When the doctor hurried to the scene with the patient who looked like he was clammy and about to pass out, she asked him a few questions then she immediately yelled out, Flight Attendant, ask the Captain to land.  We need to get this patient to a hospital. 

Where is the AED?   Where is the AED? 

WHERE IS THE AED??????

GET THE AED. 

 

 

You see AEDs, or automated  external defibrillators, in airports and other public places.

Let’s take the name apart…

Automated–means it knows what to do.  The machine is automated. 

External–means it stays outside of the body.  No one has to perform surgery on anyone.

Defibrillator–means to de-fibrillate.  Or to stop the crazy ‘fibrillation’ (a bad thing) of the heart’s electrical rhythm.  To DE-fibrillate is kinda like rebooting something that’s gone wayhire.    

It’s like pressing the RESET button.

***

The AED looks like this when stowed.

See, it’s sitting in its cubicle being charged.  

And the AED looks like this when opened.

The AED is designed so that anyone who can read and can hear can use them. 

You can do it.  You can save someone’s life.    

***

The patient has passed out. 

Remember, you’re not going to use the AED on anyone who’s still conscious.

But how will you remember this?

Well, you won’t think of performing mouth-to-mouth or CPR on someone who’s still conscious, right? 

Similarly, you would not use the AED on someone who’s still unconscious.    

The AED is for someone who’s passed out. 

***

So.  Let’s assume you got an unconscious patient in front of you.  They could be an adult, a child, or an infant.     

First, make sure the patient hasn’t had any head or neck injury, like hitting on something, or fallen down from somwhere.  If you suspect that the patient has had head or neck trauma, you need to protect the neck very carefully by not twisting, turning, or bending it.  That’s another topic to be discussed in another post.   

But 99% of the time, trauma is unlikely during a flight.

So.

Lie the patient on the floor.  Expose his/her chest.  Open the AED kit.

Follow the VERY VERY VERY SIMPLE  instructions. 

You have time.  The patient is not going to die in the 30 seconds that you need to get oriented.  Think of doing this in a methodical way like you’re putting together a computer gadget, or a kitchen appliance.  It’s going to be nerve wrecking, and you’re going to be nervous.  But try to stay confident. 

You can do this.        

***

The AED has 2 obvious buttons.  A green button for On.  And a reddish button (with a symbol of thunderbolt jolt for electricity) for Shock.  See?

So, what’s the first button you press? 

Correct.  Press the ON button.  Turn on the machine. 

Turn it ON! 

***

Nothing is going to happen if you don’t turn on the machine. 

How to turn on the machine? 

Answer: just press the ON button.  It’s usually a green button. 

You can’t miss it. 

***

Now, listen. 

I cannot stress this enough.  The cabin is really loud. 

The AED will TALK TO YOU!  

The AED talks!

***

Imagine that!

The AED talks!

The AED is like the Elmo toy that says, “touch here to hear me giggle.”

The AED will talk to you about what to do next.

The AED will talk to you and walk you through the rest of this stuff.

Most people don’t realize that the AED is a talking machine. 

***

The machine will say, “Apply pads.”

The ‘pads’ refer to the giant stickers that you will stick on the patient’s chest.  Can you identify the pads in this picture?

Excellent!  You got it.

On the stickers (or pads) themselves there are pictures  that tell you where to put them on the patient’s chest.  Again, this is super easy.  If you can read pictures, you can follow instructions. 

One sticker goes on the right side of the chest.

Another sticker goes on the left side of the chest.

***

So now, you may be wondering: why the stickers (pads)?

Well, the answer is this.  The machine has to make contact with the patient’s body in order to receive information from the patient’s body, and to deliver the electric shocks to the patient’s body.  Think of it this way: this is not going to work wirelessly!  So use the stickers.

See the picture?  Great. 

“Apply pads.”  That means, put the stickers on the patient’s chest.

***

Now, look carefully.  Do you see that coming out of the sticker pads are wires that are plugged into the AED?  That’s right.  The pads are like a mouse that needs to be plugged into the compter. 

So make sure that the pads are plugged into the AED machine.   

So let’s recap.  First you lie the patient down.  Then you expose his chest.  Then you turn on the AED machine.  Next, you apply pads, and make sure the wires that are connected to the sticker pads are plugged into the AED.  Now you’re good to go.     

***

Now, the machine will analyze the heart rhythm.  See, in this picture, the screen reads “analyzing.” 

Exhibit A

The AED is analyzing the heart rhythm. 

If the heart rhythm is fine, the AED will say nothing. 

If the heart rhythm is not good, like something that requires shocking, the AED will tell you to shock. 

However, don’t just follow the machines blindly (like someone driving himself into a river because the GPS said ‘go straight.’  Use your common sense).

Use your common sense.  If someone is talking to you and is still conscious, you’re not going to perform CPR on him right?  Similarly, if someone is talking to you and is still conscious – I don’t care if the AED begs you to shock the patient – you’re not going to shock him. 

Remember, we only shock someone if 1) they’ve passed out, and 2) the AED says to shock.         

In which case, the AED will say something like this.

“Prepare to shock.  Stand clear of the patient.”

