Overview
Defibrillation is a procedure used to deliver electrical energy to the heart to terminate life-threatening arrhythmias and restore normal cardiac rhythm.
Defibrillation is crucial for treating ventricular fibrillation and pulseless ventricular tachycardia, which are the most common causes of sudden cardiac death.
Learn more in our comprehensive RxDx Medicine Course
Indications
Chaotic rhythm
Fast rhythm without pulse
No pulse, no breathing
Unstable tachyarrhythmias
Atrial fibrillation/flutter
Contraindications
Absolute Contraindications
Relative Contraindications
📋 Equipment Checklist
Check off items as you gather them:
Pre-procedure Preparation
Preparation includes patient assessment, equipment setup, safety measures, and understanding indications.Step-by-Step Procedure
Step 1: Scene Safety
Ensure scene is safe for all personnel.
⚠️ Common Mistakes to Avoid:
- Unsafe environment
- Poor communication
💡 Pro Tip:
Clear the area and announce shock.
Step 2: Patient Assessment
Assess responsiveness, breathing, pulse.
⚠️ Common Mistakes to Avoid:
- Inadequate assessment
- Missed signs
💡 Pro Tip:
Use ABC approach.
Step 3: Equipment Setup
Prepare defibrillator and apply pads.
⚠️ Common Mistakes to Avoid:
- Poor pad placement
- Equipment failure
💡 Pro Tip:
Use proper pad placement.
Step 4: Rhythm Analysis
Analyze cardiac rhythm.
⚠️ Common Mistakes to Avoid:
- Wrong interpretation
- Delay
💡 Pro Tip:
Minimize hands-off time.
Step 5: Energy Selection
Select appropriate energy level.
⚠️ Common Mistakes to Avoid:
- Wrong energy
- Poor technique
💡 Pro Tip:
Use recommended energy levels.
Step 6: Shock Delivery
Deliver shock and resume CPR.
⚠️ Common Mistakes to Avoid:
- Poor timing
- Inadequate CPR
💡 Pro Tip:
Resume CPR immediately.
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Post-procedure Care
Post-procedure care involves monitoring for rhythm changes, assessing for complications, and continuing resuscitation if needed.Complications & Management
| Complication | Incidence | Signs | Management | Prevention |
|---|---|---|---|---|
| Burns | 1-3% | Skin burns at pad sites | Wound care | Proper pad placement |
| Myocardial injury | 1-2% | Elevated troponins | Monitoring | Appropriate energy |
| Arrhythmias | 2-5% | New arrhythmias | Antiarrhythmics | Proper technique |
| Pulmonary edema | 1-2% | Dyspnea, crackles | Diuretics, oxygen | Monitor post-shock |
Clinical Pearls
Minimize hands-off time during CPR.
Use proper pad placement.
Follow ACLS guidelines.
Analyze rhythm properly.
Monitor for complications.
Ensure scene safety.
Resume CPR immediately after shock.