Book contents
- Intensive Care Medicine
- Intensive Care Medicine
- Copyright page
- Dedication
- Dedication
- Epigraph
- Contents
- Contributors
- Preface
- Foreword
- Abbreviations
- Section 1 Resuscitation and Management of the Acutely Ill Patient
- Section 2 Diagnosis, Assessment, Investigation, Monitoring and Data Interpretation
- Domain 3 Disease Management: Recognition, Causes and Management
- Section 4 Therapeutic Interventions and Organ Support
- Domain 5 Practical Procedures
- Introduction
- Classification of Devices
- Fixed-Performance Devices
- Variable Performance Devices
- Introduction: The 4th National Audit Project
- Anatomy
- Approaches
- Difficult Airway Society’s Recommended Technique
- Introduction: NAP4
- How to Predict an Anatomically Difficult Airway
- Equipment
- Difficult Airway Society Guidelines and Airway Management in Critically Ill Adults
- Tracheostomy difficulties
- Introduction
- Indications for Bronchoscopy in the ICU
- Contraindications
- Procedure
- Complications
- Conclusion
- Introduction
- Pre-procedural Considerations
- Procedure
- Post-procedure
- Acknowledgements
- Introduction
- Indications
- Contraindications (Relative)
- Technique for Insertion
- Drainage Bottles
- Pneumothorax Management
- Analysis of Fluid
- Complications
- Introduction
- Diagnosis of Acute Respiratory Failure
- Ultrasound in the Role of Weaning from Mechanical Ventilation
- Pleural Effusions
- Distinguishing Atelectasis from Pneumonia
- Ultrasound to Distinguish ARDS from Cardiac Pulmonary Oedema
- Introduction
- Spirometry
- Inspiratory and Expiratory Flow–Volume Loops in Upper Airway Obstruction
- Bronchodilator Response and Reversibility
- Lung Volumes
- Disease Patterns
- Gas Transfer
- Indications
- Contraindications to Line Insertion
- Risks/Complications
- Potential Insertion Sites
- Allen’s Test
- Procedure
- Introduction
- Localisation of Vasculature
- Techniques for Ultrasound-Guided Peripheral Vascular Access
- Introduction
- Indications
- Contraindications
- Complications
- Ultrasound
- Sites
- Procedure
- Confirmation of Line Placement
- Arterial Puncture
- Introduction
- Equipment Components
- Procedure
- Interpretation
- Clinical Use of Pulmonary Artery Catheters
- Complications
- Introduction
- Pad Positions
- Defibrillation
- Summary of Defibrillation Protocol in Advanced Life Support
- Optimising Defibrillation
- Oxygen
- Drugs in Defibrillation
- Energy Levels
- Implantable Cardioverter–Defibrillators
- Cardioversion outside the Cardiac Arrest Situation
- Complications
- Introduction
- Temporary
- Permanent Transvenous
- Miscellaneous
- Basic Pacing Concepts – Sensing and Capture
- Modes of Operation
- Management of Temporary Systems in the ICU
- Management of Permanent Systems in the ICU
- Pathophysiology of Cardiac Tamponade
- Aetiology of Pericardial Effusion
- Diagnosis
- Indications for Pericardiocentesis
- Contraindications of Pericardiocentesis
- Procedure
- Complications of Pericardiocentesis
- Introduction
- Pulmonary Artery Catheters
- Transoesophageal Echocardiography
- Doppler Devices
- Pulse Pressure Analysis
- Non-invasive Techniques
- Research Tools
- Introduction
- Lead placement and FICE views
- The Essence of FICE
- Common Pathologies Identified
- Acknowledgements
- Introduction
- Indications
- Contraindications
- Lumbar Punctures in the Emergency Setting
- Equipment and Technique
- Samples to Send
- Interpreting Results in Suspected Meningitis
- Complications
- Introduction
- Indications
- Anatomy, Physiology and Pharmacology
- Epidural Regimes
- Assessment and Monitoring
- Troubleshooting
- Introduction
- Indications
- Contraindications
- Technique for Insertion
- Volume Replacement
- Analysis of Fluid
- Complications
- Introduction
- Indications
- Contraindications
- Technique for Insertion
- Aftercare
- Complications
- Introduction
- Indications
- Contraindications
- Risks/Complications
- Procedure
- Additional Points
- Section 5.1 Practical Respiratory System
