An automatic external defibrillator (Life-Point mPLUS AED automatic external defibrillator) is a lightweight and portable medical device that delivers electroshock (defibrillation) to the heart through the chest via pads. This shock stops the irregular cardiac contractions for a very short period of time, allowing the heart to return to its normal contractions. Sudden cardiac arrest leads to cardiac dysfunction. Unless the shock is delivered in a very short time period, this could lead to death.
The most common form of sudden cardiac arrest is ventricular fibrillation, which is rapid and asynchronous cardiac rhythm. When ventricular fibrillation occurs, the heart should immediately be defibrillated, as the patient’s chance of survival decreases by 10% every minute.
Why is the Life-Point Automatic External Defibrillator Important?
Life-Point mPLUS AED automatic external defibrillators allow for the application of defibrillation, in cases where it is necessary, until paramedics arrive, because automatic external defibrillators are not only lightweight and portable devices, but they can also be used without the help of a medical specialist.
What Are the Advantages of Life-Point mPLUS Automatic External Defibrillators with Display Monitors?
The only difference with an automatic external defibrillator that has a display monitor is that it makes it possible to see information, such as the form of ECG waves of the patient, the time elapsed, visual images of audible commands, the number of shocks delivered etc. In cases where automatic external defibrillator with display monitor are used by healthcare professionals, the device provides much more detailed information on the patient, which assists the specialists in administering medical treatment.
What is a Heart Attack?
A heart attack (myocardial infarction) occurs when a part of the cardiac muscle dies (is permanently damaged) due to insufficient blood flow to that part (often because of the complete blockage of a coronary artery).
What Is the Difference between Myocardial Infarction and Sudden Cardiac Arrest?
Basically, myocardial infarction occurs when a part of the cardiac muscle dies or gets permanently damaged because of insufficient blood flow. Sudden cardiac arrest, on the other hand, is a transformation in cardiac rhythm from normal to abnormal.
Although many would be surprised to learn, throughout the world more people die because of cardiac arrest than the total number of deaths due to diseases such as breast cancer, AIDS and lung cancer.
Who Are At Risk of Sudden Cardiac Arrest and What Are the Reasons?
Contrary to popular belief, people of all ages, sex and race are at risk of sudden cardiac arrest; however, certain groups, including the following, are at greater risk:
Males over 40 years of age
People with Diabetes
People who do not exercise enough
People who have stress
People with high cholesterol
People with a history of cardiac diseases
An article by Esra Boğazlıyan and published in the HaberTürk Newspaper on 16.08.2014
The death of a person who had heart attack at a shopping mall in Küçükçekmece, due to a failure by anyone to intervene, has brought first aid services at shopping malls into question. Well then, what kind of emergency equipment should a shopping mall have? What kind of measures should be taken to avoid losses in emergencies? We asked these questions to someone who has the answers, Prof. Dr. İbrahim İkizceli…
As you may recall, I brought up the event that had occurred at a shopping mall in Küçükçekmece the previous day. Someone who had a heart attack passed away as he did not receive immediate treatment. Following this unfortunate event, I opened the debate with a question about the problem of first aid in shopping malls, which are visited by thousands of people everyday. Our investigations revealed that while some shopping malls in the city, of which there are about 100 of various sizes, have fully-equipped emergency teams, others don’t. Legal experts, on the other hand, admit that there is no regulation concerning first aid services in shopping malls, while pointing out that it is the constitutional responsibility of the business operators. In other words, they stated that even though there is no law or regulation on the subject, shopping malls are legally obliged to have health units, medical personnel or, at the very least staff who have training in first aid responses. The possible outcome of a lack of emergency response at a shopping mall has already become evident with the unfortunate event in Küçükçekmece, but what kind of emergency response equipment should shopping malls have? What kind of measures should shopping malls take to keep the patient alive when cases occur such as heart attacks, epileptic seizures or, as happens quite frequently with children, foreign body obstruction of the airway? Our health editor Ceyda Erenoğlu put these questions to someone who has the answers: Prof. Dr. İbrahim İkizceli, Head of the Academic Emergency Department at Cerrahpaşa Faculty of Medicine of Istanbul University. Here are the answers İkizceli gave…
Let’s say you went to the shopping mall with your wife in order to buy a gift to your soon-to-be born grandchild. You are very excited and it is very crowded in there. While you are wandering around, your wife has a chest pain; she has sweats, and suddenly collapses.
In such a situation, if the security guard or a mall employee arrives at the scene with an automatic external defibrillator (AED), attaches the pads on your wife’s chest and makes the necessary intervention, following the instructions given by AED, your wife’s survival chance would increase by 90%. If this intervention is delayed, the chance of survival declines by 10% per minute.
AED is an electronic device that delivers an electroshock to the heart, and it can be used by anyone who had first aid training as it guides the operator with easily understandable audible instructions. In the past, devices that deliver electroshock to the heart could only be used in hospitals and only operated by doctors. In the 2000s, AEDs (automatic external defibrillator) were produced and are now being used by first responders, as the early application of electroshocks to the heart when a cardiac arrest occurs considerably increases the chance of survival. You don’t have to be a doctor or a healthcare professional to use an AED automatic external defibrillator; anyone who has completed a 16-hour first aid training course can easily operate these devices.
