Appendix N
Automated External Defibrillator
/Procedural order
A.Purpose
The purpose of this Procedure Order is to establish a protocol for the use of the Powerheart Automated External Defibrillator (AED) and to assist in the care of the Sudden Cardiac Arrest (SCA) victim.
The AED is designed to detect problems during use and will guide you through corrective actions. If you get a trouble shooting message, stay calm and follow the AED voice instruction.
B.Training Requirements
Any employee that is expected to provide emergency care to a patient of SCA will be certified in CPR and AED use. This training will conform to the Medic First Aid Plus Programs or another nationally recognized training organization.
C.Indications for Use
1.The Powerheart AED should be used only on a patient who is unresponsive/not breathing and is eight (8) years old or greater.
a.Apply the Powerheart AED if victim patient is unresponsive, non-breathing, and eight years old or greater.
b.Apply the Powerheart AED with caution if patient has a nitroglycerin patch on chest (remove patch carefully, then apply AED, or implantable pacemaker (pacemaker may interfere with rhythm analysis; do not place electrodes directly over pacemaker)
D.Procedure
1.Assess scene safety
a.Is the scene free of hazards?
b.Rescuer makes sure there are no hazards. Some examples are:
(1)Electrical dangers (downed power lines, electrical cords, etc.)
(2)Chemical (hazardous gases, liquids or solids, smoke, etc.)
(3)Harmful people (anyone that could potentially harm you)
(4)Traffic (make sure you are not in the path of traffic)
(5)Fire or flammable gases (medical oxygen, cooking gases, etc.)
2.Apply the Powerheart AED if patient.
- Determine if patient is unresponsive, non-breathing, and eight (8) years old or greater.
Apply the Powerheart AED with caution if patient has:
(1)Nitroglycerin patch on chest –(remove nitroglycerin patch carefully using glove hand. Remove any medication patches if present before pad placement, and then apply Powerheart AED).
(2)Implantable pacemaker – (pacemaker may interfere with rhythm analysis. Do not place electrodes directly over pacemaker.)
(3)Stay one (1) inch below excessive chest hair. If required for proper
Defibrillation pad adhesion, any excess hair on patient’s chest may be
Shaved with a prep razor supplied in the kit. A smooth shave is not
Required.
3.Open lid – opening the lid “turns” on the Powerheart AED
4.Follow Voice prompts
a.Place electrodes, removing any metal piercing, which are located on the chest and brassiere from female subjects – Powerheart AED says “Place electrodes on patient’s bare chest.”
b.Analyze rhythm – Powerheart AED says “Do not touch patient. Analyzing rhythm.”
c.Shock advised – Device charges Powerheart AED says “Shock advised. Charging.”
d.Delivers Defibrillation Pulse – Powerheart AED says “Stand Clear! Push flashing button to deliver shock.”
(1)The rescuer will state, “clear” and make a visual head to toe check of the patient making sure that he/she and any other rescuers are “clear” of contact with the patient. Once this is accomplished, the rescuer will press the “shock button” to deliver a defibrillation pulse.
e.Analyze/Charge/Pulse
(1)After the first defibrillation, the Powerheart AED will reanalyze the patient’s heart rhythm. Powerheart AED says “Do not touch patient. Analyzing rhythm.”
After analyzing AED will direct you to begin CPR or deliver a shock.
It is safe to touch patient. Perform continuous CPR of 30-2 (chest
Compreressions-breath), unless the AED directs you to stop.
(2) If at any time during this cycle the Powerheart AED detects a heart
rhythm that does not require defibrillation, the voice prompt will say
“Check for signs of circulation. If no circulation, start CPR.”
(3) Remember that the Powerheart AED will not advise to defibrillate all
patients without a pulse. Some cardiac rhythms do not respond to
defibrillation. Call 911 or the local emergency access phone number at
this time, if not already done.
f.Rescuer gives CPR for two minute – or until the AED tells you to stop.
g. Repeat analyze/charge/defibrillation pulse
After two minute of CPR, Powerheart AED says “Do not touch patient. Analyzing rhythm.”
(1)If the cardiac rhythm is shockable, the Powerheart AED will guide the rescuer through another one (1) defibrillation pulse sequences, followed by two (2) minutes of CPR. This sequence should continue until:
(a)No shockable rhythm is detected, or
(b)The electrodes are disconnected, or
(c)Until ambulance personnel arrive on the scene.
h. Patient converts to a Non-Shockable Rhythm
If at some point during the rescue , the patient converts to a heart rhythm that
does not require defibrillation, Powerheart AED will advise you what to do.
(1) At this point, call 9-1-1 or the local emergency access phone number if
not already done.
(2)If the patient regains consciousness, make them as comfortable as possible until ambulance personnel arrive on the scene.
E.Medical Direction
1.A certified physician shall provide medical direction for the Lafourche Parish Sheriff’s Office. Medical direction shall include the following items:
a.The physician’s name
b.Physician’s signature (to be kept on file).
c.Development and review of policies and procedures defining the standards of patient care and utilization of the Powerheart AED.
d.Review of response documentation and rescue data for all uses of the Powerheart AED.
e.Oversight of the initial and continuing Powerheart AED training.
f.Provide advice regarding the medial care of those in need of such care.
F.Quality Assurance
An Automated External Defibrillator Reporting form shall be completed for each use of the Powerheart AED. The program coordinator and the medical director should review this form. Additionally, the rescue data should be reviewed for appropriate treatment.
G.Basic Maintenance
1.Weekly – Check the status indicator to ensure it is green. When the indicator is green, the unit is ready for a rescue. If the indicator is red, refer to the trouble-shooting guide in your user’s manual.
2.Monthly - The Powerheart AED’s should be opened once a month for the system to go through a diagnostic check.
3.Annually – The annual maintenance is performed to confirm that the Powerheart AED’s Rescue Ready diagnostics are functioning properly and verify the case and accessory integrity. See “Required Maintenance” section in your user’s manual for proper annual maintenance procedure.
H.Reporting – the Automated External Defibrillator Reporting Form shall be completed on all uses of the Powerheart AED.
Note: All Lafourche Parish Sheriff’s Office personnel shall be certified on the operation, policy, and procedure of the AED and CPR every two years. The Lafourche Parish Sheriff’s Office Training Division shall be responsible for the re-certification and training of personnel.
1