A defibrillator is used in cases where a patientís heart has stopped beating. It has to be used within minutes of the attack or the patient may not recover. The first thing that the medical staff and paramedics called to the scene have to do is check for a pulse. If a patient has a pulse, no matter how weak, a defibrillator should never be used. When you start to use it, you have to apply the pads to the patientís bare chest. You need to check for jewelry, patches or anything else that might interfere with the defibrillator. Then you plug in the pads connector to the defibrillator and announce for anyone close to the patient to stand away. Make sure no one is touching the patient. If the shock waves restart the heart, you do not have to do any more shocks. Continue to do as the machine tells you until you can find a pulse or all efforts to resuscitate the patient have failed.
The portable automatic defibrillator that paramedics bring to a scene with them and the ones that are available on airplanes and in airports contain a microprocessor inside the defibrillator interprets (analyzes) the victim's heart rhythm through adhesive electrodes. The computer analyzes the heart rhythm and advises the operator whether or not a shock is needed. The electric current is delivered through the victim's chest wall through adhesive electrode pads.
With such a machine, the operator would be advised that shock is not necessary if there is a pulse. Therefore there is no chance of harming a patient since the defibrillator will detect the pulse even if you cannot find one by touching the arteries. There is also a visual text that you can read to get the proper instructions if you are operating the defibrillator in a noisy area and are unable to hear the instructions. CPR is necessary along with the defibrillator because it provides some circulation of oxygen rich blood to the victim's heart and brain. This circulation delays both brain death and the death of heart muscle. CPR buys some time until the AED can arrive and also makes the heart more likely to respond to defibrillation.
You donít need to remove the electrode pads from the patientís chest when you want to resume CPR. The pads remain on throughout the resuscitation and until the patient is transferred to advanced care providers such as the paramedics. If the pads are in their correct locations on the passenger's chest, they will not interfere with proper hand placement or compressions. When doing compressions, you do need to make sure the cable is not under your hands. You will have to remove some of the patientís clothing to use the defibrillator because the device has to be placed directly on the skin.
When the patient resuscitates and has a pulse, you still need to keep the electrodes on the chest, just in case they may be needed again. It is not unusual for a patient to revive and then suffer another attack of ventricular fibrillation soon after recovering from the first one. The device will monitor the heartbeat and should be left in place until a doctor arrives or the patient is in the hospital.
The electrodes have to be attached to a clean dry chest. Electricity has to flow from one electrode to the other on the chest and if there is any dirt or sweat, it may interfere with this operation and cause the electricity to move across the chest rather than through it. If the surface the patient is lying on is wet, you just have to make sure the patientís chest is dry and that the electrodes do not come in contact with the wet surface.
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