4.1 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:
  ×

  Place pads in anterolateral position:

  

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  • Right pad: Below the right clavicle (collarbone).
  • Left pad: Side of the chest, below the left nipple.
• If using anterior-posterior placement
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  anterior-posterior placement

  

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  (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
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  no one is touching the patient

  

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  .
• 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. Every second counts—maximize hands-on time to improve survival rates!