General defibrillation considerations

Question 1

• When should defibrillation not occur?

Answer 1

o When there is any patient movement, stretcher movement or the ambulance is not stationary.

Question 2

• What exceptions are there for when defibrillation should occur during movement?

Answer 2

o If the patient suffers cardiac arrest during transport and the process of safely parking the ambulance may cause a delay to defibrillation.
o If the patient is being transported with mechanical CPR and require regular defibrillation, where frequently stopping the ambulance will delay definitive care.
o Performing Synchronised cardioversion (MICA only)

Question 3

• In what mode should all rhythm checks and defibrillation be done in?

Answer 3

o All rhythm checks and defibrillations should be done in manual mode.

Question 4

• Are all rhythm checks to be completed on screen or printed?

Answer 4

o All rhythm checks are to be completed on screen; printing is not required.

Question 5

• When should ECG electrodes be placed if the patient has a known or suspected pacemaker?

Answer 5

o ECG electrodes should be placed when time permits and without interruption to CPR if the paramedic suspects that the pacemaker is affecting the underlying rhythm on initial analysis.

Question 6

• What will ECG electrodes allow if the patient has a known or suspected pacemaker?

Answer 6

o Enable the view of the presence or absence of pacing spikes to confirm if the pacemaker is affecting the underlying rhythm.

Question 7

• What does CPR feedback pads allow in regards to “See-through CPR”?

Answer 7

o They can be utilised to perform a preliminary rhythm check prior to charging.

Question 8

• Should compression continue during charging of the defibrillator?

Answer 8

o Yes, compressions should continue during the charging of the defibrillator.

Question 9

• When should a final rhythm check take place?

Answer 9

o Once compressions have stopped.

Question 10

• What is the preference if there is uncertainty determining if a rhythm needs to defibrillated or not?

Answer 10

o The preference is to defibrillate.

Question 11

• What is the procedure if a patient is being monitored with electrodes and the defibrillation pads then then applied and connected to the therapy cable and the monitor then displays lead fault?

Answer 11

o The paramedic is to cycle through the leads using the leads soft key until the pads view is displayed.