Cardiovascular Medicine Book

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Defibrillation EquipmentAka: Defibrillator

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  1. See Also
    1. Synchronized Cardioversion
    2. Defibrillation
  2. Background
    1. Biphasic Defibrillation preferable to monophasic
      1. Lower energy levels may be used with biphasic
      2. Resuscitation with 3 shocks is better with biphasic
        1. Biphasic: 98%
        2. Monophasic: 67%
  3. Equipment: Paddles
    1. Infant Paddles (4.5 cm)
      1. Indicated for age <1 year or weight <10 kilograms
    2. Adult Paddles (8-13 cm)
      1. Indicated for age >1 year or weight >10 kilograms
  4. Technique
    1. Turn on defibrillator
    2. Attach monitor leads to patient (Mnemonic below)
      1. White to Right
      2. Red to Ribs
      3. What's left over to the left shoulder
    3. Synch Mode
      1. If indicated for Synchronized Cardioversion
      2. R Waves should be marked in synch mode
    4. Energy Level Selection as appropriate
    5. Attach conductor pads to patient at apex and sternum
      1. Alternatively apply gel to paddles
    6. Apply paddles to sternum (left hand), apex (right hand)
    7. Announce to the Team
      1. "Charging Defibrillator - Stand Clear"
        1. Press CHARGE Button on apex paddle (right hand)
      2. "I will shock on Three - One I'm Clear"
        1. Check self for contact with patient
      3. "Two, You're Clear"
        1. Check others for contact (especially Ventilator)
      4. "Three, everybody is clear"
        1. Check self again for patient contact
    8. Apply 25 pounds paddle pressure
    9. Press discharge buttons on paddles simultaneously
  5. Efficacy: Automated External Defibrillator (AED)
    1. Test Specificity for VF/VT: 99%
    2. Test Sensitivity for VF/VT: 81%
      1. Higher sensitivity in coarse VF (>200 mV amplitude)
      2. Sensitivity related to operator error
        1. Moving of patient during rhythm analysis
        2. Prematuring halting rhythm analysis
    3. References
      1. McDonald (2001) Ann Emerg Med 38:262

Defibrillators (C0180307)

Definition (MSH)Cardiac electrical stimulators that apply brief high-voltage electroshocks to the HEART. These stimulators are used to restore normal rhythm and contractile function in hearts of patients who are experiencing VENTRICULAR FIBRILLATION or ventricular tachycardia (TACHYCARDIA, VENTRICULAR) that is not accompanied by a palpable PULSE. Some defibrillators may also be used to correct certain noncritical dysrhythmias (called synchronized defibrillation or CARDIOVERSION), using relatively low-level discharges synchronized to the patient's ECG waveform. (UMDNS, 2003)
ConceptsMedical Device (T074)
EnglishCardioverter, defibrillator, Defibrillators, Electric Shock Cardiac Stimulators
Spanishcardioversor, desfibrilador
CreditsDerived from the NIH UMLS (Unified Medical Language System)



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