automated external d fib ill tidefibrillation (()aed) · • automatic internal cardioverter...
TRANSCRIPT
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AutomatedAutomated External
D fib ill tiDefibrillation (AED)( )
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DAN AUTOMATED EXTERNAL DEFIBRILLATIONAutomated E t l
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Provider RegistrationExternal Defibrillation
Complete the following administrative paperwork
• Course Registration Form
• Statement of Understanding
• DAN Membership Form
• Other Administrative Procedures
• Introductions
• DAN Instructor and Staff
• DAN Provider Candidates
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DAN AUTOMATED EXTERNAL DEFIBRILLATIONAutomated E t l
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Course OverviewExternal Defibrillation
• Sudden Cardiac Arrest
• Providing Care for Sudden Cardiac ArrestProviding Care for Sudden Cardiac Arrest
• Skills Development Overview
• Legal ConsiderationsLegal Considerations
• Troubleshooting and Safety Considerations
• Maintaining an AEDMaintaining an AED
• What is Divers Alert Network?
• Skills Development SessionSkills Development Session
• Exam and Review
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Sudden Cardiac Arrest
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SUDDEN CARDIAC ARRESTSudden
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Sudden Cardiac ArrestSudden Cardiac Arrest
What Is It?
• In Europe each year 700.000 people die from SCA, leading cause for people older then 35
• Causes of sudden cardiac arrest include:
• Heart Disease
• Electric Shock
What's Happening?
• Healthy heart pumps oxygenated blood throughout the body
• Most common cause of Sudden Cardiac Arrest is ventricular fibrillation (VF)
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SUDDEN CARDIAC ARRESTSudden
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Ventricular FibrillationSudden Cardiac Arrest
• An abnormal chaotic rhythm
• Heart quivers – no organised rhythmHeart quivers no organised rhythm
• Only definitive treatment is defibrillation
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SUDDEN CARDIAC ARRESTSudden
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Ventricular FibrillationSudden Cardiac Arrest
There are several causes of ventricular fibrillation including:
• Electrical shock
• Cardiovascular disease
• Most common health problem in dive fatalities
• Cardiovascular disease medications are the most common drugs used by divers involved in dive fatalities
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SUDDEN CARDIAC ARRESTSudden
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DefibrillationSudden Cardiac Arrest
• The application of an electric shock across the heart muscle
• Resets the heart and allows it to begin beating normally
• Time is the key to surviving cardiac arrest:
• For every minute, chance of survival drops 7 to 10 percent
• Risk of brain damage increases
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SUDDEN CARDIAC ARRESTSudden
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Cardiovascular Disease and DivingSudden Cardiac Arrest
• Average age of divers is increasing
• Average age of DAN Members is increasing
• Average age of dive fatalities is increasing
• Cardiac problems make up about 12 percent of all dive fatalities
• Cardiac problems account for nearly 30 percent of the dive fatalities for divers over 35
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SUDDEN CARDIAC ARRESTSudden
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Warning Signs of Sudden Cardiac ArrestSudden Cardiac Arrest
Can happen without warning, but sometimes there are warning signs. They include:
• Heavy pressure or squeezing pain or discomfort in the centre of the chest behind the breastbone
• Shoulder, arm, neck or jaw pain and radiating discomfortShoulder, arm, neck or jaw pain and radiating discomfort
• Shortness of breath
• SweatingSweating
• Nausea and vomiting
• DenialDenial
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Providing CareProviding Care for
Sudden Cardiac ArrestArrest
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Chain of Survivalfor Sudden Cardiac Arrest
• The four links of the chain are:
Early Advanced Lif S t
Early A t
Early CPR
Early D fib ill ti Life SupportAccess to
EMSCPR Defibrillation
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What About CPR?for Sudden Cardiac Arrest
Cardiopulmonary resuscitation (CPR) still necessary for survival
• Keeps the body oxygenated
• Delays the onset of brain damage
• However, it cannot reset the arresting heart and allow it to begin beating on its own
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What About CPR?for Sudden Cardiac Arrest
Rescuers should provide CPR:
• Until AED is attachedUntil AED is attached
• After 1 shock
• After a no-shock advisoryAfter a no shock advisory
• If the device is unavailable
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Using an AEDfor Sudden Cardiac Arrest
• Doesn't change the way you respond to an emergency
• Use the same ABC’s
• Airway
• Breathing
• CPR (Circulation)
• Add a D for defibrillation
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Using an AEDfor Sudden Cardiac Arrest
• Start CPR according to adult BLS sequence
• If alone and AED is near, start withIf alone and AED is near, start with applying the AED
• When AED arrives:
• Switch on the AED: if more than 1 rescuer, continue CPR while this is carried out
• Place the unit near the patient's head on the patient's left side
U it ill t ti• Unit will prompt your actions
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Using an AEDfor Sudden Cardiac Arrest
• Attach the defibrillator pads
• They are marked to show proper placementThey are marked to show proper placement
• Take time to do this correctly
• Must make a good connectionMust make a good connection
• Bare the chest
• Cut away clothes, wetsuit or bra material, ifCut away clothes, wetsuit or bra material, if necessary
• Dry the chest, if wet
• Possibly shave off chest hair
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Using an AEDfor Sudden Cardiac Arrest
• Attach the pads to the AED (if needed)
• Some AEDs begin analysing automaticallySome AEDs begin analysing automatically
• Others require the user to press an analyse button
• Don't touch or move the patient during analysis
• State “I’m clear. You’re clear. All clear.”
