Questions générales
DAE signifie Défibrillateur Automatique Externe
Un DAE est un appareil pouvant émettre des électrochocs au cœur lorsqu’une personne subit un arrêt cardio-respiratoire. Un ordinateur interne analyse le rythme cardiaque de la personne et détermine automatiquement la nécessité d’émettre un choc pour lui sauver la vie. Des instructions vocales renseignent sur l’application du choc, sur la nécessité de commencer un début de massage cardiaque ou bien de pratiquer du bouche à bouche. Les instructions vocales sont également affichées sur un écran spécial. D’une façon extrêmement sûre, le DAE vous guide tout au long de la procédure de réanimation, jusqu’à l’arrivée d’une équipe de sauveteurs professionnels sur les lieux.
Comment fonctionne le DAE ?
Deux électrodes branchées au DAE sont placées sur la poitrine du patient. Un ordinateur interne analyse le rythme cardiaque du patient et détermine la nécessité d’émettre un choc pour lui sauver la vie. Si l’analyse s’avère positive, des instructions vocales et précises sont émises pour guider le sauveteur dans les actes de réanimation qui permettront de sauver la vie de cette personne.
Le DAE peut-il se tromper ?
Le DAE est basé sur un système analytique complexe qui interprète le rythme cardiaque. Lors de son utilisation, 95% de cas d’avis positif nécessitant une défibrillation, sont analysés correctement et pour les avis négatifs ne nécessitant pas de défibrillation, plus de 98% sont analysés correctement. Ces taux sont plus élevés que ceux pouvant être atteints par des secouristes professionnels. Pour éviter toute mauvaise interprétation, il est extrêmement important de ne pas toucher la victime lors de l’analyse cardiaque.
La possession des défibrillateurs est-elle obligatoire ?
La nouvelle règlementation du défibrillateur oblige les établissements recevant du public (ERP) de s'équiper d'un DAE et d'en assurer la maintenance.
« Art. R. 123-57. – Sont soumis à l’obligation de détenir un défibrillateur automatisé externe, les établissements recevant du public qui relèvent :
« 1. Des catégories 1 à 4 mentionnées à l’article R.* 123-19 du code de la construction et de l’habitation ;
« 2. Et parmi ceux relevant de la catégorie 5 :
« a) Les structures d’accueil pour personnes âgées ;
« b) Les structures d’accueil pour personnes handicapées ;
« c) Les établissements de soins ;
« d) Les gares ;
« e) Les hôtels-restaurants d’altitude ;
« f) Les refuges de montagne ;
« g) Les établissements sportifs clos et couverts ainsi que les salles polyvalentes sportives.
Qu’est-ce qu’un arrêt cardio-respiratoire ?
L'arrêt cardio-respiratoire est dû à un fonctionnement anormal du système électrique du cœur qui ne permet plus au cœur de propulser le sang vers le cerveau et vers le reste du corps. Il en résulte une perte de conscience brutale avec disparition du pouls et de la respiration. Quand une personne est victime d’un arrêt cardio-respiratoire, le défibrillateur est utilisé pour administrer un choc électrique qui va rétablir un rythme cardiaque normal.
Un arrêt cardio-respiratoire, est-il synonyme de crise cardiaque ?
Non. Les deux, la crise cardiaque (infarctus du myocarde) et l’arrêt cardio-respiratoire concernent le cœur, mais ils concernent des déficiences différentes. L’arrêt cardio-respiratoire est un problème électrique ; la crise cardiaque est un problème de « tuyauterie ». Parfois une crise cardiaque, qui peut ne pas être fatale en soi, peut déclencher un arrêt cardio-respiratoire.
Qui peut être victime d’un arrêt cardio-respiratoire ?
Tout le monde, à n’importe quel moment, n’importe où. Les enfants peuvent avoir un arrêt cardiaque, les athlètes peuvent avoir un arrêt cardiaque, les personnes âgées peuvent avoir un arrêt cardiaque. Bien que les risques augmentent avec l’âge et pour les personnes avec des problèmes de cœur, une grande partie des victimes sont des personnes sans facteurs de risque connus.
What is the recommended treatment for cardiopulmonary arrest?
Defibrillation is the only therapy that can restore a normal heart rhythm. The application of the shock using the AED must always be accompanied by cardiac massage and mouth-to-mouth resuscitation.
I know how to perform CPR, isn't that enough?
Cardiopulmonary resuscitation (CPR) saves time and is recommended for the first 2 minutes before the shock is delivered. However, a cardiopulmonary arrest absolutely requires an electric shock to restore a normal heart rhythm. In fact, all CPR training now includes defibrillator training.
How much time do I have with someone in cardiopulmonary arrest?
Only a few minutes. By defibrillating within 6 minutes, the chances of survival are 70%. After those 6 minutes, the chances of survival decrease dramatically. Every minute that defibrillation is delayed, the chances of survival decrease by 10 to 12%.
What is the importance of an AED on a victim of a cardiocirculatory arrest?
