Using AEDs to Restart Hearts
By Safety Management Group
We’re all familiar with cases in which someone who appeared to be completely healthy suddenly collapsed and died. You may have even been a witness to a situation like that. The medical community refers to a situation in which the heart suddenly stops working as Sudden Cardiac Arrest (SCA). During SCA, the blood flow stops, starving the brain and other organs of blood and oxygen, and leading to death within minutes without any intervention.
Fortunately, medical science and technology have combined to develop an inexpensive, easy-to-use device that can often restore the heartbeat. Known as automated external defibrillators (AEDs), these devices generate a strong electrical shock that often restores the heart’s normal rhythm. AEDs can now be found in many workplaces and public locations.
Not a heart attack
Some people confuse SCA with heart attacks (what doctors call myocardial infarctions), but they are very different. Heart attacks involve a physical blockage of part of the blood flow, while SCA affects the electrical system that manages the heartbeat. Most often, SCA is caused by what’s known as ventricular fibrillation, which is a type of an abnormal heartbeat.
It’s true that people who have heart disease are more likely to suffer from SCA, and the average age of SCA victims is around 65. However, it can affect anyone of any age, usually with little or no warning. According to the American Red Cross, more than 350,000 people will fall victim to it this year.
Once SCA strikes, the victim has just minutes to recover. With each minute that passes, the possibility of being revived drops by about 10 percent, and it normally takes 8 to 12 minutes for first responders to arrive after a 911 call. That’s why having (and knowing how to use) AEDs is so critical. The Red Cross estimates that access to AEDs could save 50,000 lives a year.
When to use AEDs
When someone on the jobsite collapses or appears to be unconscious, SCA may be a possibility. The first step is to determine whether the individual is responsive. You can shake the person at yell to verify that he or she isn’t just asleep.
If the individual is unconscious, have someone call 911 immediately while you determine whether he or she is breathing and has a pulse. If there is no pulse or breathing, or if the pulse and breathing are very irregular, you may need to use the AED. If you don’t have access to an AED, begin CPR.
One of the best features of an AED is that the units are capable of determining whether to apply a shock and how much of a shock should be used based on the heart rhythms they detect. If the AED determines that a shock is not appropriate, it will not deliver one. The devices also minimize the potential for injury to those who are using them.
If you’re hesitant to use an AED because of potential liability should something go wrong, you need to be aware that nobody has been held liable for a failed rescue attempt using an AED. In addition, most states now have laws that protect people who try to use AEDs to revive victims of SCA.
How to use an AED
First, if the person is in water or a wet area such a puddle, move him or her to a dry area before using the AED. Remove any clothing that covers the person’s chest (as well as metal jewelry and any undergarments with metal parts, such as a bra with an underwire), and make sure the skin is dry. If the individual has a hairy chest, you may need to trim the areas where the pads will be placed to ensure that there will be good electrical contact. If there are metal piercings, or if it appears that the individual has an implanted pacemaker or defibrillator, be sure that the pads are at least one inch away from those objects.
Turn on the AED and follow the directions it provides. You’ll be prompted to place the electrodes on the individual’s chest using the sticky pads. Typically, one pad is placed just above the right nipple, and the other just below the left nipple. Make sure the pads are tightly attached to the skin (most AEDs will verify that you have a good connection).
Move everyone away from the individual (nobody should be touching him or her) and press the “analyze” button on the AED. The device will study the heart rhythms and determine whether a shock is appropriate. If so, it will tell you when to press the “shock” button. While the shock is designed to travel between the two electrodes, for extra safety, be sure that you’re not touching the person when you apply the shock.
After applying the shock, begin CPR until the individual begins to move or first responders arrive. Tell the first responders exactly what you’ve done, and describe anything you’ve observed. That will help them determine the correct steps.
Not a perfect solution
Although AEDs save thousands of lives, there are times when victims of SCA may not survive even after an AED was used correctly. In addition, there are other heart problems that will not respond to a shock from an AED. If the device detects one of those types of rhythms, it will normally display a “no shock advised” message. In those cases, it’s best to perform CPR until first responders arrive.