Be extra careful when using an automated external defibrillator (AED) in a cardiac arrest. In an emergency, knowing how factors impact AED use is crucial. Each action you take can help achieve the best outcome for the person in need.
- Pediatric patients
- Wet or sweaty patients
- Patients lying on snow or ice, or near flammable or combustible materials
- Patients with a hairy chest
- Patients with a medication patch
- Patients with a pacemaker or implantable cardioverter defibrillator
- Patients with jewelry or body piercings
- Patients who are wearing a bra
- Patients who are pregnant
In an emergency, if there’s uncertainty, start chest compressions right away. Have someone call emergency services for help before using an AED. If the person is unresponsive and not breathing, act quickly. Every second counts for their survival.
Treating a pediatric patient.
Although cardiac arrest in children is uncommon, it can still occur. Many AEDs have a pediatric mode. This mode uses child-specific electrode pads. They adjust the shock level for safety in young patients. These features ensure the energy provided is right for infants and kids under eight. They offer essential support designed just for them.
When using an AED on a child under eight, make sure it is in pediatric mode or has child pads. This will give the right shock level for their age.
- With the ZOLL AED Plus, swap the adult pads for Pedi Padz II for kids. The device will then adjust its voice prompts to help you with pediatric use.
- The Defibtech Lifeline AED makes it easy to treat young patients. You can use optional pediatric pads for this purpose. When you connect these instead of the adult pads, the device quickly shifts to pediatric mode. This ensures that the shock level is safe for children.
- With the Philips HeartStart FRx, you can insert the optional infant or child key. This automatically lowers the shock level. It allows safe use with standard adult electrode pads.
- The Physio Control Lifepak CR2 makes treating children simple. Just press the Child Mode button. The device automatically adjusts the energy level. It uses the same electrode pads as for adults.
- For the HeartSine Samaritan PAD 350P, 360P, and 450P models, switch the adult Pad-Pak to the child version. This will activate pediatric mode. The AED gives clear voice instructions. It guides you through each step and tells you when to deliver a shock to semi-automatic units.
If child pads aren’t available and your AED lacks a pediatric mode, standard adult pads can still be used. For children, proper pad placement is essential to prevent the pads from touching. One pad should be positioned in the center of the chest, slightly left of the sternum, and the other on the upper back. Place the pads correctly for the best shock delivery. Follow this step for both adult and pediatric pads.
For infants under one year, use a manual defibrillator when you can. This is especially important if you don’t have pediatric pads available. In a cardiac emergency, using any available AED is far better than doing nothing. It doesn’t matter if it has adult or child pads.
Treating a sweaty or water-submerged patient.
When using an AED on someone who is wet or sweaty, it’s important to take a few precautions. Remove the person from the water if they’re submerged. Then, quickly dry their chest area before attaching the electrode pads. The American Heart Association says to dry only the chest. You don’t need to spend extra time drying the rest of the body. Acting quickly and ensuring good pad contact can make a big difference in an emergency.
When using an AED on someone wet or lying on a damp surface, make sure their chest is dry before applying the pads. This makes sure the shock goes straight through the heart. If it spreads through water, it could risk rescuers or bystanders. If the person is on a wet floor or near a puddle, simply move them to a drier area and continue using the AED as normal.
Treating a patient on other surfaces
Some additional safety factors should also be kept in mind when using an AED near water.
- You can safely use an AED on someone lying on snow or ice. These surfaces won’t affect the device’s ability to deliver a shock.
- Keep all metal surfaces away from the patient and the AED operator. This prevents accidental conduction when using the device.
- Avoid using an AED near flammable gases or vapors, like petrol or aviation fuel. A tiny spark can cause an explosion.
Treating a patient with a hairy chest.
Too much chest hair can stop an AED from reading the heart rhythm properly. This makes it harder to deliver a good shock. Hair blocks the pads from fully touching the skin. This reduces the conductive gel’s effectiveness and weakens the electrical connection.
The American Heart Association suggests simple steps to handle excessive chest hair before using an AED.
- Quickly shave the area where the pads will be placed to ensure good contact. It’s best to keep a disposable razor with every AED or in nearby first-aid kits for this purpose.
