How do I use a defibrillator (Automated External Defibrillator - AED)?

How to Use an Automated External Defibrillator (AED)

AEDs are simple and easy to use devices that provide voice prompts and visual cues to guide users through all appropriate steps during cardiac arrest emergencies. 1

Basic AED Operation Steps

• Turn the AED on - this activates the voice prompts that will guide you through the entire process 1
• Follow the AED prompts which will guide you through pad placement and analysis 1
• Allow the AED to analyze the heart rhythm without touching the patient 1
• Deliver shock if advised by the AED, ensuring no one is touching the patient 1
• Resume chest compressions immediately after the shock to minimize interruptions 1

Proper Pad Placement

• Remove clothing to expose the victim's bare chest 1
• Place pads on the victim's bare chest according to the diagram on the pads (typically one pad on the upper right chest and the other on the lower left side) 1
• Ensure pads make full contact with the skin for effective delivery of the shock 1
• For patients with excessive chest hair, briskly remove an electrode pad (which will remove some hair) or rapidly shave the chest if necessary, but do not delay defibrillation 1

Special Considerations

• If the victim has a transdermal medication patch where a pad needs to be placed, remove the patch and wipe the area before attaching the electrode pad 1
• If the victim is wet, quickly wipe the chest dry before attaching electrode pads 1
• For patients with implanted cardioverter defibrillators (ICDs), allow 30-60 seconds for the ICD to complete its treatment cycle before attaching an AED if the ICD is actively delivering shocks 1, 2
• Avoid placing AED pads directly over an ICD device - position them at least 8 cm away from the device 1, 2

Critical Safety Points

• Ensure no one is touching the patient during rhythm analysis and shock delivery ("clear the patient") 1
• AEDs can be used on patients lying on snow or ice 1
• AEDs are designed with safety features that make it virtually impossible to shock someone who is not in cardiac arrest 3
• The device will not allow delivery of a shock that its analysis determines is unnecessary 3, 4

AED Use in a Cardiac Arrest Scenario

1. Verify the scene is safe before approaching the victim 1
2. Check for responsiveness by tapping the victim's shoulder and shouting "Are you all right?" 1
3. If unresponsive with no breathing or only gasping, activate emergency response system 1
4. Retrieve the AED if nearby and easily accessible 1
5. Begin CPR while waiting for the AED or have another rescuer retrieve it 1
6. When the AED arrives, turn it on and follow the prompts 1
7. Continue CPR until the AED is ready to analyze the rhythm 1
8. After shock delivery (if advised) or if no shock is advised, immediately resume CPR 1
9. Continue cycles of CPR and AED analysis until emergency medical services arrive or the victim starts to move 1

Common Pitfalls to Avoid

• Do not delay defibrillation to perform other interventions - early defibrillation is critical for survival 1, 4
• Do not touch the patient during rhythm analysis or shock delivery 1
• Do not place pads over metallic objects, transdermal patches, or implanted devices 1, 2
• Do not assume the AED will automatically treat all arrhythmias - follow the device prompts 2, 5
• Do not interrupt chest compressions for longer than necessary when using the AED 1