Hb`````b (- jP zPm/0(b`$`"AIZ_CE.%b7X06gd` endstream endobj 57 0 obj 112 endobj 18 0 obj << /Type /Page /Parent 3 0 R /Resources 19 0 R /Contents [ 25 0 R 28 0 R 30 0 R 32 0 R 35 0 R 37 0 R 40 0 R 42 0 R ] /MediaBox [ 0 0 612 792 ] /CropBox [ 0 0 612 792 ] /Rotate 0 >> endobj 19 0 obj << /ProcSet [ /PDF /Text ] /Font << /F1 21 0 R /F2 23 0 R >> /ExtGState << /GS1 48 0 R /GS2 49 0 R >> /ColorSpace << /Cs8 26 0 R /Cs9 33 0 R /Cs10 38 0 R >> /Properties << /MC1 51 0 R /MC2 53 0 R /MC3 55 0 R >> >> endobj 20 0 obj << /Type /FontDescriptor /Ascent 682 /CapHeight 682 /Descent -230 /Flags 262240 /FontBBox [ -190 -250 1074 915 ] /FontName /BAFPAJ+GillSans-BoldItalic /ItalicAngle -8 /StemV 140 /XHeight 454 /StemH 100 /CharSet (/endash/Z/O/L/space/M/S/e/r/i/s/E/l/c/t/v/C/a/d/o/n/m/g) /FontFile3 45 0 R >> endobj 21 0 obj << /Type /Font /Subtype /Type1 /FirstChar 32 /LastChar 165 /Widths [ 278 271 479 584 542 719 750 240 385 385 469 584 271 333 271 281 552 552 552 552 552 552 552 552 552 552 271 271 584 584 584 375 979 781 698 771 802 635 604 813 833 333 333 719 615 885 844 875 656 875 677 604 719 823 719 1167 813 708 698 438 281 438 584 500 333 531 583 500 583 552 302 542 583 271 271 552 271 958 583 594 583 583 448 427 406 583 510 781 552 510 521 385 281 385 584 278 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 500 521 0 354 ] /Encoding /MacRomanEncoding /BaseFont /BAFOOH+GillSans-Bold /FontDescriptor 22 0 R >> endobj 22 0 obj << /Type /FontDescriptor /Ascent 682 /CapHeight 682 /Descent -230 /Flags 262176 /FontBBox [ -177 -250 1167 929 ] /FontName /BAFOOH+GillSans-Bold /ItalicAngle 0 /StemV 145 /XHeight 461 /StemH 95 /CharSet (/E/l/e/c/t/r/o/d/space/P/a/m/n/G/u/i/bullet/g/y/D/f/b/V/s/h/C/v/O/S/I/T/\ N/colon/A/R/parenleft/U/M/parenright/slash/X/hyphen/F/L) /FontFile3 44 0 R >> endobj 23 0 obj << /Type /Font /Subtype /Type1 /FirstChar 32 /LastChar 208 /Widths [ 278 260 479 584 490 719 729 240 344 344 479 584 260 344 260 281 531 531 531 531 531 531 531 531 531 531 260 260 584 584 584 323 979 625 635 688 750 583 490 740 792 302 302 646 531 948 781 833 583 833 646 521 619 750 552 948 677 563 635 375 281 375 583 500 333 552 542 469 542 510 333 490 552 260 260 509 260 823 552 563 583 552 365 375 365 552 458 729 531 490 458 385 281 385 584 278 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 469 542 0 0 0 0 0 740 0 0 0 278 0 0 278 584 278 278 0 615 278 278 278 278 278 0 0 278 0 0 0 0 0 278 0 278 278 0 0 0 278 0 0 0 0 0 500 ] /Encoding /MacRomanEncoding /BaseFont /BAFPAJ+GillSans-BoldItalic /FontDescriptor 20 0 R >> endobj 24 0 obj 4298 endobj 25 0 obj << /Filter /FlateDecode /Length 24 0 R >> stream Which is better, anterior-lateral or anterior-posterior electrode placement? In an emergency, EMS rescuersshould always act as quickly as possible, using the electrodes provided with the defibrillator at hand. However, an anterior-posterior placement can be used on adults as well with slightly different pad placement. An AED works by passing an electrical current through the body, targeting the heart for analysis and possibly one or more shocks. Change in pad position from the initial anterior-lateral configuration will occur during the 2-min cycle of CPR following the third defibrillation, minimizing any interruptions in CPR. Lack of oxygenated blood can lead to symptoms such as fatigue, dizziness, frequent fainting episodes, shortness of breath, and can even cause more serious conditions such as heart failure, sudden cardiac arrest, or even death. The two-piece construction ensures all therapy options are available to the ALS responder, while the unique design gives it utility in both the Anterior/Anterior and Anterior/Posterior placement. If the mother doesnt make it, neither will the fetusunless first-response measures are taken immediately. Use the pediatric pads and equipment if they are available, should they not be, you can use the adult pads. No matter the situation that you find yourself in, you now know how to properly apply AED pads. The efficacy of DSED may simply be the alternate plane or vector of defibrillation provided by the anterior-posterior