PELATIHAN KEGAWATDARURATAN

KARDIOVASKULAR
FAKULTAS KEDOKTERAN
UNIVERSITAS PRIMA INDONESIA
 Medical technique used to counter the onset of
ventricular fibrillation and pulseless ventricular
tachycardia in cardiac arrrest
In simple terms, the process uses an electric
shock to stop the heart arrhythmias eht ni ,
cimhtyhr htiw tratser lliw traeh eht taht epoh
.snoitcartnoc
Pulseless Ventricular Tachycardia

Wide QRS complex, regular

Wide QRS complex, irregular

The shock is generally conducted
through the heart by two electrodes, in
the form of two hand-held paddles or
adhesive patches depending on the
variety of the defibrillator.
1. Automated External Defibrillator (AED)

External defibrillators are typically used in

hospitals or ambulances, but are increasingly
common outside the medical areas.
As automated external defibrillators become
safer and cheaper .
2. Manual Defibrillator

Biphasic: Manufacturer recommendation (eg.

initial dose of 120200 J): if unknown, use
maximum available. Second and subsequent
doses should be equivalent, and higher doses
may be considered
Monophasic: 360 J
 Cardioversion is a method to restore a rapid
heart beat back to normal.
Cardioversion is used in emergency situations
to correct a rapid abnormal rhythm associated
with faintness, low blood pressure, chest pain,
difficulty breathing, or loss of consciousness.
Cardioversion can be "chemical" or "electrical".

Chemical cardioversion: refers to the use of

antiarrhythmia medications to restore the
heart's normal rhythm.
Electrical cardioversion : a procedure whereby a
synchronized electrical shock is delivered
through the chest wall to the heart through
special electrodes or paddles that are applied to
the skin of the chest and back.
Initial recommended doses:

Narrow regular (SVT) : 50100 J

Narrow irregular (AF) : 120200 J biphasic or
200 J monophasic
Wide regular (VT with pulse) : 100 J
Wide irregular (VF) : Defibrillation dose (not
synchronized)
 Consider sedation if patients are fully alert.
Place paddles so that they do not touch
patients clothing or bed linens or not near
direct oxygen supply.
Ensure monitor is attached to pat.
Do not charge the machine untill ready to
shock.
Ensure you and every body is free of the pat.
Im clear, youre clear, everybodys clear