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First on the Scene – AED
Automated External Defibrillation = AED
AED is the application of an
electric shock to a heart to
restore a normal heart rhythm.
Use of AED can dramatically
increase the survival rate
for cardiac arrest.
Student Reference Guide p. 10-1 (8-1)
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First on the Scene – AED
AED is one of the four key links in the chain
of survival for cardiac arrest which include:
1. Early Recognition of a cardiac
emergency
2. Early access to EMS
3. Early CPR if indicated
4. Early Defibrillation if required
Student Reference Guide p. 4-3
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The Heart
The heart has 4 chambers
• 2 atria (receiving chambers)
• 2 ventricles (pumping chambers)
atria
ventricles
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First on the Scene – AED
The Aorta
The aorta is the
major artery that
branches off the
heart carrying
oxygen to the
body.
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First on the Scene – AED
Coronary Arteries
Coronary arteries
branch off the base
of the aorta to
delivery oxygenated
blood to the heart
muscle.
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First on the Scene – AED
Cardiac Conduction System
The heart has specialized cells
that generate electrical impulses
causing the heart to contract
and relax.
During contraction, blood is forced
out of the heart into the arteries.
This creates a pressure wave that
can be felt as a pulse. During
relaxation, the heart re-fills with
with blood.
Student Reference Guide p. 10-1 (or) 8-1.
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First on the Scene – AED
Cardiac Conduction System
• An impulse begins in the
sinoatrial node (also called
the pacemaker) and travels
through the atria to the atrioventricular node and on
through the ventricles.
• This wave of electricity can be
measured using a ECG
(electrocardiogram).
Student Reference Guide p. 10-1 (or) 8-1.
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First on the Scene – AED
When a Heart Attack occurs • Muscle tissue dies.
• Electrical impulses do not travel across dead
tissue.
• Depending on the amount of damage and the
location of the damage, the conduction system
may be impaired.
• In some cases, the heart maintains an effective
rhythm.
• In other cases, the rhythm becomes chaotic.
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First on the Scene – AED
Abnormal heart rhythms
• A chaotic rhythm does not produce effective
blood flow.
• Examples include Ventricular Fibrillation and
Ventricular Tachycardia.
• VF and VT may be defibrillated using an AED.
• Other abnormal rhythms such as asystole (no
rhythm) or PEA (pulseless electrical activity)
cannot be defibrillated,
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First on the Scene – AED
AED will shock the following Ventricular Fibrillation (VF)
• the most common rhythm in the cardiac arrest
• Heart quivers; does not pump blood
• No pulse
• If not corrected,
will result in death.
Student Reference Guide p. 10-2 (or) 8-2.
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First on the Scene – AED
AEDs will shock the following rhythms:
Pulseless Ventricular Tachycardia (V-Tack)
• Very fast heart rate (+ 180) beats per minute
• No pulse
• If not corrected will
result in death.
Student Reference Guide p. 10-2 (or) 8-2.
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First on the Scene – AED
AEDs will not shock the following Asystole
• No electrical activity or pumping action.
• Produces a flat line on an ECG.
Pulseless Electrical Activity (PEA)
• Occurs when so much blood has been lost
there is nothing to pump.
• Produces a normal ECG but NO PULSE
Student Reference Guide p. 10-2 (or) 8-2.
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First on the Scene – AED
Defibrillation
The time from collapse to
defibrillation is the most
critical factor for survival.
The longer the heart is in
fibrillation, the more damage
occurs to the heart muscle.
Time = Muscle
For each minute
defibrillation is
delayed, survival rates
decline by up to 10%.
Student Reference Guide p. 10-3 (or) 8-3.
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First on the Scene – AED
How does AED work?
• AEDs are computerized defibrillators
• They recognize and shock VF and pulseless
VT
• If either rhythm is recognized, the AED will
charge and signal the rescuer to “SHOCK”.
AED will not shock Asystole or PEA
Student Reference Guide p. 10-3 (or) 8-3.
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First on the Scene – AED
The role of CPR in AED
• In most cases CPR alone will not restart the heart.
• It is however an important part of the Chain of
Survival.
• CPR keeps the brain alive and helps extend the
length of time the heart remains in VT or VF
(shockable rhythms).
• CPR can “buy some time” for the casualty until the
AED is attached and ready to deliver a shock.
Student Reference Guide p. 10-3 (or) 8-3.
