Sudden Cardiac Arrest and AED Use in Pregnancy

 

Can you use an AED on a pregnant woman? 

Is it safe to do CPR and use an AED on a pregnant woman? Yes, it is generally considered safe to use an AED on a pregnant woman, with data from the American Heart Association and other sources recommending use. In fact, it is deemed essential for survival, with the benefits far outweighing any risks.

That being said, it’s important to understand the procedure for treating a pregnant patient with an AED and CPR. Before going deeper, let’s first discuss what an AED (AED machine, AED defibrillator, AED Device, etc.) actually is, as well as sudden cardiac arrest (SCA), and the importance of using an AED during cardiac emergencies. 


What is an AED? 

An automated external defibrillator (AED) is a life-saving device designed to assist in sudden cardiac arrest treatment. This device analyzes the heart’s electrical activity and, if necessary, delivers controlled electrical shocks to the chest through electrode pads. These shocks, known as defibrillation, aim to stop abnormal heart rhythms, such as ventricular fibrillation or ventricular tachycardia, and allow the heart to establish an effective rhythm. 


A typical AED consists of: 

  • Electrode pads: These adhesive pads are attached to a patient’s bare chest and deliver electrical shocks to the heart. AED pads detect the heart’s electrical activity and provide the necessary shocks to restore a normal rhythm. 
  • Batteries: AEDs are powered by lithium batteries, which help ensure the device is ready for use when needed. The battery provides the necessary electrical energy to deliver shocks and operate the AED’s other functions. 
  • Shock button: If the AED is not fully automatic or semiautomatic, there will be a shock button that is typically located on the face of the AED, depending on the make and model. 
  • Voice prompt/visual instructions: AEDs often provide voice prompts or visual instructions to guide the user through defibrillation. These prompts give clear and concise instructions to help ensure that individuals with minimal or no training can effectively operate the device. 

The accessibility and availability of AEDs and public access defibrillation programs have significantly improved, with many public spaces, such as airports, schools, and shopping centers, equipped with these devices. This widespread placement of AEDs increases the likelihood of immediate response and improves survival rates in cases of sudden cardiac arrest.


How does an AED help during SCA?

It is crucial to understand that sudden cardiac arrest (SCA) does not discriminate and can happen to anyone, including pregnant women. SCA occurs when the heart starts beating abnormally, preventing it from effectively pumping blood. This results in the person collapsing and becoming unresponsive without a pulse. Immediate intervention is vital to increase the chances of survival and minimize potential neurological damage. 

Cardiopulmonary resuscitation (CPR) is the first step in treating a pregnant woman suffering from sudden cardiac arrest, as it helps circulate the remaining oxygenated blood to the brain and vital organs. However, the heart needs to be defibrillated to restore its normal rhythm, hence the importance of having an AED.

When faced with sudden cardiac arrest in a pregnant woman, there are understandable concerns and misconceptions surrounding the use of an automated external defibrillator (AED). However, as mentioned above, prompt defibrillation in cardiac arrest cases, regardless of whether a woman is pregnant, is necessary.


Importance of prompt defibrillation 

It is essential to remember that cardiac arrest in a pregnant woman affects her and the blood flow to the unborn child. Chest compressions and an AED machine can improve the blood flow, potentially saving the mother and the unborn baby. 

While there may be specific considerations with a high-risk pregnancy, such as those with conditions like high blood pressure, gestational diabetes, preeclampsia, etc., the potential benefits of using an AED on a pregnant woman in cardiac arrest far outweigh the risks. Therefore, addressing misconceptions and ensuring that individuals understand the importance of defibrillator use in maternal cardiac arrest emergencies is essential. We cover a variety of misconceptions later in this article, but let’s look at how to actually treat a pregnant woman experiencing SCA first.


How to perform CPR and use an AED on a pregnant woman

If you encounter a pregnant woman in sudden cardiac arrest, treat her like any other individual in this condition. The immediate response is critical. Start by assessing the scene for safety, checking the pregnant woman’s responsiveness to see if she is breathing, and calling 911. Request an AED or ask someone to look for one while you initiate CPR compressions. 

It’s important to remember if the woman’s pregnancy is not immediately apparent, but you are aware of it, inform the 911 operator about her condition. This way, emergency medical services (EMS) personnel and hospital staff can be prepared for the circumstances of a late-term pregnancy. In such cases, the possibility of an emergency C-section should be considered. Every effort must be made to ensure the best possible outcome for the mother and the baby.


