If the patient is pulseless, or if the patient is unstable and the defibrillator will not synchronize, use (HIGH ENERGY) unsynchronized cardioversion (defibrillation). Unsynchronized cardioversion (defibrillation) is used when there is no coordinated intrinsic electrical activity in the heart (pulseless VT/VF) or the defibrillator fails to synchronize in an unstable patient.įor cases where electrical shock is needed, if the patient is unstable, and you can see a QRS-t complex use (LOW ENERGY) synchronized cardioversion. This means that the shock may fall randomly anywhere within the cardiac cycle (QRS complex). These results suggest that patients with cardiac arrest who develop VF during the course of treatment for initially observed pulseless electrical activity or. Unsynchronized cardioversion (defibrillation) is a HIGH ENERGY shock which is delivered as soon as the shock button is pushed on a defibrillator. For cases where electrical shock is needed, if the patient is unstable, and you can see a QRS-t complex use (LOW ENERGY) synchronized cardioversion. If medications fail in the stable patient with the before mentioned arrhythmias, synchronized cardioversion will most likely be indicated. The most common indications for synchronized cardioversion are unstable atrial fibrillation, atrial flutter, atrial tachycardia, and supraventricular tachycardias. If the shock occurs on the t-wave (during repolarization), there is a high likelihood that the shock can precipitate VF (Ventricular Fibrillation). Cardiac arrest can be associated with ventricular fibrillation, pulseless ventricular tachycardia, asystole, and pulseless electrical activity. Since very fine ventricular fibrillation can be confused with asystole, different leads should be examined to determine the exact rhythm. VF uniformly develops after ischemic PEA in the absence of preconditioning. Only ventricular fibrillation and ventricular tachycardia are shockable rhythms. Prearrest left ventricular (LV) function is a major factor for initial cardiac arrest rhythm during acute coronary occlusion. Pseudo-PEA is a profound state of cardiogenic shock that is inadequate to maintain perfusion pressure (and thus a nondetectable pulse). Synchronization avoids the delivery of a LOW ENERGY shock during cardiac repolarization (t-wave). Ventricular fibrillation (VF) vs pulseless electrical activity (PEA) as the initial cardiac arrest rhythm. This occurs so that the shock can be delivered with or just after the peak of the R-wave in the patients QRS complex. During this delay, the machine reads and synchronizes with the patients ECG rhythm. When the “sync” option is engaged on a defibrillator and the shock button pushed, there will be a delay in the shock. Synchronized cardioversion is a LOW ENERGY SHOCK that uses a sensor to deliver electricity that is synchronized with the peak of the QRS complex (the highest point of the R-wave). Ever wondered what the difference between synchronized and unsynchronized cardioversion is?
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