When responding to a drowning victim, understanding the proper use of an Automated External Defibrillator (AED) is crucial. This guide clarifies the role of an AED in these emergencies.
Understanding Drowning and Cardiac Arrest
Drowning primarily leads to cardiac arrest due to a lack of oxygen, known as hypoxia. When a person is submerged, their ability to breathe is compromised, causing oxygen deprivation in the bloodstream. This differs from many typical cardiac arrest cases, where the heart stops due to a primary electrical or structural issue. In drowning, respiratory arrest, a cessation of breathing, usually precedes cardiac arrest, meaning the heart stops beating effectively because it is starved of oxygen.
The heart may still have some electrical activity even if it is not pumping blood effectively. Because oxygen deprivation is the main problem, immediate rescue breathing and chest compressions are important for drowning victims. Cardiopulmonary Resuscitation (CPR), especially with ventilation, helps circulate any available oxygen and reoxygenate the body. While an AED can be used, addressing the oxygen deficit through CPR is the initial priority.
Preparing for AED Application
Before applying an AED to a drowning victim, ensure their safe removal from the water to a dry, flat surface. Using an AED on someone who is wet or still in water can be dangerous and ineffective due to water’s conductivity.
Once the victim is out of the water, quickly remove any wet clothing covering the chest. Thoroughly dry the victim’s chest, as water can prevent the AED pads from adhering properly and interfere with the delivery of an effective electrical shock. Any available material, such as a towel or clothing, can be used to dry the chest area. If present, excessive chest hair may also need to be removed to ensure proper pad adhesion.
Applying the AED
After completing the preparatory steps, turn on the AED and follow its voice prompts. These automated instructions guide the rescuer through each stage of the process, making the device accessible even for those without extensive training. The AED will instruct you on where to place the adhesive pads, typically one on the upper right side of the chest below the collarbone and the other on the lower left side.
Once the pads are securely attached to the dry skin, the AED will begin to analyze the victim’s heart rhythm. During this analysis, no one should touch the victim to ensure an accurate reading. If the AED determines a shockable rhythm is present, it will advise a shock and instruct everyone to “clear” the victim before delivering the electrical impulse. Some AED models deliver the shock automatically, while others require the rescuer to press a button.
Immediately after any shock is delivered, or if the AED advises no shock, resume CPR without delay. Continuous chest compressions and rescue breaths are important for maintaining blood circulation and oxygenation. The AED will continue to provide prompts, guiding the rescuer through cycles of CPR and re-analysis until emergency medical services arrive. CPR should only be interrupted briefly for AED analysis and shock delivery.
Ongoing Care and Professional Help
Ideally, a bystander should call for professional help as soon as possible, allowing the rescuer to focus on CPR and AED application. Continuing CPR is important until trained medical personnel arrive and can take over care, or until the victim shows clear signs of life.
Even if resuscitation efforts are successful and the victim regains consciousness or breathing, ongoing medical evaluation is necessary. Drowning victims can experience secondary complications, such as lung injury, including pulmonary edema, or brain damage due to prolonged oxygen deprivation. Hospital evaluation allows medical professionals to assess and manage these potential issues, which may not be immediately apparent following the rescue.