Ultimately, ventricular tachycardia leads to ventricular fibrillation. In ventricular fibrillation, the electrical activity of the heart becomes chaotic, preventing the ventricle from effectively pumping blood. The fibrillation in the heart decreases over time, and will eventually reach asystole.
AEDs, like all defibrillators, are not designed to shock asystole 'flat line' patterns as this will not have a positive clinical outcome. The asystolic patient only has a chance of survival if, through a combination of CPR and cardiac stimulant drugs, one of the shockable rhythms can be established, which makes it imperative for CPR to be carried out prior to the arrival of a defibrillator.
Uncorrected, these cardiac conditions ventricular tachycardia, ventricular fibrillation, asystole rapidly lead to irreversible brain damage and death, once cardiac arrest takes place.
However, sixth-grade students have been reported to begin defibrillation within 90 seconds, as opposed to a trained operator beginning within 67 seconds. Bras with a metal underwire and piercings on the torso must be removed before using the AED on someone to avoid interference. In a study analyzing the effects of having AEDs immediately present during Chicago's Heart Start program over a two-year period, of 22 individuals, 18 were in a cardiac arrhythmia which AEDs can treat.
Of these 18, 11 survived. Of these 11 patients, 6 were treated by bystanders with absolutely no previous training in AED use. Automated external defibrillators are generally either kept where health professionals and first responders can use them health facilities and ambulances as well as public access units which can be found in public places including corporate and government offices, shopping centres, restaurants, public transport, and any other location where people may congregate.
In order to make them highly visible, public access AEDs are often brightly coloured and are mounted in protective cases near the entrance of a building. When these protective cases are opened or the defibrillator is removed, some will sound a buzzer to alert nearby staff to their removal, though this does not necessarily summon emergency services; trained AED operators should know to phone for an ambulance when sending for or using an AED.
In September , the International Liaison Committee on Resuscitation issued a 'universal AED sign' to be adopted throughout the world to indicate the presence of an AED, and this is shown on the right.
A trend that is developing is the purchase of AEDs to be used in the home, particularly by those with known existing heart conditions. There has been some concern among medical professionals that these home users do not necessarily have appropriate training, [13] and many advocate the more widespread use of community responders, who can be appropriately trained and managed.
Typically, an AED kit will contain a face shield for providing a barrier between patient and first aider during rescue breathing; a pair of nitrile rubber gloves; a pair of trauma shears for cutting through a patient's clothing to expose the chest; a small towel for wiping away any moisture on the chest, and a razor for shaving those with very hairy chests.
Most manufacturers recommend checking the AED before every period of duty or on a regular basis for fixed units. Some units need to be switched on in order to perform a self check; other models have a self check system built in with a visible indicator.
All manufacturers mark their electrode pads with an expiration date, and it is important to ensure that the pads are in date. This is usually marked on the outside of the pads. Some models are designed to make this date visible through a 'window', although others will require the opening of the case to find the date stamp.
It is also important to ensure that the AED unit's batteries have not expired. The AED manufacturer will specify how often the batteries should be replaced. Each AED has a different recommended maintenance schedule outlined in the user manual.
Common checkpoints on every checklist, however, also include a monthly check of the battery power by checking the green indicator light when powered on, condition and cleanliness of all cables and the unit, and check for the adequate supplies [15]. An AED is 'automatic' because of the unit's ability to autonomously analyse the patient's condition. To assist this, the vast majority of units have spoken prompts, and some may also have visual displays to instruct the user.
When turned on or opened, the AED will instruct the user to connect the electrodes pads to the patient. Once the pads are attached, everyone should avoid touching the patient so as to avoid false readings by the unit. The pads allow the AED to examine the electrical output from the heart and determine if the patient is in a shockable rhythm either ventricular fibrillation or ventricular tachycardia. If the device determines that a shock is warranted, it will use the battery to charge its internal capacitor in preparation to deliver the shock.
This system is not only safer charging only when required , but also allows for a faster delivery of the electric current. When charged, the device instructs the user to ensure no one is touching the patient and then to press a button to deliver the shock; human intervention is usually required to deliver the shock to the patient in order to avoid the possibility of accidental injury to another person which can result from a responder or bystander touching the patient at the time of the shock.
Depending on the manufacturer and particular model, after the shock is delivered most devices will analyze the patient and either instruct CPR to be performed, or prepare to administer another shock. Many AED units have an 'event memory' which store the ECG of the patient along with details of the time the unit was activated and the number and strength of any shocks delivered.
Some units also have voice recording abilities [16] to monitor the actions taken by the personnel in order to ascertain if these had any impact on the survival outcome. All this recorded data can be either downloaded to a computer or printed out so that the providing organisation or responsible body is able to see the effectiveness of both CPR and defibrillation.
Some AED units even provide feedback on the quality of the compressions provided by the rescuer. The first commercially available AEDs were all of a monophasic type, which gave a high-energy shock, up to to joules depending on the model. Each provider manual is provided in a Portable Document Format PDF so that you can take it with you on your digital device, wherever you go, online or off. You will not find this ebook anywhere online.
Read the any books now and if you do not have considerable time to. There are units covering rhythm recognition and the use of defibrillators and cardiovascular medications in PALS. The BLS Provider Manual provides a detailed description of basic life support in patients of all sizes including infant, children, and adults. Special attention is placed on airway management for BLS providers. Download the provider manuals, print them out or study them on your tablet PC—refer to them any time you have time to study.
Then sign up for one or more of our courses and take the certification or recertification examination. Once you pass the exam, you are certified! That is why we allow our prospective clients the opportunity to see the ACLS Study Guide before they purchase a course.
Then you should look over the ACLS algorithms. Once you feel comfortable, take the ACLS recertification examination. Read each section carefully and commit the algorithms to memory.
0コメント