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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

2
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

3
Chain of Survival
Healthy Choices
 Recognition of the Warning Signs
 Early Access to EMS
 Early CPR
 Early Defibrillation
 Early Advanced Care
 Early Rehabilitation

4
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

5
Conduction System
6
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

7
Shockable Rhythms
Ventricular Fibrillation (VF)
 Uncoordinated electrical impulses within the
heart
 Causes the heart to “quiver”
 The ventricles cannot effectively pump blood
8
Shockable Rhythms
Ventricular Tachycardia (VT)
 Very fast electrical impulses (above 180)
 The ventricles don’t have time to fill up and
pump blood
9
The AED
10
Types of AEDs
11
Operation of AEDs
Power ON
ON
Attach Pads
Analyze
ANALYZE
12
Operation of AEDs
Clear the patient !!!!
 “I’m clear!”
 “You’re clear!”
 “Everyone is clear!”
 “Shocking now”
13
AED Sequence
1
Check for responsiveness
2
If unresponsive, call 911 or your local
emergency number and get AED
3
Check Airway, Breathing, Circulation, (ABC)
Perform CPR until AED arrives
4
Attach AED if no signs of circulation
5
Stand clear, press analyze
14
Shock
/ No Shock
Protocols
15
Pad Placement
Adult
 One pad – right upper chest, just below clavicle
 One pad – left lower anterior chest wall
16
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
17
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)

18
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)

19
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

20
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

21
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

22
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

23
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
24
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

25