University of Rochester Medical Center Public Access Defibrillation Program

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University of RochesterMedical Center Public
Access Defibrillation Program
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Ground Floor Locations

• 1. G-1450
• 2. G-1300
• 3. G-5601
• 4. G-6404
• 5. G-9400
• 6. G-3294
• 7. G-6100
• 8. G-8011

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First Floor Locations

• 9. 1-1300
• 10. 1-1220
• 11. 1-1340
• 12. 1-5434
• 13. 1-9656
• 14. 1-4300A
• 15. 1-6080

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Second/Third Floor Locations

• 16. 2-6424
• 17. 3-9656

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HeartStart FRx Defibrillator
PRODUCT TRAINING
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HeartStart FRx Defibrillator
RESPONDING TO SUDDEN CARDIAC ARREST
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Sudden Cardiac Arrest (SCA)

• Abrupt loss of heart pump function
• Death certain without rapid treatment

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The Heart Pump a series of events...

• An electrical event
• stimulates a mechanical event
• which results in a rhythmic and coordinated
  pumping action of the heart muscle

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SCA and Ventricular FibrillationA Heart in Chaos

• Abnormal irregular, very fast heart rhythm
• Heart cant pump blood effectively
• Victim
• Unresponsive
• Not breathing normally
• No signs of circulation
• Only definitive treatment for VF Defibrillation

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What Is Defibrillation?

• Electric shock to the heart
• Stops uncoordinated activity
• Allows coordinated heart rhythm and pumping
  action to resume
• Only effective treatment for ventricular
  fibrillation

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HeartStart FRx Defibrillator

• HeartStart FRx is designed to be
• Simple to learn, easy to use
• On standby, alert and ready
• Places the power to save a life in the hands of
  those first on the scene
• HeartStart FRx automatically
• Prompts the user
• Interprets heart rhythm
• Advises Shock only if rhythm is shockable
• Provides CPR Coaching

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Chain of Survival

• Rapid, coordinated response improves outcome
• Defibrillation an EARLY priority

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CPR Training

• HeartStart FRx Defibrillator users should have
  training in adult cardiopulmonary resuscitation
  (CPR) and infant/child CPR if utilizing the
  Infant/Child Key.
• CPR is a vital component of defibrillator use and
  should be learned through manikin practice.

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Role of CPR

• Integral component of defibrillator use
• CPR circulates oxygen ...
• Prolongs hearts electrical activity
• Minimizes brain damage
• Primes heart for next shock
• but defibrillation is the definitive treatment
  for the most common cause of SCA

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Role of the Defibrillator Provider

• Recognize emergency and activate EMS response
• Verify victim is unresponsive and not breathing
  normally
• Get HeartStart FRx Defibrillator
• Turn on FRx and follow voice instructions
• Provide CPR as needed

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HeartStart FRx Defibrillator
ADULT DEFIBRILLATION
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Check for signs of SCA

• Assess the victim

not breathing normally
unresponsive
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Using the HeartStart FRx
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• Turn on defibrillator

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• Follow voice instructions

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• Deliver the shock

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Press the On/Off button

• Voice instructions begin

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Follow voice instructions

• Remove clothing from chest
• Dry the chest if wet clip hair if excessive

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Open Pads Case

• Open gray pre-connected SMART Pads II case

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Place pads

• Peel off one pad and place as shown on icon
• Repeat with second pad
• Press pads firmly on chest

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Pads Location

• Pad on victims right
• Below collar bone
• Right of sternum
• Pad on victims left
• On rib cage
• Below breast
• Wrapped towards back

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Rhythm Analysis

• Caution light will flash during analysis
• Dont touch victim while defibrillator is
  analyzing heart rhythm
• Caution light goes solid if a shock is advised
• Outcome of analysis
• Shock advised
• No shock advised

