An automated external defibrillator (AED) is a portable device that can save someone’s life during cardiac arrest. It’s a convenient yet simple way to provide a patient with an electric shock when their heart has stopped pumping. You will find AEDs in malls, offices, venues, transportation terminals, public buildings, fitness centers, and other populated areas. If you find someone unconscious, grab the closest AED available or have someone grab it for you. The device may literally save someone’s life.
Even though an AED is complex and technical, it is actually very easy and safe to use. Most people including children should be able to use an AED at ease. All rescuers have to do is follow the steps that are vocally and visually presented upon turning on the device. The instructions are very straightforward, so don’t worry about getting confused.
Before using an AED, have bystanders help you with the first couple of steps to minimize the amount of time wasted. The quicker you can use the AED to evaluate the patient’s heart rhythm and provide them with an electric shock if needed, the better. If you don’t have bystanders around, scream for help as loud as you can while getting started with the following the steps:
- Call for emergency help. When using an AED, it will remind you to call for emergency help. So, if you haven’t done so already, call for emergency services before using the AED.
- Remove all clothing from the patient’s chest. You’ll need to remove all the clothing from the patient’s chest, even if that means ripping and tearing apart their clothing. Once the chest is exposed, you’ll need to ensure that the area is dry. At most, the chest can be moist, but not wet. Quickly remove or move aside all jewelry, bras, and other pieces of metal to prevent electrical burns. Don’t waste too much time with this as it is not a critical step. You’ll want to move on to the next step as quickly as possible.
- Shave the chest area. Very soon, you’ll be placing sticky pads on the patient’s chest, so you’ll want to shave the hair off the chest area with a razor to maximize contact between the pads and the skin. If you don’t have a razor handy, you can use scissors to cut the hair as short as you can. Although some people recommend using the pads to rip the hair off, it’s not a great solution as most AEDs only come with one set of sticky pads. For maximizing effectiveness, you’ll want the AED to be as clean and sticky as possible.
- Turn the AED on. Finally, turn on the AED and carefully follow all the prompted instructions. With most AEDs, you can turn them on by pressing the “On” button or by opening the front lid.
- Remove the pads from the packaging. Inside the AED, you’ll find one set of pads sealed inside a plastic package. This is done to prevent the pads’ adhesives from drying out. Take the pads out of the package and look at the illustrations. It’ll show you exactly where you should place each pad on the patient’s body. The illustrations should show one pad being placed under the right collar bone and the other one under the left armpit, next to the breast. Place them as accurately as possible. Since the pads are interchangeable, you don’t have to worry about placing a specific pad on the collar bone or under the left armpit.
- Clear for analysis. After placing the pads on the patient’s body, ensure that nobody is touching the victim. The AED will start to evaluate the patient’s heart rhythm to determine whether the patient needs an electric shock or not. Shout “Clear!” and make sure that no one is touching the patient or else the evaluation may be skewed.
- Clear for shock. After the evaluation is complete, the AED will advise you whether the patient requires an electric shock or not. If no shock is needed, it means that the patient is not in a critically bad state. However, you’ll still need to perform CPR on the patient until you find a pulse or until emergency help arrives. If a shock is required, the AED will state “Shock is advised.” It’ll again prompt everyone to stay clear of the patient. Just like the analysis step, you’ll want to shout “Clear!” and make sure that no one is touching the patient. Shortly, the AED will deliver the patient with an electrical shock and then prompt you to start CPR for two minutes. After two minutes, the AED will advise you that it’s going to do another evaluation.
- CPR. When the AED prompts you to perform CPR, leave the pads on and start giving the patient 30 chest compressions followed by 2 rescue breaths. After two minutes while you repeat the CPR cycle, the AED will prompt you that it’s going to reanalyze the patient. Repeat steps 6-8 after each analysis. Keep repeating those steps until emergency help arrives.
How an AED works
The sticky pads found in the AED have sensors which are also called electrodes. As you already know, the electrodes serve as a conduit to deliver an electric shock if needed. After placing them on the patient, the electrodes collect and send information about the patient’s heart rhythm to the built-in computer found in the AED. The computer then calculates and analyzes the information to determine whether an electric shock is needed. If an electric shock is not needed, the AED will not provide a shock under any circumstances as they’re designed to only do so when Ventricular Fibrillation is detected.
