Now, lets cover the use of an automated external defibrillator otherwise known as an AED with
an infant while a CPR is already in progress. Now, I either require the AED myself, or someone's
brought it on scene, and its now available, but there is a couple points of scene safety
that need to be made prior to turning that on, and that is, is the baby laying in a puddle
of water? this would maybe be most seen like if the baby was pulled out of the pool or
pond or lake, and the water has now dripped into a bit of a pool or a water, and we're
kneeling into that water. With the conduction of an electricity, it may or may not happen,
but we don't wanna take any more chances. So, we simply would move the baby to a drier
ground, pat off the baby's chest and back, so that the pads adhere to the skin, and that
would be just fine. While we're talking about wetness and dampness, there's been some questions
about a wet diaper and using an AED. A wet diaper is no problem. Remember, we're concerned
about a puddle or a pool of water that the baby is laying in, not just damp clothing
or dampness around the baby. While we're looking at the surface of the baby, lets talk about
jewelry for some moment. There has been some concerns that the baby might have been wearing
a necklace or something, and it might cause some problems when using the AED. That's not
the case, just simply move the necklace to the side, out of the way of the AED pad, and
you should be just fine. Now, thirdly though is the combustible issue. Are there any combustible
gases or flammable liquids or anything in the environment that if we had a spark, there
would be problems. If the scene is safe, then you're ready to use the AED, so let's continue.
The first thing we wanna do with the AED when we have it, is turn it on. Once we turn the
AED on, we we'll follow the promptings. Its prompted us to remove the clothing, so that
we can actually access the points that are important for placing the pads on the baby.
As we turn the AED over, it has two sets of pads. The pediatric sized pads, and the adult
sized pads. In this case, obviously we wanna use the pediatric sized pads. When you open
up the pads, you'll see in most cases, a diagram that shows you where to place the pads. So,
this very first one, we'll take off and we'll place it as the diagram shows right on the
center of the chest. Make sure that its stuck well and not peeling up as that can affect
the way the actual pad works. Now, we take the second pad off, carefully rolling the
baby up on to its side, protecting its head and neck, we place it into its appropriate
location between the shoulder blades on the center of the back of the baby, and then roll
them back on to their back. Now, the AED is prompting insert electrodes or connect the
wires. So, we do that, we plug it in, and we follow the prompts. Its at this point,
that we wait for the AED to actually charge, and then encourage us to push the flashing
button to rescue. Making sure we're not touching the patient, its prompting us to push the
flashing button, and so we do. As soon as we deliver the shock, its vital to remember
that the per current research and guidelines, we don't wanna delay the very first compression
following the shock. We want to minimize that time gap, so that we're getting the pulse
pressures back up as soon as we can, and getting good circulation of oxygenated blood as fast
as we can. So now we can begin with our 30 compressions followed by two rescue breaths.
We're following the same guidelines that we follow with the CPR, which is compressing
a third of the depth of the chest or approximately one to one and a half inches deep, and we're
going to compress at a rate of at least a 100 to 120 compressions per minute, no more
than a 120 compressions per minute which is about two a second. One, and two, and three,
and four, and five, and six, and eight, nine, and ten, and eleven, and twelve, and thirteen,
and fourteen, and fifteen, all the way up to thirty compressions. We take our mask,
we put our one way valve shield over the baby's mouth and nose and deliver two rescue breaths.
We deliver our two rescue breaths, and then we go back to our chest compressions for 30
more times. Now note here that I am pressing here over the pad. At no point, would I want
to remove the pads from the back or the chest of the baby. We're gonna leave everything
intact, and do our CPR right over it. You will be interrupted potentially from time
to time by the AED, simply follow the prompts, and continue your protocol until EMS arrives,
something equally trained higher comes to relieve you or the baby actually regains consciousness.
But if the baby actually regains consciousness and starts to breathe on their own, though
we may stop doing CPR at that time, we would leave the AED intact, and allow it to monitor
the patient until EMS arrives and takes over.