An automated defibrillator, also known as AED automated defibrillator, is a small, lightweight and portable device that delivers an electrical shock to the heart of a person who is experiencing sudden cardiac arrest. Automated defibrillator can be used at home, in the work place or in public places by anyone who is not a medical expert but who has had the appropriate training for using the device. The advantages of having an automated defibrillator is that it helps to keep the patient alive or to resuscitate the patient who is having a heart attack / sudden cardiac arrest until a professional emergency team arrives on the scene. That said, if a person who is having a heart attack is not defibrillated as quickly as possible, their chance of survival declines with every passing minute.
Medical experts state that the most crucial period in the treatment of a cardiac arrest patient is the first three or four minutes. Otherwise, the risk of brain damage and other complications increase drastically.
Why to choose the RitimPort RTM3001 AED Automated Defibrillator (AED)?
The RitimPort RTM3001 AED Automated Defibrillator is relatively easy to use as it guides the operator through three stages, using audible and visual signals. With its self-test property, it is always ready-to-use. The RitimPort RTM3001 AED Automated Defibrillator is compact, lightweight, and comes with all accessories, thanks to a carrying case that is offered as a standard accessory. With the small first aid kit, which you will find in the carrying case, you will not need any other auxiliary materials. Weighing only 2.5 kg, the RitimPort RTM3001 AED (automated defibrillator) is very easy to carry. The metronome sound for CPR coaches the user, which more effectively assists with CPR (cardiopulmonary resuscitation) With software that has the ability to recognize automatic pediatric pads, the pediatric pads are automatically configured for use on a child patient, from the moment they are installed. The RitimPort RTM3001 AED Automated Defibrillator device also stores patient resuscitation data in its memory and the recovery history can be viewed at any time. It provides the opportunity for the end-user to remotely update the software easily in line with the variable AHA/ERC guidelines. The clear, straightforward voice commands with adjustable sound intensity makes using the device even easier. The optional wall assembly kit and wall cage accessories enable the device to be used anywhere. The RitimPort RTM3001 AED automated defibrillator offers maximum service to its users through its high quality and economic replacement parts and accessories.
Automated Defibrillator Device (AED)
The Automated Defibrillator is a life saving medical device with a light and useful design to deliver electric shock (defibrillation) to the patient in the event of a sudden cardiac arrest. Automated defibrillators are designed to be used by anyone who does not have medical training but has had training in first aid.
Automated defibrillators (AED) have advanced ECG analysis software; hence, the device analyzes the ECG signals and the operator is guided through an audiovisual system. Therefore, the operator does not need to know the cardiac rhythm.
The AED – automated defibrillator – is designed especially for first responders, and is used until emergency paramedics arrive at the scene.
The early application of defibrillation, a treatment for sudden cardiac arrest, may enable the heart to beat at a rhythm that maintains circulation once again, and can be lifesaving.
In some developed countries, it is compulsory to make automated defibrillators available and easily accessible in crowded places such as stadiums, shopping malls, airports etc.
Even though under ideal conditions automated defibrillators should be used by certified first responders, in some countries the use of these devices is permitted without any certification, as the device can be successfully used by people without any training, due to the audible commands and guidance they provide.
What Is a Semi-Automated Defibrillator?
A semi-automated defibrillator device is a type of defibrillator, which defines the rhythm and guides the operator through its audio or visual system, while leaving the application of the final defibrillation to the operator via the shock button. Semi-automated defibrillators have a SHOCK button, which is not available in fully automated defibrillators. In functional terms, semi-automated defibrillators are no different from the fully automated defibrillators.
How to Use (AED) Automated Defibrillator
Attach the disposable pads of the Automated Defibrillator to the naked chest of the patient. Wait for the device to analyze the patient’s cardiac rhythm (ECG), and if the device recommends defibrillation (shock), press “defibrillation/shock” button in semi-automated devices or with fully automated devices let the device apply the defibrillation.
Who Can Use Automated Defibrillators?
Automated Defibrillators are designed to be used by anyone that through training has knowledge of first aid but no medical training, as such. In order to save more lives, everyone should receive training on the use of AEDs (automated defibrillators) and CPR (cardiopulmonary resuscitation). Studies on awareness and social responsibility relating to this subject are being carried out in developed countries.
Automated defibrillators guide and assist users through audio and visual commands. Globally, the average time taken by an ambulance to reach the scene is between 10 and 12 minutes and during this period each minute is vital. Cerebral death begins at around three minutes in a person who is suffering sudden cardiac arrest and the chance of survival after 10 minutes is very low.
What is the Importance of Early Defibrillation?
Defibrillation is a part of basic life support. It is a lifesaving intervention that delivers an electric shock to the heart through the defibrillator, to stop irregular myocardial rhythm and restore the heart’s normal functioning. Defibrillation applied for 20-30 seconds in VF or VT without a pulse is almost entirely transformed into sinus rhythm. Each minute’s delay reduces the chance of survival by around 10%. When there is a delay of 10 minutes, chance of survival is almost 0%. After the development of cardiac arrest with VF or VT without a pulse, mortality increases by 7-10% per minute until defibrillation. The patient’s chance of survival declines when defibrillation is initiated late, and only 1 out of 250 patients on average can be saved when cardiopulmonary resuscitation and defibrillation is initiated after the first 10 minutes of cardiac arrest.
