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)

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.

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.

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!