- Section 5.2 Practical Cardiovascular System
- 5.2.1 Arterial Line Insertion
- 5.2.2 Use of Ultrasound for Vascular Localisation
- 5.2.3 Central Venous Catheterisation
- 5.2.4 Pulmonary Artery Catheterisation: Insertion and Interpretation
- 5.2.5 Principles of Defibrillation and Cardioversion
- 5.2.6 Cardiac Pacing, Implantable Cardioverter–Defibrillators and Cardiac Resynchronisation Therapy
- 5.2.7 Needle Pericardiocentesis in Intensive Care
- 5.2.8 Cardiac Output Measurement and Interpreting the Derived Data
- 5.2.9 Echocardiography in Intensive Care
- Section 5.3 Practical Central Nervous System
- Section 5.4 Practical Gastrointestinal System
- Section 5.5 Practical Genitourinary System
- Section 6 Perioperative Care
- Section 7 Comfort and Recovery
- Section 8 End-of-Life Care
- Section 9 Paediatric Care
- Section 10 Transport
- Section 11 Professionalism, Patient Safety, Governance and Health Systems Management
- Index
- References
5.2.5 - Principles of Defibrillation and Cardioversion
from Section 5.2 - Practical Cardiovascular System
Published online by Cambridge University Press: 27 July 2023
By
Book contents
- Intensive Care Medicine
- Intensive Care Medicine
- Copyright page
- Dedication
- Dedication
- Epigraph
- Contents
- Contributors
- Preface
- Foreword
- Abbreviations
- Section 1 Resuscitation and Management of the Acutely Ill Patient
- Section 2 Diagnosis, Assessment, Investigation, Monitoring and Data Interpretation
- Domain 3 Disease Management: Recognition, Causes and Management
- Section 4 Therapeutic Interventions and Organ Support
- Domain 5 Practical Procedures
- Introduction
- Classification of Devices
- Fixed-Performance Devices
- Variable Performance Devices
- Introduction: The 4th National Audit Project
- Anatomy
- Approaches
- Difficult Airway Society’s Recommended Technique
- Introduction: NAP4
- How to Predict an Anatomically Difficult Airway
- Equipment
- Difficult Airway Society Guidelines and Airway Management in Critically Ill Adults
- Tracheostomy difficulties
- Introduction
- Indications for Bronchoscopy in the ICU
- Contraindications
- Procedure
- Complications
- Conclusion
- Introduction
- Pre-procedural Considerations
- Procedure
- Post-procedure
- Acknowledgements
- Introduction
- Indications
- Contraindications (Relative)
- Technique for Insertion
- Drainage Bottles
- Pneumothorax Management
- Analysis of Fluid
- Complications
- Introduction
- Diagnosis of Acute Respiratory Failure
- Ultrasound in the Role of Weaning from Mechanical Ventilation
- Pleural Effusions
- Distinguishing Atelectasis from Pneumonia
- Ultrasound to Distinguish ARDS from Cardiac Pulmonary Oedema
- Introduction
- Spirometry
- Inspiratory and Expiratory Flow–Volume Loops in Upper Airway Obstruction
- Bronchodilator Response and Reversibility
- Lung Volumes
- Disease Patterns
- Gas Transfer
- Indications
- Contraindications to Line Insertion
- Risks/Complications
- Potential Insertion Sites
- Allen’s Test
- Procedure
- Introduction
- Localisation of Vasculature
- Techniques for Ultrasound-Guided Peripheral Vascular Access
- Introduction
- Indications
- Contraindications
- Complications
- Ultrasound
- Sites
- Procedure
- Confirmation of Line Placement
- Arterial Puncture
- Introduction
- Equipment Components
- Procedure
- Interpretation
- Clinical Use of Pulmonary Artery Catheters
- Complications
- Introduction
- Pad Positions
- Defibrillation
- Summary of Defibrillation Protocol in Advanced Life Support
- Optimising Defibrillation
- Oxygen
- Drugs in Defibrillation
- Energy Levels
- Implantable Cardioverter–Defibrillators
- Cardioversion outside the Cardiac Arrest Situation
- Complications
- Introduction
- Temporary
- Permanent Transvenous
- Miscellaneous
- Basic Pacing Concepts – Sensing and Capture
- Modes of Operation
- Management of Temporary Systems in the ICU
- Management of Permanent Systems in the ICU
- Pathophysiology of Cardiac Tamponade
- Aetiology of Pericardial Effusion
