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December 23, 2024
Steven Cumper
Can You Use a Defibrillator on a Person with a Pacemaker?
Automated External Defibrillators, or AEDs, can be crucial in saving lives outside of the hospital. It’s thought that, in addition to following CPR, using an AED can improve survival rates from cardiac arrest by up to 50%. People who are at particular risk of cardiac arrest and other heart problems might also use pacemakers and ICD (Implantable Cardioverter-Defibrillators) devices, which can help them manage healthy heart rhythms. But what if someone with a pacemaker needs extra help from an AED? Can you safely use a defibrillator on someone with an ICD or a pacemaker? The answer is yes - AEDs can be used on individuals with these devices, as long as proper precautions are taken. In this guide, we’ll answer these questions and look at a few common AED myths. Understanding Pacemakers and ICDs Pacemakers and implantable cardioverter-defibrillators (ICDs) are surgically implanted devices designed to help manage irregular heart rhythms. Pacemakers work by sending electrical impulses to prompt the heart to beat at a normal rate, typically used in cases of bradycardia (a slow heartbeat) or irregular rhythms. ICDs, on the other hand, monitor the heart for dangerous arrhythmias, such as ventricular tachycardia or ventricular fibrillation, and deliver shocks when necessary to restore a normal rhythm. These devices are vital for preventing complications associated with arrhythmias and significantly reduce the risk of sudden cardiac arrest A defibrillator, particularly an automated external defibrillator (AED), is needed in cases of sudden cardiac arrest (SCA) when the heart’s electrical system fails, leading to chaotic or absent heart rhythms such as ventricular fibrillation or pulseless ventricular tachycardia. In such scenarios, neither a pacemaker nor an ICD may be able to respond effectively. Can a Defibrillator Be Used on Someone with a Pacemaker? Yes, a defibrillator can be used on a person with a pacemaker or an implantable cardioverter-defibrillator (ICD), but precautions should be observed. When using an automated external defibrillator (AED), ensure the pads are placed at least one inch away from the pacemaker or ICD to avoid interference. AEDs are designed to assess the heart's rhythm and deliver a shock only when necessary. This means even if the pacemaker or ICD is functioning, the AED will not deliver an inappropriate shock due to its built-in safety mechanisms. However, if the pacemaker or ICD fails to correct life-threatening arrhythmias, the AED is essential for restoring normal heart rhythm. Myths and Misconceptions about Defibrillators Are AEDs dangerous for untrained bystanders? AEDs are designed to be user-friendly, providing clear instructions and analyzing heart rhythms to ensure shocks are delivered only when necessary. Even untrained individuals can safely and effectively use them during emergencies. AEDs damage pacemakers? When pads are correctly positioned, the electric shock bypasses the pacemaker, preventing any significant interference. Additionally, AEDs defibrillators have built-in safeguards to prevent incorrect usage, making them safe for a wide range of medical situations, including in patients with implanted cardiac devices AEDs don’t work on people who are overweight? There’s a myth that AEDs won’t be effective on individuals who are overweight or obese. However, AEDs are designed to work on people of all sizes. The shock delivered by the AED is based on the electrical rhythms of the heart, and the device adjusts to deliver the right level of energy for the situation. No matter a person’s body type, AEDs will still function as intended if the pads are placed correctly. Are AEDs only for heart attacks? AEDs are often associated with heart attacks, but they are specifically designed to treat sudden cardiac arrest (SCA), which is caused by an abnormal heart rhythm, not a heart attack. Sudden cardiac arrest can happen with or without a heart attack, and an AED is crucial in treating it. Statistics show that 90% of cardiac arrest patients survive when they receive AED shocks in the first minute. Every second counts – so don’t waste them wondering whether or not pacemakers are compatible with defibrillators! Training and Skills for AED Use Many modern AED devices are designed to offer in-use guidance, meaning members of the public can use them, if in a public area, in the event of an emergency. However, it is still important for professionals, such as first responders, and members of the public to learn how to use AEDs. For example, people fitted with pacemakers and