Which rhythm requires synchronized cardioversion acls

This website may not work correctly with JavaScript turned off. Synchronized cardioversion is a medical procedure that delivers a low-energy electrical shock to reset an irregular heart rhythm. The electrical shock is carefully synchronized to occur at a specific point in the QRS complex. Because synchronized cardioversion is an effective treatment for certain cardiac arrhythmias, it is important to have a basic understanding of it before taking your ACLS certification exam.

For more information on synchronized cardioversion and to review the tachycardia algorithm, check the ACLS Provider Manual. You can purchase the manual here or receive it as part of your tuition when you register for ACLS certification.

If the shock occurs on the t-wave during repolarization , there is a high likelihood that the shock can precipitate VF Ventricular Fibrillation. The most common indications for synchronized cardioversion are unstable atrial fibrillation, atrial flutter, atrial tachycardia, and supraventricular tachycardias.

If medications fail in the stable patient with the before mentioned arrhythmias, synchronized cardioversion will most likely be indicated. This means that the shock may fall randomly anywhere within the cardiac cycle QRS complex.

Catch the latest Perfusion news or peruse our article archive. Synchronized vs. Synchronized cardioversion is a specific medical procedure used to restore a normal heart rhythm to a patient who is experiencing an arrhythmia, which is an irregular heart rhythm. After this shock, the heart often may resume a normal rhythm.

Synchronized cardioversion is typically utilized in cases where a patient is experiencing an unstable tachycardia arrhythmia.

This means that the patient will have an abnormal heart rhythm coupled with an increased heart rate. Arrhythmias reduce the amount of blood the heart can effectively pump to important parts of the body. If left untreated, these conditions can cause serious and even fatal complications, such as a stroke or heart attack. For this reason, prompt treatment of a serious arrhythmia is essential. As long as a patient is experiencing one of the heart rhythms that indicates the use of synchronized cardioversion, this procedure can typically be implemented.

There are no contraindications for this procedure, and it can be used even when the patient has a pacemaker or automatic implanted cardiac defibrillator. The presence of either of these devices should not impact the effectiveness of the synchronized cardioversion procedure. Prior to beginning the synchronized cardioversion procedure, it is important to make sure the procedure is actually necessary and that the chances of the patient surviving are as high as possible.

Before the procedure begins:. The procedure begins after an IV has been placed and the sedation medication has been administered to the patient. Place the electrodes on the left side of the chest approximately two inches under the mid-axillary line. Place electrodes on the right side of the chest below the clavicle. Once the electrodes are in place, press SYNC on the defibrillator machine. Verify that the machine is sensing and marking the R wave accurately by reviewing the rhythm strip.

Otherwise, the shock may not be delivered at the appropriate time. Choose the most appropriate energy level and make sure everyone else in the room is clear of the patient before you deliver the shock. Because machines return to their default mode of defibrillation after administering the first shock, be sure to press SYNC again before administering the second shock. As with the first shock, you should make sure the machine is measuring the rhythm accurately. Clear the patient and administer the shock.

Even after a normal rhythm begins, you should continue to monitor vital signs and consciousness level until the patient is fully awake and stable. Many cardioversion procedures will be completed without any complications.

However, in some cases, complications may occur. For this reason, it is important to understand the possible complications and prepare to respond to them. Some of the most common complications of synchronized cardioversion include loss of pulse and ventricular fibrillation. The response indicated in these cases will depend on the specific type of complication. For example, in cases where a patient who has unstable supraventricular tachycardia loses pulse, the best treatment is implementation of the ACLS algorithm for pulseless electrical activity.

If a patient with an unstable ventricular tachycardia loses pulse during synchronized cardioversion, the best treatment is implementation of the ACLS algorithm for ventricular fibrillation. If a patient is not breathing properly on their own, manual ventilation may be indicated as well.

In an ideal situation, the synchronized cardioversion procedure works seamlessly and the patient resumes a normal rhythm without complications. However, in some cases, you may need to make some adjustments to the procedure in order to make it work properly. Below are some tips that may improve the success of synchronized cardioversion. It is important to remember that synchronized cardioversion and defibrillation are not the same things. Defibrillation involves the delivery of a high energy shock to the heart.