Defibrillator

introduction

A defibrillator is one in the world Acute and emergency medicine used apparatus, which by a directional Power surge to bring the heart to a standstill. Contrary to what is often assumed, the defibrillator only provides cardiac stimulation in a secondary way.

The defibrillator is used when a patient is in a life-threatening ventricular fibrillation is located. Ventricular fibrillation is a rapid and irregular contraction (fibrillation) of the heart muscle. This muscle movement is not enough to supply the body with oxygenated blood. Ventricular fibrillation poses you life-threatening condition which needs to be dealt with as soon as possible.

The defibrillator is a Electric shock through the apex of the heart cleverly. To do this, two paddles are placed on the apex of the heart and the roof of the heart and then the electric shock is triggered. The power surge interrupts the flicker and calm the heart. A few seconds later the heart begins with his Own rhythm to hit again.

A defibrillator is a box that comes with a High performance battery, one monitor and two paddles Is provided. He is part of everyone emergency medical Equipments and especially on the Intensive care unit to find.

The first stationary defibrillation machines were used after the Second World War developed for the treatment of electrical accidents. In 1976 the first early defibrillators came onto the market. In 1977 the first defibrillation device was transferred to the non-medical emergency service, as there was no nationwide emergency doctor system in Germany at that time. However, this innovative measure was blocked by politicians and medical associations at the time because early defibrillation was viewed as very critical by laypeople.

The use of those that keep appearing in public today fully automatic defibrillators (AED) is still very lowbecause many non-medical professionals do not trust themselves to defibrillate for fear of making mistakes. Numerous campaigns, such as Fight against cardiac death etc. should and should ensure that people are afraid of this important first measure.

What do you need it for?

The defibrillator is always used when a flickering heart is to be brought to a standstill so that its own rhythm starts again. It is a very vital instrument, especially in acute and emergency medicine. It is used for life-threatening ventricular fibrillation or ventricular flutter as well as for severe cardiac arrhythmias. In cardiac operations on a standing heart, too, a defibrillator that is placed directly on the heart muscle ensures that the rapidly flickering heart (clinically equivalent to cardiac arrest) comes to a complete standstill so that it starts beating again through its own rhythm.

Read more on the topic Ventricular flutter and ventricular fibrillation or Cardiac arrhythmia

From a technical point of view, a defibrillator consists of an accumulator, a converter and a capacitor. It is a biphasic current element that not only sends the current in one direction through the heart axis, but alternately, i.e. very quickly in one direction, then in the other.

In the meantime, there are also state-of-the-art and fully automatic defibrillators, which are mainly used in public buildings, and which can also be used without prior medical knowledge. Studies also show that the likelihood of dying from sudden cardiac death decreases when a defibrillator is used in the immediate vicinity.

Also read that Articles on the topic: First aid

Can you buy a defibrillator?

In principle you can all medical equipment can also be purchased acquire. No special medical training is required for this. Whether one may use certain devices even as a non-medical practitioner is another question. The classic defibrillator can also be purchased by non-medical professionals, the use without training but should fail become.

You should also consider the exact reason why you should buy a defibrillator. Is a Family member seriously ill with heart, the purchase of a defibrillator is more legitimate than if there is no increased risk of severe cardiac arrhythmias or cardiac arrest.

In any case, if you do, you should consider buying a fully automatic defibrillator that is also available in public buildings. This also as AED designated apparatus Easy to use even without medical trainingbecause a computer program guides the user through the steps to be performed.

How much does a defibrillator cost?

There are now state-of-the-art defibrillators from different manufacturers and at different price levels. Fully automatic, so-called AEDs, which are now available in large public buildings, come with prices between 400 and 2000 euros to calculate.

The ones in the Clinics existing, stationary defibrillators, which also have even more functions (for example, the monophasic and biphasic current output can be controlled manually with these devices), are many times over expensive but not suitable for everyday emergencies, especially for the inexperienced doctor or the medical layperson.

Implantable defibrillators

There are also defibrillators that do planted and only deliver an electric shock when the heart is certain pause exceeds, i.e. if either the Pulse so low is that maintaining the Circulation no longer guaranteed is or if it is to Failures whole heartbeats comes. The implanted defibrillator corresponds to a pacemaker with a defibrillator function.

