• List the indications for use of the items depicted above
  • List five precautions for consideration when applying these items

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College Answer

Indications

    • Defibrillation and monitoring in cardiac arrest
    • Continuous heart rhythm monitoring
    • Cardioversion
    • Transcutaneous pacing

Precautions

    • Avoid fluid – water, perspiration etc
    • Avoid excessive hair
    • Avoid metal (metal-backed patches, piercings, jewellery)
    • Do not place over bone
    • Roll on to the skin to avoid air pockets
    • Do not place over implanted pacemakers
    • Avoid wounds / broken skin

Discussion

There aren't many things you could do with the cutaneous defib pads. You can monitor, pace, cardiovert or defibrillate - that is about it. The image of the pads above was stolen from Zoll's UK website - there is quite a variety of electrode pads, for every conceivable use.

The precautions for the use of these pds can be found in the ARC ALS manual (I have the 2011 version).

Avoid the following:

  • Water
  • Vomit
  • Sweat
  • Excessive chest hair
  • Piercings
  • Necklaces
  • Bony prominences
  • Air pockets (burns may occur)
  • Implanted devices
  • Subclavian lines
  • Wounds

References

References

ARC: Advanced Life Support Manual, Australian Edition (6th ed) January 2011

ARC: Guideline 11.4: Electrical Therapy for Adult Advanced Life Support