Clinical Nursing Operation Technology-Use of Defibrillator
▶Purpose Correct arrhythmia and restore sinus rhythm
▶Evaluate the patient's condition, consciousness, ECG waveform, and test electrode connection
▶Preparation of materials Defibrillator (with electrode plate), conductive paste, ECG monitoring lead wire, wiring board (if necessary), first-aid supplies
▶method/step
1. Do a good job of ECG monitoring and clear indications for defibrillation.
2. The patient lies supine, loosen the collar, expose the chest, remove the denture, remove the metal ornaments and conductive objects, energy selection (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 chest wall of the patient.
5. Press the charging button, you will hear a continuous charging sound instead of a buzzer.
6. Put the electrode plate on the patient's chest wall to optimize the contact with the patient
7. Call out "Others leave" clearly and loudly. The surgeon stretches both arms to fix the electrode plates to move his body away from the edge of the bed, and then presses the discharge button with both hands at the same time to perform defibrillation.
8. Evaluation of defibrillation effect: CPR is continued immediately after electrical defibrillation, after 5 groups of CPR, heart rhythm is checked, and electrical defibrillation is given again when there are indications.
9. To release defibrillation, press the release button. Such as: the defibrillator will be automatically released if the defibrillator 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 accurately according to the specified position.
▶ the complications of electrical defibrillation
Arrhythmia: 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 ensure that the instrument is clean, dry, complete, and complete. No other objects should be placed on the instrument. Check that the instrument performance leads are not scratched, worn, or broken. Clean the lead wires and electrode plates after use, and protect the screen. Do not wipe the screen with a rough cloth. Recharge in time after each use for more than a week without recharging, and test the performance of the instrument every day and keep it in standby mode.
6. Matters needing attention 1. Ensure safety during operation and remove dentures from patients.
2. Conductive materials must not be connected, and evenly spread 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 ulcers or wounds.
7. Avoid the built-in pacemaker.
8. Mischarge must be discharged on the defibrillator.
9. Try to avoid high oxygen environment.
10. When defibrillating during cpR, defibrillation should be discharged at the end of the patient's expiration to reduce the transthoracic electrical impedance.
