Cardioversion
Definitions & Key takeaways
Cardioversion is a medical procedure used to treat an abnormal heart rhythm. A cardioversion machine uses low-energy electrical shocks to convert the heart's rhythm back to its normal sinus rhythm. Cardioversion can be done in a hospital or doctor's office. The proper term for this procedure is "electrical cardioversion," but it's often called simply "cardioversion." common conditions which may require cardioversion include Atrial Flutter, atrial fibrillation, ventricular tachycardia, pulseless ventricular tachycardia, and ventricular fibrillation.
Hello, this video will talk about cardio version of a patient. Normally you do everything on this list, but to keep things concise, we'll focus on the steps in blue and we'll also cover frequently asked questions and include a summary as a word of caution.
We're not covering every possible type of equipment on the market. Make sure you understand how your own equipment works and how it may affect your procedure.
As with any procedure, don't forget to wash your hands, introduce yourself to the client, explain the procedure and receive consent.
Start by administering oxygen and obtaining intravenous access. If possible, administer a sedative.
The stern electrodes go just to the right of the sternum underneath the clavicle. The apical electrode goes on the left mid axillary line around the 5th and 6th intercostal space.
If using traditional paddles, you need to minimize chest impedance. Apply a liberal amount of liquid electrode gel to each paddle or the chest, you could also place two solid gel patches on the chest in the same locations you'd place self adhesive electrodes.
Now ensure the sink option is turned on, give the defibrillator a few seconds to identify an R wave and then double check that has done so correctly.
Choose the appropriate energy depending on the type of dysrhythmia. More on that in a second.
Ensure the sink option is turned on and then push the charge button once the defibrillator is charged loudly, instruct other caregivers to move away from the patient.
Watch out for those ID lanyards too before you administer the shock. A phrase that you can say is I'm clear.
You're clear. Everybody's clear after other caregivers have confirmed, they are clear.
Do one last check if using self adhesive electrodes, push the shock button on the defibrillator. If using traditional paddles, place them against the chest, using firm pressure in the same locations, you'd place the self adhesive electrodes and push both buttons simultaneously.
After a short delay, the electrodes should fire at the peak of the R wave. If cardioversion is unsuccessful, allow the defibrillator to resynchronise before your next attempt.
Here are some frequently asked questions about cardioversion. What energy level should I select the energy level you choose will depend on the defibrillator.
The patient and the dysrhythmia in atrial fibrillation. Use an energy of 100 and 20 to 200 joules for a biphasic defibrillator or an energy of 200 joules for a monophasic defibrillator in atrial flutter, use an energy of 50 to 100 joules for a biphasic defibrillator or an energy of 100 joules for a monophasic defibrillator.
In ventricular tachycardia with a pulse, use an energy of 100 joules for a biphasic defibrillator or an energy of 200 joules for a monophasic defibrillator.
For subsequent shocks, you'll usually want to use the same energy again. However, studies have shown that upping the energy with each subsequent shock might improve success rates.
As for Children, the energy you choose will depend on their weight. Aim for about 0.5 to one joules per kilogram for the first shock and up that to about two joules per kilogram for the second shock.
What does the sink button do in cardioversion? The shock has to be synchronized to the peak of the R wave.
The defibrillator does this for you when you turn on the sink option. As a quick summary, administer oxygen and sedatives apply electrodes charge the defibrillator, analyze the rhythm, clear patient and shock and then repeat the process.
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