AED Information
Phillips Automated External Defibrillator Usage
An automated external defibrillator or AED, is a device designed for non-professionals. Its function is to deliver an electrical shock to a heart that is in a rhythm called ventricular fibrillation. This is a condition that can occur in a heart attack and is always fatal if not promptly treated. In ventricle fibrillation the heart is not pumping blood. Although CPR “buys time”, ultimately, recovery depends on defibrillation. Before AEDs became available, defibrillation had to wait until the patient arrived at a hospital. More recently paramedics accompanying ambulances carry portable defibrillators. An AED available at the site of the emergency and a bystander using it has increased the survivability of cardiac arrests.
CLSA has two AEDs, one stored in the first aid cabinet in the clubhouse kitchen and one aboard the Pink Lady in the storage compartment. They are similar, but not identical, due to being acquired in different times. Operation for both is identical, however. The unit in the Pink Lady is in a waterproof Pelican case.
Many CPR classes include training in the use of AEDs. It would be best if the user were trained in its use, but it is designed to provide step by step instructions as it is used. Further, by pressing blue i-button, it provides verbal coaching for administering CPR.
This device can do no harm to the patient. The only harm would be in delaying the 911 call, or delaying the beginning of CPR while accessing and opening the device. An AED will not deliver a shock that isn’t needed – even if the user presses the shock button. After the rescuer applies the adhesive electrode patches, the machine “reads” the patient’s EKG and evaluates the heart’s electrical rhythm. Only if it identifies ventricle fibrillation or certain forms of ventricular tachycardia will it enable a shock. Clear verbal instructions keep rescuers on track. The flashing hand icon means rescuers need to be not touching patient as it may interfere with diagnosis or if on steady, unit is enabled to shock the patient.
The gray package to the left if the unit is a plastic box containing the adhesive electrode pads. They are already connected to the AED. The white plastic tab with a large round hole at the bottom is a battery protector and has already been removed. On the underside of the lid are abbreviated instructions. Also in the case is a pair of scissors for cutting clothing if necessary and a disposable razor for dealing with an exceptional hairy chest interfering with electrode adhesion and a paper towel to dry the area. Rubber gloves and a rescue mask for administering CPR is under the unit. The gray and black block inside the lid is a rubber pad holding the unit in place while closed. The box containing the electrodes should not be opened unless the unit is being used on an actual patient. They are not re-usable and too expensive to use for curiosity. We do have spares. There is also a spare battery in the bottom of the case.
Pediatric Use
Unresponsive children are most likely to have airway problems rather than heart problems. Unresponsive drowning victims need CPR and evaluation for a pulse. If no pulse detected then use AED.
Only the unit on the Pink Lady is designed be used on children less than 8 years old or less than 55 lbs. If unsure, use adult mode but position electrodes as in child mode.. On the left side of the carrying case is a clear envelope containing the child key. It is inserted in the slot in the middle top of the unit. When present, it does 3 things. The intensity of the shock delivered is reduced, the verbal coaching is for child patients and instruction is given for a different placement of the adhesive electrode pads. No special electrodes are needed, but they are placed in the center chest and center back. It makes no difference which pad goes where.
Although not designed for use on children, the unit at the clubhouse can be used on children, positioning the adhesive electrode pads in the center chest and center back. The energy released in a shock in adult mode is 150 joules, and 50 joules in child mode.
Brief Protocol
Have the AED available if a patient is experiencing symptoms of a heart attack. make the call to 911. If the patient is located on the water or in the harbor, relocate him using the Pink Lady to the launch ramps by the marina. This is the location the ambulance should be instructed to meet the patient. Any immediate care can be rendered aboard. If the patient becomes unresponsive, immediately check for presence of a pulse and respiration. If absent, begin CPR and open the AED and press the green on button. The pad location icons on the device will begin to flash. Place the adhesive electrode pads on bare chest in the positions indicated on the unit. The pad icons on the diagram will stop flashing. Follow the voice instructions. When the hand icon is flashing, stop CPR and nobody touch the patient. The system is evaluating. If shock is advised, voice will tell you and shock button will flash orange. Press flashing shock button. If button isn’t pressed within 30 seconds, it will disarm and CPR is to be resumed. When landing the Pink Lady at the launch ramp, gently run the bows a short way up the concrete apron. Rescue personnel will have easy access to the patient from the bow without stepping in water.
In summary:
1. Press green button to turn on.
2. Place adhesive electrode pads on chest.
3. Press shock button when advised.
After Use
Unplug and discard used electrode pads and cable. Open outer foil wrapping of a new electrode pack. Insert plug into AED and store pack in slot to left of unit. Ensure all accessories have been returned to carrying case. Event data is available to be played back to paramedics that respond. To replay, hold down blue i-button until it beeps. This data remains in storage for 30 days unless overwritten by a subsequent event.