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Overview of AEDs

When BLS was first introduced, the technology for automatic external defibrillators was not available.  This means that the whole of CPR focused on chest compressions and breathing.  However, technology has advanced, and these AED units are a great supplement to the traditional CPR technique.  Not only can they be used by bystanders on the street, but they are also used by providers in hospital.  The AED will analyze the rhythm and recommend shocks based on that.  Truly, these units have the ability to save countless lives, and that is why they should be located in as many places in the community as possible.

One of the problems with AEDs is that there aren’t as many of them available as needed.  Although trash men and mail carriers have started to carry these units in their utility vehicles, the number of units isn’t nearly what is needed for the overall coverage of the potential victims.  You can find them now in hospitals, of course, but malls, government buildings, and even schools have started to bring AEDs into their environments.  The more AEDs that can be placed around the community, the better it will be for those who are victims of out of hospital cardiac arrest and for those who are caring for them.

Importance of AEDs in BLS

BLS and CPR in general are ways to keep the tissues viable until more skilled medicine can become involved.  In particular, this means that the patient is virtually waiting to be defibrillated, if they are in a shockable rhythm.  The innovation that comes with AEDs is the non-ACLS trained providers can defibrillate.  This means that the heart has the opportunity to be restarted without the delay for a paramedic.  It brings the cornerstone of ACLS into the hands of bystanders who would otherwise provide questionable CPR.

Another benefit of AEDs is that they can analyze rhythms, and this helps any provider – whether bystander or trained professional.  It is often difficult to remember what rhythms are shockable, and sometimes it is hard to interpret a rhythm in an emergency situation.  AEDs automate this process, which is why they are also used in ACLS in hospitals.  The ability to read and recommend a shock is one of the most important components that AEDs add to the lifesaving process of BLS.  With more of them becoming available and more people learning how to use them, the lifesaving effects of these machines will become more and more prevalent.

Setting up the AED

Most AEDs are self-explanatory.  This is helpful because not all of them work in the same fashion, so it is important to pay attention to the directions on the device.  In the future, perhaps, more regulations will be brought to the working of the AED, but this emerging technology means that several different paradigms are used to get the device up and running.  Fortunately, the AED usually has bright, easy to understand pictograms that can assist you in setting up the pads and the machine correctly.

In general, you are going to need two leads connected to the AED.  One will be placed against the skin near the right upper chest.  It is important to know which one is designed to be placed in this position, so take care to look at the pictures on the leads.  The second lead is placed on the lower left chest.  Some ACLS trained professionals may “sandwich” the heart and put one on the front and one on the back.  This is not recommended for basic AEDs as they are not designed to work that way.  Once the leads are connected to bare skin, you simply plug them in and turn the machine on.

General Guidelines

The general guidelines for using AEDs are relatively similar.  You want to start the machine and stop CPR while it is analyzing.  It will likely make a sound while it is determining the rhythm.  Some machines, such as in hospitals, will show you the rhythm, but many out of hospital devices are stripped down and simple.  If a shockable rhythm is detected, then the AED will announce that one is advised.  It is at this time that you need to make sure that no one is touching the patient, and when all are clear, you can press the button to deliver the shock.

In some cases, the patient may not have a shockable rhythm, and it will recommend that you continue CPR.  You should focus on compressions and do everything you can to get the patient into ACLS care.  After about a minute of CPR compressions, the AED will ask you to stop and will analyze the rhythm again.  If anything has changed, a shock may be advised, but non-shockable rhythms don’t tend to change without the intervention of medications and ACLS protocol.  Still, these machines are valuable for those who go into cardiac arrest outside of the hospital with a shockable rhythm.  It can restore perfusion to the heart and brain before the paramedics make it to the scene, and therefore, AEDs are an important part of BLS.