Article / Lin Xinping
Source / Ministry of Health and Welfare, public **** place AED first aid information network
Many stations, department stores, schools and other public **** place, you can see the figure of the AED, every time as long as someone suddenly cardiac arrest collapsed, the AED will be immediately mobilized, become an important tool to save the life of the AED, but what is the AED?
Why is the AED known as the "smart-ass AED" so magical that even the untrained general public can quickly get started and save a life? In fact, as long as you take the time to understand it, everyone has the opportunity to become a little emergency medical rescue.
AED Emergency Medical Rescue Troopers
"AED" is an acronym for "Automated External Defibrillator", also known as "Automated External Defibrillator" or simply "Automated External Defibrillator", which, as the name suggests, delivers electric shocks to those who have collapsed due to a fibrillating heart, but whether or not the discharge function of a normal heart is the same as that of an AED. However, does the normal heart's electrical discharge function conflict with an AED? When do you need an AED to deliver a shock?
Taipei Veterans General Emergency Department attending physician, at the same time is the Taiwan Society of Emergency Medicine Deputy Secretary General and the Taipei City Fire Department emergency medical guidance physician Liao Wanru said, AED is mainly for the arrival of pulseless people to the medical emergency, through the way of electric shock in the hope of restoring the patient's normal heartbeat and pulse, and generally only in the "ventricular fibrillation (Ventricular fibrillation, VF)", "the heart of the patient, the patient's heart, the patient's heart, the patient's heart, the patient's heart, the patient's heart".
The AED will only give electric shock when the two situations occur, namely, "Ventricular fibrillation (VF)" and "Ventricular tachycardia (VT)".
Liao Wanru explained, the heart has atria and ventricles, under normal circumstances, the heart's electrical activity and contraction is from the atria to the ventricles, and ventricular fibrillation (VF) is that this electrical activity can not be successfully transmitted from the atria to the lower part of the heart, at this time, the heart may be irregularly jumping and shaking and can not send blood to the periphery, so that the patient's pulse will be presented in the state of the feeling can not be felt.
As for the ventricular frequency pulse (VT), it means that although the heart is beating regularly, it is not following the normal conduction path of electrical activity, and the ventricle is contracting too quickly at a rate much higher than the normal contraction rate of the heart, which also causes the heart to be unable to beat out the blood smoothly, and therefore, it may also result in the loss of a pulse. Both VT and VF can be pulseless, and an AED can monitor and recognize these two conditions.
Electroshock heart reboot, to help people survive
If the ventricular fiber fibrillation (VF) and ventricular frequency pulse (VT) analogous to the computer when the computer, Liao Wanru said, whether the heart of the VF irregularly shaking or VT tachycardia, the two are still in the heart is still moving, just can not be contracted normally to beat the blood only. At this time, if the bystanders can immediately use AED shock, through the current *** heartbeat, like a computer short-circuit show, must be rebooted or let the system reorganize, the heart has the opportunity to restore the normal heartbeat pulse, and let the heart of blood to the whole body, otherwise the lack of blood supply to the brain, the lack of oxygen for too long will be damaged, even if the later successfully rescued, but also may turn into a vegetable.
It's worth noting that the AED, though called a "dumb stunner," is actually quite smart. It will only make a shock for people with ventricular fibrillation and ventricular frequency pulses. Once the patient's heartbeat has completely stopped, the ECG shows a horizontal straight line of "asystole" (cardiac arrest), or the patient himself has lost his pulse (PEA) due to other factors (such as too acidic blood, too high or too low potassium, pericardial tamponade, pneumothorax, or some drug poisoning such as maudiline, etc.), but there is still electrical activity or cardiac contraction on the cardiac monitor, the AED will automatically detect it and then deliver a shock. The AED does not give any shock advice after automatic detection.
Automatically read the heart to be shocked
Liao Wanru explains, smart AED can automatically read the heart can function normally, whether the heart has completely stopped no function or it still has electrical activity, just the average person can not detect the pulse, these times AED will not be easy to shock the heart.
Because the machine automatically recognizes this, people don't have to be afraid to say, "What if he's still alive and I shock him? If the AED reads that the heart is still beating normally, it won't recommend electrocution, so there's no need to worry about harming normal people with an AED.
Liao Wanru further said that the reason why CPR is important, mainly because the brain as long as there is no blood flow through the lack of oxygen for more than 5 minutes, even if the follow-up to take a series of medical emergency measures to save the life of the patient back to the necrosis of the brain cells, it is likely to lose a lifetime of memory, language, control of limb activity and other functions, and vegetative as a cabbage. Therefore, it is very important to use CPR to maintain the blood supply and normal functioning of the brain in an emergency.
