Avoiding discussions about training standards and agencies, would one of your students have been able to make it through one of your classes without understanding that you don't hook someone up to an AED who is conscious and responsive?bnelson:
AED Use...Question?
- Thread starter Sean C
- Start date
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pismodiver
Registered
Some terminology leads to confusion. Heart Attack (or MI--myocardial infarction) is NOT the same as cardiac arrest. While it is true that the former often leads to the latter, the treatments are quite different. An MI is caused by a lack of oxygen to the cardiac muscle. Generally the patient is alert and complaining of pain, shortness of breath, and/or a myriad of other symptoms. In a cardiac arrest the patient's heart is no longer functioning as a pump, and will exhibit disorganized or no electrical activity. They are unconscious without a pulse or respirations. These are the folks that an AED may help. If it senses a "shockable" rhythm (V-fib or V-tach) it can deliver one, if it senses asystole (no electrical activity) it will not.
DennisW
Contributor
As most of you have said, if a person is awake and responsive, you should not attach the AED pads. The unit should not give the order to initiate a shock if one is not needed or not appropriate. Hopefully an AED will not automatically initiate a shock without someone pushing the button, but I would not attach the pads to myself for any reason. I'm an Electrical Engineer and I know for sure that all electronics devices can fail. Devices that are more complicated can fail in a more complicated manner, usually in a manner that you will not expect. Murphy lives.
BlueDevil
Contributor
A conscious person having a heart attack may be in an abnormal heart rhythm. If they are in ventricular tachycardia (VT) the AED may well advise a shock. This would be extremely painful for the conscious patient, and unless the shock is "synchronized" carries a risk of sending them into ventricular fibrillation (VF). These patients are generally treated first with drugs to try to revert their rhythm, and if that doesn't work they are then shocked (synchronized cardioversion) under sedation. An AED is not an appropriate device for this procedure. For this reason I would agree with those who have said it should never be connected to a conscious patient.
Sorry, I don't know how to do the quote thingy, but you asked if a student could make it through a course without knowing not to apply pads to a cons., responsive patient. Unfortunately, (agree with you) it can happen, the student might miss something or be afraid to ask for fear of being chastized.
I was aware of the stated limitations of an AED and the guidelines for their use, but I'm not a medical professional and like broadening my knowledge base. The one rule I will never overstep, is to stay within the confines of my training, but as we are all aware sometimes training does not answer everything or address all scenerios.
For example: I recall that it was advised to turn back my tank valve a 1/4 turn when turning on my tank, I believe that is a questionable action. But, I'm positive that people will argue both sides of the issue.
I will never be afraid to ask a question, it will likely save me from doing something really stupid.
Sean
I was aware of the stated limitations of an AED and the guidelines for their use, but I'm not a medical professional and like broadening my knowledge base. The one rule I will never overstep, is to stay within the confines of my training, but as we are all aware sometimes training does not answer everything or address all scenerios.
For example: I recall that it was advised to turn back my tank valve a 1/4 turn when turning on my tank, I believe that is a questionable action. But, I'm positive that people will argue both sides of the issue.
I will never be afraid to ask a question, it will likely save me from doing something really stupid.
Sean
You did right in asking the question Sean... and no one should take you to task for it.
Your point about a student missing something and then not asking for fear of being chastized is a good one and every one responding to this kind of thread should think about that.
Your point about a student missing something and then not asking for fear of being chastized is a good one and every one responding to this kind of thread should think about that.
njrn2
Registered
In addition to the unsyncronized shock possibly converting someone to VF, it can cause what is known as an R on T phenomenon and possibly send the patient into asystole (FLAT LINE). :lightingz: :angel_2:BlueDevil:
There are three things that I would recommend for someone who is having chest pain (which may not be discernible from an "MI")
1.) dial 911 or call the local agency that is responsible for emergencies....possibly the coasguard if on the water
2.) administer high flow oxygen
3.) Have the patient position thenself in the most comfortable position that they can be in
Do not place an AED unless someone is unconscious, unresponsive. This is not only unresponssible it is reckless.
Sean C:
Soooo, I hope that you were the one on the winning side of the argument.
-Joe
Ha Ha, no arguement and I did not take offence to anyones replys. The one piece of advice that will likely be the most crucial was CORNFED's. He suggested setting up the unit but not applying the pads, a definite timesaver should the patient arrest and something that I probably would not have the foresight to do in an emergency.
The unit we practised with had the applicable voice prompts and the unit required the user to initiate a shock if recommended. I took the automated word for what it should mean not what it does mean and failed to anticipate that a unit may malfunction and was unaware of certain conditions that could trigger a shock to a cons. patient, something I did not know about and I doubt most who take the course don't know about.
If anyone thought this was a ridiculous post, please read the EFR course book and tell me where these other conditions that were mentioned in this thread are stated and explained. What can I say, I like to know why. Obviously, you guys must have asked a lot of questions at some point.
Hey, its not like I was suggesting the move in the movie "What About Mary" where the dog is zapped with an electrical cord in attempt to bring it back.
The unit we practised with had the applicable voice prompts and the unit required the user to initiate a shock if recommended. I took the automated word for what it should mean not what it does mean and failed to anticipate that a unit may malfunction and was unaware of certain conditions that could trigger a shock to a cons. patient, something I did not know about and I doubt most who take the course don't know about.
If anyone thought this was a ridiculous post, please read the EFR course book and tell me where these other conditions that were mentioned in this thread are stated and explained. What can I say, I like to know why. Obviously, you guys must have asked a lot of questions at some point.
Hey, its not like I was suggesting the move in the movie "What About Mary" where the dog is zapped with an electrical cord in attempt to bring it back.
njrn2
Registered
Sean:
I think that some of the more in depth infromation comes from higher medical training, other courses in the medical feild, and experience. The technical infromation as to when the unit shocks is found in the AED insert usually supplied when purchased. Just remeber the machine is looking for electrical impulses in the heart. It cannot determine if a pulse is present in the patient. There are some instances where the patietn may "be shockable" and still have a pulse as it was already mentioned.
-Joe
P.S. And even in an emergency I wouldn't recommend using the lamp :lightning :1poke:
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