CPR: Defibrillation with an AED
Authors: Rednenko V.V., Poplavets E.V.
Editor: Rednenko V.V.
Equipment for the practical skill:
- protective medical gloves;
- СPR simulator;
- AED.
Clinical situation:
While at the train station, you heard a call for help. As you approached the scene, you found a group of people surrounding a woman (appearing to be about 60 years old) lying on the floor. First responder beside the casualty asks you to bring a bag-mask device and an AED from medical station. You delivered the devices to the scene of the incident. First responder is performing chest compressions. You should give the person defibrillation using the AED.
Order of the skill performance:
- Place the AED next to the person.
- Turn the device on.
- Remove or cut away clothing and undergarments to expose the person’s chest.
- If the person’s chest is wet, dry it using a towel or gauze pad. Do not use an alcohol wipe to dry the skin.
- Wait for the signal that the AED is operational and ready for use (Voice command “Device is on”).
- Follow the device’s directions.
- Apply the AED pads.
o Peel the backing off the pads as directed, one at a time, to expose the adhesive.
o Place one pad on the upper right side of the person’s chest and the other pad on the lower left side of the person’s chest below the armpit, pressing firmly to adhere.
o Plug the connector cable into the AED (if necessary).
- After the device’s direction to analyze the heart rhythm (option “Rhythm analyzing. Do not touch the patient”) ensure that no one should touch the person while the AED is analyzing the heart rhythm (option: say “Clear" loudly).
- After the device’s direction to analyze the heart rhythm (option “Rhythm analyzing. Do not touch the patient”) ensure that no one should touch the person while the AED is analyzing the heart rhythm (option: say “Clear" loudly”).
- Follow one of options of the device’s directions:
o If a shock is indicated (option: “Shock required, do not touch patient. Press the “shock” button”), ensure that nobody is touching the victim (option: say “Clear" loudly). Push the shock button as prompted.
o Immediately restart CPR with 30 compressions.
o If no shock is indicated (option: “No need for shock. Continue CPR”), immediately restart CPR with 30 compressions.
- If restoration of heart rhythm is determined (option: “Rhythm restored”), check person’s breath and pulse. If you notice an obvious sign of life, stop CPR but leave the AED turned on and the pads in place on the person’s chest, and continue to follow the AED’s prompts.