CARDIOVERSION AND DEFIBRILLATION

Cardioversion - is the synchronous application of an electrical shock of short duration to the heart through the use of chest paddles.

• It is done to convert cardiac dysrhythmia (other than ventricular fibrillation) into a more hemodynamically stable, sinus rhythm.
• Electric shock is applied during the R wave, never on the T wave.

Defibrillation - is unsynchronized passing of an electric shock of short duration through the heart to terminate ventricular fibrillation or ventricular tachycardia without pulse.

Nursing Interventions during Cardioversion and Defibrillation:

1. Place the client in a flat, firm surface.
2. Apply interface material (gel, paste, saline pads) to the paddles.
3. Grasp the paddles only by the insulated handles. To prevent electrocution.
4. Give command for personnel to STAND CLEAR of the client and the bed.
5. Apply the chest paddle as follows: one at the right of the sternum, third ICS, and the other one on the left mid axillary, fifth ICS.
6. Push the discharge button in both paddles simultaneously.
7. For defibrillation, release 200 to 360 watts/s. (Joules); for cardioversion low energy is required.
8. Defibrillation is done before initiating CPR.