Debunking the myths, Automated External Defibrillator AED
The sad fact is that if someone had a cardiac arrest and nothing is done to save them, they will die 100% of the time. If someone starts CPR their chances are slightly better, still not great. If an Automated External Defibrillator (AED) is used along with CPR their chances of survival are optimised. However, even with prompt first aid treatment not everyone who suffers a cardiac arrest will survive. Even if it happens in hospital, on a cardiac ward.
A cardiac arrest is a sudden cessation of the heart; commonly caused by an interruption in its electrical signals. The lower chambers of the heart (Ventricles) go into Fibrillation (VF). As a result blood flow to the brain stops, the casualty goes unconscious and dies. It differs from a ‘heart attack’, myocardial infarction or MI which is usually caused by a blockage. In this case a casualty may still be conscious and breathing although in some distress.
What do we do about it?
In a Cardiac Arrest the most important thing to do is ensure help is on the way. Therefore you might have to leave the casualty to ensure help is on the way. Even if you have immediate access to an Automated External Defibrillator (AED) make sure an ambulance is on its way. Delegate, get friends or passers by to alert the emergency services. If one is close by get them to bring back an AED.
You can put your mobile onto speakerphone and the operator will guide you through the process. Once you are sure help is on the way start CPR or if you have one open the AED, switch it on. Follow the verbal or written instructions, or the diagrams showing what goes where. The machine will guide you through the procedure and prompt you if a shock is advised. When advised to do so, you press the shock button which passes an electrical current between the pads, through the heart. The shock stops the heart, De-Fibrillating it and with luck it then beats in a normal (sinus) rhythm.
The short answer is no; not yet. There have been no successful claims made against anyone using an AED in the UK. Again, a casualty will die if nothing is done, it can’t get any worse. The pads on an AED will detect a shockable rhythm, anything but a shockable rhythm and the machine will not deliver a shock. (even if you constantly press the ‘shock’ button). There are reasons why it will not deliver a shock: the casualty’s heart might not have gone into fibrillation (meaning they have already died) or the machine may be picking up your pulse (if you are touching the casualty) or you may have miss-diagnosed their condition and they still have a pulse.
The Harvard Health website says “An AED includes two sticky pads with sensors (electrodes) that you place on either side of the unconscious person’s bare chest. To determine if a shock is needed the pads detect the heart’s rhythm and a computer analyses it.
Do you need to be trained to use an AED?
AED’s are becoming more prevalent throughout the UK. Misunderstandings in their use arise because the majority of those trained# have done so because out of an ‘at work’ need. (Saint John’s, 2015) The Health and Safety Executive (HSE, 2015) who govern ‘at work’ courses insist anyone using an AED must have proper training.
The Resuscitation Council UK (2015) and the European Resuscitation Council (2015) both leading authorities in first aid, say that any person trained or not should to try to use an AED. Some first aid instructors do not pass on this extra information. Worse still, they did not know it. As a result, since the majority of those trained have done so in an at work capacity, we have confusion in regards to who can use an AED.
It is my hope that moral sense would win and if called upon most people would do their best, trained or not.
Attendance figures on First Aid courses UK
Of the adult population only around Only around 10% have attended any formal first aid training. In Norway that figures is 95%, Austria and Germany 85% and Iceland 75%. In these countries first aid is taught to school leavers, at work and in some training is compulsory to obtain a driving license.
To conclude, all good first aid instructors should provide some AED training, even on the most basic of courses. They do not have to encourage the use of AED’s by the untrained (friends of hose trained) but maybe they should and also ask the untrained to assist them with CPR – trained or untrained. The effectiveness of CPR to prolong life diminishes as the rescuer tires.