Physio-Control LIFEPAK 20e - Manual (Page 74)

Therapy
4-4 LIFEPAK 20e Defibrillator/Monitor Operating Instructions
Figure 4-2 Anterior-posterior Placement for Noninvasive Pacing or Defibrillation
Special Placement Situations
When placing therapy electrodes or standard paddles, be aware of the special requirements in
the following possible situations.
Synchronized Cardioversion
Alternative anterior-posterior placements for cardioversion of supraventricular arrhythmias
include:
• Place the ♥ or + therapy electrode over the left precordium and the other electrode on the
patient’s right posterior infrascapular area
– or –
• Place the ♥ or + therapy electrode to the right of the sternum and the other electrode on the
patient’s posterior left infrascapular area.
Obese Patients or Patients with Large Breasts
Apply therapy electrodes or standard paddles to a flat area on the chest, if possible. If skin folds
or breast tissue prevent good adhesion, it may be necessary to spread skin folds apart to create
a flat surface.
Thin Patients
Follow the contour of the ribs and spaces when pressing the therapy electrodes onto the torso.
This limits air spaces or gaps under the electrodes and promotes good skin contact.
Patients with Implanted Pacemakers
If possible, place therapy electrodes or standard paddles away from the internal pacemaker
generator to help prevent damage to the pacemaker. Treat the patient like any other patient
requiring care. When operating the defibrillator in AED mode, pacemaker pulses may prevent
advisement of an appropriate shock, regardless of the patient’s underlying rhythm.
Patients with Implanted Defibrillators
Apply therapy electrodes or standard paddles in the anterior-lateral position and treat this patient
as any other patient requiring emergency care. If defibrillation is unsuccessful, it may be
necessary to try alternate electrode placement (anterior-posterior) due to the insulative
properties of implanted defibrillator electrodes.
QUIK-COMBO Electrodes FAST-PATCH Electrodes
Po ANTERIOR POSTERIOR ANTERIOR POSTERIOR