Navigation data
Part of NREMT Skillset
Page data
Type Medical skill
Keywords medical, trauma
SDGs Sustainable Development Goals SDG03 Good health and well-being
Aliases ABC's
NREMT
Published by GSTC
Published 2020
License CC BY-SA 4.0

When performing CPR on a pulseless adult or a non-breathing child aged 8 or older who weighs more than 55 pounds, an AED should be applied as soon as it is available.

Perform the following steps without interruption of CPR:

  1. Turn on the AED and follow the visual and/or audio prompts from the machine.
  2. Open the person's shirt and wipe his or her bare chest dry. If the person is wearing any medication patches, you should use a gloved hand or other protective barrier on your hand to remove the patches before wiping the person's chest.
  3. Plug in the AED pads, remove the adhesive backing, and place the pads in the indicated locations on the patient's right upper chest and left lower ribcage.
  4. Tell everyone to "stand clear" and make sure no one is touching the person.
  5. Push the "analyze" button (some models start analysis automatically) and allow the AED to analyze the person's heart rhythm.
  6. If the AED recommends that you deliver a shock to the person, it can take some time to charge. Continue chest compressions while charging.
  7. Once charged, tell everyone to "stand clear" - make sure that no one, including you, is touching the person while the shock is delivered automatically. For some models which do not auto deliver the shock, once the AED is charged and the patient is clear, press the "shock" button.

Restart CPR immediately after the shock was delivered, or if no shock was advised. Perform 2 minutes (about 5 cycles) of CPR and continue to follow the AED's prompts. If you notice obvious signs of life, discontinue CPR and monitor breathing for any changes in condition.

If ALS is not arriving on the scene, most local protocols advise transporting the patient when one of the following occurs:

  • The patient regains a pulse
  • Six to nine shocks have been delivered without Return of Spontaneous Circulation (ROSC)
  • The AED gives three consecutive messages (separated by 2 minutes of CPR) that no shock is advised.

Your local protocol always takes precedence over this general guideline.

For children and infants, there are specialized pads for child and infant AED application, but adult pads should be used if no pediatric pads are available.