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Now moving on to CPR in the AED stage itself. The AED is probably the most critical point of the resource itself. It has to be done quickly, it has to be done smoothly, but remember, CPR and oxygen bag and mask or bag valve masking has to keep going whilst we set the defib up. We cannot stop that and put the defib on. It all needs to be a flowing chain of events. So CPR would carry on, bagging and masking would carry on, and the defib would be applied to the chest whilst CPR is underway. We do not stop to put the defib on. The only times we will stop will be to expose the chest. So the first thing we do is to expose the chest completely so as we can actually apply the defib pads in the correct places. So there are many different types of defibs on the market and they all have the same operating procedure, which is the European Resource Council Guidelines. The European Resource Council Guidelines mean all European countries resuscitate patients to the best practical way known at this time. Research is ongoing all the time, but all defibs across Europe will work to the same system. However, all defibs are not the same. The pads might look at different shapes. Some defibs you turn on, some defibs turn on automatically. Some defibs once you start to put the defib on, we stop CPR whilst the defib analyses, and others, like this one, it will analyze whilst your still doing CPR.

So look at the defib and follow the voice prompts and look at the pictures and words on the actual defib itself because they are all very simple, very easy, and extremely safe pieces of kit. This piece of kit will do no harm whatsoever to the patient or yourself. You follow the process, the process will do no harm to the patient or yourself, but you must follow it. So once the chest is exposed, we are looking to put pad placement on the top right pectoral muscle and the left side of the abdomen. Remember what we said in early videos, the heart is roughly the size of the owner's clenched fist, slightly to the left of the chest. So with one pad in the top right pectoral muscle and one pad to the left side of the chest, we are delivering a shock from the pads to the heart. If we put the pad too close together, we get a glancing blow over the heart and we want the shocks to go directly through the centre of the chest, through the centre of the heart to stop and stun the myocardium to allow it to reset.

What I always teach when I am teaching defibrillation is this is exactly the same as your laptop or your mobile phone. Back in the day, they used to stop, they used to freeze, they used to lock up. Your heart, in all intents and purposes, has locked up or frozen. It is giving a rhythm that is non-compatible with life. The faster we shock that rhythm, the better the outcome will be, but the shocking stuns the heart. Basically like your laptop or mobile phone, you turn it off, it resets, you turn it back on again, and that is what this defib is doing. It is stopping the heart, allowing it to reset, and allowing it to turn it back on again back to a rhythm that will actually be compatible with life.