Defibrillation is a common treatment for life-threatening cardiac dysrhythmias, ventricular fibrillation, and pulseless ventricular tachycardia.

Defibrillation consists of delivering a therapeutic dose of electrical energy to the affected heart with a device called a defibrillator.

Defibrillators can be external, transvenous, or implanted, depending on the type of device used or needed. Some external units, known as automated external defibrillators (AEDs), automate the diagnosis of treatable rhythms, meaning that lay responders or bystanders are able to use them successfully with little, or in some cases no training at all.

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units are used in conjunction with (or more often have inbuilt) electrocardiogram readers, which the healthcare provider uses to diagnose a cardiac condition (most often fibrillation or tachycardia although there are some other rhythms which can be treated by different shocks). The healthcare provider will then decide what charge (in joules) to use, based on proven guidelines and experience, and will deliver the shock through paddles or pads on the patient's chest

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simple-to-use units are based on computer technology which is designed to analyze the heart rhythm itself, and then advise the user whether a shock is required. They are designed to be used by lay persons, who require little training to operate them correctly.

The anterior-posterior scheme is the preferred scheme for long-term electrode placement. One electrode is placed over the left precordium (the lower part of the chest, in front of the heart). The other electrode is placed on the back, behind the heart in the region between the scapula. This placement is preferred because it is best for non-invasive pacing. The anterior-apex scheme can be used when the anterior-posterior scheme is inconvenient or unnecessary. In this scheme, the anterior electrode is placed on the right, below the clavicle. The apex electrode is applied to the left side of the patient, just below and to the left of the pectoral muscle.

1.Place defibrillator on a solid, dry surface. 2.Turn on the manual defibrillator. Depending on the model, there might be a dial to turn or a power button to push. Defibrillators have batteries and should be fully charged. If the defibrillator monitor shows low battery output, plug the defibrillator into a power source, or obtain another manual defibrillator.

3. Insert the connecting cables into the receptor on the manual defibrillator. 4. Attach the self-adhesive defibrillation pads to the connecting cable leads. 5.Remove self-adhesive defibrillation pads from packaging and connect pads to conducting cables. If using paddles, connect paddles to monitor by inserting adapter into receiving port identified on the manual defibrillator. 6. Apply conducting gel to paddles or ensure that selfadhesive defibrillation pads are moist with sufficient conducting medium. If the pads were not properly sealed in the packaging, the conducting gel may dry out and not perform properly. In this case, get a new set of pads.

7. Apply paddles/pads to the chest. There are two placement options for defibrillating. With paddles, use the anterolateral placement. If using a manual defibrillator with self-adhesive pads, the anteroposterior is preferred, but if a patient cannot be moved, or it is difficult to reach the patient's back, use anterolateral placement. 1) Anterolateral: one paddle/pad is placed to the right of the upper sternum, below the clavicle (collar bone) and one paddle/pad is placed to the left of the left nipple with the center of the paddle/pad in the midaxillary line (imagine a line extending down from the middle of the arm pit.) 2) Anteroposterior: One paddle/pad is placed over the left side of the chest, below the clavicle and the other is placed on the left side of the back below the shoulder blade and to the left of the spine.

8. Set the energy level for electrical discharge. There are two types of manual defibrillators: biphasic or monophasic. 1) Biphasic waveform devices have device-specific energy levels that are indicated on the defibrillator. If you do not know the device specifics, the default initial energy setting is 200 joules (J). 2) Monophasic waveform device energy setting is 360 J for all defibrillation attempts. 9. Press the charge button on the manual defibrillator. If you are using paddles, there also is a charge button on the paddles. 10. Discharge the defibrillator by pressing the shock button on the manual defibrillator or, if using paddles, the discharge button on the paddles.