Procedure
Defibrillation
search
Defibrillation
, Unsynchronized shock
See Also
Defibrillator
Equipment
Synchronized Cardioversion
Indications
Ventricular Fibrillation
Pulseless Ventricular Tachycardia
Types
Monophasic
Shock
one-way travels from one electrode to another
Biphasic
Shock
round-trip travels from one electrode to another and back again
Doses
Pediatric
Initial: 2-4 J/kg
Subsequent: 4 J/kg
May increase up to 10 J/kg (or maximum adult dose)
Adult
Monophasic: Start 200 J (may increase to 300 J, then 360 J)
Biphasic: Start 120-200 J (use manufacturers recommendations per specific device)
Technique
Pearls for successful Defibrillation
Successful Defibrillation of
Ventricular Fibrillation
requires Defibrillation of 95% of the heart
Lateral pad placement over the cardiac apex is important for success
Reduce impedence (minimize barriers to electrical transmission)
Stop bag-valve-mask during Defibrillation (air in chest increases impedence)
Dry a diaphoretic patient
Shave excessive hair interfering with transmission
Optimize perfusion
Optimal
Chest Compressions
Epinephrine
Consider double sequential external Defibrillation
Two
Defibrillator
s attached to chest for simultaneous shock
Doubles current delivered to the heart
References
Shinar and Cheskes in Herbert (2016) EM:Rap 16(6): 5-6
Type your search phrase here