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  • DC Shock

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    Sangidu Edo
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    1. The document provides instructions for performing DC shock using defibrillator paddles on patients experiencing cardiac arrest. 2. It describes the steps for DC shock, which include turning on the defibrillator, placing paddles on the chest in specific locations, charging the defibrillator, shouting warnings, and administering the shock. 3. It also lists indications for when DC shock is appropriate, such as ventricular fibrillation and pulseless ventricular tachycardia, as well as recommendations for joule levels and situations when DC shock should not be administered, such as asystole.

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    Original Title

    DC-SHOCK

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    1. The document provides instructions for performing DC shock using defibrillator paddles on patients experiencing cardiac arrest. 2. It describes the steps for DC shock, which include turning on the defibrillator, placing paddles on the chest in specific locations, charging the defibrillator, shouting warnings, and administering the shock. 3. It also lists indications for when DC shock is appropriate, such as ventricular fibrillation and pulseless ventricular tachycardia, as well as recommendations for joule levels and situations when DC shock should not be administered, such as asystole.

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    © All Rights Reserved
    Download as PPT, PDF, TXT or read online from Scribd
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    85 views20 pages

    DC Shock

    Uploaded by

    Sangidu Edo
    1. The document provides instructions for performing DC shock using defibrillator paddles on patients experiencing cardiac arrest. 2. It describes the steps for DC shock, which include turning on the defibrillator, placing paddles on the chest in specific locations, charging the defibrillator, shouting warnings, and administering the shock. 3. It also lists indications for when DC shock is appropriate, such as ventricular fibrillation and pulseless ventricular tachycardia, as well as recommendations for joule levels and situations when DC shock should not be administered, such as asystole.

    Copyright:

    © All Rights Reserved
    Download as PPT, PDF, TXT or read online from Scribd
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    of 20

    DC SHOCK

    Dr Buyung SpAn
    Dr Ruddi SpAn

    DC shock
    Oles dulu paddles
    dengan jelly ECG
    tipis rata, baru
    kemudian :
    1. Switch ON
    Pasang paddles pada posisi
    apex dan parasternal
    (boleh terbalik)

    sternum

    apex

    2. Charge 360 Joules


    (Non-synchronized)

    DC shock

    Ucapkan dengan keras :

    Awas semua lepas dari pasien!


    nafas buatan berhenti dulu
    bawah bebas,
    samping bebas,
    atas bebas,
    saya bebas!

    3. Shock!!
    (tekan dua tombol paddles bersama)

    Lepas paddles dari dada,


    lanjutkan chest compression.
    4. Segera pijat jantung lagi 2 menit
    baru raba lagi/ baca lagi ECG

    sternum

    apex

    apex

    Position
    of the paddles electrodes
    on thorax of an infant sternum
    apex

    Size of paddle electrode


    - 4.5 cm diameter for infants and small children
    - 8-12 cm diameter larger children

    Jelly kurang rata, menekan paddles kurang kuat - luka bakar

    INDICATIONS

    Defibrillation (Non-Synchronized DC Shock):


    VF
    Pulseless VT
    Recommended joule: 360 J

    15

    INDICATIONS

    Synchronized DC Shock (Only with unstable


    hemodynamic):
    AF
    Atrial Flutter
    SVT

    start with 50 J

    VT with pulse
    (despite of
    medication)

    start with 100 J


    Infant and Children: 2
    J/kg
    16

    DO NOT SHOCK!!!
    Asystole
    Pulseless Electrical Activity
    Bradicardia
    Heart Block
    Stable hemodynamic with AF, Atrial Flutter, SVT, &
    VT with pulse

    17

    VF / pulseless VT

    1). a single shock


    Defibrilation strategy

    Biphasic 150-200 Joule


    Monophasic 360 Joule

    CPR 30 : 2
    2 MINUTES, 30 : 2
    NO

    2).

    Check ECG
    Check pulse

    a single
    shock
    Biphasic 150-360
    Joule
    Monophasic 360 Joule

    YES

    ROSC
    2 MINUTES, 30 : 2

    Recovery of
    Spontaneous
    Circulation

    VF/ VT
    Intubasi : as soon as possible, without stop CPR
    Cardiac
    arrest

    CPR -1
    30 : 2
    CALL
    FOR
    HELP
    PASANG
    MONITOR

    Pijat >100x/menit
    Nafas 8-10x/menit

    adrenalin
    VF / VT

    2 menit

    2 menit
    2 menit

    a single shock
    CPR-2

    adrenalin

    a single shock

    a single shock

    CPR-3

    CPR-4

    adrenalin
    Adrenaline: 1 mg, iv,
    repeated every 3-5
    minutes

    Evaluasi CPR : tiap 2 menit

    2 menit

    Amiodaron

    a single shock
    CPR-5

    a single shock
    CPR-6

    Amiodaron is the first choice


    300 mg, bolus. Repeated 150 mg
    for reccurrent VT/VF. Followed by
    900 mg infusion over 24 hours
    LIDOCAIN. Do not exceed
    a total dose of 3 mg/kg,
    during the first hour.

    TERIMA KASIH

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