During my refresher I was a bit surprised to hear the instructor say that if a victim requires an AED and is soaking wet, it's okay to just pat them dry The water would help create a connection between the pad and the skin.
AHA is teaching that you should remove them from standing water and remove excess water from their bodies... but they also say that you "don't have time" to make sure they are totally dry.
Basically remove the patient from standing water and quickly pat off as much water from the chest as you can in a quick amount of time. You obviously don't want to spend a minute or two completely drying them off.. but just enough that they aren't soaking wet and the pads can stick to the patient.
Electrically speaking, having water between the electrodes and skin would decrease the conductivity signifigantly. In fact pure water (H2O only) is an extremely poor conductor, but naturally found fresh water is an ok conductor because of the minerals in it. Salt water is a fairly good conductor but still does not approach the conductivity of metals. Having a layer of water between the electrodes and skin of a patient would be very bad thing, and would almost certainly prevent the AED from analyzing properly, let along shocking properly.
<Puts on EMT hat>
The way the pads are designed most likely pushes out most of the water that would be on the chest out of the way and gets allows a good connection by way of the conductive gel on and around the electrodes. My guess as to the biggest reason to dry off the chest is that it might prevent a pad from sticking well enough to the chest to remain there while compressions are being done.
As I understand it the gel is water soluable. I would think that a wet patient, and I've seen it in those who are sweating profusely, would cause the gel to get too soft and gooey and not stick. I've found using an alcohol wipe can help sometimes.
But the point being made by the AHA is that rapid defibrillation is important and taking too much time making sure the pt is completely dry is going to decrease the effectiveness of the AED due to the increased time.
But the point being made by the AHA is that rapid defibrillation is important and taking too much time making sure the pt is completely dry is going to decrease the effectiveness of the AED due to the increased time.
I find that all useful and very interesting... It's true about the pads not sticking to diaphretic patients--they probably won't to a drowning victim as well unless at least wiped off where the pads should go.. I've used betadine wipes on our patients that are too diaphretic in our ER and need a 12-lead EKG...seems to work well
well if you having trouble getting the pads to stick use a sheet and rap it around the pt chest to hold the pads on...i was tought that can work also....improv guys....thats also part of the job
well if you having trouble getting the pads to stick use a sheet and rap it around the pt chest to hold the pads on...i was tought that can work also....improv guys....thats also part of the job
well if you having trouble getting the pads to stick use a sheet and rap it around the pt chest to hold the pads on...i was tought that can work also....improv guys....thats also part of the job
well if you having trouble getting the pads to stick use a sheet and rap it around the pt chest to hold the pads on...i was tought that can work also....improv guys....thats also part of the job
I think it's a guide line to not bust out a hair drier and make sure there's not a drop of water on them, there's usually liquid on a person, sweat/oil/etc/
I was told a few interesting things regarding AED use in my class. Apparently the new ACLS protocol for AED use is that after analysis and during the charging phase of the defibrillator it is recommended to do compressions until the "all clear for shock" call is given. During a clincal study this showed something like a 25% improvement in successful conversions. I don't remember the exact number.
The wet patient thing does not surprise me though. The human body is chock full of electrolytes especially the cardiac muscle. Most water is not nearly as conductive as a persons internals, so it chooses the direct path through the body.
