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5.2.5 - Principles of Defibrillation and Cardioversion

from Section 5.2 - Practical Cardiovascular System

Published online by Cambridge University Press:  27 July 2023

By
Jonny Coppel
Edited by
Ned Gilbert-Kawai ,
Debashish Dutta  and
Carl Waldmann
Ned Gilbert-Kawai
Affiliation:
The Royal Liverpool Hospital
Debashish Dutta
Affiliation:
Princess Alexandra Hospital NHS Trust, Harlow
Carl Waldmann
Affiliation:
Royal Berkshire Hospital, Reading
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Summary

Key Learning Points

  1. 1. Biphasic waveform defibrillators are used to depolarise cardiac muscle to restart the normal pacemaker functions of cardiac tissues.

  2. 2. Delays in defibrillation drastically reduce the chances of a successful outcome.

  3. 3. Communication and minimising peri-shock pauses are key to successful defibrillation.

  4. 4. Energy level settings should be determined by the manufacturer’s instructions on a local machine.

  5. 5. Synchronised cardioversion can be used for arrhythmias with adverse features, with different initial energy settings being used for different types of arrhythmias.

Keywords

defibrillationcardioversionpad positioningcardiac arrest
Type
Chapter
Information
Intensive Care Medicine
The Essential Guide
 , pp. 576 - 579
Publisher: Cambridge University Press
Print publication year: 2021

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References

References and Further Reading

European Society of Cardiology (ESC); European Heart Rhythm Association (EHRA); Brignole, M, Auricchio, A, Baron-Esquivias, G, et al. 2013 ESC guidelines on cardiac pacing and cardiac resynchronization therapy: the task force on cardiac pacing and resynchronization therapy of the European Society of Cardiology (ESC). Developed in collaboration with the European Heart Rhythm Association (EHRA). Europace 2013;15:1070–118.Google Scholar
Morrison, LJ, Henry, RM, Ku, V, et al. Single-shock defibrillation success in adult cardiac arrest: a systematic review. Resuscitation 2013;84:1480–6.CrossRefGoogle ScholarPubMed
Nichol, G, Sayre, MR, Guerra, F, Poole, J. Defibrillation for ventricular fibrillation. J Am Coll Cardiol 2017;70:1496–509.CrossRefGoogle ScholarPubMed
Resuscitation Council UK. Advanced Life Support, 7th edn. London: Resuscitation Council UK; 2016.Google Scholar
Soar, J, Nolan, JP, Bottiger, BW, et al. European Resuscitation Council Guidelines for Resuscitation 2015 Section 3. Adult advanced life support. Resuscitation 2015;95:99–146.CrossRefGoogle ScholarPubMed

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