Knowing How to Use a Defibrillator Could Save Lives
What happens in the minutes following a sudden cardiac event is a matter of life and death. In many instances, knowing how to use a defibrillator can be the determining factor for survival. According to the 2021 Resuscitation Guidelines from the Resuscitation Council UK, approximately 55 in 100 000 people will suffer a sudden cardiac event – most of which take place at home or in the workplace.
The survival rate of a sudden cardiac arrest sufferer reduces by up to 10% per minute without CPR or the use of a defibrillator. In seven out of ten cases, CPR will be undertaken by a bystander. While taking charge in these critical moments before the ambulance arrives may seem daunting, defibrillators are easy to use and can be used by anybody in these emergency situations.
While this life-saving equipment is an invaluable healthcare tool, awareness among the general public is relatively low in proportion to its value. That’s why it’s important to spread awareness around the important role they play in saving lives and to find out more about what they are and how they work. In this blog, we take it back to basics and give important information on how to use a defibrillator.
What is a defibrillator?
A defibrillator is a portable machine that administers a shock to the heart following cardiac arrest. Following a sudden cardiac event, the heart stops beating normally. Once the defibrillator pads are placed on the chest of the patient, the machine administers a shock when necessary.
Not all defibrillators look the same, but their functionality is similar. Anyone can use one. All you need to do is follow the voice or visual prompts and simple-to-follow instructions. You also cannot hurt someone using a defibrillator. If the patient is not in cardiac arrest, the machine will not administer the shock.
Different kinds of defibrillators
Defibrillators come in two main varieties. These are automatic and semi-automatic defibrillators. The only real difference between the two is that semi-automatic defibrillators require operators to press a button to administer the shock. Automatic defibrillators administer the shock automatically. This refers to portable defibrillators.
There are also wearable and implantable defibrillators, which are worn and used by people at risk of a sudden cardiac event.
Where to find defibrillators
Defibrillators are located in many public locations such as schools, stadia, airports, gyms, police stations, churches, malls and shops, and convention centres and other venues where crowds of people would be accommodated.
Look for the heart and lightning symbol
The appearance of different defibrillators may differ, but you should be able to recognise the heart and lightning bolt symbol on the cabinet or other storage locker. Policies around locking these boxes may vary according to area. Take the time to find out whether your local defibrillators are stored in locked cabinets and how to go about gaining access to these machines in an emergency.
If you are in the middle of an emergency and find the defibrillator is locked away, call emergency services and give them the number on the defibrillator storage box. The ambulance service should be able to assist with the code.
As mentioned above, defibrillators are very easy to use, with voice and visual prompts to assist you. Anyone can use a defibrillator machine safely. If you are a bystander in an emergency sudden cardiac event, you should start using a defibrillator immediately if it is available. While no training is required to operate the machine, undergoing voluntary defibrillator training is a good idea to help you act calmly and confidently in an emergency.
When not to use a defibrillator
It’s important to grow awareness around when to use a defibrillator, but it is also important to know when not to use one. Here are a few instances:
- If a person is suffering a heart attack (you will know this is the case because the patient is breathing and responsive and experiencing pain)
- If the battery is low, if there are any expired parts (such as the pads), or if the machine shows a fault
These are the primary considerations around safety and effectiveness of using a defibrillator. Operators should also be aware of the following circumstances when faced with the possibility of using a defibrillator:
- If there is some sign that the person is a DNR (do not resuscitate) patient, using a defibrillator could fall within the ambit of this.
- Water and flammable materials. Ensure the patient is moved out of water or combustible materials and is completely dry before using a defibrillator.
- Be on the lookout for a pacemaker or medication pad. In the presence of either, do not place the defibrillator pads over the pacemaker or medication pad. Rather, aim to put the pad as close to the target as possible without touching the pacemaker and remove medication pads and wipe the surface of the skin before applying the defibrillator pad.
- Clothing. The defibrillator pads need to be placed on bare skin. This means the patient’s clothing needs to be removed or moved clear of the target area. It is also important to consider the presence of jewellery and metal – such as underwire bras – which will need to be removed before using the defibrillator machine.
- Body hair. If the victim has a hairy chest, this could affect the contact between the pads and the skin. In these cases, it is best practice to shave the chest – and many defibrillator maintenance officers place razors and other helpful tools into the defibrillator cabinet for the purpose of effective use. If a razor is not available, apply as much pressure to the pad as possible without touching the skin of the victim.
- If the victim is a child, standard defibrillators are safe for use on children over the age of eight. For children younger than eight, paediatric defibrillator pads or paediatric defibrillators should be used. Defibrillators should not be used on children aged one or younger.
- If you’re on your own with the victim, start administering CPR and don’t stop to locate a defibrillator. If possible, send another person to find the closest AED machine and put your phone on speaker to speak to emergency services.
- Pads on, hands off. Don’t touch the patient once the pads have been applied to the skin.
How to use a defibrillator: a step-by-step guide
Step 1: Perform a Primary Survey and Start CPR
Conduct a quick Primary Survey:
- Danger: Is the area safe to proceed?
- Check for a response
- Open the airway
- Check for breathing
- Check circulation
- Administer treatment
Call emergency services
Once this is done, commence CPR while you wait for a defibrillator – whether it is being brought by a bystander or the ambulance service. Someone who is suffering cardiac arrest will be unconscious, unresponsive, and won’t be breathing or won’t be breathing normally.
Step 2: Turn On the Defibrillator and Apply the Pads
Press the green button on the defibrillator and follow the instructions. Remove or move aside any clothing for easy access to the patient’s bare skin and wipe away any sweat or moisture. You may also need to shave the chest for best contact. Remove the paper protectors from the sticky pads. Again, follow the prompts. If you are not alone, ask another bystander to assist you with this to ensure continued CPR.
Defibrillator paddles positions
Where on the chest should the defibrillator pads be applied?
The first pad should be applied on the right-hand side under the collar bone. The second pad should be applied on the left-hand side below the armpit.
Step 3: Let the Defibrillator Tell You if a Shock is Necessary
Once the pads have been put in place, stop CPR and get everyone to stop touching the patient. The machine will provide you with instructions. If a shock is necessary, get everyone clear of the patient and administer the shock or wait for this to be done automatically. The defibrillator will prompt you to continue CPR. Follow the instructions.
If a shock is not required, continue CPR until the defibrillator instructs otherwise.
Step 4: Monitor Changes
If the patient becomes responsive or starts breathing, put him or her into the recovery position with the defibrillator pads still attached. Watch the patient closely and recommence CPR if required.
Working defibrillators? Find out in a heartbeat
There are two fundamental considerations when it comes to using defibrillators in a cardiac emergency. The first is location. The second is operational status. The presence of these life-giving machines is a source of hope for both sudden cardiac event sufferers and bystanders, but these are core considerations in an emergency.
Smarter Technologies has identified and sought to counteract issues around defibrillator location, maintenance, and operational requirements using their powerful IoT smart technologies and Orion Data Network. These tags, sensors, pressure pads, and gateways send data to a remotely accessible dashboard in real time – informing users about the location and status of defibrillators.
These data readings give instant insights into metrics like battery life, maintenance history, and exact storage location for quick uptake. By programming technologies to report on customisable factors, this also inspires optimal ongoing maintenance and prevents tampering and theft.