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Defibrillator - Cardiology - Lecture Slides, Slides of Cardiology

Cardiology is branch of Biology. Its all about heart. Why it beat fast at different occasions? What can be caused to stop its working? How to do ECG? When bypass is due? ECG, valvular, ventricular spetal defect, atria, blood pressure are main topics here. This lecture is about: Defibrillator, Actions, SCA, Questions, CPR, Shock, Cycle, Energy

Typology: Slides

2011/2012

Uploaded on 10/19/2012

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Defibrillator

Definition

An electrical device used to counteract fibrillation of the heart muscle and restore normal heartbeat by applying a brief electric shock

For every minute that passes between collapse and defibrillation, survival rates from witnessed VF SCA decrease 7% to 10% if no CPR is provided

Ann Emerg Med. 1993;22:1652– 1658

3 actions that must occur

within the 1st^ moment of SCA

  • Activation of the emergency medical services (EMS) system
  • Provision of CPR, and
  • Operation of an AED

When 2 or more rescuers are present, activation of EMS and initiation of CPR can occur simultaneously

Shock First Vs CPR First

  • Out-of-hospital witnessed arrest
  • If AED is immediately available
  • Use the AED as soon as possible.

In hospital

CPR first

Shock First Vs CPR First contd..

  • One cycle of CPR consists of 30 compressions and 2 breaths
  • When compressions are delivered at a rate of about 100 per minute, 5 cycles of CPR should take roughly 2 minutes

This recommendation regarding CPR prior to attempted defibrillation is supported by 2 clinical studies

JAMA. 2003;289:1389 – 1395 JAMA. 1999;281:1182– 1188

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 for at least 5 sec following the shock
  • VF frequently recurs after successful shocks, but this recurrence should not be equated with shock failure
  • Modern defibrillators are classified as Monophasic Biphasic
  • Energy levels vary by type of device
  • No specific waveform is associated with a higher rate of return of spontaneous circulation (ROSC) or rates of survival to hospital discharge after cardiac arrest

Biphasic waveform

Defibrillators

  • The optimal energy for termination rate for VF has not been determined
  • 200 J is safe and has equivalent or higher efficacy for termination of VF than monophasic waveform shocks of equivalent or higher energy (Class IIa)

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

Electrode placement

  • Right pad – Right Infraclavicular
  • Left pad – Inf-lateral left chest, lateral to the left breast
  • Position the pad at least 1 inch (2.5 cm) away from the implantable medical device
  • Do not place pads directly on top of a transdermal medication patch
  • If the victim’s chest is covered with water or the victim is extremely diaphoretic, wipe the chest before attaching pads
  • AEDs can be used when the victim is lying on snow or ice
  • If the victim has a hairy chest, remove some hair