When someone suffers a cardiocirculatory arrest, for example following a heart attack, the cause of the arrest will be for 70 to 80% of the cases due to a total chaos of the cardiac electrical system. In reality, it is not a real cardiac arrest. In fact, the heart is not completely stopped, but beats in a very chaotic way and no longer contracts. These heart vibrations are also called ventricular fibrillations. By applying cardiac massage and mouth-to-mouth resuscitation, the brain is supplied with oxygen again. However, it is not possible to completely stop fibrillations. The only effective way to stop them is rapid defibrillation of the heart, which regulates the chaotic heart rhythm. If defibrillation is delayed, the heart loses its sensitivity and the chances of survival decrease.
Is the use of an AED always effective during a cardiac arrest?
No. AED analysis applies only to ventricular fibrillation or other cardio-rhythmic deficiency that is susceptible to defibrillation. On the other hand, resuscitation of the victim must be accompanied by oxygen and cardiac massage. However, if defibrillation is not performed quickly enough, the heart will lose its sensitivity and the chances of survival will be greatly reduced.
Is it safe to use an AED?
If you have received basic AED training and follow the safety instructions, the use of an AED is absolutely safe for the person. The AED can be used in many different situations, so the device has several safety parameters. Only if the analysis deems it necessary, the AED recommends and authorizes defibrillation. It is therefore impossible to deliver shocks to any individual. There are also voice instructions not to touch the victim during defibrillation. If this instruction is not followed, the AED will detect these movements and will not deliver a shock.
Why is it necessary to perform cardiac massages and provide oxygen between defibrillations?
After a positive analysis, the AED will recommend defibrillation. After defibrillation, the AED will instruct the patient to perform cardiac massage and provide oxygen (mouth-to-mouth resuscitation if an oxygen mask is not available). By doing this, the heart and brain will be re-supplied with oxygen and the heart will become more responsive to defibrillation.
Why is it sometimes necessary to apply multiple shocks?
Sometimes the heart does not respond sufficiently to the first defibrillation, so it is necessary to defibrillate several times while applying cardiac massage and providing oxygen.
In the past, the use of defibrillators was reserved for medical specialists, but since the decree of May 4, 2007, anyone is allowed to use an AED. Since that date, the market for AEDs designed for non-professionals has expanded. Several international research studies have shown that the early use of a defibrillator significantly increases the chances of survival of people suffering from cardiorespiratory arrest. As a result, more and more businesses and public places are equipped with AEDs. Anyone can use the defibrillator, but basic training is strongly recommended. This training, which takes no more than four hours, allows for more effective use when every second counts.
An AED can be purchased by companies as well as individuals. Unlike some countries such as the United States, it can be purchased without a medical prescription.
Can the defibrillator also be used on children?
Cardiorespiratory arrest in children is rare. If it does occur, it is often not a cardio-rhythmic deficiency (ventricular fibrillation) that can be defibrillated. Nevertheless, some providers offer options for adapting the defibrillator to children aged 1 to 8 years. Usually one of these options consists of electrodes specifically designed for children. They are smaller and emit less strong shocks. In our range of AEDs, we have an AED that can determine if the victim is under 8 years old.
Use of the AED in children aged 1 to 8 years
Since June 2004, defibrillation can be used in children aged 1 to 8 years (Circular of 28 June 2004).
In children, cardiac arrest is only exceptionally due to ventricular fibrillation (about 1 ‰). In most cases, arrest is secondary to oxygen deprivation (drowning, choking, intoxication, spontaneous apnea), with young, healthy heart tissue. The application of the DSA patches is most of the time useless and delays the resuscitation maneuvers, which are very efficient.
However, there are rare cases where the heart will actually be in ventricular fibrillation, especially in cases of cardiac malformation or if the cardiac arrest is due to an electric shock. The procedure for intervention on a child between one and eight years of age therefore takes this particularity into account by requiring the practice of cardiopulmonary resuscitation for one minute before the application of a biphasic wave AED, if the pulse has not resumed.
Specific electrodes for children can be used and applied according to the manufacturer's instructions. Otherwise, "adult" electrodes should be used, one on the front of the chest and one in the middle of the back, between the two shoulder blades.
Where should I place my defibrillator?
The ideal location for a defibrillator is in a wall-mounted box, outside your building so that everyone can access it in an emergency.
" Sec. R. 123-58. - The automated external defibrillator shall be installed in a location that is visible to the public and permanently easy to access."
Questions pratiques
Can a wet person be defibrillated?
If the victim is wet (coming out of a swimming pool, the sea, a river, or because of a drowning), it is necessary, first of all, to dry the front of the thorax in order to be able to put the electrodes on it. Then, it is extremely important not to touch the victim during the defibrillation.
Can I defibrillate a patient on a wet or metal floor?
