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1. Introduction
2. Definition
3. Objective
Define defibrillation
Describe need and history of defibrillation
Describe the principle and mechanism of defibrillation
Types and classes of defibrillator
4. Purpose of defibrillation
5. Principle of defibrillator
Energy is storage a capacitor is charged at relatively slow rate from AC
line.
Energy stored in capacitor is then delivered at a relatively Rapid rate to
chest of the patient.
Simple arrangement involved the discharge of capacitor energy through
the patient's on resistance.
The discharge resistance which the patient represents as purely ohmic
resistance of 5 to 100Ω approximately for a typical electrode size of 80
cm2
This particular waveform figure is called lower wave form.
The pulse width of this waveform is generally 10ms.
6. Mechanism of defibrillator
7. Steps of defibrillation
8. Types of defibrillators
Electrode placed directly around the heart area of chest higher voltage required
then internal defibrillator.
Paddle placement
4 positions
On right of sternum below clavicle (2nd & 3rd ICS) other left 4th or 5th ICS
mid axillary line.
Reversing paddle markings “sternum and apex” does not affect
defibrillation
Paddles placed along axis of heart
AP placement used in children with adult paddles
Paddle size
1. Duration of VF
The longer VF lasts the harder it is to cure
The quicker the better
Shock early shock often
Likelihood of resuscitation decrease by 7 to 10% with every passing
minute
Note:
6. Paddle size
7. Paddle placement
In pacemaker/ ICD at least 12 cm from general 90 degree to AICD
electrode avoid placing bets directly over no delay in defibrillation.
CARDIOVERSION
It uses energy less that that used for defibrillation in shockable SCA
Avoid delivery shock during repolarization period (T wave on ECG)
Indications
Atrial flutter
Atrial fibrillation
Wide complex tachycardia of uncertain type
Contra indications
Cardioversion
Dose/ Details
Synchronized Cardioversion
Elective Cardioversion
Preprocedure consideration
Steps
Complications of Cardioversion
Systemic embolization
Post shock cardiac arrhythmias
Asystole
Heart block
Atrial / ventricular ectopias
Ventricular tachy arrhythmias
Translucent ST & T wave changes
Risks in Defibrillation
Skin burns form the defibrillation paddles are the most common
complication of defibrillation
Other risks include injury to the heart muscle, abnormal heart rhythms and
blood clots.
BIBLIOGRAPHY
2) En.wikipedia.org/wiki/ defibrillation
3) http://www.slideworld.org/viewslides.aspx/defibrillator