An Automated External Defibrillator (AED) is a portable medical device designed to treat sudden cardiac arrest, a condition where the heart unexpectedly stops beating effectively. This machine analyzes the heart’s rhythm and, if necessary, delivers an electrical shock to help restore a normal heartbeat. Its timely application can significantly improve survival rates. AEDs are designed with clear instructions, making them accessible even to those with minimal training.
Recognizing the Need for AED Use
A person experiencing sudden cardiac arrest will collapse, be unresponsive, and not be breathing normally, or may only be gasping for air. They may also show slight shaking movements, similar to a seizure.
Upon recognizing these signs, immediately call emergency services, such as 911. If another person is present, ask them to retrieve an AED while you initiate cardiopulmonary resuscitation (CPR). If you are alone, use a hands-free speaker on your phone to communicate with dispatch while beginning CPR. Rapid action is important because the chances of survival decrease by approximately 10% for each minute defibrillation is delayed.
Essential Steps for AED Deployment
Once an AED is available, turn it on and follow its voice prompts. Expose the person’s bare chest by removing all clothing, and if wet, quickly wipe it dry. Apply the AED pads directly to the bare skin, following the diagrams on the pads. For adults, one pad is typically placed on the upper right chest, just below the collarbone, and the other on the lower left side, a few inches below the armpit.
Ensure that the pads adhere firmly to the skin. Proper contact is necessary for the AED to accurately read the heart’s rhythm and deliver an effective shock. After pads are attached, plug the connector cable into the AED. The AED will then analyze the heart’s rhythm. It is important that no one touches the person during this analysis to ensure an accurate reading. If a shock is advised, the AED will prompt you. Before delivering the shock, loudly announce “CLEAR!” then press the shock button if it’s a semi-automatic model, or the device will deliver it automatically.
Critical Safety and Situational Factors
Several factors require special consideration when using an AED. If the person is in water, move them to a dry area and thoroughly dry their chest before applying the pads. It is safe to use an AED on a wet surface, in snow, or on a metal surface, provided their chest is dry and no one is in direct contact during the shock.
Medication patches on the chest, such as nitroglycerin or nicotine patches, should be removed and the area wiped clean before placing AED pads. This ensures proper energy transfer. If the person has an implanted device like a pacemaker or implantable cardioverter-defibrillator (ICD), place the AED pads at least one inch away from the device. This allows the AED to function effectively.
For individuals with very hairy chests, excessive hair can prevent proper pad adhesion. If a razor is available in the AED kit, shave the areas where the pads will be placed. If no razor is present, firmly press the pads down; some kits include a second set of pads which can be used to quickly remove hair by applying and tearing off the first set. For children, use pediatric pads and settings if available, or adult pads with specific front-to-back placement if pediatric pads are not an option.
Actions Following AED Use
After the AED delivers a shock, or if no shock is advised, immediately resume chest compressions and continue CPR. The AED will often provide a metronome sound to maintain the correct compression rate, typically around 100-120 compressions per minute. Continue following the AED’s voice prompts, which will indicate when to perform two minutes of CPR before re-analyzing the heart rhythm.
Do not remove the AED pads or turn off the device, as it will continue to monitor the person and may advise additional shocks. Continue these cycles of CPR and AED use until emergency medical services (EMS) arrive. Even if the person regains consciousness and breathing, monitor their condition closely and keep the pads attached until medical professionals can provide further care.