Heartsaver AED for the Lay Rescuer and First Responder American Heart Association

Extent of the Problem 1.1 million heart attacks 480,000 deaths due to coronary heart disease 250,000 prehospital cardiac arrests Discuss the scope of the problem and the importance of the role of Heartsaver AED providers. Explain that they provide three very important interventions: Calling EMS Performing CPR Using the AED

Recognize Emergency and Call 911 Airway obstruction Universal distress signal, blue skin Respiratory arrest Not breathing but has pulse Cardiac arrest Not breathing and no pulse Briefly discuss the recognition of common cardiovascular emergencies and the importance of early access. Do not spend too much time explaining these conditions.

Activate EMS Know your local EMS number Give the location of call Telephone number The nature of the emergency Advise that AED is on the scene Don’t hang up until dispatcher advises Review the steps for contacting EMS and the information to provide. Explain that dispatcher-assisted CPR and AED operation may be available in an EMS system to help the rescuer. Provide an example of how the rescuer may express the important information.

Signs of Cardiac Arrest Unresponsive Not breathing No pulse Explain the importance of assessment. Provide rescue breathing only when there is no breathing Perform compressions only when there is no pulse Use the AED when there is no breathing or pulse

AEDs and Ventricular Fibrillation VF is the most frequent initial rhythm in sudden cardiac arrest VF is a useless quivering of the heart that results in no blood flow Defibrillation is the only effective treatment for VF Successful electrical defibrillation diminishes rapidly over time Explain the importance of defibrillation in the treatment of VF and that CPR alone cannot convert this rhythm.

Time and AEDs Approximately 50% survival after 5 minutes Survival reduced by 7% to 10% each minute Rapid defibrillation is key CPR helps extend survival time Explain the importance of time. Emphasize the importance of attaching the AED as quickly as possible (in less than 90 seconds of placement of the AED next to the victim). minutes

Priorities and the AED C - Circulation A - Airway B - Breathing D - Defibrillation Explain the importance of a systematic approach guided by the ABCD structure.

AEDs and Personnel One rescuer Two rescuers More than two rescuers Unresponsiveness – Call 911 – Get the AED Assess Breathing/Pulse Attach AED Two rescuers #1 – Call 911/Perform CPR #2 – Attach AED More than two rescuers #1 – Call 911 #3 – Perform CPR Discuss the varying roles of one rescuer versus two or more rescuers. Emphasize that EMS must be called first and that the ABCD approach should guide you through the sequence.

Special Considerations Is victim lying in water? Is victim less than 8 years old? Is victim wearing a transdermal medication patch on his or her chest? Does victim have a pacemaker or implanted defibrillator? Explain the rationale behind these special considerations and how they play an important role in the safety of the victim, bystanders, and rescuers.

Operation of AED POWER ON the AED ATTACH pads ANALYZE rhythm SHOCK (if advised) Explain the simplicity of using the AED and demonstrate the operation of the specific AED that the rescuers will use in their system.

Electrode Pad Placement Right electrode pad To the right of the breastbone Below the collarbone above the right nipple Left electrode pad Outside the left nipple, upper edge of the pad several inches below the left armpit Show placement of pads using the slide and a manikin.

Effective Adherence of Pads Sweaty chest Dry with a towel Do not use alcohol Hairy chest Shaving may be needed Explain how to prepare the chest to ensure effective pad adherence. Explain that this may not be necessary in all victims and that it must be done very quickly to avoid delay in defibrillation.

AED Safety No patient contact during analysis and shock Warn bystanders: “I’m clear” “You’re clear” “Everybody’s clear” Perform a visual inspection Press to shock Emphasize the importance of safety and clearing the victim. It requires both verbal communication and visual inspection of the victim.