Saving lives： how to use an AED
The AED consists of an automatic rhythm analysis system and a shock advisory system that automatically gives instructions on whether defibrillation is required and how to administer the shock.
The AED is used for patients with unresponsive, non-breathing and non-circulatory indications of ventricular fibrillation and pulseless ventricular tachycardia.
How to perform an AED
1 Remove the patient's shirt to expose his or her chest
2 Turn on the power switch and follow the voice prompts
3Place electrode pads
At the voice prompt, place the electrode pads on the patient, plugging them into the socket at the lighted area. The apical electrode should be placed at the fifth intercostal space behind the left anterior axillary line and the other electrode at the right edge of the sternum, below the clavicle.
For infants and children, AEDs with special electrode pads can be placed at the fifth intercostal area after the left anterior axillary line and under the clavicle at the right edge of the sternum, or at the middle of the chest and behind the left scapula.
The placement of the electrodes is crucial to the effectiveness of defibrillation, so please take special care.
4 Cue not to touch the patient
The ambulance attendant shouts to all those in the vicinity not to touch the patient and to wait for the AED to analyse the rhythm to determine if defibrillation is required.
5 Wait for the AED to recharge and prepare for defibrillation
The ambulance attendant receives the defibrillation message and waits for the AED to recharge, making sure that no one is touching the patient and preparing to defibrillate.
6 Press the key button and defibrillate electrically
7 When defibrillation is complete, continue to follow their voice prompts
Continue chest compressions and follow the automated external defibrillator's guidance to implement the next step until the health care professional arrives
You may need to consider some special circumstances before placing the AED electrode pads. Before attaching the electrode pads, quickly scan the injured patient to determine if any of the following conditions are present and take appropriate action
i. If there are hairs on the patient's chest that may prevent the electrode from being attached, you can use the razor in the AED's carrying case to quickly shave off the hairs at the electrode placement site or, if there is a spare set of electrode pads, use them to remove the hairs by: (1) applying the electrode pads and then pressing down firmly on the electrode pads; (2) then pulling off the electrode pads firmly to remove the hairs; (3) Re-attaching a set of electrode pads to the bare skin.
ii. If the injured patient is lying in water, move him/her quickly to a dry place or if there is water on the patient's chest, dry the water quickly before applying the AED.
iii. If the injured patient has a defibrillator or pacemaker implanted, do not apply the electrode pads directly to the implanted device and follow the normal procedure for operating an automated external defibrillator.
iv. If the injured patient has a medication patch in the location where the electrode pad needs to be placed, do not apply the electrode pad directly to the medication patch, gently but quickly remove the medication patch, wipe the area clean and then apply the electrode pad.
Now let's summarise the key points to note when using the AED
Firstly, when switching on the AED, always operate it at the voice prompt, do not operate it early or delay in doing so. If the defibrillator is analysed and the voice prompts do not recommend defibrillation, do not press the defibrillation power button.
Secondly, as the AED has to be discharged during defibrillation, the operator's body, including the limbs, must be away from the casualty and also loudly remind the person next to him/her to stay away from the casualty to prevent electrocution.
