DEFIBRILLATOR

Definition :
Defibrillator is a device that
deliver a therapeutic dose of
Electrical Energy (Electrical
Shock) to the affected heart to
force the heart to produce more
normal cardiac rhythm.
 Mechanism

Current depolarises the myocardium

Induces arystole temporarily

Allow SA Node to take over because

it’s the first to repolarize
 Indication

Pulse – less polymorphic VT/VF.

When unsure weather monoor polymorphic

VT in a unstable patient.
 Non-Shockable rhythm’s
Asystole

Pulseless electrical activity (PEA)

 Types of Defibrillator

1. Manual External Defibrillator

2. Manual Internal Defibrillator
3. Semi Automated External Defibrillator
4. Automated External Defibrillator
5. Implanted(Automated) Cardioverter Defibrilltor
6. Wearable Cardiac Defibrillator
 Placements of Paddles

Four position:
1. Anterior-lateral > most convenient
2. Anterior-posterior
3. Anterior-left intrascapular
4. Anterior-right intrascapular
 Anterior-lateral position
 One-right of sternum Pediotic- small paddles
below clavicle (2nd and 3rd <1yr
ICS) . Infants <10kg- 4.5cm
 Other left 4th or 5th ICS Chidren >10kg-8cm
mid axillary line .
 Paddle size :
Adult- 10 to 13cm
Diameter.
 Steps of Defibrillation
1. Give 2min CPR before analysis .
2. Power on ADE (Application of Defibrillation in the Entreprise).
3. Attach electrode pad .
4. Check rhythm .
5. Clear .
6. Give shock(120 - 200J) .
7. Resume CPR for 2min before analysis of cardiac rhythm again .
8. Consider giving-vasopressors/anti-arrhythmics’s during
subsequent shock .
 Defibrillation success

Termination of VF into an organized

rhythm or asystole for atleast 5seconds
after shock .
Start with
150 – 200J Biphasic truncated waveform .
120J Rectiliner biphasic waveform
 Monitoring
 Monitor that patient stay in converted rhythm .
 Keep patient well oxygenated (SPO2 >18%) .
 Check scrum K+ and Hg+ levels .
 Maintained acid base balanced .
 Get 12 lead ECG after procedure .
 Check for chestpain and access .
 Get CPR and Troponin done .
 Access patients skin .
 Complication and its mangements

1. Arrhythmias – RX Shack transthoracic pacing .

2. Embolization - RX Anticoagulation .
3. Soft tissue injury _ {Ensure wiping the fluids from the
4. Thermal burns to skin before Defibrillation.}
5. Myo/Epicardial injury - RX minimizing Energy level.
6. Airway compromise – O2 administrator.
THANK YOU
from : Poorvika S Kumar