![]() In the United States, many advanced EMTs and all paramedics are trained to recognize lethal arrhythmias and deliver appropriate electrical therapy with a manual defibrillator when appropriate. For instance, every NHS ambulance in the United Kingdom is equipped with a manual defibrillator for use by the attending paramedics and technicians. These units are primarily found in hospitals and on some ambulances. ![]() A healthcare provider first diagnoses the cardiac rhythm and then manually determine the voltage and timing for the electrical shock. They are used in conjunction with an electrocardiogram, which can be separate or built-in. Manual external defibrillators require the expertise of a healthcare professional. ( August 2014) ( Learn how and when to remove this template message) Unsourced material may be challenged and removed. Please help improve this article by adding citations to reliable sources in this section. This section needs additional citations for verification. Compared to people presenting with a non-shockable rhythm (such as asystole or PEA), people with a shockable rhythm (such as VF or pulseless ventricular tachycardia) have improved survival rates, ranging between 21 and 50%. Within the group of people presenting with cardiac arrest, the specific cardiac rhythm can significantly impact survival rates. Outcome for in-hospital cardiac arrests are higher at 20%. Survival rates for out-of-hospital cardiac arrests are poor, often less than 10%. There also exist written instructions of defibrillators that explain the procedure step-by-step. That is possible because the machine produces pre-recorded voice instructions that guide to the user, and automatically checks the patient's condition and applies the correct electric shocks. The defibrillation device that is usually available out of the medical centers is the automated external defibrillator (AED), a portable machine that can be used even by users with no previous training. Improperly given electrical shocks can cause dangerous dysrhythmias, such as ventricular fibrillation. Defibrillation is also not indicated if the patient is conscious or has a pulse. ![]() If the heart has completely stopped, as in asystole or pulseless electrical activity (PEA), defibrillation is not indicated. Defibrillation is indicated only in certain types of cardiac dysrhythmias, specifically ventricular fibrillation (VF) and pulseless ventricular tachycardia. CPR is an algorithm-based intervention aimed to restore cardiac and pulmonary function. Use of defibrillators Indications ĭefibrillation is often an important step in cardiopulmonary resuscitation (CPR). Some external units, known as automated external defibrillators (AEDs), automate the diagnosis of treatable rhythms, meaning that lay responders or bystanders are able to use them successfully with little or no training. ĭefibrillators can be external, transvenous, or implanted ( implantable cardioverter-defibrillator), depending on the type of device used or needed. ![]() Although the person may still be critically ill, cardioversion normally aims to end poorly perfusing cardiac arrhythmias, such as supraventricular tachycardia. In contrast to defibrillation, synchronized electrical cardioversion is an electrical shock delivered in synchrony to the cardiac cycle. Like this asystole sometimes converts into a shockable rhythm, which can be treated by cardioversion or defibrillation. A heart which is in asystole (flatline) cannot be restarted by a defibrillator, but would be treated only by cardiopulmonary resuscitation (CPR) and medication. Subsequently, the body's natural pacemaker in the sinoatrial node of the heart is able to re-establish normal sinus rhythm. Although not fully understood, this process depolarizes a large amount of the heart muscle, ending the arrhythmia. A defibrillator delivers a dose of electric current (often called a counter-shock) to the heart. Defibrillation is a treatment for life-threatening cardiac arrhythmias, specifically ventricular fibrillation (V-Fib) and non-perfusing ventricular tachycardia (V-Tach).
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