CPR Chapter Three
What is an arrhythmia?
An arrhythmia is an irregular or abnormal heartbeat.
What are the two common placements of AED pads?
Anterolateral and anteroposterior.
What are the two types of life-threatening arrhythmias that cause cardiac arrest?
Pulseless ventricular tachycardia and ventricular fibrillation.
What are the universal steps for operating an AED?
1.) Open the carrying case. Power on the AED if needed. ~ Some devices will power on automatically when you open the lid or case. ~ Follow the AED prompts as a guide to the next steps. 2.) Attach AED pads to the victim's bare chest. Choose adult pads (not child pads or a child system) for victims 8 years of age and older. ~ Peel the backing away from the AED pads. ~ Attach the adhesive AED pads to the victim's bare chest. Follow the placement diagrams on the pad. ~ Attach the AED connecting cables to the AED device (some AED cables are already preconnected to the device). 3.) "Clear" the victim and allow the AED to analyze the rhythm. ~ When the AED prompts you, clear the victim during analysis. Be sure that no one is touching the victim, not even the rescuer in charge of giving breaths. ~ Some AEDs will tell you to push a button to allow the AED to begin analyzing the heart rhythm; others will do that automatically. The AED may take a few seconds to analyze. ~ The AED then tells you if a shock is needed. 4.) If the AED advises a shock, it will tell you to clear the victim and then deliver a shock. ~ Clear the victim before delivering the shock: be sure that no one is touching the victim. ~ Loudly state a "clear the victim" message, such as "everybody clear" or simply "clear." ~ Look to be sure that no one is touching the victim. ~ Press the shock button. ~ The shock will produce a sudden contraction of the victim's muscles. 5.) If no shock is needed, and after any shock delivery, immediately resume CPR, starting with chest compressions. 6.) After about 5 cycles or 2 minutes of CPR, the AED will prompt you to repeat steps 3 and 4. Continue until advanced life support providers take over or the victim begins to breathe, move, or otherwise react.
What is an AED?
An automatic external defibrillator (AED) is a lightweight, portable, computerized device that can identify an abnormal heart rhythm that needs a shock.
How would a rescuer identify if the victim has an implanted defibrillator or pacemaker? Why might this cause an issue?
An implanted defibrillator or pacemaker creates a large lump beneath the skin of the upper chest or abdomen. The lump is about half the size of a deck of playing cards. If you place an AED pad directly over the implanted medical device, the implanted device may block delivery of the shock to the heart.
When do arrhythmias occur?
Arrhythmias occur when the electrical impulses that cause the heart to beat happen too quickly, too slowly, or erratically.
How are communities, businesses, or public facilities where AEDs are available encourages to participate in local PAD programs?
Communities, businesses, or public facilities where AEDs are available are encouraged to participate in local PAD programs by... ~ Notifying or registering their AED with the local EMS agency. ~Establishing medical authority (appointing a local physician) to provide medical oversight for quality control. ~Ensuring that all expected rescuers are trained in high-quality CPR and AED use.
What should a rescuer do if the victim has a transdermal medication patch? Why can't the rescuer ignore the patch?
If it does not delay delivery, the rescuer should remove the patch and wipe the area before attaching the AED pad. The medication patch may block the transfer of energy from the AED pad to the heart and also cause small burns to the skin.
What does the AED do when a pulseless ventricular tachycardia (pVT) or ventricular fibrillation (VF) is detected?
If pVT or VF is identified, the device prompts the delivery of an electrical shock to the heart. The shock temporarily "stuns" the heart muscle. This stops the pVT or VF and "resets" the electrical system of the heart, so a normal (organized) heart rhythm can return. If an organized rhythm returns and high-quality CPR continues, the heart muscle can begin to contract and pump blood effectively. If circulation returns, a pulse is palpable, and this is called return of spontaneous circulation (ROSC)
What is the importance with minimizing the time between the last compression and shock delivery?
If rescuers minimize the interval between the last compression and shock delivery, the shock is much more likely to be effective (i.e eliminating ventricular defibrillation and increasing the chances of return of spontaneous circulation).
