Manual Defib

Question 1

PPE

Answer 1

Don appropriate PPE, and undertake
appropriate hand hygiene.

Question 2

Equipment

Answer 2

Defibrillator
Appropriate sized pads

Question 3

Indications

Answer 3

Patient where Life Support has
commenced and;
Patient presenting with a shockable
rhythm – Ventricular Fibrillation (VF)
or Pulseless Ventricular Tachycardia
(pVT).

Question 4

Contraindications

Answer 4

Hazardous environments:
- water, metal fixtures,
flammable substances, and
oxygen.
Patient presenting with a non-
shockable rhythm – Asystole or PEA.
Patient whose condition is
unequivocally associated with death.

Question 5

Prepare equipment

Answer 5

Position defibrillator to maximise
operator view, yet not interfere with
resuscitation.
Ensure pad type is appropriate for
patient’s age.
Check that pads are in date and that
wires are intact.

Question 6

Prepare patient

Answer 6

Place the patient supine.
Remove or cut away sufficient
clothing to expose chest.
Remove medication patches,
jewellery, or ECG electrodes.
Shave chest hair, if considered thick
enough to interfere with
pad/electrode adhesion.
Dry the chest (if required)

Question 7

Position pads

Answer 7

Antero-lateral pad position is the
position of choice for initial pad
placement

Anterior-posterior position where
required, e.g. Children
Avoid breast tissue, placement over
the sternum and patient’s neck. Place pads > 8 cm away from pacemakers and ICDs
Roll pads on to avoid air pockets, To ensure contact adhesion.

Question 8

Set
defibrillator
energy

Answer 8

Set defibrillator energy to
recommended level
– paediatric
guidelines.
In the absence of any clear evidence
for the optimal initial and
subsequent energy levels, any
energy level within th
e range of 120
-
360j is acceptable for the initial
shock, followed by an escalating
strategy up to maximum output of
the defibrillator.

Question 9

Evaluate
rhythm

Answer 9

Pause CPR
Rapidly evaluate the presenting
rhythm to identify Ventricular
Fibrillation (VF) or pulseless
Ventricular Tachycardia (pVT) from
non-shockable rhythms

Question 10

Charge defib

Answer 10

Continue chest compressions during
defibrillator charging.

Question 11

Move oxygen away

Answer 11

Move oxygen away from the patient, at least 1 metre away. Unless the patient is intubated or igel insitu

Question 12

Safety of others

Answer 12

Ensure CPR has stopped and noone is touching the patient. Check the top middle and bottom of the patient is clear, clearly verbalise the command to stand clear.

Question 13

Defibrillate / Disarm

Answer 13

If the rhythm is VF or pulseless VT, deliver the shock if safe to do so.
Interuption of chest compression less that 5 seconds.
Confirm the shock has been delivered and it is safe to touch the patient
Immedietley resume chest compressions

Question 14

Report / document

Answer 14

Handover relevant information such as the initial rhythm, number of shocks, pad placement and the joules used