Cardioversion And Defibrillation

Although the defibrillator is the basic piece of equipment for both defibrillation and cardioversion, these are teo distinctly different procedures. The energy level is the watt-second or joule.


Defibrillation Procedure
1. Use paste or pads on the skin (see step 3 for location).
2.Charge the defibrillator, syschronization switch off (if on,the defibrillator may not fire). In adults, energy levels begin at 200 joules and increase it upto 360 joules. In childern, use 2 joules/kg and advance to 6 joules/kg maximum.
3.Place paddles as directed on the handles: one at the right upper sternum and one at the left anterior axillary line (apex).
4.Apply paddles with firm pressure.
5.Shout "Clear the area" and make sure no one touches the patient or bed.
6.Press both paddle buttons simultaneously to fire the until, and abserve for any change in the dyshythmia.


Cardioversion
Used for ventricular tachycardia with a pulse. atrial arrhythmias with rapid ventricular response, or in an attempt to slow the heart or convert rhythm. the procedure is the same for defibrillation except:

* Use low enery levels (20-50 joules).
* Keep the synchronizer switch on (prevents shocking during the vulnerable part of the QRS complez when shock may cause ventricular fibrillation, so-called R on T phenomenon).