ICDs, i.e., those with pre-existing heart conditions, are likely to be at higher risk than those without such fittings. Therefore, it’s wise to learn about AED pad placement, appropriate use, and what to look for in a quick visual inspection of your patient. As mentioned, you might typically see pacemaker scarring or slight chest lumps that suggest your patient has internal devices. In the event of having a cardiac arrest, it’s highly unlikely the victim will be able to tell you if they have a pacemaker or not – so, it’s better to be aware of what to look for. Just as it’s important to refresh first aid training and the basics of CPR, it’s just as important that building personnel know how to use AEDs effectively – don’t overlook the value of investing in training for your team! Do also take care to engage your team on how to use different types of defibrillators – such as manual devices – wherever possible. How to Perform CPR on People with Pacemakers In the event of someone with a pacemaker suffering a cardiac arrest, it’s vital to follow standard CPR procedures, regardless of using AEDs. The basics of CPR still apply with people fitted with pacemakers. However, you should adjust your compressions slightly to avoid disrupting where the implant is fitted. Apply compressions quickly and firmly – between 100 and 120 per minute – close to the centre of the chest, and away from the pacemaker site. Simply being mindful of a pacemaker or ICD during CPR is enough – you can usually tell if someone has a fitting if they have a small bump under the skin, or if there is chest scarring. In which case, it is better to be safe rather than sorry, and to avoid damaging the device or causing harm to the patient. Conclusion It’s a myth that you can’t use AEDs on someone with a pacemaker or an ICD. In fact, in many cases, doing so will make the difference between life and death. Therefore, always make sure to account for potential pacemaker fittings before using an AED, consult any manuals provided, and top up your team’s training – even knowing the basics can help to save lives in the event of an emergency. FAQ on Using a Defibrillator on a Person with a Pacemaker Let’s close our guide with some commonly asked questions about AEDs and pacemakers. Can a defibrillator cause electrical interference when used on a metal surface? Yes, using a defibrillator directly on a metal surface can cause interference and stop an AED from working correctly. However, it is usually safe to use an AED on a patient who is lying on a metal surface. Devices such as metal detectors, cellphones, and headphones are unlikely to cause interference or impede AEDs, either. What if the pacemaker or ICD is delivering a shock when I use the defibrillator? You can still use an AED alongside an ICD when attending to a patient. The AED pads should be placed at least one inch away from the implanted device to avoid interference. The AED will analyze the heart rhythm and determine if a shock is necessary. AED’s built-in safety mechanisms will guide appropriate action. Experts agree that it’s safe to use general CPR while ICDs are in effect, too. Sources Berkman, M. (2023). AED with Pacemaker - How To Use Defibrillator With Pacemaker. In Avive AED. Avive AED. https://avive.life/blog/aed-with-pacemaker Can you use a defibrillator on someone with a pacemaker? (n.d.-a). In www.bhf.org.uk. Retrieved December 2, 2024, from https://www.bhf.org.uk/informationsupport/heart-matters-magazine/medical/ask-the-experts/cpr-with-a-pacemaker-and-icd Cleveland Clinic medical professional. (2024). Defibrillator: Types, Uses and Purpose. In Cleveland Clinic. Cleveland Clinic. https://my.clevelandclinic.org/health/treatments/23020-defibrillator Devices That May Interfere With ICDs and Pacemakers. (n.d.). In www.heart.org. Retrieved December 2, 2024, from https://www.heart.org/en/health-topics/arrhythmia/prevention--treatment-of-arrhythmia/devices-that-may-interfere-with-icds-and-pacemakers It’s shockingly simple to help save a life. (n.d.). In Heart Foundation. Retrieved December 2, 2024, from https://www.heartfoundation.org.au/media-releases/shockingly-simple-to-save-a-life Jane. (2023). CPR for Pacemaker & Defibrillator Users. https://cpraedcourse.com/blog/is-it-possible-to-perform-cpr-on-someone-with-a-pacemaker/# Mascitti, A. (2023). Special Considerations When Using an AED. In AED Brands. https://www.aedbrands.com/blog/special-considerations-when-using-an-aed/ AED Fact Sheet. (2023). American Heart Association. https://cpr.heart.org/-/media/CPR-Files/Training-Programs/AED-Implementation/2023-updates/AED-fact-sheet-Feb-2023.pdf
December 16, 2024
Steven Cumper
How Often Should Your CPR Skills Be Refreshed?
