Tuesday, December 18, 2007

Chosing a Automated External Defibrillator (AED) for Personal Use

Sudden cardiac arrest, one of America's leading causes of death, can be reversed by a timely response with an Automated External Defibrillator (AED). Because of this, AEDs are becoming more and more commonplace in public areas such as malls, airports, stadiums and schools. Many businesses have implemented AED programs as part of their employee safety plan. Although this proactive position has all ready prevented many deaths, statistics continue to show that the majority of sudden cardiac arrests occur in the home.

Recently AED manufacturers have begun pursuing the "home market" by producing simpler and less expensive models. One model has the distinction of being cleared by the FDA for home use. What this means is that a prescription is not necessary to purchase it. However, most sellers will supply a prescription for any AED at no additional cost.

All AEDs are similar but not alike. Selecting a specific AED for personal use should depend partly on your circumstances and lifestyle.The differences in ease of use, size, weight, water and dust protection, pad and battery shelf life, not to mention overall costs, can be significant depending on whether you plan to keep it in your home, boat, RV or perhaps part of your camping gear.

AEDs usually have an Ingress Protection Rating which describes how they are protected against dust and water or liquids. The actual definition of the word ingress is the act of entering. The rating is expressed in two numbers; the first number shows the amount of protection from particles ranging from 0 equaling no protection to 6 which signifies dust tight. The second number shows protection from liquids with 0 describing no protection to 8 which is protection during continuous submersion in water.An AED with a rating of IP54 would be protected from dust or sand and could be used in heavy rain. In your home this rating will not matter too much but if you plan on keeping an AED on a boat or you like to camp in the desert or at the beach, it makes a difference.

AEDs have different sizes and weights. The lightest is 2.4 lbs. and not much bigger than a compact disc. The heaviest one is over six lbs and is closer to the size of a small laptop computer. If you are schlepping an AED on a backpacking trip obviously size and weight makes a difference.

Costs vary depending on which manufacturer you chose and where you by it. Prices range from under $1000 to $2400. The costs of replacing the pads and batteries differ considerably as well as how often they need to be replaced. One manufacturer uses consumer batteries which are inexpensive and accessible.

Some AED features are universal such as verbal instructions on how to apply the pads (electrodes) and to stand clear of the patient during analysis and shock. Several AEDs have voice and text commands, others have pictures with flashing lights. Because Cardio Pulmonary Resuscitation (CPR) is a critical component of using an AED, some give instructions on doing CPR, others have a metronome to assist with the correct rate of compressions and one even gives the rescuer feedback on the correct compression depth. Some defibrillators also have an option of an LCD readout that shows the hearts electrical activity once the pads are applied.

How important is all this? That really depends on your level of comfort or discomfort. If you do not have a medical background an LCD readout (which often costs more) is probably not necessary. Some people prefer simplicity and others like every bell and whistle. If you plan on taking the AED near water or outdoors it is important to be aware of the ingress rating. If you plan on carrying it for any distance then size, weight and how compact it is will be important. Pads and batteries with a longer shelf life are more cost effective.

Knowing which features are important to you before you begin to look will make narrowing the choice down that much easier. Remember all AEDs will shock the same cardiac arrhythmias and potentially reverse sudden death. Ultimately the best AED is the one you have.

Sunday, December 9, 2007

How to Use an Automated External Defibrillator (AED): It’s very simple!

An Automated External Defibrillator (AED) is a device that can give an electric shock to a victim of sudden cardiac arrest and potentially reverse this fatal condition and restore a victim's heartbeat. In the first few minutes of cardiac arrest the heart is fibrillating (chaotic electrical activity) and can be corrected by an electric shock. In December 2005 the American Heart Association simplified assessment protocols for aiding a victim in sudden cardiac arrest. It is now an uncomplicated two-part evaluation.

1. The victim does not respond when shaken and spoken loudly to.
2. The victim is not breathing.

If both criteria are met then Cardio Pulmonary Resuscitation (CPR) should be initiated and an AED should be placed on the victim as soon as possible. AEDs vary in size, shape and even color as part of the manufacturers marketing ploys to distinguish between them. All AEDs on the market have been cleared by the Food and Drug Administration as a safe and effective medial device. They are designed specifically for the non-medically trained user who is undoubtedly nervous and fearful.

AEDs have verbal cues that begin as soon as they are turned on. These instructions are very straightforward and talk the user through the simple steps of defibrillation. Some AEDs give more in-depth directions that cover the steps of CPR as well. One of the first instructions will be to place the pads (also called electrodes) on the victim's chest. The pads are in a sealed foil package and are pre-jelled with a conductive substance which is quite sticky. The package and often the pads themselves will have pictures that clearly show where to place them. One pad goes on the upper right side of the chest just below the collar bone and the other one goes on the left side below the ribs. The heart is in the center of the chest just left of the breastbone. The pads are placed so the shock actually travels from pad to pad inside the victim's body through the heart. One AED has a one piece pad that is connected in the middle between the two pads offering greater simplicity in placement.

There are several special considerations before placing the pads on a victim. There should be a "prep kit" with the AED that includes gloves, a razor, scissors and a dry wipe.

  1. If the victim has a lot of chest hair (especially if the skin in not visible) they will need to have the excess removed. This should take about ten seconds using the disposable razor only on the areas where the pads are to be applied.
  2. Jewelry around the neck particularly that hangs down into the chest area should be removed or pushed aside. Body piercings should be left alone regardless of location. The pad should be placed at least one inch away from body piercings.
  3. A Band-Aid or adhesive type patch on the chest may be a meditation patch and should be removed and the area cleaned off with the dry wipe.
  4. If the victim's chest is wet or sweaty it should be dried off before applying the pads.
  5. If the victim has a pacemaker or internal defibrillator (you will notice a lump or visible scar) place the pad at least one inch away.

Once the pads are adhered to the victim's chest the AED will give a verbal cue to the user to stop touching the victim as it automatically begins to analyze the electrical activity in the heart. If the AED interpret the hearts electrical activity as fibrillation it will tell the rescuer to press the clearly marked flashing shock button. There should be no physical contact with the victim during analysis and shock. Some AEDs automatically shock after issuing a verbal warning.

Regardless of outcome all AEDs will instruct the rescuer to begin Cardio Pulmonary Resuscitation immediately after a shock is administered. American Heart Association protocol calls for two minutes of CPR before the AED automatically reanalyzes and if necessary advises another shock. This sequence of shocking followed by two minutes of CPR should be continued until the victim revives or until emergency medical personnel arrive and take over.

Sudden Cardiac Arrest is a leading cause of death that can occur without warning. Fortunately automated external defibrillators are becoming more and more prevalent outside of the hospital. CPR/ AED training classes are available through various agencies including the American Heart Association and the American Red Cross.