1. What does the abbreviation AED mean?

AED stands for Automated External Defibrillator.

2. What is a defibrillator?

A defibrillator is a device that delivers therapeutic doses of electrical energy to an affected heart. It is used for uncontrolled shaking of the heart (ventricular fibrillation) when the heart stops pumping blood and the AED will ensure through the electric shocks that the heart functions again. Through their 2 electrodes that are sent via the pads on the body, the AED analyses the heart assessing the ventricular fibrillation.

3. How does an AED work?

An AED has two adhesive electrodes that must be added to the body of the victim. The AED analyzes the heart rhythm, CPR and in the case of a ventricular fibrillation, the AED will send a shock. The Defibrillator HeartStart HS-1 and FRx Philips voice will tell yoyu what to do. Then the heart restores itself to a normal circulation.

4. What does CPR mean?

Cardiopulmonary resuscitation (CPR) is an emergency procedure which is performed in an effort to manually preserve intact brain function until further measures are taken to restore spontaneous blood circulation and breathing in a person in cardiac arrest. It is indicated in those who are unresponsive with no breathing or abnormal breathing, for example agonal respirations. It may be performed both in and outside of a hospital. CPR involves chest compressions at least 5 cm deep and at a rate of at least 100 per minute in an effort to create artificial circulation by manually pumping blood through the heart. In addition, the rescuer may provide breaths by either exhaling into the subject's mouth or utilizing a device that pushes air into the subject's lungs. This process of externally providing ventilation is termed artificial respiration. Current recommendations place emphasis on high-quality chest compressions over artificial respiration; a simplified CPR method involving chest compressions only is recommended for untrained rescuers.

5. What is the use of an AED?

An AED increases the survival chances of a victim of heart failure significantly. The sooner CPR and defibrillation is started, the higher the chance of survival. This opportunity is from 5-10% to 70-90%.

6. Can anyone use an AED?

In Switzerland anyone can operate a Philips HS-1 as well as the FRx HeartStart AED Defibrillators. The SUVA advises that this device should be placed everywhere. By not helping a dying person, everyone has not only moral and ethical reasons but also it is illegal not to help and by letting someone die, you are making yourself ... you can go to prison-

7. Is a training necessary for the use of an AED?

It is for all the AED's exept the Phiips AEDs. That is another reason why Swiss Defibrillator chose this brand. Never the less a training is recommended.

8. AED is an obligation for companies?

Most likeley it will in the near future. Also the fact that having one will make a hero of the user as he or she will be able to save a life and at the same time by purchasing an AED you are making sure that your company will have the necessary equipment before the ambulance arrive and then if your employé dies in your company, your insurances expenses can be saved dramatically by the use of an AED.

9. What to consider before purchasing an AED?

Swiss Defibrillator considers that the HS-1 HeartStart Philips defibrillator is by far the best one. Of course there are many in the market and you have approximately about 20 AED producers. But the HS-1 Phiilps has many features that will suit everyone. E.g. if you are in a wet area, the Philips device is the only one that will work on wet areas, such as snow, moist, etc. You also have to make sure it is reliablable and easy to use.

10. Where would it be best placed? Indoor? Outdoor? Public spaces?

An AED should be placed where you can get it as fast and as easy as possible. It has to be placed somewhere you know that if needed, the access for most of the people will be fast and easy to access.

11. What is a defibrillation?

Defibrillation is a common treatment for life-threatening cardiac arrhythmias, ventricular fibrillation and pulseless ventricular tachycardia. Defibrillation consists of delivering a therapeutic dose of electrical energy to the affected heart with a device called a defibrillator. This depolarizes a critical mass of the heart muscle, terminates the arrhythmia, and allows normal sinus rhythm to be reestablished by the body's natural pacemaker, in the sinoatrial node of the heart. Defibrillators can be external, transvenous, or implanted, depending on the type of device used or needed. Some external units, known as automated external defibrillators (AEDs), automate the diagnosis of treatable rhythms, meaning that lay responders or bystanders are able to use them successfully with little, or in some cases no training at all.

12. What is a cardiac arrhythmia?

Cardiac dysrhythmia (also known as arrhythmia and irregular heartbeat) is any of a large and heterogeneous group of conditions in which there is abnormal electrical activity in the heart. The heart beat may be too fast or too slow, and may be regular or irregular.

Some arrhythmias are life-threatening medical emergencies that can result in cardiac arrest and sudden death. Others cause symptoms such as an abnormal awareness of heart beat (palpitations), and may be merely annoying. These palpitations have also been known to be caused by atrial/ventricular fibrillation, wire faults, and other technical or mechanical issues in cardiac pacemakers/defibrillators. Still others may not be associated with any symptoms at all, but may predispose the patient to potentially life threatening stroke or embolism.

