1. Defibrillation delivers an electrical current to the heart muscle to terminate ventricular fibrillation and pulseless ventricular tachycardia, while cardioversion delivers a timed electrical current to terminate tachydysrhythmias. 2. Cardioversion is usually a planned procedure, while defibrillation is an emergency treatment for ventricular fibrillation or pulseless ventricular tachycardia. 3. Electrode placement for cardioversion can be anterior-posterior or anterior-anterior, with anterior-posterior preferred for maximum current flow through the atria.

1. DEFIBRILLATION
Mr.VEERABHADRA.B.B
ASST PROFESSOR
DEPT OF MEDICAL SURGICAAL
NSG.

2. DEFIBRILLATION
• Defibrillation is the delivery of
electrical current to the heart muscle
either directly through the open chest,
or indirectly through the chest wall, to
terminate ventricular fibrillation (VF)
and pulseless ventricular tachycardia
(VT).

3. CARDIOVERSION
• Cardioversion involves the delivery of a
“timed” electrical current to terminate a
tachydysrhythmia. In cardioversion, the
defibrillator is set to synchronize with the
ECG on a cardiac monitor so that the
electrical impulse discharges during
ventricular depolarization (QRS complex).

4. DIFFERENCE
DEFIBRILLATION
• Defibrillation is
usually
performed as an
emergency
treatment,
CARDIOVERSION
• Cardioversion is
usually, but not
always, a
planned
procedure.

5. Electrode Placement
Cardioversion electrodes can be placed either
• Anterior–Posterior (AP)
• Anterior-Anterior (AA), though AP
placement is preferable for maximum
current flow through the atria.

6. Anterior-Anterior placement
• Place one paddle on the right of the sternum
between the second and third intercostal
space and the other at the fifth intercostal
space, left midclavicular line, -near the apex
of the heart.

7. Anterior–Posterior (AP)
placement
• The anterior pad should be placed right
lateral to the sternum, at the fourth
intracostal space
• posterior electrode should be placed at the
left upper corner of the active area sub-
scapular and the edge of the active area
immediately left lateral to the spine.

8. Procedure:
1. Establish unresponsiveness.
2. Check to make sure patient is pulseless and
not breathing.
3. Have someone begin CPR while you
prepare the defibrillator.
4. Turn the monitor/defibrillator to the ON
position and select the paddle mode in
preparation for using quick-look paddles.
fib/pulseless VT .

9. .5. Use hands-free pads or defibrillation gel
pads to be used with paddles.
6. Select the correct electrical charge per v-
fib/pulseless VT SOP.
7. Press the charge button and release.
8. If using paddles, place the paddles firmly
on the chest, exerting 20 to 25 pounds of
pressure. Place one paddle on the right of
the sternum between the second and third
intercostal space and the other at the fifth
intercostal space, left midclavicular line,

10. .
-near the apex of the heart.
9. Call "CLEAR" and visually clear the area
to verify that no one; including yourself is
in contact with the patient.
10. Check monitor screen one more time
before defibrillating to make sure the
patient is still in ventricular fibrillation.
12. After defibrillation continue CPR for two
minutes. After two minutes, check the
patient's EKG strip, to see if ventricular
fibrillation was terminated.

11. .
13. If repeat defibrillation is indicated,
depress CHARGE and repeat the above
steps according to the algorithms.
14. Document the procedure. Documentation
should include:
• a. EKG strip of defibrillation .
• b. Patient's name, date, time, lead, joules delivered
and number of defibrillations.
• c. Post defibrillation rhythm.
(NOTE:- Once the machine is disarmed, quickly clean the paddles by wiping them with a paper towel or
gauze pad. .)

12. Automated External
Defibrillator
• An automated external defibrillator (AED)
is a lightweight, portable device that
delivers an electric shock through the chest
to the heart. The shock can stop an irregular
rhythm and allow a normal rhythm

14. IMPLANTABLE CARDIOVERTER
DEFIBRILLATOR
• The implantable
cardioverter
defibrillator (ICD) is
a device that detects
and terminates life-
threatening episodes
of VT or ventricular
fibrillation in high-risk
patients.

15. .• An ICD consists of a generator and at least
one lead that can sense intrinsic electrical
activity and deliver an electrical impulse.
• When a dysrhythmia occurs, rate sensors
take 5 to 10 seconds to sense the
dysrhythmia. Then the device takes several
seconds to charge and deliver the
programmed charge through the lead to the
heart. Battery life is about 5 years