AEDs and Oxygen in the Aquatic Environment

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AEDs and emergency oxygen, though not a panacea, have been demonstrated to be effective lifesaving tools in public facilities. Aquatic environments arguably have even more potential for benefit as the use of supplemental oxygen or an AED may make the difference between a successful resuscitation and a tragedy. While such equipment has not yet become mandatory, its availability and use certainly is at least prudent.

In a wet environment, the most common concern involving AEDs is the potential electrical hazard to those in the general proximity. Numerous tests have been performed using both one- and two-phase devices on simulated victims in both fresh and salt water. These tests demonstrated that the defibrillation of a patient in a wet environment produced insignificant electrical potential that posed a negligible risk to the patient, operator, or bystanders. Because most AEDs are self-grounded they are shown to be safe to use in wet environments. In order to provide an even greater safety margin, the following protocol for the use of an AED in a wet environment is recommended:

  • The patient should be placed on a backboard and moved at least six feet from the water’s edge.
  • The patient's chest should be dried before attaching the AED electrode pads. This will help ensure that the pads can be properly applied and will avoid stray electrical currents.
  • The AED operator and others should never be in contact with the patient during rhythm analysis or defibrillation.
  • The attached AED cable should be extended away from the patient as far as possible before the defibrillation button on the AED is pressed.

The primary safety concern during the operation of the AED is that no one should be touching the patient when the defibrillator is discharged. As long as the electrode pads are properly placed and there is no contact between the operator or bystanders and the patient, there is no direct current path that would cause a shock to those other than the patient. When administering oxygen in combination with an AED, be sure that the oxygen is removed from the victim and placed several feet away or that the oxygen flow is shut off when a shock is delivered. This is to reduce the possibility that the electrical charge from the AED may ignite the oxygen-enriched space surrounding the victim.

Any victim of a potentially life threatening emergency, without exception, should receive emergency oxygen. In a drowning or any other hypoxic emergency the vital organs and tissue of the victim will suffer from low oxygen levels, that, if sustained, will lead to brain damage and cardiac arrest. It is important to restore as much oxygen to the victim as possible through the use of emergency oxygen. Oxygen should be administered to both breathing victims, via a mask, and non-breathing victims through rescue breaths. Oxygen use should be maintained until EMS arrives, even if the victim appears to recover.

Please call us at 800-463-8546 to discuss this or any other risk management safety tip, or visit our web site at www.redwoodsgroup.com to learn more about YMCA risk management issues.

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