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DEFINITION:
Electric current is delivered through the chest to the heart. The flow of
current through the heart causes depolarization of the myocardial cells.
Ideally, a normal underlying heart rhythm will then resume. This energy
charge is delivered from the defibrillator capacitor through either metal
paddles or adhesive patches (hands free).
DEFIBRILLATION SUCCESS
Successful defibrillation depends upon the following:
Time to the first shock
o Survival declines 7-10% each minute from collapse to the first
shock if no CPR is performed.
o Deliver the first shock as quickly as possible for a witnessed
arrest.
Effective CPR
o Survival decreases-3-4% each minute from arrest to the first
shock if CPR is performed.
o Perform CPR for 2 minutes before defibrillation if the arrest is
unwitnessed.
An effective level of energy delivery
o The amount of energy needed to defibrillate varies according to
the defibrillation waveform.
DEFIBRILLATION TECHNIQUE
The technique for defibrillation will vary depending on whether you are
using manual paddles or self-adhesive (hands-free) defibrillation patches.
The two most common methods ate the use of manual paddles and handsfree defibrillation.
WARD BASED MODULE
phone: 555.555.5555 | fax: 555.555.5555 | Kwaifyah, Benghazi | www.nursingcollegebenghazi.com
defibrillator:
120-200
(based
on
the
manufacturers
recommendations)
IMPLEMENTATION:
ACTION
DEFIBRILLATION
RATIONALE
USING
MANUAL PADDLES:
1. Turn
on
the
power
to
monitor/defibrillator
fibrillation(VF)
ventricular tachycardia(VT)
3. Verify that the patient has no To continue the procedure.
pulse.
4. Apply conduction gel to the This prevents burning the skin of the
paddles or pre-gelled conduction patient.
WARD BASED MODULE
the
appropriate
level.
restoring the conditions.
6. Place the paddles on the patients
chest.
Anterior-anterior (sternum-apex):
Proper
placement
of
the
paddles
on
the
power
to
depolarization
of
the
myocardial muscles
monitor/defibrillator
properly.
2. Determine that the rhythm is Determining the heart rhythm ensure
ventricular
fibrillation(VF)
ventricular tachycardia(VT)
3. Verify that the patient has no To continue the procedure.
pulse.
4. Place the adhesive defibrillation
(sternum-apex) Proper
placement
of
the
paddles
the
point
of
maximal
level.
restoring the conditions.
7. Press the charge button while For effective defibrillation.
reassessing the rhythm.
8. Call Im clear, youre clear, To ensure that no one is touching the
everyone is clear! while looking patient.
head to toe.
9. Resume CPR
To revive the client.
10.Check the rhythm after 2-cycles of To flow the current through the heart
CPR and defibrillate again if causing
indicated.
depolarization
myocardial muscles
of
the
NOTE:
First, DO NO HARM! You must be sure that neither you nor any of
your teammates are touching the patient when you defibrillate.
Dont stop CPR while the defibrillator pads are applied or during the
time the defibrillator is charging.
References:
American Heart Association, AHA Guidelines for Cardiopulmonary Resuscitation and
Emergency Cardiovascular Care, Circulation 112, suppl. 1 (2005).
McKenna, K. ACLS Essentilas, Basic and More, McGraw-Hill Companies, Inc., 2008,
p.12-18