ZOLL M Series Defibrillator Rev YH - Manual (Page 47)

6-1
SECTION 6
SYNCHRONIZED CARDIOVERSION
General Information
Certain arrhythmias, such as Ventricular Tachycardia
(VT), atrial fibrillation, and atrial flutter, require
synchronizing the defibrillator discharge with the ECG
R-wave to avoid the induction of ventricular fibrillation. In
this case, a synchronizing (SYNC) circuit within the
instrument detects the patient’s R-waves. When the
SHOCK buttons are pressed and held, the unit will
discharge with the next detected R-wave, thus avoiding
the vulnerable T-wave segment of the cardiac cycle.
When placed in the SYNC mode, the unit places markers
above the ECG trace to indicate the points in the cardiac
cycle where discharge will occur. The sync markers
appear as arrows (“

”) above the ECG trace.
Verify that markers are clearly visible on the monitor and
their location is appropriate and consistent from beat to
beat. If necessary, use the LEAD button and SIZE button
to establish settings that yield the best display.
The synchronized cardioversion procedure for MFE
Pads is identical to that for paddles, with the exception of
the SHOCK button location.
Synchronized Cardioversion
Determine patient condition and provide care following
medical protocols.
Prepare Patient
Remove all clothing covering the patient’s chest. Dry
chest if necessary. If the patient has excessive chest
hair, clip it to ensure proper adhesion of electrodes.
Attach ECG electrodes.
A standard ECG cable and ECG electrodes are
recommended for use during cardioversion. MFE Pads
may be used as an ECG source and signal quality will be
equal to that of standard leads except immediately
following a discharge when there may be more noise due
to muscle tremors, especially if a pad is not in complete
contact with the skin.
Apply MFE Pads to the patient according to the
instructions on electrode packaging.
Ensure that the electrodes are in good contact with the
patient’s skin and are not covering any part of any other
electrodes.
Connect MFE Pads to the multi-function cable unless
preconnected.
If paddles are being used for synchronized
cardioversion, refer to the Emergency Defibrillation
Procedure with Paddles Section for preparing paddles,
applying paddles, charging the defibrillator, and
delivering a shock.
Paddles are a defibrillation protected Type BF patient connection.
ECG leads are a defibrillation protected Type CF patient connection.
WARNING
• Synchronized cardioversion should only be attempted by skilled personnel trained in ACLS
(Advanced Cardiac Life Support) and familiar with equipment operation. The precise cardiac
arrhythmia must be determined before attempting defibrillation.
• Prior to attempting synchronized cardioversion, ensure that the ECG signal quality is sufficient to
minimize risk of synchronizing on artifact