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Synchronized Cardioversion

Clinical Indications:

    Unstable patient with a tachydysrhythmia (rapid atrial fibrillation, supraventricular tachycardia, ventricular tachycardia)
    Patient is not pulseless (the pulseless patient requires unsynchronized cardioversion, i.e., defibrillation)


    1. Ensure the patient is attached properly to a monitor/defibrillator capable of synchronized cardioversion.

    2. Have all equipment prepared for unsynchronized cardioversion/defibrillation if the patient fails synchronized cardioversion and the condition worsens.

    3. Consider the use of pain or sedating medications.

    4. Set energy selection to the appropriate setting.

    5. Set monitor/defibrillator to synchronized cardioversion mode.

    6. Make certain all personnel are clear of patient.

    7. Press and hold the shock button to cardiovert. Stay clear of the patient until you are certain the energy has been delivered.

    8. Note patient response and perform immediate defibrillation if
    the patient's rhythm has deteriorated into pulseless ventricular tachycardia or ventricular fibrillation.

    9. Note procedure, response, and time in the patient care report (PCR).

Competency Based Skill Requirements:

    Maintain knowledge of the indications, contraindications, technique, and possible complications of the procedure.

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