To use an AED (Automated External Defibrillator) involves seven clear steps: check the person, turn on the AED, expose the chest, attach the pads, let the AED analyse the heart rhythm, deliver the shock if advised, and immediately continue CPR. These steps are designed to be followed by anyone — with or without formal medical training — because the AED’s voice prompts guide you through every action. In Australia, sudden cardiac arrest kills more than 25,000 people each year, and the chance of survival drops by roughly 10 per cent for every minute that passes without defibrillation. Acting quickly with an AED can more than double a person’s chance of surviving in certain cases.
This guide walks through each step in detail, explains how AED use fits within the broader DRSABCD first aid framework, covers CPR technique, addresses special situations, and outlines what Australian workplaces need to know about defibrillator regulations and training.
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Key Takeaways
- An AED is a portable device that analyses heart rhythm and delivers a controlled electrical shock to restore a normal beat.
- Anyone can use an AED — voice prompts guide you step by step, and the device will not shock unless it detects a shockable rhythm.
- Always follow DRSABCD before starting AED use: Danger, Response, Send for help, Airway, Breathing, CPR, Defibrillation.
- The seven AED steps work alongside CPR — do not stop chest compressions any longer than absolutely necessary.
- In children under 8, use paediatric pads if available; if not, adult pads can be used in an anterior-posterior position.
- Australian workplaces are not universally required by law to have an AED, but Safe Work Australia guidelines strongly recommend them for many environments.
What Is an AED and Why Is It Important in the Workplace?
An Automated External Defibrillator is a portable, battery-powered medical device designed to assess a person’s heart rhythm and, when necessary, deliver a carefully calibrated electrical shock — known as defibrillation — to help the heart re-establish a normal beat. The word “automated” is key: the device does the diagnostic work for you. Once the electrode pads are attached to the patient’s chest, the AED reads the electrical signals produced by the heart and determines whether a shock is needed. No medical knowledge is required to operate one safely.
How Does an AED Work?
Cardiac arrest occurs when the heart’s electrical system malfunctions, causing it to beat chaotically — a condition called ventricular fibrillation or ventricular tachycardia — or to stop beating altogether. In shockable rhythms, the AED delivers a burst of electrical energy that momentarily halts all electrical activity in the heart, giving its natural pacemaker the chance to reset and restart a normal rhythm. CPR keeps oxygenated blood circulating during this process, which is why both interventions are always used together.
Why Every Australian Workplace Should Have an AED
Most cardiac arrests occur outside of hospitals. A significant proportion happen at work. The average ambulance response time in Australian metropolitan areas is around nine minutes, and in regional or rural areas it can be considerably longer. With survival rates falling by approximately 10 per cent per minute during untreated cardiac arrest, the difference between a defibrillator being used within the first three minutes versus waiting for paramedics to arrive can be the difference between life and death. Workplaces with AEDs on-site and trained staff are far better positioned to respond effectively.
AED vs CPR: Do You Still Need to Do CPR?
Yes — absolutely. CPR and AED use are complementary, not alternatives. CPR (cardiopulmonary resuscitation) keeps blood moving to the brain and vital organs while you wait for the AED to analyse the rhythm and recharge between shocks. Even after a shock is delivered, CPR must resume immediately. Think of CPR as buying time and keeping the patient viable, while the AED addresses the underlying electrical fault in the heart.
Table 1: CPR, AED, and Rescue Breaths — What Each Does and When to Use It
Intervention | What It Does | When to Use |
CPR (chest compressions) | Manually pumps blood to the brain and vital organs | As soon as cardiac arrest is confirmed; continue between AED cycles |
AED (defibrillation) | Delivers an electrical shock to reset a chaotic or absent heart rhythm | As soon as the device is available; follow all voice prompts |
Rescue breaths | Delivers oxygen directly to the lungs | Included in full CPR (30:2 ratio); optional in hands-only CPR |
Understanding DRSABCD Before You Use an AED
In Australia, the standard framework taught in all accredited first aid courses is DRSABCD. Before reaching for the AED, a first responder should have already moved through the first steps of this framework. DRSABCD ensures that the scene is safe, the emergency is correctly identified, and initial life support has commenced before defibrillation begins.
What Does DRSABCD Stand For?
D — Danger: Check for hazards to yourself, bystanders, and the patient. Do not enter an unsafe environment.
R — Response: Tap the patient firmly on the shoulders and call out loudly. Determine whether they are conscious or unresponsive.
S — Send for help: Call Triple Zero (000) immediately. Send someone to retrieve the AED. If you are alone, call before beginning CPR.
