Question

Discuss the first 3 steps you would take when using an AED.

Answer 1

AED or an automated external defibrillator helps in restoring the functioning of a failing heart. This is an electronic device which can detect the type of  cardiac arrhythmia and will deliver the suitable amount of electric current to restore the normal rhythm of the heart. It is designed with simple audio and visual commands so that even a layman can operate it. Use of AED are taught as a part of BLS training, and in the training of certified first responder and first aid course. As per basic life support guidelines it is important to identify a cardiac arrest as early as possible and to begin with effective compressions and early defibrillation.

When a person falls unresponsive, tap on the chest and check for responsiveness (ask if he/she is feeling okay), check for breathing up to 5 to 10 seconds. If breathing is present connect the victim to the cardiac monitor. If respiration is absent then the health care provider must immediately activate the Emergency response system and retrieve  AED. Pulse check should be performed for 5 to 10 seconds [less than 10 seconds but not less than 5 seconds] and if pulse is detectable then start rescue breaths for one second every 6 seconds and perform rechecking in every 2 minutes. If pulse is not present, start chest compressions at a compression ventilation ratio of 30:2 . As soon as AED or a defibrillator is available check for the cardiac rhythm. Then shock must be delivered subsequently if indicated.

Steps to be followed while using an AED are as follows:

Place the AED by the side of the victim, near to the rescuer who is going to apply shock while the other rescuer continues CPR

• Turn on the AED (some AED will turn on automatically when the case is opened), listen to the audio and visual instructions
• Open the shirt of the victim and wipe dry his/her chest. [In case, if victim is wearing any slow release medication patches it should be removed with the help of a gloved hand before wiping the chest]. Also remove the jewellery (if any) that the victim is wearing. Also check for pacemaker or implants
• Attach the AED pads as indicated on the diagram or on the pads and connect to a power plug if required (choose between pediatric and adult pads if applicable)
• If required press the analyze button to identify the victims heart rhythm before delivering current
• If the AED recommends to deliver a shock, make sure the site is clear. Instruct all to stand clear [ no one should be in contact with the patient or his/her belongings while delivering shock]
• Press the 'deliver shock button'
• Begin CPR soon after the shock for next 2 minutes and reassess the client. If shock is not advised begin CPR immediately.