You’re probably wondering how to use an AED for a reason. You hope it’s never necessary, but the reality is that sudden cardiac arrest can happen to anyone. In such a moment, you don’t want to stand by helplessly. You want to act.

In this step-by-step guide, we explain how to use an AED. Or as we at Pulse4all prefer to say: deploy it. From the moment someone collapses until the handover to medical personnel.

Suddenly someone collapses. What do you do first?

Aligned with guidance from the Resuscitation Council UK, you should act as follows: 

• Ensure a safe environment for yourself, the victim, and others. 
• Check if the person responds. Grasp their shoulders and ask if they are okay.
• No response? Call 999 immediately or have someone else call 999. If you’re not alone, have someone fetch an AED as quickly as possible. 
• While you wait for the call to be answered, lay the victim on their back. Tilt the head back by placing one hand on the forehead and lifting the chin. This opens the airway.
• Check breathing for a maximum of ten seconds.
  Note: Someone may appear to breathe but barely does, or they may gasp for air, groan, or sigh. They might even breathe very noisily, heavily, or with difficulty. This is not normal breathing and is common during cardiac arrest. The dispatcher will be able to help you recognise this. 
• Start CPR immediately if someone is not breathing normally or if you are in doubt.
  • Place the heel of your hand on the center of the chest and put your other hand on top.
  • Interlock your fingers and keep your arms straight.
  • Press the chest down 5 to 6 cm at a rate of 100 to 120 times per minute.
  • Give 30 chest compressions.
  • If trained, open the airway and give two rescue breaths. Keep interruptions to chest compressions as short as possible.
  • Continue alternating 30 compressions and two rescue breaths. 

If you’re unable to get an AED, because you’re alone or there simply isn’t one nearby, it’s important to continue CPR until emergency services arrive.

But in this scenario, you’ve managed to get an AED. What do you do now?

• Use the AED as soon as it is available
• Turn on the AED, usually by opening the lid or pressing a button.
• Follow the instructions from the AED. 
• Apply the electrodes to the positions indicated in the instructions. There are usually clear diagrams.
  • Expose the chest. Use scissors to cut open clothing or a razor to shave a very hairy chest if necessary. Remove the bra if necessary to place the pads on bare skin.
  • If possible, have someone continue compressions while the electrodes are being placed.
• Continue to follow the AED’s spoken/visual instructions. Some AEDs, like the Philips models, adjust instructions to the user’s pace.
• The AED will analyze the heart rhythm. Make sure no one touches the victim.
• The AED will indicate if a shock should be delivered. With a semi-automatic AED, press the button when prompted. A fully automatic AED will count down and deliver the shock automatically.
• Do not touch the victim after the device advises a shock.
• After the shock, immediately resume chest compressions and follow the AED’s instructions. Many AEDs also guide you through CPR. Continue following the instructions until emergency services arrive. 
• No shock advised? Continue CPR until emergency services arrive.

Prefer to see how to deploy an AED? Check out this video where we explain it step by step using a Philips FRx.

Why should you deploy an AED?

During cardiac arrest, there is no effective blood circulation. As a result, the brain and other vital organs no longer receive oxygen. If you do nothing, permanent brain damage is likely after just five minutes. After more than eight minutes, the victim is likely to die. 

Although ambulances try to arrive as quickly as possible, there’s a chance they won’t make it in time. In the United Kingdom, it has been agreed that the average response time for emergency incidents should be under seven minutes, and that 90% of ambulances should arrive within fifteen minutes. However, every minute without help significantly reduces the chances of survival.

That’s why it’s crucial to start chest compressions immediately. This keeps blood flowing through the body and temporarily supplies oxygen to the organs.

But in the case of ventricular fibrillation, a common cause of cardiac arrest where the heart rhythm becomes chaotic, only an AED can restore the heart to a normal rhythm.

Chest compressions and rescue breaths are essential to buy time, but they cannot make the heart beat normally. The sooner you deploy an AED, the greater the chance that someone will survive cardiac arrest without lasting damage.

Is deploying an AED always safe?

When you suspect cardiac arrest, you can usually connect an AED without any problem. However, there are a few situations where some people wonder if it’s truly safe. Below, we discuss those.

Can an AED cause harm if a shock isn’t needed?

No. Of course, you usually don’t know exactly what’s wrong with the victim. There could be an issue that an AED cannot fix. But an AED will never cause harm in that case. The AED always analyzes the heart rhythm first. A shock is only delivered if it’s necessary. Want to read more about the different types of cardiac arrest and whether an AED helps in those cases? Click here.

What if someone is still conscious and/or breathing normally?

Then there is no cardiac arrest, and connecting the AED is pointless.

Can you safely deploy an AED on a child?

Yes. However, if you need to resuscitate a child younger than eight years old, the Resuscitation Council UK recommends deploying an AED with a child mode if possible. If such an AED is not  available, you can still deploy a standard AED for adults. That is always better than not deploying an AED at all. You can find more information about deploying an AED on a child here.

Can you safely deploy an AED on someone with a pacemaker or ICD?

Yes. If someone has a pacemaker or ICD, you can safely deploy an AED, as emphasized by the British Heart Foundation. Some AEDs, including Philips models, automatically detect pacemaker signals.

Is an AED safe in the rain or when the victim is lying in a puddle?

Yes. According to the Resuscitation Council UK, you can safely deploy an AED in such a situation. This is because the current flows between the electrodes and does not come into contact with the puddle. However, make sure to dry the victim’s chest thoroughly before applying the electrodes so they stick properly.

Is a metal surface safe?

Yes. According to the Resuscitation Council UK, a metal surface does not pose a problem.

Are there other safety risks?

It’s always a priority to ensure that you and the victim are in a safe location before using the AED. If you are in a place where you and the victim are not safe, such as a fire hazard area, it’s important to leave that location first.

Conclusion

When you need to deploy an AED, it’s best to know what’s involved. You now know that an AED is not only essential but also simple and almost always safe. When the time comes, you surely won’t hesitate!

Want to prepare further for an emergency? Check out one of our other articles for more essential information about heart safety.