Defib safety points

Question 1

Environmental safety

Answer 1

• do not use around flammable agents, oxygen rich atmospheres or anaesthetics
• do not use on or near water or on metal surfaces

Question 2

Equipment

Answer 2

• damaged therapy cables must be replaced
• do not use dry, damaged, faulty or expired defibrillator pads
• if monitor displays the Stop symbol, it indicates monitor failure

Question 3

Chest preparation

Answer 3

• wipe moist or sweaty skin with a dry towel only, no betadine or alcohol wipes as they can cause burns interfere with pad adhesion
• clip chest hair only when coarse, dense and wiry. refrain from saving as this can cause electrical arcing

Question 4

Defib pad location considerations

Answer 4

• do not place over GTN patches, pastes, pacemakers or ECG electrodes and/or cables
• avoid skin pigmentation and nipples to prevent burns
• avoid skin fold to prevent electrical arcing
• do not allow contact between the defibrillator pads and/or ECG electrodes or cables
• do not perform compressions over the pads or wires

Question 5

Defib pad placement and application

Answer 5

• the apex pad is rolled horizontally from anterior aspect of cardiac apex on pts L) side, at mid or anterior axillary line
• sternal pad is rolled horizontally from R) eternal margin on R) chest, under R) clavicle and above R) nipple

Question 6

Defib pad application technique

Answer 6

• apply in a rolling motion to avoid air pockets
• smooth the pad into the intercostal spaces of thinly built people
• apply gentle pressure over entire surface of the gel and adhesive ring to ensure adhesion
• do not defy is pads are not properly adhering

Question 7

Operator safety

Answer 7

• just prior to analysing, charging and defibrillator call stand clear and confirm all clear
• to confirm all clear visually check no one is touching the pt or equipment attached to pt when analysing, charging or shocking. Maintain visual contact with pt.

Question 8

Defib considerations

Answer 8

-do not defib when pt, stretcher or ambulance movement except when:
.pts suffer cardiac arrest during transport, where safely stopping can cause delay to defibrillator
.pts being transporting with mechanical CPR in progress and require regular defib where frequently stopping will delay definitive care
.performing sych cardioversion

Question 9

SAM contras

Answer 9

pts 11 or under

Question 10

SAM considerations

Answer 10

-defib regardless of result of SAM analysis should occur when:
.unconsicous, pulseless, VT is present at rate less than 150
.motion or electrical artefact has affect analysis but underlying rhythm is VF or VT as determined by printout
.pacing spike have affect analysis but underlying rhythm is VF or VT. put on 4 limb leads if possible

Question 11

weight/age limit of paed defib pads

Answer 11

as per manufacturers instructions for weight

Question 12

Paed defib pad application

Answer 12

• as close as possible to adult placement
• anterior pad is placed on the L) side, anterior to the axillary line
• posterior pad is placed on the R) upper chest/clavicle
• wrapping over the shoulder is permissible to ensure sufficient gap between pads. avoid the neck.

Question 13

Paed defib energy selection

Answer 13

• paed pts aged 1-9. age x2 + 8
• paed pts aged 10-11. age x3.3
• if calculated joules value falls between 2 pre-set joule options, you should round up to the next option.