Defibrillation is used in emergencies, and it works like a pacemaker for treatment of choice for ventricular fibrillation and pulseless VT. Defibrillation.
Defibrillation is the passing of an electrical shock of a short duration through the heart to terminate ventricular tachycardia without a pulse.
Cardioversion is defibrillation in a synchronized mode or timed electrical shock to the seat to remove specific dysrhythmias.
Table of Contents
- Ventricular fibrillation
- Ventricular tachycardia
- Pulmonary edema
- Atrial fibrillation
- Atrial flutter
- Supraventricular tachycardia
- Ventricular tachycardia with a pulse
Defibrillation can administer by
Specially trained nurses (Advance nurse practitioner)
Emergency medical technician
Physician (As this procedure is performed in emergency settings.)
Along with life support measures, this can be used and performed with CPR
- Direct current defibrillator with paddles
- Interface material (disposable conductive gel pads, electrode gels, and pastes)
- Resuscitative equipment
- If ventricular fibrillation is recognized within 2 minutes, give precordial thump, assess rhythm and carotid pulse, and expose the anterior chest.
- If within 2 minutes of detection of ventricular fibrillation, defibrillate before initiating cardiopulmonary resuscitation (CPR). Beyond 2 minutes, start resuscitation efforts immediately.
- Expose the anterior chest and remove jewelry in the area.
- Start CPR immediately
- Apply interface material to the patient (gel pads) or the paddles (gel, paste). The electrode paddles should be in firm contact with the patient’s skin.
- Remove oxygen from the immediate area.
- A second person should turn on the defibrillator to the prescribed setting. The American Heart Association recommends that initial defibrillation should be 200 to 300 joules of delivered energy. A second attempt at the same level should be given if the first attempt is unsuccessful. A third attempt with an increase of energy level to 360 joules should be attempted. Allow only approximately 5 seconds between successive shots to assess rhythm and pulse.
Apply electrodes in one of three ways:
- Apply one electrode just to the right of the upper sternum below the clavicle and the other electrode only to the left of the cardiac apex or left nipple
- The anterior paddle is held with pressure on the middle sternum while the patient lies on the posterior paddle under the left infrascapular region.
- Posterior paddle in the right infrascapular area and anterior paddle over the left apex.
- Grasp the paddles only by the insulated handles. Charge the paddles. Once paddles are charged, give personnel the command to stand clear of the patient and the bed. Glance to make sure all are away from the patient and bed.
- Push the discharge buttons on both paddles simultaneously while placing about 25 pounds of pressure onto each paddle
- Remove the patient’s paddles immediately after the shock is administered (unless paddles are being used as monitor leads). Resume CPR efforts until stable rhythm, spontaneous respirations, pulse, and blood pressure return. Look at the electrocardiograph monitor to determine the specific therapy for the resultant electrical mechanism. Further high-energy counter shocks may be necessary.
Why is defibrillation important?
Sudden cardiac arrest is a fatal one in which the best chance of survival is a shock from the defibrillator within the first 5 minutes after the fall. If the heart can be shocked with a defibrillator within minutes after collapse, it may restore a normal heart rhythm, many victims can survive. If defibrillation happens within the first 5 minutes, more than 50-70% of sudden cardiac arrest survivors survive.
This post will help you to learn more:
How does a defibrillator work?
Defibrillators are three types: AEDs, ICDs, and WCDs. Each type works by checking for irregular heart rhythms. Learn about how the types of defibrillators work.
- AEDs: AED is a battery-operated, lightweight, portable device that checks the heart’s rhythm and shock to the heart to restore a normal rhythm. This device is used to help people having a sudden cardiac arrest.
- ICDs: ICD used for a shock to correct the arrhythmia. ICDs are placed surgically in the abdomen or chest. It checks for arrhythmias.
- WCDs: WCDs can send a record of your heart’s activity to your doctors. WCDs can have sensors that attach to your skin.
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