Emergency Response for the Workplace AED Safety Training Emergency Response for the Workplace

Activate EMS (Call 9-1-1) Use cell phone or land line Recognize cardiac arrest Not responding Chest not moving, no breathing Don’t delay: early 9-1-1 linked to increased survival Send bystander if possible If unsure, go call! CPR/AED for Community Rescuers Chain of Survival

Early Defibrillation Use AED when it arrives Early Defibrillation Defibrillators can restart the heart of a victim Calling 9-1-1 gets a defibrillator to the scene An Automated External Defibrillator (AED) is used by citizen rescuers Some public places like airports have AEDs accessible to all rescuers CPR/AED for Community Rescuers Chain of Survival

Advanced & Post-Arrest Care Advanced Care Post-Arrest Care AKA: Advanced Life Support Provided by paramedics, continued at hospital Adds advanced airway management, drug therapy, cardiac monitoring to CPR Goal: restart heart and stabilize for post-arrest care Comprehensive care once person is stabilized Begins at hospital and continues through discharge Provided by doctors, nurses, therapists and many others Goal: Improve chances of continued survival with least disability CPR/AED for Community Rescuers Chain of Survival

What is an AED What it does… Uses voice and visual prompts Automated External Defibrillator (AED) What it does… Uses voice and visual prompts Easily guides rescuers Analyzes heart rhythm Determines if shock is needed Restores normal rhythm Provides CPR reminders CPR/AED for Community Rescuers CPR Overview

Ventricular Fibrillation (V-fib) SCA=Sudden Cardiac Arrest V-fib to Shock to Normal V-fib is common in SCA Heart overwhelmed by electrical activity Can be related to lack of oxygen Quickly lethal Victim unresponsive CPR won’t stop V-fib “Defib” is only treatment for “V-fib” V-fib present in 90% of SCA cases CPR/AED for Community Rescuers CPR Overview

How an AED Works AED detects V-fib Power on & Attach pads AED detects V-fib Sends powerful current through heart Shock resets heart’s electrical activity Heart may start beating normally Like a ‘control-alt-delete’ for the heart CPR/AED for Community Rescuers CPR Overview

Sum it Up CPR restores flow of oxygen to the brain CPR can extend time for successful AED use The sooner an AED is used, the more likely it will work CPR/AED for Community Rescuers CPR Overview

When to Use the AED If 2nd Rescuer Present Rescuer 1 continues CPR Use AED when it’s available If 2nd Rescuer Present Rescuer 1 continues CPR Rescuer 2 operates AED Switch roles when the AED prompts to stop CPR If no AED, switch performing CPR about every 2 minutes Observe CPR provider & give feedback Pushing hard/fast enough? CPR/AED for Community Rescuers C-A-B

Using an AED CPR/AED for Community Rescuers

Key Concepts AEDs can be used on adults, children and infants An AED has a status indicator to show if it is ready for use Follow local protocols for age-specific AED guidelines if they differ from this course Basic AED Sequence: Power on the AED Apply pads Follow AED prompts CPR/AED for Community Rescuers Using an AED

Power the AED Place AED near head Power on AED AED guides actions CPR/AED for Community Rescuers Using an AED

Apply AED Pads Expose chest Apply pads (follow pictures) If 2 rescuers Cut clothing Wipe dry Apply pads (follow pictures) Right upper chest, just below collarbone Lower left side of the chest If 2 rescuers Rescuer 1 continues CPR Rescuer 2 operates AED CPR/AED for Community Rescuers Using an AED

Shock or No Shock? After pads are applied: AED prompts rescuer to stop CPR AED analyzes the heart’s electrical rhythm Do not touch or move the person AED will state ‘shock advised’ or ‘no shock advised’ If no shock advised, AED will prompt rescuer to resume chest compressions If shock advised, rescuer must clear victim first CPR/AED for Community Rescuers Using an AED

Clear Victim and Shock Do not touch victim or clothing during a shock Clear victim first Loudly state, “Clear!” Look up and down entire victim Ensure no one touching person or clothing Press shock button Some AEDs shock automatically (no button) AEDs announce when safe to resume compressions CPR/AED for Community Rescuers Using an AED

Resume CPR Immediately resume CPR Start with chest compressions AED will analyze heart rhythm every 2 minutes If 2nd rescuer present Switch roles when AED prompts to stop CPR One rescuer rests Other rescuer gets in position for CPR Rescuer 2 will continue to operate AED Immediately resume CPR CPR/AED for Community Rescuers Using an AED

AED Use on Children For AED use: A child is 1-8 years old, or less than 55 lbs. An infant is < 1 year old Children & infants require less electrical current Special equipment reduces amount of energy delivered Child/Infant Pads Energy reducer or attenuator Pediatric key or switch If pediatric equipment is not available, use standard equipment CPR/AED for Community Rescuers Using an AED

For Smaller Children or Infants Use front-to-back AED pad placement if needed Pads should not touch or overlap Do not cut or fold pads to fit CPR/AED for Community Rescuers Using an AED

Defibrillation Use when available Place near victim’s head Power on AED Follow prompts Apply pads Press shock button Resume compressions after shock CPR/AED for Community Rescuers Adult CPR

Special considerations - AED

Special Considerations - AED Key Concepts There are 3 situations to consider when applying AED pads that may alter rescuer’s actions: A very hairy chest An implanted device (e.g. pacemaker) A medication patch CPR/AED for Community Rescuers Special Considerations - AED

Special Considerations - AED Implanted Devices Device may appear as a small raised lump under skin Devices may include Pacemaker Automated Implantable Cardioverter-Defibrillator (AICD) Medication administration port Most implanted devices do not affect AED pad placement. Do not place pad directly over implanted device Adjust pad placement at least 1” from device CPR/AED for Community Rescuers Special Considerations - AED

Special Considerations - AED Medication Patches Medication can be embedded in an adhesive patch applied to skin Do not place an AED pad over a medication patch Use a gloved hand to remove the patch Quickly wipe chest clean with a towel or cloth Apply pads after area is wiped clean CPR/AED for Community Rescuers Special Considerations - AED

Special Considerations - AED Storage & Maintenance Close to trained rescuers Near most of people, most of the time Visible signage; easy access Common areas easy to describe With accessories Spare adult pads Pediatric pads or adaptor CPR barrier, gloves Safety razor Absorbent towel Inspection Status indicator shows ‘Ready’ Pads & battery not expired No visible damage No missing accessories CPR/AED for Community Rescuers Special Considerations - AED

Special Considerations - AED Troubleshooting An AED performs self checks regularly and every time it is powered on. The AED will notify operator if problem detected “Check pads” Press down firmly, or replace pads w/ back up set Check pad connection to AED “Low Battery” Replace battery Even in low battery state, AED may provide several shocks Refer to AED manufacturer for more information Movement Disrupts analysis of heart rhythm When AED is analyzing, do not touch or move victim CPR/AED for Community Rescuers Special Considerations - AED

Special Considerations - AED Sum It Up Avoid placing pads over implanted device Remove medication patches Store AED near trained rescuers and a phone If a problem with AED cannot be quickly solved, discontinue AED use and resume CPR CPR/AED for Community Rescuers Special Considerations - AED