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Time is of the essence when using a defibrillator

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Newark Community First Aid
Newark Community First Aid

A defibrillator is a device that gives a high energy electric shock to the heart through the chest wall to someone who is in cardiac arrest.

A cardiac arrest happens when the heart stops pumping blood around the body.

With no blood reaching the brain the patient falls unconscious and stops breathing normally.

The most common cause of a cardiac arrest is a life-threatening abnormal heart rhythm called ventricular fibrillation (VF).

VF happens when the electrical activity of the heart becomes so chaotic that the heart stops pumping and quivers or ‘fibrillates’ instead.

Common causes of VF are heart attack, other heart-related illness, electrocution, using recreational drugs, severe bleeding and lack of oxygen in the body due to conditions such as choking.

The first recorded use of a defibrillator on a human was in 1947.

It took decades before these devices became commonplace in hospitals ­— they were bulky and required the skills of a medical doctor to read the heart rhythm detected by the device and decide if a shock could be delivered.

In 1960 more portable defibrillators were developed by Frank Pantridge in Belfast. Again, it was decades before these devices were seen outside of hospital.

They appeared on ambulances when paramedics were introduced into the NHS as they still needed a healthcare professional to interpret the heart rhythm.

In the 1990s, with improvements in electronics, much smaller portable devices became available that did not need a person to interpret the information as the device itself could decide if a shock was needed.

They were called Automated External Defibrillators, or AEDs, and could be used by untrained people.

The introduction of AEDs was an important development as once VF occurs it is vital that a defibrillator is used as soon as possible ­— ideally within the first ten minutes, but the sooner the better.

This is because the chaotic electrical activity of VF will not last much longer than ten minutes after which the heart will become electrically dead and defibrillators will not work.

Despite the best efforts of the NHS ambulance service they cannot always get to a patient in that ten-minute time frame whereas a person close to the incident could use an AED within the first few minutes, giving the patient a much better chance of survival.

Today, AEDs are seen in many places. They are common in workplaces and sports facilities, and where people gather such as theatres, railway stations and airports.

AEDs are also found in public places such as disused phone boxes, on the side of village halls or public buildings and are kept in a protective box.

The protective boxes Public Access Defibrillators (PADs) or Community Public Access Defibrillators (CPADs) are in may be secured and protected by an entry code.

The PADs have often been provided by community groups who register them with the ambulance service, which will know the box code.

We provide first aid training in Newark and surrounding villages and in the last few years have trained on average just over 1,000 people per year.

One of the points most noticeable to our training team is the amount of confusion and concern around the use of PADs.

This stems, in many cases, from what people see on television when defibrillators are used in hospital settings. Our aim is to dispel some of the myths and fears and give people confidence to use these life-saving devices.

  • Public access defibrillators are there for untrained people to use. They are not there for the ambulance service or community responders to use ­— they have their own.
  • The AED will decide if a shock is needed and will only let a shock be delivered if it is needed. It will not allow a shock to be delivered to a normally working heart.
  • You do not have to be trained to use a PAD, although attending a training session increases people’s confidence.
  • Some worry about being sued. Although British law is complicated there have been no reported cases of successful prosecutions of those attempting first aid in any form.
  • Workplaces often train their first-aiders in the use of AEDs but best practice would be encouraging any member of staff to use one quickly.

So, if you find a collapsed person check for dangers and make safe, then seek a response ­— talk, shout and tap their shoulders. If they do not move, open their eyes or speak then you need to quickly open their airway. Do this by tilting their head back and lifting their chin.

Check their breathing for ten seconds. Look for chest rise and put your ear to their nose/mouth and listen/feel for breath.

You are looking for normal breathing. In an adult you would expect to see two or more breaths in ten seconds.

In the first minutes after cardiac arrest a casualty may display agonal breathing, making infrequent, slow, and noisy gasps of breath. Do not confuse this with normal breathing.

If your check shows the person does not respond they are unconscious and if they are not breathing normally they are in cardiac arrest.

  • First call 999 for an ambulance. Ideally get a bystander to do this but if you are alone phone yourself.
  • You will then need to give CPR. For an adult patient, after every 30 chest compressions give two breaths. If you are not prepared to give breaths continue with continuous chest compressions. CPR must be continued until the person breaths normally for themselves.
Once you have called 999 always start CPR
Once you have called 999 always start CPR
  • If the ambulance control have a defibrillator registered within 500 metres they will ask if a bystander can be sent to fetch the AED and will provide the box code.
  • Once the defibrillator arrives, switch it on. It will issue instructions by voice and, in some cases, by pictures on the device.
  • Follow the prompts. It will ask you to bare the chest. Scissors are with the AED so cut all clothing quickly off the chest.
  • If the chest is wet/sweaty dry it with the towel provided and push any necklaces behind the neck.
  • If the chest is very hairy a razor is provided to shave just where the pads will be applied.
  • Apply the sticky pads ­— pictures on them show where they go.
  • You will be told to move clear (stop CPR) while the AED checks the heart rhythm.
  • If the AED tells you to deliver a shock, make sure no one is touching the casualty and press the shock button before immediately returning to CPR (30:2).
If the automated external defibrillator tells you to shock, stand clear and press the shock button
If the automated external defibrillator tells you to shock, stand clear and press the shock button
  • If the AED tells you no shock is indicated immediately return to CPR (30:2).
  • Every two minutes the AED will analyse the heart and direct you further with voice/visual prompts.
  • Follow the instructions from the AED and continue with CPR until you notice a return of consciousness. If this happens check breathing. If the patient is breathing normally place them in the recovery position. If they are not, continue with CPR.

To gain confidence join one of our free training sessions or courses to practise the key skills required to save lives. Details of course dates are at www.newarkcommunityfirstaid.co.uk on our Facebook page and via email: newarkcommunityfirstaiders@hotmail.com

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