A — Airway: Open and clear the airway by tilting the head back and lifting the chin. Check for any visible obstruction.
B — Breathing: Look, listen, and feel for normal breathing for no more than 10 seconds. Occasional gasping is not normal breathing.
C — CPR: Begin 30 chest compressions followed by 2 rescue breaths. Maintain this ratio until the AED is ready.
D — Defibrillation: Attach and operate the AED as soon as it arrives. Follow the voice prompts precisely.
How DRSABCD and AED Use Work Together in a First Aid Emergency
In a real emergency, DRSABCD is not a slow, methodical checklist — it is a rapid sequence of checks that takes no more than 60 to 90 seconds when performed by a trained responder. The final step, Defibrillation, is where the AED’s seven steps begin. In a workplace setting, the ideal scenario involves at least two people: one performing CPR while the other retrieves and sets up the AED.
When Should You Move From DRSABCD to Using an AED?
The moment an AED becomes available. If someone else has already begun CPR, the AED operator should immediately power on the device, attach the pads, and follow the prompts without waiting. Every second the AED is inactive is a second the patient’s chance of survival is declining.
The 7 Steps of AED: How to Use a Defibrillator Step by Step
The following steps apply to adults and older children (those who weigh more than 25 kg). Specific considerations for children and infants are noted within the relevant steps.
Step 1: Check the Person — Is It Safe to Approach?
Before touching the patient, scan the environment for hazards: electrical cables, moving vehicles, unstable structures, or any substance that could harm you. If it is safe to approach, tap the patient firmly on the shoulders and call out loudly: “Are you okay? Can you hear me?” If there is no response and the person is not breathing normally, you are dealing with a potential cardiac arrest. Send someone to call Triple Zero (000) and to retrieve the nearest AED immediately. Do not leave the patient alone unless you are the only person present — in that case, call 000 before beginning CPR if a phone is within reach.
Step 2: Turn On the AED — How to Activate a Defibrillator
Most modern AEDs power on automatically when you open the lid or remove the device from its case. Others have a prominent power button — usually green or clearly marked with a power symbol. Once activated, the AED will begin speaking to you immediately. The voice prompts are clear, calm, and designed for use under stress. Trust them completely and follow each instruction in order. If you have never used that particular brand of AED before, the prompts will still guide you through every required action.
Step 3: Expose the Chest — Preparing the Patient for Defibrillation
The AED pads must make direct contact with skin to work effectively. Remove or cut away the patient’s clothing. If the chest is wet — from sweat, rain, or immersion — dry it quickly with a cloth or item of clothing before applying the pads. Moisture on the skin can conduct electricity across the surface of the chest between the two pads, reducing the effectiveness of the shock and potentially causing a skin burn. If the patient has a medication patch (such as a nitroglycerine or nicotine patch) on their chest, remove it and wipe the area before attaching the pads. For patients with excessive chest hair, press the pads down firmly to maximise contact. If the kit contains a razor, shaving the pad placement area quickly will improve adhesion.
Step 4: Attach the AED Pads — Correct Pad Placement for Adults and Children
Each pad has a clear diagram printed on it showing exactly where it should be placed. For adults: one pad goes on the upper right chest, below the collarbone; the other goes on the lower left side of the chest, below and to the left of the armpit — roughly in line with the heart’s apex. Press each pad firmly onto dry skin and ensure there are no air pockets beneath it.
If the patient has an implanted pacemaker or cardiac defibrillator — usually visible as a small lump under the skin near the collarbone — place the pad at least 5 centimetres away from the device.
For children under 8 years of age or under 25 kg, use paediatric pads if the kit contains them. These deliver a lower energy shock appropriate for a smaller body. If only adult pads are available, place one pad on the front of the chest and one on the back — this is known as the anterior-posterior position. Never place both adult pads on the front of a small child’s chest, as the pads may overlap and cause the current to arc across the skin surface rather than passing through the heart.
| Patient | Pad 1 Position | Pad 2 Position | Pad Type |
|---|---|---|---|
| Adult | Upper right chest, below collarbone | Lower left chest, below the armpit | Adult pads |
| Child (8+ or 25+ kg) | Upper right chest, below collarbone | Lower left chest, below the armpit | Paediatric pads preferred |
| Child (under 8 or under 25 kg) | Centre of chest (front) | Centre of the back | Paediatric pads; adult pads in anterior-posterior if unavailable |
| Infant | Centre of chest (front) | Centre of the back | Paediatric pads only |
Step 5: Let the AED Analyse the Heart Rhythm — Stand Clear
Once the pads are connected, the AED will instruct everyone to stand clear of the patient and will begin analysing the heart rhythm. This is critical: any movement or contact with the patient during analysis can interfere with the reading and produce an inaccurate result. Call out loudly “Stand clear — everyone step back!” and visually confirm that nobody is touching the patient, including yourself.