In crowded places, such as shopping malls, airports, bus terminals etc, the availability of individuals who have first aid training and who are able to use automatic external defibrillator AEDs, would minimize deaths and injuries due to health problems and accidents that may happen in these environments.
With events like sudden accidents, bleeding, cardiac arrest, foreign body obstruction of the airway, burns, electric shock, fainting, epileptic seizure etc, someone who had first aid training can make the required interventions, using the available equipment and tools, to keep the victim alive or to prevent the injury from getting worse until the paramedics arrive.
Foreign body obstruction of the airway occurs rather frequently, particularly in children, and can result in the child’s death within 3-to-5 minutes if the foreign body obstructs the trachea completely. Therefore, it would be useful for everyone, particularly for mothers, to know what should be done when a foreign object obstructs the airway, because in such situation, the foreign object can be removed with the Heimlich maneuver, which may in turn keep the child alive. Waiting for the paramedics to arrive in a situation like this would probably result in death. Throughout the world, the time for an ambulance to arrive on the scene is around 8-to-10 minutes on average and this is also the case for Turkey.
In crowded places like shopping malls, apart from the availability of people who have first aid training, first aid rooms with easy access for ambulances, can also be established. This should be a room where accident victims can relax, simple medical procedures can be carried out, and it should also be one that ambulance or paramedics can get to easily.
The First Aid Regulation issued in 2002 also states that “In all institutions and organizations one in twenty employees, and in businesses that are categorized as heavy and dangerous work, according to relevant legislation, one ‘first responder’ who has at least ‘Basic First Aid Training’ for every ten employees should be assigned by the center authorized according to this Regulation.” Considering shopping malls as a single business instead of a collection of separate businesses operating inside, they would be obliged to have one certified first responder per 20 employees.
Habibe Höcük Köylü – Çankaya İYEM
The Importance of the Use of Automatic External Defibrillator in Places of Business
Death is an inevitable phenomenon and one that will be experienced by all living creatures; however, there are vital practices, which should be performed in order to resuscitate a person, to keep her alive on the thin line between life and death. The most important of these practices is Basic Life Support (BLS). Basic Life Support involves crucial interventions such as CPR and mouth-to-mouth resuscitation performed on the scene by certified first responders. Unfortunately, in these kind of cases, unless BLS is initiated, it is impossible for the ambulance to reach the scene in time. In fact, even in the most advanced systems, the time for an ambulance to get to the scene takes a certain amount of time, i.e. 10 minutes on average. This period is crucial for the patient’s survival, and unless a first responder intervenes to resuscitate the patient in cases of failed cardiac and respiratory functions, it is unfortunately very rare that the patient is kept alive, even with the most well-equipped ambulance or hospital.
Cells need oxygen to live and the cells most sensitive and vulnerable to a lack of oxygen are in the brain. When there is a lack of oxygen, the brain can live for 4-to-6 minutes before brain damage kicks in. The brain death of a patient is complete in only 10 minutes. Even though this may take longer in some exceptional situations or in cold environments (such as freezing, drowning etc.), in cases of cardiac arrest the patient’s chance of survival is very low unless first aid is provided.
Besides cardiac arrest, what is called fibrillation in medicine, i.e. the disruption of heart’s electrical activity (in a nutshell, the failure of the heart to contract – thus, the inability to pump blood – despite the presence of minor electrical activities such as twitching and pulsation) also causes the failure of vital functions. In this situation, in addition to BLS, defibrillators (electroshock devices) must be used as a complementary tool. Defibrillators give very effective results, and they may ensure the cardiac resuscitation in minutes. Furthermore, automated versions of defibrillators used in ambulances and hospitals, which can be used safely at the scene, have been manufactured to assist first responders. Even though the chance of survival decreases by 10% with every minute, unless intervention takes place when there are no vital functions, defibrillators increase this chance twice. (Source: Heart and Stroke Foundation of Canada)
Although automatic external defibrillators are not commonly used in Turkey, extending their use, even making it compulsory to have AEDs available in crowded environments, such as places of work, subway stations, shopping malls etc., can be vital for reducing mortality. Used much more commonly in developed countries, automatic external defibrillators are mobile devices that can be kept in a cupboard in first aid stations, like fire extinguishers. Anyone who has a first aid certificate can operate these devices safely after taking an hour-long course. While these devices, also known as AEDs, can be rented by businesses where air circulation is high (such as construction sites, tourism facilities, movie sets etc.) for around $79 per month, more established and permanent businesses may choose to purchase them.
In order for a business to be fully prepared for emergencies, the number of certified first responders should be adequate, and the names and photos of these first responders should be put on the first aid section of the notice board, so everyone can get to know who they are. It would also be appropriate to keep the first aid kit and the stretcher, which would be used when giving first aid, in the same place. In addition to all these, it is essential to have the most important device, an automatic external defibrillator (AED), available at the first aid station. One should never forget that this device is the only lifesaver in cases of cardiac arrest, when it is impossible to go to the hospital and ambulances cannot immediately come to the scene.
