Abbreviation AED The term "AED" comes from the English words "Automated External Defibrillator." An AED is a medical device that, by applying a current of appropriate energy to the heart, helps save lives in the event of cardiac arrest. The goal of defibrillation is to suppress the chaotic electrical impulses that flow through the heart and allow it to return to normal, regular rhythm. AEDs only qualify for defibrillation in cases of ventricular fibrillation (VF). VT can always produce a pulse, so manual defibrillation has the advantage in this case.
The market offers many AED models. Individual brands differ in more than just obvious aspects, such as size, weight, appearance, and features, but also in the lifespan of replaceable parts (batteries and electrodes), self-test frequency, heart rate analysis and electrical impulse charging speed, sealing level, and memory capacity. Despite these differences between models, all AEDs, without exception, are designed to restore cardiac function.
The AED consists of the AED main unit and electrodes. Once the defibrillator is activated, the device guides the rescuer through the lifesaving process, even if a shock is not indicated. Voice and audio instructions provide step-by-step instructions. During ECG analysis and defibrillation, do not touch the victim (the AED clearly indicates this with voice prompts). After analyzing the heartbeat, AEDs indicate whether a shock is necessary. If the patient does not require a shock, the defibrillator will not deliver a shock.
An AED is a device used to defibrillate ventricular fibrillation or pulseless ventricular tachycardia. A pulse of the heart's electrical activity is transmitted via two self-adhesive electrodes, then analyzed by a microprocessor, and the identified arrhythmia is communicated to the rescuer via voice and/or graphical prompts.
Basic equipment of AED defibrillators Contains adult electrode pads. Pediatric electrode pads are required for defibrillating children up to 8 years of age (up to 25 kg body weight). The defibrillator automatically recognizes pediatric electrode pads.
Some devices allow the AED pads to be reconnected without removing them from the victim's chest and connected directly to the clinical defibrillator. Others can achieve this using a special adapter. The adapter connects the pad plug to the connector on the clinical defibrillator. This is a practical solution that shortens rescue time and eliminates the need for an additional pair of pads.
AEDs have built-in memory cards that allow for the recording of defibrillation and ECG analysis, and also record the voices of rescuers and bystanders. In situations where a rescue operation needs to be recreated, the recorded data can be easily retrieved from a computer and the process tracked.
AED reliability is ensured by a self-test module. These devices automatically check the internal electronics, software, battery level, and pads at appropriate intervals. If the device detects an error during the check, it causes the indicator LED to illuminate or change color, and voice prompts are displayed when the device is turned on. This self-test function ensures that most AEDs do not require servicing. Maintenance is the responsibility of the user and involves replacing the batteries and pads at the appropriate time, as well as monitoring the status of the indicator LEDs.
To make operation as easy as possible and to assist the rescuer during resuscitation, some AED defibrillators have pressure force control (using special pads), others offer the possibility of First Aid training by switching the AED to training mode and using training pads.
An interesting solution is to place AEDs in cabinets equipped with a module that alerts emergency services about their use. Information about the cabinet being opened is sent to a server, where it is processed, and then automatic notifications are sent via text message or email to the appropriate users. The users typically stored in the system's memory are the emergency services and the unit supervising the defibrillator.
Ischemic heart disease (IHD) is the leading cause of death in Poland and worldwide. Sudden cardiac arrest (SCA) accounts for over 60% of deaths caused by IHD in adults. Annually, 38 per 100,000 people experience out-of-hospital SCA (regardless of the mechanism of cardiac arrest). The annual incidence of SCA due to VF (ventricular fibrillation) is 17 per 100,000 people, of which 10.7% survive to hospital discharge for all mechanisms and 21.2% for SCA due to VF.1.
In out-of-hospital cardiac arrest, early CPR and defibrillation (3-5 minutes after collapse) increase survival to 49-751 TP3T. Each minute of delay in defibrillation reduces the chance of survival by 10-121 TP3T.1.
What is the time it takes for specialist assistance to reach the patient?
- 4 minutes is the statistical time from cardiac arrest to the occurrence of irreversible changes in the brain
- 8 minutes is the average ambulance time in the city
- 15 minutes is the average time it takes for an ambulance to arrive outside the city
Statistically, Polish society is a perfect representative of European society. Each year, approximately 400,000 Europeans experience sudden cardiac arrest, of which approximately 350,000 occur outside of hospital. Out-of-hospital cardiac arrest can happen anywhere and can happen to anyone (on the street, at work, during exercise). The vast majority of SCAs occur at home. Fewer than one in ten people survive. Early CPR can result in a two- to three-fold increase in survival. However, only one in five out-of-hospital SCAs receives resuscitation. Increasing the frequency of resuscitation could save 100,000 people in Europe annually.
The 350,000 people mentioned above who suffer out-of-hospital cardiac arrests represent 1,000 deaths per day in Europe. That's equivalent to the deaths of two full planes each day. jumbo jet!
The number of deaths caused by cardiovascular disease is increasing year by year. In Poland, 46 out of every 10,000 people die, meaning that over 100,000 deaths are reported each year due to heart disease.2. Of the patients who suffer SCA outside the hospital, only 5% are saved.3.
“We strongly believe that if more people were trained in CPR (e.g. in airports, sports centers, hotels, etc.) and if more AEDs were placed at strategic points, sudden cardiac deaths could be reduced by 50%” says Professor Maaret Castrén, Karolinska Institutet, Sweden, Chair of the ERC3.
ANY BYSTANDER OF THE INCIDENT CAN USE THE AED. The State Emergency Medical Services Act does not specify the qualifications or education of a person providing first aid. Pursuant to Article 3, Section 7 of the Act is a set of actions taken to save a person in a state of sudden health threat, performed by a person at the scene of the event, including the use of medical devices and medicinal products available for general circulation.
Of course, medical devices must be approved for general circulation. Due to its simplicity of operation (the AED operator simply follows the device's instructions), the Automated External Defibrillator meets this criterion.
The new 2015 European Resuscitation Council (ECR) Guidelines clearly state that, in order to minimize the time to defibrillation in SCA victims, defibrillator use should not be limited to those who have completed training. AEDs can be used correctly without prior training; an AED course is not required to use them. However, there is nothing stopping you from taking advantage of the wide range of first aid training available, as each of them increases the efficiency, speed, and effectiveness of our actions.4.
1 data from the Polish Resuscitation Council Guidelines 2010.
2 Central Statistical Office data from 2014.
3 based on data from the Polish Resuscitation Council www.prc.krakow.pl
4 data from the European Resuscitation Council ECR Guidelines from 2015.
Aleksandra Sierpińska, PHU OLAMED Myszków
Part of the article „"Modern AED defibrillators, or who can become a rescuer?"”. To the Rescue, Magazine for Lifesaving Services. No. 6/2015, p. 52
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