Procedure 23 - Cardiac: Synchronized Cardioversion

What tachydysrhythmias indicate synchronized cardioversion in an unstable patient?

Rapid atrial fibrillation, supraventricular tachycardia, or ventricular tachycardia with a pulse.

What pulse status is required for synchronized cardioversion?

The patient must have a pulse.

What treatment is required for a pulseless tachydysrhythmic patient instead of synchronized cardioversion?

Unsynchronized cardioversion (defibrillation).

What must be confirmed about the cardiac monitor before synchronized cardioversion?

That the patient is properly attached to a cardiac monitor capable of synchronized cardioversion.

What equipment should be available in case synchronized cardioversion fails?

All equipment for unsynchronized cardioversion/defibrillation.

What medications should be considered before synchronized cardioversion?

Pain or sedating medications, per the specific protocol.

How is the energy selection determined for synchronized cardioversion?

As indicated by the specific protocol.

How is synchronization confirmed on the monitor during synchronized cardioversion?

By the arrow (or other appropriate mark) located above each and every electrical complex.

What must be assured before depressing the charge button for synchronized cardioversion?

That all personnel are clear of the patient.

What button is depressed to begin charging for synchronized cardioversion?

The "charge" button.

What should be done once charging is complete for synchronized cardioversion?

Stay clear of the patient and hold the "shock" button down until the energy has been delivered.

Why might there be a delay between pressing the shock button and energy delivery in synchronized cardioversion?

It may take the monitor several cardiac cycles to synchronize before delivering the energy.

What should be done if the patient's condition remains unchanged after synchronized cardioversion?

Repeat the charging and shock steps using escalating energy settings as indicated by protocol.

When should synchronized cardioversion attempts stop?

Until maximum settings have been reached or until efforts succeed.

What should be documented after each synchronized cardioversion attempt?

The procedure, response, and time of each cardioversion attempt in the patient care report.

What provider level can perform synchronized cardioversion per CFD protocol?

EMT-P.