AED and CPR are good partners for successful life-saving
But for both ventricular fibrillation and ventricular pulse, CPR alone is not enough; only by giving electric shocks like the "Reset" command, and helping the heart to "reboot" through the AED, can the heartbeat be restored to normal. Therefore, in addition to the traditional CPR first aid, for patients with out-of-hospital cardiac arrest, AED shock is a complementary life-saving partner to CPR, which can reduce the damage of hypoxia to the brain and organs of the whole body, so that patients with pre-hospital cardiac arrest can have a chance to return to normal, and not only survive, but also walk out of the hospital in good health.
According to the statistics released by the Ministry of Health and Welfare in recent years, heart disease is among the top 3 causes of death. Heart disease causes death, mostly in the form of sudden cardiac arrest, and electric shock can make the heart return to normal heartbeat. According to the literature, in cases of sudden cardiac arrest due to arrhythmia, the success rate of resuscitation is as high as 90% if electric shock or CPR is administered within 1 minute; however, the success rate decreases by 7-10% for every 1-minute delay in resuscitation.
Because the survival of patients with injuries and illnesses is a tug-of-war between time and death, in order to fight for the golden rescue time, many crowded public **** places will be set up AEDs, such as department stores, stations, subway, airports, highway rest stops, schools, courts, public institutions, swimming pools, gyms, etc., but also to provide the general public with a simple and rapid first-aid to save patients with injuries and illnesses. The new technology will also help to reduce the risk of pre-hospital deaths.
Simple "call piezoelectric" first aid measures
Liao Wanru said that the people see someone collapsed and unconscious, you should immediately dial 119, call "ambulance technician or emergency medical technician (EMT)" immediately to come to the first aid. However, before the paramedics arrive, people should take "call - call - pressure - electricity" first aid measures.
"Scream" means to call out to the collapsed person to confirm consciousness and response.
"Scream" means to call 119 to get a paramedic if the person is unresponsive, and ask someone to get an AED.
"Press", immediately perform CPR chest compressions on the collapsed person, press down hard and fast to a depth of 4-5 centimeters, and maintain 100 compressions per minute for at least 5 minutes until the AED is brought in.
"Electricity", after obtaining an AED, even if a person has not received professional first aid training, as long as you follow the diagrams on the device and voice instructions, you can directly operate the cardiac shock device to save lives.
How to use an AED: After people open the AED box, they turn on the power switch, insert the plug, and place the patch on the patient's upper right sternum and lower left apical position, which is the direction of electrical conduction in the heart.
Then the AED will analyze the heart rhythm of the collapsed person, at this time listen to the voice instructions to stop CPR, remember not to contact the patient until the results of the analysis to inform whether it is recommended to administer electric shock.
Liao Wanru said, for the AED judgment can not shock people, the public must continue to do CPR, until the ambulance crew arrived to take over. On the other hand, if the AED analyzes the collapsed person can be electroshocked, then the bystanders must leave the collapsed person's body around, after the electroshock, and then with the CPR beat continue to press the chest first aid.
How can CPR+AED save a life?
If you have received professional training in first aid, you can also adopt the principles of "CAB" or "CABD" first aid, that is, Compressions, Airway, Breathing. If there is no response, start the CAB first aid measures. In addition to chest compressions, you can also help to open the other person's airway by compressing the chest 30 times, pressing down on the forehead, and lifting the chin up to open the airway so that air can flow into the lungs smoothly. Then do mouth-to-mouth breathing (Breathing) 2 times in a row, blowing for more than 1 second each time, and make sure that the chest cavity rises and falls smoothly. Continue CAB until paramedics arrive to take over or obtain an AED (D).
The so-called "C" also refers to the force and rapid pressure in the center of the chest, at least 100 chest compressions per minute, the frequency of compressions can be compared to the "Bee Gees" (Bee Gees) 〈Stayin ' Alive 〉 (Stayin ' Alive) song, or Wang Caihua sang Taiwanese pop song 〈Bao Biao〉 rhythm, are very suitable for CPR chest compressions. The frequency is very suitable for CPR chest compressions.
Liao Wanru emphasized that CPR is actually an artificial way to help the heart outside of the body *** through artificial chest compression to press the blood flow out of the heart, so that the brain can get a temporary blood flow oxygen supply. Although artificial CPR can not be like a normal heartbeat to provide rich blood flow to the brain and the whole body tissues and organs, but at least there is a chance to maintain about 30 ~ 40% of the normal cardiac blood supply, to fight for this point in time to avoid the brain hypoxia damage is extremely important, so, continuous uninterrupted CPR, is the key to the pre-hospital cardiac arrest patients to save their lives.
