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Using an AED - brief overview and demonstration
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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 because 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. Training Scenario. One, an adult patient called
for medical assistance, remove clothing from patient's chest to expose bare skin. Paused. Why don't I just pause that for a second.
Now, you notice the start with, it's saying that we're using adults. Now adults because
if we had pediatric pads in there, maybe they've been put in, you'd to tell them, so you'd
know that there's a problem with the pads. It's telling you audio what type of pad's
in there. Most would always have adult pads in. The other thing it's saying is to expose
his chest. We've already done this so it will then carry on. So, we just continue that on. Pull green tab to remove pads. So, you pick the unit as you can see. 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 are 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 a 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 middle of 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 are 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. Good compressions. 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... Push faster. Going too slow, the unit will tell you to
speed up. And when you then get good compressions... 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
Using an AED: Step-by-Step Guide
1. Introduction
Exploring the process of using an AED (Automatic External Defibrillator) in a training room setting.
While the training scenario may differ from a real-life situation, breaking down the steps makes it easier to follow.
2. Initial Stages
Assuming that you've already assessed the scene for safety, introduced yourself, opened the airway, confirmed the absence of breathing, and initiated CPR.
3. Preparing the Chest
Ensuring the chest is ready for AED placement.
- Remove clothing to expose the bare chest, including bras and underwear.
- Inspect for any medical devices like pacemakers or scarring from heart surgery.
- Check for patches and jewelry, removing any metal-containing items.
4. AED Application
The importance of swift AED attachment and continuous CPR.
Every minute counts; the AED increases the chances of survival, and the device provides real-time CPR guidance.
Even those with limited experience can confidently use AEDs, as they offer step-by-step assistance.
