1st Resp AED Protocol Needed

[jim whitfield]

We're in the process of updating/revising our medical protocols for our Division of Emergency Medical Response, and will be adding a new protocol for AED use.

If anyone has a good AED Protocol on 1st Responder/EMR/MFR level that you are willing to share, it would be greatly appreciated!

Thanks!
(email address below in signature)

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James A. Whitfield, Jr., MCEM
Sunflower County Fire Coordinator
Indianola, Missisippi
(662) 887-6253
fire_coordinator@SunCoFD.intranets.com
Battalion 1 - The Pride of the South

[N2DFire]

You're in luck James,
Just so happens I have my "Field Bible" (aka Protocol Book) with me here at work (Most time it stays in my jump kit).

The AED protocol for First Responders, EMT-Basic & EMT-Shock Trauma (it's a Virginia thing - don't ask) is as follows :

- Perform inital assesment & establis unresponsive, pulseless, and apneic.
- if Pulseless & apneic 1st rescuer begins CPR while 2nd connect AED (If only one resucer - apply AED & analyze PRIOR to CPR)
- Do not defibrillate when Patient is wet or in contact with metal. If Nitroglycerin patches or cream present on chest, use gloves to remove nytroglycerin before defibrillating
- Stop CPR immediately once AED is applied & analyze. Deliver up to three consecutive shocks if machiene allows.
- ALWAYS call & visually clear Patient before each analysis and Defibrillation
- After 3rd shock check pulse. If no pulse resume CPR for one minute, then reanalyze. Attempt to deliver up to three consecutive shocks if machiene allows.
- If after ANY analysis shock is NOT advised, check pulse. If no pulse continue CPR for 1 minute & reanalyze. Attempt to deliver up to three consecutive shocks if machiene allows.
- If no ALS has arrived, thansport when:
1) Pt. Regains a pulse
2) 6 shocks have been delivered.
3) AED gives you 3 consecutive messages that no shock is advised, each message seperated by one minute of CPR.
- Non-transporting First Response agencies should continue with CPR for 1 minute and then repeat 3 stacked shocks as indicated, continuing until arrival of transporting agency.
- Once Enroute, contact Medical Control for permission to deliver additional defibrillations.
- If Pt. becoes pulseless & apneic during transport or if additional defibrillations are ordered during transport, stop the unit and follow AED protocol. DO NOT ATTEMPT TO USE AED IN A MOVING VEHICLE
- If Pt. is hypothermic deliver a MAXIMUM of 3 shocks, then transport and contact medical control.
- If arrest is secondary to major trauma, transport immediately without applying AED

Well - there it is straight from the "Bible". Oone personal observation - ALS is never specificaly called for in the early stages, however arrival of ALS is used as a decision point in the protocol. I would add a "Call for ALS" somewhere within the first 2 or 3 steps.

If you have specific questions, feel free to e-mail me. Good Luck with your protocol(s).

Take Care - Stay Safe
Stephen
FF/Paramedic