AED Technical Instructions Automated External Defibrillator (AED)

TECHNICAL INSTRUCTIONS PAPER

New Employee Instructions on Use of ZOLL AED PLUS:

INSTRUCTIONS

VOICE PROMPTS

MAINTENANCE

PRECAUTIONS

FAQ

The Zoll model Automatic Electrical Defibrillator is a machine used by this office that is designed to shock and provide electricity to the heart to stop the heart from beating in two bad rhythms called ventricular fibrillation and ventricular tachycardia. Ventricular fibrillation and tachycardia are two most common arrhythmias or irregular heartbeat patterns in the heart.

The heart is made out of muscle cells, but they are different from regular muscle cells. They are capable of generating their own electrical impulses that are conducted throughout the rest of the heart muscle that are capable of making the heart beat in a certain rhythm. Because each of those cells can generate and conduct an electrical impulse, the bad side is one type of cell can take over and conduct too much of the generation or conduction impulse. This is called ventricular fibrillation. In tachycardia, the heart beats too fast. One of a group of cells in the ventricles starts beating too fast too effectively circulates blood. In fibrillation, a whole series of pacemakers start firing randomly, and b/c so many start firing so randomly the heart just quivers and not beating regularly, and the heart can die.

A well placed or well timed jolt of electricity through the heart muscle that overpowers all of the individual cells or group of cells beating irregularly will cause the heart to pause and the heart will sometimes start to beat again regularly. The AED is a machine with a defibrillator and a computer, and the computer will evaluate the rhythm of the heart, like an EKG machine that paramedics use.

INSTRUCTIONS

The use of the AED is indicated if a person in the office exhibits any of the following symptoms:

Loss of consciousness

No breathing

Lack of discernable pulse

If a person falls unconscious, check their pulse first by feeling along their neck. If you do not find a pulse, place your face next to the person's nose to see if they are breathing. You may also observe their chest for up and down motions. If the person is not breathing, they fit all criteria for use of the AED.

How do you know that someone should be shocked using this equipment?

Check for responsiveness. Put a hand on the persons shoulder, and try calling them by name. Give them a shake. Ask if they are ok. If they are unresponsive, call [HIDDEN] The machine will only shock lethal rhythm. If you can't palpate or feel a pulse in the carotids (major arteries) in the neck, if there are no rise and fall of the chest, it is likely safe to use this machine.

REMEMBER! The AED will only shock someone that the electrodes sense have one of the irregular rhythms the machine can restore. If a shock is not indicated, the machine will instruct you in performing CPR on the patient. It will not do anything harmful to someone not in one of the two rhythms described above.

STEPS TO UTILIZE:

Open up the machine.

Turn it on. There is an ON/OFF button located on the top of the machine. A light will click on indicating the machine is on.

Move the patient away from any devices that may conduct electricity, including metal surfaces. DO NOT USE MACHINE NEAR WATER! Accidental spillage could cause harm or death.

Ensure that there are no flammable materials near by, such as oxygen tanks, gasoline, or an artificially oxygenated atmosphere (ZOLL, 2000).

Turn off any cell phones or high power radio equipment near the machine, as this may interfere with the Zoll Aid's ability to discern an appropriate heart rhythm (ZOLL, 2000).

After you have ensured that the atmosphere surrounding the patient is safe, it is time to shock the patient. Remember that the AED does all of the work for you. When set up correctly, if the AED senses one of the two irregular rhythms described above, it will automatically shock the person with an appropriate amount of electricity.

If defibrillation can be administered within a couple of minutes, a normal rhythm can be restored before hypoxia or some other ill effects set in. The AED is designed to be a self-managing piece of equipment, and thus is self explanatory.
In the case of the Zoll AED, when you open it up and turn it on, it will tell you what to do with voice commands, and will also display print instructions on the screen, which is why it is especially well programmed to assist a layperson in dealing with an emergency.

OPERATION:

Remove patients shirt

Dry Patients Chest if Applicable

Apply Electrodes

** PAD PLACEMENT: One will go in the middle of chest, and one is lateral, meaning it will go on the side of chest. The machine will have a pictograph to show you where the pads should go fresh pack of electrode pads is supplied in the AED Kit. Ensure that the pads are not expired before applying to patient. Failure to do so may result in burning! (ZOLL, 2000).

Remove the patient's shirt, and dry the patient's chest if it is whet prior to beginning.

NOTE** If the electrodes do not stick to the persons chest due to excess hair, a razor is included in the AED kit. You may shave the chest hair to assist in applying the electrodes.

The following warning will be issued if the ZOLL detects that a patient is ready to be shocked: "Don't Touch Patient, Press Treatment Button" (ZOLL, 2000). After pressing the treatment button, a shock is delivered. The user will be directed to perform CPR if the AED does not restore an appropriate rhythm in the patient.

A treatment button is located on the top of the machine, and is used to start the shock process. The Treatment Button will light up when the AED is charged and ready to shock the patient, after the machine has assessed the individual's heart rhythms to determine if a shock is needed. **If no shock is required the following voice and digital prompt is offered: NO SHOCK IS ADVISED. Open Airway/Check Breathing/Check Circulation. If there is no circulation - Start CPR (ZOLL, 2000).

If the treatment button is pressed when it is not illuminated, the machine is not charged, and will deliver a voice prompt that indicates the number of shocks that have already been delivered to an individual if applicable (ZOLL, 2000).

VOICE PROMPTS:

UNIT OK

PLUG IN CABLE - electrode cable may not be properly connected to AED patient connector

CHECK ELECTRODE PADS - Attach defibrillation pads to individual

DON'T TOUCH PATIENT - ANALYZING

TREATMENT ADVISED

NO TREATMENT ADVISED

ANALYSIS HALTED. KEEP PATIENT STILL - This happens when the rhythm analysis is stopped usually because there is too much ECG signal being received. If this happens stop CPR and keep the individual still, they may be moving too much.

PRESS TREATMENT BUTTON

RELEASE TREATMENT BUTTONS

TREATMENT DEVLIERED

NO TREATMENT DELIVERED - This may happen due to user error.

SHOCKS DELIVERED

Source: (Zoll, 2000)

MAINTENANCE:

Also on the equipment is a Check Mark that will light up when a self test is complete and the machine is ready to be used. A self test can be conducted by pressing the self test button. An X will indicate when lit up that the unit is not ready and has not successfully passed the self test.

An LCD Display shows the following: User prompts, shock count, CPR compression measurements and ECG (Electrocardiograph or heart) waveforms (ZOLL, 2000).

PRECAUTIONS:

If the individual has a known pacemaker, do not place the electrodes over this area as the pacemaker may disrupt the ECG reading the defibrillator retrieves (ZOLL, 2000). The pacemaker may also be damaged by the discharges released from the AED.

AED Contraindications: Children under 8 years of age.

FAQ:

When shocked, what happens? Slight…