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Electrical Therapy
Skills Lab
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Defibrillation
Definition and Purpose
Delicate procedure wherein electrical
shock/s of short duration is/are discharged
through the heart in an attempt to terminate
death-forming dysrhythmias.
Purpose is to produce a momentary
asystole by attempting to deliver a uniformelectrical current of sufficient intensity to
depolarize ventricular cells.
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Principles of Defibrillation
ost fre!uent initial rhythm in sudden
cardiac arrest is "entricular #ibrillation $"#%.
&he most effective treatment for "entricular
#ibrillation is Defibrillation.
&he success of defibrillation diminishes
rapidly overtime.
"# converts to asystole within few minutes.
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Indications of Early
Defibrillation
"entricular #ibrillation
"entricular &achycardia pulseless
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Types of Defibrillators
'(D $'utomated ()ternal
Defibrillator%
Portable defibrillator with
microcomputer that
senses and analyzes
patient*s heart rhythm and
gives step-by-step
instruction on how to
proceed if defibrillation isindicated.
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anual Defibrillator
Paddles or pads
Placement
+ight of the uppersternum ,ust below the
right clavicle nd 0S.
Left of the nipple in
the mid-a)illary line
1th 0S
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Types of Manual Defibrillator
onophasic
Deliver a single
current of electricity in
one direction betweenthe pads or paddles
on the patient*s chest
&o be effective a
higher electrical
current is re!uired
234 5
6iphasic Pad or paddle placement is
the same the discharged
electrical current travels in a
positive direction for aspecified duration
n addition7 it reverses the
flow in a negative direction7
thus delivering double
currents of electricity. 84 57 814 57 44 5
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Monophasic Biphasic
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+ight before Defibrillation
Still continue chest compression while
defibrillator is still charging7 stop compression
when ordered.
ake sure ("(+96:D9 S 0L('+.
ake sure :is out $turn off :source if
possible%. ake sure to verify shockable rhythm right
before pressing the S;:0< button.
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+ight 'fter Defibrillation
Start compression and ventilations.
=o rhythm and pulse checking. Shock attempts are followed with
medications e)cept for the first shock.
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Cardioversion
Definition and Purpose
Delivery of timed but direct electrical shock to
the heart as an emergency or elective treatment
performed by an D/0ertified ;ealthcareProvider.
&rigger the client*s >+S comple) to avoid
accidental electrical discharge at repolarization
phase $& wave% due to the danger of converting
to ventricular fibrillation.
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Indications
;emodynamically ?=S&'6L( tachydysrhythmias
$positive pulse but systolic 6P @A4 mm;g%.
?nstable monomorphic "(=&+0?L'+
&'0;90'+D' $"&% with pulse. ?nstable '&+'L #6+LL'&:= with pulse.
?nstable '&+'L #L?&&(+ with pulse.
?nstable '&+'L &'0;90'+D'/S"& with pulse
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ndicated (nergy Dose
onomorphic tachycardia- 844 5
S"&/'trial #lutter - 14 to 844 5 'trial fibrillation - 84 to 44 5
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Artificial Pacemaker
Definition and Purpose
During (mergency 0ardiovascular 0are
$(00%7 treatment of patients with
symptomatic slow heart rate rhythms is by
means of &ranscutaneous Pacemaker
$&0P%.
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ndications for &0P
Symptomatic or unstable S=?S
6+'D90'+D' not responding to
'tropine
Second degree '" 6lock &ype
&hird Degree '" 6lock
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Basic ECG Interpretation
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ormal !inus "hythm
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!inus Tachycardia
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Atrial Tachycardia
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