A 75-year-old man sustained cardiac arrest in the observation ward.

CPR was started by

nursing staff. You are summoned as ‘Code Blue’ team.
Perform defibrillation
Performances Marks Marks
allocate obtained
d
1 Professionalism
1.1  Proper attire 2
 Greeting to examiner

2 Confirming shockable rhythm

2.1  Student to ask: Stop chest compression 5
 Student switches on the defibrillator
 Student performs rhythm check at the defibrillator

Examiner to ask: what is the rhythm?

Student to answer:
 It is VF
 It is shockable rhythm

2.2  Student to ask: continue chest compressions 1

3 Selection of an appropriate energy level
3.1  Select 200 joules for the first shock. 1
4 Placement of paddles for defibrillation
4.1  Take out the two paddles from the defibrillator machine 6
 Apply adequate gels to the surface of the paddles
 Place the paddles on the cardiac arrest victim’s chest as
sternum- apex position
 One to the right side of the sternum just below the right
clavicle
 Another one at the left midaxillary line lateral to the
cardiac arrest victim left nipple
 Applying firm downward pressure (about 25 lb) is applied
to each paddle
5 Charging the defibrillator
5.1  Press the “Charge” button located on the apex paddle 3
 Student to tell as the machine charges: all team
members except for the chest compressor, immediately
clear the patient
 Student checks whether defibrillator machine 200 J fully
charged or not
6 Delivery of shock
6.1  Student to tell when the defibrillator is fully charged: 5
chest compressor, immediately clear the patient
 Student do final check whether a shockable rhythm is
still present
 Student to say: All clear
 Student looks around (360 degrees) to be sure everyone
—including himself/herself is clear of the patient, the
 bed, and any equipment connected to the patient
 Student makes sure oxygen is not flowing over the
patient’s chest

6.2  Student presses the “SHOCK” control to discharge 2

energy to the patient
 Student releases the shock control after the shock has
been delivered

7 Post defibrillation management

7.1  Student Instructs the CPR team to resume chest 4
compressions immediately
 Student instructs CPR must continue another 2 minutes
without interruption
 Student put back the paddles to the defibrillator machine
 Student put back immediately

8 Overall performance
8.1  Good communication skill 3
 Good time management
 Smooth sequences of performance
32
Total