Instructions for use
PRIMEDIC
™
Defi-Monitor ECO 1 / DM 1 / DM 3
19499 / 05.03
105
7. Select
energy.
The energies required for synchronized cardioversion are in most cases lower than for
defibrillation (unsynchronized cardioversion) as it is not necessary to depolarize all heart
muscles.
The energy depends roughly on the patient's body height and weight. The indications, however,
determine the energy, i. e. the following empirical values are applicable:
Ventricular tachycardia with unstable pulse: 50 joule, further cardioversions to be increased by
approx. 50 joule each (100 j, 160 j, 200 j, ...)
Supraventricular tachycardia:
50-100 joule
Atrial
flutter:
20-50
joule
Atrial
fibrillation:
100
joule
If ventricular fibrillation arises from the treatment immediate defibrillation in asynchronous mode
at adjusted and higher energy is necessary.
8.
Positioning of the paddles.
Stick the paddles firmly to the bare chest of the patient by applying a pressure of approx. 100 N
to ensure perfect energy transfer. Applying not enough pressure may cause that the skin under
the electrodes gets burnt.
The position of the paddles decides on the success of the resuscitation. The flow of current
between the paddles through the chest has to flow through a large part of the tissue of the
heart muscle. The change to eliminate the ventricular fibrillation only exists when the "critical
mass" of about 80 % of the heart is perfused sufficiently.
In case of incorrect paddle position most of the current misses the heart and is thus ineffective.
Position of the sternum paddle:
- right chest area
- right close to sternum
- below the clavicle
Position of the apex paddle:
- left, lower chest area
- above apex of the heart
- midaxillary line
Make sure that no electrode gel has been spread between the paddles on the patient's chest.
Otherwise the current flows on the surface between the paddles. Do not spread the electrode
gel on the handles of the paddles, otherwise energy may flash over to the doctor in charge.
9. Energy
charging
After charging the energy remains available for a certain time, i. e. 15 seconds with the
PRIMEDIC
™
Defi-Monitor
. This time is also shown on the monitor and counted down in steps
of seconds. If no shock is released during this time the energy is discharged internally for safety
reasons and has to be recharged afterwards.
10. Check ECG signal.
See item 5.