In the event of someone experiencing a sudden cardiac arrest, cardiopulmonary resuscitation, or CPR, could make all the difference in saving a life. However, little more than 50% of the Australian population are fully trained in CPR – and it pays to refresh your knowledge, too. Taking CPR refresher training helps to ensure you’re still competent at the skills required to support people in need – and for many professionals and healthcare providers, helps to ensure compliance. In this guide, we’ll explore when to refresh your skills and what that involves. How Often Should Your CPR Skills Be Refreshed? You should refresh your CPR certification – that is, HLTAID009 – once every 12 months. Although CPR certification validity doesn’t expire, the Australian Resuscitation Council (ARC) recommends a yearly renewal to make sure you’re clear on what CPR entails. However, in some cases, employers might require you to renew your CPR certification more frequently. Many of our clients, who are first responders and healthcare professionals like you, say that refreshing at least yearly is a great boost to their confidence in an emergency. CPR Training Guidelines and Standards The standard CPR training supported by the Australian Red Cross typically requires you to attend a two-and-a-half-hour classroom session. It’s the most standardised of CPR skill refreshment options. It’s a hands-on session, which means you’ll get the chance to practice what you learn as well as learn the differences in techniques used to support adults and children. CPR guidelines set by the ARC are nationally recognised – meaning from ACT to Western Australia, you can legally use the skills gained in the course nationwide. Of course, beyond basic training and refresher courses, you should always refer to standardised CPR guidelines to ensure you’re delivering appropriate legal care in emergencies. CPR Training Equipment When attending a CPR refresher course, you’ll likely encounter standardised training equipment such as CPR manikins. These human-shaped devices help you practice compressions and breathing techniques and help trainers measure your pacing and aptitude. During skills refreshment, you’ll also have the opportunity to use an Automated External Defibrillator (AED), which can be lifesaving between rounds of traditional CPR. In fact, you’ll also learn the difference between CPR vs AED, and when you should effectively switch between one technique and the other. Hands-on learning is widely hailed as one of the most effective ways to develop long-term skills, with studies claiming nine out of ten people agree. What better way, then, to refresh your CPR competencies? Components of a CPR Refresher Course Key components of a CPR refresher course supported by the ARC include: ● Detailed CPR steps ● Basic life support ● Physical competency with an AED ● Welfare considerations ● Legal considerations and requirements The ARC states that HLTAID009’s live, hands-on training experience is designed to give students the confidence to be able to support people experiencing sudden cardiac arrest, and those who are simply not breathing properly. The course is largely physical, covering roleplay with other students, practical AED use, and manikin training. However, there’s also a theory element, where students can test their knowledge so that they can recall the essential CPR steps in an emergency situation. Of course, after attending refresher training, it’s also important to have a standard CPR emergency handbook if you need it. Many of our clients say that, while refreshing their training helps the CPR basics to stick, having a physical resource gives them an extra layer of confidence. Importance of CPR Refresher Training Although the standard CPR refresher course is fairly short, it’s an essential booster to both your confidence and skill set. Simply learning CPR skills at the start of your training is all well and good, but like many skills, your knowledge and confidence might wane over time. CPR refresher training allows you to practice typical steps and to get re-accustomed to equipment such as AEDs in safe environments. You’re never practicing with real people, and you don’t have to wait until an emergency occurs to try out your skills. It’s thought that only 10% of people survive cardiac arrests outside of hospital largely due to a lack of CPR support and defibrillation. Acting fast with effective CPR can not only save someone’s life without the need for hospital support, but can also prevent brain