pad placement added to standard anterior-anterior pad placement. When cardioversion is successful, the patients heartbeat will begin beating at a normal rhythm. Various sizes available. Item #: 2742-40289. The integrated handle and paddle combination reduces the need for assembly. If you can detect a heart rate or the patient is breathing, dont try to use a defibrillator. In order for the heart to pump, cells must generate electrical currents that allow the heart muscle to contract at the right time. When in use, defibrillator pads are placed on the bare chest of the individual who is in need of treatment. If this is the case, it is important that you have your AED fixed as soon as possible to prevent any liability arising from your failure to have a working automatic external defibrillator in the event of a medical emergency. This type of defibrillator pad placement is when one AED pad is placed on the right side of the chest (just below the collarbone) while the other pad is put on the lower left side of the chest. Using incorrect pad placement can result in the shock not being administered to the heart efficiently. A coordinated approach to defibrillation pad and ECG electrode placement, including rolling the patient for anterior-posterior pad placement, is necessary. That side is coated with an adhesive gel containing metallic particles. Todays AED machines, though sophisticated in their design, have an increasingly friendly user interface with visual media and auditory cues. Describe the relationship between potential difference and electrical potential energy. Before applying the pads, carefully remove the patch (wearing gloves) and quickly wipe the area with alcohol or a towelette. Nearly all of our cells can use these charged elements, called ions, to generate electricity. Some pads come pre-connected to the AED. An expiration date is marked on the front of the pad cartridge. This then results in the heart being shocked back into a regular rhythm. Knowing how to properly place the pads means that you can avoid any burns or other standard injuries that are often associated with the use of an AED. 2Topjian AA, et al. ZOLL also incorporates a unique technology in its R Series monitor/defibrillator. The second pad should be placed on the back of the child in order to complete the path for the shock. For a better experience, please enable JavaScript in your browser before proceeding. +B*;lu=lzF_M2 132 7YyX)[75WGCQgf_KHmnt\/w44#n t#h;jUAgdC?'As Another aspect that not many people consider is the fact that the AED pads must be in contact with the skin of the patient. Pacemakers are small devices that help some heart patients maintain a normal heart rhythm. ZOLL AED Plus Fully Automatic; Physio Control Lifepak CR2; I no the truth.Ans: I know the truth.(2). Transcutaneous BBB = bundle branch block pacing is delivered via cutaneous adhesive pads placed in an anteroposterior position, CHB = complete heart block ECG = electrocardiogram has the advantage of being immediately available for emergency cases of asystole but LAFB = left anterior fascicular block it requires high energy to capture the heart . If the AED stops giving direction, continue CPR until the emergency medical services team arrives. I use anterior/posterior pad placement, for pacing, cardioverting, and defibrilation. There are a few basic steps youll need to follow beforehand if your patient has a hairy chest, a medicated patch, or wet skin. An AED kit often includes extra gel to put on the aed pads if needed. In a similar vein, if you work in an area where audio reminders might be more useful, you would prefer to go that path. So observe the baby carefully, and if they arent clearly choking (in which case apply choking measures first) and an AED is available, using the AED on the infant that is not breathing and has no palpable pulse will be their best chance of survival, even if choking was the initial cause. There are no issues with defibrillation and tattoos. The posterior fat pad sign (PFPS) on the lateral elbow X-ray is useful in diagnosing a suspected nondisplaced