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First on the Scene – AED
Legal aspects of providing AED in BC
• AEDs used in the workplace must follow WorkSafe
BC requirements as outlined in Section G3.17
(1).1 of the Occupational Health and Safety
Regulation.
• AED rescuers may use AED where there is a need
outside the workplace.
Student Reference Guide p. 10-4 (or) 8-4.
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First on the Scene – AED
Use AED -
If the casualty:
• is unresponsive and not breathing
• Is over 1 year of age.
Do not use AED If the casualty:
• has severe multi-system trauma
• Is conscious
• Is under 1 year of age
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First on the Scene – AED
How To Use an AED
1. Press the POWER ON button.
2. Follow the voice prompts.
• Bare the chest
Shave the chest only if necessary.
Make sure the chest is dry.
• Apply the pads.
Peel away the protective plastic and
attach the adhesive pads.
Student Reference Guide p. 10-4 (or) 8-4.
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First on the Scene – AED
How To Use an AED
•
Connect the cables to the
AED.
• Stand clear and ensure
no one is touching the
casualty.
• Wait while the AED
analyzes the rhythm
3. Press Shock (if advised).
Student Reference Guide p. 10-4 (or) 8-4.
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First on the Scene – AED
Electrode Pad Placement
Right electrode pad
• to the right of the breastbone
• below the collarbone
• above the right nipple
Left electrode pad
• Outside the left nipple
• Upper edge of the pad several
inches below left armpit
Student Reference Guide p. 10-4 (or) 8-4.
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First on the Scene – AED
Electrode Pad Adhesion
Sweaty Chest
• Dry with a towel. Do not use alcohol.
Hairy Chest
• Shaving may be necessary.
Pregnant
• Follow first aid principles for an unresponsive,
pregnant casualty (wedge under right hip).
Student Reference Guide p. 10-6 (or) 8-6.
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First on the Scene – AED
Special Considerations
Pacemaker
Place pads at least 1 inch away from the pacemaker.
Implanted defibrillator
Do not place pads on implant site.
If device triggers, wait until it is finished (20-30
seconds) before using AED
Student Reference Guide p. 10-6 (or) 8-6.
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First on the Scene – AED
Special Considerations
AEDs and Children
• AED is safe to use on children with no signs of life if
over 1 year of age.
• Some AEDs have special pediatric pads or settings
for children 1 to 8 years of age.
• Use adult pads if pediatric pads are not provided.
• Follow instructions for pad placement.
• Do not use pediatric pads on children over 8 years
of age.
Student Reference Guide p. 10-6 (or) 8-6.
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First on the Scene First Aid and CPR
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First on the Scene – AED
Special Considerations
Trauma Casualties
• AED not recommended for severe multi-system
trauma.
Hypothermia
• If the casualty is severely hypothermic, deliver up to a
maximum of 1 shock. If unsuccessful, focus on CPR.
Patch medication
• Remove patch and wipe the area clean.
Student Reference Guide p. 10-7 (or) 8-7.
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First on the Scene – AED
Special Considerations
Wet environment
• Remove to a dry area if possible.
• Dry the chest.
Metal surface
• No special precautions needed.
Moving Vehicle
• If transporting in a moving vehicle, stop the vehicle
to analyze.
Student Reference Guide p. 10-7 (or) 8-7.
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First on the Scene – AED
Post-Resuscitation
Care and Handover
The
Heart
• Leave the AED attached. The AED continues to
monitor the heart and may be needed if the heart
stops again.
• Give a verbal report to EMS
 Time of collapse
 Time CPR was started
 Time first shock was delivered
 Number of shocks
Student Reference Guide p. 10-6 (or) 8-6.
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First on the Scene – AED
Trouble Shooting
Check electrodes
• Check cable connection
• Check adhesion of pads to chest
Motion detected
• Stay clear
• Don’t touch the casualty
Student Reference Guide p. 10-7 (or) 8-7.
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First on the Scene – AED
Trouble Shooting
Low battery
• Replace battery soon.
Service indicated
• Unit needs servicing now.
• Do not use unit.
• Check owner’s manual.
Student Reference Guide p. 10-7 (or) 8-7.
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First on the Scene – AED
STORAGE
Store in a well-marked and easily accessible location
preferably near a phone.
Kit should include –
 AED
 Spare Batteries
 Pocket Mask
 Spare electrode pads
 Gloves
 Scissors
 Razor
 Towel
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First on the Scene – AED
MAINTENANCE
•
•
•
•
Daily checks
Monthly checks
Annual checks
See owner’s manual
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