Key facts and statistics

Sudden cardiac arrest (SCA) does not discriminate by age, gender, or even pregnancy status. Although less common in pregnant women, the impact of SCA can be devastating. According to the Resuscitation Council UK, prompt administration of CPR and, if necessary, defibrillation are crucial steps in improving survival rates. Statistics suggest that early defibrillation can increase the survival rate by up to 70% when initiated promptly.

Key definitions

• Automated External Defibrillator (AED) - This portable electronic device automatically diagnoses and treats life-threatening cardiac arrhythmias by defibrillating them.
• Sudden Cardiac Arrest (SCA) - An abrupt loss of heart function, which can lead to death if not treated immediately.
• Pregnancy - This is a physiological condition of carrying one or more offspring, fetuses or embryos inside the uterus.

Relevant legislation and regulations

In the UK, the use of AEDs is supported by several guidelines and legislative frameworks:

• Health and Safety (First-Aid) Regulations 1981 - Employers must provide adequate and appropriate equipment, facilities, and personnel to ensure immediate and effective first aid in the workplace.
• Resuscitation Council UK Guidelines - These provide specific instructions on performing CPR and using AEDs on pregnant women, emphasising modifications to standard procedures to accommodate the physiological changes during pregnancy.

Best practices

• Positioning - If the patient is in the late stages of pregnancy, perform chest compressions slightly higher on the breastbone.
• Use of AED - Do not hesitate to use an AED. The electrodes should be placed one below the right collarbone and the other on the side of the left breast to avoid a larger abdomen.

Understanding the need for AED use in pregnancy

Pregnancy introduces physiological changes that can increase the risk of SCA. Factors such as elevated blood volume, hormonal changes, and increased cardiac output create unique challenges during resuscitation. Addressing these needs effectively requires understanding and preparedness.

Steps to safely use an AED on a pregnant woman

• Call for help - Immediately dial 999 and ask for an ambulance. Inform them that the patient is pregnant.
• Check responsiveness - Gently tap or shake the woman to see if she responds.
• Initiate CPR - If there is no response, begin CPR. Remember to adjust hand placement and depth of compressions.
• Prepare the AED - Turn on the AED and follow the voice prompts. Attach pads correctly, avoiding the abdomen.
• Deliver shock if advised - If the AED determines a shock is needed, ensure no one is touching the patient and proceed.

Challenges and considerations

• Physiological changes - Pregnant women are at an increased risk of regurgitation and aspiration, so position the head accordingly.
• Emotional factors - The presence of family or bystanders can heighten emotional tension. Stay calm and reassure those around you.

Recommendations

• Training - Regular training for emergency responders and public awareness can save lives. Ensure that your organisation is equipped with the right skills and equipment.
• Awareness - Increase awareness about the safety and necessity of AED use in pregnant women through workshops, seminars, and information sessions.

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