2. OBJECTIVES
1. Defibrillation
2. Need of defibrillation
3. Types of defibrillator
4. Automated external defibrillator (AED)
5. Precautions and risk
6. Troubleshooting of defibrillator
3. DEFINITION
Defibrillation is a process in which an electronic
device sends an electric shock to the heart to
stop an extremely rapid, irregular heartbeat, and
restore the normal heart rhythm.
Defibrillation is a common treatment for life
threatening cardiac dysrhythmias –
1. ventricular fibrillation(VF)
2. pulseless ventricular tachycardia (pVT).
4. NEED FOR A DEFIBRILATOR.
VF/pVT - asynchronous rapid ineffective contraction
of the heart.
Early defibrillation – high chance of rhythm to revert
back to normal.
9. DEFIBRILLATION WAVEFORMS
AND ENERGY LEVELS
The energy settings are designed to provide the
lowest effective energy needed to terminate VF
Shock success -Termination of VF at 5 seconds
after the shock
VF frequently recurs after successful shocks, but
this recurrence should not be equated with shock
failure
10. Based on energy delivery, defibrillators are
classified as:-
Monophasic
Biphasic
Energy levels vary by type of device
Monophasic – (360 J)
Biphasic – (120 – 200J)
In pediatrics –
Use of pediatric paddle – Doses are 2 – 4
J/kg upto a maximum of 10J/kg with subsequent
shocks.
11. Synchronized Cardioversion
Tachyarrhythmias with pulse, but an unstable
patient.
Energy selection is from 50 – 200 J.
ECG leads must be attached to the defibrillator,
paddles/pads attached and ‘sync’ button pressed.
Following synchronization, the device is charged
and shock delivered.
Patients usually require sedation/analgesics.
12.
13. Transcutaneous Pacing
Cardiac pacing can be done using the same
device using the pads.
Needed in bradyarrhythmias.
Select ‘Pacer’ mode and select the required
current and heart rate.
15. TYPES OF DIFIBRILATOR……..
a) Internal defibrillator (Implantable cardiac
defibrillator)
• Electrodes placed directly into the heart
• Have both defibrillation and pacing functions
b) External defibrillator
1.Automated
2.Semi automated
17. DEFIBRILLATOR ELECTRODES
Types of Defibrillator electrodes:-
A) Spoon shaped electrode
• Applied directly to the heart.
B) Paddle type electrode
• Applied against the chest wall
C) Pad type electrode
• Applied directly on chest wall
24. Automated external Defibrillators
AEDs are sophisticated, reliable devices
Use voice and visual prompts to guide lay
rescuers and healthcare providers to safely
defibrillate VF SCA
26. WORKING OF AED
Turned on or opened AED.
AED will instruct the user to:-
• Connect the electrodes (pads) to the patient.
• Avoid touching the patient to avoid false
readings by the unit.
• The AED analyses rhythm and determines if
shockable or not.
27. When device determined that shock is
warranted, it
will charge its internal capacitor in
preparation to
deliver the shock.
When charged, the device instructs the
user to ensure
no one is touching the victim and then to
press a red
button to deliver the shock.
They come with a pediatric dose
attenuator for children < 8 years.
28. PRECAUTION
The paddles used in the procedure:
Should not be placed on a breasts
Over an internal pacemaker generator.
Over wet/hairy skin
Before the paddle is used, a conducting jelly must be
applied and spread over the electrode surface.
29. RISK IN DEFIBRILATOR
Skin burns from the
defibrillator paddles
are the
most common
complication of
defibrillation.
Other risks include
injury to the heart
muscle,
abnormal heart
rhythms, and
dislodgement of blood
30. TROUBLESHOOTING
Attach the external and internal paddles if the
monitor
reads, "No paddles."
• Check to ensure that the leads are securely
attached if
the monitor reads, "No leads.“
• Connect the unit to AC power if the message
reads, "Low battery."
• Verify that the Energy Select control settings are
correct
if the defibrillator does not charge.
