Clinical application of defibrillator
1 device
The electrical cardioversion machine, also called a defibrillator, is the main equipment for implementing electrical cardioversion. Equipped with electrode plates, most of them have two pairs of large and small. The large one is suitable for adults and the small one is suitable for children. Before use, check whether the defibrillator functions are intact, whether the power supply is faulty, whether the charging is sufficient, and whether the various wires are broken and If the contact is poor, the defibrillator, as a rescue equipment, should always maintain good performance, and the battery should be fully charged, so that emergency electric shock defibrillation can be implemented at any time in an emergency.
2 electrodes
There are two positions of electrode plates in external cardioversion. One is called the anteroposterior position, that is, one electrode plate is placed in the subscapular area of the back; the other is placed at the level of the 3-4 intercostal space on the left edge of the sternum. Some people believe that this method passes more current through the heart, so that less electrical energy is required, and potential complications can also be reduced. Selective electrical cardioversion should use this method. The other is an electrode plate placed in the 2~3 intercostal space (bottom of the heart) on the right edge of the sternum. The other is placed in the fifth intercostal space (apex of the heart) in the left anterior axillary line. This method is quick and convenient, and is suitable for emergency electric shock defibrillation. The distance between the two electrode plates should not be less than l0cm. The electrode plate should be close to the patient's skin and slightly pressurized, no gaps should be left, and the edges should not be lifted. The skin where the electrodes are placed should be coated with conductive paste, saline gauze can also be used, or even water can be used in an emergency, but alcohol is absolutely prohibited, otherwise it may cause skin burns. Those who are thin and the intercostal space is obviously sunken and the electrode is in poor contact with the skin should use saline gauze, and several more layers can be used to improve the contact between the skin and the electrode. Keep dry between the two electrode plates to avoid short circuit caused by conductive paste or salt water connection. The handle of the electrode plate should also be kept dry. It should not be contaminated by conductive paste or salt water to avoid injury to the operator. When cardiac surgery or open heart massage requires direct electrical shock defibrillation of the heart, a special small electrode plate is required, one is placed on the surface of the right ventricle; the other is placed on the apex of the heart, the surface of the heart is sprinkled with saline, and the electrode plate Close to the ventricular wall.
3 choice of electric energy
The electrical energy used in electrical cardioversion is represented by J. Charge according to need, ventricular fibrillation is 250J~300J, asynchronous cardioversion. Ventricular tachycardia is 150J~200J, atrial fibrillation is 150J~200J, atrial flutter is 80J~100J, and supraventricular tachycardia is 100J, all of which are synchronous cardioversion.
