CARDEONEWS

by Jorge Chavez, M.D. F.A.C.C.

Automated External Defibrillator (AED)
 
WHAT IS IT?

An automated external defibrillator (“AED”) is used to shock a victim in a cardiac arrest.

Description

In a cardiac arrest the heart may exhibit an electrical rhythm called ventricular fibrillation, which is a disorganized electrical rhythm that results in death within minutes unless cardiopulmonary resuscitation (CPR) and defibrillation with an AED are performed. The steps below summarize how to use an AED. There are different manufacturers for these devices, but all of these devices operate on the same general principles. (See two examples below: Phillips Heart Start (left) and LifePak 1000 by Physio control (right).)

How To Use an AED

First remember to assess the victim and perform CPR. Victims whose collapse has been witnessed do not require mouth to mouth breathing and hands-only CPR (chest compressions) can be performed. Cardiac arrest victims may gasp or exhibit other unusual breathing patterns, so do not hesitate to start CPR if you determine the victim is unresponsive. A good way to determine if the victim is unresponsive is to rub the breastbone hard, called a “sternal rub”.

In many public places, such as airports, you will see AEDs available on the terminal walls. Your Hotel should also have them too, if you do not sse them, you can send a suggestion to the mannagement urging them to have them on the premises.

Get the AED and bring it to the victim. Be sure that 911 has already been called, in Puerto Vallarta 066 or the  GLOBAL AMBULANCES AT 209-91123.  Some hotels have a medical office inside the hotel with a doctor or a nurse that most likely

will have an AED. Then follow these steps:
Turn on the AED. Most AEDs have the power button prominently displayed in the front. This is the most important step!

The AED will now speak to you and give you all the remaining steps that you need. The AED will tell you to:

Bare the chest from any clothing.

Take the defibrillation patches, and following the pictures on the patches, place one patch on the right upper chest and the other patch on the left side of the chest. Each patch has a picture showing exactly where it goes. If the skin is wet, dry it off before you place the patch.

Plug the patches into the AED (if they do not appear to already be connected).

The AED will automatically start analyzing the heart rhythm and will direct you not to touch the patient as this interferes with the machines ability to analyze.

If the AED has determined that the patient is in ventricular fibrillation it will advise a shock and you will hear the device charge up. The AED will NOT deliver a shock, however, unless you push the shock button.

Make sure everybody is clear of the victim and then press the shock button.

The AED will then advise you to continue chest compressions for about 2 minutes, and will also direct you when it is time to re-analyze the rhythm.

If the AED has determined that a shock is not advised, it will direct you to resume CPR.

Special Considerations

The standard defibrillation patches are intended for adults and children over the age of 8. Smaller, pediatric patches are available for younger children. Do not use the pediatric patches on adults, however.
If the victim has a pacemaker or internal defibrillator (ICD), try to avoid placing the patches directly over the device.
More important than anything else is to act! Do not be afraid to touch the victim and perform CPR. The worst thing you can do is to call 911 and just wait for the paramedics to arrive.  Local chapters of the American Red Cross and the American Heart Association offer CPR classes, where you can learn more about CPR and using AEDs.