Defibrilator

Question 1

What wave do you need to synchronise with when doing electrical cardioversion?

Answer 1

The R wave

Question 2

Why do you sync with the R wave when cardioverting?

Answer 2

Reduced the risk of VF

Question 3

How do you manage a patient that requires cardioversion or pacing?

Answer 3

Sedation

Question 4

Why would a patient require the use of cardiac pacing?

Answer 4

To maintain cardiac output temporarily while expert help to deliver longer term treatment is obtained

Question 5

What rhythms requires cardiac pacing?

Answer 5

Broad complex complete heart block
Bradycardia not responding to treatment

Question 6

What rhythm is pacing not successful and why?

Answer 6

Aystole - no present P waves so no evidence of electrical activity

Question 7

What are the advantages of cardiac pacing?

Answer 7

It can be established quickly
It is widely available
It is easy to perform and requires minimum training

Question 8

What is the disadvantage of cardiac pacing?

Answer 8

In an awake patient it is uncomfortable as it stimulates contraction of the chest wall muscle

Question 9

What are the stages of cardiac pacing?

Answer 9

1. Attach ECG monitoring and the pads - right pectoral and apical position
2. Sedate patient
3. Select an appropriate pacing rate - 60-90 bpm
4. Set the energy output to the lowest value, gradually increasing till pacing is captured
5. Increase electrical activity by and extra 20

Question 10

When defibrillating a patient what current would you start on and then how would you increase?

Answer 10

Initial shock - 150-200J
Subsequent shocks - 150-360J