Successful application of the AED pads means the initial preparation steps, including calling emergency services and preparing the patient’s chest, are complete. The subsequent actions are entirely dictated by the device itself, making a smooth, immediate transition into the analysis phase paramount. The time between collapse and defibrillation is directly linked to the chance of survival, emphasizing the speed required for the next procedural steps.
Initiating Analysis and Ensuring Safety
Once the pads are firmly attached and the connector is plugged in, ensure the AED is powered on. Many modern AEDs automatically begin analysis upon connection, but some models require the user to press a power button. The device will communicate its status through clear voice prompts, which serve as your instruction guide.
The AED then enters the analysis phase, assessing the heart’s electrical activity for a shockable rhythm. During this period, it is essential that no one touches the patient or any conductive material. The voice prompt will typically announce “Analyzing rhythm” or “Stand clear,” prompting you to loudly state “Clear!” to warn bystanders. This command prevents accidental shock delivery and ensures an accurate reading of chaotic electrical patterns like ventricular fibrillation (VF) or pulseless ventricular tachycardia (pVT).
Following the AED’s Analysis
The analysis phase concludes with one of two announcements: “Shock Advised” or “No Shock Advised.” If a shockable rhythm is detected, the device automatically begins charging its internal capacitor. This charging process takes several seconds, and the AED will continue to instruct everyone to stand clear of the patient.
When fully charged, the AED issues a final warning. The rescuer must visually confirm everyone is clear by shouting “I’m clear, you’re clear, everybody’s clear!” before pressing the shock button. This action delivers the life-saving electrical current.
If the AED announces “No Shock Advised,” it means the device did not detect a rhythm that can be corrected by defibrillation. In this case, the crucial next step is to immediately pivot back to manual intervention. The pads must remain attached regardless of the outcome, as the AED will continue to monitor the heart rhythm.
Immediate Resumption of CPR
Whether a shock was delivered or advised against, the next step is the immediate resumption of Cardiopulmonary Resuscitation (CPR). There is no waiting period to check for a pulse or breathing. The goal is to immediately circulate blood and oxygen.
The rescuer should immediately begin chest compressions, aiming for a rate of 100 to 120 compressions per minute and a depth of at least two inches for an adult. The AED often provides a metronome beat to help maintain the correct rate.
The CPR cycle continues for approximately two minutes, consisting of 30 compressions followed by two rescue breaths. At the conclusion of this period, the AED automatically prompts the rescuer to stop CPR and stand clear for another rhythm analysis. This cycle must continue until emergency medical personnel take over care or the patient shows signs of consciousness and normal breathing.