• Unit will prompt you to clear the patient and deliver the shock
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Using an AEDfor Sudden Cardiac Arrest
• Make sure that nobody touches the victim when you push the shock button
• AED delivers one shock
• Continue as directed by the voice/visual prompts
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Using an AEDfor Sudden Cardiac Arrest
• AED unit may also determine no shock required
• Immediately resume CPR at the ratio 30:2Immediately resume CPR at the ratio 30:2
• Follow voice / visual prompts
• Continue to follow prompts until:Continue to follow prompts until:
• Qualified help takes over
• Victim starts to wake upVictim starts to wake up
• You become exhausted
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When EMS Arrivesfor Sudden Cardiac Arrest
• Report the care provided
• You may be asked to continue to provideYou may be asked to continue to provide care briefly
• EMS may attach their own defibrillator to your pads or may remove them andyour pads or may remove them and attach their own pads
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Skills Overviewfor Sudden Cardiac Arrest
• Scene Safety Assessment
• Initial Assessment with Basic Life SupportInitial Assessment with Basic Life Support
• BLS with Supplemental Oxygen (Optional)
• Providing Care with an AEDProviding Care with an AED
• AED Equipment Maintenance
• Emergency Assistance PlanEmergency Assistance Plan
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Scene Safety Assessmentfor Sudden Cardiac Arrest
Remember S-A-F-E
• S - StopS Stop
• A - Assess scene
• F - Find and secure first aid,F Find and secure first aid, oxygen and AED units
• E - Exposure protection
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Initial Assessment with Basic Life Supportfor Sudden Cardiac Arrest
• Remember SAFE
• Unresponsive?Unresponsive?
• Shout for help
• Open airwayOpen airway
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Initial Assessment with Basic Life Supportfor Sudden Cardiac Arrest
• Not breathing normally?
• Activate EMSActivate EMS
• 30 chest compressions
• 2 rescue breaths / 30 compressions2 rescue breaths / 30 compressions
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Basic Life Support with Supplemental Oxygen (Optional)for Sudden Cardiac Arrest
• Remember S-A-F-E
• Perform initial assessment
• If breathing, use:
• Demand inhalator valvePerform initial assessment (BLS)
• Provide supplemental oxygen as soon as it becomes available
Demand inhalator valve
• Non-rebreather mask
• If not breathing:as soon as it becomes available If not breathing:
• Provide rescue breaths using an oronasal resuscitation mask with anresuscitation mask with an oxygen inlet
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Providing Care with an AED (scenarios)for Sudden Cardiac Arrest
• Unresponsive
• Shout for help
• Not breathing normally?
• Send or go for AED and call EMS• Send or go for AED and call EMS
• Call EMS
• CPR 30:2 until AED is attached
• Attach the defibrillator pads
• Allow the AED to analyse heart rhythm
• Don't touch the patient
If shock required:
• Follow the AED unit's prompts
• Visually and physically clear the patient
• Say “Clear”
Administer shock• Administer shock.