The analysis takes only a few seconds. The AED is looking specifically for shockable rhythms — ventricular fibrillation or pulseless ventricular tachycardia. If it detects a non-shockable rhythm (such as asystole), it will advise that no shock is needed and instruct you to resume CPR.
Step 6: Deliver the Shock if Advised — What Happens When You Press the Button
If the AED detects a shockable rhythm, it will charge automatically and prompt you to press the shock button — usually a flashing orange or red button. Before pressing, make a final visual check that nobody is touching the patient and announce clearly: “I’m going to shock — stand clear!” The electrical current passes through the chest wall and into the heart in a fraction of a second. The patient may convulse briefly; this is a normal response. The shock is harmless to the operator provided no one is in contact with the patient at the moment of delivery.
If the AED advises that no shock is needed, skip this step and follow the prompt to resume CPR. Do not attempt to override the AED’s decision.
Step 7: Continue CPR After the Shock — Why CPR Comes Next
Immediately after the shock is delivered — or if no shock was advised — resume CPR without delay. Do not pause to check for a pulse or wait to observe whether the patient has recovered. A single shock rarely restores normal circulation instantly; CPR is needed to keep blood moving to the brain while the heart attempts to re-establish its own rhythm.
Follow the AED’s voice prompts: the device will re-analyse the rhythm every two minutes and advise whether another shock is needed. Maintain a compression rate of 100 to 120 compressions per minute at a depth of 5 to 6 centimetres for adults, allowing the chest to fully recoil between compressions. If trained in rescue breathing, maintain a 30:2 ratio (30 compressions followed by 2 rescue breaths).
| Element | Standard |
|---|---|
| Hand position | Heel of dominant hand on the centre of the chest (lower half of the sternum); second hand on top |
| Compression depth | 5–6 centimetres |
| Compression rate | 100–120 per minute |
| Chest recoil | Full recoil between compressions — do not lean on the chest |
| Ratio (with rescue breaths) | 30 compressions to 2 breaths |
| Ratio (hands-only CPR) | Continuous compressions at 100–120 per minute |
Keep Going — When to Stop AED and CPR
Many bystanders are uncertain about how long to continue. The answer is straightforward: keep going until one of the following conditions is met.
| Situation | Action |
|---|---|
| Paramedics or emergency medical services arrive | Hand over care, provide a clear verbal handover, and follow their instructions |
| The patient shows clear signs of life | Normal breathing resumes or the patient moves purposefully — place in the recovery position and monitor closely |
| You are physically unable to continue | Rotate with another trained bystander if one is available |
| A medical professional assumes care | Transfer responsibility; remain available to answer questions |
Continue Until Emergency Services Arrive
In most cases, CPR and AED use should continue uninterrupted until paramedics take over. Fatigue is common — if there are bystanders present, rotate the person performing compressions every two minutes to maintain quality. Shallow or slow compressions are significantly less effective, and quality matters as much as continuity.
Handing Over to Paramedics: What to Tell Them
When paramedics arrive, provide a brief, clear handover. Tell them when the patient collapsed, how many shocks the AED delivered, how many cycles of CPR were performed, and whether the patient showed any signs of response at any point. This information helps paramedics continue care effectively and may influence treatment decisions at hospital.
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AED and CPR Together: Why Both Skills Are Essential for Workplace First Aid
CPR and AED use are two halves of the same response. Neither is fully effective without the other. CPR without defibrillation can sustain a patient in ventricular fibrillation for a reasonable period of time, but it will rarely convert the rhythm back to a normal beat on its own. Defibrillation without CPR is also less effective, because the heart muscle deteriorates rapidly without oxygenated blood. The combination — good-quality CPR interrupted only to deliver a shock and allow rhythm analysis — is what gives a patient in cardiac arrest the best possible chance.
How to Perform CPR Correctly Alongside AED Use
The key principle is minimising interruptions to chest compressions. Stop compressions only when the AED is analysing the rhythm or delivering a shock. Resume compressions within 10 seconds of the shock being delivered. Many AEDs include a metronome feature or compression timing prompts to help the rescuer maintain the correct rate.
Hands-Only CPR vs Full CPR: What Is Recommended in Australia?
