Public access defibrillation
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In public access defibrillation, automated external defibrillators are placed in busy public places such as malls and office buildings or in hard-to-reach locations such as ships and aircraft. The idea is to be able to attempt to restart the heart of a person after a cardiac arrest as soon as possible. This is made possible by the microprocessor-controlled operation of automated external defibrillators.
All automated external defibrillators approved for use in the U.S. use a synthesized voice to prompt users through each step. Most units today are designed for use by non-medical operators. Experts agree that public access defibrillation has the potential to be the single greatest advance in the treatment of out-of-hospital cardiac arrest since the invention of CPR.
[edit] Procedure
Defibrillation is an electric shock which re-initialises the cells of the heart. This in turn allows cardiac nervous pulsations to re-take control of the heart and restart a normal heart rhythm. Modern semi-automatic defibrillators can monitor a patient's heart and decide whether a shock is recommended or not. They can be used over a pacemaker. The system is very safe and can be used by trained non-professional personnel. Defibrillation is an essential part of the CPR, and a patient's chance of survival is directly proportional to how long it takes for defibrillation to be administered.
A defibrillator is programmed to monitor a patient and determine whether a shock is appropriate. During delivery of a shock, no person may touch the patient. A shock is delivered by pressing the appropriate button.
Defibrillators can also be used for monitoring and recording purpose only; a different set of patches is available (two or three small round patches). Should fibrillation occur when the monitoring patches are on, the defibrillator will ask the operator to change patches.
Basic usage of an AED defibrillator is shown as followed. Do not use this information unless you are qualified by a trained instructor to do so.
If you find a victim on the ground, perform 2 full minutes of CPR, starting with checking responsiveness, then call for help and get an AED, unless someone else, other than the victim, is there with you, have them retrieve one. If you see a victim go down, if available, use an AED first. If the AED is not available, continue CPR until one arrives. When an AED arrives, you must:
- Move the victim to a dry, safe location and dry chest area if wet.
- Unzip or open the AED unit.
- Remove shirts, jackets, and on women, remove bras.
- Remove (rip out) any metal objects in the chest area, such as piercings and necklaces.
- Remove medicine patches and wipe the area dry.
- Turn on the unit and follow its instructions.
- Apply pads to the chest as according to the pictorial directions on the pads.
- Plug the pads into the unit.
Once you plug the pads in, it will analyze the victims heart rhythm. Make sure no one is touching the victim during this time. There will be two possible outcomes and solutions, both are shown below:
- It will tell you that no shock is advised.
- it will tell you that a shock is advised.
For the first outcome, leave the pads on and continue CPR starting with chest compressions, unless the device has not been updated. If it has not, follow what the device says, no matter what you were taught. For the second outcome, it will start charging. At this point, no persons should be touching any part of the victim. Once it is done charging, it will tell you to push the shock button. Again make sure you, and everyone else is clear of the victim. After the shock is delivered, it will reanalyze the victim. It will produce the two possible outcomes stated above. If no shock was advised, leave the pads on and continue CPR starting with chest compressions for 2 minutes, or until further help arrives.
For children (1-8), it is exactly the same, with the exception of the pads. Child size pads will be smaller. If there are no child size pads, use the adult ones, placing one on the chest and one on the back. DO NOT USE CHILD PADS ON ADULTS!
Use of an AED on infants is not recommended.
If the victim has an internal defibrillator or pacemaker, place the pads about an inch below it. If the victims chest is hairy, there may be a shaving kit included, if not press the pads down firmly. If the AED tell you to check the pads, rip the pads off, which effectively shaves the area, and apply new ones. If there is only one set of adult pads, but you have child pads as well, use the child pads to shave the area first, then apply the adult pads in the same spot.