fracture of the elbow following a subtle injury. These results should be considered in clinical practice, for the design of defibrillation electrode pads, and when guidelines for cardioversion of atrial fibrillation are updated. The first, and most common mistake, is that people misplace the second pad. Medial means towards the midline, lateral means away from the midline. Most AED first responder kits include razors. All that you have to do is ensure that the first of the electrodes is placed on the right side of the chest, just below the collarbone, and that the second is placed on the lower chest wall on the left side. { TR6cie;%,,iC(hkA{(4JDFapyzss(PHHDqyz)r8 . For pacing or defribrilating the anterior pad should be more over the apex of the heart. Liquid gel is ideal for procedures such as cardioversion or long-term pacing; the liquid gel provides better skin coupling and less skin irritation. 4 Keep the electrodes separated and take care that the gel or the paste applied on the chest is not smeared between paddles, in this case, the current can . All rights reserved. This is referred to as anterior lateral placement. When defibrillating infants and small children under 8 years of age or weighing less than 25 kg (55 lb), the AHA recommends using pediatric electrodes. AEDs are vulnerable to being interrupted or tampered with because they are often placed in public places. The real CPR Help provides real-time feedback on . On an adult, AED pads should be placed on the opposing side of the chest. Cardioversion often refers to synchronized cardioversion, which corrects a patients heart rate by delivering shocks that are timed with particular points on the QRS complex. In this case, the placement differs in order to protect the child. Sea- or Rain-water: typical of outdoor conditions. For this reason, the AHA recommends that any child under 8 years of age should be defibrillated using pediatric pads.2, It is also important that electrodes dont overlap or make contact during defibrillation. In fact, every minute that passes without an AED shock reduces the chances of survival by 7-10%. Effective defibrillation requires defibrillation of 95% of the cardiac muscle. The second pad goes on the child/infants back, exactly between the shoulder blades, as shown above. When paddles are required and sterility is an issue, the external paddles can be autoclaved quickly in the OR because they are made of a durable plastic that can tolerate high heat. In the 1980s, doctors and engineers had a special interest in minimizing patient discomfort, prompting them to develop large adhesive electrodes and ECG filtering. Both adult and pediatric electrodes come packaged with simple graphics showing placement that will optimize the delivery of current. However, for many people, a slow heart rate, or bradycardia, can prevent the heart from pumping enough oxygen-rich blood to vital organs, including the brain. In these courses, emergency simulations give supervised training so that the first-aider has actual hands-on experience in giving highly effective CPR. Steps to perform a Life-saving SCA Response. Zoll recommends ANTERIOR AND POSTERIOR pad placement : PICTURES ARE ON THE PADS 1) Place anterior pad at the apex 2) Place posterior pad on the left side of the patient's back below the scapula. Knowing how to properly apply these pads, whether to a fully-grown adult or to an infant can assist you in saving a life one day. They've also placed the wrong pad on the anterior aspect. . Properly placing AED pads varies with the age and/or size of the victim. With sound and pictures, CPR hand position and compression rates are indicated, correct AED pad placement is shown, etc. Aluminum, Steel, Iron: Used for seating and other structures, especially at sports venues. 