*** 

When the machine says, “Stand Clear, prepare to shock,” you should stand clear and you should make sure that everyone stands clear from the patient.  No one should be touching the patient, unless they want to be shocked too when the shock is delivered.  Check for hair, jewelery, dangling clothing, etc.  You should make sure that YOU’RE cleared i.e., not in contact with the patient. 

Then the machine will say, “Administer shock.”

*** 

When the machine says, “Administer shock.”  You shock.

But how?

Well, you shock by pressing the RED button (the one that has the picture of thundering bolt/electricity on it).

Which button is the shock button in the picture below?

Correct.  It’s the red button with the picture of electric shock on it. 

***

So how does an AED work? 

Like we said before, it works by ‘resetting the heart rhythm’ by delivering a little shock of electricity. 

So what will happen when you shock the patient with electricty?

The patient will jolt.

That’s it. 

There’s not going to be any fire or sparks. 

***

After the shock has been delivered, the AED will re-analyze the heart rhythm and tell you whether you need to shock again. 
Exhibit B

It’s continuously analyzing the patient’s heart rhythm.  It may be silent for a few minutes, and then all of a sudden the AED may say,

“Stand clear, prepare to shock.”

So you make sure everyone’s standing clear of the patient, and you shock again.

How do you shock?

You shock by pressing the red button (with the lightening thunder bolt picture on it).

***

Or the AED may say, “Continue CPR.” 

***

If the AED is telling you to perform CPR but you don’t know how to perform CPR, do nothing. 

***

But if you want to attempt CPR you can do the following. 

Basically, you are now taking over the heart’s function to pump blood to the rest of the body.  So press down on the patient’s heart

Put both your hands over the patient’s heart, and start pressing down hard, one per year, starting counting, 2011, 2012, 2013, 2014… 

Press down hard.  You are pumping the heart to move the blood to the entire body including to the heart itself.  So don’t be wimpy.  Go about 2 inches in depth.  Remember, now the patient’s entire body depends on YOU to pump enough blood out of his heart to supply the rest of the body.  Go about 2 inches deep.  Don’t worry about breaking a rib.  A broken rib will heal.  A dead body and a dead heart will not. 

Forget about doing mouth-to-mouth.

***

In an emergency, it’s hard to remember where the heart is.

Well, to find out where the patient’s heart is, find where YOUR heart is…beating.  It’s on the left side of your chest. 

Now use that as reference, find where the patient’s heart is, and press down hard on it in CPR. 

Remember, if the patient is awake, you don’t do CPR.  You don’t do mouth to mouth.  You don’t shock.  You might get ready to do these things, but you don’t actually do them.   

***

While you’re giving CPR, the machine is constantly analyzing to see whether you need to shock again.

***

Just follow what the AED tells you.

If the AED says, “stand clear, shock” again?

You shock again.

How do you shock?

By pressing the red button with the picture of the lightening thunderbolt on it.

***

Let’s say someone has passed out, and it’s somewhere outside of a plane, in a terminal.   They’re unconscious.

What do you do before you do anything with the AED? 

Yell out for someone to call 911!!!!  I can’t stress this enough.  Remember, nothing you can do in the field can beat what a hospital can do.  So before you do anything, get help to get the patient to a hospital.

You gotta be loud.  Don’t be embarrassed.  Establish eye contact with the person who’s calling 911 for you, and hold that person responsible. 

If you’re on a flight, ask the Flight Attendants to ask the captain to land so that the patient can be transported to a hospital.

If you are on ground, ask someone to get help from 911 to get the patient to the hospital.

Before you do ANYTHING – make sure you’ve made contact with 911 (through someone else).  It will be a frightening experience but it’s a sign that you care.  So just execute.  Carry it through.  You can do this. 

*** 

So one final time.  The take home point is that the AED is a simple machine to use.

Before you do anything, call 911/get help to get the patient to a hospital.

Lie the unconscious patient on the ground.  Protect the neck (by supporting it so it’s not bent, twisted, or turned) if you suspect neck injury.    

Turn on the AED. 

Apply the sticker pads to the patient’s chest and plug in the pads to the machine. 

Follow instructions spoken by the AED.

***

So, what if you have a patient who’s still conscious but they look like they’re about to pass out (like in the vignette in the beginning of this post)?  In that case, the doctor thought that the patient would pass out at any minute. 

So, she lied the patient on the floor, and hooked him up to an AED.  She turned on the AED, applied the pads, and hooked up the pads.  Then she stood back and Let the AED do its analysis.  She listened very carefully to hear what the AED instructed her to do next. 

***

Final Quiz:  What’s wrong with Exhibits A and B?
Answer: the AED is not physically connected to the patient (via the sticker pads) yet it says it’s analyzing!  What is the AED analyzing?  Air????  Hahahahaha.  This is a stupid picture that works only on Halloween.  And this is a stupid joke intended to help you remember to put on those big ass sticker pads to the patient and to the AED.

This post is provided as a public service in accordance with the spirit of the Good Samaritan law, and is a simplified version of the Basic Life Support and the Advanced Life Support training.  It’s intended for people who have never taken one of those courses.  To get more information, take a course.