Although training manuals recommend that rescuers move the patient away from a wet or metal surface before defibrillating, there are times when this is very difficult or impossible or when it delays treatment. It is possible to use a defibrillator on a patient who is lying on a wet surface - whether fresh or salt water - or a metal floor. It has been demonstrated that as long as there is no direct contact between the defibrillator user or bystander and a victim, there is no current flow that could cause a shock to the user or bystander. It should be emphasized that successful defibrillation depends on good contact between the electrodes and the patient. In wet conditions, it is important to ensure that the patient is dry where the electrodes are placed to ensure proper electrical contact and to prevent the electrodes from coming off.
Why is AED training necessary?
The AED user must know how to recognize the signs of cardiorespiratory arrest. For this, certain medical knowledge is essential. Then he must know when to call for help and how to perform resuscitation. Obviously, the user will be really helped if he is familiar with the AED he is using, he will then waste less time connecting the patient, analyzing his heart rhythm and issuing possible cardiac shocks.
Should I buy the same brand of AED that my local rescue center has?
No, it is not necessary at all. Of course, during defibrillation, speed is extremely important, but the time it takes for the rescuers to change the electrodes is very minimal, especially since if the rescuers use a monitor, in most cases it cannot be connected to your AED, so they are forced to use their own AED. Currently, the equipment used by professionals is often more expensive than the AEDs designed for the general public. We therefore advise you not to limit yourself to one brand, but to invest in an AED that suits you personally and fits your budget.
Are there brands that save more lives than others?
All AEDs on the market today are European devices and have one purpose: to save lives. No manufacturer can claim that their device saves more lives than another. Nor can there be any relationship between the price of an AED and its ability to save lives.
What is an AED recall and how do I know if my AED contains a manufacturing error?
AEDs are manufactured in an automated production line and if the manufacturer notices a malfunction in one part, he recalls the entire batch as a precaution. If this happens to you, you will receive an automatic recall from your supplier and a new device will be sent to you, obviously at no extra cost. If you have not purchased your AED from an official supplier, it will be difficult to be informed of a possible recall.
On a large site, how many defibrillators should I provide? What is the recommended mesh size?
You should not think in terms of the number of people but in terms of the size of the site. It is therefore inconsistent to say "provide 1 defibrillator for x people". The defibrillator must be accessible in less than 4 minutes (this is a maximum). The most reliable solution is also the simplest: do the test! Take it in hand, run to the other end of your business. If you go over 4 minutes, you need an extra one. Please note: the installation in a fixed area and specialized signage are ESSENTIAL to reduce this access time to the victim.
For information: The mesh is the expression used in the case of the installation of emergency devices to talk about the number of devices to be provided per person or per floor or per m²...
I don't know where to put my defibrillator: in the medicine cabinet, in my desk drawer, locked or not?
The main thing is to ensure that the defibrillator can be accessed as quickly as possible. To this end and in all cases, locking the device is not recommended. Prefer the use of a seal. Each installation has its own constraints, but in general, it should be a place of high traffic, easy access, where the ready light can be checked regularly and easily and where it is easy to hear the modulated audible alarm emitted when the battery charge becomes low or when the defibrillator requires intervention. The ideal location for the defibrillator is near a telephone, so that the emergency response team or emergency medical services can be called as quickly as possible in the event of a sudden cardiac arrest. It may be advisable to install the defibrillator in a wall-mounted cabinet at eye level. Its location should be clearly marked with a standard sign.
Questions techniques
How waterproof is the defibrillator? What is the IP rating?
According to standard NF EN 60-529 June 2000, the degree of protection provided by an enclosure is defined by the letters IP (protection index) followed by two figures characterizing :
- the protection against the penetration of solid foreign bodies
- the protection against the penetration of water.
For more detailed information, please visit our "information pages".
Does my defibrillator need maintenance and servicing?
To ensure that the defibrillator is always ready for an emergency rescue response, comprehensive self-tests are performed daily to verify the vital functions of the emergency device.
Does the defibrillator indicate a signal if there is a problem?
Yes, in addition to the self-testing process described below, defibrillators have a warning light, which is essential for noisy environments. If it is green and flashing, all is well. If there is the slightest problem, the green light goes out and a big blue button flashes in addition to the beep that warns you at regular intervals. In this case, you just have to press this "info" button which lights up so that the voice tells you the defect found (weak battery, electrodes badly inserted, ...)
When to recharge the battery?
The battery is not recharged, it should be called a BATTERY and not a battery. This is the only way to ensure that the device is always operational. Moreover, you don't have to worry about anything: the standby time is from 2 to 5 years (depending on the model) and you are warned by an audible and luminous signal when it's time to plan its replacement (at that moment you have an autonomy of 9 shocks: an important safety margin giving you plenty of time to order a new battery!)
How can I be sure my defibrillator will still work if I change the battery?
A battery insertion self-test is performed each time a battery is installed in the device. Your equipment is therefore automatically checked for your peace of mind.
If I buy replacement electrodes in advance, what is their shelf life?
The electrodes can be stored in their original hermetically sealed packaging for 2 to 2.5 years. The expiration date is clearly indicated on the packaging and on the electrode cartridge once installed.
Having electrodes in advance is not necessarily interesting. Electrodes can be delivered quickly after use.
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