3.2 AED operation and safety considerations
4 min read•august 7, 2024
AEDs are lifesaving devices that shock the heart back into rhythm during cardiac emergencies. They're designed for easy use by anyone, with guiding you through each step. Proper operation and safety are crucial for successful outcomes.
Understanding AED components, , and safety considerations is vital for effective use. From electrode placement to scene assessment and , knowing these details can make the difference in saving a life during CPR.
AED Components and Operation
Key Components of an AED
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- (AED) is a portable electronic device used to automatically diagnose and treat life-threatening cardiac arrhythmias through defibrillation
- AEDs contain a , , and to analyze the heart's rhythm and deliver an appropriate shock when needed
- are adhesive pads applied to the patient's bare chest to allow the AED to monitor the heart rhythm and deliver the shock
- Pads are placed on the upper right chest and lower left side of the chest
- AEDs use voice prompts and to guide the user through the steps of operation (electrode pad placement, when to perform CPR, when to stand for shock delivery)
Delivering a Shock with an AED
- Shock delivery occurs when the AED detects a shockable rhythm ( or ) and prompts the user to stand clear and press the shock button
- Shocks are delivered in a specific (typically between 120-360 joules for adults) to depolarize the heart muscle and allow it to reset to a normal rhythm
- Most AEDs will automatically analyze the heart rhythm after each shock and prompt for additional shocks if needed
- or a should be used for children under 8 years old or weighing less than 55 lbs to reduce the energy delivered during the shock (typically 50-75 joules)
Scene Safety Considerations
Environmental Hazards
- is the first priority when using an AED, rescuers must ensure there are no that could harm the patient or rescuers
- Hazards may include traffic, unstable structures, fire, or hazardous materials
- are necessary as water conducts electricity and can cause the shock to arc or spread to rescuers or bystanders
- Move patient to a dry area if possible, or ensure no one is touching the patient or standing in any puddles during shock delivery
- can also conduct electricity and should be avoided during AED use (remove the patient from metal bleachers, gurneys, or chairs if possible)
Ensuring Rescuer and Bystander Safety
- Always loudly state "Clear" and visually check that no one is touching the patient before delivering a shock
- Ensure rescuers and bystanders stand several feet away from the patient during analysis and shock delivery
- If needed, assign a bystander to help keep the area clear and crowd controlled
Patient-Specific Precautions
Medical Devices and Patches
- such as or can be damaged by AED shocks
- Avoid placing electrode pads directly over these devices, move the pad at least 1 inch away from any visible devices
- (nitroglycerin, nicotine, pain relief patches) must be removed from the patient's chest before applying electrode pads
- Patches can block the conduction of the shock and cause skin burns
- Ensure the chest is wiped clean of any residual medication patch adhesive before applying electrode pads
Patient Characteristics Affecting AED Use
- AED use is not recommended for patients under 1 year of age, as the lowest energy setting may still be too high
- Manual defibrillators should be used for infants, allowing trained providers to adjust the energy setting
- Patients with excessive chest hair may need to have electrode pad sites shaved quickly to allow the pads to adhere and conduct the shock properly
- Patients with large breasts may require a modified pad placement, placing one pad on the upper chest and one on the side of the chest to ensure proper shock conduction
AED Maintenance
Routine Checks and Upkeep
- is crucial to ensure the device is always ready for use in an emergency
- Most AEDs will perform regular and alert with a chirp or flashing light if maintenance is needed
- AED batteries should be checked monthly and replaced every 2-5 years depending on the model
- are the most common cause of AED failure
- Electrode pads have , typically 2-5 years, and should be checked monthly and replaced as needed
- Expired or damaged electrode pads can fail to stick or conduct the shock properly
Post-Use Procedures
- After an AED is used on a patient, it must be properly cleaned and decontaminated according to manufacturer guidelines and local protocols
- The AED data should be downloaded by the appropriate personnel for and
- Most AEDs save data on the patient's heart rhythm, shocks delivered, and CPR intervals that can be useful for the patient's medical record or for training and quality control
- Any used supplies (electrode pads, razors, towels) should be replaced and the AED returned to its storage location for the next use
Key Terms to Review (32)
AED Maintenance: AED maintenance refers to the regular checks and care that are necessary to ensure an Automated External Defibrillator (AED) is functioning properly and ready for use in an emergency. This includes tasks such as checking the battery life, ensuring the pads are not expired, and confirming that the device is clean and free from any damage. Proper maintenance is essential for the reliability of the AED during critical moments, as any malfunction could hinder its effectiveness in treating sudden cardiac arrest.
Automated external defibrillator: An automated external defibrillator (AED) is a portable device that analyzes heart rhythms and delivers an electric shock to restore a normal heartbeat in individuals experiencing sudden cardiac arrest. AEDs are designed to be user-friendly and can be operated by laypersons, making them critical tools in emergency situations. Their rapid deployment can significantly increase survival rates by addressing life-threatening arrhythmias quickly.
Battery: Battery refers to the unlawful and intentional touching or use of force against another person without their consent. In the context of emergency medical situations, understanding battery is crucial as it emphasizes the importance of obtaining consent before providing care, especially when using potentially invasive techniques like CPR or using an AED. This legal principle protects both the patient’s rights and the responder’s responsibilities in a medical emergency.