13. What is a ventricular fibrillation?

Ventricular fibrillation (V-fib or VF) is a condition in which there is uncoordinated contraction of the cardiac muscle of the ventricles in the heart, making them quiver rather than contract properly. Ventricular fibrillation is a medical emergency and most commonly identified arrythmia in cardiac arrest patients. While there is activity, it is undetectable by palpation (feeling) at major pulse points of the carotid and femoral arteries especially by the lay person. Such an arrhythmia is only confirmed byelectrocardiography. Ventricular fibrillation is a medical emergency that requires prompt Basic Life Support interventions because should the arrhythmia continue for more than a few seconds, it will likely degenerate further into asystole ("flatline"). The condition results in cardiogenic shock, cessation of effective blood circulation, and sudden cardiac death (SCD) will result in a matter of minutes. If however the patient is revived after a sufficient period (at room temperature, roughly 5 minutes) of cerebral hypoxia, the patient could sustain irreversible brain damage and possibly be left brain dead (death often occurs if normal sinus rhythm is not restored within 90 seconds of the onset of VF, especially if it has degenerated further into asystole).

14. What is a ventricular tachycardia?

Ventricular tachycardia (V-tach or VT) is a tachycardia, or fast heart rhythm, that originates in one of the ventricles of the heart. This is a potentially life-threateningarrhythmia because it may lead to ventricular fibrillation, asystole, and sudden death.

15. Which side should we do compressions from on a left laterally tilted pregnant woman?

In a pregnant patient who is having CPR with a left lateral tilt, it is easier to do chest compressions from the victims left side. There are no studies however that have looked at this in real patients.

16. Which CPR ratio is to be used when an adult is found arrested in water? What do you recommend if cause of collapse is unknown and the adult casualty is found in water?

Call 144. Give 5 initial breaths then 30:2. If you experience difficulty with ventilation, change to compressions alone. If you have never learnt CPR, continue with compressions alone, but consider adding ventilation after, say, a minute, subject to 3 above. The guidelines were referring here specifically to drowning children, but I would recommend exactly the same for drowning adults. In summary: Standard 30:2 CPR for drowning adults and children UNLESS you have a special duty of care for drowning victims, in which case give 5 initial breaths and continue CPR for 1 minute before leaving the victim if this is necessary.

17. Should we do chest thrusts in pregnant woman or the obese if unable to do abdo thrusts (as part of our standard choking manoeuvres) along with back blows or should we just do back blows?

Chest compressions ('chest thrusts') are poorly tolerated by conscious adults. If abdominal thrusts are not possible because the patient is pregnant, use back blows. If the victim becomes unconscious start CPR. Chest compressions may help dislodge a foreign body in the airway.

18. How may a period of chest compression during defibrillator charging be carried out when using defibrillation paddles?

The European Resuscitation Council Guidelines 2010 include the recommendation to continuing chest compressions during charging of a manual defibrillator. The aim is to minimise interruptions to chest compressions for shock delivery, which may increase the likelihood of shock success. Minimising interruption to chest compressions during charging of a defibrillator is best achieved by using self-adhesive pads. When using defibrillator paddles, hindrance from the close proximity of paddles on the patient's chest makes it difficult to safely continue chest compressions during defibrillator charging. If manual defibrillator paddles are the only option available, the safest approach is to pause the compressions during charging of the defibrillator paddles on the patient's chest. It remains important to keep this interruption to an absolute minimum. It is possible to charge the defibrillator with paddles housed in the defibrillator. This will enable compressions to continue during charging. But the need to then move charged paddles from the defibrillator across to the patient's chest is perceived by many to increase the risk of an accidental shock to rescuers. Although there are no scientific data to support this concern, the decision to adopt this strategy can be made only after a risk-benefit analysis by individual national resuscitation councils and healthcare systems. For these reasons, it is clearly better to use self-adhesive pads wherever possible; there are no known outcome advantages from using defibrillator paddles.

19. Should chest compressions be given during charging when using an automated external defibrillator (AED)?

Current European Resuscitation Council 2010 guidelines state: "The continuation of compressions during charging of the defibrillator is recommended... in combination with continuation of compressions during defibrillator charging, the delivery of defibrillation should be achievable with an interruption in chest compressions of no more than 5 s." and "The pre-shock pause can easily be reduced to less than 5 s by continuing compressions during charging of the defibrillator and by having an efficient team coordinated by a leader who communicates effectively."

20. Should chest compressions be given during charging when using a defibrillator that can deliver a shock immediately it is indicated?

The current guidelines recommend a pause to assess the rhythm. If the rhythm is shockable, chest compressions are resumed while the defibrillator charges; there is then a second short pause while the shock is delivered. Some new defibrillators are now capable of charging during shock analysis so that when a shock is indicated, no pause is needed for charging and the shock can be delivered immediately after rhythm analysis. In these circumstances, it is inappropriate to perform a further period of chest compression prior to defibrillation; the shock should be delivered immediately while the team stands clear of the patient. Any advance that minimises interruptions to chest compression in relation to defibrillation is welcomed.