Guide on Using an Automated External Defibrillator (AED) | Wellbeing

1. The Phenomenon of Cardiac Arrest

Cardiac arrest occurs when the heart abruptly stops beating. A dangerous reality of this condition is that it can strike normal, healthy individuals without any prior medical history, at any time and in any place. The most common cause is an abnormal heart rhythm, specifically Ventricular Fibrillation. This irregularity can arise when the heart muscle is damaged due to a heart attack or when the heart is deprived of sufficient oxygen. An AED is specifically designed to correct this chaotic rhythm by delivering a controlled electric shock. The device is engineered to be incredibly compact, allowing individuals with absolutely no medical background or experience to use it effectively, thereby increasing the survival chances of cardiac arrest victims both in hospital settings and in the community. In most emergency scenarios, the rescuer must initiate Cardiopulmonary Resuscitation (CPR) immediately while waiting for the AED to arrive. Once the device is on the scene, continue rescue breaths and compressions while a helper prepares to power on the machine and apply the electrodes to the victim's chest.

2. Step-by-Step AED Operation

Begin by turning on the AED and removing the electrode pads from their sealed package. You must remove or cut through the victim's clothing and wipe away any sweat from the chest to ensure proper adhesion. Next, peel the protective backing off the pads and apply them to the designated areas on the victim's chest. Place the first electrode pad on the upper right side, directly below the collarbone. Place the second electrode pad on the left side of the rib cage, positioned directly below the armpit, ensuring the pad aligns with the body's vertical axis from head to toe. Once attached, the AED will begin analyzing the heart rhythm. During this critical phase, ensure absolutely no one is touching the victim, and strictly follow the visual and/or verbal instructions issued by the machine.

3. Critical Safety Precautions

Safety is paramount; ensure that no one is in contact with the victim while the machine analyzes the rhythm or delivers the shock, as this can interfere with the AED's accuracy and poses a risk of accidental electric shock to bystanders. Do not turn off the AED or remove the electrode pads, even if the victim appears to have recovered, as cardiac arrest can recur, and repeat shocks may be necessary. While using an AED can sometimes be complicated by underlying medical conditions, external factors, clothing, or the specific cause of the arrest, the safety of all individuals involved must always remain the primary consideration.

• Clothing: You should remove or cut away any clothing or jewelry that obstructs pad placement. Normal chest hair is generally not an issue, but if it prevents good skin contact, it should be shaved. Ensure all metal is removed from the pad application area, including underwire bras, which must be taken off.

• External Factors: Excessive water or sweat on the chest can reduce the efficacy of the shock; therefore, the chest must be dry. If the victim is pulled from water, dry their chest before applying the pads. If the victim is unconscious due to electric shock, ensure the power source is disconnected before starting CPR.

• Medical Conditions: Some victims may have an implanted pacemaker or defibrillator (often visible as a lump under the skin). This does not prevent AED usage; simply avoid placing the pad directly over the implanted device. If the victim has a medication patch (such as a nitroglycerin patch) on their chest, remove it before applying the electrodes.

• Pregnant Victims: There are no contraindications for using an AED on pregnant women. However, increased breast size may present a challenge. To place the AED pads correctly, gently push the breast tissue to the right and apply the left electrode pad on the lateral side (outer side) of the left breast, ensuring the pad is not placed directly on top of the breast tissue.