Automatic External Defibrillator

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Automatic External Defibrillator
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- Why we use the AED?- How to use the AED?-
Indications for the AED?- Contraindications to
AED?
Objectives for this subject
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The chain of survival- early access to
911-early CPR-early defibrillation-early
advanced care
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Defibrillation is the application of electrical
shock to help restore the hearts regular rhythm
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Defibrillator is the device used to deliver that
shock and it can be manual or automatic.
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Early defibrillation is the single most important
factor in determining survival from cardiac
arrest.
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• Defibrillation should be performed with in the
  first 8 minutes after cardiac arrest. Ideally,
  the sooner, the better.

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AED

• Most common initial rhythms patients go into as
  they enter into cardiac arrest are

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2 Shockable Rhythms V-Tach and V-Fib
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Ventricular TachycardiaFast heart rhythm which
does not allow the heart to fill properly and
cardiac output is compromised and reduced.
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Ventricular Fibrillationdisorganized series of
electrical discharges in the ventricles. Where
the ventricles quiver.Stops Cardiac output and
hearts pumping ability.
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AEDs that are available are automatic and
semi-automatic.
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Automatic where machine does all of the
work.Semi Automatic where machine tells you
when to push button to deliver shock.
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Apply AED as soon as you determine that your
patient is not breathing and does not have a
pulse.
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Always making sure that CPR is still in progress
while you are setting up the AED.
If by yourself, apply the AED.
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• Ensure before putting pads on chest, it is clear
  of all patches, paste or pacemakers. Dont cover
  something up with pad.

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• If patient has hair on chest that could interfere
  with conduction, make sure you shave it off with
  razor provided to you.You want pads on chest to
  fit snug and secure.

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Now attach the adhesive pads to the cables
remembering-White is negative, anterior chest
wall.Red is positive , left anterior axillary
line.
Red on Ribs! White on right!
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Do Not Utilize The Anterior Posterior (Front
and Back) Lead Placement For Automatic
Defibrillation
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Now turn on machine and wait for AED to analyze
the patients rhythm. Making sure that CPR has
been stopped for machine to detect rhythm.
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While waiting for machine, you can begin your
patient information by speaking clearly into the
tape recorder of the machine. You want to give
certain information.
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- Patients age.- Patients past medical
history.- Patients medications. - Brief
description of what happened prior to your
arrival.
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When machine advises a shock is indicated,
CLEAR your patient. Ensuring that no one is
touching patient or stretcher.
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When the AED delivers a shock it will go back and
reanalyze the rhythm. If another shock is
appropriateClear Patientanddeliver the shock.
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Sets of 3 shocks are called stacked shocks and
they are done without any pauses to check
patients pulse or administer CPR
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If No shock is indicated-Check breathing
give appropriate oxygen therapy.-Check pulse,
if no pulse! Start CPR for 1 minute and then
have the AEDreassess.
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Transport patient whenPatient regains a
pulseTotal of 6 shocks have been given.AED
has indicated 3 no shockswith intervening CPR.
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DefibrillatorSome ALS providers will choose to
leave the AED in place. Some will choose to
use their monitor for manual defibrillation.
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Safety should always be maintained by the
provider -Not using near or around
water-Ensuring all med patches and pastes are
off the patient.-Making sure that everyone is
clear of the patient when the shock is delivered.
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Indications for AED Unresponsive Apneic
Pulseless patients.
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Adult Patients

• gt 8 years old
• gt 55 lbs.
• Unresponsive,pulseless and apneic.

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Contraindications

• Infants and children
• lt 8 years old
• lt 55 lbs.

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Contraindications!! Hypothermia !!(Contact
medical control)
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ContraindicationsRigor / Livor Mortis No
Code /DNR
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The AED cant properly analyze patient in moving
ambulance. It is recommended that you stop the
medic and let AED do its job.
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Please review your RegionalMedical Protocol
Manualfor further information