See also COLD WATER DROWNING; RESCUE BREATH-
ING; RESPONDER SAFETY AND PERSONAL PROTECTION; SITE
AND SITUATION ASSESSMENT; SYMPTOM ASSESSMENT AND
CARE TRIAGE; WARM WATER DROWNING.
defibrillation Delivery of a controlled electrical
shock, using an AUTOMATED EXTERNAL DEFIBRILLATOR
(AED), to restore a functional HEART BEATof a per-
son who has suffered CARDIAC ARRESTand whose
HEARTis in a state of fibrillation (rapid, disorgan-
ized, and useless contractions). Numerous public
locations and businesses have AEDs.
The AED provides voice instruction for defibril-
lation. The AED pads, when placed on the per-
son’s chest as directed, first detect and send to the
AED’s computer the heart’s electrical signals. If the
rhythm is one that could respond to defibrillation,
the AED prepares to deliver a preset electrical
shock. If the heart is not beating or has a rhythm
for which defibrillation is inappropriate the AED
advises the responder what to do, which may be
to perform CARDIOPULMONARY RESUSCITATION(CPR).
As with any life-threatening situation, the
responder should first call 911 to summon emer-
gency medical personnel.
See also HEART ATTACK; RESPONDER SAFETY AND
PERSONAL PROTECTION; SITE AND SITUATION ASSESSMENT;
SUDDEN CARDIAC DEATH; SYMPTOM ASSESSMENT AND
CARE TRIAGE.
electrocution Injury resulting from electrical
shock. Typically a person who experienced elec-
trocution is not BREATHINGand may not have a
HEART beat, which is a life-threatening circum-
stance. The person is also likely to have electrical
BURNS.
Do notapproach a person who has suf-
fered electrocution until certain the
source of electricity is no longer active.
Do not try to move a person who
remains in contact with a high-voltage
power line.Site and situation assessment The scene of an
electrocution is extremely hazardous. The first
person to respond must determine whether the
source of electricity remains “live.” Indications of
this include downed power lines and plugged in
power tools or appliances. Water, including wet
surfaces, increases the risk to the responder as
water conducts electricity. There may also be risk
for explosion or fire.
Responder personal protection measures Latex
gloves, which the responder should put on before
approaching the injured person, are essential for
personal protection from bloodborne pathogens. A
resuscitation shield is necessary for personal pro-
tection when performing RESCUE BREATHINGor full
CARDIOPULMONARY RESUSCITATION(CPR).
First response actions When certain there is no
live electricity at the scene, determine whether
the person is breathing and has a heart beat.
When necessary, begin rescue breathing or CPR.
When these measures are not necessary, provide
basic FIRST RESPONSEfor burns and any other appar-
ent injuries.
Follow-through The person requires urgent
transportation to a trauma center or hospital
emergency department. Burns are usually more
severe than they appear and other injuries are
likely.
See also PATHOGEN; RESPONDER SAFETY AND PER-
SONAL PROTECTION; SHOCK.Heimlich maneuver A method to dislodge a for-
eign object from the upper airway that blocks the
flow of air. The most common substances that
become stuck and block BREATHING are incom-
pletely chewed foods, especially meats, and small
foods such as grapes, nuts, and hard candies.
Young children may choke on nearly any food as
well as small toys and other objects they pick up
and put in their mouths.
To perform the Heimlich maneuver:- Confirm that the person is choking by asking
him or her to speak. If the person cannot speak,
the airway is blocked. - Stand behind the person, with the person
standing. - Reach around the person and place one hand
formed into a fist just above the person’s belly
button, thumb-side of the fist toward the per-
son’s body.
372 Emergency and First Aid