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Now we're gonna cover one rescuer adult AED for the health care professional. A scene is safe, not only for me the rescuer with my gloves and my one way valve rescue mask, but when using an automated external defibrillator, I think it's vitally important that we're also thinking about the surroundings. Is there combustible gases? Are there liquids that are gonna connect the patient with me and I might become electrocuted when I use the AED? These are all considerations that should be thought about as we're preparing to defibrillate our patient. Now, there's a couple of other things I want to make note of here as we're talking about defibrillation and the adult patient. We get lots of questions from our students about well what if they. What is they are a female and they have an underwire bra? Is that going to cause a problem with the AED? You know the technologies are getting so much better now that we tend not to see those complications as often. But if you're thinking about it and you believe that it might be in the pathway, disconnect it so the pathway is clear for the two electrodes to defibrillate the heart. If there's a necklace in the way, we're gonna move it to the side. If there's a nicotine patch or an analgesic patch or a nitro gel patch, we're gonna take that off and wipe it clear if it's in the way of the pad. But other than that, other piercings, things like that, there's no problem just putting your pads in place. Some people have asked, what if they're a drowning victim? Is it OK for them to be in wet clothing as long as the chest is dry? Yes, it is. They can stay in their wet clothes as long as they're not lying in a pool of water or in the water submerged so that we're not connected to each other when I defibrillate we should be OK. If it's a pregnant female, there should be no complication other than the fact that understanding that when you're saving your primary patient the mother, we're also saving the baby in most cases. So we do have two patients here but we have to take care of Mom if we want to take care of baby. So we're gonna be just as aggressive and we do not have to worry about hurting the baby and putting them in any more jeopardy than we already know them to be in with the fact that Mom is in cardiac arrest. So keep those things in mind as we go through this step by step. We check our patient for responsiveness. Are you alright? Are you OK? They don't respond to my verbals. So I place a hand on the forehead and I tap on the collarbone. Can you hear me? Sir, can you hear me? There's no response from this patient on my taps and shouts. It's at this time, if I didn't have an AED already with me, I would say, you in the plaid shirt, go call 911 and come back. Bring an AED with you if you find one or I would call 911 myself and activate a code. But now we have 911 on the way so I'm able to access my patient for normal breathing and I'm going to check for a carotid pulse for no more than 10 seconds. I do not see any normal breathing and this patient is unresponsive and does not have a pulse. Because I have my automated external defibrillator here with me now, I'm gonna turn it on first thing. AED: Remove clothing from person's chest. Speaker 1: I remove the clothing so I have a bare chest to work with. AED: Attach pads firmly to person's chest. Speaker 1: The pads have a diagram to remind me how to put them on appropriately. I put one up here in the top right side of the chest, the second on the bottom left side, mid axillary just under the left breast. Now I'm gonna plug in the cable. There's only one direction this cable will go. AED: Analyzing rhythm. Everyone stand clear. Speaker 1: Do not touch the patient so that the AED can analyze the underlying rhythm of the heart. AED: Charging. Everyone stand clear. [high pitch] Everyone stand clear. Speaker 1: Make sure that no one's touching the patient as I push the flashing button. AED: Shock delivered. Begin five cycles of CPR. Speaker 1: I'm going to go right into my 30 compressions now. Remember I'm compressing right over the pads. I'm not moving the pads. I'm going to compress at a rate of between 100 and 120 times per minute and I'm going to compress the chest two to two point four inches deep. I'm going to give 30 total compressions, then with my one way valve mask I'm going to give two rescue breaths. AED: One minute and thirty seconds of CPR remain. Speaker 1: two and three and four and five and six and seven and eight and nine and 10 and 11 and 12 and 13, 14, 15, 16, 17, 18, 19, 20, 27, 28, 29, 30. AED: Analyzing rhythm. Everyone stand clear. Speaker 1: I let the AED analyze again. AED: Shock advised. Charging. Everyone stand clear. [high pitch] Everyone stand clear. Speaker 1: Clear. AED: Push the shock button. Shock delivered. Speaker 1: Right back into my compressions. We're gonna continue this whole cycle of CPR, reanalyzation, charging if it's gonna charge, shock, back into CPR and we're gonna continue this until help arrives, until this person becomes responsive and the next level of care can take over.
In this lesson, we'll cover one-rescuer adult AED usage for the healthcare professional, including baseline environmental checks, clearing physical obstructions on the patient, and managing the workflow between the AED and CPR cycles.
An AED (Automated External Defibrillator) is a portable electronic device that analyzes the rhythm of the heart and delivers an electrical shock, known as defibrillation, which helps the heart re-establish an effective rhythm.
Before powering on or delivering a shock with an automated external defibrillator, it is vitally important that you pause to evaluate your immediate surroundings for specific safety hazards:
Pro Tip #1: If the environment is unsafe due to standing water or dangerous materials, drag or move the patient to a dry, clear area before attempting to analyze their cardiac rhythm or deliver a shock.
Healthcare professionals often ask about physical items on a patient's body when preparing to defibrillate an adult patient. Use these rules to handle potential complications seamlessly:
Pro Tip #2: When treating a pregnant patient in cardiac arrest, you must be just as aggressive as you would with any other adult patient. Your primary target is saving the mother; prioritizing her care is the absolute best way to ensure the safety and survival of the baby.
1. Verify Responsiveness: Shout to assess the victim's status (*"Are you alright? Can you hear me?"*). If they do not respond to your voice, place a hand on their forehead and firmly tap their collarbone.
2. Activate the Code: If the patient remains completely unresponsive to taps and shouts, immediately activate emergency services (call 911 or call for your facility's code team).
3. Check Pulse and Breathing: Simultaneously check for normal breathing and feel for a carotid pulse for no more than 10 seconds. If they are unresponsive, have no pulse, and are not breathing normally, proceed directly to your AED.
4. Apply the Device: Turn the AED on immediately. Expose the patient's chest and apply the pads firmly according to the illustrated diagrams. The first pad goes on the upper right side of the chest; the second goes on the bottom left side (mid-axillary, just below the left breast).
5. Analyze Rhythm: Plug the pad cable into the device and shout for everyone to stand clear. Ensure no one touches the patient while the AED analyzes the underlying rhythm.
When the AED finishes charging and prompts you to clear the area, visually confirm that no one is touching the patient's body or bedding before depressing the flashing shock button. Failing to clear the scene can result in severe accidental shock to a team member.
6. Resume CPR Cycles: The moment the shock is delivered, transition directly into chest compressions. Compress the chest at a depth of 2 to 2.4 inches and at a rapid rate of 100 to 120 compressions per minute. Maintain a strict cycle of 30 compressions followed by 2 rescue breaths over the next two minutes until the AED instructs you to clear and re-analyze.