- Diagnosis
- Indications for Pericardiocentesis
- Contraindications of Pericardiocentesis
- Procedure
- Complications of Pericardiocentesis
- Introduction
- Pulmonary Artery Catheters
- Transoesophageal Echocardiography
- Doppler Devices
- Pulse Pressure Analysis
- Non-invasive Techniques
- Research Tools
- Introduction
- Lead placement and FICE views
- The Essence of FICE
- Common Pathologies Identified
- Acknowledgements
- Introduction
- Indications
- Contraindications
- Lumbar Punctures in the Emergency Setting
- Equipment and Technique
- Samples to Send
- Interpreting Results in Suspected Meningitis
- Complications
- Introduction
- Indications
- Anatomy, Physiology and Pharmacology
- Epidural Regimes
- Assessment and Monitoring
- Troubleshooting
- Introduction
- Indications
- Contraindications
- Technique for Insertion
- Volume Replacement
- Analysis of Fluid
- Complications
- Introduction
- Indications
- Contraindications
- Technique for Insertion
- Aftercare
- Complications
- Introduction
- Indications
- Contraindications
- Risks/Complications
- Procedure
- Additional Points
- Section 5.1 Practical Respiratory System
- Section 5.2 Practical Cardiovascular System
- 5.2.1 Arterial Line Insertion
- 5.2.2 Use of Ultrasound for Vascular Localisation
- 5.2.3 Central Venous Catheterisation
- 5.2.4 Pulmonary Artery Catheterisation: Insertion and Interpretation
- 5.2.5 Principles of Defibrillation and Cardioversion
- 5.2.6 Cardiac Pacing, Implantable Cardioverter–Defibrillators and Cardiac Resynchronisation Therapy
- 5.2.7 Needle Pericardiocentesis in Intensive Care
- 5.2.8 Cardiac Output Measurement and Interpreting the Derived Data
- 5.2.9 Echocardiography in Intensive Care
- Section 5.3 Practical Central Nervous System
- Section 5.4 Practical Gastrointestinal System
- Section 5.5 Practical Genitourinary System
- Section 6 Perioperative Care
- Section 7 Comfort and Recovery
- Section 8 End-of-Life Care
- Section 9 Paediatric Care
- Section 10 Transport
- Section 11 Professionalism, Patient Safety, Governance and Health Systems Management
- Index
- References
Summary
Key Learning Points
1. Biphasic waveform defibrillators are used to depolarise cardiac muscle to restart the normal pacemaker functions of cardiac tissues.
2. Delays in defibrillation drastically reduce the chances of a successful outcome.
3. Communication and minimising peri-shock pauses are key to successful defibrillation.
4. Energy level settings should be determined by the manufacturer’s instructions on a local machine.
5. Synchronised cardioversion can be used for arrhythmias with adverse features, with different initial energy settings being used for different types of arrhythmias.
- Type
- Chapter
- Information
- Intensive Care MedicineThe Essential Guide, pp. 576 - 579Publisher: Cambridge University PressPrint publication year: 2021
References
References and Further Reading
European Society of Cardiology (ESC); European Heart Rhythm Association (EHRA); Brignole, M, Auricchio, A, Baron-Esquivias, G, et al. 2013 ESC guidelines on cardiac pacing and cardiac resynchronization therapy: the task force on cardiac pacing and resynchronization therapy of the European Society of Cardiology (ESC). Developed in collaboration with the European Heart Rhythm Association (EHRA). Europace 2013;15:1070–118.Google Scholar
Morrison, LJ, Henry, RM, Ku, V, et al. Single-shock defibrillation success in adult cardiac arrest: a systematic review. Resuscitation 2013;84:1480–6.CrossRefGoogle ScholarPubMed
Nichol, G, Sayre, MR, Guerra, F, Poole, J. Defibrillation for ventricular fibrillation. J Am Coll Cardiol 2017;70:1496–509.CrossRefGoogle ScholarPubMed
Resuscitation Council UK. Advanced Life Support, 7th edn. London: Resuscitation Council UK; 2016.Google Scholar
Soar, J, Nolan, JP, Bottiger, BW, et al. European Resuscitation Council Guidelines for Resuscitation 2015 Section 3. Adult advanced life support. Resuscitation 2015;95:99–146.CrossRefGoogle ScholarPubMed