Synchronized Cardioversion

In certain cardiac arrythmias like Unstable supraventricular tachycardia (SVT),Aflutter, A Fib
we need to deliver an electrical shock during the QRS complex with a goal of converting tachy arrhythmias to more stable rhythms.
Synchronized cardioversion is a direct-current synchronized shock .
Explain the procedure If the patient is conscious or the family as the delivery of a small electrical impulse to the heart
Premedicate with sedative and analgesic medications as prescribedCardioversion may be painful and cause anxiety for patients. Sedation increases comfort, decreases anxiety, and may produce amnesia regarding the event.
Continuously monitor hemodynamic status.
Anteroposterior position: The anterior defibrillation electrode is placed over the precordium; the posterior defibrillation electrode is placed behind the heart at the left scapular line, at the inferior angle of the scapula.
So the deference between cardioversion and defibrillation is the timing; defib once we press the buttons the energy will be released but cardioversion will release the energy during R
How will make the machine give cardioversion not defibrillation
Depress the SYNC button to activate the synchronized (“sync”) mode.
Look for markers on the QRS complex indicating that the defibrillator is in sync mode.
Adjust the R wave gain on the monitor to ensure that synchronization markers occur on each QRS complex.
if You are using the paddles Apply a conductive gel
Press firmly to ensure full contact between the paddles and the chest wall.
Joules will be ordered based on the type of arrythmias ,Select desired joules based on arrhythmia in the video 100 J
Perform these steps immediately before delivering the shock:
Charge the defibrillator and state “Clear” loudly.
Visually confirm that no health care team member has direct or indirect contact with the patient.
If oxygen from a face mask or bag mask is blowing directly on the patient’s chest, turn the oxygen device away from the patient’s chest.
Check the cardiac monitor one last time to verify that the patient is still experiencing tachyarrhythmia and that the defibrillator is in sync mode.
Read the message which is written
Deliver a shock by depressing the discharge button until the energy is delivered; this may take several milliseconds as the defibrillator seeks the next R wave. When using paddles, depress both of the discharge buttons simultaneously and hold them down until discharge occurs.
Press and hold until energy delivered
If you need to give another cardioversion ,after each shot it needs to be reset synchronized shock.
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[@zingoringo4656]

جمييل وراضح

[@Duijnkiller]

My left ear is thankful for this video.

[@merohsal4871]

thank you Fadi, I found most of your videos so helpful and easy to understand

[@renamaze]

Thank you!

[@MrRnoOo]

مختصر وكل المعلومات فيه 👏🏼👏🏼👍🏼👍🏼

[@sohairghanem8929]

شكرا علي الشرح

[@islamtoot4187]

Wonderful Fadi, keep it up 👍

[@ahmadqouzah7088]

Amazing 👍🏻

[@user-nx5xj2dq4v]

مبسط و واضح كلام ناس فاهمة

[@user-nx5xj2dq4v]

فنااااااان الشرح اتمنى تكون اديوكيتار بمستشفاك

[@shenekamal6722]

Is anticoagulant mandatory before synchronizing cardioversion????

[@criticalrnskills5326]

Not in the all cases like SVT for example, but if its planned AF usually yes and they will do TEE.

[@alisabobi5324]

استاذ يعني هو الفرق بين cardio veration و ال defibiration

[@criticalrnskills5326]

Cardioversion بيكون اعطاء الكهرباء على R wave