If tachycardia continues to persist, you should increase the energy level according to the Electrical Cardioversion Algorithm. Make sure the patient is clear once more after the defibrillator is charged.Make an announcement to the team members that you’re charging the defibrillator and tell everyone to stand clear.If treating unstable polymorphic V-tach, you should treat it as VFib and deliver a high-energy shock. If treating another unstable SVT or atrial flutter, the initial dose is 50 to 100 J.ĭ. If treating unstable monomorphic V-tach, the initial dose is 100 J.Ĭ. If treating unstable atrial fibrillation, the initial dose is 200 J.ī. Choose the appropriate energy level and deliver monophasic synchronized shocks in the following sequence:Ī.Adjust the monitor, if necessary, until the sync markers occur with each R wave.Look for markers on the R wave which indicate the sync mode.Engage the synchronization mode by pressing the sync control button.Then position the adhesive electrode or conductor pads on the patient. You should also ensure that the patient’s rhythm is displayed properly. Remember lead placement with this – white to right, red to ribs, what’s left over to the left shoulder. Attach the monitor leads to the patient.Turn on the monophasic or biphasic defibrillator.Sedate conscious patients unless they are unstable or rapidly deteriorating.Synchronized Cardioversion StepsĪCLS providers should be aware that they may have to modify these steps for the specific device they’ll be using. Healthcare providers must place the defibrillator/monitor in synchronized mode, which is designed to deliver energy just after the R wave of the QRS complex. When performing synchronized cardioversion, the shocks are administered through either adhesive electrodes or handheld paddles. In fact, it may actually increase the rate of the tachyarrhythmia. In these scenarios, the delivery of a shock typically cannot stop these rhythms. Synchronized cardioversion is also routinely used to treat unstable atrial flutter and unstable atrial fibrillation.Ĭardioversion may not be effective when treating junctional tachycardia or ectopic or multifocal atrial tachycardia, as these rhythms have an automatic focus arising from cells that are spontaneously depolarizing at a rapid rate. Synchronized cardioversion is the recommended treatment for patients who have a symptomatic, unstable reentry SVT or V-tach with pulses. Synchronized cardioversion is recommended in some ACLS algorithms, such as unstable tachycardia, particularly when a persistent tachyarrhythmia is causing the following to occur: These low-energy shocks must always be delivered as synchronized shocks to avoid precipitating VFib.
Synchronized cardioversion uses a lower energy level than normal defibrillation. This is a period of vulnerability in which a shock can precipitate VFib. Synchronization avoids the delivery of a shock during cardiac repolarization, which is represented on the surface ECG as the T wave. Instead, the shock delivery will be synced with the peak of the R wave in the patient’s QRS complex. However, when a healthcare provider uses synchronized cardioversion, after pushing the shock button, that shock may not be delivered immediately. This means that the shock is not delivered precisely in the cardiac cycle in other words, unsynchronized shocks are more random.
#2 1 atrial flutter professional#
Unsynchronized shocks refer to a shock that is delivered immediately after the healthcare professional pushes the shock button. Synchronized cardioversion is a treatment technique that uses a sensor to deliver a shock that is synchronized with a peak in the QRS complex.ĭefibrillators can deliver two types of shocks – synchronized and unsynchronized.
0 kommentar(er)