The Australian Resuscitation Council recognises both hands-only CPR (continuous chest compressions without rescue breaths) and full CPR (30:2 ratio with rescue breaths) as acceptable in cardiac arrest. For bystanders who are not trained in rescue breathing, or who are uncomfortable performing it, hands-only CPR is an effective alternative and is strongly preferred over doing nothing. For trained first aiders, full CPR with rescue breaths is recommended for adults, and is particularly important for children and drowning victims, where hypoxia (oxygen deprivation) is often the primary cause of the cardiac arrest.
Safe Work Australia Guidelines on Workplace First Aid
Safe Work Australia’s Code of Practice: First Aid in the Workplace provides guidance on first aid requirements based on workplace size, hazard level, and proximity to emergency services. While the code does not universally mandate AEDs, it advises employers to assess their specific risk profile and provide resources accordingly.
| Workplace Type | AED Recommendation | Basis |
|---|---|---|
| Small office (under 25 staff, urban) | Recommended | Non-zero cardiac arrest risk despite proximity to EMS |
| Large office (100+ staff) | Strongly recommended | Higher probability of cardiac event based on population size |
| Industrial or construction site | Strongly recommended | Physical exertion; potential for electrically-related cardiac arrest |
| Remote or rural workplace | Strongly recommended | Long EMS response times; limited access to hospital care |
| Aged care or health settings | Required in most cases | High-risk population; regulatory requirements typically apply |
| Gyms and fitness facilities | Strongly recommended / required | Elevated cardiac risk during physical exertion |
The Critical Importance of Knowing How To Use An AED
Sudden cardiac arrest does not give advance notice. It can happen to any person, at any age, at any time — including during an ordinary workday. The seven steps of AED use are simple, logical, and supported by one of the most well-designed pieces of emergency medical technology available to the public. Combined with CPR and the DRSABCD framework, they represent the most effective chain of survival that any workplace can put in place before paramedics arrive.
The evidence is clear: early defibrillation, ideally within the first three to five minutes of cardiac arrest, can increase survival rates from under 10 per cent to over 50 per cent. That window of opportunity belongs to whoever is nearest — and that person could be you or one of your colleagues.
Knowing what to do is not enough if you have never practised it. Enrol in a nationally recognised first aid course with First Aid Pro Workplace Training and give yourself — and your team — the skills and confidence to act decisively when it matters most.
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Related Reading
- Australian Resuscitation Council. (2021). Guideline 11.5: Electrical therapy for adults. ARC.
- Better Health Channel: First aid basics and DRSABCD
- Healthdirect: Defibrillators and AEDs
- Heart Foundation: Shockingly Simple
- First Aid Pro: Automated External Defibrillator Explained: How AEDs Work & When to Use Them
Frequently Asked Questions
Can anyone use an AED without training?
Yes. AEDs are specifically designed for use by people with no medical training. The device uses clear voice prompts and visual indicators to guide the operator through every step, and it will only advise a shock when it detects a rhythm that warrants one. That said, accredited first aid training is strongly recommended because it builds confidence, ensures you know how to perform effective CPR alongside AED use, and familiarises you with the DRSABCD framework so you can respond calmly under pressure. In a real emergency, confident and effective action saves lives — and training makes that possible.
Can you hurt someone by using an AED incorrectly?
The risk of causing harm by using an AED on a person in cardiac arrest is extremely low. The device will not deliver a shock unless it identifies a shockable heart rhythm. The main risks from incorrect use are minor — a skin burn can occur if the pads are not pressed firmly or if the skin is wet, and poor pad placement can reduce the effectiveness of the shock. The far greater risk is failing to use the AED at all. Australian law provides protection to bystanders who act in good faith to assist in an emergency situation.
How long does an AED battery last, and how do you maintain one?
Most AED batteries last between two and seven years in standby mode, depending on the make and model. The device will display a green indicator or ready symbol when operational, and will emit an alert when the battery is low or the pads are expired. Workplace AEDs should be checked visually at least once a month — confirm the charge indicator is green, the pads are within their expiry date, and the device shows no visible damage. Assign monthly checks to a specific person and keep a written maintenance log.
Do Australian workplaces have to provide AED training for staff?
There is no universal federal law requiring AED training for all Australian workers. However, if a workplace has an AED on-site, staff should be trained to use it — a device that nobody knows how to operate provides no benefit in an emergency. Under Work Health and Safety legislation, employers have a general duty to ensure workers can respond to health and safety emergencies. Training in CPR (HLTAID009) and first aid (HLTAID011) is the most practical and effective way to fulfil this duty.
