Philips HeartStart MRx - Performing Synchronized Cardioversion; Preparing for Synchronized Cardioversion

Performing Synchronized Cardioversion 6 Manual Defibrillation and Cardioversion
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Performing Synchronized Cardioversion
Synchronized Cardioversion allows you to synchronize delivery of the defibrillator shock with the
R-wave of the ECG being monitored in Wave Sector 1. You may choose to perform synchronized
cardioversion through either:
• multifunction electrode pads, or
• external paddles
When using paddles, you should monitor the ECG through monitoring electrodes connected to a 3-,
5- or 10-lead ECG cable or a Philips bedside monitor. You may choose to monitor through an
alternate source when using pads, as well. Cardioversion is still delivered through either pads or
paddles.
Preparing for Synchronized Cardioversion
In preparation for synchronized cardioversion:
1 Perform the tasks as described in “Preparing for Defibrillation” on page 74
2 If monitoring through a 3-, 5-, or 10-lead ECG cable, plug the ECG cable into the ECG port on
the HeartStart MRx and apply monitoring electrodes to the patient. (See “ECG and Arrhythmia
Monitoring” on page 47.)
3 Use the Lead Select button to select pads, paddles or a lead from attached monitoring
electrodes. The selected ECG source should have a clear signal and a large QRS complex. (See
“Lead Selection” on page 53.)
NOTE When the patient is already connected to Philips bedside monitoring equipment, an external ‘Sync’
cable plugs into the ECG Output jack of the bedside monitor and connects to the ECG port of the
HeartStart MRx. This connects the ECG signal from the monitor into the HeartStart MRx, where it is
displayed and synchronization occurs.
The signal from the bedside monitor is displayed as Lead II on the HeartStart MRx, even though it is
not necessarily Lead II coming from the bedside monitor.
WARNING • If you use an external monitor as the ECG source, a biomedical technician MUST verify that the
external monitor and the HeartStart MRx combination will deliver a synchronized shock within 60
ms of the peak of the R-wave. Use a 1 mV QRS complex with a QRS width of 40 ms. This
performance cannot be guaranteed with all commercially available monitors.
• When monitoring through paddles only, artifact introduced by paddle movement may resemble an
R-wave and trigger a defibrillation shock.