Defibrillator ppt.pptx

its device used for life saving procedure

1. Guided by Dr.Anjalatchi Vice principal Era college of Nursing Safrazganj Lucknow 226003 Prepared by MISS ARTI CHAUDHARI PBBSC NURSING 2 nd YEAR Era college of Nursing Sarfrazganj Lucknow 226003 DEFIBRILATOR

2. Definition of defibrillator Purpose of defibrillator Principle of defibrillator Power of defibrillator Defibrillator electrodes Types of defibrillator Indication of defibrillator Contraindication of defibrillator Electrode position Equipment of defibrillator Procedure of defibrillator Nursing management Summary Conclusion References CO NTENT

3. A defibrillator is a device that provides an electric shock to your heart to allow it to get out of a potentially fatal abnormal heart rhythm, or arrhythmia, —  ventricular tachycardia  (with no pulse) or  ventricular fibrillation  — and back to a normal rhythm. Both of these arrhythmias happen in your heart’s ventricles or lower chambers. What is a defibrillator?

4. DEFIBRILATOR

5. Defibrilator 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 . DEFINITION

6. Defibrillator is performed to correct life threatening fibrillation of the heart , which could result in cardiac arrest . It should be performed immediately after identifying that the patient is experiencing a cardiac emergency , has no pulse , and is unresponsive . PURPOSE

7. While cardiopulmonary resuscitation ( CPR ) provides temporary assistance, a defibrillator can help you survive sudden  cardiac arrest . You can even use a defibrillator if someone already has a pacemaker or implantable cardioverter defibrillator (ICD). Why is a defibrillator used?

8. Energy storage capacitor is charged at relatively slow rate from AC line . Energy stored in capacitor is then delivered at a relatively rapid rate to chest of the patient. Simple arrangement involve the discharge of capacitor energy through the patient’s own resistance . The discharge resistance which the patient represents as purely ohmic resistance of 50 to 100ohm approximately for a typical electrode size of 80 cm2. This particular wave form fig is called ‘ Lown ’ waveform. The pulse width of this waveform is generally 10 ms . PRINCIPLE OF DEFIBRILATOR

9. Higher voltages are required for external defibrillation than for internal defibrillation . A corrective talk of 750 to 800 volts is applied within a 10 of a second . That is the same voltage as 500 to 533 number of AA batteries ! POWER OF DEFIBRILLATION

10. On a biphasic defibrillator, this is usually between 120 joules to 200 joules . On a monophasic defibrillator, this is usually 360 joules. How many joules is a defibrillator?

11. Spoon shaped electrode Applied directly to he electrode . Paddle type electrode Applied against the chest wall Pad type electrode Applied directly on chest wall DEFIBRILLATOR ELECTRODES

12. Internal defibrillator -Electrodes placed directly to the heart . example- pacemaker External defibrillator- Electrodes placed directly on the heart . example - AED TYPES OF DEFIBRILATORS

13. Two types of defibrillators are showing below. AC defibrillators DC defibrillators

14. An AC defibrillator is the oldest and simplest type. The construction of AC defibrillator is such that appropriate values are available for internal and external defibrillation. In AC defibrillation, a shock of 50 Hz a.c frequency is applied to the chest for a time of 0.25 to 1 second through electrodes. The procedure of applying electric shock to resynchronize heart is known as Countershock . AC Defibrillators

15. DC defibrillator does not produce side effects and produces normal heartbeat. Ventricular fibrillation is avoided when high-energy shock is passed through discharging capacitor that is exposed to heart or chest of the patient. DC defibrillator consists of auto transformer T 1 that acts as primary of the high voltage transformer T 2 . DC defibrillator

16. An AED, or automated external defibrillator, is used to help those experiencing sudden cardiac arrest . It's a sophisticated, yet easy-to-use, medical device that can analyze the heart's rhythm and, if necessary, deliver an electrical shock, or defibrillation, to help the heart re-establish an effective rhythm. What is AED

17. Different types

18. Pulseless ventricular tachycardia . Ventricular fibrillation What are the 4 shockable rhythms? The two shockable rhythms are ventricular fibrillation (VF) and pulseless ventricular tachycardia (VT) while the non–shockable rhythms include sinus rhythm (SR), supraventricular tachycardia (SVT), premature ventricualr contraction (PVC), atrial fibrilation (AF) and so on. INDICATION   Function Component In Defibrillator The electrodes send information about the person's heart rhythm to a computer  in the AED. The computer analyzes the heart rhythm to find out whether an electric shock is needed. If it is needed, the electrodes deliver the shock .