When an electric shock is needed, electrical currents are delivered to the patient’s heart, temporarily stunning it. This process gives the patient’s heart a chance to beat normally by interrupting the abnormal rhythm. As mentioned earlier, although AEDs seem very technical, they are 100% safe to use by anyone, including children. You’ll find AEDs in public areas, so learning how to use one beforehand will increase your confidence upon using one.
Things to look out for
There are multiple things to look for when using an AED. When it’s time to use one, you can’t be careless as it may cost the patient their life. Here are some things to look out for:
- The surrounding environment. Before doing any medical procedure, you need to ensure that your surrounding environment is safe. If there’s anything that can harm you, try to remove it as quickly as possible or relocate the patient to a safe area. Remember, you won’t be able to effectively help someone in need of an AED if you get badly injured. Also, if there’s lots of water nearby e.g. the patient is lying in a puddle or pool, move them to a dry area to prevent burns and shocks to the rescuer and bystanders.
- Children and infants. When using an AED on children between the ages of 1 and 8, you’ll ideally want to use an AED with pediatric pads. If there isn’t one available, a regular AED should still be used. Depending on the AED, you may be able to deliver a pediatric shock instead. Look for a labeled pediatric shock switch and turn it on. Again, if there isn’t one available, you’ll have to use a regular one instead. When using an AED on infants under the age of 1, you’ll ideally want to use a manual defibrillator to manually set the energy delivery and shock to the infant’s heart. These are done for children and infants because they require lower levels of energy to defibrillate their hearts.
- A hairy chest. Excessive chest hair may actually limit the contact between the electrode pads and the skin, and this may lead to an inaccurate or poor evaluation of the patient’s heart rhythm. So, if you don’t have a razor or scissors, quickly look around to see if there’s a sharp object that can cut the chest hair. However, most AEDs will come with a razor. If there’s another set of pads in the AED, use them to remove the hair. You may also find another set of pads where the AED was stored.
- A wet chest. A wet or sweaty chest may interfere with the AED. Always dry the chest before attaching the pads to maximize effectiveness.
- Implanted devices and medication patches. Some patients may have medical devices in their bodies such as a pacemaker. These devices will usually appear as a small and hard lump. If the patient has one where the pads should be placed, do not place them over the implanted device(s). Instead, move the pads at least an inch away. The same goes for adhesive medication patches on the skin. Never place an AED pad over these patches. Instead, remove the patch and clean the area with a towel, cloth, or wipe. Ensure the area is dry and then attach the pads.
- Staying clear. When the AED prompts everyone to stay clear of the patient, you must ensure that no one is touching them. This can skew the analysis and shock results which may consequently lead to a failed rescue. So, when the AED prompts that it’s going to perform an analysis or deliver a shock, visually check to see that no one is touching the patient.
- Extras. As mentioned, AEDs are stored in public areas, so you may find extra medical equipment at the same location or nearby. When grabbing an AED, look for extra pads, batteries, CPR masks, razors, gloves, and other accessories. You never know if you’ll need extras, so grab them when you can.
- Damages. Before using an AED, you should do a quick look around to see if there are any damages, or if the pads and batteries have expired. If you find damages, replace them to maximize effectiveness and to prevent malfunctions and other complications.
- Malfunctions. If you run into problems while using the AED, it will prompt you to do some troubleshooting. First, make sure that the pads have been attached correctly. Reattach or replace them on the patient and press down firmly. Then, check the cable connection and make sure it’s tightly connected. Now, see if the battery is low. If it is, quickly replace it.
- CPR. Once an AED prompts you to perform CPR, you need to do so with full concentration. You must not solely rely on AED to save a patient’s life. Supplementing an AED with effective CPR can double the chances of survival.
- Liability. Some believe that using an AED requires a certification or medical training. However, that is completely false. Anyone can to use an AED on someone who is need of emergency help, so don’t be afraid to take action. If you feel like you don’t want to be liable, remember that the patient will die regardless. So, it only makes sense that you try to help them out.
- Wasting time. When going through the steps of using an AED, you have no time to waste. Every second counts, so you need to do your best to proceed quickly. It’ll take some time for emergency help to arrive, but it may be too late. You need to be 100 percent focused on the rescue.