How to Use an AED

Excerpt from the AED Superstore Ultimate AED Buyer’s Guide

AEDs are so simple, they can be used by virtually anyone. You do not need to be a medical professional! Every AED walks a rescuer through the event, from the time the AED is turned on until EMS arrives, using both visual and voice prompts. Simple graphics on the AED, electrode packaging (which varies by make and model), and clear voice commands guide the rescuer through the event.

If you have to use an AED to save someone, here are the basic steps:

1. Call 911 for help
2. Turn on the AED
3. Remove clothing from the patient’s chest
4. Place the electrode pads
5. Do not touch the patient
6. Allow the AED to analyze the patient’s heart rhythm
7. If prompted, press the shock button on the AED (some AEDs do this automatically)
8. Begin CPR

How to Use an AED on an Adult

Turn the AED on either by lifting the lid, pressing the power button, or removing the electrode pads (the method of turning on the AED varies by make and model). A typical scenario of voice prompts once the AED is turned on would be:

“Call for help”

• If you are with other people – instruct someone else to call 911
• If you are alone:
  • If you have a mobile phone and service – call 911, put your phone on speaker, and place the phone next to the patient so you can speak to the dispatcher during the rescue
  • If you do not have a mobile phone or service, find a way to reach 911 either by seeking another individual or finding another phone and then return to the patient as quickly as possible

“Remove clothing from patient’s chest” – all AEDs sold by AED Superstore include a rescue kit to assist with this step

• Remove all clothing from patient’s chest
  • Do not be afraid to cut clothing if necessary (and you have the means), or tear the clothing – a rescue kit usually includes a pair of scissors
  • Bras may be cut, lifted over the patient’s breasts or left on (if it does not impede electrode pad placement)
  • Make sure skin is clean and dry of water or sweat – a rescue kit usually includes a towel or you can use your own clothing or the patient’s clothing if it is dry and clean enough
• Make sure skin is free of excessive hair,if possible – a rescue kit usually includes a disposable razor

“Place electrode pads on patient’s bare chest”

• Visual guides on the electrode pads or electrode pad packaging will show placement
• Press the electrode pads firmly to clean, bare, dry skin

“Do not touch the patient”

• Sit back from the patient and make sure you are not touching the patient
• Instruct others in the area to also stand back
  • Why this is important: The AED is checking the heart rhythm to detect whether it is a shockable or non-shockable heart rhythm. If the patient is being jostled, this interferes with the analysis

“Shock advised” – The AED has detected a shockable heart rhythm and is getting a charge ready to shock the patient.

• “Do not touch the patient” – stand back from the patient and advise others around you to do the same
• If the AED is semi-automatic, “Press the flashing shock button”
  • The orange or red shock button will flash
  • Press the button
• If the AED is fully-automatic, “Shock will be delivered in 3, 2, 1…”
  • The AED does not have a shock button and will deliver the shock when the countdown finishes.

“Shock delivered” – the shock was successfully administered to the patient.

“It is now safe to touch the patient” – you can safely touch the patient.

OR  

“Shock not advised”

• The AED has detected a non-shockable rhythm
  • The patient may be in asystole (or “flatline”)
  • If the patient is still unresponsive and not breathing, perform CPR

“Begin CPR”

• Most AEDs have some form of CPR prompting/assistance. These may
  include:
  • A metronome to keep you on track for rate of compressions
  • A timer which will alert the rescuer how many more seconds to perform CPR on the patient
  • CPR Feedback (providing real-time guidance on the quality of the rescuer’s CPR), including:
    • Rate of compressions – will prompt “good speed”, “push faster”, or “push slower”
    • Depth of compressions – will prompt “good compressions”, “press deeper”, “press harder”, or “press softer”
    • Recoil – will prompt “press harder, fully release”
• Some AEDs provide guidance to give rescue breaths between CPR compression cycles
  • If you are uncomfortable giving breaths, continue compressions in the “hands-only” CPR method
  • If you are comfortable giving breaths, or if you have a second rescuer with you who can administer the breaths, give rescue breaths
• To perform CPR on the patient, interlace your fingers and press hard on the lower half of the sternum (breastbone); you may hear ribs crack or break – this is normal and necessary to reach the proper depth!
• The rate of chest compressions should be between 100 and 120 beats per minute – songs to sing in your head to keep the correct rate include the Bee Gee’s “Stayin’ Alive”, Queen’s “Another One Bites the Dust” (unfortunate), or Darth Vader’s theme from Star Wars
• Chest compression depth should be between 2”-2.4”
• Make sure to let the chest recover its rise completely between compressions
• The AED will inform you when it is time to stop CPR compressions
  “Do not touch the patient” – same as earlier
  

“Analyzing heart rhythm” – same as earlier

How to Use an AED on Infants or Children up to 55 lbs

Turn the AED on either by lifting the lid, pressing the power button, or removing the electrode pads (the method of turning on the AED varies by make and model). A typical scenario of voice prompts once the AED is turned on would be the same as those when the AED is used on an adult.  There are some differences, however:

Electrode pads

• If your AED uses a pediatric or infant/ child “key” (to lower the energy settings for a pediatric patient), make sure the key is inserted into the AED
• If your AED uses pediatric or infant/child electrode pads, make sure to connect these electrode pads to the AED (You may need to disconnect the adult electrode pads if they are already connected to the AED)
• Position the electrode pads according to the placement diagrams provided on the electrode pads/packaging
• If you do not have a pediatric or infant/child key or electrode pads, use the adult electrode pads instead and position as illustrated below

CPR

• Chest compressions at a rate of 100 per minute
• Chest compressions at 1/3 the depth of the patient’s chest
• For children, place heel of one hand on the lower part of sternum for compressions
• For infants, use your index and middle finger to perform compressions
• Rescue breathing is essential to child/infant CPR: give two breaths for every 30 compressions