Defib Safety & Contras

Question 1

Environmental Safety Issues (x2)

Answer 1

• Do not use the defibrillator around flammable agents, oxygen rich atmospheres or anaesthetics.
• Do not use the defibrillator on or near water or on metal surfaces.

Question 2

Operator Safety Issues (x3)

Answer 2

• Do not defibrillate without first calling “Stand Clear” and checking “All Clear”.
• Just prior to defibrillation, visually check check no one else is touching the Pt or equipment attached to the Pt.
• When defibrillating, don’t touch the Pt or equipment attached to the Pt other than the monitor.

Question 3

Patient Preparation Issues (x4)

Answer 3

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

Question 4

Pad Adhesion Issues (x2)

Answer 4

• Do not defibrillate if the defibrillation pads are not properly adhering to the Pt.
• Do not perform Chest compressions over the defibrillation pads.

Question 5

Equipment Issues (x3)

Answer 5

• Damaged therapy cables must be replaced.
• Faulty Defibrillation pads must be replaced.
• If the monitor displays the STOP symbol in the RFU indicator window, it indicates a monitor failure and it should be replaced.

Question 6

General Defibrillation Contras (x4)

Answer 6

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

Question 7

AED Contras (x3)

Answer 7

• Patients who are 11 years of age or less.
• Any ambulance that is not stationary. It must be brought to a halt.
• All general defibrillation contras.

Question 8

Defibrillation Pad Placement (x2)

Answer 8

• The ‘Apex’ pad is placed horizontally on the patient’s left side, on the mid o anterior axillary line at the level of the cardiac apex.
• The ‘Sternal’ pad is placed horizontally on the patient’s right chest, under the right clavicle, above the right nipple.

Question 9

Defibrillation Pad Application Technique (x5)

Answer 9

• 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 patient.
• Roll apex pad from the anterior aspect of the cardiac apex, with the cable end of the pad pointing away from the patient.

Question 10

Defibrillation Pad Pre-Application Check (x2)

Answer 10

• Check the expiration date of the pads.
• Check for dried out or damaged pads.

Question 11

Chest Preparation Measures (x2)

Answer 11

• 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 arcing.

Question 12

Weight/Age Limit of Paediatric Defibrillation Pads (x1)

Answer 12

• As per manufacturer instructions.

Question 13

Paediatric Defibrillation Pad Application (x3)

Answer 13

• As close as possible to adult placement.
• When using paediatric pads, the ‘Anterior’ pad is placed on the left side, anterior to the axillary line (as per adult ‘Apex’), with the ‘Posterior’ pad on the right upper chest/clavicle (as per adult ‘Sternal’).
• Wrapping over the shoulder is permissible to ensure sufficient gap between the pads. Avoid the neck.

Question 14

Paediatric Defibrillation Energy Selection (x3.5)

Answer 14

• Pt aged 1 - 9 ⇒ Age x 2 + 8

4 joules/kg

• Pt aged 10 - 11 ⇒ Age x 3.3
• If the value calculated falls between two pre-set joule options, you should round up to the nearest pre-set joule option.