Automatic External Defibrillator - AED Level 2 (VTQ)

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Course Content

How to Use an AED

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9 min 15 sec
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What we're going to do now is have a look at actually using an AED. Now, we're in a training room scenario here so we're using the mannequins, and in the real, we work the same but you'd work much quicker. Honestly, I'm breaking this down into individual stages just to make it easier and know exactly what you're doing. The first thing we're going to assume, we'll assume we've already walked into the room, we found the person on the floor, we've done the scene safety and obviously, I've got my gloves on. The initial stages we would've been done already. We'd have already introduced ourselves trying to get a reaction out of them, open the airway, found out they're not breathing, and continuing CPR. This is the moment we're taking on from when the AED arrives. So, the first thing we need to do is we need to put the pads on to bare skin. The first thing we do here is literally take off clothing just to expose the chest. The reason we do this is that we need to put the pads on to bare skin. Now, we would need to take off any clothing that's there, including bras or any underwear that's on there as well because we must make sure we get contact with clean skin and there's nothing going to be in the way.

We're also going to have a visual inspection around to make sure maybe with even at this stage see that there's a pacemaker inserted, which you'd see under the skin here, maybe look for other scarring, which might indicate that the person could've had some heart surgery, something like that. We're also looking for any obvious patches and jewellery. Now, some of the patches have metal in them, and this can in some cases because of a problem. But if not jewellery, if they're wearing a necklace you just pull out the wire and take it off, because we don't want the electricity to be transferred through the necklace and not through the heart.

So, we're checking the entire area is clear. Now, in the real world of doing this, especially if there's two of you, one could get the AED ready and the other one could carry on the CPR. It's crucial that we keep the CPR cycle going the whole time. Now, remember, the quicker we get this AED unit on the better. Every minute the chance of survival drops 10%, so if you can get on within four minutes, this person's chance of survival is much better than maybe eight minutes or more when the ambulance turned up.

So, we've shown the area's completely clear. For this example, maybe in the real world, someone will be doing CPR, maybe from the other side while I get everything ready. Now the AED unit is sitting up here, it's close to me so I can get access to it. I'm not having to lean over the patient to push the buttons. I can easily see what's going on. Now, what we're doing now is using a training AED. It'll function the same way, but we need to pause it, and we need to run through the cycles. It's the easiest and safest way of demonstrating the skill. So, assuming the person's carrying on with CPR, the first thing we do is turn the AED unit on.

We're pulling down this tab and we're pulling out the pads. And what's happening now is we're taking the pads out with the wire, place that back down and the pads themselves are on an adhesive backing. They clearly state where they go. So, this one here is just below the collarbone on the left-hand side, and this one's under the arm. So, all we need to do is we take the pads and we can peel them off the backing. So just hold the tab at the back, peel the tab away, lay that one down, and then we can take the pad and just pop it onto the chest, push it down firmly to make sure it stays intact and it's on there properly. The other pads, just peel that off, and with this one, we're popping it underneath the arm. Again, make sure it's firmly in place. Now, with the pads on, then the next stage of it, the unit will often go straight automatically into an analyze cycle. As soon as it picks up that those pads are in place, it's going on to analyze. Now, because we're using in training mode, I need to tell it that we're then working through, analyse is the next stage.

Apply pads to patient's bare chest as shown in the picture.

So, as you're carrying on and you're putting the pads on, it will just keep repeating this message. Once the actual pads are in place, it will come up with a different message.

Assessing heart rhythm, do not touch the patient.

So, at this stage I need to be away from them, I don't want it to pick up my heart beat at all. We also need to make sure that everyone's clear so we tell everyone to back off, they're not standing anywhere near the patient.

Stand clear of the patient.

Just get ready with your finger, holding it over the button 'because I want to be looking around to make sure no one's there. So, I'm holding over the finger, I'm telling everyone to stand clear, keep clear, delivering the shock, and I'm looking at them.

Press the orange shock button now. Shock delivered. Begin CPR.

So, I'm going to pause that for a second just to explain what's happened. It's done the analyzing cycle, we've delivered the shock, and it's now telling me to commence CPR. So again, exactly as we've shown earlier, keep your hands solid above, and we're pushing directly down onto the chest. And with this unit, it's working slightly different from some others because it'll also give you help, so it's got a metronome to keep you in time, so you're doing 100 to 120 compressions a minute. It's also got electronic sensors that are detecting the speed and the depth of your compressions. So actually, I'm doing the compressions, just push down.

Good compressions... Good compressions. Stop CPR. Assessing heart rhythm. Do not touch the patient. Analyzing. Do not touch the patient. Analyzing. No shock advised. Begin CPR. It is safe to touch the patient. Place overlapping hands in the middle of the chest.

So, what we've done, we've delivered the shock to start with. We would have done two minutes of CPR, and what I did there is just continue chest compressions just to make it easier for this demonstration. But obviously, if you can do the breaths as well in which case you're going to need to count to 30, so do 30 compressions, two breaths. But maybe you're dealing with this with somebody else and they're not sure what to do, so continuing with chest compressions is the best one. It then said, "Stop CPR," and then I'm coming away 'because it needs to analyze the heart rhythm. The scenario we got set up here was the No Shock Advice for the next time. So, this would be a time where maybe the first shock has worked and this person may be starting to show signs of life now, or maybe they're no longer in VF, they're in asystole. Therefore, there's no way the unit will work, the shocks would not work properly on it.

So, what we do is continue CPR on that stage, until the person shows signs of life. The emergency services take over and when they do arrive, just keep going what you're doing until they tell you to stop. Otherwise, you just keep going this cycle, unless you're on your own, you would carry on until you start to show that you're too tired to continue. But the unit will keep going in this cycle, it will keep giving you the advice you need, and it'll help you. With this unit, if there are any problems with your CPR, it will tell you. So, if we just resume this... So, if there are any problems with your CPR, this unit will tell you.

And the minute it's showing good compressions, the bar chart on there is showing green so everything's working fine. If there were other issues like now when it's saying that they need to push faster, the indication would tell you. And also, once you're...

Going too slow, the unit will tell you to speed up. And when you then get good compressions...

The unit tells you that as well. So, it's giving you lots of help with your CPR, whether you're doing fast, going too fast, you're going to deep, the actual unit is telling you that that's the case. So, it's a very good way of giving you real-time CPR help. This is perfect if someone hasn't got that much experience. In this example here, we're looking at complete low experience scenario: We got somebody just turned up, the AED unit's there, they're doing continued chest compressions, they've activated the emergency services, all the things they have to do, but the unit is guiding them through. It's guiding them through their CPR, if they're not good enough, they need to do more, then that's fine. So, these units are extremely simple and they're just perfect for anybody who needs that extra CPR help.

Learning Outcomes:
  • IPOSi Unit two LO1.5 & 2.4