Defibrillation Process: Step-by-Step Guide on Using the Defibrillator Function

Defibrillation is a critical procedure for treating life-threatening cardiac dysrhythmias such as ventricular fibrillation (VF) and pulseless ventricular tachycardia (VT). Using the defibrillator function of the X Series Advanced involves specific steps that ensure the safety and effectiveness of the treatment. Below is a detailed, step-by-step guide based on the Queensland Ambulance Service (QAS) guidelines and the features of the X Series Advanced.

Preparation for Defibrillation

Ensure Safety:

• • Confirm that the environment is safe for defibrillation (non-conductive, non-explosive, and no-contact).
  • Ensure that the patient and others are not in contact with conductive materials not involved in the delivery of care.

Patient Preparation:

• • Expose the patient's chest and ensure it is dry. Shave the area if covered with excessive hair to ensure good contact with the pads.
  • Remove any jewelry or metal objects in the vicinity of the chest.

Equipment Setup:

• • Turn on the X Series Advanced by pressing the power button.
  • Ensure the defibrillator is set to the correct mode (manual or AED as required).

Attaching Electrodes

Position Defibrillation Electrodes:

• • Place the anterior-lateral pads as follows: the anterior pad just below the clavicle to the right of the sternum, and the lateral pad on the left mid-axillary line below the apex of the heart.
  • For pediatric patients or small adults, consider using an anterior-posterior placement if standard placements overlap.

Setting Energy Levels

Select Energy Level:

• • For adult patients, the initial shock should be set to 200 J. Subsequent shocks may follow escalating energy protocols if the first shock is unsuccessful.
  • Adjust the energy level using the 'Select Energy' button on the X Series Advanced.

Charging and Delivering the Shock

Charge the Device:

• • Press the 'Charge' button. Ensure all personnel are clear of contact with the patient and the bed.
  • The device will indicate when it is fully charged.

Deliver the Shock:

• • Ensure everyone is clear of the patient. Confirm verbally "All clear?"
  • Press and hold the 'Shock' button to deliver the shock.

Post-Shock Procedures

Assess Patient Response:

• • Immediately re-assess the patient's rhythm. If VF/VT persists, prepare for subsequent shocks following the same procedure.
  • If a non-shockable rhythm is detected or there is a return of spontaneous circulation (ROSC), proceed with post-resuscitation care.

Continuous Monitoring:

• • Continue to monitor the patient closely. Provide post-cardiac arrest care according to current Advanced Cardiac Life Support (ACLS) guidelines.

Documentation

• Document the entire procedure, including the time of the shock, energy levels used, patient's response, and any changes in patient condition.

Following these detailed steps ensures that defibrillation performed with the X Series Advanced is carried out safely and effectively, adhering to best practices and clinical guidelines. Please consult with the QAS CPM and relevant CPG's for up to date and accurate information. Queensland Ambulance Service - Clinical guidelines