Prepared By: Prof. Dr. Erdem YILMAZ. First Aid Academy
How Does the Automatic External Defibrillator Work?
Today, healthcare professionals use automatic external defibrillators (AEDs), as part of first and advanced life support. AEDs most important advantages are their portability and non-invasive application. Having AEDs available in highly crowded areas such as airports, airplanes, shopping malls etc. is mandatory in developed countries.
Including self-adhesive electrodes and a built-in system, which recognizes cardiac rhythm, automatic external defibrillator can identify shockable rhythms by defining the electrical activity of the heart with very high precision, at 100% for coarse VF and 92% for fine VF, guiding the operator accordingly to deliver a shock to the heart, in order to regulate rhythms, such as ventricular fibrillation and ventricular tachycardia without a pulse.
There are numerous studies showing that early defibrillation considerably increases the chance of survival. Early resuscitation and defibrillation (in 1-2 minutes) may increase survival chance by 60%. Unfortunately, unless there is intervention, the patient’s chance of survival decreases at around 7 to 10% per minute. The fact that every year 700,000 cardiac arrest cases occur in Europe alone highlights the importance of early resuscitation and defibrillation.
According to the structure of the electric current they generate, AEDs are defined as monophasic and biphasic. Biphasic AEDs (automatic external defibrillator) can generate the same impact as monophasic AEDs by delivering a lower intensity electric current. Hence, these days the use of biphasic automatic AEDs is much more prevalent. Moreover, there are automatic and semi-automatic types of AED defibrillators, in terms of their technical setup. The main difference between a full and semi-automated AED defibrillator is that the former can deliver the electroshock without waiting for a further command from the operator when it identifies the shockable rhythm. With semi-automated defibrillators, in turn, the electroshock is delivered after the operator presses a button.
How to Use an Automatic External Defibrillator ?
AED defibrillators have two self-adhesive pads, on which the words “Sternum” and “Apex” are usually written. The “Sternum” pad should be attached below the right collar bone, on the 2nd or 3rd intercostal space The “Apex” pad should be attached on the left-hand side of the victim’s chest, below the 5th intercostal space. Even if the AED pads do not have these names written on them, each pad will have visual warnings on where to place them.
While attaching the pads, you should first ensure that the areas to which each pad will be attached are dry; wipe the surface with a dry towel if needed. If there are too many hairs on the surface where the pads will be placed, shave the surface quickly before attaching the pads. Furthermore, while AED is analyzing the rhythm, devices such as mobile phones or handheld radios should be kept at least 1 meter away and preferably turned off. Otherwise, these devices may cause the AED automatic external defibrillator to misdetect the rhythm.
Pediatric pads should be used on children younger than 8 years old and/or lighter than 25 kg. The use of AEDs on children younger than 1 year of age is usually not recommended.
What are the Intervention Steps for Automatic External Defibrillators?
1- Check the patient’s state of consciousness. (Shake the adult or child gently by the shoulders and ask if they are okay and whether they can hear you.)
2- Check the patient’s mouth and after making sure that there is nothing inside, pull the head backwards, lifting the chin slightly upwards to open the airway.
3- Check the patient’s chest movements when the airway is open; listen for breathing and feel the warmth of the breath on your cheek. Evaluate the patient for 5 to 10 seconds by using this approach called look, listen and feel.
After checking respiration, if the patient is not breathing, healthcare professionals should also assess blood circulation. If the patient has circulation but is not breathing, one rescue breath per 5-6 seconds should be given and the patient’s pulse should be checked every 2 minutes. If there is no circulation, the procedure should continue from Step 4.
4- A) If the patient is not breathing, perform 2 rescue breaths, each for 1 second, until the patient’s chest rises, and start to give 30 compressions placing the heel of your hand over the center of the person’s chest or on the lower half of the sternum. The target rhythm of CPR is 100 compressions/minute, and the chest should be compressed up until 1/3 of its lateral section.
B) If the patient is breathing, immediately place them in the coma position.
5- Continue basic life support, applying 2 rescue breaths and 30 compressions each time. After attaching the automatic external defibrillator AED’s electrodes in the appropriate positions, switch on the device. The device will first give an audible warning before starting to analyze the rhythm, while asking you not to touch the patient.
6- A) If the defibrillator finds a shockable rhythm, it asks you not to touch the patient and to press the shock button to deliver an electroshock to the patient (fully automated external defibrillators deliver the electroshock automatically without pressing the button). After this step, follow the audio/visual guidance of the device.
B) If the defibrillator cannot find a shockable rhythm, it asks you to continue giving 2 rescue breaths and 30 compressions.
7- Following the audible and visual warnings of the AED (automatic external defibrillator) in this way, continue until:
paramedics arrive at the scene,
the victim starts breathing normally,
you become exhausted.
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