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Defibrillator Contraindications

Most of us have seen the defibrillator with two paddles used on medical TV shows, or practiced with a portable version called the AED (automated external defibrillator) in first aid class, so we know it can save lives. The machine's main purpose is to correct or improve an abnormal heart rhythm that has become life-threatening by administering a series of electric shocks. However, in some cases a defibrillator is contraindicated, which means the use of one is inadvisable.

  1. Touching the Victim

    • When placing the defibrillator paddles on a victim who has no pulse, nobody can be touching the victim when the device is turned on, or the bystanders could receive the shock also. The device operator will yell "clear" before administering the shock pulses in order to warn bystanders to move away who may not be paying attention. Also, women's breasts should not be touched by the paddles, since it isn't necessary and could interfere with proper current distribution. If the woman is wearing a bra, it should be removed and placed loosely on the neck.

    Alert Patient

    • A defibrillator should never be used on an alert patient or a patient with a pulse, even if that pulse is erratic but not life-threatening. If the patient has a pulse, a shock could have the opposite of the intended effect and result in a dangerously abnormal heart rhythm or cardiac arrest. If the patient is unconscious and not breathing, but still has a pulse, CPR should be performed by a qualified individual.

    Wet Surface

    • An effort should be made to dry the victim's chest before applying the paddles, or improper current distribution could result. In addition, if the victim is lying on a wet surface, he should be moved off of that surface unless it's considered an unsafe act, in which case all bystanders should leave the wet area. Otherwise, bystanders could be shocked when the device is turned on. Operators of defibrillators can wear latex gloves to reduce the effect of any shock they receive in wet conditions.

    Implanted Defibrillator

    • If the victim is known to have an implanted defibrillator (surgically placed inside the chest), an external defibrillator is contraindicated unless the implant is not operational, in which case the external device can be operated normally. A shock from outside won't harm the implant, but if both devices are working and are used, there could be a problem with excess voltage.

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