The automated external defibrillator (AED) is a computerized medical device that can check a person’s heart rhythm. It can recognize a rhythm that requires a defibrillation shock and advise the rescuer to deliver the shock if needed. The AED uses voice prompts, lights and text messages to tell the rescuer the steps they need to take. AEDs are very accurate and easy to use. With a few hours of education, anyone can learn to operate an AED safely. There are many different brands of AEDs, but the same basic steps apply to all of them. We do not recommend a specific model.
Public access to defibrillation (PAD) means making Automated External Defibrillators (AEDs) available in public and/or private places where large numbers of people gather.
How do I get an AED in my facility? How many units will I need and where do I place them?
A:
HSFO recommends the ratio of 1000 employees: 1 AED unit. The caller should contact the local EMS to initiate conversations regarding AED placement in facility. Local EMS will then visit the site to do initial assessment which will determine how many units are needed and where they should be placed.
When the company has gotten their AED(s) installed, they need to notify local EMS, who will then notify 911 of the unit in the facility. EMS will then arrange training for staff.
Everyone needs to be trained in the current Resuscitation Guidelines, 2005. You do not take a separate AED course in addition to the BLS course, as all of the BLS courses offer an AED component. If you have not been (re)certified under the 2005 Guidelines then you must do so in order to receive AED training.
When to transport a patient that is in arrest and is being shocked with an AED?
A:
Excellent CPR and shock are the best that can be done for this patient so it makes sense to stay at the scene until you get 3 "no shocks".
Rationale:
There is no science on this subject but this patient has by far the best probability of survival if a pulse is regained at the scene. Once transport is begun there are many interruptions and opportunities for poor CPR built in to the process including: need to get the patient onto the stretcher, then in to the ambulance, then do CPR in moving ambulance, then move patient out of the ambulance, etc. Excellent CPR and defibrillation are the best that can be done for this patient so it makes sense to stay at the scene until you get 3 "no shocks". After 3 "no shocks" there is like no point in remaining at the scene any longer. The chances of survival of this patient are now very minimal. If there is a shock advised, continue CPR until there are 3 "no shocks". So it can go shock, shock, no shock, no shock, no shock OR shock, shock, shock, shock, shock, no shock, no shock, no shock. The reasoning here is that the best chance of survival is shocking VF into a perusing rhythm. If shock continues to be advised then best treatment continues to be excellent CPR and shock. If you transport after 3 shocks your ability to do good CPR is greatly diminished and if you can't shock VF in to a rhythm at the scene, you are unlikely to do better at the clinic -- especially if the patient is no longer in VF on arrival because of interruptions and less than excellent CPR en route.
