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Defibrillator: definition,purpose of defibrillator, indication,types of defibrillator brief contraindicated, complications,waves of defibrillator, electrodes position,type of lead , nursing interventions after defibrillation. Bag and mask ventilation Definition,type, difference between types, indication, contraindications, advantages, disadvantages, complications, Nursing diagnosis and intervention.
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Defibrillation is a process in which an electronic device sends an electric shock to the heart to stop an extremely rapid, irregular heartbeat, and restore the normal heart rhythm. Defibrillation is a common treatment for life threatening cardiac dysrhythmias –
The energy settings are designed to provide the lowest effective energy needed to terminate VF Shock success -Termination of VF at 5 seconds after the shock VF frequently recurs after successful shocks, but this recurrence should not be equated with shock failure Based on energy delivery, defibrillators are classified as:- Monophasic Biphasic Energy levels vary by type of device Monophasic – (360 J) Biphasic- (120-200J) .In pediatrics Use of pediatric paddle Doses are 2-4 J/kg upto a maximum of 10J/kg with subsequent shocks.
Tachyarrhythmias with pulse, but an unstable patient. Energy selection is from 50-200 J. ECG leads must be attached to the defibrillator, paddles/pads attached and ‘sync’ button pressed. Following synchronization, the device is charged and shock delivered.
The AICD is a device that delivers electric shock directly to the heart muscles in order to terminate lethal dysrhythmias.
It has a pulse generator and a sensor that continuously monitor rhythm and detects dysrhythmias. ⚫ It automatically delivers a counter shock.
Turned on or opened AED. AED will instruct the user to:- Connect the electrodes (pads) to the patient.
The paddles used in the procedure: Should not be placed on a breasts Over an internal pacemaker generator. Over wet/hairy skin Before the paddle is used, a conducting jelly must be applied and spread over the electrode surface.
The patient’s cardiac status, breathing, and vital signs are monitored until he or she is stable. An electrocardiogram and chest x ray are taken. The patient’s skin is cleansed to remove gel or paste, and, if necessary, ointment is applied to burns. An Intravenous line provides additional medication, as needed.
ventilation in the operation theatre when intubation is not required, but it is now often substituted by the laryngeal mask airway.
The BMV consists of
1.Flow inflating bag (Anaesthesia Bag)Fills only when oxygen from a compressed source flows into it Depend on a compressed gas source Must have a tight face-maskSeal to inflateUse a flow-control valve to regulate pressure-inflation.
Fill spontaneously after they are squeezed. Pulling oxygen or air into the bag Remain inflated at all times Can deliver positive-pressure ventilation without a compressed gas source. Require attachment of an oxygen reservoir to deliver 100% oxygen
BMV TECHNIQUE