When Should The Rescuer Operating The AED Clear The Victim?

An Automated External Defibrillator (AED), when used in conjunction with Cardiopulmonary Resuscitation (CPR), significantly enhances the chances of reviving a person experiencing sudden cardiac arrest. This life-saving combination is a crucial part of emergency response. However, it’s essential for a rescuer to be aware of specific instances when they must clear the victim during AED operation. Clearing the victim before analyzing heart rhythm, delivering a shock if advised, and after a shock, ensures the safe and effective use of the AED in the resuscitation process. Our expert Jeff Haughy has discussed in detail later below.

Importance of Clearing the Victim

Clearing the victim is a crucial step in ensuring the proper and safe use of the Automated External Defibrillator (AED), ultimately increasing the chances of a successful revival. 4 reasons to clear a victim before delivering a shock or while using the AED are:

• Safety: Clearing the victim minimizes the risk of accidental shock to the rescuer or bystanders, ensuring their safety during the resuscitation process.
• Accurate Analysis: A clear and motionless environment allows the AED to accurately analyze the victim’s heart rhythm, enabling it to provide precise guidance for treatment.
• Effective Shock Delivery: In cases where a shock is advised, clearing the victim ensures that the electrical therapy is administered directly to the victim’s heart, maximizing the chances of restoring a normal rhythm.
• CPR Effectiveness: After a shock, clearing the victim briefly allows for effective chest compressions, aiding blood circulation before further analysis.

When Should The Rescuer Operating The AED Clear The Victim?

Clearing the victim during AED operation is a critical procedure for various reasons (already discussed above), including the necessity for accurate rhythm analysis. To ensure the AED can provide effective instructions, it is imperative to create a motionless environment. This clear and safe state is essential prior to and following shock delivery or heart rhythm analysis. This protocol guarantees the precision and safety of electrical therapy, allowing optimal chances for restoring a normal cardiac rhythm and ensuring effective chest compressions between treatment phases. This meticulous approach underscores the importance of careful victim clearance, promoting the AED’s effectiveness in the resuscitation process. Let’s learn in more detail about when to clear victim when using AED:

Clear Victim Before Analysis

Before using the AED to analyze the victim’s heart rhythm, it’s crucial to clear the victim because clearing the victim means ensuring that no one is in contact with the victim’s body or interfering with the AED’s sensors. This step is essential to prevent any electrical interference and to allow the AED to accurately assess the heart’s rhythm. AED may alter it’s analysis data and provide inaccurate results if victim is in contact with rescuer .

Clear Victim Before Delivering The Shock

Prior to delivering a shock, the rescuer must again clear the victim. This means making sure that no one is touching the victim, and that everyone is at a safe distance from the victim’s body. Clearing the victim is essential to ensure that the electrical shock is delivered effectively to the heart, rather than being dispersed through unintended pathways.

Clear Victim After Delivering The Shock

After the AED delivers a shock, if advised by the device, it’s important to clear the victim once more. This is to prevent any contact with the victim while the AED continues to assess the heart rhythm and determine if additional shocks are necessary. It also ensures the safety of the rescuers during the resuscitation process.

Clear Victim in Presence of Multiple Rescuers

In situations where multiple rescuers are present, coordination is important. Clear communication is needed to ensure that all rescuers are aware of when to clear the victim, especially before and after shock delivery or rhythm analysis. This coordination minimizes the risk of confusion and maximizes the chances of a successful resuscitation.

Check These While Clearing a Cardiac Arrest Victim

Clearing victims completely before using an AED is crucial; even the slightest presence of moisturizer can alter AED analysis results and its effectiveness. Here are the factors influencing the output of AED on an unresponsive victim:

Pediatric Patients

Check if the patient is a child. Cardiac arrest in a child is rare, but there may be a chance of unresponsiveness due to choking and drowning, where the use of AED is inevitable. The setting of an AED needs to be adjusted if a patient is less than 8 years old or less than 55 pounds (25 KG). AEDs come with child settings and special electrode pads for children. In the absence of child settings and pediatric pads, an adult pad can be used, but with different patch placements. One pad should be placed in the middle of the chest, while the other should be placed in the middle of the back.

Wetness

Because sweat and water are good conductors of electricity, the electricity produced by the AED after analysis will travel across the skin of the victim rather than penetrating it through the skin and shocking the heart. Also, the use of alcohol to wipe the victim’s body can affect negatively as the alcohol is extremely flammable. If a victim is wet or you see moisturizer (water droplets, sweat), first dry the victim and clear for AED.

Patients With a Hairy Chest

A cardiac arrest patient with dense hair on the chest prevents the contact of electrode pads, which affects the effectiveness of AEDs analysis of heart rhythm and timed shock. Shaving the hair on the chest can clear the victim for proper pad placement and rhythm analysis. If a razor is not available, push down hard on the electrode pads and clear the victim immediately after the defibrillator advises the shock. If the machine still does not respond, then clear the victim by removing some of the hair forcefully and applying the pads in the correct position.

Patients With a Medication Patch

If shock is delivered while a medication patch is on the body, a burn hazard can present aftershock. Therefore, remove any medication patch and wipe any sticky residue before applying AEDs or delivering a shock.

Patients With a Pacemaker or Implantable Defibrillator

External defibrillators can analyze heart rhythm and deliver shock even in the presence of a pacemaker in a victim. But, applying pads over the pacemaker can affect the effectiveness of shock. Attach the electrode pad few inches below the pacemaker.

When Should A Rescuer Who is Operating The AED Begin CPR?

The AED operator clears the victim before rhythm analysis and delivering a shock. After the AED operator delivers a shock to the victim, a rescuer should immediately begin delivering CPR with cycles of 30 chest compressions and 2 rescue breaths. Prior to commencing CPR, the operator or rescuer should briefly check if the victim is breathing. In the absence of any discernible signs of circulation or breathing, the rescuer should then proceed to initiate CPR.

FAQs

What do you do after an AED says no shock advised?

If the AED machine gives “No Shock” advised you should monitor the victim’s condition, check if the victim is breathing, clear the airway and provide rescue breathing as needed.

When using the AED what does clear mean?

When an AED operator shouts “Clear” with commanding voice that means nobody touches the victim and clears to proceed operating AED or delivering shock.

How do you clear a patient before administering a shock?

Before administering AED say “CLEAR” in a loud, commanding voice. Use physical force if needed to ensure that nobody is in contact with the patient. It’s essential to make sure there is no interference, as the AED may not accurately assess the victim if not cleared properly.

Do you continue CPR until an AED prompts to clear?

Yes, do not stop delivering CPR unless you see an obvious sign of life or an AED is ready to use. Continuous delivery of CPR is important until a professional takes over or an AED arrives.

What happens if you touch a person while AED is delivering shock?

If any rescuer is in contact with a patient during defibrillation, they may inadvertently receive a portion of the delivered energy. It’s worth noting that energy levels exceeding 1 joule have been reported to have the potential to induce ventricular fibrillation.