1 / 23

In the name of God

In the name of God. DC SHOCK. دکتر علیرضا اسماعیلی استاد یارطب اورژانس. Defibrillation is a nonsynchronized delivery of energy during any phase of the cardiac cycle. cardioversion is the delivery of energy that is synchronized to the large R waves or QRS complex. Indications.

lucindacollins
Télécharger la présentation

In the name of God

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. In the name of God

  2. DC SHOCK دکتر علیرضا اسماعیلی استاد یارطب اورژانس

  3. Defibrillation is a nonsynchronized delivery of energy during any phase of the cardiac cycle

  4. cardioversion is the delivery of energy that is synchronized to the large R waves or QRS complex.

  5. Indications • Supraventricular tachycardia • Atrial fibrillation • Atrial flutter • Ventricular tachycardia

  6. Pulseless ventricular tachycardia (VT) • Ventricular fibrillation (VF) • Cardiac arrest due to or resulting in VF

  7. Contraindications • digitalis toxicity and catecholamine-induced arrhythmia • Multifocal atrial tachycardia

  8. Anesthesia • Cardioversion is almost always performed under induction or sedation (short-acting agent such as midazolam)

  9. Equipment • Defibrillators • Paddle • adhesive patch • Conductive gel or paste • ECG monitor with recorder • Oxygen equipment • Intubation kit Emergency • pacing equipment

  10. Positioning • Ant&post • Ant&lat • Ant&Rt Inf scapular • Ant&lt Inf scapular

  11. Monophasic vs biphasic waveforms • Monophasic defibrillation delivers a charge in only one direction, • biphasic defibrillation delivers a charge in one direction for half of the shock and in the electrically opposite direction for the second half. • Biphasic waveforms defibrillate more effectively and at lower energies than monophasic waveforms

  12. Synchronized electrical cardioversion begins with 25-50 treat atrial flutter • 50-100 treat atrial fibrillation

  13. Rapid polymorphic ventricular tachycardia (rate >150 bpm) associated with hemodynamic instability should be treated with immediate biphasic equivalent [100-200 J])

  14. Monomorphic ventricular tachycardia should be treated with biphasic equivalent [50-100 J]. • Ventricular fibrillation should be treated with unsynchronized electrical counter shock with biphasic equivalent [100-200 J].

  15. Complications • Atrial fibrillation • Ventricular fibrillation • Junctional premature beats • ventricular fibrillation

  16. Thromboembolization is associated with cardioversion in 1-3% of patients • Myocardial necrosis can result from high-energy shocks • Pulmonary edema is a rare complication of cardioversion • Painful skin burns can occur after cardioversion or defibrillation

  17. دستگاه بایفازیک با انرژی کمتر موفقیت بیشتر ویا مساوی از دستگاه مونو فازیک دارد

  18. میزان شوک در اطفال • 2j/kg • 4j/kg • 4j/kg

  19. پدل نباید بر روی پچ ترانس درمال قرار گیرد

  20. شوک بر روی یخ وبرف مانعی ندارد • بیمار در آب وبیمار با تعریق فراوان نباید شوک داد.

  21. اندازه پدل در بزرگسالان 8*12 است. • هر چه پدل کوچکتر باشد شانس نکروز میوکارد بالا می رود.

  22. فاصله بین پدل و ICD باید حداقل 8 سانتی متر باید باشد.

  23. THE ENDthank you

More Related