How to Perform CPR and Use an AED in a Single-Rescuer Scenario

Cardiopulmonary resuscitation (CPR) and automated external defibrillator (AED) use are critical life-saving techniques employed during cardiac emergencies. Before the AED becomes available, it is essential to perform continuous high-quality CPR. Once the AED arrives, CPR should be paused immediately to allow for proper placement of the device and rhythm analysis.

Initiating the Defibrillation Process

Begin by turning on the AED and selecting the appropriate setting—typically a biphasic waveform in a non-synchronized mode with an energy level of 200 joules. Apply the conductive gel evenly on the electrode pads and ensure the patient's chest area is dry. Proper pad placement is crucial: one pad should be positioned on the upper right chest, and the other on the lower left side, just below the armpit.

Analyzing the Heart Rhythm

Once the pads are correctly placed, the AED will begin to analyze the patient's heart rhythm. During this time, ensure no one is touching the patient to avoid interference with the reading. If the AED detects ventricular fibrillation (VF) or pulseless ventricular tachycardia (VT), it will prompt the rescuer to deliver a shock using the biphasic non-synchronized defibrillation method.

Delivering the Shock and Continuing CPR

When delivering the shock, press both defibrillation buttons simultaneously with firm pressure. Immediately after the shock, resume CPR for five cycles (approximately two minutes) before reassessing the patient's condition. Continue to monitor breathing and pulse throughout the process.

What to Do If No Shock Is Advised

If the AED displays a flat line or asystole, do not attempt to deliver a shock. Instead, continue CPR immediately and follow advanced cardiac life support (ACLS) protocols as appropriate. Timely and effective chest compressions remain the cornerstone of resuscitation in this scenario.