9. Manual defibrillator Flashcards by Kira Harms

anterior-anterior

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posterior-Left anterior

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posterior-Right anterior

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anterior-anterior PAD placement is best used with

AED pads
defibrillator paddles

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posterior-L anterior PAD placement is best used with

pacing
defibrillation
sync cardioversion of ventricular rhythms

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posterior-R anterior PAD placement is best used with

sync cardioversion of atrial rhythms

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what paddles should you use for an adult?

large adult paddles

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adult paddle placement

anterior-anterior

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what paddles should you use for child > 1 year old?

large adult

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> 1 year old child paddle placement

anterior-anterior
or
anterior-posterior

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what paddles should you use for an infant?

small infant paddles

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infant paddle placement

anterior-anterior

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most common AED pad placement

anterior-anterior

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alternate AED pad placement

posterior-L anterior

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most comm pad placement transcutaneous pacing

posterior-L anterior
(anterior pad under L breast)

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alt pad placement for trancutaneous pacing

anterior-anterior

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most common pad placement defibrilaltion or cardioversion of VTACH

posterior-L anterior

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alt placement for defib/cardioversion of VTACH

anterior-anterior

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which is better: hands free pads or paddles

pads

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why are pad recommended

decr current arcing
better ECG monitoring
more rapid defibrillation

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what is required when using paddles

conducting gel to reduce transthoracic impedance

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‘analyze’ button

indicated if BLS provider cannot analyze rhythms

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‘energy select’

adjusts energy for shock

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‘charge’ button

charges before shocking

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'shock'

initiates shockh

how long does clearing/shocking take

<5 seconds

'monitor' mode

view 3 tracing screens

'defib' mode

allows selection and delivery of energy - defib - sync cardioversion

'pacer' mode

allows pacing

'output'

amount of current delivered while pacing

'rate'

controls HR while pacing

'4:1'

causes 3 of 4 pacer impulses to be suppressed - allows provider to see intrinsic heart rhythm and determine if bradycardia is still present

sync cardioversion steps

1. place pads posterior-L anterior 2. knob to defib 3. press sync 4. select energy (75-120J) 5. press charge 6. press shock

if atrial rhythm place, place anterior pad on ______ chest

right

if ventricular rhythm, place anterior pad on ____ chest

left

defibrillation steps

1. place pads either post-ant or ant-ant 2. knob to defib 3. select energy (200J) 4. charge 5. shock

what functions are performed on the paddles

energy selection charging shocking

trancutaneous pacing steps

1. place pads post-L anterior 2. knob to pacer 3. set HR w/rate (right) knob 4. turn current until you get capture (left knob) 5. set mx threshold 10% above capture

what produces ECG strip

some pads paddles ECG leads w/defibrillator

ECG lead advantage

more accurate ECG tracing more reliable R wave sensing

when is reliable R wave sensing required

pacing sync cardioversion

when are ECG leads required

pacing sync cardioversion

are ECG leads needed for defibrillation

standard pads disadvantages

less reliable R wave sensing dont measure chest compression effectiveness

compression sensor prompts

rate depth idle time see thru CPR filter

rate prompt

<80 compressions/min

depth sensor

hexagon fills between 2-2.4 inch

see thru CPR filter

can visualized underlying rhythm during compressions

Posterior L Anterior CPR pad

posterior: on back, Left of spine anterior: left of xyphoid, under nipple vertical line: mid-sternum horizontal line: between nipples

4 types of Zoll "one step" pads

1. One Step CPR 2. One Step Pacing 3. One Step Complete 4. One Step Basic

which Zoll pads have a CPR sensor

one step CPR one step Complete

One step CPR limitation

less effective R wave sensing requires ECG cable for pacing/sync cardio

one step CPR placement

post-L anterior horizontal line: between nipples vertical line: mid-sternum

one step pacing pad

defibrillation pad w/3 lead ECG

when do you need an ECG cable with one step pacing pad

to pace/cardiovert atrial rhythm because you will be placing the pad in post-R anterior (inverted)

when does reliable pacing occur with one step pacing pad

only in post-L anterior position

one step pacing pad limitations

no chest compression sensor

one step pacing pad lead channel

"best" one step pad

One step complete

one step complete features

CPR feedback accurate R wave sensing w/o cable

one step complete features in post-L anterior placement

compression feedback defibrillation pacing w/o ECG cable sync cardioversion w/o ECG cable

one step complete features in post-R anterior placement

compression feedback defibrillation

one step basic pad features

just a standard defibrillator pad

which pad is the compression sensor located on (ant or post)

pad placement for ventricular rhythms

upright and left of sternum

pad placement for atrial rhythms

inverted and above right chest

an anesthetist has a std defib pad and wants to attempt sync cardioversion. Is it recommended for a separate ECG cable to be placed?

Post-R anterior w/ECG cable

an anesthetist has a standard defib pad and wants to pace. Is it recommended for separate ECG cable to be placed?

Post-L anterior w/ECG cable

an anesthetist has a "one step" complete pad and wants to attempt synchronized cardioversion of monomorphic VTACH. Is it recommended for separate ECG cable to be placed?

post-L anterior no extra ECG cable needed

an anesthetist has a "one step" complete pad and wants to attempt synchronized cardioversion of afib. If the anterior pad is placed correctly, is it recommended for a separate ECG cable to be placed?

yes

an anesthetist has a "one step" pacing pad and wants to attempt sync cardioversion of monomorphic VTACH. Is it recommended for separate ECG cable to be placed?

nop

an anesthetist has a "one step" complete pad and wants to initiated pacing. Is a separate ECG cable recommended?

one step cable hooks up

pads paddle ECG leads

one step red end

screws into defibrillator for power

one step 2 port end

hooks up pads, paddles, ECG leads

top adapter

connects defibrillator pad

bottom adapter

connect ECG leads

standard pads connect

top adapter

one step pads connect

top and bottom adapters

when doe sthe ECG adapter (black) need to be plugged in

for monitoring ECG with one step cable instead of ECG leads

energy dose for internal handles

10-20J