Unit 6 Automated External Defibrillation

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Unit 6Automated External Defibrillation

• PE 216 Emergency Response

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Purpose of AED

• Most cardiac arrests occur outside of hospitals
• Combined with CPR, early defibrillation increases
  the chance of surviving cardiac arrest

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Electrophysiology of the Heart

• Muscle relies on electrical currents in order to
  contract
• The heart regulates itself through electrical
  nodes which create electrical impulses
• The impulse is delivered to the muscle through
  nervous pathways
• Rate and regularity of contraction is regulated
  within medulla oblongata

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Electrophysiology of the Heart
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Electrical Dysfunction

• Signals can be disrupted by disease or injury
• Congenital defects
• Blunt force
• Brain injury
• Respiratory distress
• When signals become disrupted or irregular, the
  heart does not circulate blood effectively to the
  body

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Types of Heart Rhythms

• Sinus rhythm normal heart beat
• Ventricular tachycardia excessively fast heart
  beat
• Ventricular fibrillation totally disorganized
  electrical activity
• Asystole heart is absent of electrical activity

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Sinus Rhythm
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Ventricular Tachycardia(V-tach)
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Ventricular Fibrillation(V-fib)
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Asystole
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Defibrillation

• V-tach and V-fib are the only treatable heart
  arrhythmias, and most commonly occur within the
  first few minutes after collapse, before the
  heart stops completely
• Defibrillation causes a disruption in heart
  activity, with the hope of resetting it to normal
• Defibrillation is not intended to restart a heart
  that has no electrical activity

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AED

• A machine that analyzes the hearts rhythm
• If fibrillation or tachycardia are present, the
  machine is capable of delivering a shock
  significant enough to reset the heart
• Should be attached to any victim suspected of
  being in cardiac arrest

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Using an AED

• Should be used ASAP
• Select pads based on child or adult (1-8 child)
• If AED does not have child pads, placement of
  adult pads may be altered
• Center of Chest
• Middle of Back

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Using an AED

• Turn on the machine
• Remove the victim from water or metal surfaces
• Wipe the chest dry
• Shave any excess hair
• Attach the pads
• Plug the pads into the AED

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Pad Placement
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Analyzing and Shocking

• Ensure that no one is touching the patient!
• Bystanders too close will be shocked as well
• Do not stand in water around the patient
• Push the analyze button and wait
• The machine will advise whether or not a shock is
  advised
• If so, everyone should be clear, push button to
  administer the shock
• If not, re-check for a pulse, and continue CPR as
  necessary

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Considerations

• Shave the pad areas on excessively hairy patients
  before attaching pads to increase contact quality
• Remove any metal jewelry from the patient
• Do not use alcohol to wipe the chestit is
  flammable
• Do not use around oxygen or gasoline
• Do not use in a moving vehicle

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Considerations

• Remove nitroglycerin, nicotine, or birth control
  patches before shocking
• Patch will burn into the skin
• Always do so with a gloved hand (absorption)
• Do not use cell phones or radio within 6 feet of
  AED while analyzing
• Remove victim from water (rain, puddles, pool)
  before shocking
• Ensure that rescuers, bystanders are not standing
  in water either
• Charge may arc between puddles and shock
  bystanders

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AED Maintenance

• Pads are only used once, but are very expensive
  (75-100/set)
• Adequately check battery and system regularly
• Perform other necessary maintenance consistent
  with manufacturers guidelines