is back to normal, only that the system does not detect a VF or VT heart rhythm.
What if I don't do all the steps of AED/CPR perfectly?
Responding in the event of SCA is a highly stressful situation. Even experienced health care professionals don’t always do everything perfectly. In the event of SCA, performing CPR and using an AED can only help the victim.
What if I'm not certain whether or not I need to use an AED?
When you are unsure whether or not to use and AED remember this rule:
Only use an AED on someone you would give CPR to – unresponsive and not breathing.