Everything You Need To Know About Using A Defibrillator
- When would I use a defibrillator?
- Where will I find a defibrillator?
- How would you spot a defibrillator?
- What if the defibrillator is in a locked cabinet?
- Do you have to be trained to use a defibrillator?
- How do I use a defibrillator?
- When should I use an AED instead of CPR?
- Can I use a defibrillator on a pregnant woman?
- Can I use a defibrillator on a child?
- When is it unsafe to use an AED?
- Can you use a defibrillator if the casualty has a pacemaker or ICD?
At first, using a defibrillator can seem a little daunting. While in pressured situations, it is vital to use it correctly; the steps and guidelines to remember are simple and could help you save a life. Here is everything you need to know about using a defibrillator:
When would I use a defibrillator?
When someone has collapsed and is suffering from cardiac arrest, the use of a defibrillator is vital. Cardiac arrests are caused by an electrical malfunction in the heart, resulting in an irregular heartbeat, also known as arrhythmia. Blood cannot then be pumped to organs and around the body.
A defibrillator's main aim is to restore the heart’s rhythm, and get it back to its normal beating rate. It does this by delivering an electrical shock, which causes depolarisation of the heart muscles, beginning the usual electrical impulse of the heart.
Where will I find a defibrillator?
In public spaces with many people, you will often find a defibrillator. Examples include shopping centres, airports, train stations, community centres, as well as schools and most workplaces. These are known as Public Access Defibrillators (P.A.D.S), and anyone can use them.
However, if you cannot locate a defibrillator, when calling 999 the emergency operator will be able to identify the closest available kit and provide instructions to aid the victim while it is being reached.
How would you spot a defibrillator?
Defibrillators are simple to spot, with a green sign above, around or on the casing of the kit, a large heart drawing and the words ‘AED’ or ‘defibrillator’. If they’re public access defibrillators, they will be nailed into a wall, often near a recognisable spot/item like a phonebox. The casing for these will almost always be bright yellow or green - making it easy to pick out.
What if the defibrillator is in a locked cabinet?
Some defibrillators will be locked in a fixed location, due to protection against vandalism, theft or weather conditions which may decrease the effectiveness of the defibrillator kit over time. If this is the case, a 999 emergency operator will be able to provide you with the code once they confirm that it is a cardiac arrest - you should always call for an ambulance as soon as possible.
Do you have to be trained to use a defibrillator?
There are no legal training requirements to use a defibrillator – they’re not included in the First Aid at Work or Emergency First Aid courses. However, taking a training course or watching a detailed demonstration video online is highly advisable, to increase your knowledge and confidence while using the kit. There are simple steps to use the defibrillator kit, but following them correctly is vital and can be life-saving.
How do I use a defibrillator?
The first step when finding someone who has collapsed is to check their responsiveness and breathing. If they’re unconscious, unresponsive and not breathing or breathing abnormally, there’s a chance they’re in cardiac arrest. You must immediately call 999 for an ambulance, and begin CPR. Call for help, and if someone else can identify a local defibrillator, have them retrieve it while you continue CPR. If there isn’t a defibrillator kit nearby, the 999 emergency operator will talk you through the necessary steps.
To perform CPR, remember the CAB acronym:
C-ompressions: Place the heel of your hand in the center of the victim’s sternum (middle of the chest), with your other hand interlaced on top. Press down to compress the chest by at least 2 inches for an adult, or 1.5 inches in infants. Do this at the rate of 100 times a minute, or even a little faster. Complete 30 compressions.
A-irway: Next, open the airway with a head-tilt and chin-lift manoeuvre.
B-reathing: Pinch the victim’s nose to keep it closed. Take a normal breath, cover the victim’s mouth with yours, then give two, one-second breaths. After the chest has risen, compress the chest 30 times again - continue the cycle of two breaths and 30 compressions until help arrives.
Once the defibrillator becomes available, follow these steps to use it:
- Step 1: Activate defibrillator by using the ‘on’ button
- Step 2: Take out the electrode pads, remove their protective packaging and stick one pad on each side of the victim’s chest, as instructed on the pads or instruction manual.
- Step 3: At this point, stop CPR and avoid contact with the victim - this will allow the defibrillator to analyse their heart’s rhythm.