damage. It’s estimated that brain damage can start to take effect within six minutes of a person stopping breathing, or their heart failing. Therefore, supporting someone with CPR and AEDs confidently and within minutes can make a tremendous difference. It’s all the more reason to reinvest in CPR knowledge regularly. Workplace Compliance and CPR Training Across Australia, it’s generally accepted that first aiders in the workplace should refresh their CPR certifications at least once a year. Beyond this, they should also renew their standard first aid qualifications every three years. Guidelines set by Safe Work Australia (SWA) state that workplaces must possess at least one recognised first aid kit, and that they should be accessible to trained first aiders. Its guidelines also state that companies should undergo first aid risk assessments to ensure compliance. CPR refresher training can ensure further compliance by providing first raiders with the knowledge and confidence to apply legally recognised techniques in an emergency situation. Trained first aiders, according to SWA, should receive additional training in the event of special risks and circumstances – to keep businesses compliant and to ensure the safety of anyone who falls ill. Conclusion Basic CPR and first aid training is an asset to anyone working with the public or who might need to support employees who suffer cardiac arrests. However, knowledge of CPR can dwindle over the course of a year, especially if no emergencies take place. Therefore, refreshing your knowledge with a course every 12 months will ensure you can confidently help people who are struggling to breathe. As mentioned, acting fast with effective CPR and AED use can save lives and even prevent brain damage. We hope there may never be an occasion where you need to practice CPR in real life. But, it’s always better to be safe than sorry – and refreshing your knowledge is your ticket to practicing CPR with confidence. Sources ANZCOR. (n.d.). Guideline 8: Cardiopulmonary resuscitation (CPR). Australian and New Zealand Committee on Resuscitation. https://www.anzcor.org/assets/anzcor-guidelines/guideline-8-cardiopulmonary-resuscitation-cpr-225.pdf First Aid Pro. (n.d.). Determining the frequency of instruction: Australian CPR training requirements. https://www.firstaidpro.com.au/blog/determining-the-frequency-of-instruction-australian-cpr-training-requirements Lifesaving First Aid. (n.d.). The importance of regular CPR training. https://lifesavingfirstaid.com.au/blog/the-importance-of-regular-cpr-training/ West Coast First Aid. (n.d.). How often should your CPR skills be refreshed? https://westcoastfirstaid.au/how-often-should-your-cpr-skills-be-refreshed/ LFA First Response. (n.d.). How often should CPR skills be refreshed? https://lfafirstresponse.com.au/blog/how-often-should-cpr-skills-be-refreshed/ Heart Foundation. (n.d.). Staying alive: A history of CPR. https://www.heartfoundation.org.au/blog/staying-alive-a-history-of-cpr Red Cross. (n.d.). Provide cardiopulmonary resuscitation. https://firstaid.redcross.org.au/provide-cardiopulmonary-resuscitation/ Safety Learning. (n.d.). How often should your CPR skills be refreshed? https://safetylearning.com.au/how-often-should-your-cpr-skills-be-refreshed Skillsforce. (2023, August 2). How long is your first aid certificate valid for? Understanding the expiry of HLTAID011 and HLTAID009. https://skillsforce.com.au/2023/08/02/how-long-is-your-first-aid-certificate-valid-for-understanding-the-expiry-of-hltaid011-and-hltaid009/ Learnwell Collective. (2024, May 21). Hands-on learning in high school. https://learnwellcollective.org/2024/05/21/hands-on-learning-high-school/ Gitnux. (n.d.). Hands-on learning statistics. https://gitnux.org/hands-on-learning-statistics/ Mayo Clinic. (n.d.). Sudden cardiac arrest: Symptoms and causes. https://www.mayoclinic.org/diseases-conditions/sudden-cardiac-arrest/symptoms-causes/syc-20350634 ABC News. (2024, July 5). Australia’s cardiac arrest rates targeted through CPR campaign. https://www.abc.net.au/news/2024-07-05/australias-cardiac-arrest-rates-targeted-through-cpr-campaign/104048532 My CPR Certification Online. (n.d.). CPR success rate. https://www.mycprcertificationonline.com/blog/cpr-success-rate Safe Work Australia. (n.d.). First aid. https://www.safeworkaustralia.gov.au/safety-topic/managing-health-and-safety/first-aid Safe Work Australia. (2019). Code of practice: First aid in the workplace (Document No. 1908). https://www.safeworkaustralia.gov.au/system/files/documents/1908/code_of_practice_-_first_aid_in_the_workplace_0_0.pdf