16 0 obj << /Linearized 1 /O 18 /H [ 1290 224 ] /L 50075 /E 47614 /N 1 /T 49637 >> endobj xref 16 42 0000000016 00000 n 0000001187 00000 n 0000001514 00000 n 0000001720 00000 n 0000001957 00000 n 0000002277 00000 n 0000002934 00000 n 0000003320 00000 n 0000004104 00000 n 0000004126 00000 n 0000008502 00000 n 0000008576 00000 n 0000008598 00000 n 0000012801 00000 n 0000012823 00000 n 0000016861 00000 n 0000016883 00000 n 0000021210 00000 n 0000021284 00000 n 0000021306 00000 n 0000025500 00000 n 0000025522 00000 n 0000029616 00000 n 0000029690 00000 n 0000029712 00000 n 0000033990 00000 n 0000034012 00000 n 0000038137 00000 n 0000038710 00000 n 0000041619 00000 n 0000043511 00000 n 0000044111 00000 n 0000044790 00000 n 0000044929 00000 n 0000045067 00000 n 0000045820 00000 n 0000045906 00000 n 0000046659 00000 n 0000046745 00000 n 0000047498 00000 n 0000001290 00000 n 0000001493 00000 n trailer << /Size 58 /Info 14 0 R /Root 17 0 R /Prev 49627 /ID[<2ecf4f088d8ba91d9fecc7f979501378>] >> startxref 0 %%EOF 17 0 obj << /Type /Catalog /Pages 3 0 R /Metadata 15 0 R /JT 13 0 R /PageLabels 2 0 R >> endobj 56 0 obj << /S 36 /L 127 /Filter /FlateDecode /Length 57 0 R >> stream One of the most important components of these devices is the defibrillation pads. Regardless of which system or unit you want to buy, whether its the ZOLL AED Plus or another option, itll come with its own set of benefits and drawbacks. If someone with a pacemaker goes into cardiac arrest, it is both necessary and safe to use an automated external defibrillator. To keep blood moving to the brain and vital organs, CPR should be started immediately. More to the point of this article, deploying an AED is practiced on various models, adult, child, and infant: Defibrillator pad placement directly influences the effectiveness of the AED machine as it analyses the heart rhythm and delivers any needed AED shock. An anterior-posterior electrode position is more effective than the anterior-lateral position for external cardioversion of persistent atrial fibrillation. Above all, it is important to make sure that the pads are completely adhered to the victims skin. The patients heart is the most important organ. Move the victim and the AED away from sources of water, remove any wet clothing, and dry the victim to the best of your ability before applying electrodes. Their recommendation for cardioversion of atrial arrhythmias is Ant/Post with the Apex/anterior pad to the right of the sternum. The first pad must always be placed on the chest just beneath the patients collarbone, and the second pad should be placed on the left chest wall, just underneath the armpit area. Powerheart pads that come as part of an AED package, or replacement pads such as . CPR statpadz is designed for use with ZOLL manual defibrillators. For instance, smaller pediatric pads are to be used with infants. You may still have some questions in regard to some special circumstances. In both of these cases, the most appropriate position for the AED pads will be illustrated on the pads themselves and all you need to do is follow the electrode pad placement instructions. existing anterolateral placement was no longer used and there was a need to teach with anterior/posterior electrode pad placement . . It is important that you always follow the manufacturers directions for the AED you have ordered, no matter how minor the issue is, in order to prevent potential problems. . Generally, your defibrillator kit will tell you where to place the pads on adults using both audio prompts and visual diagrams. These plates are placed onto a plastic shell with one side uncovered. By following the instructions provided to you, you can ensure that you are able to deliver the best possible treatment to the patient experiencing a sudden cardiac arrest. These are also discussed here. The following instructions apply to individuals who are adults (they are older than eight years old, or weigh more than 55 pounds): You should always make certain to apply the pads to the chest in accordance with the pictures that are on the pads. If the pregnancy is advanced and the mother dies, it might still be possible to save the baby via an emergency C-section. Although a situation may be extremely stressful, and as a result, you may be tempted to just put the pads on as quickly as possible, this is a serious mistake. 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