Automated External Defibrillator (AED) Use

by Mehmet Ali Aslaner

Introduction

AED is a portable electronic device that produced to detect and treat the life-threatening cardiac arrhythmias such as like ventricular fibrillation and ventricular tachycardia in case of sudden cardiac arrest (SCA). AED defibrillate (electrical therapy) the patient to stop life-threatening arrhythmias and allow an effective rhythm.

AED device gives simple orders and can be used by a layperson who was previously trained before, a certified first responder, and health care professionals.

Indication

2015 European Resuscitation Council Guidelines recommend using an AED for adult basic life support (BLS). It should be used in combination with cardiopulmonary resuscitation (CPR).
Pulseless ventricular tachycardia and ventricular fibrillation are the most common and treatable causes of SCA. Therefore, the use of an AED is very important and vital.

Where to find an AED?

Public areas, corporate or government, should keep an AED in offices, shopping centers, airports, airplanes, restaurants, casinos, hotels, sports stadiums, community centers, fitness centers, health clubs, theme parks, schools and universities, workplaces and any other location where people may gather.

AED Kit

An AED kit contains

  • a face shield to provide a barrier between the patient and first aid provider during rescue breathing,
  • rubber gloves,
  • trauma shears for cutting through a patient’s clothing to expose the chest,
  • a towel for wiping away any moisture on the chest, and
  • a razor for shaving extensively hairy chests.

How to use an AED?

  1. recognize abnormal status in case of BLS. When facing an unconscious person, you should decide if he/she is alive or not (unresponsive and not breathing normally) by the BLS algorithm.
  2. If the person is not breathing normally, call the emergency services and send someone to get AED.
  3. begin chest compressions with rescue breaths 30-2 (if trained or able to do).
  4. As soon as the AED arrives,
    • switch on the AED and attach the electrode pads on the patient’s bare chest.
    • CPR should be continued while electrode pads are being attached to the chest, if there is two rescuer.
    • Follow the spoken/visual directions,
    • ensure that no one is touching the patient while the AED is analyzing the rhythm.
      • If a shock is indicated, push the shock button as directed (fully automatic AEDs will deliver the shock automatically). Immediately restart CPR 30-2 and continue as directed by the voice and visual directions.
      • If no shock is indicated, continue CPR until emergency medical service (EMS) arrives.

CPR providers should continue CPR with minimal interruption of chest compressions while attaching an AED. Standard AEDs are suitable for use in children older than 8 years. AEDs are safe to use. Currently, There are no published reports of AEDs’ harmful effects on bystanders. Also, there are no reports of AEDs delivering inappropriate shocks. If someone has a sudden cardiac arrest, using an AED and giving CPR can improve the person’s chance of survival.

Reference and Further Reading

  • Kerber, R.E., et al., Automatic external defibrillators for public access defibrillation: recommendations for specifying and reporting arrhythmia analysis algorithm performance, incorporating new waveforms, and enhancing safety. A statement for health professionals from the American Heart Association Task Force on Automatic External Defibrillation, Subcommittee on AED Safety and Efficacy. Circulation, 1997. 95(6): p. 1677-82.
  • Yeung, J., et al., AED training and its impact on skill acquisition, retention and performance – A systematic review of alternative training methods. Resuscitation. 82(6): p. 657-664.
  • Perkins, G.D., et al., European Resuscitation Council Guidelines for Resuscitation 2015: Section 2. Adult basic life support and automated external defibrillation. Resuscitation, 2015. 95: p. 81-99.
  • Mitani, Y., et al., Public access defibrillation improved the outcome after out-of-hospital cardiac arrest in school-age children: a nationwide, population-based, Utstein registry study in Japan. Europace, 2013. 15(9): p. 1259-1266.
  • AEDs 101: Covering the basics | 2014-10-02 | ISHN. https://www.ishn.com/articles/99726-aeds-101-covering-the-basics