What are the conditions in which an AED is not indicated?
Although AEDs are easy to use, beginners can quickly save lives, but there are still some cases where AEDs are not suitable, or people must pay attention to some small details when using them, so as not to affect the machine's interpretation and operation. Liao Wanru explained, such as the body of the fallen person is too wet, this time may have to wipe the other side of the body dry, so as not to connect to the AED, but their own electric shock.
In addition, if the patient has a cardiac pacemaker, it is still possible to use an AED, but the patch should not be attached directly to the skin directly above the pacemaker before the shock. In addition, too thick chest hair may also affect the conductivity, the best before the electric shock shaved chest hair, so as not to affect the conductive effect. Most importantly, the shock patch must be attached to the skin, not to the clothes, to avoid the AED can not be read correctly.
There are also a lot of people will be worried about good intentions, "see the sudden collapse and unconscious people CPR or AED first aid, once the other side of the final is not rescued, or rescued after the unavoidable organ damage or brain damage, at this time will be involved in the controversy of criminal responsibility? In this regard, Liao said that according to Article 14-2 of the Emergency Medical Care Act, "Anyone other than the ambulance personnel who uses emergency medical equipment or gives first aid in order to save the life of another person from imminent danger shall be exempted from the provisions of the Civil Law and the Criminal Law on emergency evacuation, and the exemption from the provisions of the Civil Law and the Criminal Law also applies to the first aid given by the ambulance personnel during the period when they are not on duty". Therefore, people do not need to worry about getting caught in the middle of a criminal offense when they are trying to save someone's life.
Liao Wanru emphasized that people outside the hospital or public **** place, as long as you see someone suddenly collapsed, and shouting at each other no response, may need AED first aid, through the smart AED automatic reading, and with CPR first aid, can let the pre-hospital cardiac arrest of the injured and sick patients, but still have the opportunity to save from the ghost of the door, not only to increase the chances of survival, but also to see again!
These are the first time I've ever seen a computer that was designed to work with a computer.
What are the conditions in which an AED is not indicated?
Although AEDs are easy to use and beginners can quickly save lives, there are still some situations where AEDs are not suitable, or where people must pay attention to some small details when using them, so as not to affect the machine's interpretation and operation. Liao Wanru explained, such as the body of the fallen person is too wet, this time may have to wipe the other side of the body dry, so as not to connect to the AED, but their own electric shock.
In addition, if the patient has a cardiac pacemaker, it is still possible to use an AED, but the patch should not be attached directly to the skin directly above the pacemaker before the shock. In addition, too thick chest hair may also affect the conductivity, the best before the electric shock shaved chest hair, so as not to affect the conductive effect. Most importantly, the shock patch must be attached to the skin, not to the clothes, to avoid the AED can not be read correctly.
There are also a lot of people will be worried about good intentions, "see the sudden collapse and unconscious people CPR or AED first aid, once the other side of the final is not rescued, or rescued after the unavoidable organ damage or brain damage, at this time will be involved in the controversy of criminal responsibility? In this regard, Liao said that according to Article 14-2 of the Emergency Medical Care Act, "Anyone other than the ambulance personnel who uses emergency medical equipment or gives first aid in order to save the life of another person from imminent danger shall be exempted from the provisions of the Civil Law and the Criminal Law on emergency evacuation, and the exemption from the provisions of the Civil Law and the Criminal Law also applies to the first aid given by the ambulance personnel during the period when they are not on duty". Therefore, people do not need to worry about getting caught in the middle of a criminal offense when they are trying to save someone's life.
Liao Wanru emphasized that people outside the hospital or public **** place, as long as you see someone suddenly collapsed, and shouting at each other no response, may need AED first aid, through the smart AED automatic reading, and with CPR first aid, can let the pre-hospital cardiac arrest of the injured and sick patients, but still have the opportunity to save from the ghost of the door, not only to increase the chances of survival, but also to see again!
This is the first time that we have seen an application for CPR in the United States.
4 situations where CPR is essential
Basically, patients in OHCA (Out of Hospital Cardiac Arrest) will not be able to feel a pulse on the cardiac monitor when they are admitted to the emergency room, in 4 situations, including cardiac arrest, asystole, partial cardiac arrest, and a heart attack. Asystole", "pulseless electrical activity" from partial depression of the heart (PEAVFVT4CPR)