Use of AED

• = automated external defibrillator
• the intended users of the AED are laypeople with minimal or no training
• it enables the rescuer to perform defibrillation, to deliver a shock to the patient's heart and, thus, reset the abnormal and ineffective heart rhythm
• with the AED, the rescuer can defibrillate the patient before arrival of the professional help

How does the AED work?

• once you attach the electrode pads on the patient's bare chest, the AED will automatically start analysing the patient's heart rhythm and indicate whether the current rhythm should be defibrillated or not
• the AED reanalyses the patient's heart rhythm every 2 minutes

If the shock is indicated

• the AED automatically charges itself and gets ready to deliver the shock

If no shock is indicated

• the rescuer continues with the CPR

How to use the AED correctly?

1.	Switch on the AED by pressing the button.
2.	When using the AED, continue as directed by the voice/visual prompts and unpack the package with two electrode pads.
3.	Attach the electrode pads on the patient's bare chest as you can see in the picture. If possible, continue with CPR while the electrode pads are being attached to the chest.
4.	Ensure that nobody is touching the patient while the AED is analysing the heart rhythm.
5.1 (shock is indicated)	Ensure that nobody is touching the patient and press the flashing button to deliver the shock. Once the AED has delivered the shock, continue with CPR until the AED starts the analysis of the heart rhythm again; it happens every 2 minutes automatically.
5.2 (shock is not indicated)	Continue with CPR until the AED starts the analysis of the heart rhythm again; it happens every 2 minutes automatically.

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Fully automatic AEDs

• the steps mentioned above are only valid by semi-automatic AEDs (the machine analyses the rhythm and indicates the shock (or not), then it charges, but to deliver the shock the rescuer has to push a flashing button)
• by fully automatic AEDs the machine analyses the rhythm, indicates the shock, charges, asks the rescuers not to touch the patient and delivers the shock immediately
• it is not necessary to know, which type of AED you are using, but you always have to listen to the instructions of the machine and follow them

Use of the AED in children

• standard AED is suitable for use in children older than 8 years
• the package might contain paediatric electrode pads (for children between 1 and 8 years), or a paediatric mode of AED might be available
• standard adult mode of the AED can be used if the paediatric one is not available
• if using adult electrode pads in children, the pads cannot touch each other
• in children, the primary cause of the cardiac arrest is rare

The positioning of electrodes

• attach the electrode pads on the patient's bare chest
• after being attached, the electrode pads must not touch each other
• place one pad on the right side of the sternum just below the clavicle and the other pad on the left lateral side of the chest approximately at the level of the nipple (anterolateral position)

  

• the second possibility is the antero-posterior position; one pad is placed on the left front side of the sternum and the other pad on the upper left side of the back

  

• the last acceptable position is to place the pads on the lateral chest wall on the right and left side just below the armpits (biaxillary position)

  

• if you swap the Apex and the Sternum electrodes, but otherwise their position is correct, you do not need to reattach them for the shock administration
• the shock passes back and forth
• if you want to use the AED in the patient who has been drowning, you must first dry his/her chest (electric shock always seeks the path of the least resistance and since water is a good conductor, skin burns would occur and the shock would pass over the skin surface, not through the heart and, thus, it would be ineffective)
• if the patient has an ICD or a pacemaker , place the pads at least 8 cm away from the implanted device, alternatively use the antero-posterior or biaxillary position

• How can I know that the patient has an implanted device?
  The control unit of the device (size about 5 cm) is usually visible and palpable just below the left or the right clavicle.

• Can I use the AED in the patient with ICD or pacemaker?
  Yes, you can. The AED automatically analyses the heart rhythm and decides if the rhythm is shockable or not, i.e. if the patient needs the shock or not.

Where can you find AEDs?

• the map of all deployed AEDs in the Czech Republic is available in the app Záchranka, under Locator tap

  

  

  

• the locations of all AEDs in Brno can also be found on the web: http://www.aedjmk.info/mapa/
• the dispatcher provides you with the information about the location of the nearest AED and also with the access code to open the locker in which the AED is stored
• the dispatcher notifies you if there is the AED available in your proximity, or he can send somebody to bring you the AED
• some rescue teams (e.g. Fire Rescue Service, Volunteer fire department, Municipal police) are also equipped with the AED; they can be asked by the dispatcher to join you in the area of the incident

• the Czech Republic is currently introducing the system of First Responders - they are trained volunteers who are available to be dispatched to attend an emergency in their local area
• in the case of a life-threatening situation such as cardiac arrest, the nearby first responders are alerted by the system and get navigated to the area of the incident where they provide first aid until the arrival of EMS