Defibrillation
If a person is collapsed and unconscious, has no pulse and is not breathing, apply first aid for an apparent sudden cardiac arrest.
Follow DRSABCD first:
Danger: check for danger to yourself and others
Response: ask the patient's name, squeeze their shoulders
Send for help: call Triple Zero (000) for an ambulance and ask a bystander to locate a defibrillator (AED)
Airways: clear mouth and nose of fluid or solids
Breathing: look, listen and feel for 10 seconds. If no breathing, start CPR
CPR: 30 x compressions then 2 x breaths into patient's mouth with nose pinched, at a steady, continuous pace (100-120 cycles per minute)
Defibrillation:
1. Open and turn on AED (Automated External Defibrillator), listen to voice prompts while helper continues CPR. Use adult pads for adult patient, child pads for under 8 yrs old.
2. Remove ALL upper body clothing, dry skin if wet, and shave chest where the pads will be placed if it is particularly hairy and a razor is available.
3. Peel backing from pads and adhere firmly to bare skin: one under RIGHT SIDE collarbone, and one under LEFT SIDE breast. Pads must be firmly stuck to skin.
4. AED will advise to pause CPR and not to touch patient while it assesses heart rhythm. Stand clear of patient.
5. AED will advise either PRESS SHOCK button OR will automatically deliver shock.
6. After shock is delivered, resume CPR. In 2 minutes AED will advise to stop CPR as it assesses patient and prepares for shock again if needed.
7. Once shock is delivered, resume CPR and continue cycles of CPR, AED analysis and shock until patient regains consciousness or medical responders arrive.
Frequently Asked Questions
How does a defibrillator actually help someone in cardiac arrest? Sudden cardiac arrest is when the heart muscle is either quivering (ventricular fibrillation) or stops beating completely, starving the brain and vital organs of the oxygen usually delivered via the blood it pumps around the body. A defibrillator may save a life by delivering an electrical current to 'shock' the heart muscle back into its normal rhythm.
What if there are no child (paediatric) pads available? Adult AED pads deliver a stronger current, but using them is better than nothing at all. It's recommended that one pad be applied to the chest, and the other to the child's back, so that they do not come into contact.
Can CPR stop once the patient is attached to a defibrillator? No, it is essential that CPR (30 x compressions and 2 x breaths at a steady pace) continue regardless of the defibrillator being attached. The voice prompts will only advise to stop CPR while it analyses the patient's heart rhythm and delivers a shock. If the first aider can't give mouth-to-mouth breaths, just doing compressions is better than nothing at all.
Why is a defibrillator also called an AED? The full name for a defibrillator is an Automated External Defibrillator. The acronym "AED" is commonly seen on signage, and the conveniently short "defib." is often used in speech.
Can anyone use a defibrillator? Yes, most AEDs are designed for anyone to use in an emergency, regardless of first aid or medical training. It is vital to maintain calm and focus while the voice and visual prompts guide the operator through its use until medical responders arrive.
How many people are required to operate a defibrillator? Ideally two people: one to continue CPR, and the other operating and following the AED prompts, interchanging when compression-giver gets tired but with as little interruption to the CPR cycles as possible. If anyone else can be of assistance, ask them to keep onlookers and disrupters well clear of the scene.