3.3 CPR and AED integration in cardiac emergencies
5 min read•august 7, 2024
and AEDs are lifesaving tools in cardiac emergencies. They work together to keep blood flowing and restart the heart. Knowing how to use them correctly can mean the difference between life and death.
This section covers the basics of CPR techniques, operation, and how to integrate them effectively. We'll look at proper hand placement, compression depth, and AED pad placement. These skills are crucial for anyone who might need to respond to a cardiac emergency.
CPR Fundamentals
Chain of Survival Steps
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American Heart Association (AHA) and American Red Cross (ARC) offer widely recognized certification programs
Healthcare providers require Basic Life Support (BLS) certification, which includes CPR and AED training
Certification typically lasts for two years before requiring renewal
Regular training and practice are essential to maintain skills and confidence in performing CPR
AED Integration
AED Operation and Prompts
AEDs are designed to be user-friendly with voice and visual prompts guiding the rescuer
Power on the AED and follow the device's instructions
AED will analyze the heart rhythm and determine if a shock is needed
If a shockable rhythm (ventricular fibrillation or pulseless ventricular tachycardia) is detected, the AED will charge and instruct the rescuer to deliver the shock
Resume CPR immediately after shock delivery or if no shock is advised
Proper Pad Placement
Remove clothing from the patient's chest and ensure the skin is dry
Apply one pad on the upper right side of the chest, just below the collarbone
Place the other pad on the lower left side of the chest, below the armpit
For infants and small children, use pediatric pads (if available) and place one pad on the front of the chest and the other on the back
Ensure pads are adhered securely to the skin and not touching each other
Safe Shock Delivery
Ensure no one is touching the patient before delivering the shock to avoid accidental electrocution
Loudly state, "Clear!" and visually check that everyone is clear of the patient
Press the shock button when instructed by the AED
Immediately resume CPR after the shock, starting with chest compressions
Continue CPR until the AED prompts to stop for the next rhythm analysis or until advanced life support arrives
CPR-AED Sequence
Perform CPR until the AED is available and ready to use
Turn on the AED and follow the prompts
Attach the AED pads to the patient's bare chest as directed
Allow the AED to analyze the heart rhythm, ensuring no one is touching the patient
Deliver a shock if advised by the AED, ensuring everyone is clear of the patient
Resume CPR immediately after the shock, starting with chest compressions
Continue the CPR-AED sequence until advanced life support arrives or the patient shows signs of life
AED Maintenance and Readiness
Regularly check the AED's battery life and replace batteries as needed
Ensure are within their expiration date and replace if necessary
Perform routine maintenance as specified by the manufacturer
Store the AED in an easily accessible location and ensure all potential rescuers know its location
After each use, replace used electrode pads, batteries, and other consumables
Document the use of the AED and any maintenance performed
Post-Resuscitation Care and Considerations
Post-Resuscitation Care Priorities
Continuously monitor the patient's vital signs, including heart rhythm, blood pressure, and oxygen saturation
Provide supplemental oxygen and advanced airway management as needed
Treat underlying causes of the cardiac arrest (heart attack, drug overdose, etc.)
Initiate targeted temperature management (therapeutic hypothermia) to improve neurological outcomes
Transfer the patient to a hospital with comprehensive post-cardiac arrest care capabilities
Legal and Ethical Considerations
Good Samaritan laws protect rescuers who provide CPR and use AEDs in good faith
Obtain consent for CPR and AED use whenever possible, but implied consent applies in emergency situations
Respect patient's advanced directives (DNR orders) if known
Maintain patient confidentiality and privacy when discussing the incident
Document the resuscitation attempt, including the use of CPR and AED, for legal and quality improvement purposes