Defibrilation

Defibrillation
Introduction
Defibrillation is used in emergency situations as the treatment of choice for
ventricular fibrillation and pulseless VT, the most common cause of abrupt loss of
cardiac function and sudden cardiac death.
Definition
Defibrillation is a treatment for life-threatening cardiac dysrhythmias, specifically
ventricular fibrillation (VF) and non-perfusion ventricular tachycardia (VT.A
defibrillator delivers a dose of electric current (often called a counter-shock) to the
heart.
Indication
Defibrillation is often an important step in cardiopulmonary resuscitation .CPR is
an algorithm-based intervention aimed to restore cardiac and pulmonary function.
Defibrillation is indicated only in certain types of cardiac dysrhythmias,
specifically ventricular fibrillation (VF) and pulseless ventricular tachycardia. If
the heart has completely stopped, as in asystole or pulseless electrical activity
(PEA), defibrillation is not indicated.
Procedure
For the initial and subsequent shocks using a monophasic defibrillator should be
set at 360 joules (Link et al., 2015). The energy setting for the initial shock using a
biphasic defibrillator may be set at 150 to 200 joules, with the same or an
increasing dose with subsequent shocks (Link et al.,2015). the sooner defibrillation
is used, the better the survival rate
If immediate CPR is provided and defibrillation is performed within 5minutes,
more adults in ventricular fibrillation may survive with intact neurologic function
(Link et al., 2015). The availability and the use of Antiarrhythmic medications
such as amiodarone, lidocaine, or magnesium may be given if ventricular
dysrhythmia persists
What Is an Automated External Defibrillator (AED)?
Is device that delivers an electric shock through the chest to the heart.
The shock can stop an irregular rhythm and allow a normal rhythm to resume in a
heart in sudden cardiac arrest.
Important points when using an AED:
- Wet chest:
Some patient may have a wet chest, for example due to profound sweating or
following rescuer from water. Quickly wipe the chest dry before attaching the
AED pads to the chest.
- Jewelry:
Remove any metal jewelry that might come into contac with the AED pads. Pads
should be kept clear of irremovable jewelry, inculding that used with body
piercing.
- Hairy chest:
Only rarely will a hairy chest cause problems with adherence of the AED pads. In
such cases it may be necessary to shave or cut away some of the hair to obtain an
adequate contact. Do not shave routinely this wastes valuable time.
- Plasters:
Remove any plasters or other material attached to the patient's skin to ensure good
AED pad contact. Some patient may have medication "patches" on their chest wall.
These must be removed as they can cause sparking or burns during defibrillation.
- Pacemakers:
some patients have a heart pacemaker fitted. These are usually visible under the
skin of the chest wall, just below the collar bone. Ensure that AED pads are not
placed on top of this pacemaker, but just aside or below.
Manual external defibrillator

Manual external defibrillators require the expertise of a healthcare professional.
They are used in conjunction with an electrocardiogram, which can be separate or
built-in. A healthcare provider first diagnoses the cardiac rhythm and then
manually determines the voltage and timing for the electrical shock. These units
are primarily found in hospitals and on some ambulances.
Manual internal defibrillator

Manual internal defibrillators deliver the shock through paddles placed directly on
the heart. They are mostly used in the operating room and, in rare circumstances, in
the emergency room during an open heart procedure.
Automated external defibrillators are designed for use by untrained or briefly
trained laypersons.
 Describe precautions and safety measures to be used:

 Maintain a log that records discharges of an implantable cardioverter
defibrillator (ICD).
 Record events that precipitate the sensation of shock.
 Wear medical identification (e.g., Medic-Alert) that includes primary
provider information.
 Avoid frightening family or friends with unexpected shocks from an ICD,
which will not harm them. Inform family and friends that in the event they
are in contact with the patient when a shock is delivered, they may also feel
the shock.
 Carry medical identification with the primary provider’s name, type and
model number of the device, manufacturer’s name, and hospital where
device was inserted.

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Defibrillation

What Is an Automated External Defibrillator (AED)?

Manual external defibrillator

Manual internal defibrillator

 Describe precautions and safety measures to be used:

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