What Are The Dangers Of A Defibrillator?
The wonder of modern medical technology is never more evident than when a life is saved. A medical emergency that would have ended in certain death or permanent injury years ago, can be turned around thanks to the design of innovative devices that can quickly render aid.
The Automatic External Defibrillator, or AED, is a portable electronic instrument that can detect life-threatening irregular heartbeats, also known as cardiac arrhythmia, and administer electric shocks, or defibrillation, to help the heart start beating regularly. Certain types of cardiac arrhythmia indicate a life or death situation, and the use of a defib can make all the difference. It is important to understand how AEDs work, their intended use, and what the dangers are.
Understanding What a Defibrillator Is and Is not
When you hear the term “automated external defibrillator”, you may think of an EMT in an ambulance or a doctor in an emergency room applying large pads to a patient’s chest and yelling, “Clear!”, before applying a charge.
While that is one type of defibrillator (a manual external one, at that), it is not an AED. “Automated” refers to the fact that AEDs are designed to automatically detect whether defibrillation is necessary. Unlike the manual versions, which should only be used by medical professionals, automated defibrillators are intended for use by laypersons who ideally have had some type of training, especially as part of basic first aid, first responder, or basic life support education.
AEDs are designed to respond to two types of heartbeat irregularities:
- Pulseless Ventricular Tachycardia, or V-Tach or VT: rapid, but regular heart rate due to improper electrical activity occurring in the ventricles of the heart.
- Ventricular Fibrillation, or V-Fib or VF: an unusual heart rhythm where the ventricles quiver instead of pumping the blood normally.
Both conditions can lead to brain damage, cardiac arrest, and death, if left untreated. With both conditions, an AED can shock the heart back into a regular rhythm to pump blood regularly.
Defibrillators are not effective for shocking flat line or a-systole patterns “back to life.” That usually requires the use of cardiopulmonary resuscitation (CPR) and some type of cardiac stimulant drug to establish a shockable rhythm, for which the AED can be used.
Tracking the History and Proliferation of AEDs
Use of a machine to apply a shock to jumpstart a heartbeat is a concept that dates to the late 19th century. In 1899, Swiss physiologists confirmed the restarting of a heart with electrical shocks through experiments on dogs.
In the 1930s, brothers Albert and Charles Hyman, respectively a doctor and electrical engineer, designed a machine inspired by the way a vehicle’s starter works when the engine is stalled. By 1947, Dr. Claude Beck confirmed the theory of restarting a heartbeat on a 14-year old patient whose heart stopped during surgery.
Although the first shock was unsuccessful, a second attempt resulted in success. Some thirty years later, the very first AED was introduced.
With time, AEDs became easy enough for people without medical backgrounds to use. Today, many facilities, including non-medical buildings, have AEDs all over the place, with some being required to have them by law.
It’s not uncommon to see AEDs mounted in building corridors like fire alarms and extinguishers. From office buildings to schools, the proliferation of these life-saving devices has also increased available training to operate them as part of an overall safety plan in many environments. Even without formal AED training, you should know what the dangers of a defibrillator are if you must use one.
Using an AED
Because AEDs are intended for use by laypersons, most devices include visual and audio prompts to guide a user through the steps.
- Open the victim’s shirt or cut it open using the scissors included with the AED.
- Wipe chest dry with an included towel.
- Remove any medication patches using the gloves that came with the defibrillator.
- Affix the pads to the victim’s chest.
- Plug in the connector, if applicable.
- Ensure that no one is touching the victim’s body, including you.
- If prompted, select the analyze button. Some AED models may do this automatically.
- If directed to deliver a shock, press the button. Make sure no one is touching the victim.
- Administer CPR when prompted by the machine.
- Perform two minutes of CPR (approximately five cycles) and follow further prompts from the defib.
- If you observe the victim responding, discontinue CPR and monitor breathing.
Consider getting certified in CPR/AED training which is available for medical and non-medical professionals alike. This coursework can give you the knowledge and confidence to intervene if the need to use an AED ever arises. It is also a great idea if you work in an industry that requires completion of continuing education or professional development hours.
Recognizing the Dangers of a Defibrillator
As expected, a device that can send an electrical shock through the body will have some precautions that you must follow to not only maximize the likelihood of saving someone’s life, but to make sure that no one is harmed by use of an AED.
- Water: Water is a great conductor of electricity, so you should not use an AED in a wet environment or where water is present. Before applying the electrical pads, you should dry off any moisture on the victim’s chest, as any shock would travel through the water and not the heart. Often defibrillators include a towel to dry skin.
- Metal: Metal also conducts electricity very well. It is strongly recommended that the metal underwire in a bra or metal piercings be removed to prevent conduction of the electrical shock which can lead to arcing or a fire.
- No Touching: The human body also conducts electricity, so take care that no one is touching the body when operating the AED. If you must use it, direct others to stand clear of the victim before applying electrical shocks.
- Flammable Environments. Never use a defib in a room where there is a buildup of combustible vapors. Sparks generated pose risk of explosion and fire.
- Medication Patches: These patches may be a burn hazard or interfere with the shock being delivered to the heart. Remove these using gloves prior to placing AED pads. Some models include gloves.
- Hairy Chest: Excessive chest hair may interfere with the adhesion of the pads, preventing the defibrillator from delivering the shock to the heart. Some defibrillators include a razor for use on especially hirsute chests.
- Pacemakers and Implanted Defibrillators. For victims with pacemakers or implanted defibrillators, stick AED pads at least one inch away from these devices. Implanted devices are usually located on the upper left side of the chest, near the heart. Such a device may not be working properly, so the presence of one should not stop you from attempting to use the AED to save someone’s life.
- Following the Prompts: Most automated external defibrillators offer prompts or automatically check to see if defibrillation is necessary. Always follow the prompts to make sure the AED is used for the purpose it was intended.
Clearing up Misconceptions About Defibrillators
While it is necessary to consider what the dangers of a defibrillator are, it is also important to clear up misconceptions about using automated defibrillators. Misunderstanding how an AED works and when it should be used can create a dangerous, if not deadly, situation.
Here are some things to remember:
- Use of AEDs in infants and young children: Despite defibs being generally designed for use in adults and children over the age of eight, you can use them in younger and smaller children. While the American Heart Association recommends the use of pediatric-sized pads and lower charges with babies and small children, the use of adult AEDs is better than nothing. Sudden cardiac arrests end in death if left untreated.
- Shocking someone accidentally: Simply put, this does not happen. AEDs by their definition are designed to send a shock If and only when a shockable arrhythmic condition is detected. Even if you were to accidentally hit a shock button, the defibrillator will not deliver one if it is not necessary.
- Flailing limbs or violent jerking: Unlike what is often depicted in entertainment, an electric shock does not make the victim’s body shake or limbs jump in dramatic fashion. It should be repeated here that AEDs cannot revive someone who has flatlined. A shock might cause a shoulder shrug or slight movement, but it is important not to delay treatment or assume that the device is not working because the victim does not jerk when the charge is applied.
AEDs represent a significant achievement in life-saving medical care. These devices can prevent cardiac arrest and death in people experiencing v-tech and VF.
While it is recommended that you seek official training on using an AED, you can use one to help render aid. “Good Samaritan” laws in most states protect volunteers from civil liability when using an AED to help save a life, so there is no good reason not to embrace the use of these portable devices at your office, other public spaces, or even your home.