AED Advanced Flashcards

What is the main advantage of a biphasic waveform AED over older monophasic devices?

Answer: It is more effective at lower energy levels, reducing myocardial damage

Biphasic AEDs are as effective or more effective at lower energies than monophasic devices, causing less myocardial damage.

When should pediatric AED electrode pads or attenuation keys be used?

Answer: For children aged 1-8 years (or under 25 kg) when available

Pediatric pads or attenuation keys should be used for children under 8 years or under 25 kg when available, as they reduce delivered energy to safe levels.

What is the correct anteroposterior (front-to-back) electrode pad placement for AED use?

Answer: One pad on the front center of the chest, one pad on the back between the shoulder blades

Anteroposterior placement puts one pad on the front center of the chest and one on the back, which is used in special situations like a pacemaker or breast tissue.

What should be done if a patient has a hairy chest when applying AED electrode pads?

Answer: Firmly press and rip off the first set of pads to remove hair, then apply a new set

Pressing and removing the first set of pads removes chest hair, allowing the second set to adhere properly and deliver current effectively.

What is the significance of an AED's rhythm analysis algorithm in the context of shock delivery?

Answer: It detects VF and pVT patterns and advises shock, while detecting non-shockable rhythms and advising no shock

AED algorithms analyze the ECG signal to identify shockable (VF/pVT) vs. non-shockable (asystole/PEA) rhythms and advise the rescuer accordingly.

A patient is found to have an implanted cardioverter-defibrillator (ICD). How does this affect AED pad placement?

Answer: Place AED pads at least 1 inch away from the ICD device and in a standard or alternate position

AED pads should be placed at least 1 inch (2.5 cm) away from an ICD or pacemaker to avoid device damage and ensure effective shock delivery.

What should a rescuer do if the patient is lying in water when using an AED?

Answer: Move the patient to a dry surface before applying pads and using the AED

The patient must be moved from standing water to a dry surface before AED use to prevent current conduction through water to rescuers and to ensure effective shock delivery.

In an automated external defibrillator with a 'manual override' feature, when might a trained healthcare provider choose to use this mode?

Answer: To perform synchronized cardioversion for a patient with a pulse in an unstable tachyarrhythmia

Manual override enables synchronized cardioversion for unstable tachyarrhythmias in patients with a pulse, where unsynchronized shock risks causing VF.

What is the recommended energy for the first defibrillation attempt with a biphasic AED when treating adult VF/pVT?

Answer: 120-200 joules (manufacturer specified) or 200 joules if unknown

Biphasic AEDs should use the manufacturer's recommended energy (120-200 J); if unknown, use 200 J for the first shock.

How often should AED electrode pads be replaced in a maintenance program?

Answer: According to manufacturer's expiration date, typically every 2-5 years

AED pads should be replaced according to the manufacturer's expiration date (typically 2-5 years) and after each use.

What is a 'waveform analysis artifact' in the context of AED use during CPR?

Answer: Electrical interference from CPR compressions that can confuse the AED's rhythm analysis

Motion artifact from chest compressions creates electrical noise that can confuse AED algorithms, which is why compressions must pause during analysis.

For which of the following situations is AED use contraindicated or should be used with caution?

Answer: In a patient with a transdermal medication patch in the pad placement area

Transdermal medication patches should be removed and wiped clean before AED pad placement, as patches can cause arcing, burns, and reduce shock effectiveness.

What is the purpose of the 'analyze' phase in AED operation?

Answer: To analyze the patient's heart rhythm and determine whether a shock is indicated

The analyze phase uses the AED's algorithm to evaluate the cardiac rhythm and determine whether defibrillation (shock) is indicated.

What is 'defibrillation threshold' (DFT) and its clinical significance?

Answer: The minimum energy level at which defibrillation is reliably successful for a given patient

Defibrillation threshold is the minimum energy needed to successfully terminate VF/pVT for a given patient, which varies among individuals.

How does transthoracic impedance affect AED shock delivery, and how do modern AEDs compensate?

Answer: Higher impedance reduces current flow to the heart; biphasic AEDs adjust waveform characteristics to compensate

Biphasic AEDs measure transthoracic impedance and automatically adjust shock waveform characteristics to maintain effective current delivery despite variation.

What should a rescuer do while the AED is charging in preparation for a shock?

Answer: Continue chest compressions until the shock is ready, then clear

Continue compressions while the AED charges to minimize the pre-shock pause, then clear just before the shock is delivered.

What are the two main types of electrode placement for AED use?

Answer: Anterior-posterior (AP) and anterior-lateral (AL)

Anterior-lateral (standard) and anterior-posterior (alternative) placements are the two main configurations for AED pads.

What is the role of an AED's 'ready' indicator or status display?

Answer: It indicates that the AED is in working order and ready for use (battery and pads are functional)

The ready indicator confirms the AED is functional and ready for deployment—battery is charged and pads/accessories are present and connected.

Following unsuccessful defibrillation of VF, what is the correct post-shock action?

Answer: Immediately resume CPR starting with chest compressions for 2 minutes

After any shock (successful or not), immediately resume CPR starting with chest compressions for 2 minutes before re-analyzing rhythm.

What information should be documented when an AED is used in a cardiac arrest event?

Answer: Time of collapse, time of CPR start, time of AED use, number of shocks, energy used, and patient outcome

Comprehensive documentation of all resuscitation timelines, interventions, and outcomes is required for quality improvement and legal purposes.