User:Marekpawlowski/SELF/Perioperative Nursing/Defibrillation with AED/Psychomotor Skills Practice Instructions

NB:

#	Step	Instructions	Good Skills (Learning Objectives)	Common Errors	Guidance
1	Start chest compressions while the AED is prepared	Say aloud: “Chest compressions are started immediately while the AED is retrieved and prepared.” If practising with a CPR manikin, begin simulated chest compressions according to local protocol.
2	Power on the AED	Turn on the AED immediately and follow all voice and visual prompts.	Activates the AED promptly and follows device prompts correctly.	Delays turning on the AED; hesitates after power-on; ignores or misinterprets prompts.	Repeat until the AED can be activated confidently and the learner responds promptly to every prompt.
3	Prepare the anterior chest	Say aloud: “The anterior chest is exposed and prepared for AED pad application.” Simulate removing clothing and preparing the skin according to local protocol.
4	Assess for pad-placement hazards	Say aloud: “Chest inspected for excessive hair, medication patches, implanted cardiac devices, moisture, or other factors that may affect pad placement.”
5	Apply the right upper chest pad	Place the first AED pad firmly below the right clavicle on the upper right chest using the anatomical landmarks.	Identifies landmarks accurately and applies the pad securely in the correct position.	Pad placed too high, too low, or too medial; poor adhesion; wrinkled pad.	Repeat until pad placement is accurate, secure, and performed without hesitation.
6	Apply the left lateral chest pad	Place the second AED pad on the left lateral chest below the armpit, ensuring appropriate separation from the first pad.	Correctly positions the second pad to create an effective electrical pathway through the heart.	Pad placed too anteriorly; pads too close together; poor adhesion.	Practise identifying the left lateral position quickly and applying the pad securely every time.
7	Connect the pads to the AED (if required)	Connect the pad cable to the AED if it is not already connected and confirm that the device recognizes the pads.	Correctly connects the pads and prepares the AED for rhythm analysis.	Connector not fully inserted; skips the connection; delays rhythm analysis.	Practise checking the pad connection as part of the routine workflow without interrupting CPR unnecessarily.
8	Clear the patient for rhythm analysis	Announce, “Stop compressions—everyone clear,” and visually confirm that no one is touching the patient before rhythm analysis begins.	Performs an effective safety check before rhythm analysis.	Fails to ensure everyone is clear; incomplete visual check; unclear communication.	Develop the habit of performing a deliberate visual confirmation every time before rhythm analysis.
9	Respond to the AED prompt	Follow the AED prompts exactly, whether “Shock Advised” or “No Shock Advised.”	Responds appropriately to AED prompts without hesitation or independent rhythm interpretation.	Attempts to override the AED; delays responding to prompts; confusion about the next action.	Trust the AED prompts and focus on carrying out the indicated action promptly and safely.
10	Deliver a simulated shock (if advised)	Confirm that everyone remains clear, announce the shock, and press the shock button when instructed by the AED trainer.	Performs complete safety checks before simulated shock delivery.	Shock delivered while someone is touching the patient; incomplete safety check; hesitation after the prompt.	Always perform a final visual check immediately before pressing the shock button.
11	Resume simulated chest compressions immediately	Immediately instruct the assistant to resume chest compressions or begin simulated compressions yourself if appropriate.	Minimizes interruptions to CPR following rhythm analysis or simulated shock delivery.	Delayed resumption of CPR; unclear instructions; prolonged pause after shock.	Practise transitioning immediately from AED actions back to chest compressions with minimal interruption.
12	Continue AED-guided care	Say aloud: “Continue following the AED prompts, repeating the sequence of rhythm analysis, shock delivery (if advised), and immediate resumption of chest compressions until the simulated scenario ends or additional clinical support assumes care.”

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