Automated External Defibrillators (AED’s)

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Automated External Defibrillators

The automated external defibrillators are portable defibrillators that senses and analyzes the heart rhythm and then gives step by step directions on how to proceed if defibrillation is needed.

Some key points:

  • Contain cardiac rhythm analysis systems
  • May be fully or semi-automated
  • For patients with no pulse and no respirations
  • Less training needed to operate
  • Faster speed of operation and delivery
  • Hands-free-technique
  • Energy level = 200 to 360 joules
 

How AED’s Sense Rhythm

The accuracy of the AED in rhythm is considered very high.  A microprocessor analyzes features of the patient’s EKG signal for frequency, amplitude, and integration of frequency and amplitude.  A safety filter checks for false signals, such as those deriving from radio transmissions, poor electrode contact, 60-cycle interference, or loose electrodes.

Safety Tips for Defibrillation

You must take precautions when defibrillating a patient with an implantable carioverter-defibrillator (ICD) or pacemaker or for a patient who’s wearing a transdermal medicine patch.  You must also be careful when defibrillating a patient who’s in contact with water.
 

Defibrillating a Patient with an ICD or Pacemaker

Avoid placing the defibrillator paddles or pads directly over the implanted device.  Place them at least 1 inch away from the device.
 

Defibrillating a Patient with a Transdermal Medicine Patch

Avoid placing electrodes directly on top of a transdermal medicine patch, such as nitroglycerin, nicotine, analgesics, or hormone replacement.  The patch can block delivery of energy and cause a small burn to the skin. Remove the medicine patch and quickly wipe the area clean before defibrillation.
 

Defibrillating a Patient Near Water

Water is a conductor of electricity and may provide a pathway for energy from the defibrillator to the rescuers treating the patient.  Remove the patient from free-standing water and quickly dry his chest before defibrillation.

2 Types of Defibrillators

Monophasic Defibrillators — delivers a single current of electricity that travels in one direction between the two pads or paddles on the patient’s chest.  To be effective, a large amount of electrical current is required for monophasic defibrillation.  

 

Biphasic Defibrillators — the discharged electrical current travels in a positive direction for a specified duration and then reverses and flows in a negative direction for the remaining time of the electrical sidcahrge, thereb delivering two currents of electricity.  Using two currents lowers the defibrillation threshold of the heart muscle, increasing the likelihood for successful defibrillation of ventricular fibrillation with a smaller amounts of energy.  Most newer defibrillators are biphasic.

Image taken from:  www.edu.andrewking.id.ua
AED’s can restore a cardiac rhythm and return of spontaneous circulation.  It is critical that an AED is applied as quickly as possible.  For every minute that AED is not used, it decreases the chances of survival by 10 percent.
 
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