Bonner County EMS System Procedures Cardiac: Defibrillation- Manual- 9036

DEFIBRILLATION- MANUAL Clinical Indications

Defibrillation for patients in cardiac arrest with ventricular fibrillation or pulseless tachycardia Pulseless, not breathing Pulseless patient requires unsynchronized defibrillation. Patients with an organized rhythm can receive synchronized Cardioversion.

PROCEDURE GUIDELINESR- EMR E – EMT A-AEMT P-PARAMEDIC **M-Medical Control **

***Higher level providers are responsible for lower level treatments*** Assess patient, monitor cardiac status and determine cardiac arrest and need

for defibrillation. If multiple rescuers are available, one rescuer should provide uninterrupted

chest compressions (CPR- 9031) while the defibrillator is being prepared for use.R

Assist ALS: Apply defibrillator pads to patient’s chest: One pad to left mid chest next to sternum, one pad to mid left posterior chest next to spine. E

Alternately apply appropriate conductive agent and apply paddles to right of sternum at 2nd intercostal space (ICS) and at the left anterior axillary line at the 5th ICS.

Set the appropriate energy level. Charge the defibrillator to the selected energy level (200 joules first attempt suggested). Continue CPR while the defibrillator is charging.

If using paddles, assure proper contact by applying 25 pounds of pressure on each paddle.

Hold compressions and assertively state “CLEAR” and visualize that no one, including yourself, is in contact with the patient prior to defibrillation.

Deliver the shock by depressing the discharge buttons when using paddles, or the “shock” button for defibrillator pads.

Immediately resume CPR (chest compressions and ventilations) after defibrillation.

After two minutes of CPR, analyze rhythm and check for pulse. Repeat every 2 minutes as indicated by patient response and ECG rhythm. Transport; continue treatment as indicated.

P

_______________________________________________________________________________________________________________________________________BCEMS Medical DirectorEffective: 04/01/14 final 5/8/2023 page 1 of 2

Bonner County EMS System Procedures Cardiac: Defibrillation- Manual- 9036

Note procedural details, response and time in patient care report (PCR).

** Consider discussion with Medical Control if defibrillation is unsuccessful after 2 attempts** M

Pearls:Age less than 8 use pediatric pads. Keep interruptions of CPR as brief as possible. Adequate CPR is the key to successful resuscitation.

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