AUTOMATED EXTERNAL DEFIBRILLATOR

2 Outline  AED Intro  Review Adult CPR (if needed)  AED Course (lesson and hands-on)  AED Practical test  AED Written test

3 Course Objectives  Conduction System of the Heart  What is an AED  When and how to use an AED  Special Situations  Troubleshooting  Legal Aspects  Handover to EMS

4 Chain of Survival  Healthy Choices  Recognition of the Warning Signs  Early Access to EMS  Early CPR  Early Defibrillation  Early Advanced Care  Early Rehabilitation

5 Conduction System  The heart has it’s own electrical system  Impulses come from Sino-Atrial (SA) Node (natural pacemaker)  Travel to the Atrio-Ventricular (AV) Node  The tissue where the heart attack happens dies  Impulses cannot cross the dead tissue  Electrical impulses are no longer coordinated resulting in abnormal heart rhthyms

6 Conduction System

7 What is an AED  Analyzes heart rhythm  Generates an electric shock – if required to stop abnormal rhythm in the heart  Blood is not circulating if the heart is in ventricular fibrillation or ventricular tachycardia  Time from collapse to shock is critical  CPR and defibrillation give the best chance of survival

8 Shockable Rhythms Ventricular Fibrillation (VF)  Uncoordinated electrical impulses within the heart  Causes the heart to “quiver”  The ventricles cannot effectively pump blood

9 Shockable Rhythms Ventricular Tachycardia (VT)  Very fast electrical impulses (above 180)  The ventricles don’t have time to fill up and pump blood

10 The AED

11 Types of AEDs

12 ON Operation of AEDs ANALYZE Power ONAttach PadsAnalyze

13 Operation of AEDs Clear the patient !!!!  “I’m clear!”  “You’re clear!”  “Everyone is clear!”  “Shocking now”

14 AED Sequence 1 Check for responsiveness 2 If unresponsive, call 911 or your local emergency number and get AED 3 Check Airway, Breathing, Circulation, (ABC) Perform CPR until AED arrives 4 Attach AED if no signs of circulation 5 Stand clear, press analyze

15 Shock / No Shock Protocols

16 Pad Placement Adult  One pad – right upper chest, just below clavicle  One pad – left lower anterior chest wall

17 Pad Placement Child:  Child Pads (if available) One pad – right upper chest One pad – left lower anterior chest wall  Adult Pads One pad – front middle of chest One pad – middle of back

18 Special Situations  Hypothermia (one shock only)  Water – Wet Environments (do not use)  Moving vehicles or toboggan (must be stopped)  Aircraft or Helicopters (tell aircrew AED in use)  Trauma Patients (not likely to work)  Pregnant Patients (use as normal)

19 Special Situations  Metal Surfaces (use as normal)  Patch Medications (remove patch if in way)  Pacemakers or Implanted Defibrillators (if in way- place pad at least one inch away)  Oxygen (move oxygen one arm length away)  Radio Use (do not transmit during analyze and shock)

20 Who uses AEDs  Healthcare providers, emergency workers, or community responders whose job or volunteer work demands that they know how to defibrillate someone  Caregivers, such as family members of people who are under medical supervision due to a high risk of sudden cardiac death

21 Ceasing AED Sequences  The patient has a pulse  Another trained rescuer takes over  EMS arrives  It is unsafe to continue  A medical doctor says to stop

22 Legal Aspects  In some Provinces/Territories, the use of an AED is considered a Medical Act  The supervising physician provides certification and medical control  Follow provincial or local regulations  Check with Zone or Division Training Officers on the use of AEDs in your area

23 Documentation  Internal event recorders  Patroller should complete a medical report  The AED coordinator is usually responsible for ensuring for passing this information together with the medical report to the receiving hospital.  Annual AED and CPR skill retention/certification

24 Handover to EMS  Paramedics will need to know When was the patient last seen Did anyone see the patient collapse How long has CPR been performed Number of shocks delivered Your name, contact information and whom you are certified under

25 Common Errors  Not checking for ABCs before using AED  Failure to dry or shave chest (if needed)  No CPR or not long enough between “no shocks” or “shocks”  Interrupting the shock protocol to perform CPR  Not following AED voice (display) prompts