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    Defibrillator1 200806145633

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    110 views28 pages

    Defibrillator1 200806145633

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    of 28

    DEFIBRILLATOR

     SUBMITTED TO:
    Mrs. Mamta Toppo
    Subject Coordinator
    College of Nursing  SUBMITTED BY:
    RIMS, RANCHI Chandra Tamang
    Roll No. 05
    Basic Bsc Nursing
    3rd year
    College of nursing
    RIMS, RANCHI
    CONTENT
     Introduction
     Definition
     Types of defibrillator
     Procedure/Technique
     Checklist
     Nursing consideration
     Post defibrillation care
     Precautions
     Related care
     New research
     Summary
     Reference
     Bibliography
    INTRODUCTION
    Defibrillation is the definitive treatment for the life-
    threatening cardiac arrhythmias, ventricular
    fibrillation and pulseless ventricular tachycardia.
    Defibrillation consists of delivering a therapeutic dose
    of electrical energy to the affected heart with a device
    called a defibrillator. This depolarizes a critical mass of
    the heart muscle, terminates the arrhythmia, and
    allows normal sinus rhythm to be restablished by the
    body’s natural pacemaker, in the sinoartrial node of
    the heart.
    DEFINITION
    Defibrillator is an apparatus used to counteract
    atrial or ventricular fibrillation by application of
    brief electric shock to the heart.

