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AUTOMATED EXTERNAL DEFIBRILLATOR. Outline. AED Intro Review Adult CPR (if needed) AED Course (lesson and hands-on) AED Practical test AED Written test. Course Objectives. Conduction System of the Heart What is an AED When and how to use an AED Special Situations Troubleshooting
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Outline • AED Intro • Review Adult CPR (if needed) • AED Course (lesson and hands-on) • AED Practical test • AED Written test
Course Objectives • Conduction System of the Heart • What is an AED • When and how to use an AED • Special Situations • Troubleshooting • Legal Aspects • Handover to EMS
Chain of Survival • Healthy Choices • Recognition of the Warning Signs • Early Access to EMS • Early CPR • Early Defibrillation • Early Advanced Care • Early Rehabilitation
Conduction System • The heart has it’s own electrical system • Impulses come from Sino-Atrial (SA) Node (natural pacemaker) • Travel to the Atrio-Ventricular (AV) Node • The tissue where the heart attack happens dies • Impulses cannot cross the dead tissue • Electrical impulses are no longer coordinated resulting in abnormal heart rhthyms
What is an AED • Analyzes heart rhythm • Generates an electric shock – if required to stop abnormal rhythm in the heart • Blood is not circulating if the heart is in ventricular fibrillation or ventricular tachycardia • Time from collapse to shock is critical • CPR and defibrillation give the best chance of survival
Shockable Rhythms Ventricular Fibrillation (VF) • Uncoordinated electrical impulses within the heart • Causes the heart to “quiver” • The ventricles cannot effectively pump blood
Shockable Rhythms Ventricular Tachycardia (VT) • Very fast electrical impulses (above 180) • The ventricles don’t have time to fill up and pump blood
ANALYZE ON Operation of AEDs Power ON Attach Pads Analyze
Operation of AEDs Clear the patient !!!! • “I’m clear!” • “You’re clear!” • “Everyone is clear!” • “Shocking now”
Pad Placement Adult • One pad – right upper chest, just below clavicle • One pad – left lower anterior chest wall
Pad Placement Child: • Child Pads (if available) • One pad – right upper chest • One pad – left lower anterior chest wall • Adult Pads • One pad – front middle of chest • One pad – middle of back
Special Situations • Hypothermia (one shock only) • Water – Wet Environments (do not use) • Moving vehicles or toboggan (must be stopped) • Aircraft or Helicopters (tell aircrew AED in use) • Trauma Patients (not likely to work) • Pregnant Patients (use as normal)
Special Situations • Metal Surfaces (use as normal) • Patch Medications (remove patch if in way) • Pacemakers or Implanted Defibrillators (if in way- place pad at least one inch away) • Oxygen (move oxygen one arm length away) • Radio Use (do not transmit during analyze and shock)
Who uses AEDs • Healthcare providers, emergency workers, or community responders whose job or volunteer work demands that they know how to defibrillate someone • Caregivers, such as family members of people who are under medical supervision due to a high risk of sudden cardiac death
Ceasing AED Sequences • The patient has a pulse • Another trained rescuer takes over • EMS arrives • It is unsafe to continue • A medical doctor says to stop
Legal Aspects • In some Provinces/Territories, the use of an AED is considered a Medical Act • The supervising physician provides certification and medical control • Follow provincial or local regulations • Check with Zone or Division Training Officers on the use of AEDs in your area
Documentation • Internal event recorders • Patroller should complete a medical report • The AED coordinator is usually responsible for ensuring for passing this information together with the medical report to the receiving hospital. • Annual AED and CPR skill retention/certification
Handover to EMS • Paramedics will need to know • When was the patient last seen • Did anyone see the patient collapse • How long has CPR been performed • Number of shocks delivered • Your name, contact information and whom you are certified under
Common Errors • Not checking for ABCs before using AED • Failure to dry or shave chest (if needed) • No CPR or not long enough between “no shocks” or “shocks” • Interrupting the shock protocol to perform CPR • Not following AED voice (display) prompts