The document discusses defibrillators, which are medical devices used to deliver electric shocks to the heart to correct irregular heart rhythms like ventricular fibrillation. It defines different types of defibrillators, including manual external defibrillators, automated external defibrillators (AEDs), implantable cardioverter defibrillators, and wearable cardiac defibrillators. The document also outlines the procedures for using defibrillators, important nursing considerations, post-defibrillation care, and precautions.

1. DEFIBRILLATOR
 SUBMITTED TO:
Mrs. Mamta Toppo
Subject Coordinator
College of Nursing
RIMS, RANCHI
 SUBMITTED BY:
Chandra Tamang
Roll No. 05
Basic Bsc Nursing
3rd year
College of nursing
RIMS, RANCHI

2. CONTENT
 Introduction
 Definition
 Types of defibrillator
 Procedure/Technique
 Checklist
 Nursing consideration
 Post defibrillation care
 Precautions
 Related care
 New research
 Summary
 Reference
 Bibliography

3. INTRODUCTION
Defibrillation is the definitive treatment for the life-
threatening cardiac arrhythmias, ventricular
fibrillation and pulseless ventricular tachycardia.
Defibrillation consists of delivering a therapeutic dose
of electrical energy to the affected heart with a device
called a defibrillator. This depolarizes a critical mass of
the heart muscle, terminates the arrhythmia, and
allows normal sinus rhythm to be restablished by the
body’s natural pacemaker, in the sinoartrial node of
the heart.

4. DEFINITION
Defibrillator is an apparatus used to counteract
atrial or ventricular fibrillation by application of
brief electric shock to the heart.
An electrical device used to counteract fibrillation
of the heart muscle and restore normal heartbeat
by applying a brief electric shock.

5. TYPES OF DEFIBRILLATOR
Manual external defibrillator
Manual internal defibrillator
Automated external defibrillator
Semi-automated external defibrillator
Implantable cardioverter defibrillator
Wearable cardiac defibrillator

6. MANNUAL EXTERNAL DEFIBRILLATOR

7. Manual external defibrillator
An device life support medical device that monitors
the heart rhythm and allow the user to manually set
the energy delivery and deliver a shock.
The units are used in conjunction with (or more often
have inbuilt) electrocardiogram readers, which the
healthcare provider uses to diagnose a cardiac
condition (most often fibrillation or tachycardia
although there are some other rhythms which can be
treated by different shocks).

8. Manual internal defibrillator
• The electric charge is usually pumped in by
internal paddles in close or direct contact
with the heart.
• They are virtually identical to the external
version.
• These device are mainly used in operating
theatres, where the chest can be opened or
being treated by a surgeon.

9. AUTOMATED EXTERNAL DEFIBRILLATOR
(AED)
An automated external defibrillator is a portable electronic
device that automatically diagnoses the life-threatening
cardiac arrhythmias of ventricular fibrillation and pulseless
ventricular tachycardia, and able to treat them through
defibrillation, the application of electricity which stops the
arrhythmia, allowing the heart to re-establish an effective
rhythm
Automated external defibrillators are generally either held
by trained personnel who will attend incident,or are public
access units which can be found in places including
corporates government offices, shopping centres, airport
etc.

12. Implantable cardioverter
Defibrillator
 Implantable cardioverter defibrillator also known as
automatic internal cardiac defibrillator (AICD).
 These devices are implants, similar
to pacemaker.
 They constantly monitor the patients
heart rhythm, and automatically
administer shocks for various life
threatening arrhythmias, according
to the device programming.

13. Wearable Cardiac Defibrillator
 It is a portable external defibrillator that is worn like
vest.
 The unit monitors the patient 24 hours a day and will
automatically deliver a biphasic shock if needed.
 This device is mainly indicated in patients awaiting an
implantable defibrillator.
PLACEMENT: Anterio-apical placement of external
defibrillator electrodes (when defibrillator is
unsuccessfull, anterior-posterior placement is also
sometimes attemted).

