2. CPR with AED


In the previous video, we looked at the algorithm of first aid for a person without consciousness and breathing, & we talked about proper action and conducted CPR to maintain vital functions of the body until the ambulance arrives. Today we will discuss how to provide first aid to the victim in the absence of consciousness and breathing when there is an automatic external defibrillator (AED) and learn how to use it safely.

What does an automatic external defibrillator do? AED is a device that delivers a controlled electrical discharge in order to restart the heart. It is important to know that the AED is your assistant and in a sense, the leader of your actions. It will tell you what to do and will produce an electric discharge. However, it will never replace your actions. Therefore, if there is an AED nearby, be sure to use it within performing CPR. Remember, if the defibrillation is started within three to five minutes from the development of the cardiac arrest it allows the victim to survive in 50 to 70 percent of cases.

Of course, it is not always possible to use the AED. If there is no one around, you must follow the CPR action that we examined in the last video. Traditionally, the AED is located in public places, shopping centers, airports, schools. A common international sign indicates its location. It is a green square with a white cross in the right upper corner, the heart and lightning. When you see this sign, that means that there is an automatic external defibrillator.

Let's recall the CPR algorithm and include the use of AED. In the last video, we said that when you find the victim and approach him first, you need to check the safety for yourself the victim and eyewitnesses. If nothing threatens you, approach the victim, kneel down, gently shake his shoulders and ask loudly in both ears, "Are you all right? Do you need help?" Thereby assessing consciousness. If the victim responds, leave him in the same position, find out what happened to him. Regularly, evaluate his condition, breathing and consciousness.

If the victim does not respond, check the breathing. The breath test is determined by tilting their head and lifting the chin. To do this, place one palm on the victim's forehead, wrap his lower jaw with two fingers of your other hand and carefully tilt the head back. Inspect the oral cavity for foreign objects. Next, bring your ear closer to the victim's lips, observe the chest movement with your eyes and count out loud to ten.

Again, there are three principles. Watch for movements of the chest. Listen, feel the victim’s breath on your ear and cheek. If within 10 seconds you have not found breathing and there is someone near you, ask their assistant to bring AED and call an ambulance following the calling algorithm. The assistant rushes for the AED and calls for an ambulance.

At the same time, you'll start CPR having released the chest from clothes. As soon as the assistant brings the AED, turn it on, the assistant puts electrodes on the shirtless chest of the victim while you are continuing the CPR. Teamwork is essential here so as not to interfere with each other. It is often indicated how to place the electrodes on the victim’s chest properly, right on the packaging or on the electrodes themselves. The correct location of the electrodes on the chest is crucial and associated with anatomical and physiological characteristics of the heart. The first electrode must be placed below the left armpit, stepping back the palm. Place the second electrode under the right clavicle, to the right of the sternum and then follow the defibrillators prompts. After applying electrodes, the device will analyze the heart rhythm. During the heart rhythm analysis, do not touch the victim and make sure that no one around reaches him. If the device has counted the rhythm and the application of the discharge is shown, shout, "Step aside everyone" and visually check that no one is touching the victim. Press the discharge button as instructed.

After discharge, if a cardiac activity has not been restored, immediately begin CPR under the voice commands of the device at a rate of 30 to two. Cardiopulmonary resuscitation must be continued for two minutes. Then the defibrillator will begin the rhythm analysis again and so every two minutes. Do not stop CPR until your AED tells you to do this. Or the victim shows signs of life, begins to breathe, move, opens his eyes, makes noises. Or you are too exhausted physically.

In terms of AED use, it's important to pay attention to the wet chest. In some cases, the chest will be wet due to profuse sweating, or after a water rescue. It is necessary to drain the breast before applying the AED electrodes quickly. The next is excessive chest hair. In some cases, an excessively hairy chest can cause problems with application of AED electrodes. In such a situation, it is necessary to shave or cut the hair to ensure got contact of the electrodes with the skin. There is no need to shave the chest in all the victims, this is a waste of time.

Remove any stickers or other material placed on the victims chest to ensure that AED electrodes are in a good contact with the skin. In some patients, there can be medical patches on the chest. They must be removed as they can cause sparking or even burns during defibrillation. Remove any metal jewelry that might come in contact with the AED electrodes, place the electrodes away from jewelry that cannot be removed, such as piercings. Some victims may have implantable pacemakers. They're usually visible under the skin, under the collarbone. Sometimes they are located under the right clavicle instead of the left. Make sure that the AED electrodes are not placed on or near the pacemaker.

To sum up, today you learned the algorithm of first aid with the use of an automatic external defibrillator for the victims in the absence of consciousness and breathing. To consolidate the material, watch the video and see how the right action in case of sudden cardiac arrest will look.

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