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Press the Shock Button

• The defibrillator will advise a shock only if it
  detects a shockable rhythm
• Visually and verbally clear victim before
  pressing shock button
• Press flashing orange button when instructed to
  deliver a shock

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No Shock Advised

• If no shock is advised, the defibrillator will
  tell you it is safe to touch the patient
• The Caution light will turn off
• The FRx will tell you to check the patient and
  perform CPR if needed

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CPR Coaching

• Press the flashing blue i-button to activate CPR
  coaching
• Provides instruction in basic CPR, including rate
  and depth of compressions
• Gives instructions for adult or, if Infant/Child
  Key is inserted, pediatric CPR

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HeartStart FRx Defibrillator
INFANT/CHILD DEFIBRILLATION
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Infant/Child Key

• Available separately as accessory
• For use when defibrillating infants and young
  children under 55 lbs or 8 years old
• With Key inserted, FRx announces Infant/Child
  mode when turned on
• Pads are placed anterior-posterior on the middle
  of chest and back
• Use icons on pads for correct placement

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Insert Infant/Child Key

• Remove the Infant/Child Key from its pocket in
  the carry case.

• Insert Key in slot on the face of the FRx.
• Push down firmly until Key clicks into place

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Indications for Use
Same as adult
not breathing normally
unresponsive
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Prepare Chest

• Remove all clothing from patients chest
  and back

• Clean/dry skin as necessary

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Recommended Pad Placement Anterior-Posterior
(front-back)
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Recommended Pad PlacementAnterior (front)

• Place first pad over sternum between
  nipples

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Recommended Pad PlacementPosterior (back)

• Place second pad between shoulder
  blades on back

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Alternative Pad PlacementAnterior-Anterior
(front-front)

• For larger children
• Right pad may wrap over patients shoulder
• Pads must not touch

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Rhythm Analysis

• As soon as the pads are in place, the FRx begins
  to analyze the patients heart rhythm
• Use of Infant/Child Key does not change basic
  operation, but FRx recognizes the Key and
  provides pediatric CPR coaching if requested

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Considerations

• No special pads are required for pediatric
  defibrillation with the FRx.
• For infants or children under 55 lbs or 8 years
  old, use Infant/Child Key if available.
• If no Key is available and victim is under 55 lbs
  or 8 years, use the FRx and place pads in
  anterior-posterior (front-back) position.
• If victim may be over 55 lbs or 8 years old, do
  not use Key. Place pads in anterior-anterior
  (front-front) position.
• Do not delay treatment to determine the childs
  exact age or weight.

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Essential Training
Philips recommends that all persons trained to
use the FRx Defibrillator on pediatric patients
also be trained to provide pediatric CPR and
other basic life support.
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HeartStart FRx Defibrillator
TROUBLESHOOTING
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Troubleshooting

• During use, FRx will give voice instructions
• Pads contact FRx will tell you to press the pads
  firmly to the skin, or that pads should not be
  touching the patients clothing
• Battery power low FRx will tell you to replace
  battery
• Rhythm analysis difficulty FRx will tell you to
  stop all motion
• When not in use, FRx will chirp, green Ready
  light will be off, and blue i-button will flash
  to alert you to any problem
• Press flashing blue i-button for voice
  instructions

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HeartStart FRx Defibrillator
OTHER CONSIDERATIONS
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Other Considerations

• Implanted pacemakers or defibrillators
• Wet surfaces
• Metal surfaces
• Medication patches
• Children
• Trauma and hypothermia

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Philips Medical Fast Response Kit

• 2 pairs of hypoallergenic nitrile gloves
• Laerdal pocket breathing mask
• Paramedic scissors
• Gallant chest hair razor
• Large extra-absorbent paper towel
• These items are contained in a 5-1/2" x 9-1/2"
  zippered pouch

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Training Needs

• For training in CPR
• Contact the Office For Educational Resources
  (OER)
• 275-7666
• www.urmc.edu/smd/education/oer
• Contact your local Ambulance Service or Fire
  Department