CPR on a Pregnant Woman

Performing CPR on a pregnant woman requires specific considerations and modifications to ensure the safety of both the mother and the unborn child, and understanding the steps to perform CPR can give rescuers the confidence they need to act quickly. 

Step 1: Make sure the pregnant woman is lying flat on her back in the supine position on the ground or floor. 

Step 2: Kneel beside the victim and place the heel of one hand on the center of her chest. Place the other hand on top of the first hand. 

Step 3: Begin CPR by pressing at least 2 inches deep into the center of the chest. Push hard and fast at 100-120 compressions per minute. 

Step 4: Allow the chest to recoil between compressions fully. The American Heart Association, AHA, recommends pushing to the beat of “Stayin’ Alive” by the Bee Gees, “Crazy in Love” by Beyoncé, or “Hips Don’t Lie” by Shakira. 


AED Use on a Pregnant Woman 

Once the AED arrives, turn it on and follow the voice or visual prompts provided. 

Step 1: Find the adult electrode pads and, using the visuals on the pads, peel and place the adhesive side to the pregnant woman’s bare chest. One pad should be placed on the upper right chest and the other on the lower left side. Be sure to avoid placing the pads over the abdomen. 

Step 2: Do not allow anyone to touch the pregnant woman while the AED analyzes or delivers shocks. 

Step 3: Begin CPR by pressing at least 2 inches deep into the center of the chest. Push hard and fast at 100-120 compressions per minute. 

Step 4: Allow the chest to recoil between compressions fully.

Step 5: Alternate between chest compressions and rescue breaths in a ratio of 30 compressions to 2 breaths. If you are uncomfortable providing rescue breaths, continue with chest compressions until help arrives. 

It is essential to continue CPR and AED analysis/shocks until EMS arrives and takes over. If the patient regains consciousness before EMS arrives and there are no signs of trauma, such as broken bones or spinal injuries, gently place her on her left side in the recovery position, as shown in the image above. This position optimizes blood flow to the mother and the fetus, ensuring their well-being.


Misconceptions and Myths about AED Use in Pregnancy 

Many people wonder if the electrical shock from an AED is safe for pregnant women or if it can potentially harm an unborn baby. According to the research found by the American Heart Association, there is enough evidence to strongly support the use of AEDs in pregnancy, meaning prompt intervention during maternal cardiac arrest is crucial. 

An AEDs electric shock target’s the mother’s heart and does not significantly impact the fetus or amniotic fluid. Using an AED on a pregnant woman can help restore normal heart rhythm and improve blood flow to the mother and the unborn child. 


Common Causes of Maternal Cardiac Arrest

  • Bleeding
  • Heart failure
  • Amniotic fluid embolism
  • Sepsis
  • Blood infection


CPR and Use of an AED: Common Mistakes to Avoid 

When administering CPR and using an AED, it’s essential to be aware of the common mistakes and misconceptions to ensure the safety and effectiveness of the emergency response. Here are some key considerations to avoid errors in CPR techniques specific to pregnant women and the importance of proper training and certification.


Error in CPR techniques specific to pregnant women

Proper hand placement during CPR can be a risk to pregnant women. Although you still place your hands in the same spot, the middle of the chest, be sure not to place your hands too low on the center of the chest as this can put excessive pressure on the sternum. Adjust hand placements higher on the sternum to avoid direct pressure on the pregnant woman’s belly. These modifications help maintain blood flow to the heart and the unborn child, improving the effectiveness of CPR. 


Importance of proper training and certification 

To ensure the best possible outcomes in emergencies involving pregnant women, proper training and certification in CPR and AED usage can help provide you with the knowledge and ability to recognize the signs of cardiac emergencies and know when to act. 

By undertaking proper training, individuals can acquire the necessary expertise to confidently perform CPR and use an AED on pregnant women, reducing the likelihood of errors and improving the chances of successful resuscitation.

When confronted with a pregnant woman in sudden cardiac arrest, an immediate bystander response can be lifesaving. Treat the situation urgently and follow the same protocols as you would for others experiencing SCA. 

 


Time is of the essence, and initiating CPR and utilizing an AED can significantly increase the chances of survival for both the mother and the baby. Remember to inform the emergency services about the pregnancy to ensure appropriate measures are taken.
To learn more about AEDSuperstore’s services, call 800-582-5348 or fill out our contact us form here.

 

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