Defibrillator power point presentation for medical students

complete information about defibrillator , that is introduction, definition, types, procedure, checklist, nursing consideration, post defibrillation care , precautions, related care, new research, summary and bibliography.

1. DEFIBRILLATOR SUBMITTED TO : Mrs. Mamta Toppo Subject Coordinator College of Nursing RIMS, RANCHI SUBMITTED BY : Chandra Tamang Roll No. 05 Basic Bsc Nursing 3 rd year College of nursing RIMS, RANCHI

2. CONTENT Introduction Definition Types of defibrillator Procedure/Technique Checklist Nursing consideration Post defibrillation care Precautions Related care New research Summary Reference Bibliography

3. INTRODUCTION Defibrillation is the definitive treatment for the life-threatening cardiac arrhythmias, ventricular fibrillation and pulseless ventricular tachycardia. Defibrillation consists of delivering a therapeutic dose of electrical energy to the affected heart with a device called a defibrillator. This depolarizes a critical mass of the heart muscle, terminates the arrhythmia, and allows normal sinus rhythm to be restablished by the body’s natural pacemaker, in the sinoartrial node of the heart.

4. DEFINITION Defibrillator is an apparatus used to counteract atrial or ventricular fibrillation by application of brief electric shock to the heart. An electrical device used to counteract fibrillation of the heart muscle and restore normal heartbeat by applying a brief electric shock.

5. TYPES OF DEFIBRILLATOR Manual external defibrillator Manual internal defibrillator Automated external defibrillator Semi-automated external defibrillator Implantable cardioverter defibrillator Wearable cardiac defibrillator

6. MANNUAL EXTERNAL DEFIBRILLATOR

7. Manual external defibrillator An device life support medical device that monitors the heart rhythm and allow the user to manually set the energy delivery and deliver a shock. The units are used in conjunction with (or more often have inbuilt) electrocardiogram readers, which the healthcare provider uses to diagnose a cardiac condition (most often fibrillation or tachycardia although there are some other rhythms which can be treated by different shocks).

8. Manual internal defibrillator The electric charge is usually pumped in by internal paddles in close or direct contact with the heart. They are virtually identical to the external version. These device are mainly used in operating theatres, where the chest can be opened or being treated by a surgeon.

9. AUTOMATED EXTERNAL DEFIBRILLATOR (AED) An automated external defibrillator is a portable electronic device that automatically diagnoses the life-threatening cardiac arrhythmias of ventricular fibrillation and pulseless ventricular tachycardia, and able to treat them through defibrillation, the application of electricity which stops the arrhythmia, allowing the heart to re-establish an effective rhythm Automated external defibrillators are generally either held by trained personnel who will attend incident,or are public access units which can be found in places including corporates government offices, shopping centres, airport etc.

10. Implantable cardioverter Defibrillator Implantable cardioverter defibrillator also known as automatic internal cardiac defibrillator (AICD). These devices are implants, similar to pacemaker. They constantly monitor the patients heart rhythm, and automatically administer shocks for various life threatening arrhythmias, according to the device programming.

11. Wearable Cardiac Defibrillator It is a portable external defibrillator that is worn like vest. The unit monitors the patient 24 hours a day and will automatically deliver a biphasic shock if needed. This device is mainly indicated in patients awaiting an implantable defibrillator. PLACEMENT: Anterio -apical placement of external defibrillator electrodes (when defibrillator is unsuccessfull , anterior-posterior placement is also sometimes attemted ).

12. PROCEDURE/TECHNIQUE Articles needed : A cardiac monitor with defibrillation capability or an automated external defibrillator (AED) and Electrodes, paddles, conductive jelly etc. Cardiac arrest patients in VF/VT without a pulse should be defibrillated as soon as possible(even before CPR, medications or advanced airway procedure). Initiate CPR/ACLS protocols until defibrillator available. Power on the defibrillator and select “unsynchronized/defibrillator” mode Turn monitor selector to “paddles” Apply conductive materials before paddle placement. Apply defibrillator monitor cables, pads, or “quick-look” paddles to patient in cardiac arrest to determine rhythm.

13. PADDLES PLACEMENT First sternum paddle : To the right of the upper sternum and below the clavicle. Second apex paddle: To the left of the nipple in the midaxillary line, centered in the 5 th intercostal space. Avoid placing both paddles next to one another on the anterior chest wall. Lead placement “white-on-the-right” “smoke-over-fire” Electrode pad placement . Anterior pad just to the left of the sturnum , and posterior pad on the patients back to the left of the spine.(this technique “sandwiches” the heart between pads).

14. Assess rhythm to confirm VF/VT. Choose energy level and charge defibrillator. Deliver shocks by simultaneously pressing the discharge buttons located on the paddles after ensuring “all clear” from the patient for equipment and providers.

15. NURSING CONSIDERATION Ensure client’s condition by assessing the state of consciousness prior to intervention. Monitor vital signs of the patient especially blood pressure, heart rate and rhythm. Adminiter emergency medications as indicated. Administer antiarrhythmic medications as prescribed. Before defibrillation ensure that the paddles don’t touch with patient clothing and bed linen. Maintain safety to caregivers, since electric current can be conducted from the patient to another individual. Ensure defibrillator is not in synchronized mode. Don’t charge the device until ready to shock.

16. Post Defibrillator care Evaluate neurologic status. Reorient to person,place and time. Evaluate respiratory status. Evaluate cardiovascular status. Initiate IV antidysrhythmic therapy. Monitor for burns. Treat if indicated. Documentation Patient/family education.

17. PRECAUTIONS Check all equipments for proper grounding to prevent current leakage. Disconnect temporary pacemaker and other electrical equipment. Do not defibrillate directly over an implanted pacemaker. Defibrillation may result in damage to equipment.

18. RELATED CARE Support patient and family as necessary after defibrillation. Clear defibrillator of remaining electric current immediately . Support patient with CPR as appropriate. Check possible causes of failure to convert ventricular dysrhythmias . Recognize the following change for pacemaker defibrillation.

19. NEW RESEARCH A study to decrease the death rate of CVD sufferer due to unavailability of electricity in remote areas of the country . Date: 10,Nov 2017. “ Ashish Gawade ” (Director of Jeevtronic,private limited, Pune , Venture centre) Abstract: This low cost life saving device only requires the administrator to power it up in less than 12 sec by rotating a small hand paddle. Background : Developed world’s first hand-cranked defibrillator, which can save cardiac arrest patients without electricity. Objectives : To decrease the death rate of CVD sufferer due to unavailability of electricity in remote areas of the country. Materials and method : surveys and many experiments has been done and the team was inspired by management guru CK Prahalad to develop the device. Results : shows that over 25% of the tested defibrillator fail to work due to battery charge issues or other electrical problems which is a leading cause of death in remote areas. Conclusion : The study concluded that this device reaches the nooks and corner of India where immediate access and affordable lifesaving technology is distant and helps revive many lives. Keywords : defibrillator,CVD .

20. SUMMARY A defibrillator is a medical device that is used to deliver an electrical shock to the heart. The shock is intended to correct irregural electrical activity of the heart and to establish an organized rhythm. Electrodes are used to deliver the electrical shock to the patient.

21. REFERENCE BOOK INTERNET DISCUSSION WITH TEACHER

22. BIBLIOGRAPHY Javed Ansari “A Textbook Of Medical Surgical Nursing 2” PV Publication Page No. 1238 – 1246. BT Basavanthappa “Textbook Of Medical Surgical Nursing” Third Edition, Jaypee Publication page No. 1011 – 1015. www.slideshare.com www.wikipedia.com.