AED Use in Clinical Settings
Automated External Defibrillators (AEDs) are crucial for early defibrillation in cardiac arrest. As a healthcare provider, you will frequently encounter AEDs in hospitals, clinics, ambulances, and public settings.
Key Differences in HCP AED Use
- Immediate recognition of shockable rhythms (though AED analyzes for you)
- Integrating AED use with ongoing CPR
- Special considerations in clinical settings (e.g., pacemakers, medication patches, wet patients)
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Steps for Using an AED
1. Power On the AED
- Some AEDs turn on automatically when opened, while others require a button press.
2. Attach the AED Pads
- Expose the patient’s chest (shave if necessary).
- Place pads in anterolateral position:
- Right pad: Below the right clavicle (collarbone).
- Left pad: Side of the chest, below the left nipple.
- If using anterior-posterior placement (common in infants/small children):
- Front pad: Center of chest.
- Back pad: Between shoulder blades.
3. Analyze the Rhythm
- Ensure no one is touching the patient.
- Press the analyze button if prompted (some AEDs analyze automatically).
4. Deliver the Shock if Advised
- Clear the area and loudly announce: “CLEAR!”
- Ensure no one is touching the patient.
- Press the shock button if required (some AEDs shock automatically).
5. Resume CPR Immediately
- Do not check for a pulse yet—immediately start compressions.
- Continue CPR for 2 minutes before the next analysis.
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Special Considerations in Clinical Settings
1. Pacemakers and Implanted Defibrillators
- Avoid placing AED pads directly over a pacemaker or defibrillator (usually seen as a lump under the skin).
- Place pads at least 1 inch away from the device.
2. Medication Patches
- If a medication patch (e.g., nitroglycerin patch) is present where the pad should go, remove it and wipe the skin dry.
3. Wet or Sweaty Patients
- Remove the patient from water before using an AED.
- If the patient is very sweaty, wipe the chest dry before attaching pads.
4. Hairy Chests
- Thick chest hair can prevent pads from making contact with the skin.
- Use a razor (if available) to quickly shave the area, or apply one set of pads, rip them off to remove hair, and apply a fresh set.
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Integrating AED Use with CPR
Unlike layperson CPR, healthcare providers must integrate AED use without interrupting compressions:
- Apply AED pads while compressions continue.
- Switch compressors during AED analysis to minimize downtime.
- Perform chest compressions while the AED charges (if applicable).
Every second counts—maximize hands-on time to improve survival rates!