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This procedure is for use by nurses who have attained certification in the delegated act of
defibrillation.
Defibrillation is the application of a controlled electrical shock to terminate ventricular fibrillation
or pulseless ventricular tachycardia. The shock is delivered through the chest wall in an attempt
to completely depolarize the myocardium and provide an opportunity for the SA node to take
over (ACLS). The longer that the myocardium is in VF or VT, the more damage that is done, the
less chance there is of survival. The ONLY effective treatment is defibrillation. The probability of
successful defibrillation diminishes rapidly over time.
NOTE: nurses in the ICU are NOT certified to perform cardioversion; please refer to the cardioversion
procedure
For further information on delegated acts, please refer to the hospital policy:
Certification of Staff in the Performance of Delegated Controlled Acts
Procedure
2. Lay pt flat and initiate CPR. Ask a colleague to get the crash
cart.
Rationale
Precordial thump may produce
enough energy to terminate VF if
given early in VF.
above.
References
1. American Heart Association. (2000)Guidelines 2000 for cardiopulmonary Resuscitation and
Emergency Cardiovascular Care. Part 6: advanced cardiovascular life support: 7D. The American Heart
in collaboration with the International Liaison Committee on Resuscitation.Circulation, August 22; 102(8
suppl).
2. Zoll defibrillator M series Operators manual
Developed By : Rachelle McCready, Clinical Educator, Critical Care, ICU-UC
Date: July 2004
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Disclaimer
Contact: Rachelle M
E-mail rachelle.mccready@lh