AED Use on a Wet Deck
You are a lifeguard at an indoor pool. A 60-year-old man collapses on the pool deck after swimming. You and another lifeguard respond. The man is unresponsive and not breathing. You send someone to call 911 and retrieve the AED. The deck is wet from swimmers. The man is lying on his back. You have started CPR with chest compressions. The AED arrives within 30 seconds. You are about to apply the pads. The other lifeguard is preparing to continue CPR. There are several bystanders around. The man has a medication patch on his chest.
1. What should you do before applying the AED pads, considering the wet deck and the medication patch?
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Before applying the AED pads, you need to ensure the victim's chest is dry and free of obstacles. The wet deck is a concern because water can conduct electricity and pose a risk during defibrillation. You should quickly move the victim to a dry area if possible, or dry the chest thoroughly with a towel. If the victim is on a wet surface, you can still use the AED but must ensure that no one is touching the victim when the shock is delivered. As for the medication patch, you should remove it and wipe the area clean before applying the AED pad, because some patches can interfere with the electrical current or cause burns. Also, remove any other patches or medication delivery devices. Ensure the chest is dry and the patch is removed, then apply the pads as shown on the diagrams. Continue CPR until the AED is ready to analyze.
2. After applying the pads and analyzing the rhythm, the AED advises a shock. What should you do next, and what precautions should you take with bystanders?
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When the AED advises a shock, ensure that no one is touching the victim. Loudly state 'Clear!' and visually check that everyone, including the other lifeguard and bystanders, is clear of the victim. Do not allow anyone to touch the victim during the shock. Press the shock button as directed by the AED. After the shock is delivered, immediately resume CPR, starting with chest compressions. Do not delay to check for a pulse or breathing; the AED will prompt you to continue CPR for 2 minutes before reanalyzing. Keep bystanders back and ensure they do not interfere. If the victim is on a wet surface, make sure no one is in contact with water that could conduct electricity. Continue to follow the AED prompts until EMS arrives or the victim starts breathing.