Clinical Nursing Operation Technology - Defibrillator Use
First, the purpose is to correct arrhythmia and restore sinus rhythm
Second, assess the patient's condition, consciousness, ECG waveform, and detect the connection of electrodes
Third, preparation of materials Defibrillator (with electrode pads), conductive paste, ECG monitoring lead wires, wiring boards (if necessary), first aid items
Fourth, method/step
1. Do a good job of ECG monitoring and clarify the indications for defibrillation.
2. The patient lies supine, the collar is loosened, the chest is exposed, the denture is removed, the metal accessories and conductive objects are removed, and the energy is selected (single: 360J, adult defibrillation biphasic: 200J, child: 2.4J/Kg)
3. Energy selection.
4. Coat the electrode plate with conductive paste or place saline gauze on the patient's chest wall.
5. Press the charging button, you will hear a continuous charging sound instead of a beeping sound.
6. Place the electrode pads on the patient's chest wall to optimize contact with the patient
7. Clearly and loudly shout "the others leave". The surgeon straightens his arms to fix the electrode pads to keep his body away from the edge of the bed, and then press the discharge button with both hands to perform defibrillation.
8. Evaluation of defibrillation effect: continue CPR immediately after defibrillation, after 5 groups of CPR, check the heart rhythm, and give defibrillation again if indicated.
9. To release the defibrillation, press the release button. For example, the defibrillator will automatically disarm if the defibrillator shock is not performed within seconds
10. After the operation is completed, turn off the power, reset the button, clean the electrode plate, and place it in the specified position accurately.
Fifth, the complications of electrical defibrillation
Arrhythmias: premature beats, ventricular fibrillation, sinus bradycardia, atrioventricular block, etc. Hypotension, pulmonary edema, embolism, myocardial injury, skin burns, etc. The maintenance and maintenance of the defibrillator ensures that the instrument is clean, dry, complete and complete. Do not place other objects on the instrument, and check that the instrument performance leads are not scratched, worn, or broken. After use, clean the lead wires, electrode plates, and pay attention to protect the screen. It is strictly forbidden to wipe the screen with a rough cloth. After each use, charge it for more than a week if it is not used and recharge it, and turn it on every day to test the performance of the instrument and keep it in a standby state.
Sixth, matters needing attention 1, to ensure the safety of the operation, the patient removes the dentures.
2. Conductive substances must not be connected, apply evenly to avoid local skin burns.
3. Master the handle pressure.
4. Keep the electrode plates clean and spaced 10cm apart.
5. In order to be able to time accurately, the record should be based on a clock.
6. Avoid festering or wound sites.
7. Avoid the built-in pacemaker site.
8. Mischarging must be discharged on the defibrillator.
9. Try to avoid high oxygen environment.
10. During defibrillation during cpR, discharge defibrillation should be performed at the end of patient expiration to reduce transthoracic electrical impedance.
