Before reading this lesson you should have already worked through lesson 1
Public Access Defibrillators are popping up everywhere. You can find them on the side of public buildings such as restaurants, cinemas, and public houses; most town centres will now have one somewhere. The thing that puts people off using one or stopping to help is the misconception that they are difficult to use, or you must be trained to use one.
Automatic, or semi-automatic external defibrillators are extremely simple to use and designed in such a way that they cannot deliver a shock to someone who doesn’t need one. You simply open the lid and stick the pads to the casualties bare chest; the device evens shows and tells you where to put them.
Most ambulance service trusts will have a register of these defibrillators, including the location and access code. When you phone 999 and explain that someone has collapsed and is not breathing they will give you the location of the nearest unit and the access code to get into the cabinet. If someone else is available then send them for it, otherwise you will need to get it yourself.
As soon as a defibrillator is available you should attach it to the patient.
- Open the lid and listen carefully to the audio information;
- Locate the pads and attach one to the upper right hand side of the patient’s chest;
- Take the second pad and place it on the lower left hand side of the chest, underneath the armpit;
- The unit should detect that the pads have been applied and carry out an assessment of the patient’s heart;
- It will either advise a shock and tell you to stay clear of the patient and push a flashing button, you, or ask you to continue CPR.
If the patient’s chest is excessively hairy then the pads will not stick properly. You will need to shave the area where the pads are to be applied. The Defibrillator should come with a safety razor for this purpose. There should also be a pair of tough cut scissors and a cloth for wiping away excessive perspiration.
Every couple of cycles of CPR or at a pre-set interval the device will assess the heart rhythm. It is important that while this is happening everybody remains still and does not touch the patient. Movement may cause a false reading within the device and it will have to start the assessment again, wasting valuable minutes.
|Important Excessive chest hair will need to be shaved before applying the pads to the patient’s chest.Excessive perspiration will need to be wiped from the patient’s chest before attaching the electrodes. Defibrillators should not be used in pools of standing water, or flammable atmospheres. Before administering a shock make sure that nobody is touching the patient.|
The Recovery Position
Should the patient recover, the device will ask you to check for a pulse. You should do this, and check to see if they are breathing normally.
If they are breathing again we need to put the patient in the recovery position and LEAVE THE PADS ON just in case they go back into cardiac arrest.
To place someone in the recovery position:
- Kneel down next to the patient;
- Move the arm nearest to you so that it is pointing towards you, at a right angle to the body;
- Take the arm that is furthest away from you and fold it over the casualty so that the back of their hand is resting against the cheek closest to you;
- Lift the knee furthest away from you and use the patient’s leg as a lever to roll them over towards you;
The patient should now be lying on their side facing towards you. Continue to monitor the patients breathing