How to Do CPR and Use an AED on the Elderly: A Lifesaving Guide for Senior Care

Lucy Dale

Published:17 January 2025

Cardiac arrest is one of the leading causes of death among the elderly. With advancing age, the likelihood of heart-related emergencies significantly increases due to conditions such as coronary artery disease, arrhythmias, and congestive heart failure. Recognising this risk is essential for caregivers, family members, and senior living facilities to be equipped with both knowledge and tools to respond effectively. This guide provides detailed insights into performing CPR and using an AED for elderly individuals, ensuring preparedness in critical moments.

Understanding Cardiac Arrest in the Elderly

Cardiac arrest occurs when the heart stops pumping blood effectively. In older adults, this can result from:

Heart Disease: A leading cause of cardiac events in seniors.
Medication Side Effects: Many elderly individuals are on medications that can affect heart rhythms.
Underlying Health Conditions: Conditions like diabetes, hypertension, and prior strokes increase the risk.

Without immediate intervention, survival rates drop by 10% for every minute that passes without treatment.

CPR for the Elderly: Unique Considerations

Performing CPR on elderly individuals requires understanding their physical vulnerabilities and adjusting techniques accordingly.

1. Compression Depth and Rate

The recommended compression depth is 5–6 cm (2–2.4 inches), even for elderly patients. However, the risk of rib fractures is higher due to reduced bone density.
Compress at a rate of 100–120 compressions per minute, maintaining consistency to ensure oxygen delivery to vital organs.

2. Assess Responsiveness

Tap the shoulders and ask loudly, Are you okay?
If unresponsive, call emergency services immediately. Use the opportunity to locate an AED while initiating chest compressions.

3. Chest Wall Stiffness

Older adults often have less flexible chest walls. Ensure complete recoil after each compression to allow the heart to refill with blood effectively.

4. Pre-existing Conditions

Pacemakers or Implantable Cardioverter Defibrillators (ICDs): Avoid placing hands directly over these devices during compressions.
Osteoporosis: Be cautious but prioritise effective compressions over concerns of potential rib fractures. Broken ribs can heal, but brain damage from lack of oxygen cannot.

17 January 2025

AED Use in Elderly Patients

An Automated External Defibrillator (AED) is a critical tool in restoring a normal heart rhythm during cardiac arrest. AEDs are designed to assess heart rhythms and deliver shocks when necessary. For elderly patients, the following factors are vital:

1. Choosing the Right AED

AEDs like semi-automatic AEDs and fully automatic AEDs are effective options for elderly users in community or indoor settings. Features to consider include:

Clear voice prompts.
Visual indicators for proper pad placement.
Adaptive guidance for high-stress situations.

2. Pad Placement

Place one pad on the upper right chest, just below the collarbone.
Place the second pad on the lower left side of the chest, below the armpit.

For elderly individuals with fragile skin, ensure the chest is clean and dry before applying pads. If chest hair interferes with adhesion, use the razor included in AED rescue kits.

3. Shock Delivery and Timing

Most AEDs deliver between 150–200 joules of energy. AEDs with SMART analysis adjust energy levels based on the patient’s needs.
AEDs, like indoor defibrillators, ensure consistent functionality in home or facility environments.

4. Special Considerations

Pacemakers: Avoid placing pads directly over the pacemaker site, which is usually identifiable as a small lump under the skin.
Medication Patches: Remove any transdermal medication patches before placing AED pads to avoid burns or interference with electrical conductivity.

CPR and AED Integration: The Chain of Survival

Combining CPR and AED use maximises survival chances, especially in elderly patients. The Chain of Survival includes:

Early Recognition and Call for Help: Identify cardiac arrest and contact emergency services.
Immediate CPR: Maintain blood flow to the brain and organs while awaiting the AED.
Early Defibrillation: Use the AED to reset the heart’s rhythm as soon as it arrives.
Advanced Medical Care: Continue care upon EMS arrival.

Studies show that this integrated approach can increase survival rates by over 70% when applied within the first few minutes of cardiac arrest.

Preparing Senior Living Facilities and Homes

For senior facilities and homes, readiness involves more than just owning an AED. Here’s how to create a cardiac-ready environment:

1. Strategic AED Placement

Place AEDs in visible, easily accessible locations.
Consider community AEDs designed for shared spaces.

2. Training for Staff and Family Members

Conduct regular CPR and AED training for caregivers and family members.
Use resources like AED training videos or hands-on simulations to boost confidence.

3. Maintenance Checks

Test AEDs regularly to ensure they are rescue-ready.
Replace electrode pads and batteries before expiration to avoid device failures during emergencies.

Overcoming Barriers to Action

Hesitation is a common challenge in responding to emergencies. Here are ways to address it:

Fear of Injury: Remember, performing CPR, even imperfectly; is better than doing nothing.
Uncertainty About AED Use: Modern AEDs provide step-by-step instructions, making them user-friendly for all skill levels.
Legal Concerns: Good Samaritan laws protect those who act in good faith during emergencies.

Why Preparedness Matters

Statistics reveal the critical importance of being prepared:

Nearly 90% of out-of-hospital cardiac arrests are fatal without immediate CPR and defibrillation.
Elderly patients have a higher chance of survival when bystanders intervene promptly.

By equipping yourself with the right knowledge and tools, you can make a life-saving difference.

Conclusion: Be the Lifesaver They Need

Cardiac arrest in the elderly is a pressing concern, but it’s one that can be addressed through proper education, training, and preparedness. Whether you’re a caregiver, family member, or facility operator, understanding how to perform CPR and use an AED effectively is vital. Let’s work together to create safer spaces for the elderly, empowering everyone to respond confidently when every second counts.