II. Background

  1. Biphasic Defibrillation preferable to monophasic
    1. Lower energy levels may be used with biphasic
    2. Resuscitation with 3 shocks is better with biphasic
      1. Biphasic: 98%
      2. Monophasic: 67%

III. Equipment: Paddles

  1. Infant Paddles (4.5 cm)
    1. Indicated for age <1 year or weight <10 kilograms
  2. Adult Paddles (8-13 cm)
    1. Indicated for age >1 year or weight >10 kilograms

IV. Technique

  1. Images: Zoll
    1. cvEkgMonitorZoll.png
  2. Turn on Defibrillator
  3. Attach monitor leads to patient (Mnemonic below)
    1. White to Right
    2. Red to Ribs
    3. What's left over to the left Shoulder
  4. Synch Mode
    1. If indicated for Synchronized Cardioversion
    2. R Waves should be marked in synch mode
  5. Energy Level Selection as appropriate
  6. Attach conductor pads to patient at apex and Sternum
    1. Alternatively apply gel to paddles
    2. Defibrillation pads may be placed regardless of underlying AICD (as of 2010) to prevent delays
  7. Apply paddles to Sternum (left hand), apex (right hand)
  8. Announce to the Team
    1. "Charging Defibrillator - Stand Clear"
      1. Press CHARGE Button on apex paddle (right hand)
    2. "I will shock on Three - One I'm Clear"
      1. Check self for contact with patient
    3. "Two, You're Clear"
      1. Check others for contact (especially Ventilator)
    4. "Three, everybody is clear"
      1. Check self again for patient contact
  9. Apply 25 pounds paddle pressure
  10. Press discharge buttons on paddles simultaneously

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