Synchronized Cardioversion
1. Presses ON.
2. Attaches patient ECG cable and ECG electrodes.
3. Selects Lead II or lead with greatest QRS complex
amplitude (positive or negative). If using therapy
electrodes, places the electrodes in anterior-lateral
position and select PADDLES lead.
4. Presses SYNC.
5. Observes the ECG rhythm and confirms that a triangle
sense marker (t) appears near the middle of each
QRS complex.
6. Connects the therapy electrodes to the therapy cable
and confirms cable connection to the defibrillator.
7. Prepares patient’s skin:
• Bares patient’s chest.
• Removes excessive chest hair.
• Wipes skin clean and dry.
• Briskly wipes the skin with a towel or gauze.
• Ensures alcohol, benzoin and antiperspirant
are not used on skin sites.
8. Applies therapy electrodes or standard paddles to patient
in the anterior-lateral position:
• Places the ♥ therapy electrode or APEX paddle lateral
to the patient's left nipple in the midaxillary line, with
the center of the electrode in the midaxillary line. If
using standard paddles, applies conductive gel prior to
placing on skin.
• Places the other therapy electrode or STERNUM
paddle on the patient’s upper right torso, lateral to the
sternum and below the clavicle.
Optional: Applies therapy electrodes in the anterior-posterior position.
9. Presses ENERGY SELECT or rotates the SPEED DIAL to
select the desired energy. On the standard (hard) paddles,
rotates the ENERGY SELECT dial.
10. Presses CHARGE.
11. Makes certain all personnel, including the operator, stand
clear of the patient, stretcher, bed, and any equipment
connected to the patient.
12. Presses and holds the (SHOCK) button on the
defibrillator until the ENERGY DELIVERED message
appears on the screen. For standard paddles, presses
and holds both (SHOCK) buttons on the paddles
simultaneously until the ENERGY DELIVERED
message appears on the screen. Releases buttons.
13. Cancel (Optional): Presses SPEED DIAL to cancel charge.
14. Observes patient and ECG rhythm. Repeats procedure
starting from Step 4, if necessary.