Post on 26-Mar-2015
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Automatic External Defibrillator
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- Why we use the AED?- How to use the AED?- Indications for the AED?
- Contraindications to AED?
Objectives for this subject
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The chain of survival:- early access to 911
-early CPR-early defibrillation-early advanced care
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Defibrillation is the application of electrical shock to
help restore the heart’s regular
rhythm
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Defibrillator is the device used to deliver that shock and it can be
manual or automatic.
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Early defibrillation is the single most important factor in
determining survival from cardiac arrest.
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• Defibrillation should be performed with in the first 8 minutes after cardiac arrest. Ideally, the sooner, the better.
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AED
• Most common initial rhythms patients go into as they enter into cardiac arrest are:
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“2 Shockable Rhythms”
V-Tach and V-Fib
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Ventricular Tachycardia:Fast heart rhythm which does not allow
the heart to fill properly and cardiac output is compromised and reduced.
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Ventricular Fibrillation:disorganized series of electrical
discharges in the ventricles. Where the ventricles “quiver”.Stops Cardiac output
and hearts pumping ability.
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AED’s that are available are automatic and semi-automatic.
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Automatic: where machine does all of the work.
Semi Automatic: where machine tells you when to push button to
deliver shock.
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Apply AED as soon as you
determine that your patient is not breathing and does not have a pulse.
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Always making sure that CPR is still in progress while you are
setting up the AED.
If by yourself, apply the AED.
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• Ensure before putting pads on chest, it is clear of all patches, paste or pacemakers. Don’t cover something up with pad.
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• If patient has hair on chest that could interfere with conduction, make sure you shave it off with razor provided to you.You want pads on chest to fit snug and secure.
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Now attach the adhesive pads to the cables remembering-
White is negativeWhite is negative, anterior chest wall.Red is positiveRed is positive ,
left anterior axillary line.
“Red on Ribs! WhiteWhite on right!”
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Do Not Utilize The Anterior – Posterior (Front and Back) Lead
Placement For Automatic Defibrillation
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Now turn on machine and
wait for AED to analyze the
patients rhythm. Making sure that CPR has
been stopped for machine to
detect rhythm.
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While waiting for machine, you can begin your patient
information by speaking clearly into the tape recorder of the machine. You want to give
certain information.
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- Patients age.- Patients past medical history.- Patients medications. - Brief description of what happened prior to your arrival.
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When machine advises a shock is indicated, ”CLEARCLEAR”
your patient.
Ensuring that no one is touching patient or stretcher.
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When the AED delivers a shock it will go back and reanalyze the
rhythm.
If another shock is appropriate“Clear Patient”“Clear Patient”
anddeliver the shock.
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Sets of 3 shocks are called stacked shocks and they are done
without any pauses to check patients pulse or administer CPR
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If “No shock” is indicated:
-Check breathing give appropriate oxygen therapy.
-Check pulse, if no pulse! Start CPR for
1 minute and then have the AEDreassess.
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Transport patient when:
*Patient regains a pulse
*Total of 6 shocks have been given.
*AED has indicated 3 “no shocks”with intervening CPR.
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Defibrillator
Some ALS providers will choose to leave the AED in place.
Some will choose to use their monitor for manual defibrillation.
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Safety should always be maintained by the provider:
-Not using near or around water
-Ensuring all med patches and pastes are off the patient.
-Making sure that everyone is clear of the patient when the shock is delivered.
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Indications for AEDIndications for AED * Unresponsive * Apneic * Pulseless patients.
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Adult Patients• > 8 years old
• > 55 lbs.
• Unresponsive,pulseless and apneic.
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Contraindications:
• Infants and children
• < 8 years old
• < 55 lbs.
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Contraindications:
!! HypothermiaHypothermia !!
(Contact medical control)
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Contraindications:
Rigor / Livor Mortis
No Code /DNR
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The AED can’t properly analyze patient in moving
ambulance.
It is recommended that you stop the medic and let AED do it’s
job.
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Please review your RegionalMedical Protocol Manual
for further information