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Defibrillation
From WikEM
(Redirected from Unsynchronized cardioversion)
See critical care quick reference for defibrillation settings (joules) by weight.
Contents
Indications
It is important to note that the procedure for and indications differ between defibrillation and cardioversion
Defibrillation (Unsynchronized cardioversion)
Synchronized Cardioversion
- Supraventricular tachycardia (SVT)
- Atrial fibrillation
- Atrial flutter
- Ventricular tachycardia with a pulse
Contraindications
- None
Equipment Needed
- Automated External Defibrillator (AED)
- Defibrillator
Procedure
- Apply pads or paddles
- Paddles may be slightly quicker but pads are viewed to be safer[1]
- Larger pads reduce transthoracic impedance[2]
- “Adult” size in adults
- “Adult” size (8 to 10 cm) for children >10 kg (> approximately 1 year)[3]
- “Infant” size for infants <10 kg
- 4 accepted pad positions: anterolateral, anteroposterior, anterior-left infrascapular, and anterior-right-infrascapular
- Anteroposterior position performs slightly better[4]
- Biphasic setting
Complications
- Defibrillator Refractory VF
See Also
External Links
References
- ↑ Benedikte H, et al. Time and safety in defibrillation with paddles versus pads: A comparative study of two defibrillation regimes. Resuscitation. 2013; 84(11):e141–e142.
- ↑ Connell PN, et al. Transthoracic impedance to defibrillator discharge. Effect of electrode size and electrode-chest wall interface. J Electrocardiol. 1973; 6:313–M.
- ↑ Atkins DL, et al. Pediatric defibrillation: current flow is improved by using “adult” electrode paddles. Pediatrics. 1994; 94:90–93.
- ↑ Krasteva V, et al. Transthoracic impedance study with large self-adhesive electrodes in two conventional positions for defibrillation. Physiol Meas. 2006; 27:1009–1022.
- ↑ Neumar RW, et al. 2010 American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science. Part 8: Adult Advanced Cardiovascular Life Support. Circulation. 2010; 122: S729-S767.
- ↑ Kleinman ME, et al. 2010 American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science. Part 14: Pediatric Advanced Life Support. Circulation. 2010; 122: S876-S908.
- ↑ Hoch DH, et al. Double sequential external shocks for refractory ventricular fibrillation. J Am Coll Cardiol. 1994; 23(5):1141-5.
- ↑ Cabanas JG, et al. Double Sequential External Defibrillation in Out-of-Hospital Refractory Ventricular Fibrillation: A Report of Ten Cases. Prehosp Emerg Care. 2015; 19(1):126-130.
