Clinical Indications:

 

• Patients with symptomatic tachycardia (usually greater than 150 per minute) with signs and symptoms of inadequate cerebral or cardiac perfusion such as:
  • Chest Pain
  • Hypotension
  • SOB
  • Alterreted mental status, confusion, etc.
  • Dizziness

 

Procedure:

 

1. Attach standard 4-Lead monitor
2. Consider the use of sedation or analgesia if patient is uncomfortable.
3. Apply defibrillation/pacing pads to right upper chest and left lower chest as indicated by picture on pads.
4. Select synchronize option on monitor
5. Set appropriate energy setting for an adult and pediatric indicated by appropriate protocol.
6. Note that you have R wave capture on EKG screen.
7. Select charge on the monitor.
8. Once the monitor has charged to the appropriate energy setting clear the patient. Hold and press the shock button until shock delivered. Ensure you have R wave capture prior to shock.
9. After shock has delivered check for rhythm conversion and assess vital signs.
10. Consider increasing energy setting if initial attempt is unsuccessful per protocol.
11. Document the dysrhythmia and the response to cardioversion with EKG strips in the patient care report (PCR).

 

Certification Requirements:

 

• Maintain knowledge of the indications, contraindications technique, and possible complications of the procedure.  Assessment of this knowledge may be accomplished via quality assurance mechanisms, classroom demonstrations, skills stations or other mechanisms as deemed appropriate by medical control.  Assessment should include direct observation at least once per certification cycle.