15. PROCEDURE/TECHNIQUE
Articles needed: A cardiac monitor with defibrillation
capability or an automated external defibrillator (AED)
and
Electrodes, paddles, conductive jelly etc.
 Cardiac arrest patients in VF/VT without a pulse should be
defibrillated as soon as possible(even before CPR,
medications or advanced airway procedure).
 Initiate CPR/ACLS protocols until defibrillator available.
 Power on the defibrillator and select
“unsynchronized/defibrillator” mode
 Turn monitor selector to “paddles”
 Apply conductive materials before paddle placement.
 Apply defibrillator monitor cables, pads, or “quick-look”
paddles to patient in cardiac arrest to determine rhythm.

16.  PADDLES PLACEMENT
First sternum paddle : To the right of the upper
sternum and below the clavicle.
 Second apex paddle: To the left of the nipple in the
midaxillary line, centered in the 5th intercostal space.
 Avoid placing both paddles next to one another on the
anterior chest wall.
 Lead placement
“white-on-the-right”
“smoke-over-fire”
Electrode pad placement.
 Anterior pad just to the left of the sturnum, and
posterior pad on the patients back to the left of the
spine.(this technique “sandwiches” the heart between
pads).

17.  Assess rhythm to confirm VF/VT.
 Choose energy level and charge defibrillator.
 Deliver shocks by simultaneously pressing the
discharge buttons located on the paddles after
ensuring “all clear” from the patient for equipment
and providers.

20. NURSING CONSIDERATION
Ensure client’s condition by assessing the state of
consciousness prior to intervention.
Monitor vital signs of the patient especially blood pressure,
heart rate and rhythm.
Adminiter emergency medications as indicated.
Administer antiarrhythmic medications as prescribed.
Before defibrillation ensure that the paddles don’t touch
with patient clothing and bed linen.
Maintain safety to caregivers, since electric current can be
conducted from the patient to another individual.
Ensure defibrillator is not in synchronized mode.
Don’t charge the device until ready to shock.

21. Post Defibrillator care
 Evaluate neurologic status. Reorient to person,place
and time.
 Evaluate respiratory status.
 Evaluate cardiovascular status.
 Initiate IV antidysrhythmic therapy.
 Monitor for burns. Treat if indicated.
 Documentation
 Patient/family education.

22. PRECAUTIONS
 Check all equipments for proper grounding to prevent
current leakage.
 Disconnect temporary pacemaker and other electrical
equipment.
 Do not defibrillate directly over an implanted
pacemaker. Defibrillation may result in damage to
equipment.

23. RELATED CARE
 Support patient and family as necessary after
defibrillation.
 Clear defibrillator of remaining electric current
immediately .
 Support patient with CPR as appropriate.
 Check possible causes of failure to convert ventricular
dysrhythmias.
 Recognize the following change for pacemaker
defibrillation.

24. NEW RESEARCH
A study to decrease the death rate of CVD sufferer due to
unavailability of electricity in remote areas of the country.
Date: 10,Nov 2017. “ Ashish Gawade”
(Director of Jeevtronic,private limited, Pune, Venture centre)
Abstract: This low cost life saving device only requires the
administrator to power it up in less than 12 sec by rotating a
small hand paddle.
Background: Developed world’s first hand-cranked defibrillator,
which can save cardiac arrest patients without electricity.
Objectives: To decrease the death rate of CVD sufferer due to
unavailability of electricity in remote areas of the country.
Materials and method: surveys and many experiments has been
done and the team was inspired by management guru CK
Prahalad to develop the device.
Results: shows that over 25% of the tested defibrillator fail to work
due to battery charge issues or other electrical problems which is
a leading cause of death in remote areas.
Conclusion: The study concluded that this device reaches the
nooks and corner of India where immediate access and
affordable lifesaving technology is distant and helps revive many
lives.

25. SUMMARY
A defibrillator is a medical device that is used to
deliver an electrical shock to the heart. The shock is
intended to correct irregural electrical activity of the
heart and to establish an organized rhythm.
Electrodes are used to deliver the electrical shock to
the patient.

26. REFERENCE
 BOOK
 INTERNET
 DISCUSSION WITH TEACHER

27. BIBLIOGRAPHY
 Javed Ansari “A Textbook Of Medical Surgical Nursing
2” PV Publication Page No. 1238 – 1246.
• BT Basavanthappa “Textbook Of Medical Surgical
Nursing” Third Edition, Jaypee Publication
page No. 1011 – 1015.
• www.slideshare.com
• www.wikipedia.com.