This paper draws on personal teaching experience to examine the importance of educating nurses and other healthcare staff in the use of the Philips HeartStart Automated External Defibrillator (AED). It begins by outlining the prevalence of sudden cardiac arrest (SCA) and the role ventricular fibrillation plays in cardiac death. The paper explains how AEDs function, contrasts semi-automated and fully automated devices, and presents survival-rate data demonstrating the device's life-saving potential. It concludes by emphasizing that accessible AEDs, regular retraining, and nurse educator involvement are essential to reducing preventable cardiac deaths in clinical and community settings.
Children, young adults, and older adults alike can and do experience sudden cardiac arrest. Estimates indicate that undiagnosed heart conditions cause the death of one individual every three days in organized youth sports in the United States (AED Universe, 2012). The Survivor's Foundation reports that 460,000 deaths occur each year in the U.S. from sudden cardiac arrest (SCA). SCA is said to occur when the lower chambers of the heart — the ventricles — suddenly stop beating normally and develop what is called ventricular fibrillation (VF). VF is a chaotic heart rhythm in which the heart muscle begins quivering, preventing the heart from effectively pumping blood. If this condition is not corrected immediately, death will follow within ten minutes.
The automated external defibrillator (AED) is described as a sophisticated, computerized device that delivers defibrillatory shocks to a person in cardiopulmonary arrest (Survivor's Foundation, 2003). A defibrillator is the only known device or technique that stops chaotic electrical heart activity and allows the heart to re-pace itself to a normal rhythm (Survivor's Foundation, 2003). In approximately five percent of cases, the heart will re-pace itself without intervention. CPR increases the chance of survival by five percent; however, use of a defibrillator increases the patient's chances of survival by up to 80%. Every minute that passes after the onset of sudden cardiac arrest reduces the chance of survival by 10%. Leading manufacturers of defibrillators have developed a new generation of devices that require very little training, are portable, and are relatively inexpensive — known as Automated External Defibrillators (Survivor's Foundation, 2003).
The educator with experience in the use of the AED plays a vital role by passing that knowledge on to those being instructed. The AED has a primary role in decreasing the number of individuals who do not survive sudden cardiac arrest. All healthcare staff should be trained, equipped, and encouraged to perform defibrillation, and AEDs should be easily accessible — not locked away (Nursing Times, 2011). All healthcare staff, including practice nurses, community nurses, and health visitors, have a duty to perform effective CPR on their patients when required (Nursing Times, 2011). Deakin et al. (2010) confirms that these individuals should be "trained, equipped, and encouraged to perform defibrillation" (as cited in Nursing Times, 2011).
The AED may be either semi-automated or fully automated. The semi-automated AED analyzes the patient's ECG, advises that a shock is required, charges automatically, and then prompts the operator to press a shock button to defibrillate the patient (Nursing Times, 2011). The fully automated AED analyzes the ECG, charges up, and delivers the shock automatically — without requiring the operator to press any button (Nursing Times, 2011).
According to the Nursing Times, training and retraining in the use of AEDs is inconsistent across healthcare settings. A survey by Day et al. (2008) found that, in over half of health centers that possessed an AED, clinical staff had not received AED update training. Poor retention of resuscitation skills following training — for both nursing and medical staff — is well documented, and regular updates are required to maintain competence and proficiency (Hamilton, 2005; Woollard et al., 2004, as cited in Nursing Times, 2011).
The Resuscitation Council UK (RCUK) 2010 guidelines include two key statements relating to AED training:
"Technical differences between two AED types"
"RCUK guidelines and retraining survey findings"
"Nurse educator role in reducing cardiac deaths"
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