    An electrical device used to counteract fibrillation


    of the heart muscle and restore normal heartbeat
    by applying a brief electric shock.
    TYPES OF DEFIBRILLATOR
    Manual external defibrillator
    Manual internal defibrillator
    Automated external defibrillator
    Semi-automated external defibrillator
    Implantable cardioverter defibrillator
    Wearable cardiac defibrillator
    MANNUAL EXTERNAL DEFIBRILLATOR
    Manual external defibrillator
    An device life support medical device that monitors
    the heart rhythm and allow the user to manually set
    the energy delivery and deliver a shock.
    The units are used in conjunction with (or more often
    have inbuilt) electrocardiogram readers, which the
    healthcare provider uses to diagnose a cardiac
    condition (most often fibrillation or tachycardia
    although there are some other rhythms which can be
    treated by different shocks).
    Manual internal defibrillator
    • The electric charge is usually pumped in by
    internal paddles in close or direct contact
    with the heart.
    • They are virtually identical to the external
    version.
    • These device are mainly used in operating
    theatres, where the chest can be opened or
    being treated by a surgeon.
    AUTOMATED EXTERNAL DEFIBRILLATOR
    (AED)
     An automated external defibrillator is a portable electronic
    device that automatically diagnoses the life-threatening
    cardiac arrhythmias of ventricular fibrillation and pulseless
    ventricular tachycardia, and able to treat them through
    defibrillation, the application of electricity which stops the
    arrhythmia, allowing the heart to re-establish an effective
    rhythm
     Automated external defibrillators are generally either held
    by trained personnel who will attend incident,or are public
    access units which can be found in places including
    corporates government offices, shopping centres, airport
    etc.
    Implantable cardioverter
    Defibrillator
     Implantable cardioverter defibrillator also known as
    automatic internal cardiac defibrillator (AICD).
     These devices are implants, similar
    to pacemaker.
     They constantly monitor the patients
    heart rhythm, and automatically
    administer shocks for various life
    threatening arrhythmias, according
    to the device programming.
    Wearable Cardiac Defibrillator
     It is a portable external defibrillator that is worn like
    vest.
     The unit monitors the patient 24 hours a day and will
    automatically deliver a biphasic shock if needed.
     This device is mainly indicated in patients awaiting an
    implantable defibrillator.
    PLACEMENT: Anterio-apical placement of external
    defibrillator electrodes (when defibrillator is
    unsuccessfull, anterior-posterior placement is also
    sometimes attemted).
    PROCEDURE/TECHNIQUE
    Articles needed: A cardiac monitor with defibrillation
    capability or an automated external defibrillator (AED)
    and
    Electrodes, paddles, conductive jelly etc.
     Cardiac arrest patients in VF/VT without a pulse should be
    defibrillated as soon as possible(even before CPR,
    medications or advanced airway procedure).
     Initiate CPR/ACLS protocols until defibrillator available.
     Power on the defibrillator and select
    “unsynchronized/defibrillator” mode
     Turn monitor selector to “paddles”
     Apply conductive materials before paddle placement.
     Apply defibrillator monitor cables, pads, or “quick-look”
    paddles to patient in cardiac arrest to determine rhythm.
     PADDLES PLACEMENT
     First sternum paddle : To the right of the upper
    sternum and below the clavicle.
     Second apex paddle: To the left of the nipple in the
    midaxillary line, centered in the 5th intercostal space.
     Avoid placing both paddles next to one another on the
    anterior chest wall.
     Lead placement
    “white-on-the-right”
    “smoke-over-fire”
    Electrode pad placement.
     Anterior pad just to the left of the sturnum, and
    posterior pad on the patients back to the left of the
    spine.(this technique “sandwiches” the heart between
    pads).
     Assess rhythm to confirm VF/VT.
     Choose energy level and charge defibrillator.
     Deliver shocks by simultaneously pressing the
    discharge buttons located on the paddles after
    ensuring “all clear” from the patient for equipment
    and providers.
    NURSING CONSIDERATION
     Ensure client’s condition by assessing the state of
    consciousness prior to intervention.
     Monitor vital signs of the patient especially blood pressure,
    heart rate and rhythm.
     Adminiter emergency medications as indicated.
     Administer antiarrhythmic medications as prescribed.
     Before defibrillation ensure that the paddles don’t touch
    with patient clothing and bed linen.
     Maintain safety to caregivers, since electric current can be
    conducted from the patient to another individual.
     Ensure defibrillator is not in synchronized mode.
     Don’t charge the device until ready to shock.
    Post Defibrillator care
     Evaluate neurologic status. Reorient to person,place
    and time.
     Evaluate respiratory status.
     Evaluate cardiovascular status.
     Initiate IV antidysrhythmic therapy.
     Monitor for burns. Treat if indicated.
     Documentation
     Patient/family education.
    PRECAUTIONS
     Check all equipments for proper grounding to prevent
    current leakage.
     Disconnect temporary pacemaker and other electrical
    equipment.
     Do not defibrillate directly over an implanted
    pacemaker. Defibrillation may result in damage to
    equipment.
    RELATED CARE
     Support patient and family as necessary after
    defibrillation.
     Clear defibrillator of remaining electric current
    immediately .
     Support patient with CPR as appropriate.
     Check possible causes of failure to convert ventricular
    dysrhythmias.
     Recognize the following change for pacemaker
    defibrillation.
    NEW RESEARCH
    A study to decrease the death rate of CVD sufferer due to
    unavailability of electricity in remote areas of the country.
    Date: 10,Nov 2017. “ Ashish Gawade”
    (Director of Jeevtronic,private limited, Pune, Venture centre)
    Abstract: This low cost life saving device only requires the
    administrator to power it up in less than 12 sec by rotating a
    small hand paddle.
    Background: Developed world’s first hand-cranked defibrillator,
    which can save cardiac arrest patients without electricity.
    Objectives: To decrease the death rate of CVD sufferer due to
    unavailability of electricity in remote areas of the country.
    Materials and method: surveys and many experiments has been
    done and the team was inspired by management guru CK
    Prahalad to develop the device.
    Results: shows that over 25% of the tested defibrillator fail to work
    due to battery charge issues or other electrical problems which is
    a leading cause of death in remote areas.
    Conclusion: The study concluded that this device reaches the
    nooks and corner of India where immediate access and
    affordable lifesaving technology is distant and helps revive many
    lives.
    SUMMARY
    A defibrillator is a medical device that is used to
    deliver an electrical shock to the heart. The shock is
    intended to correct irregural electrical activity of the
    heart and to establish an organized rhythm.
    Electrodes are used to deliver the electrical shock to
    the patient.
    REFERENCE
     BOOK
     INTERNET
     DISCUSSION WITH TEACHER
    BIBLIOGRAPHY
     Javed Ansari “A Textbook Of Medical Surgical Nursing
    2” PV Publication Page No. 1238 – 1246.
    • BT Basavanthappa “Textbook Of Medical Surgical
    Nursing” Third Edition, Jaypee Publication
    page No. 1011 – 1015.
    • www.slideshare.com
    • www.wikipedia.com.

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