An automated external defibrillator (AED) is a portable medical device designed to deliver an electrical shock to the heart during sudden cardiac arrest. Immediate action before an AED analyzes the heart rhythm is important because early intervention significantly improves the chances of survival and can prevent permanent organ damage.
Recognizing the Emergency and Activating Help
The initial steps upon encountering a potential cardiac arrest victim involve quickly assessing the situation and activating the emergency response system. A person experiencing sudden cardiac arrest will typically collapse without warning, lose consciousness, and become unresponsive. They may also exhibit abnormal breathing, such as gasping, snorting, or gurgling sounds.
Once unresponsiveness and abnormal or absent breathing are confirmed, immediately call for emergency medical services, such as 911 in the U.S. or the equivalent local emergency number. If another person is present, one individual should make the call while the other prepares to provide aid. Simultaneously, if an AED is available nearby, someone should be dispatched to retrieve it.
Initiating Chest Compressions
After activating emergency services and securing an AED, the next immediate step involves initiating high-quality chest compressions without delay. Compressions help maintain blood flow to the brain and other vital organs until the heart’s normal rhythm can be restored.
To perform chest compressions on an adult, kneel beside the person and place the heel of one hand on the center of their chest, specifically on the lower half of the breastbone. Place the other hand on top, interlocking your fingers. Position your shoulders directly over your hands, keeping your arms straight, and use your body weight to press down.
Compressions should be at least 2 inches (5 cm) deep but no more than 2.4 inches (6 cm) for adults. The rate of compressions should be between 100 to 120 compressions per minute, ensuring the chest fully recoils after each compression to allow the heart to refill with blood. While rescue breaths can be administered if trained, the priority for an untrained rescuer is continuous, high-quality chest compressions.
Preparing the Patient
Once the AED arrives, preparing the patient’s chest is crucial for the device to function effectively. This involves exposing the patient’s chest by removing all clothing, including bras, to ensure the AED pads can make direct contact with the skin. If the chest area is wet from sweat or water, it must be wiped thoroughly dry, as moisture can interfere with pad adhesion and electrical conductivity.
Any medical patches, such as nitroglycerin or nicotine patches, located where the AED pads will be placed, should be removed with a gloved hand and the skin wiped clean. Remove any metallic jewelry that might be directly under a pad to prevent burns. If there is excessive chest hair, it may need to be quickly trimmed or shaved to ensure firm pad adhesion, as poor contact can reduce the shock’s effectiveness.
Apply the AED pads to the bare skin, following the diagrams on the pads themselves for correct placement, usually one on the upper right chest and the other on the lower left side of the rib cage. Ensure the pads are firmly pressed onto the skin, avoiding air pockets, which can lead to arcing and burns.