Time / Success Rate for Normalization of Cardiac Rhythm using Defibrillation
As shown in the figure, each passing minute reduces the patient’s chance of survival. According to research, the chance of survival is almost nil after 10 minutes.
Is it possible that I could accidentally hurt a patient using a RitimPort RTM3001 AED automated defibrillator device?
NO! As long as you follow the audible commands of the AED (automated defibrillator). An automated defibrillator device is designed to apply defibrillation only when necessary owing to its reliable ECG analysis.
Is it possible that I could hurt myself or anybody else around me with a RitimPort RTM3001 AED?
NO! As long as you follow the audible commands of the automated defibrillator (AED). As a fundamental principle, when the automated defibrillator device recommends the delivery of a shock (defibrillation), prior to defibrillation ensure that nobody is touching the patient and everybody is safe. The RitimPort RTM3001 AED will audibly warn you when it is safe for you to touch the patient.
Can I use a RitimPort RTM3001 AED Automated Defibrillator on infants or children?
YES! But you do need to use pediatric pads for patients between 1 and 8 years old.
0-1 year of age – Defibrillation is not recommended.
1 – 8 years of age – Use pediatric pads for patients who weigh less than 25 kg
8 years or older – Use adult pads for patients who weigh more than 25 kg
If you already have a RitimPort RTM3001 AED (automated defibrillator), is there anything to which you should pay particular attention?
1- Your RitimPort RTM3001 automated defibrillator has periodic self-test feature. In the event of it detecting a malfunction or negative situation, the device alerts the operator with a red warning sign. Consequently, you should always keep your RitimPort RTM3001 defibrillator somewhere where you can see the indicator and be able to easily access the device whenever required.
2- Make sure your defibrillator is regularly serviced and calibrated. Please use only authorized RitimPort services for these processes.
3- Make sure that all disposable pads, accessories and batteries are original. Otherwise, your device may malfunction, and this could cost a life.
4- To ensure the device is always ready for use, have the software of your RitimPort RTM3001 AED Automated Defibrillator updated by an authorized service provider according to current resuscitation guidelines.
Where should automated defibrillators be made available?
Primary care clinics
Patient transfer ambulances
All amateur and professional sports clubs
Airports and airplanes
Places of worship
Train, bus and subway stations
Countryside and villages
Police vehicles and fire trucks
CPR keeps you alive, electroshock resuscitates your heart!
Assoc. Prof. Dr. Mutlu VURAL
Bağcılar Training and Research Hospital Cardiology Clinic, ISTANBUL / TURKEY
It is estimated that on average 100,000 people die in Turkey each year due to sudden cardiac arrest that occurs outside a hospital. As witnesses hesitate to call 112 and initiate basic life support, most of these incidents result in death. The fact that automated defibrillators (AEDs) are not commonly available in the public space in Turkey is another factor that has an impact on such a high mortality rate.
It is accepted that the five or six people out of every 10 who experience cardiac arrest outside a hospital and eventually die, lose their lives due to members of the public consciously choosing not to (or being unable to) intervene. In sudden cardiac arrest, the chance of survival declines by 10% with each minute, brain damage begins after only three minutes, and unless he or she receives medical attention, the person can be considered dead after 12 minutes. Unfortunately, in this context, the survival rate in Turkey is less than 1%. This is due to only health professionals intervening in such incidents; the first aid awareness of the society being low; there being no obligation to carry AEDs and ambulances taking an average of 10 minutes to reach the patient in city centers and 30 minutes in the countryside. On the other hand, the chances of survival for a person experiencing cardiac arrest outside hospital is accepted to be 38% when there is an AED and someone who knows how to apply hands-only CPR. Nowadays, in countries where first aid awareness is higher and AEDs have become prevalent, survival rates are around 10% in both urban and rural areas. The aim of developed countries is to establish stronger cooperation under a legal guarantee between society and the emergency health services in order to raise this figure to the order of 50% in the coming years and, as a result, saving thousands more lives.
While calling 112 (emergency call) and initiating basic life support are the first two links in the chain of saving a live, Automated defibrillators developed for delivering electroshock to the patient by a member of the public before the ambulance arrives is accepted as the third link. In many countries, particularly in the United States and Britain, from their childhood citizens are trained through public service information on how to apply CPR (1,2). At first aid courses, such as
www.cprtoday.com, which is supported by the American CNN news network, first aid training is provided and certificates may be given. When the hands-only CPR taught in these courses is applied to a patient who is in cardiac arrest, brain damage commences after 20 minutes rather than three. As cell death in the vital organs is delayed and the heart remains in ventricular fibrillation for a longer period (as cardiac asystole is delayed) when hands-only CPR is initiated early, the possibility of resuscitating the heart in the ambulance, by applying electroshock using the defibrillator, also increases.
