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  1. Adult AED

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In this lesson, we'll cover how to use an AED on an adult victim.

An AED (Automated External Defibrillator) is a portable electronic device that analyzes the rhythm of the heart and delivers an electrical shock, known as defibrillation, which helps the heart re-establish an effective rhythm.

Warning: When using an AED, there are a couple of important things to keep in mind as it relates to your surroundings.

  • Are there combustible gases or liquids at the scene?
  • Are there any liquids that could connect the victim with yourself, the rescuer, or someone else, that could result in electrocution?

Pro Tip #1: If the scene isn't safe enough to use an AED, drag or move the patient to a safer area where you won't have to worry about explosives or electrocution from water and then use the AED.

These are two important considerations before using an AED, but there are a few other things to note when defibrillating an adult patient.

  • If the victim is female and wearing an underwire bra, it shouldn't present any complications. However, if it is a concern, you can disconnect it and remove it from the pathway to the heart.
  • Necklaces should be moved to the side.
  • Any patches – nicotine, analgesic, nitro gel, etc. – should be removed if they are in the way of the pads.
  • Piercings shouldn't cause any problems.
  • It's OK if the victim or the victim's clothing is wet, as long as the chest area is dry and you or the victim aren't submerged in water or connected by it.
  • There are no special considerations for pregnant women.

Pro Tip #2: It's OK to be just as aggressive with a pregnant woman as you would any other victim. The primary focus should be on the mother, as saving her will also help save the baby. The care you provide to the mother won't put the baby in any more jeopardy.

How to Provide Care

Let's assume a few things:

  • The scene is safe, and your gloves are on
  • You or a bystander called 911
  • You have an AED, whether you found one or had it with you
  • The victim is unresponsive and not breathing normally
  • CPR is already in progress

Remember, as long as you have your cell phone, you're never alone. If no one is around to help you and you aren't sure what to do, call 911 on your cell phone, put it on speaker, and follow their instructions. Dispatch can help coach you through the situation.

However, when it comes to AEDs, they supply their own instructions. Well, at least after the first step below.

AED Technique for Adults

Pro Tip #3: This is really the anti Pro Tip, as you don't need to be a pro to execute it. The AED will tell you what to do and what it's doing, like "remove clothing" or "analyzing rhythm." All you have to do is follow along.

  1. Turn on the AED.
  2. Remove the patient's clothing to reveal a bare chest and dry the chest off if it's wet. (AEDs will typically include a pair of scissors somewhere on the unit.)
  3. Attach the AED pads to the victim's chest. The pads should have a diagram on placement if you need help. The first pad goes on the top right side of the chest. The second pad goes on the bottom left side of the victim's side, under the left breast. Make sure they adhere well.
  4. Plug the cable into the AED and be sure no one is touching the victim. The AED should now be charging and analyzing the rhythm of the victim's heart.
  5. If the scene is clear and no one is touching the victim, push the discharge button to deliver a shock. Then go right back into CPR. It's OK to perform CPR over the pads, so don't worry about moving them.
  6. Perform 30 chest compressions.
  7. Grab the rescue shield and place it over the victim's mouth and nose.
  8. Lift the victim's chin and tilt his or her head back.
  9. Deliver two rescue breaths.

Continue with CPR until the AED interrupts you. At some point, it will reanalyze the victim's heart rhythm and again advise you on what to do next. If the AED advises a shock, do that. If it advises you to NOT shock the victim, continue with CPR only, again over the pads. (The AED will continue to reanalyze.)

Continue this cycle of CPR, re-analyzation, charging, shock, back into CPR until EMS arrives, the patient is responsive and breathing normally, or someone who's equally trained or better can relieve you.

A Couple Special AED Considerations

There could be special situations that go beyond what you found in the list that opened this lesson. These include using an AED on a victim who's wearing an implantable device and a victim with an excessive amount of chest hair.

Implantable Devices

Implantable devices, like pacemakers, are sometimes located below one of the collarbones in the area where one of the AED pads should go. This can be problematic as the device could interfere with shock delivery.

An ICD (Implantable Cardioverter-Defibrillator) is another common implantable device you may encounter. It's sort of like a mini version of an AED, as it detects abnormal heart rhythms and restores them to normal.

If one of these devices is visible – a small lump can sometimes be seen or felt – or if you know the victim has one in a specific location, do not place the AED pad on top of it. Instead, adjust the placement of the pad to avoid the device.

Excessive Chest Hair

Chest hair rarely interferes with AED pad adhesion, but it is nonetheless a possibility. If the victim has excessive chest hair, press firmly on the pads when placing them on the victim's chest. If you get an error message, like check pads, or something similar, remove them and replace with new pads.

Some of the victim's chest hair will likely come off with the old pads, which may solve the problem. However, if the AED still refuses to work, you'll have to shave the victim's chest (or cut some of the hair) before applying a third round of pads.