AED Training: Challenges to AED Use

When an individual suffers from ventricular fibrillation – an irregular and life-threatening heart rhythm that negatively impacts circulation – immediate CPR and defibrillation can save his or her life. Both life-saving skills are taught in Basic Life Support (BLS) and Advanced Cardiac Life Support (ACLS) training.

What is defibrillation?

Defibrillation is an electrical shock to the chest that stuns the heart; it’s most commonly delivered through an AED (automatic external defibrillator). An AED is a small, portable device that analyzes the heart’s rhythm and, if necessary, directs the rescuer to deliver an electrical shock to the heart of someone suffering from sudden cardiac arrest. The AED, if properly used, should stimulate regular circulation and blood flow in a patient. Health Ed Solutions’ ACLS and BLS courses offer modules on AED training and use.

What to do when defibrillation is difficult

What do you do in a medical emergency if you can’t easily use an AED? BLS and ACLS training will teach you to recognize and account for the four most common challenges to AED use:

Internal pacemakers. Individuals with prior cardiac problems may have implanted pacemakers to help regulate their heartbeat, or implanted defibrillators to deliver an emergency shock. These devices don’t prevent an AED from being used. However, electrode pads shouldn’t be placed over the area of an implanted device, as the electrode pad can’t penetrate through the implanted device. If an implanted device exists, a rescuer will feel a small, firm lump the size of a small cell phone in the chest or abdomen area.
Water. If an individual in cardiac arrest is found in water, remove him or her from water before using an AED. The shock that an AED delivers is one that can be carried by water. Therefore, if the patient is wet the shock won’t adequately penetrate the heart. Be sure to first dry the person’s chest if he or she was removed from water.
Transdermal patches. If an individual has a transdermal patch – a means of medication delivery – on his or her chest, don’t place an AED electrode pad over top of it. Doing so will block the shock and it may also burn the person. Instead, remove the transdermal patch before executing an AED.
Chest hair. For a successful AED shock to take place, the electrode pads must be in direct contact with an individual’s skin. For people with a lot of chest hair this may not be possible. A rescuer will either need to push down firmly on the pads or shave the chest area with a razor (often provided in the AED case) to provide sufficient skin contact.

The earlier that defibrillation occurs, the better. For every minute that defibrillation is delayed on a person suffering from ventricular fibrillation, his or her chance of survival declines by seven to 10 percent.

Health Ed Solution's online certification and recertification for advanced cardiac life support (ACLS) training contains a module dedicated to defibrillation and AED certification. Our online ACLS course was designed for healthcare professionals.

The information included in this article is based on the 2020 guidelines for CPR, first aid and advanced cardiovascular care. Read more about how the 2020 guidelines impact ACLS training online.