9. Manual defibrillator Flashcards
anterior-anterior
posterior-Left anterior
posterior-Right anterior
anterior-anterior PAD placement is best used with
AED pads
defibrillator paddles
posterior-L anterior PAD placement is best used with
pacing
defibrillation
sync cardioversion of ventricular rhythms
posterior-R anterior PAD placement is best used with
sync cardioversion of atrial rhythms
what paddles should you use for an adult?
large adult paddles
adult paddle placement
anterior-anterior
what paddles should you use for child > 1 year old?
large adult
> 1 year old child paddle placement
anterior-anterior
or
anterior-posterior
what paddles should you use for an infant?
small infant paddles
infant paddle placement
anterior-anterior
most common AED pad placement
anterior-anterior
alternate AED pad placement
posterior-L anterior
most comm pad placement transcutaneous pacing
posterior-L anterior
(anterior pad under L breast)
alt pad placement for trancutaneous pacing
anterior-anterior
most common pad placement defibrilaltion or cardioversion of VTACH
posterior-L anterior
alt placement for defib/cardioversion of VTACH
anterior-anterior
which is better: hands free pads or paddles
pads
why are pad recommended
- decr current arcing
- better ECG monitoring
- more rapid defibrillation
what is required when using paddles
conducting gel to reduce transthoracic impedance
‘analyze’ button
indicated if BLS provider cannot analyze rhythms
‘energy select’
adjusts energy for shock
‘charge’ button
charges before shocking
‘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
- place pads posterior-L anterior
- knob to defib
- press sync
- select energy (75-120J)
- press charge
- press shock
if atrial rhythm place, place anterior pad on ______ chest
right
if ventricular rhythm, place anterior pad on ____ chest
left
defibrillation steps
- place pads either post-ant or ant-ant
- knob to defib
- select energy (200J)
- charge
- shock
what functions are performed on the paddles
energy selection
charging
shocking
trancutaneous pacing steps
- place pads post-L anterior
- knob to pacer
- set HR w/rate (right) knob
- turn current until you get capture (left knob)
- 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
no
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
- One Step CPR
- One Step Pacing
- One Step Complete
- 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
P3
“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)
anterior
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?
no
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
