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Medtronic Lifepak 20 Monitor/Defibrillator with Biphasic Technology
Delivers energy in 2 directions between the quick combo redi-pak pads
The monitor/defibrillator is located on top of the cart. The patient’s cardiac rhythm can be monitored via the quick combo redi-pak or electrode and lead wires. The “lead” button or rotation of the speed dial is utilized to change the ECG lead (“Paddles refers to the quick combo redi-pak pads).
Electrical Intervention
With quick-combo
With the wire:
redi-pak:
Transvenous Defibrillate pacing
Synchronized
Cardioversion
Pacing
Treat the patient not the monitor
Defibrillation
(AED or Manual)
Immediate defibrillation is the most effective therapy for the treatment of ventricular fibrillation and pulseless ventricular tachycardia. Defibrillation delivers an electrical current to the heart to completely depolarize the heart and the impulses that are causing the dysrhythmia are disrupted. The current can be delivered through the chest wall by use of the quick combo redi -pak connected to the defibrillator/monitor for AED or manual mode defibrillation. The Medtronic lifepak in the AED mode delivers joules of 200, 300, and 360 and can only be used in cardiac arrest (unconscious patient, pulseless and not spontaneously breathing). The joules can be changed when in the manual mode. Possible complications of defibrillation include burns and damage to the heart muscle.
Anterior/Posterior Anterio-Apical
Pad Placement Pad Placement
Special Considerations
ICD/Pacemaker: Avoid placing pads directly over the implanted device. Place at least 1 inch away from device.
Water: Remove patient from free-standing water and dry the chest before defibrillation.
Topical medication patches/paste (i.e. nitroglycerine): must be removed before defibrillation.
Synchronized Cardioversion
Cardioversion is similar to defibrillation, except that the delivery of energy is synchronized to occur during ventricular depolarization (QRS complex) to disrupt the rhythm, rather than depolarize the heart. Cardioversion can be performed with a lower energy level of 50 joules. Cardioversion would be utilized in an emergency situation to treat patients with ventricular tachycardia or atrial tachycardia who have a pulse but are symptomatic (hypotension, cool clammy skin and decreased level of consciousness). Elective cardioversion can also be utilized to treat atrial fibrillation and atrial flutter.
The electrodes/lead wires and quik combo redi-pak must both be utilized for synchronized cardioversion
Be sure to sedate the patient before cardioversion
Transcutaneous Cardiac Pacing
Transcutaneous cardiac pacing is a noninvasive Advantages: Disadvantages:
treatment indicated for symptomatic bradycardia (HR
<60), second and third degree heart blocks. Cardiac Easy to May be pacing stimulates the heart with externally applied initiate uncomfortable cutaneous pads that deliver an electrical impulse that is Fast to for the patient conducted through the chest wall to stimulate the myocardium. The lifepak has the transcutaneous initiate pacemaker option for either demand (synchronous) or non-demand (asynchronous) pacing modes. Non-
Demand mode: inhibits pacing when it senses the invasive patients own beats. Non-demand mode: generates pacing impulses at the selected rate regardless of the patients EKG rhythm.
The electrodes/lead wires and quick combo redi-pak must both be utilized for pacing.