> For the complete documentation index, see [llms.txt](https://kam-1.gitbook.io/kam-docs/llms.txt). Markdown versions of documentation pages are available by appending `.md` to page URLs; this page is available as [Markdown](https://kam-1.gitbook.io/kam-docs/medical-jap/cardiac/02_aed_manual.md).

# Cardiac Arrest Treatment & AED Manual

4 different heart rhythms can be present while unconscious. They are listed in the order at which they occur:

| No. | Rhythm Type                             |                         Treatment                        | AED-X monitor (EKG) reading      |
| :-: | --------------------------------------- | :------------------------------------------------------: | -------------------------------- |
|  -  | Normal                                  |                        Not needed                        | ![](/files/LcLuJzpCo7szSTG1tSvb) |
|  1  | **VT** - Ventricular Tachycardia        | Epinephrine\* Amiodarone\* Lidocaine\* + **Shock / CPR** | ![](/files/GWirC7C9fPNzc2BTa2cX) |
|  2  | **VF** - Ventricular Fibrillation       |     Epinephrine\* Amiodarone\* + **Shock /** **CPR**     | ![](/files/G09tSkHpCi0hckMNtGJe) |
|  3  | **PEA** - Pulseless Electrical Activity |                  Epinephrine\* + **CPR**                 | ![](/files/LcLuJzpCo7szSTG1tSvb) |
|  4  | Asystole                                |                  Epinephrine\* + **CPR**                 | ![](/files/QmQ9G6q5S19lUdMBZrlO) |

{% hint style="info" %}
**Note:** Medications mentioned are not required for successful treatment, but they will boost the effectiveness of the treatment. In addition, take note of **Essential Values** (such as blood volume) as blood loss will affect the success rate of these treatments.
{% endhint %}

Exact EKG readings for sinus rhythm (Normal and PEA):

| Electric Pulse Frequency | AED-X Monitor (EKG) reading      |
| :----------------------: | -------------------------------- |
|        **0 - 49**        | ![](/files/nQYzfRsEFfNSYM6rCnEP) |
|        **50 - 69**       | ![](/files/TrCukuxvOtZFOKtOrYGh) |
|        **70 - 89**       | ![](/files/LcLuJzpCo7szSTG1tSvb) |
|       **90 - 109**       | ![](/files/cqSWGUBCtLILORM5muy8) |
|       **110 - 129**      | ![](/files/8AHwc407plf1nHewM87j) |
|         **> 130**        | ![](/files/D24hFSQMrkqkLovYnoaL) |

The EKG reading during the CPR:

| ![](/files/UCZDhp2G1UigiyvzxSLt) |
| -------------------------------- |

The EKG reading while AED pads are not connected:

| ![](/files/23r1XGRB9asyeIS1Q9FW) |
| -------------------------------- |

Please note that heart rhythm EKG readings do not resemble the actual pulse that must be read separately. Sinus (normal) electrical activity causes the heart to pump as it should. Other (VT, VF) rhythms cause inappropriate heart functioning, therefore determining cardiac arrest. Please note that PEA rhythm resembles the normal rhythm while actually it is an asystole with fake electrical activity, hence CPR treatment.

The rhythm will deteriorate from VT to VF, PEA (starting from VT or VF) until it reaches Asystole with exception of a fatal amount of blood as it always leads directly to Asystole. VT and VF, can be treated with AED shock. PEA and Asystole can be treated only by CPR. Each successful AED shock/ CPR brings the rhythm up by one “level” (e.g. PEA → VF) . There is a random chance that a successful AED shock/ CPR will bring normal heart rate regardless of the rhythm (return of spontaneous circulation). Timer till death slows down by 50% while CPR is conducted.

If hardcore settings are selected, heart rhythm can go straight to non-shockable regardless of the blood volume. It can also deteriorate as a result of incorrect AED use.

If no AED is present, treat all cardiac arrest cases as asystole and treat them with CPR (as listed previously). Repeat until heart rate is restored.

***

## 🩺 AED Manual

{% stepper %}
{% step %}

### Preparation

Ensure nobody touches the patient (no CPR or BVM should be performed during analysis).
{% endstep %}

{% step %}

### Apply Pads

Click on the patient's chest and select **Attach AED pads** in the *Advanced Treatment* section.
{% endstep %}

{% step %}

### Analyze Rhythm

Select **Analyze Rhythm** in the *Examine Patient* section.

* **“Shock Advised”**: The AED will charge automatically and give a sound notification when ready. It is then possible to perform a shock. *(Tip: Using Epinephrine/Amiodarone/Lidocaine beforehand is advised. Apply only one medication per shock).* The AED will disarm itself automatically if no shock is administered within a certain timeframe.
* **“No Shock Advised”**: Perform CPR, administer Epinephrine (optional/not essential), and check the pulse every 2 minutes.
  {% endstep %}

{% step %}

### Re-evaluate

Analyze the heart rhythm again after administering the shock or after 2 minutes of CPR.
{% endstep %}
{% endstepper %}

***

## 🩺 AED-X Manual

AED-X has all the options of regular AED and can be used accordingly. It is a more sophisticated tool though as it enables the following:

* Manual charging and disarming (Advanced Treatment section)
* Vitals Monitor (accessed through Examine Patient section or attached separately through ACE interaction) which combines all options necessary for the AED usage and heart’s electrical activity view.