Capacitor: A capacitor is an electronic component that stores and releases electrical energy in a circuit. It consists of two conductive plates separated by an insulating material, known as a dielectric. In the context of automated external defibrillators (AEDs), capacitors play a crucial role in storing the necessary energy required to deliver a shock to the heart during a cardiac emergency.
Clear: In the context of AED operation, 'clear' refers to the command given to ensure that no one is in contact with the patient or the AED before delivering a shock. This critical safety step prevents accidental injury to bystanders and ensures that the electric shock is effectively delivered to the intended person.
Computerized circuitry: Computerized circuitry refers to the electronic systems and components that are designed to process information using computer technology. This term is crucial in the context of automated medical devices like Automated External Defibrillators (AEDs), which rely on computerized circuitry to analyze heart rhythms, determine the need for defibrillation, and deliver shocks safely. Understanding this term helps highlight how technology enhances the accuracy and efficiency of life-saving interventions.
Defibrillator Pads: Defibrillator pads are adhesive electrodes used in automated external defibrillators (AEDs) to deliver an electric shock to a person experiencing cardiac arrest. These pads are placed on the patient's chest and are essential for monitoring the heart's rhythm and administering a shock if necessary. Proper placement of these pads is crucial for effective defibrillation and improving the chances of survival during a cardiac emergency.
Documentation: Documentation refers to the systematic recording of information related to patient care, interventions, and outcomes in first aid and emergency situations. It ensures continuity of care, provides a legal record, and enhances the overall quality of medical response by detailing actions taken, observations made, and any equipment used. Proper documentation supports accountability and can be crucial during legal inquiries or for future medical reference.
Electrode pads: Electrode pads are adhesive patches used in automated external defibrillators (AEDs) to deliver an electric shock to the heart during a cardiac emergency. These pads contain conductive gel that facilitates the transfer of electrical energy, allowing for the monitoring of the heart's rhythm and delivering defibrillation when necessary. Proper placement and use of electrode pads are crucial for the effectiveness of an AED, ensuring a higher chance of restoring a normal heart rhythm.
Environmental Hazards: Environmental hazards refer to any physical, chemical, or biological agents in the environment that can cause harm or adverse effects to individuals' health and safety. Understanding these hazards is crucial for assessing personal and scene safety, ensuring proper operation of life-saving devices, and providing appropriate care for vulnerable populations like the elderly.
Expiration Dates: Expiration dates are the specific dates marked on medical devices, including Automated External Defibrillators (AEDs), indicating the last day the device or its components are guaranteed to function effectively and safely. These dates are crucial for ensuring that the AED is ready for use in emergencies, as they directly impact the reliability and efficacy of the device during critical situations.
Expired Batteries: Expired batteries refer to power sources that have surpassed their intended shelf life or use-by date, rendering them ineffective or potentially hazardous for devices like AEDs. Using expired batteries can compromise the functionality and reliability of essential medical equipment, emphasizing the importance of regular checks and maintenance to ensure safety and effectiveness in emergency situations.
Implanted medical devices: Implanted medical devices are medical instruments or gadgets that are surgically placed inside the body to assist with various health conditions. These devices can monitor bodily functions, deliver medication, or provide structural support to organs and tissues. They often play a critical role in the management of cardiac issues, chronic pain, and other medical problems, and understanding their operation and safety considerations is essential for effective emergency response, particularly in situations involving automated external defibrillators (AEDs).
Internal Defibrillators: Internal defibrillators, also known as implantable cardioverter-defibrillators (ICDs), are medical devices designed to monitor and correct life-threatening arrhythmias in patients. These devices automatically deliver electrical shocks to the heart when they detect abnormal heart rhythms, effectively restoring normal rhythm and preventing sudden cardiac arrest. Internal defibrillators are essential in providing ongoing protection for individuals at high risk for severe heart problems.
Joule Setting: The joule setting refers to the specific amount of electrical energy, measured in joules, that a defibrillator delivers to the heart during an electrical shock. This setting is crucial because it determines the strength of the shock, which must be sufficient to restore a normal heart rhythm in cases of cardiac arrest. Different types of defibrillators have varying joule settings based on the intended use, and understanding these settings is essential for safe and effective AED operation.
Medication patches: Medication patches are transdermal delivery systems designed to administer medication through the skin into the bloodstream. These patches provide a steady release of medication over time, offering an alternative to oral or injectable routes. They play an important role in various emergency and first aid scenarios, particularly when a patient cannot take medications orally or requires long-term therapy.
Metal surfaces: Metal surfaces refer to the conductive materials that are often found in various environments, including floors, equipment, and structures. In the context of AED operation and safety considerations, understanding metal surfaces is crucial as they can affect the performance of an Automated External Defibrillator (AED) and the safety of both the rescuer and the patient during defibrillation.