19. Patient who are conscious or have a pulse . Non shockable rhythm – asystole , pulseless ,electrical activity. Multifocal atrial tachycardia . Dysrhythmia due to enhanced automaticity such as digitalis toxicity . CONTRAINDICATION

20. Sterno apical position Anterior posterior position BI- Axillary position ELECTRODE POSITION

21. Defibrillator with paddle or adhesive patches Conductive gel ECG monitor with recorder Oxygen supply Incubation kit Multi para monitor – BP,Pulse,Spo2 Intravenous access Suction device Code cart with ACLS medication EQUIPMENT’S

22. Confirm cardiac arrest – check for signs life. CPR should be on going . Turn the defibrillator on . Stop chest compression confirm VT (Ventricular tachycardia) from the ECG. Squeeze generous amount of jelly on the defibrillator paddles . PROCEDURE

23. The designated person select the appropriate energy on the defibrillator . 150-200 jule for biphasic defibrillator and 150-360 J for monophasic defibrillator . Press ‘ charge’button to charge the capacitor. While the defibrillator is charging ,warn all rescuers other then the individual performing the chest compressions to ‘stand clear ‘ and remove any oxygen delivery device as appropriate . Once the defibrillator is charged , tell the rescuer doing the chest compression to “ Stand clear “ . When clear , discharge the current by pressing both paddle of discharge buttons sinultaneously .Give shock . To examing the patients ECG to see whether debifrillation as altered the patients condition and restored the normal rhythm. Continue CPR for 2 minutes . If desired outcome is not restored , defibillate again following same procedure . Perform the 3 counter shocks in rapid succession .

24. If the patient no pulse after 3 initial defibrillation . Resume CPR . Give supplemental oxygen . Begin administrating epine phrine and switch to non shockable algorithm If further defibrillation is unnecessary ,discharge the machine by turning off . Once machine if discharge , clean the paddles /making sure to remove conductive jelly . Any jelly remains the patients level of status . Obtain baseline data / ABG levels and 12 lead ECG. Provide supplemental oxygen ventilation . Document the procedure .

25. The benefit of AED

26. A defibrillator can save your life if it’s used for the correct arrhythmia and it’s done within 10 minutes after the abnormal rhythm starts. advantages of a defibrillator?

27. A defibrillator needs to be used for ventricular tachycardia (without a pulse) or for ventricular fibrillation. If you use it for any other kind of arrhythmia, it could give someone ventricular fibrillation and cardiac arrest. risks or complications of a defibrillator?

28. Monitor cardiovascular status Monitor respiratory status Monitor neurologic status Initiate IV antiarrythmic therapy Monitor for burns Documentation Patient /family education NURSING MANAGEMENT

29. Wipe the defibrillator and case over thoroughly with an antibacterial cleansing wipe . Once it's clean, check there is no obvious damage and see if the battery/self-test indicator is still showing OK as per the manufacturer's instructions . If the battery needs to be replaced, follow the manufacturer's instructions. Cleaning of defibrillator

30. Pads, Paddle, and Accessories Cleaning Step 1:  For the conventional defibrillators, use  pre-saturated alcohol wipes  to clean the surface of the paddle and the other accessories. This is a routine step that should be performed after each usage. For the pads of AED, check whether the pads are expired. Standard expiration is 2 years from the manufacturing date. Pads determine how many joules will be delivered to the patient; if the pads have expired, the adhesive may not ensure a good connection and it might fail to operate normally. Step 2:  Use a  dry microfiber cloth  or alcohol wipes to clean the display and overall appearance of the machine. Step 3:  Power off the defibrillator. Use  aerosol contact cleaners  to clean the connectors and connection ports. Insert the extension tube into the actuator to remove soil from tight areas. Allow the solvent to evaporate before reenergizing the equipment. Disinfectant of defibrillator

31. Keep Your AED Properly Maintained Place your AED in a visible and unobstructed location. Verify the battery installation is correct. Check the status / service indicator light. Note the absence of the visual/ audio service alarm. Inspect exterior components and sockets for cracks . Confirm that you have two sets of sealed AED pads that have not expired Keep accurate records and replace the AED battery as recommended for your particular device Refer to the manufacturer manual for more information and proper maintenance procedures for your particular device How do you maintain a defibrillator?

32. Clean the devices as per disinfectant advices Disinfect the devices Keep cover the devices appropriate Store away from rat, mouse etc Avoid dry, moisture , leaking area to store Maintain appropriate temperature Storage of defibrillator

33. The lifespans of different defib units vary from model to model. Most AEDs will be supplied with warranties spanning from 5 to 10 years but the actual life expectancy of most defib units will be 10 years. What is the life of a defibrillator?

34. Define defibrillator ? Purpose of defibrillator? What is the joules for defibrillator ? Which area pad has to keep for shocks? What are the indication for shock? Question related topic ?

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