CARDIOVERSION & CARDIOVERSION & DEFIBRILLATIONDEFIBRILLATION

CARDIOVERSION AND CARDIOVERSION AND DEFIBRILATIONDEFIBRILATION

1. CARDIOVERSION1. CARDIOVERSION - - The synchronous application of an elec-The synchronous application of an elec- trical shock of short duration to the trical shock of short duration to the heart heart

through the use of chest paddles.through the use of chest paddles. - It is done to convert cardiac dysrhythmia- It is done to convert cardiac dysrhythmia into a more active and stable sinus into a more active and stable sinus

rhythm.rhythm.

DYSRHYTHMIADYSRHYTHMIA

- It is a disorder in the formation of the electrical - It is a disorder in the formation of the electrical impulse within the heart thus altering or changing the ff: - impulse within the heart thus altering or changing the ff: - heart rate and rhythm thus causing altered blood flow. heart rate and rhythm thus causing altered blood flow.

2. DEFIBRILLATION2. DEFIBRILLATION

- - the unsynchronized passing of an the unsynchronized passing of an electric shock of short duration electric shock of short duration through through the heart to terminate the heart to terminate ventricular ventricular fibrillation or ventricular fibrillation or ventricular

tachycardia.tachycardia.

FIBRILLATIONFIBRILLATION - uncoordinated and fast contraction of heart - uncoordinated and fast contraction of heart

muscle not in synchronization with the muscle not in synchronization with the ventricular beat. ventricular beat.

If ventricular fibrillation is not acted upon If ventricular fibrillation is not acted upon immediately, it would result to irregularity in the immediately, it would result to irregularity in the pulse rhythm. This is most often associated with pulse rhythm. This is most often associated with organic heart disease like:organic heart disease like:

1. Hypertension1. Hypertension 2. Mitral valve disorder2. Mitral valve disorder 3. Rheumatic Heart Disease3. Rheumatic Heart Disease

EQUIPMENTEQUIPMENT

1. Defibrillator with paddles1. Defibrillator with paddles

2. Electrode gel 2. Electrode gel

3. Cardiac board3. Cardiac board

4. Oxygen therapy equipment4. Oxygen therapy equipment

5. Handheld resuscitation bag5. Handheld resuscitation bag

NURSING INTERVENTIONS NURSING INTERVENTIONS DURING CARDIOVERSION AND DURING CARDIOVERSION AND

DEFIBRILLATIONDEFIBRILLATION

1. Place the client in a flat firm surface.1. Place the client in a flat firm surface.

2. Apply gel or paste to the paddles.2. Apply gel or paste to the paddles.

- for better contact with the skin.- for better contact with the skin.

- to prevent burns.- to prevent burns.

3. Hold the paddles only by the insulated 3. Hold the paddles only by the insulated

handles to prevent electrocution.handles to prevent electrocution.

4. Give command to personnel to stand 4. Give command to personnel to stand clear of clear of the client and the bed.the client and the bed.

5.5. Apply the chest paddles as follows: Apply the chest paddles as follows:

- one at the right of the sternum 3’rd - one at the right of the sternum 3’rd intercostal space.intercostal space.

- the other at the left midaxillary 5’th - the other at the left midaxillary 5’th intercostal space.intercostal space.

- press firmly against the chest - press firmly against the chest using 25 lbs. pressure.using 25 lbs. pressure.

6. Push the discharge buttons in 6. Push the discharge buttons in both both paddles simultaneously.paddles simultaneously.

7. For defibrillation, release 200-360 7. For defibrillation, release 200-360 watts/sec. (joules). For watts/sec. (joules). For cardio version, cardio version, lower energy is required.lower energy is required.

DISTINCTION BETWEEN DISTINCTION BETWEEN CARDIOVERSION AND DEFIBRILLATIONCARDIOVERSION AND DEFIBRILLATION

Cardioversion Cardioversion - electrical current delivery is - electrical current delivery is synchronized with the patient’s electrical synchronized with the patient’s electrical impulse.impulse.

Defibrillation Defibrillation - electrical current delivery - electrical current delivery is immediate and unsynchronized. is immediate and unsynchronized.

Defibrillation of a heart attack victimDefibrillation of a heart attack victim