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 Saint
Joseph Health Center is among the first to begin using automatic external
defibrillators (AEDs) throughout its entire facility.
AEDs are not new to health care. For years, emergency
medical service (EMS) personnel have used AEDs to provide defibrillation
outside the acute care environment in the community. Recently, a push
has been underway to expand the use of AED's beyond the EMS arena to hospital
environments and into airports, retail malls, golf courses and athletic
facilities.
The AED is a defibrillator that automatically detects
shockable arrhythmias and applies a shock to the patient with the push
of a button. It does not require special critical care training or experience
and the user does not need to identify special rhythm problems. The nurse
simply attaches the electrodes to a person who is unresponsive, not breathing
and pulseless and activates the AED. If the device detects a shockable
arrhythmia, it automatically charges and signals that defibrillation is
indicated, allowing the nurse to decrease the time to first defibrillation.
According to Louisa Kamatuka, RN, CS, MSN, CCRN, critical
care clinical nurse specialist at Saint Joseph Health Center, "the Medtronic
Physiocontrol LifePak 12 AED is flexible, easy to use and reliable. We
decided to use it throughout the entire hospital to speed up assessment
time and delivery of the initial shock if needed. The device we are using
provides a shock advisory if an arrhythmia is detected. The operator then
pushes a button to deliver the shock."
Also, the AED is a smart device. Unlike conventional defibrillators,
AEDs will not deliver a shock unless the electrode pads are properly attached
and a shockable rhythm is detected. According to the American Journal
of Nursing, "the most common rhythm in cardiac arrest is ventricular
fibrillation (VF) which is a rapid, ineffective quivering of the ventricles
accompanied by chaotic electrical activity and no pumping action. The
only effective treatment for VF is electrical defibrillation that terminates
the chaotic activity, allowing an organized rhythm to take over. Whether
defibrillation restores a pulse depends on how soon after arrest it occurs.
With each minute defibrillation is delayed, there is a steady decline
in the probability of survival." Also, the AED is capable of detecting
and defibrillating ventricular tachycardia, a rhythm in which three or
more PVC's (premature ventricular contractions) arise in sequence at a
rate of greater than 100 beats per minute.
Approximately 1,000 sudden cardiac arrests occur daily
in the United States. Approximately 70 percent of cardiac arrest patients
have initial cardiac rhythm of VF. In several studies, response time to
defibrillation was significantly improved by first responder use to AEDs.
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