II. 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%

III. 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

IV. Technique

  1. Images: Zoll
    1. cvEkgMonitorZoll.png
  2. Turn on Defibrillator
  3. Attach monitor leads to patient (Mnemonic below)
    1. White to Right
    2. Red to Ribs
    3. What's left over to the left Shoulder
  4. Synch Mode
    1. If indicated for Synchronized Cardioversion
    2. R Waves should be marked in synch mode
  5. Energy Level Selection as appropriate
  6. Attach conductor pads to patient at apex and Sternum
    1. Alternatively apply gel to paddles
    2. Defibrillation pads may be placed regardless of underlying AICD (as of 2010) to prevent delays
  7. Apply paddles to Sternum (left hand), apex (right hand)
  8. 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
  9. Apply 25 pounds paddle pressure
  10. Press discharge buttons on paddles simultaneously

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Ontology: Defibrillators (C0180307)

Definition (UMD) Cardiac electrical stimulators that apply brief high-voltage electroshocks to the heart. These stimulators are used to restore normal rhythm and contractile function in patients who are experiencing ventricular fibrillation or ventricular tachycardia 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.
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)
Concepts Medical Device (T074)
MSH D047548
SnomedCT 19257004
English FIBRILLATOR, AC, Cardioverters, Defibrillator, device, defibrillators, cardioverter, defibrillator, Cardioverter, Defibrillator, device (physical object), Defibrillator, Cardioverter, NOS, Defibrillator, NOS, Defibrillators, Stimulators, Electrical, Cardiac, Shock, Electric Shock Cardiac Stimulators
Portuguese Desfibriladores
Swedish Defibrillatorer
Czech defibrilátory
Finnish Defibrillaattorit
Russian DEFIBRILLIATORY, ДЕФИБРИЛЛЯТОРЫ
Japanese 自動体外除細動器, 除細動装置, 自動体外式除細動器, 心臓細動除去器, 細動除去器, 除細動器
Italian Stimolatori cardiaci per shock elettrici, Defibrillatori
Polish Defibrylatory
Norwegian Defebrillatorer, Hjertestartere
Spanish cardioversor, desfibrilador (objeto físico), desfibrilador, Desfibriladores
French Défibrillateurs, Stimulateurs cardiaques par chocs électriques
German Defibrillatoren
Dutch Defibrillator