Pacemakers: A pacemaker is a medical device that helps regulate the heartbeat by sending electrical signals to the heart muscle when the heart's natural pacemaker fails to function properly. These devices are crucial for individuals with arrhythmias or irregular heartbeats, ensuring that the heart maintains an adequate rate and rhythm. Understanding pacemakers is vital for recognizing how they interact with automated external defibrillators (AEDs) during cardiac emergencies.
Patient-specific precautions: Patient-specific precautions are tailored measures designed to ensure the safety and well-being of an individual during medical interventions, particularly in emergency situations. These precautions take into account the unique medical history, conditions, and needs of the patient, ensuring that actions such as using an Automated External Defibrillator (AED) are both effective and safe. Understanding these precautions is critical in preventing additional harm and optimizing patient outcomes during critical moments.
Pediatric Key: A pediatric key is a specialized feature or accessory used in automated external defibrillators (AEDs) designed specifically for children. This component ensures that the device delivers appropriate energy levels and settings for pediatric patients, minimizing the risk of harm and maximizing the chance of survival in cardiac emergencies involving children.
Pediatric pads: Pediatric pads are specialized adhesive electrode pads designed specifically for use with automated external defibrillators (AEDs) on children. These pads are smaller in size and have different energy settings compared to adult pads, ensuring safe and effective defibrillation for younger patients. Their design helps to deliver appropriate electrical shocks to children during cardiac emergencies, making them a critical component of pediatric emergency care.
Post-Use Procedures: Post-use procedures refer to the necessary actions and protocols that should be followed after an Automated External Defibrillator (AED) has been used. These steps are crucial for ensuring the device is properly maintained, returned to service, and ready for future use, while also addressing any patient care follow-up required after resuscitation efforts.
Pulseless ventricular tachycardia: Pulseless ventricular tachycardia (pVT) is a life-threatening cardiac rhythm characterized by a rapid heartbeat originating in the ventricles, resulting in the absence of an effective pulse. This condition can lead to cardiac arrest as the heart fails to pump blood effectively, making immediate intervention crucial. Understanding pVT is essential for recognizing the need for advanced life support measures, including the use of defibrillation and effective CPR techniques.
Quality Improvement Review: Quality improvement review is a systematic process aimed at enhancing the efficiency and effectiveness of emergency medical procedures, particularly in the use of automated external defibrillators (AEDs). This process involves evaluating past incidents, assessing adherence to protocols, and identifying areas for improvement to ensure better outcomes in cardiac arrest situations. By integrating these reviews into practice, responders can enhance both their skills and the overall safety of AED operations.
Routine Checks: Routine checks refer to regular assessments or inspections conducted to ensure the proper functionality and safety of medical equipment, particularly Automated External Defibrillators (AEDs). These checks are critical as they help identify potential issues, ensuring that the device is ready for use in an emergency situation and complies with safety standards.
Scene safety: Scene safety refers to the assessment and management of potential hazards at an emergency scene to ensure the safety of responders, victims, and bystanders. It is a crucial first step in emergency response, allowing responders to identify threats and take necessary precautions before providing aid. This involves evaluating environmental factors, potential dangers, and establishing a secure area to operate safely.
Self-checks: Self-checks refer to a series of assessments performed by the operator to ensure that an Automated External Defibrillator (AED) is functioning properly and is safe to use in emergencies. This involves checking the device's battery status, pad integrity, and ensuring that the AED is in a ready state for deployment when needed. Regular self-checks are crucial as they help to maintain the reliability and effectiveness of the AED during critical situations.
Shock Delivery: Shock delivery refers to the administration of an electrical shock to the heart using an Automated External Defibrillator (AED) in cases of cardiac arrest. The goal is to restore a normal heart rhythm by delivering a controlled electrical pulse, which can help the heart start beating effectively again. Proper shock delivery is essential for maximizing the chances of survival and requires attention to safety protocols to ensure both the victim's and the responder's safety during the process.
Ventricular Fibrillation: Ventricular fibrillation (VF) is a life-threatening heart rhythm disorder characterized by rapid and chaotic electrical signals in the ventricles, leading to ineffective contractions and a loss of blood circulation. This condition is a critical emergency as it can result in sudden cardiac arrest, requiring immediate intervention with defibrillation and advanced cardiac life support to restore a normal rhythm.
Visual Indicators: Visual indicators are cues that provide important information about the operational status and safety of a device, such as an Automated External Defibrillator (AED). These indicators can include lights, symbols, and screens that communicate whether the device is ready for use, if it detects a shockable rhythm, or if there are any issues that need to be addressed before administering a shock.
Voice Prompts: Voice prompts are audio instructions given by an Automated External Defibrillator (AED) to guide users through the steps of operation during a cardiac emergency. These prompts are designed to be clear and concise, ensuring that even untrained bystanders can effectively use the device in critical situations. The use of voice prompts enhances user confidence and helps maintain the correct sequence of actions, ultimately improving the chances of survival for the victim.
Wet environment precautions: Wet environment precautions refer to the specific safety measures taken to ensure the effective and safe use of automated external defibrillators (AEDs) in situations where moisture is present, such as in rain, pools, or other wet settings. These precautions are crucial for preventing electrical shock to both the patient and the rescuer, ensuring that the AED operates correctly under potentially hazardous conditions.