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AED Canadian Ski Patrol System CSPS AED Instructor Guide Time 5 Topic Intro Content Objectives Ref AED 1 Ch 6 AED 6B-1 AED 6BFig 1 AED 6BFig 1 AED 6B-1 AED 6B-3 AED 6B-4 AED 6B5-6 AED 6B-7 AED 6B-7 Demonstrate AED Practical session Written test Conclusion Review Adult CPR – Chain of Survival Role of AED with CPR A & P Heart Conduction System What is an AED How does an AED work Shock – No shock Protocols Special Situations Legal aspects of AED Hand over to EMS Certification Use, troubleshooting Scenarios 1 to 4 Closed book test Review, conclusion, questions 40 10 60 30 5 2:30 AED 1. LESSON a) 2. 3. Objectives The Patroller will be able to: • Describe what an AED • Demonstrate when and how to use the AED • Describe special situations when using the AED • Troubleshoot problems with the AED • Describe the legal aspects regarding AED use • Describe the hand over of patient to EMS • Successfully complete testing and qualification LESSON CONTENT a) Must Cover • Review Adult CPR (if not part of course) • Chain of Survival • Role of AED with CPR • A & P Heart • Conduction System • What is an AED • How does an AED work • Shock – No shock Protocols • Special Situations • Legal aspects of AED • Hand over to EMS • Certification b) Should Cover c) Nice To Cover RESOURCES a) Additional Reading/Instructor Teaching Aids AED.ppt b) Follow-up Activity AED c) Teaching Notes 1. Review Adult CPR (if not part of course) 2. − − − − − − − Explain the Chain of Survival, and how the AED fits in. Healthy Choices Early Recognition Early Access to EMS Early CPR Early Defibrillation Early Advanced Care Early Rehabilitation 3. Anatomy and Physiology of the Heart. The heart needs blood and oxygen to function. The aorta supplies the body with blood and oxygen. The coronary arteries supply blood and oxygen to the heart itself. If these arteries become blocked (heart attack) the tissue dies, which can cause the heart to stop. Explain MI (heart attack), difference between MI and Angina. Explain difference between heart attack and cardiac arrest. 4. Cardiac Conduction System. Describe the electrical system of the heart and how it works. The heart has specialized cells that can generate electrical impulses. The SA node is the natural pacemaker. These impulses travel from the SA node to the AV node. Explain Myocardial Infarction (MI) – heart attack. Difference between heart attack and angina. Electrical impulses cannot travel across dead cardiac tissue (heart attack). Depending on the area of damage or size of heart attack the heart can be sent into uncoordinated electrical rhythms. These rhythms can stop the heart from pumping blood to the body. Most adults go into Ventricular Fibrillation (VF) or Ventricular Tachycardia (VT) (explain) when breathing and pulse are absent. 5. How does an AED work. Explain and show the AED and the functions. − It is used to analyze the heart rhythm, only shocks VF and VT. − Describe the process of using the AED. Turn the AED on, and follow the voice prompts. The screen will also display the voice prompts (in loud environments the voice prompts may not be heard). Expose the chest, shave and dry the chest if needed. Ensure there is no jewellery/clothing in the way. Check expiry date on pads then open pad package. Peel and stick the pads on bare chest. Plug pads into AED if needed. Pads should be upper right and lower left on patient. Follow the picture and directions on the pad package. The pads must be connected correctly. Explain and show different types of pads, adult, child, D type. AED 6. Explain the Shock and No shock Protocols. Use the flow charts from manual. Explain the difference between witnessed and un-witnessed arrest. Explain child and adult protocol differences. In a witnessed arrest, perform CPR ASAP and use the AED as soon as it arrives. For an un-witnessed perform two minutes of CPR before using the AED. CPR may get the heart into a shockable rhythm. With a child arrest, perform two minutes on CPR before using the AED. CPR may get the heart into a shockable rhythm. Explain that no one can be in contact with the patient during the analyze and shock phase. Make sure the Patroller verbally states everyone is to be clear of the patient twice (when analyzing and when delivering shock). Make sure the Patroller looks at the patient when delivering shock, and not at AED. AED’s cannot be used on infants. 7. Special Situations when using an AED. Explain each situation from manual text. − Hypothermia − Water - Wet Environments − Moving Vehicles − Aircraft or Helicopters − Trauma Patient − Pregnant Patient − Metal surfaces − Patch medications − Pacemakers – Internal Implantable Defibrillators − Children (Using child pads delivers smaller shock. Use adult pads only when child pads not available) − Oxygen − Radio use 8. Legal Aspects of using the AED. Define a Medical Act; it requires a medical doctor to sign off certification. Use of an AED is under his/her medical licence. Some provinces have AED use as a Medical Act, while others do not. Medical Control; A Medical Doctor controls training/certification. The Doctor issues medical directives to the users. Medical oversight; A Medical Doctor oversees the AED use/program, but using the AED is not a Medical Act. The Doctor confirms and reviews all AED use and medical reports. CSPS rules/policy/procedures may change from Zone to Zone. Explain local CSPS policies and procedures for AED use. Contact local or provincial office of Heart and Stroke Foundation Canada for provincial requirements. 9. Hand over to EMS. This must be done smoothly. Explain the verbal (minimum info to EMS) and written reports (formal written report) to EMS. Some areas AED require the information recorded in the AED memory to be downloaded and sent to Dr/hospital for addition to the patient chart. Some AED’s can be plugged into a phone jack, so the information can be sent to the medical control office for processing. They may also be connected to a computer for information download. Show the medical report form. (Completed sample report if possible.) 10. Qualification/Certification. Yearly certification is required. CPR is a prerequisite for AED training. Some zones may require refresher training at specific times during year; (quarterly/monthly/semi annually). After one year, if retraining is not done the Patroller may be decertified. The Patroller may be deactivated if his/her refresher or retraining is not done. When there is a concern with a Patroller’s AED use (unsafe use of AED or poor or no medical report done after use), it will be addressed by the AED program supervisor/manager. 11. Troubleshooting. Show the AED failure procedure (battery or pads). Show trouble codes on the AED (picture/prompt) for battery/maintenance. 12. Pads. Show a set of real pads (jell/sticky) peel and stick. Point out the Lot numbers and expiry dates on the packages. Discuss the accessory equipment with the AED. (gloves, scissors, razor, towel, barrier device and two sets of pads.) Pads (and packaging) that do not work should be returned to the manufacturer for investigation (importance of Lot numbers). Explain the proper process for cleaning of the AED. 13. Have the Patrollers complete a minimum of two (max four) testing scenarios. Make the scenarios as realistic as possible. Use groups of two or three, one CPR responder, one AED responder and a third as a bystander/911 caller. One AED trainer is required per group. 14. Written Test. Once practical testing is complete, do written test. 15. Review, Conclusion and Questions d) Lesson Plan Attached? Yes No