Accreditation

Question 1

Defibrillation Safety Knowledge Table

Answer 1

EOPPE

Question 2

Environmental Safety Issues

Answer 2

• Do not use around flammable agents, 02 rich atmospheres or anaesthetics
• Do not use the defib on or near water or on metal surfaces

Question 3

Operator Safety Issues

Answer 3

• Do not defib without first calling ‘Stand Clear’ and checking ‘all clear’
• Just prior to defibrillation, visually check no one else is touching pt or equipment attached to the pt. Maintain visual contact with pt
• When defibrillating, don’t touch pt or equipment attached to the pt other than the monitor

Question 4

Pt Preparation Issues

Answer 4

• Do not place defib pads over GTN patches, GTN paste, implanted pacemakers or ECG electrodes/ cables
• Avoid skin pigmentations and nipples to prevent burns
• Avoid skin folds to prevent electrical arching
• Do not allow contact between pads and or ECG electrodes or cables

Question 5

Pad Adhesion Issues

Answer 5

• Do not defib if the pads are not properly adhering to the pt
• Do not perform chest compressions over the defib pads

Question 6

Equipment Issues

Answer 6

• Damaged therapy cables must be replaced
• Faulty defib pads must be replaced
• If the monitor displays the stop symbol in the RFu indicator window, it indicates monitor failure and should be replaced

Question 7

General Defib Contraindications

Answer 7

• Any pt movement (except synchronised cardioversion)
• Any pt with a pulse (Except for synchronised cardioversion)
• Any stretcher movement
• Any person touching the pt. There must be no pt contact when the monitor is analysing, charging or delivering a shock

Question 8

AED Contraindications

Answer 8

• Pts who are 11 years of age or less
• An ambulance that is not stationary. must be bought to a halt
• All general defib contraindications

Question 9

Defib Pad Placement

Answer 9

• Apex Pad: placed horizontally on the pts left side, on the mid axillary line at the level of the cardiac apex
• Sternal Pad: placed horizontally on the pts right chest under the right clavicle, above the right nipple

Question 10

Defib Pad application technique

Answer 10

• Apply the pad in a rolling motion to avoid air pockets
• Smooth the pad into the intercostal spaces of thinly built people
• Apply gentle pressure over the entire surface of the gel and adhesive ring to ensure adhesion
• Roll sternal pad from the right sternal margin, with the cable end of the pad pointing away from the pt
• Roll apex pad from the anterior aspect of the cardiac apex, with the cable end of the pad pointing away from the pt

Question 11

Defib Pad pre- application check

Answer 11

• Check expiration date of the pads

- Check for dried out or damaged pads

Question 12

Chest Preparation measures

Answer 12

• Wipe moist or sweaty skin with a dry towel only. Do not use betadine or alcohol wipes as they can cause burns and interfere with pad adhesion
• Clip chest hair only when coarse, dense and wiry. Refrain from shaving as this can cause electrical arching.

Question 13

Weight/ Age limit of defib pads

Answer 13

As per manufacturers instructions

Question 14

Paediatric Defib pad application

Answer 14

• As close as possible to adult placement i.e. Anterior/ anterior
• When using Paediatric pads, the anterior pad is placed on the left side, anterior to axillary line with the posterior pad on the right upper chest/ clavicle (same as adult placement’
• Wrapping over the shoulder is permissible to ensure sufficient gap between pads. Avoid the neck

Question 15

AV Basic ECG Recognition Criteria

Answer 15

• Ventricular Rate
• Ventricular Rhythm
• P waves ?
• PR interval
• QRS interval

Question 16

Ventricular Fibrillation (VF) criteria

Answer 16

Rate: Non Discernable
Rhythm: Bizarre, chaotic, amplitude >0.1mV
P waves: Nil discernible
QRS: Nil Discernible

Question 17

Ventricular Tachycardia (VT) criteria

Answer 17

Rate: greater than 100
Rhythm: Regular 
P waves: not associated or non discernible 
Pr Interval: non discernible 
QRS: > 0.12 seconds

Question 18

Asystole Criteria

Answer 18

rate: non discernible
rhythm: no electrical activity, flat, isoelectric line
p waves: nil discernible
PR interval: nil discernible
QRS: nil discernible

Question 19

Normal Sinus rhythm criteria

Answer 19

Rate: 60-100 bpm
rhythm: Regular 
P waves: present and associated with each QRS
Pr interval: 0.12- 0.2 seconds 
QRS duration: <0.12 seconds

Question 20

ECG Paper

Answer 20

1 small square= 0.04
2 small squares= 0.08
large square= 0.2
2 large squares= 0.4