Many, especially the Heart Project, have voiced the fact that thousands of lives could be saved if hands-only CPR training were to be provided in Turkey. CPR not only maintains blood circulation by compressing the heart between the chest and vertebral column, but also ensures breathing at around 250 ml. When chest compression is stopped, the sternum rises, the heart is filled with blood and 250 ml of air spontaneously enters the lungs. In other words, through hands-only CPR, apart from maintaining blood circulation, some artificial ventilation also takes place spontaneously (Figure 1). Since blood is relatively well oxygenated, particularly in the very first minute of sudden cardiac arrest, it is recommended that hands-only CPR is initiated within 30 seconds. As artificial respiration is no longer recommended in some of the community-based first aid guidelines, the use of artificial respiration is gradually diminishing.
The project for the first online hands-only CPR training course in Turkey, developed within the context of the Heart Project, brought me the Golden Stethoscope IT-Friendly Doctor Award granted by the Healthcare Information Technologies Association. Through the Heart Project, we believe that in 10 years 10 million and in 20 years 30 million people will learn hands-only CPR, eventually saving 20,000 lives per year (3,4). In view of the fact that in terms of survival rates, the aim of developed countries is to set a higher standard – in the order of 50% – in the coming years, even though their current level of 10% is more than 10 times greater than that of Turkey, it is clear that the Heart Project is a critically important mission for our country. After the Ministry of Health amends the relevant regulation, with the support of sponsors, we are planning to launch the first free of charge, certified online CPR course in Turkey, under the leadership of the Stay Alive Association.
Years ago, Heimlich defined a maneuver that people could learn, it being impossible for healthcare professionals to reach each case of complete upper respiratory tract obstruction immediately. It is estimated that with this community-based first aid method, called the Heimlich maneuver, throughout the world 50,000 lives are saved every year. Sudden cardiac arrests are a medical emergency too. When people wait for an ambulance to arrive without intervening, the first valuable minutes, which are worth their weight in gold, are lost and medical intervention by paramedics, after 12 minutes, could become nothing more than a “social indication”. As with the case of the Heimlich maneuver, teaching “hands-only CPR” to the society could save thousands of lives. Hence, with the Heart Project, we teach our society how to use CPR and invite our people to save lives when they witness sudden cardiac arrest.
Sudden cardiac arrest is still a huge “paradox” in our country. Let’s examine two concrete examples: Recently, there was a breaking news story from Bursa. City surveillance camera footage of a citizen being resuscitated was made public on visual and print media, published in papers and broadcast on TV under headings such as “coming back to life second-by-second”. It was seen in this news story that paramedics resuscitated the patient with the appropriate application of CPR and electroshock at the scene, which was in turn referred to as “coming back to life” by news desks. However, only in a few days, it turned out that this was not the reality. Even though the man was resuscitated, we ascertained that he never woke up and in fact he died a few days later. He had suffered brain damage, due to nobody intervening during those golden first minutes. The other example was reported as, “the man got off the bus, collapsed and died instantly”. In fact, this man died 12 minutes after he collapsed, as he did not receive deliberative first aid from the community. For these reasons, we decided to carry out sudden cardiac arrest awareness studies in our society. Our public service announcement numbered 2013/613 was approved by Radio and Television Supreme Council and broadcast as a preferential advertisement. The lyrics for the song “Stay Alive” were written. The song addressed the theme of sudden cardiac arrest and the sequence of how to save lives. We are planning both to increase awareness by featuring this song on TV networks and to have people practice CPR on 20 dummies by following the rhythm of the song, which is 100 beats per minute. Applied awareness studies that were started in Istanbul this year are planned for the rest of Turkey next year.
In Turkey, a patient who collapses on street due to cardiac arrest is thought to have died immediately; hence, nobody intervenes. We need to teach our society that a person in such a situation is certainly not dead in the first three minutes, that they may delay cell death by starting hands-only CPR in the first minute and that, by resuscitating the patient with an electroshock via an automated defibrillator AED, they may save a life. Our believe is that by teaching the public how, when these golden minutes are missed the resuscitation of the patient would be impossible, even if paramedics were able to give successful CPR, as the brain cells would have already been damaged, could encourage more people to learn first aid. Furthermore, following the examples set by countries that have achieved success in this field, making first aid certificates obligatory for employment, enforcing regulations on making Automated Defibrillators available, including the use of Automated Defibrillators in first aid training curricula, enacting protective laws which render individuals with automated defibrillator certificate immune from prosecution when they intervene to help a stranger and having well-informed people give first aid and operate AEDs, should be promoted.
In addition to increasing the number of people trained on hands-only CPR, as in developed countries, it is possible to save thousands of people who die due to sudden cardiac arrest by enacting laws that protect those who render first aid and making Automated Defibrillators much more prevalent in communal areas.
Image 1. In hands-only CPR, active compression is applied by the hands, in the middle of patient’s sternum, like a piston and when the compression is released, passive relaxation occurs. While blood is pumped out of the heart when compression is applied during CPR and the patient exhales around 250 ml of air, during relaxation the heart is filled with blood and the patient inhales around 250 ml of air.
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