How to use an aed on a pregnant woman

What do I do if the victim is pregnant in the event of cardiac arrest? This is a common question that Emergency Care Instructors hear when covering cardiopulmonary resuscitation (CPR) and automated external defibrillator (AED) topics. Some bystanders might feel hesitant to intervene out of fear of harming the baby or mother. This topic is important to discuss to help reduce barriers to bystander CPR and AED use.

Just like with other cardiac arrest victims, it’s better to provide care than to do nothing at all. CPR and defibrillation steps are the same—you'll perform CPR and use an AED as you would with non-pregnant adults.

Here’s some information to better understand how a woman’s body adapts during pregnancy and special considerations to take when providing emergency care.

Heart Health During Pregnancy

Pregnancy causes many anatomical and physiological changes that can create an extra strain on a woman’s body.

During pregnancy, there’s an increased need for blood flow within the mother’s body. Cardiac output (or blood volume) rises 30% to 50% to meet the needs of both the mother and growing baby. Additionally, a woman’s heart rate may increase by 15 to 20 beats per minute throughout her pregnancy.

With the heart working overtime and other influencing factors, many health conditions can arise during pregnancy.

Maternal Cardiac Arrest Data

Sudden cardiac arrest can happen to anyone at any time, including during pregnancy. Data on maternal deaths and cardiac arrests suggests cardiac arrest occurs in 1 out of 12,000 admissions for delivery in the United States. But that number doesn’t include women who experience cardiac arrest outside of hospital settings throughout different stages of pregnancy.

While maternal cardiac arrests are considered rare events, they can happen for many reasons. If a pregnant woman were to collapse in front of you, would you know what to do?

CPR and AED Use on Pregnant Women

Bystanders can become more hesitant to perform CPR when the person is pregnant. Even more so when using an AED. But it’s important to remember that without providing these life-saving measures, the mother and the baby will likely not survive.

So, act fast and with confidence. Don’t delay chest compressions or defibrillation for a pregnant person.

• Call 911. Let the emergency dispatchers know the woman is pregnant, so first responders can be prepared to respond accordingly when they arrive on the scene.
• Start immediate CPR. There is no scientific evidence to support changing your hand placement for chest compressions on a pregnant woman. If you aren’t trained, give compression-only CPR by pushing hard and fast at the center of the chest.
• Use the AED. The sooner an AED shock is provided as directed, the better the chance for survival. Follow the normal steps for operating the AED. To be clear, defibrillation shock will not harm the baby and is considered safe in each stage of pregnancy.

If the person starts breathing, moving, or reacting in other ways, place the person on their left side for better blood flow.

For more information about performing CPR and the use of an AED in a specific situation, take a CPR, AED and First Aid class near you.

Learn more about CPR, AED, and First Aid training programs for your organization and how to become a CPR instructor with HSI.

The life-saving ability of AED units has prevented over 30,000 fatalities to date in the UK alone. With over 523 million people worldwide living with diagnosed heart conditions (and many more undiagnosed), the increased availability of AEDs provides complete peace of mind should an unexpected cardiac arrest occur. In the event of sudden cardiac arrest, it’s important to employ an AED without hesitation to maximise chances of survival.

There are however some potential risks to be mindful of when employing an AED to save someone’s life – and although it is crucial to use an AED in a timely manner, these considerations ensure a swift response so that AED use will help, not harm, patients suffering from sudden cardiac arrest.

In this blog we’ve shared some key groups to be aware of when using a defibrillator – those fitted with a pacemaker, the elderly, and pregnant women.

Using an AED on people fitted with a pacemaker

A pacemaker is a small device which is fitted in the chest of a person with abnormal heart rhythm, to help the heart beat more regularly. Another type of similar device is an Implantable Cardioverter-Defibrillator (ICD for short), which detects potentially life-threatening abnormal heart rhythms and automatically delivers an electric shock to restore a normal heartbeat.

The good news is you can still use an AED on people fitted with a pacemaker or ICD. Where the person has an ICD, it should shock them back immediately meaning additional defibrillation isn’t required. However if you are aware that the person has an ICD and suffers cardiac arrest an AED should still be used if the ICD does not revive them.

Signs someone is fitted with a pacemaker include a small bump in the left side of the chest under the collarbone, or a bump on the left side of the ribcage towards the back, covered by a scar. The most important thing to be aware of when employing an AED is time – rapid action is required to save a life during cardiac arrest, so don’t spend too long looking for a medical identification bracelet or evidence that a pacemaker is present before using it.

Using an AED on pregnant women

SCA doesn’t discriminate and sadly pregnant women can also be at risk for sudden cardiac arrest – so it’s important to know whether pregnancy impacts upon the potential success rate and use of a defibrillator, and if so, how an AED may be used safely to save lives.

It will often be apparent that a woman is pregnant – but not always. Fortunately AEDs are safe to use on pregnant women – in fact, it’s crucial not to hesitate when deploying an AED as without rapid defibrillation an unborn baby will not be likely to survive.

There are a few specific steps to remember if you use an AED on a pregnant woman, including:

*Provide CPR in the first instance as you wait for the defibrillator to arrive, at 100-120 compressions per minute. If you are comfortable to do so, accompany chest compressions with rescue breaths
*Always notify the emergency services when dealing with sudden cardiac arrest, making sure to let them know that the woman in SCA is pregnant. This ensures they can send appropriate support and prepare to take the patient to a hospital that can provide specialist care for the woman and her unborn baby
*Once the pregnant patient has been revived, place her on her left side to help support blood flow to the heart and foetus

Using an AED on the elderly

Older people tend to be more at risk for sudden cardiac arrests, but is it safe to use an AED on an older person who appears to be frail or in poor general health?

The answer as above is to use an AED as quickly as possible in this circumstance, as without rapid intervention involving a defibrillator they are unlikely to survive SCA. Some considerations when using an AED on an elderly person include:

*Contact emergency services as soon as possible, letting them know that the person suffering SCA is elderly (along with any medical conditions you are immediately aware of)
*Begin manual chest compressions while waiting for the AED – as always, in an emergency the faster an AED can be sourced and deployed, the better
*Remember that cardiac arrest does often affect middle-aged and older people, so don’t hesitate to use one if needed

It is also worth noting that many elderly people who are vulnerable to SCA have already been fitted with an ICA – in these cases you can follow the guidance above for patients with pacemakers.

How to identify possible risk factors or complications when using AEDs

Unfortunately it’s not always possible to know whether a person is vulnerable due to an existing condition or medical situation, or in the earlier stages of pregnancy just through looking at them.

The most important thing to remember is to use AEDs quickly and confidently in all of the above situations – ensuring that additional steps are followed to maximise safety and survival of a person in SCA.

Intelligent AEDs that only deliver a shock when needed

No training is required to effectively use an AED – this is one key aspect of their lifesaving ability. But through spreading awareness of how easy and safe AEDs are to use, we can avoid any potentially harmful hesitation that members of the public may naturally feel when dealing with a person who is elderly, pregnant or fitted with a pacemaker.

Our award-winning defibrillators automatically detect SCA through a series of sophisticated algorithms, and won’t deliver a shock if one is not needed. They’ve repeatedly been identified as the simplest on the market to use, providing reliable and trusted support when it matters most. This allows members of the public to use AEDs confidently and without hesitation – ultimately saving more lives.

For more on our award-winning range of defibrillators or advice on choosing an AED, visit our product pages or contact us today.