December 12, 2024
Steven Cumper
AED Maintenance Checklist: Essential Steps
For anyone suffering a sudden cardiac arrest outside of hospital, an Automated External Defibrillator (AED) could make all the difference when saving a life. Around 26,000 Australian people suffer arrests outside of medical facilities each year. Therefore, it’s crucial to have AEDs on standby in public places. By delivering electric shocks, AEDs can also help to prevent brain damage and support CPR. However, these devices must always be properly maintained and stored so they continue to support public emergencies. In this guide, we will break down a simple AED maintenance checklist you can follow to ensure your equipment is clean, safe, and operational. AED Maintenance Checklist An AED maintenance checklist ensures that you regularly test, clean, and fix up your life-saving devices whenever needed. As critical as AEDs are, you can’t expect them to keep working properly without due care and attention. Key Components to Include in the Checklist The key points we recommend you include in your AED maintenance checklist are: Checking and replacing batteries Checking and replacing pads Visually inspecting the device Cleaning the device Storing the device safely and securely This list isn’t just based on our expert knowledge of AED equipment, but also on years of feedback from business owners and first responders who shop with us! We’ll explore each of these points in more detail below. Importance of Documentation Before checking, cleaning, or even fixing your AED for the first time, carefully read the manual provided with your device. Failing to look after your AED properly could lead to it breaking down, therefore putting lives at risk. All AEDs we provide at Medshop arrive with clear instruction manuals to help you learn how to use the devices and how to care for them. Let’s start with the key points from our AED maintenance checklist. Battery and Pads Replacement AED batteries, like any, will slowly expire over time. In most cases, you’ll need to replace them within five years of starting to use the device or fitting new batteries. However, some will expire in as few as two years – always check your manual. Most AEDs will also have battery indicator levels to inform you when replacement is approaching. Always follow your manual’s advice on how to safely remove expired batteries before trying to do so yourself. Removing the batteries will depend entirely on the model of AED you use. In many cases, there will usually be a back cover you can safely remove to find the batteries to remove and replace. Always make sure to purchase AED batteries from a reputable supplier. AED pads expire, too. For example, over time, the gel used to adhere pads to skin will gradually lose applicability. Expired pads might become loose during operation – meaning your AED won’t work properly. There’s no guarantee when AED pads generally dry out and expire, so make sure to check any expiration dates listed by the manufacturer. Add these dates to your checklist. It’s also a good idea to visually check your pads for any damage – cracks or tears, for example – these simply won’t work properly. We recommend keeping a second or even third set of fresh pads on standby just in case you find their adherence has dried up before use. You should always make sure to buy pads designed for your specific AED, and to store them in sealed packaging to stop them drying up and getting damaged. Cleaning and Maintenance Procedures Always carry out routine visual inspections and clean your AEDs at least monthly to make sure they are safe and operational for use in emergencies. However, using abrasive chemicals can damage the device, so use appropriate cleaning solutions such as rubbing alcohol, or isopropyl. Carefully clean the AED itself and any corners and nooks in the device, along with the case and any additional pieces. You should use a damp cloth with rubbing alcohol for the best results, but you can also use disinfectant wipes or water. Any damaged or faulty parts should be replaced outright – make sure to line up a supplier or to speak with your manufacturer if this is the case. At the same time, it’s important to test your AED occasionally – again, monthly, at least – to ensure it’s fully operational. Many AEDs will have safe test functions and offer warning indicators if there’s a problem. This is another procedure you can follow via your device’s