• Resume CPR 30:2 for 2 minutes
• Continue as directed by the voice/visual prompts
If no shock required:o s oc equ ed
• Continue CPR 30:2 until the injured person starts to wake up, open eyes and to breathe normally
• Continue as directed by the voice/visual prompts
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AED Equipment Maintenancefor Sudden Cardiac Arrest
Follow manufacturer recommendations for periodic equipment check
• Check Battery – must have enough power for one complete rescue
• Run self test
• Check expiration date on supplies
• Stock up after use
• Defibrillator pads
• First aid supplies including gloves
• Clean resuscitation mask
• Reassemble unit and store ready for use
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Emergency Assistance Planfor Sudden Cardiac Arrest
Diver Information
• Name
General Information
• Emergency contact informationName
• Age or Date of birth
• Address
Emergency contact information (EMS, DAN)
• Initial contact phone number (Call back #)Address
• Emergency contact phone
• Current complaint(s)
(Call back #)
• Directions to nearest medical facilityCurrent complaint(s)
• Past medical history including current medication
• DAN phone numbers
• Other• Dive profile(s)
• Drug allergies
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Legal Considerations
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LEGAL CONSIDERATIONSLegal
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AEDs and the LawLegal Considerations
• In some countries, AEDs are classified as medical devices
• Regulations and administrative codes vary widely
• Check with DAN for more specific information for your area
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LEGAL CONSIDERATIONSLegal
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AEDs and the LawLegal Considerations
• In many countries there are Good Samaritan Laws
• No cases where lay rescuers have been successfully sued for providing care with an AED
• Protects rescuers who:
• Voluntarily provide assistance and are not legally obligated
• Expect nothing in return
• Are not grossly negligent
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TroubleshootingTroubleshooting and
Safety ConsiderationsConsiderations
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TROUBLESHOOTING AND SAFETY CONSIDERATIONSTroubleshooting
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Troubleshootingand Safety Considerations
• The primary reason an AED cannot analyse a heart rhythm is poor pad connection. Make sure:
• Pads are firmly attached
• Pads aren't damaged
• Pads are plugged in completely
• There’s no hair or moisture under the padt e pad
• Other considerations include:
• Stop all movement
• Do not touch the patient
• Check for a low battery
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TROUBLESHOOTING AND SAFETY CONSIDERATIONSTroubleshooting
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Safety Considerationsand Safety Considerations
Only attach an AED unit to a person that:
• Is unresponsiveIs unresponsive
• Is not breathing normally
Do not attach an AED Do not attach an AED to a responsive person
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TROUBLESHOOTING AND SAFETY CONSIDERATIONSTroubleshooting
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Safety Considerationsand Safety Considerations
• Move supplemental oxygen away
• Clear the patientClear the patient
• Remove the patient from standing water
• Safe to use around wet environments like a pool, boat or in the rain
• However, don't immerse it or spill liquid on it
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TROUBLESHOOTING AND SAFETY CONSIDERATIONSTroubleshooting
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Safety Considerationsand Safety Considerations
• Some people wear implanted devices such as:
• Automatic internal cardioverter defibrillators
• Pacemakers
• Place the pads at least one inch / 3 centimeters away from the implanted device
• AED’s and children:
• Standard AED’s are suitable for use in Children older than 8 years.
• For children between 1 and 8 years, use pedriatic pads or a pediatric mode if availablepediatric mode if available
• If not available, use the AED as it is.
• Use of AED’s not recommended for children less than 1 yearUse of AED s not recommended for children less than 1 year
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Maintaining an AED
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MAINTAINING AN AEDMaintaining an
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MaintenanceMaintaining an AED
• Follow manufacturers’ recommendations
• Check the status regularlyCheck the status regularly
• Check the batteries and all the supplies and spares in the kit
• They are all dated, so you need to make sure you have not exceeded any of those dates
• If available, make sure the spare PC card is in the unit and ready
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MAINTAINING AN AEDMaintaining an
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MaintenanceMaintaining an AED
Perform a Battery Insertion Test
• Remove the battery and then replace it
• The unit will perform an automatic self-test
• If the Battery Insertion Test fails, replace the battery
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What isDivers AlertDivers Alert Network?
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WHAT IS DIVERS ALERT NETWORK?What isDi Al t
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The Mission of DANDivers Alert Network?
• Divers Alert Network (DAN), a nonprofit organisation, exists to provide expert information and advice consistent with current medical literatureliterature
• Provides emergency medical advice and assistance for underwater scuba diving accidents, works to prevent accidents and promotes diving safetydiving safety
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WHAT IS DIVERS ALERT NETWORK?What isDi Al t
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The Mission of DANDivers Alert Network?
• Promotes and supports underwater diving research and education, particularly as it relates to the improvement of diving safety, first aid and medical treatmentand medical treatment
• Provides accurate, up-to-date, and unbiased information on issues of common concern to the diving public, and advocates for divers' concerns for diving safetyconcerns for diving safety
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WHAT IS DIVERS ALERT NETWORK?What isDi Al t
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DAN ServicesDivers Alert Network?
• DAN Medicine
• Diving Emergency Hotline
• DAN Membership
• DAN Travel AssistDiving Emergency Hotline
• Diving Medicine Information
• Chamber Assistance
DAN Travel Assist
• Alert Diver
• Dive accident and liabilityChamber Assistance
• DAN Training
Dive accident and liability insurance
• DAN Research
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DAN AUTOMATED EXTERNAL DEFIBRILLATIONCourse
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Course SummaryCourse Summary
In this course, you learned about:
• Sudden Cardiac Arrest
• Providing Care for Sudden Cardiac Arrest
• Skills Development Session
• Legal Considerations
• Troubleshooting and Safety Considerations
• Maintaining An AED
• What is Divers Alert Network?