- Step 4: After analysing the victim, the defibrillator will determine whether a shock is needed, and if so will prompt you to press the ‘shock’ button, if you’re using a semi-automatic defibrillator. If your kit is automatic, it will deliver the shock without a prompt, which is why it is important to refrain from contact with the individual at this point.
- Step 5: You will be informed by the defibrillator when the shock has been delivered, and whether you must continue CPR.
- Step 6: Resume chest compressions and rescue breaths until the victim begins normal breathing and circulation, or until the defibrillator instructs you to stop, so it can examine the heart’s rhythm again.
When should I use an AED instead of CPR?
This is a commonly asked question, as there can be some confusion. If you find an individual who is unconscious but has no breathing problems, place them in the recovery position and call an ambulance. If the victim is unconscious, unresponsive and breathing issues/ no breathing, they’re suffering from cardiac arrest. This is caused by a malfunction in the heart’s electrical impulses, where CPR is needed before the use of a defibrillator.
Cardiac arrests can sometimes be confused with a heart attack, which is where blood flow to the heart is blocked, often by a buildup of plaque in the arteries or a blood clot. A victim of this won’t require CPR, but will need urgent medical attention and transportation to a hospital. The cause of cardiac arrests can often be heart attacks.
Can I use a defibrillator on a pregnant woman?
Maternal cardiac arrest is unfortunately on the rise due to the increased average age that women are giving birth. As women get older, they’re more susceptible to cardiac conditions and pregnancy-related issues which can be worsened by factors like hypertension, high cholesterol and obesity.
Cardiac arrest on pregnant women is most often caused by heart failure, sepsis or bleeding - 6 in 10 victims survive when treated immediately in a hospital. However, outside of these situations, it is often unknown whether it’s safe to use a defibrillator on a pregnant woman.
Luckily, it is safe to do so. In cardiac arrest situations, following the same procedures as you would for any other victim is advised, with a minor adjustment of hand placement during CPR being slightly higher on their sternum. As well as this, when calling 999, you must inform them that the victim is pregnant so they can receive the right personnel and treatment. Using an AED will not cause harm to the mother or the fetus. When revived, the mother should be placed on their left side to aid blood flow and recovery.
Can I use a defibrillator on a child?
Most defibrillators can be used on children down to the age of 1 year old. However, the guideline from the UK Resuscitation Council is that if possible and under the 25Kg threshold, paediatric electrodes should be used to reduce the shock level. However, if there are no attenuation devices available, then adult electrodes can be used but placed front and back of the patient.
The number of child cases where defibrillation is needed is extremely low in comparison to adult cases, but it is useful to know that paediatric pads should be used, as well as paediatric settings for the kit (if it features it).
When is it unsafe to use an AED?
AED’s require electrode pads and batteries, which have expiry dates. If the pads have gone past this date, the specialised gel used to adhere to the victim’s skin will dry up. The lack of this viscous gel will inhibit the pads from sticking to the victim’s chest, and the defibrillation process can be fatally disrupted. AED batteries need to be in-date or the defibrillator kit simply won’t function properly.
As well as this, there are scenarios where it is unsafe to use a defibrillator - most prominently relating to water. If the victim is lying in water, has liquid on them or their chest is wet from rain or sweat, an AED shouldn’t be used. The stickiness of the pads can again be affected, which is vital to delivering a consistent shock to the victim. If it is raining and the person cannot be moved to a dry area, wipe their chest until dry and ensure that any surrounding people are distanced from the victim before using the defibrillator - to avoid danger from conducted electricity.
Can you use a defibrillator if the casualty has a pacemaker or ICD?
Care must be taken when using a defibrillator on an individual with a pacemaker or ICD - try to place the AED pads not directly above or near the internal devices (aim for a minimum 1 inch away), as it can interfere with the defibrillation process.
Pacemakers only give low-energy electrical pulses to restore a regular heartbeat and stop it from beating too slowly, whereas ICDs monitor heart rhythm and can send low or high energy pulses to correct an abnormal beat and those at risk of sudden cardiac arrest. However, they’re not fully effective against cardiac arrests and defibrillation must still be used.
Either of the devices should be visible when exposing the chest, via a small bump and scar. Most patients will have them on their upper left chest - if the pacemaker delivers a shock while you’re attempting to use the AED you must simply wait 30-60 seconds.
Do not worry about damaging the internal devices - they are built to withstand a defibrillation shock, and even if damaged are far less vital than the victim’s life.