The AED protocol has seven basic steps:
Check unresponsiveness.
Call 9-1-1 or the local emergency number (if applicable) and retrieve the AED.
Open the airway and check for breathing. If there is no breathing or breathing appears abnormal, give two slow breaths.
Check for a pulse. If there is no pulse, turn on the AED. A second rescuer should continue CPR until the AED is attached.
Attach the AED electrode pads.
Analyze the heart rhythm. Make sure no one is touching the victim.
Press the "shock" button, if advised. Make sure no one is touching the victim.
Let's look at these steps in more detail to demonstrate how simple it can be to save a life.
Note: The following protocol addresses procedures for using an AED. It is essential that the AED student has had prior CPR training and understands CPR protocols.
Step 1: Establish unresponsiveness.
Step 2. Call 9-1-1 or the local emergency number (if applicable) and retrieve the AED.
Call 9-1-1 or the local emergency number as soon as you recognize the emergency. Even if you have an AED with you, it's important to notify EMS.
Note: Circumstances will vary. The responder with the AED may be part of the official 9-1-1 response. In this case, there is no need to call 9-1-1. In other cases, ensure that help is on the way.
Step 3. Open the airway and check for breathing. If there is no breathing or breathing appears abnormal, give two slow breaths.
Note: When the heart stops, even though there is no circulation, the victim may continue ineffective breathing motions.
Step 4. Check for a pulse. If there is no pulse, turn on the AED. A second rescuer should continue CPR until the AED is attached.
Note: If there is no pulse, turn on the AED power. Press the "on" button or open the lid, depending on the device. If a second rescuer is available, he or she should continue CPR until the AED is attached.
Step 5: Attach the AED electrode pads.
Bare the victim's chest and make sure it is dry. Remove the adhesive AED electrode pads from the package and attach them firmly to the chest, as illustrated on the package.
Note: It is very important to place pads correctly so that the electric current passes through the heart. One pad should be placed on the victim's upper right chest, the other on the lower left chest. Thick chest hair should be removed prior to pad placement to ensure adequate contact.
Step 6: Analyze the heart rhythm. Make sure no one is touching the victim.
Some AEDs analyze the heart rhythm automatically. Other models prompt you to press the analyze button. Follow the AED's prompt and call out, "Analyzing rhythm, stand clear!" or "I'm clear, you're clear, we're all clear!" or words to this effect. Make sure no one is touching the victim when the AED is analyzing.
If the AED indicates "shock advised" go to step 7.
If the AED indicates that the victim does not need to be shocked, check his or her pulse again. If there is no pulse, do CPR (ventilations and chest compressions) for one minute, advise onlookers to stand clear, and analyze again. Repeat this sequence of CPR and analysis every minute until help arrives.
Step 7: Press the "shock" button, if advised. Make sure no one is touching the victim.
If the AED determines that the victim does need to be shocked, it will prompt you to press the shock button. To ensure the safety of onlookers, make sure no one is touching the victim. Call out, "Shock indicated. Stand clear!" Or, say, "I'm clear, you're clear, we're all clear," or words to this effect. Then, press the shock button. Sometimes, the victim will be revived after just one shock.
After the first shock is delivered, immediately analyze again. If the AED advises that another shock is needed, press the shock button a second time.
After the second shock is delivered, immediately analyze again. If the AED advises that another shock is needed, press the shock button a third time.
After three shocks, if the victim still has no pulse, do CPR (ventilations and chest compressions) for one minute.
Then, if there still is no pulse, give additional sets of three quick shocks, interspersed with one minute of CPR, until the AED prompts that no shock is indicated.
Note: The AED will deliver appropriate energy levels for each shock. Continue cycles of one minute of CPR followed by heart rhythm analysis and appropriate shocks until advanced help arrives.
The most important thing to remember when using an AED is to confirm that the victim is unresponsive, not breathing normally and pulseless. For all such victims in confirmed cardiac arrest, turn on the power, analyze, and the AED will coach you through the rest of the steps with visual and/or audio prompts. There is no need to be anxious. Even if you get flustered, as people often do in emergencies, the AED will be your guide.