Defibrillators and settings

[celticcare]

Hi guys and gals. Got a question here especially for the techno kids amongst the teams. Had a patient yesterday that had svt, gave adenosine and no reversion but bounced into conscious vt with symptomatic complaints. Sedated and cardioverted at 100 joules, the patient then went into vf and then defibrillated at 360 joules. For the cardioversion the lead input was lead 2 but after the shock the input converted to paddles lead. The senior nurses said that the units at our hospital were apparently calibrated that after a sync shock that they remained in sync mode. Thankfully this one didn't but the question I have is: has your defib done that post sync shock and are any of you aware of machines being calibrated to do remain in sync mode post shock? I think it's dangerous and in this case pleased it went to async mode.

Thanks in advance guys

Scotty

[Kiwiology]

Killing patients again mate?

I had a quick squiz at the book and it seems the Lifepak 12 can be configured to remain in sync mode or return to manual (async) following a sync shock it seems.

My personal preference would be for the defib to return to async mode, less chance of error because we both know AOs are taught to select ON, ENERGY, CHARGE, SYNC, SHOCK so you get used to doing it, so if you have to do it again to re-zap them (medikal term right there...) you do the same thing again and not shock them in async mode.

Oh PS where the bloody hell are my sedatives ....

Edited June 29, 2011 by kiwimedic

[croaker260]

Hi guys and gals. Got a question here especially for the techno kids amongst the teams. Had a patient yesterday that had svt, gave adenosine and no reversion but bounced into conscious vt with symptomatic complaints. Sedated and cardioverted at 100 joules, the patient then went into vf and then defibrillated at 360 joules. For the cardioversion the lead input was lead 2 but after the shock the input converted to paddles lead. The senior nurses said that the units at our hospital were apparently calibrated that after a sync shock that they remained in sync mode. Thankfully this one didn't but the question I have is: has your defib done that post sync shock and are any of you aware of machines being calibrated to do remain in sync mode post shock? I think it's dangerous and in this case pleased it went to async mode.

Thanks in advance guys

Scotty

In the US I believe it used to be an FDA requirement that any defib will revert to unsynchronized mode immediatly after syn cardioversion for the very situation discussed above. I could be wrong though....

[BushyFromOz]

Cme to think of it bro, i dont think ive ever seen a defib that didn't revert to DCCS after a sync cardioversion

[celticcare]

Cme to think of it bro, i dont think ive ever seen a defib that didn't revert to DCCS after a sync cardioversion

Ok so have an answer to one part of the process, the machines are designed to return to asynchro mode post sync shock. There is only one unit in the hospital that doesn't and that is the one in the theatre that does the cardioversions on an elective level. The operators there are reminded via large prompts that it will remain in sync mode when the sync button is pushed *or until it is powered down*.

In regards to the defibrillator reverting to paddles lead from lead 2 after the sync shock? I am still stumped.