Automated External Defibrillators: 5 Mistakes That Can Cause Injuries

Automated external defibrillators (AEDs) are portable electronic devices that you can use to administer vital first aid to somebody who has suffered cardiac arrest. The devices automatically detect life-threatening arrhythmias and, where necessary, administer an electric shock to restore normal heart rhythm. The devices are easy to use, but even trained first aiders can make mistakes. Make sure your first aiders always use AEDs safely by highlighting the five following mistakes that can lead to serious injuries.

Failing to check the area around the patient is safe

First aiders should always make sure there are no potential hazards surrounding the patient. For example, puddles of water and other liquids present a potential shock hazard to the patient and anybody else nearby. If possible, you should also move the patient off any metal surfaces before using an AED.

While there are no reports of AED injuries in bystanders or first aiders, it's also important to make sure other people stand well clear of the patient's body. Before administering the shock, the first aider should always give a verbal warning. Some airlines train their staff members to remember the following safety command:

"Top clear, middle clear, bottom clear, I'm clear, everyone clear, oxygen clear. Shock!"

Consider using a command like this with your first aiders.

Interrupting chest compressions

Cardiopulmonary resuscitation (CPR) remains vital throughout the process of using an AED. First aid and CPR training involves a range of techniques, including chest compressions, which the first aider can use to help get blood circulating. CPR also makes sure that the brain continues to receive oxygen, cutting the risk of further injuries.

An AED is only effective when a first aider continues with chest compressions. Early, uninterrupted chest compressions are vital, and first aiders should never delay CPR while waiting for somebody to fetch an AED. The first aider should only interrupt CPR to analyze the heart rhythm and deliver a shock. Always make sure that somebody else calls the emergency services, so the first aider doesn't pause CPR.

Ignoring AED instructions

The latest AEDs are extremely user-friendly, and, once the first aider starts using the device, an AED will issue automated voice commands telling the user what to do next. Under no circumstances should a first aider ever ignore the AED prompts.

Most AEDs follow the same sequence of actions and voice prompts. The device will tell users to:

• Deliver a single shock when the device finds a suitable rhythm
• Resume CPR immediately after the shock

After two minutes, the AED will then resume rhythm analysis. This programming offers the patient the best chance of survival, so it's vital that first aiders act exactly according to what the device says. Any deviation from this programming could cause serious injuries - the AED counts the time for you, so your first aider can concentrate on CPR.

Delaying the use of an AED

Timely use of the AED is critical to the patient's survival. According to the National Heart, Lung & Blood Institute, every minute's delay after sudden cardiac arrest cuts the patient's chances of survival by ten percent.

As such, confident, timely use of the AED is vital. First aiders should never wait to decide if the device is necessary, nor should they wait for further medical advice. Given the risk of death after sudden cardiac arrest, first aiders cannot even afford to consider other health issues. For example, a first aider should always use an AED on a patient with a pacemaker or on pregnant women if he or she suspects cardiac arrest.

Misplacement of AED pads

To deliver an electric shock to the patient, the AED uses two electrodes, which the first aider places on the cardiac arrest victim's chest. Correct placement is vital to the success of the process because the electrodes need to make good contact with the body. The first aider should place one pad on the right center of the patient's chest above the nipple, and the other pad just below the other nipple.

It's important to remove any jewelry or clothing that may get in the way. A small amount of body hair is not normally a problem, but AED kits usually include equipment you can use to trim away excess body hair. The first aider should also dry the victim's chest before using the device.

The AED gives detailed instructions on where to place the pads. It doesn't matter if you mix up the left or right pads, and first aiders should never waste time trying to get the attachments the right way round. You can use standard pads on children over the age of 8, but special pediatric pads are better for younger children, if available.

AEDs save lives, and these portable devices are generally easy to use. That aside, it's important to highlight best practices while training first aiders, to avoid potential injuries.