If the victim has a hairy chest, why must you remove the hair before applying the AED pads to the victim's chest?
If the victim has a hairy chest, the AED pads may stick to the hair and not to the skin on the chest. If this occurs, the AED will not be able to analyze the victim's heart rhythm. The AED will display a "check electrodes" or "check electrode pads" message.
If there are no adult AED pads, is it okay to shock an adult victim with a pediatric AED pad?
No, as the shock dose delivered by child pads is too small for an adult and will likely not be successful. It is better to provide high-quality CPR that to attempt to shock an adult victim with child pads.
What is public access defibrillation? What are some examples of it?
Public access defibrillation (PAD) means having trained rescuers and AEDs available in public places where large numbers of people gather or where there is reasonable likelihood of witnessed cardiac arrests. Examples include airports, convention centers, sport facilities, industrial buildings, offices, fitness facilities, shopping malls, apartments, and healthcare facilities.
What does the following abbreviations stand for? ROSC pVT VF AED
ROSC: Return Of Spontaneous Circulation pVT: Pulseless Ventricular Tachycardia VF: Ventricular Fibrillation AED: Automatic External Defibrilator
Before applying the AED pads to a victim with a hairy chest, what might you have to do first?
Remove of the hair from the victim's chest. In doing so, the rescuer may shave the chest (using a razor that is provided) or use a first set of pads to remove the hair before applying a second set of pads to the chest.
When the AED first arrives, why is it ideal to place it at the victim's side, next to the rescuer who will be operating it?
This position provides ready access to AED controls and easy placement of AED pads. It also allows a second rescuer to perform high-quality CPR from the opposite side of the victim without interfering with AED operation.
Why might a rescuer wish to use protective gloves or another barrier when removing a medication patch?
To avoid delivery of the medication to the rescuer, use protective gloves or another barrier to remove the patch.
What is a ventricular fibrillation (VF)?
Ventricular fibrillation is an arrest rhythm. The heart's electrical activity becomes disordered. The heart muscle quivers in a fast, unsynchronized way so the heart does not pump blood.
What should a rescuer do if the victim is in or covered with water?
Water is a good conductor of electricity. Do not use an AED in water. ~ If the victim is in water, pull the victim out of water. ~ If the chest is covered with water, quickly wipe the chest before applying the AED pads. ~ If the victim is lying on snow or in a small puddle, you may use an AED after quickly wiping the chest.
What is the purpose of a shock from an AED?
When an abnormal heart rhythm is detected, an AED delivers a shock that can stop the abnormal rhythm (ventricular fibrillation or pulseless ventricular tachycardia) and allow the heart's normal rhythm to return.
What is a pulseless ventricular tachycardia (pVT)?
When the lower chambers of the heart (ventricles) begin contracting at a very fast pace, a rapid heart rate known as pulseless ventricular tachycardia develops. In extremely severe cases, the ventricles pump so quickly and inefficiently that no pulse can be detected. Body tissues and organs, especially the heart and the brain, no longer receive oxygen.
Where are the AED pads located during anterolateral placement?
With the anterolateral placement, both AED pads will be placed on the victim's bare chest. ~ Place one pad directly below the right collar bone. ~ Place the other pad to the side of the left nipple, with the top edge of the pad a few inches below the armpit.
Where are the AED pads located during anteroposterior placement?
With the anteroposterior placement, one pad will be placed on the victim's bare chest (anterior) and the other will be placed on the victim's back (posterior). ~ Place one AED pad on the left side of the chest, between the victim's left side of the breastbone and left nipple. ~ Place the other pad on the left side of the victim's back, next to the spine.
What are some examples of how to properly maintenance an AED?
~ Battery replacement. ~ Calibration and testing of energy doses. ~ Ordering and replacing supplies - AED pad replacement, including pediatric pads -Additional emergency equipment (scissors, razors, wipes, gloves, barrier devices)
What should a rescuer do if the victim has an implanted defibrillator or pacemaker?
~ If possible, avoid placing the AED pad directly over the implanted device. ~ Follow the normal steps for placing an AED.