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Defibrillation: Manual

Clinical Indications:

    Cardiac arrest with ventricular fibrillation or pulseless ventricular tachycardia

Procedure:

    1. Ensure that Chest Compressions are adequate and interrupted only when absolutely necessary.

    2. Clinically confirm the diagnosis of cardiac arrest and identify the need for defibrillation.

    3. After application of an appropriate conductive agent if needed, apply defibrillation hands free pads (recommended to allow more continuous CPR) or paddles to the patient's chest in the proper position Paddles: right of sternum at 2nd ICS and anterior axillary line at 5th ICS Pads: anterior-posterior position

    4. Set the appropriate energy level

    5. Charge the defibrillator to the selected energy level. Continue chest compressions while the defibrillator is charging.

    6. If using paddles, assure proper contact by applying 25 pounds of pressure on each paddle.

    7. Hold Compressions, assertively state, "CLEAR" and visualize that no one, including yourself, is in contact with the patient.

    8. Deliver the countershock by depressing the discharge button(s) when using paddles, or depress the shock button for hands free operation.

    9. Immediately resume chest compressions and ventilations for 2 minutes. After 2 minutes of CPR, analyze rhythm and check for pulse only if appropriate for rhythm.

    10. Repeat the procedure every two minutes as indicated by patient response and ECG rhythm.

    11. Keep interruption of CPR compressions as brief as possible. Adequate CPR is a key to successful resuscitation.

Competency Based Skill Requirements:

    Maintain knowledge of the indications, contraindications, technique, and possible complications of the procedure.

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