11/13/24, 7\:39 PM Guide | Using an automated external defibrillator (AED)

Using an automated external de

Table of contents

Automated external de

An automated external de
energy to the heart through the chest wall.
1-4
A cardiac arrest occurs when the heart stops beating e1,3
The patient will lose consciousness and stop breathing.
De
Early recognition and call for help
Early CPR
Early de
Early advanced cardiac life support

How does an AED work?

An AED works by analysing the heart rhythm and delivering an electrical shock if the patient is in a shockable rhythm. An AED
is an automated device, meaning it can be used by people with little or no medical training.
The two shockable rhythms are\:
1,3,4
Ventricular
Ventricular tachycardia (VT)\: a regular and fast rhythm that originates in the lower chambers of the heart
The electrical shock delivered by the AED disrupts the abnormal electrical activity in the heart and restores a normal rhythm.
The shock depolarises a large portion of the heart muscle simultaneously. This causes the heart's electrical activity to reset,
allowing the normal electrical conduction pathways to be restored.
3
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It is important to note that an AED cannot restore a normal heart rhythm in all cases of cardiac arrest. The success of an AED
shock depends on several factors, including the underlying cause of the cardiac arrest, the duration of cardiac arrest, and the
patient's overall health. However, the prompt use of an AED can signi
sudden cardiac arrest.
3, 5
The AED will not deliver an electrical shock if the patient is in a non-shockable rhythm (e.g. asystole).
History of AEDs
The history of automated external de
electrical shocks to revive people in cardiac arrest. However, it wasn't until the late 1970s and early 1980s that the
AEDs were developed.
Physio-Control Corporation developed the Heartstart AED in the early 1980s. It was a portable device that could be used
by non-medical personnel to deliver a shock to a person in cardiac arrest. The Heartstart was a signi
in emergency medicine, allowing laypeople to perform de
In the 1990s, AEDs began to be installed in public places such as airports, shopping malls, and sports venues. This was
due to the growing awareness of the importance of early de
in cardiac arrest.
2,3
In the 2000s, AEDs became more widely available and were installed in many public places. In addition, the technology of
AEDs has advanced, with newer devices featuring improved design and features such as voice prompts and real-time
ECG monitoring.
2,3

How to

In the UK, AEDs are widely available in public places, including shopping centres, airports, sports facilities, and train stations.
They can also be found in workplaces, schools, and community centres.
1-3
The British Heart Foundation estimates there are approximately 100,000 public AEDs in the UK, with many funded by charities
or local communities.
1,2
Anyone can use an AED in an emergency, regardless of whether they have received formal training. However, the Resuscitation
Council UK recommends that people are trained to use an AED during
and e
3,5
The location of an AED in public places should be indicated by clear signage. 3,5
Ambulance services hold up-to-date
information on deDe).
3,5
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Figure 1. An example of a public access automated external de

Using an automated external de

Using an AED is a vital part of basic life support, and the AED should be combined with high-quality cardiopulmonary
resuscitation (CPR).
1. If a bystander or assistant is available, ask them to continue cardiopulmonary resuscitation.
2. Switch on the AED. Once switched on, the AED will start giving instructions (audio-visual) to the operator.
3. Attach the two self-adhesive pads immediately to the patient’s bare chest (as labelled)\:
The right of the sternum below the clavicle
The mid-axillary line, with its long axis vertical and su
4. Pause chest compressions whilst the AED analyses the patient's heart rhythm. Do not touch the patient or electrodes during
this time, as this may interrupt the analysis.
5. If a shock is required (i.e., the patient is in a shockable rhythm), follow the AED instructions and deliver a shock.
Stand clear\: check that no one is in contact with the patient before delivering a shock; otherwise, the electrical current may
travel to others.
Oxygen away\: remove free-
endotracheal tube or supraglottic airway device does not increase the oxygen concentration around the area of
de
6. If no shock is advised, leave the self-adhesive pads in place and follow AED instructions.
7. Re-start chest compressions.
8. Follow instructions from the AED\: the AED will time CPR, prompt the user to stop for a rhythm check every 2 minutes and
deliver additional shocks if necessary.
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Switch on the AED

Special circumstances

There are some special circumstances to consider when using an AED to ensure that the AED is used e
3,4,6
Obstructive clothing
Remove clothing and any other objects obstructing the patient’s chest to allow the correct placement of the electrode pads.
Age and size of the patient
The AED electrode pad size needs to be selected based on the age and size of the patient to ensure that the device is used
e
Some AEDs require speci
guidance should be followed, and where necessary, both adult and paediatric pads should be kept with the AED.
Adult pads can be used on a child if no paediatric pads are available.
Wet conditions
If the patient is lying in water or is wet, move them to a dry area before using the AED. The moisture can interfere with the
device's ability to deliver a shock and pose a risk of electrocution to the operator.
Wet skin
Dry the patient's chest as much as possible before applying the electrodes/pads. You may need a dry cloth or towel to dry the
area before applying the electrodes.
Hairy skin
To use an AED on hairy skin, you should shave the patient’s chest hair to expose the skin. This will help ensure that the
electrodes make good contact with the skin and that the AED can accurately analyse the patient’s heart rhythm.
Metal objects, jewellery, buttons
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