manual. Legal and Compliance Requirements Legal and compliance requirements for AEDs and public buildings vary depending on location. However, in South Australia, for example, it’s a legal requirement for public building owners to install a fully-working AED in an accessible location with clear signage. That said, compliance and legal requirements can vary depending on your building and services, too. Best practice, generally, is to store and maintain your AED carefully and ensure it’s clean and operational. It’s also important to register your AED defibrillators with any local authorities – making sure you meet the standards expected of you not only keeps people safe, but also ensures you remain on the right side of the law. Proper Placement and Storage As per compliance and for public safety, all AEDs should be stored appropriately in accessible areas with clear signage. In the event of an emergency, people in need should not have to spend time looking around for life-saving equipment. To preserve AEDs and their pads, always keep your equipment away from extreme temperatures. Many of our customers also say that keeping AEDs safely secured in storage boxes and cabinets helps prevent damage – and we agree. Just make sure the cabinets or boxes you use are durable! Even if you haven’t used your AED for a while, always regularly test it and visually check for damage. Training and Awareness for AED Users Many AEDs are simple to use with instructions provided during application. However, it still pays to invest in training for people who are likely to use the equipment over time. Train your personnel regularly – just as you would with first aid and CPR – so that your whole team knows how to use AED defibrillator equipment should the worst-case scenario occur. Basic awareness is just as important – in the event of a sudden cardiac arrest, your team needs to know where the life-saving equipment is held! Cost-Effective Ways to Maintain Your AED Here are some final tips to help you maintain your AED and accessories without the unnecessary expense: Invest in and store high-quality replacement parts Set up a regular schedule for maintenance to avoid costly replacements and fixes Shop with a reputable AED provider with positive customer reviews – reputable providers offer long-lasting equipment Trust your manual – not your gut – when it comes to maintaining your AED If in doubt about your AED’s functionality – contact the manufacturer before purchasing parts Conclusion Maintaining your AED and its equipment effectively means that, should you ever need to use them, you have the best possible chance at saving lives. Whether the people you help need CPR, an electrocardiogram (ECG), or hospital treatment afterwards, you’re taking the right steps to get them back to full health. Don’t just leave your AEDs in place – check, test, clean, and repair them – lives could depend on you doing so. Sources AED.com. (n.d.). Cleaning your Physio Control AED or Manual Defibrillator. In AED.com. Retrieved December 2, 2024, from https://www.aed.com/blog/cleaning-your-physio-control-aed-or-manual-defibrillator/ April. (2024). Australian regions needing cardiac arrest education revealed. In Monash University. Monash University. https://www.monash.edu/news/articles/australian-regions-needing-cardiac-arrest-education-revealed Bray, J., Howell, S., Ball, S., Doan, T., Bosley, E., Smith, K., Dicker, B., Faddy, S., Thorrowgood, M., Swain, A., Thomas, A., Wilson, A., Shipp, C., Walker, T., Bailey, P., Finn, J., Smith, T., Bernard, S., Grantham, H., … Perkins, G. (2022). The epidemiology of out-of-hospital cardiac arrest in Australia and New Zealand: A binational report from the Australasian Resuscitation Outcomes Consortium (Aus-ROC). In Resuscitation (Vol. 172, pp. 74–83). Elsevier BV. https://doi.org/10.1016/j.resuscitation.2022.01.011 Defibtech LLC. (n.d.). How to Check a Defibrillator. In AED Maintenance Checks. Retrieved December 2, 2024, from https://www.defibtech.com/news/latest/how-to-check-a-defibrillator/ Enser, M. (2024). Do AED Units, AED Batteries, & AED Pads Expire? & Why? In First Response Safety Training. https://www.firstresponsecpr.com/blog/do-aed-units-aed-batteries-aed-pads-expire/ Heart Saver NZ. (2021). Why Do AED Pads Expire? Heart Saver NZ. https://www.heartsaver.co.nz/news/why-do-aed-pads-expire/ How to Change an AED Battery on 6 FDA-Approved Brands. (2023). https://www.aedleader.com/blog/how-to-change-aed-battery/
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