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How to Use Public Defibrillator Machines

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How to Use Public Defibrillator Machines

May 14, 2014

They’re becoming more available in public places–but how do you use a defibrillator machine? Dr. Troy Madsen talks about public defibrillators, when to use them, and how they might save someone’s life. He also tells you what to do under pressure if someone goes down in public.

Scot: Have you ever seen one of those defibrillation machines on the wall and wondered "huh, I wonder how that works"? We're going to find out next on The Scope.

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Scot: So you're starting to see them pop up more and more in public places-defib machines-in case somebody's having a heart attack or heart failure. But have you ever wondered boy, would I know how to use one? We're talking with Dr. Troy Madsen, emergency medicine at University of Utah Hospital. How do you use those machines?

Dr. Troy Madsen: You know, it's one of those things where fortunately they've made them easy enough to use that, you know, I'd like to say they're foolproof. They're probably not quite foolproof but pretty close to it.

Scot: Okay.

Dr. Troy Madsen: So, you know, the big scenario where I would use it would be where someone didn't have a pulse and they weren't breathing. So someone falls down. And you're going to find these machines in lots of different places, lots of different public sort of locations. But if someone falls down, they're not responding to you, they don't have a pulse, number one-start CPR. Call for 911. But meanwhile ask someone to go get one of those machines.

Scot: So can you get them? I thought they were permanently mounted on the wall.

Dr. Troy Madsen: They are, but usually you can just break through that just like, you know, you would break through some sort of thing for a fire extinguisher or something like that or get it open.

Scot: And then carry them?

Dr. Troy Madsen: And just bring it over.

Scot: Oh, they're battery powered?

Dr. Troy Madsen: They are. They are battery powered.

Scot: Oh, I thought they were mounted permanently.

Dr. Troy Madsen: No.

Scot: Oh, okay.

Dr. Troy Madsen: Fortunately you can just pull them right off the wall, bring them to wherever you are and wherever you need help.

Scot: Okay, all right. So somebody goes and gets one. They bring it on over.

Dr. Troy Madsen: Yeah.

Scot: And the only time you'd use it, if somebody doesn't have a pulse, that's the only time?

Dr. Troy Madsen: Yeah, exactly.

Scot: Okay, all right.

Dr. Troy Madsen: This is something for CPR.

Scot: Okay.

Dr. Troy Madsen: You're going to use if you're doing CPR. Ideally, you know, if you're in a situation where someone goes down and you don't have any experience with CPR, just start chest compressions but ask "hey, does anyone here know how to do this?"

Scot: All right.

Dr. Troy Madsen: Get the most experienced person in there, but it's something where you can pull that thing off the wall, get it down there, and start using it. So once you open it up and turn it on, it'll tell you what to do. It'll tell you "place pads," and it'll show you where to place the pads. You're putting them on the person's chest.

Scot: Really? So it's a little video screen?

Dr. Troy Madsen: It'll speak to you. It actually talks to you.

Scot: It talks to you.

Dr. Troy Madsen: It will talk to you.

Scot: Wow.

Dr. Troy Madsen: Yeah, these things are programmed just so they talk to you, and they'll tell you what to do.

Scot: Okay.

Dr. Troy Madsen: And then they'll tell you "Do chest compressions" because that's the most important thing you're going to do in any of these situations. Just do good chest compressions. Keep pushing on that person's chest at 100 beats a minute. Just keep going.

Scot: Staying alive.

Dr. Troy Madsen: Staying alive.

Scot: Bee Gees song.

Dr. Troy Madsen: Yeah, think staying alive.

Scot: Sing it in your head.

Dr. Troy Madsen: Because that is 100 beats a minute. And then it will tell you "Stop compressions" and then it will say that it's analyzing the rhythm, and what that means, it's looking at the person's heart rhythm to decide is this something it can shock or not. And there are certain heart rhythms when a person's heart is not beating, but it still has some electrical activity where it can shock that, and by shocking it, it can put it back in normal rhythm. So that's what the machine's looking for.

Scot: Okay.

Dr. Troy Madsen: And then if it can shock it, it says "shock," and it tells you "push this button," and you push it, and it shocks the person, and that shock might be the thing that saves that person's life.

Scot: So it sounds really easy to use this machine.

Dr. Troy Madsen: It is.

Scot: Just do what it tells you to do.

Dr. Troy Madsen: Exactly.

Scot: Wow.

Dr. Troy Madsen: They've really designed it so it just walks you through the steps. So, you know, if you're in that situation and you don't have any experience or there's just no one there who knows how to use it, that's okay. Just jump in and do it, and it will walk you through the steps. Keep in mind that this person if they don't have a pulse and they're not breathing, for all intents and purposes, they are dead. So you are doing something to try and help them, so just jump in and do it, and it'll tell you what to do.

Scot: In that instance, you're not doing harm.

Dr. Troy Madsen: You are not doing harm. We always tell ourselves "Do no harm." You're not doing harm. Without your help, this person is dead, so just jump in and see what you can do, and the machine will tell you how to do it.

Scot: And then you just keep doing what the machine tells you until when?

Dr. Troy Madsen: Exactly. It'll just keep telling you until the ambulance gets there. That's the most important thing. Until they get a pulse back. It'll tell you to check for a pulse, so you can feel the best places on the neck. Feel for the carotid pulse. It's the big artery there on the neck. If you don't feel a pulse, then it'll just tell you "Keep doing chest compressions." And it'll tell you "Stop chest compressions." And it'll tell you again if it can shock, and you push the shock button. So it'll walk you through the steps very nicely.

Scot: So, to the best of your knowledge, are these machines in a lot of places? Just a few places? Is it publicly owned places?

Dr. Troy Madsen: You're going to find them in most large places where people are congregating, meaning airports, arenas, concert venues, schools, certainly hospitals. You know, all these places are usually going to have a defibrillator or an AED, an automated external defibrillator. So wherever you are, if you're in a public place, look for one if you need it, if you're in that situation . . .

Scot: Sure.

Dr. Troy Madsen: . . . or ask someone "can you go find something?"

Scot: Just be aware that there could be something that could help you.

Dr. Troy Madsen: Exactly.

Scot: Because that would be terrible after the fact to realize that that tool was there and you didn't use it.

Dr. Troy Madsen: It would be, yeah.

Scot: What if you're in a situation where you have to make the choice of doing the chest compressions or going to get the machine because there's nobody else around at that point?

Dr. Troy Madsen: That's a tough situation.

Scot: Would you run and get the machine or should you do the chest compressions?

Dr. Troy Madsen: My number one thing there would be calling 911, and if I didn't have a phone there with me, I would go to a phone and call 911 because they're going to give the most help. But I would do chest compressions. If I were in that situation, chest compressions are going to keep that person alive long enough for the ambulance to get there.

Scot: But first call 911 before you do anything.

Dr. Troy Madsen: Number one-call 911. Yep, that is the first step before you do anything because they're going to get the advanced care and get that person where they need. But you can keep that person alive, keep at least some blood going to their brain and their body by doing chest compressions.

Scot: All right. Any final words of advice on using one of these things?

Dr. Troy Madsen: Final word of advice would be, you know, if you're in this situation, think chest compressions first. Do that. Call for 911. But if you've got access to it, don't be scared of it. Just jump in and use it. It'll walk you through the steps.

Announcer: We're your daily dose of science, conversation, medicine. This is The Scope, University of Utah Health Sciences Radio.