External Direct Current (DC) Shock
- CARDIOVERSION – Electrical termination of any arrhythmia other than ventricular fibrillation
- DEFIBRILATION – Electrical termination of one and only one arrhythmia: ventricular fibrillation
Dose
| Cardioversion | SVT | ¼- ½ Joules/kg |
| VT | 1-2 Joules/kg | |
| Defibrillation | VF | 2-4 Joules/kg |
Note:
- Use the small paddle for children that will completely contact skin over their surface.
- No dry contacts- Electrode pad or paste must completely cover the contact area between paddles and skin. Do not use ultrasound gel.
- Never SYNC (synchronize) for ventricular fibrillation
- Always SYNC for cardioversion, even for atrial “fibrillation”, whenever QRS is distinct
- Connect 3 or 5 lead ECG cable for best SYNC during cardioversion
- Power on
- Set dose
- Charge
- Call “clear” and observe that all personnel are not in contact with the patient
- Press hard for good contact (minimum paddle-to-skin electrical resistance)
- Hold both buttons depressed for at least 3 seconds (sync takes time, particularly with relatively slow ventricular rates)
- Always record rhythm strip during procedure (some machines do this automatically)
For subsequent cardioversion attempts, push SYNC again.
