Where’s the AED (Automated External Defibrillator)
When someone has a cardiac arrest and isn’t breathing, you should start CPR immediately, then send someone to fetch the AED.
Not all AEDs have locked cabinets, so you may be able to just pull open the door.
Some of the locked units have quite a lot of writing on them and you could be in panic mode, so may not see, “Call 999 for the access code”
Once you’ve dialed 999/112, you’ll be able to open the door. If you’re not by the cabinet, they’ll tell you if there’s a unit within a few minutes of where you are.
Take the AED out of the cabinet.
Once you’re back with the casualty, open the unit, unzip, pull the lever, switch it on if necessary.
Follow the voice instructions and do whatever they say.
Remove Clothing
Remove all clothing from the casualty’s chest, cutting it off if necessary.
Most AED packs include a set of heavy-duty shears, these will easily cut through cloth and underwired bras.
If there are bystanders, get them to hold up a blanket, rug or towel to preserve the casualty’s dignity.
Once you’ve removed the clothes, wipe dry the skin.
Look at the pads to see where they need to go, if the casualty has a lot of chest hair, be prepared to shave it.
There’s a razor in the pack, use it to clear the areas where the pads are to go.
Remove the pads from the backing and place them as shown in the diagram on the reverse side.
Don’t worry if you get them mixed up, they’ll work just as well in either position.
Before placing the pads, make sure they’re not touching any metal or jewellery, including piercings.
Remove all patches and plasters and avoid placing the pads over existing internal pacemakers or defibrillators. (If there’s an internal defibrillator beneath the skin, it has failed, so continue with pad placement adjacent to it)
Attach the Pads
Once the pads are attached, the AED should now be giving you further instructions.
If you’ve already been performing CPR it will tell you to stop and not touch the casualty, while it analyses their heartbeat.
Following a cardiac arrest, the heart won’t be beating normally, it will be quivering or fibrillating.
The AED will detect this, but if someone is touching them it will detect their pulse and stop the defibrillator from shocking.
When the AED has stopped analysing, having failed to find a heartbeat, it will tell you the patient needs a shock.
Deliver a shock
Some AEDs deliver this automatically, but others require the person using it to press a button to deliver the shock.
When you’re told the shock’s been given, if the heart hasn’t restarted, you’ll be instructed to begin CPR again.
The unit will give you the option to follow instructions for this and give you a rhythm to follow for the correct rate of compressions.
You should follow the audible instructions from the unit, administering CPR and shocks as directed.
Always continue this until medical professionals tell you to stop, the casualty comes round and makes definite signs of life, or you’re just too exhausted to carry on and there’s nobody to take over from you.
If the casualty comes around, never remove the pads, they could easily have another arrest. Because they’re single use they can’t be reattached.
Myths about defibrillators.
- They start the heart – defibrillators stop the heart from quivering or fibrillating. This allows the heart to naturally “reboot” into a normal rhythm.
- The casualty can be harmed by an AED – The person is clinically dead, you can only help them
- You can be shocked by an AED – You can only shock someone if there is no heartbeat, this why it’s important not to touch them when the device is analysing.
And this is where the comparison with the rat comes in, you worry about being in close proximity with Mr Rat, but who even thinks about how close you are to a cardiac defibrillator?