- If there’s no razor, and the AED says “check pads,” press the pads firmly on the chest for better contact. Then, step back when it tells you to stand clear.
- If the AED still doesn’t respond, quickly peel off the pad to remove some hair, then apply a new set. Only attempt this if spare pads are available.
Treating a patient with a transdermal medication patch.
Transdermal patches deliver medications, such as hormones or nicotine, through the skin. Yet, if they are placed under AED pads, they can interfere with shock delivery. During cardiac arrest, energy may be diverted away from the heart if a shock is delivered over a patch.
Before attaching AED pads, take off any medication patches. Wipe away any leftover residue for better contact. Always wear gloves during removal to avoid absorbing the medication through your skin.
Treating a patient with a pacemaker or an implantable defibrillator.
Pacemakers and implanted defibrillators need extra care when using an AED. Avoid placing pads directly over these devices, as they can disrupt the shock or harm the implant. Position the pad a few inches lower, or try a front-and-back placement for better safety.
You can often spot a pacemaker or defibrillator by a small scar or bump. It’s usually found on the upper chest or abdomen, often on the left side near the heart. In most cases, this placement won’t interfere with where AED pads are normally applied.
Please note: If someone with a defibrillator has a cardiac arrest, the device likely isn’t functioning. Don’t hesitate to use an AED – while machines can be replaced, a life cannot.
Treating a patient who is wearing jewelry or has body piercings.
If a person in cardiac arrest can’t quickly remove metal jewelry or piercings on their chest, use the AED right away. Don’t wait. The slight risk of burns is far less important than immediate defibrillation. Place the pads a few inches from any metal. This keeps good skin contact and ensures effective shock delivery.
Treating a patient who is wearing a bra.
For an AED to work properly, the pads must attach directly to bare skin. If the patient is wearing a bra or similar clothing, cut it away to expose the chest area. For privacy, bystanders can stand nearby and face outward to provide a modest shield.
Treating a patient who is pregnant.
The American Heart Association says to use an AED for pregnant patients in cardiac arrest. Apply the pads as you would for any adult—the device will deliver a shock only if a treatable rhythm is detected. Restoring the mother’s heartbeat quickly is vital for both her and the baby’s survival.
Prepare ahead and take immediate action.
Occasionally, special situations may arise when using an AED. In most cases, you can still use the device correctly. Make a few quick changes for safe and proper treatment.
To be ready for emergencies, make sure your AED kit has pediatric pads or a pediatric key, depending on the model. Also, include a razor, scissors, and gloves. Having these essentials ready lets you act fast and with confidence. A quick shock can save a life.
FAQs
What are some special considerations when using an AED?
When using an AED, special considerations include checking for water, chest hair, implanted devices, medication patches, and pediatric needs. The victim’s chest should be dry. Pads must touch the skin fully. Also, placement should avoid pacemakers and jewelry. These steps ensure that the shock is delivered effectively and safely.
What are the special considerations when using an AED on children?
Children under eight need pediatric pads or a child mode setting to reduce shock energy. Pads should never touch each other and must be positioned accurately on the chest and back. If pediatric pads are unavailable, adult pads may be used as a last resort.
Can you use an AED on a person with a pacemaker?
Yes, an AED can safely be used on someone with a pacemaker. Avoid placing the electrode pads directly over the implant. Place the pads a few inches from the device. This way, the electrical shock works well and won’t interfere with the pacemaker.
What are the contraindications for using an AED?
There are very few contraindications for AED use. The main exceptions are places with explosive gases or flammable materials. Sparks can ignite these substances. AEDs are safe for almost all cardiac arrest victims. This includes pregnant women and those with implants.
An AED should be used when?
Use an AED if someone is unresponsive, not breathing normally, and has no signs of circulation. Acting fast is key. Early defibrillation boosts survival chances in sudden cardiac arrest.
Conclusion
Knowing how to use an AED helps you act fast and with confidence in an emergency. Small adjustments can save lives, whether the patient is wet, has chest hair, has a pacemaker, or is a child. Remember, an AED is designed to guide you step by step – don’t hesitate to use it. Every second matters. Your quick action might help someone survive sudden cardiac arrest.