One distinguishes one Single chamber- of a Dual chamber defibrillator. The implantation takes place through an approx. 5 cm incision below the left collarbone, sometimes below the right collarbone. The left side is preferred because of the better blood distribution in the event of defibrillation. The electrodes are advanced to the heart via a superficial vein or via the clavicle vein. This is done under X-ray control. Once the catheter with the electrodes has reached the heart, it is fixed to the apex of the heart in the right ventricle. The electrode consists of two different parts. The tip serves as a monitor module, i.e. this part monitors the own chamber rhythm and gives alarmas soon as the heart one falls below a certain, previously set frequency or if one or even several Subject to blows and long breaks arise. Above this monitor module there are coils, which in this case generate a strong current and then deliver it to the apex of the heart.

Meanwhile, there is not only all-or-nothing defibrillation, but also multi-chamber Combinations of pacemakers and defibrillators, i.e. with the most modern defibrillators you can too previously set rhythms by slight impulses maintain become.

After the operation should be Trial shock to see if the electrodes are in the correct position. To do this, the heart is first artificially put into such a severe cardiac arrhythmia that the implanted defibrillator would have to be triggered. If he does not do this, the patient is freed from the cardiac arrhythmia with a defibrillator permanently installed in the operating room. In this case, additional electrodes must be attached to the heart to ensure a regular heartbeat, so that it is ensured that a serious cardiac arrhythmia that occurs in everyday life can be successfully remedied by defibrillation.

What is an AED?

AED stands for ,,Automated external defibrillator'.

The Automated External Defibrillator (AED) is a state-of-the-art small device that is a fully automatic operation and who is involved in the treatment of life-threatening cardiac arrhythmias, such as the Ventricular fibrillation or Ventricular flutter is used. 85% of all sudden cardiac deaths come about due to ventricular fibrillation or ventricular flutter. The use of an AED can be proven to lead to a Lowering the death rate contribute to this medical emergency. This is also the reason why now many public buildings unhook such AED.

Nowadays almost every doctor's office has a fully automated AED device. An AED is necessary for safety reasons, especially if stress ECGs are carried out in the practice (including general practitioners' practice). Studies by the German Center for Cardiovascular Research show how important an AED or stationary defibrillator is. According to these numbers 81 out of 100,000 people die each year in Germany from sudden cardiac death. Just under 39% of them are of working age.

How do I use an AED?

The AED consists of a box with a small monitor display that shows the heart rhythm in the sense of a EKG indicates, furthermore two Adhesive electrodes and some buttons.

If you find a lifeless patient, you should first follow common first aid methods, such as Pulse-, and Breathing rate check, Action.

If an AED is on hand, they should two adhesive electrodes under the right collarbone and under the left armpit be glued on. After that, a Pulse control respectively. An EDP-controlled computer program guides the first aider through the necessary steps to be taken.

• Is it a complete cardiac arrest, becomes no shock triggered, but it must be with the manual heart massage to be started.
• However, the AED analyzes a Ventricular fibrillation or ventricular flutter, the computer voice recommends a To trigger shock.

Before pressing a special shock button, anyone in the vicinity of the patient must distance take, as the shock jumps to the first aider when touching the body. After the shock has been triggered, a further check of the rhythm begins fully automatically. If a normal rhythm has set in, nothing further should be taken apart from monitoring measures. If ventricular fibrillation or flutter persists, the shock must be repeated until the heart rate has returned to normal.

After the mission an AED should be the device delivered to the manufacturer so that he can check the function and make the device operational again. The adhesive electrodes are replaced.

When using an AED you can not much wrong do. However, it is important not to cause any major delays during use, since every second that the patient is left untreated leads to a deterioration in the end result. When not in use, AEDs have one 5 year guarantee. Maintenance is not necessary during this time without use. After 5 years without use, the device should also be transferred to the medical technology department, which checks and maintains the most important control elements of the device. As a rule, no parts are exchanged for unused AEDs.