Early defibrillation is critical for the survival of patients in cardiac arrest. Although protocols for the use of an automated electronic defibrillator (AED) vary from facility to facility, there are many standard operating procedures that are held across facilities. To ensure that the patient gets the proper care that she needs, you need training in the proper use of the device (which includes training in CPR as a prerequisite). In addition, you must familiarize yourself with your facility's protocol in use of the device.
Instructions
1. Before an actual emergency occurs, ensure the AED is in proper working order with batteries fully charged.
2. Take body substance isolation precautions (e.g., put on a pair of gloves). Ensure that advanced life support (call 911) is activated. Assess the patient by obtaining a brief synopsis from witnesses of what happened to the patient. If you did not see the arrest, immediately perform CPR for 2 minutes. Stop CPR if it is in progress. Verify that the patient is unresponsive, not breathing and without a pulse
3. Bare the patient's chest and attach the AED to the patient. Place one electrode to the right of the upper portion of the sternum, below the clavicle. The other electrode is placed over the ribs to the left of the nipple, with the center in the midaxillary line. Check for diagrams if you are having difficulty in electrode placement.
4. Turn on the power.
5. Stop CPR and state, "All clear." Make sure that all personnel are clear of the patient. If someone is touching the patient, it will distort the AED's rhythm analysis. Initiate analysis of rhythm.
6. If a shock is advised, deliver the first shock. If a shock is not advised, do 2 minutes of CPR. Then, go back to Step 5.
7. Check the patient's pulse. If the patient has a pulse, then check breathing. If patient is breathing adequately, wait for advanced life support. If patient is breathing inadequately, provide rescue breaths. If the patient is without a pulse and not breathing, resume CPR for 2 minutes. If shock is advised, deliver one more shock and reassess pulse.
8. If the patient does not regain a pulse after the completion of a second shock, follow your local protocol regarding continued use of the AED.
Tags: shock advised, advanced life, advanced life support, advised deliver, life support