Standards Procedure (Skill)
Clinical Indications: Level: EMT-P only
Ø Cardiac arrest patient with ventricular fibrillation or pulseless ventricular tachycardia present
Procedure:
a. Clinically confirm the diagnosis of cardiac arrest and identify the need for defibrillation.
b. After application of an appropriate conductive medium as necessary, apply paddles or hands-free pads to the patient’s chest in the proper position (right of sternum at 2nd ICS and anterior axillary line at 5th ICS).
c. Set the appropriate energy level (adult—200,300,360 joules; pediatrics—2 joules/kg, 4joules/kg, 4 joules/kg) for monophasic devices.
d. Charge the defibrillator to the selected energy level.
e. Assure proper placement of the paddles or pads.
f. Assure proper contact by applying 25 pounds of pressure on each paddle or make sure fast patch pads have good skin contact.
g. Assertively state “Clear” and visualize that no one, including you, is in contact with the patient.
h. Deliver the counter shock by depressing the discharge button(s) when using paddles, or depress the shock button(s) for hands-free operation.
i. Assess the patient’s response and the ECG rhythm and repeat if necessary at the indicated energy settings.
j. Document the procedure, response and time on the ACR.
Certification Requirements:
Successfully complete an annual skill evaluation including the indications, contraindications, technique, and possible complications of the procedure.