***Critical
Performance Elements
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| COMPETENCY
STATEMENT: Provides care for the patient
requiring defibrillation. |
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| 1. Identifies
the indications for defibrillation. Performs
initial assessment IAW AHA standards. |
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| 2. Assembles the
necessary equipment for defibrillation. |
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| 3. Prepares
patient and paddles with proper conductive medium. |
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1.
Turns power "ON" defibrillator.
Defaults to 200 joules.
a. Set
"lead select" to "paddles"
for quick look.
b. *** If other than
200 joules is desired, presses "ENERGY
SELECT" and selects the energy desired.
c. *** Presses "CHARGE"
on defibrillator front panel or on the Apex
paddle. Wait until the indicator stops flashing
to indicate fully charged.
d.
Checks that defibrillator is in nonsynchronized
mode.
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| 5. Turns on ECG
recorder for continuous printout. |
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| 6. Applies 25lbs/square
inch pressure to paddles. |
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| 7. *** States "all
clear"" and visually checks that all
personnel are clear of contact with bed, patient
and equipment. |
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| 8.
*** Checks rhythm
immediately before discharge. |
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| 9. Depresses
both buttons simultaneously and maintains
pressure until electrical current delivered. |
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| 10. ***
Assesses for
conversion of cardiac rhythm. |
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| 11. If
unquestionable VF/VT remains, immediately repeats
steps 1 through 8 @ 300 joules avoiding any
delays. If there is any question about the
rhythm, check for pulse. |
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| 12. After 2nd
defibrillation, if unquestionable VF/VT remains,
immediately repeats steps 1 through 8 @ 360
joules avoiding any delays. If there is any doubt
about the rhythm, check for pulse. |
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| 13. If 3rd
defibrillation is unsuccessful, continues BCLS
and initiates ACLS protocols. Assesses patient
status and precipitating factors to prevent
further decompensation of patient. |
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| 14. Cleans
defibrillator and paddles, discards supplies, and
washes hands. |
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| 15. Documents
procedure in patient record or cardiac arrest
flowsheet. |
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| 16. Verbalizes
post-defibrillation nursing care. |
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| *** = Must performs
these critical elements for successful completion.
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| NOTE:
Joules should be adjusted to 2joules/Kg for
children. Also please remember to convert to
pediatric paddles for children. |
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