Defibrillator

Manual defibrillator is an advanced medical life support device that monitors heart rhythm and allows the user to manually adjust and shock the energy selection. Users of manual defibrillators are professional specialists such as doctors, nurses, paramedics. The reason for this is the diagnosis of the patient’s condition through the paddles of the manual defibrillator device or the ECG signal from the ECG electrodes. If the patient’s ECG signal is shockable rhythm, the medical specialist adjusts the required energy level according to the patient’s condition and performs the defibrillation process.

* Manual defibrillators are used by physician or ancillary health

* ECG rhythm is user defined, user make to decision for defibrillation and charges the device and applies the shock if necessary.

* Electro gel is applied external paddles and apply defibrillation on chest at the desired energy level electric current is supplied.

* Automated Defibrillator (AED) functions it can be found on manual defibrillator

Manual defibrillators are medical devices designed to save the lives patients who are diagnosed with arrhythmia, pulseless ventricular tachycardia and ventricular fibrillation, and can be operated only by professional medical specialists in hospitals, ambulances etc. Medical training is required to use this kind of defibrillator, as a specialist physician examines the patient’s ECG rhythm and decides whether or not to deliver an electroshock. These defibrillators, which you usually see on television, have been developed with the rapid advance of technology, and have evolved into automated defibrillators that can be used without the assistance of a physician.

Automatic defibrillators, or AEDs, are only one type of defibrillator being used today.

Automated defibrillators are electronic devices that can be used without medical training and are designed to diagnose even fatal diseases such as cardiac arrhythmia. Besides analysing cardiac rhythm, AEDs can also perform defibrillation, as with conventional defibrillators.

As it is easy to use, the fully automated defibrillator has gained popularity throughout the world. Even an ordinary person without any medical training can use this device and save lives, after taking a short and simple training course. As the name implies, the use of automated defibrillators is very simple. They guide the operator through audible and visual instructions, and help to save the patient by guiding the operator until the very last moment.

External defibrillator devices are divided into two according to their waveform and usage.

According to the waveform; Biphasic Defibrillators and Monophasic Defibrillators. It is worth noting that there is a technological difference between biphasic and monophasic waveforms.

According to usage; Automatic External Defibrillator Device and Manual Defibrillator Device.

Cardioversion is the procedure used to deliver a low dose of electric current to the patient in rhythm disturbances such as VT with pulse, atrial fibrillation (Af) and atrial flutter (AF). If ventricular rate is over 150 BPM, urgent cardioversion is required. The shock to be delivered in order to revert VT with pulse, Af and AF back to normal sinus rhythm is applied simultaneously with the R-wave of the QRS complex in ECG. This is called synchronized cardioversion.

Cardioversion is applied using a manual defibrillator. Using the “sync” (synchronization) button on the defibrillator,

R-wave of the patient’s ECG is captured; in other words, synchronization with the R-wave is ensured. This procedure is called “sync-defib” or cardioverter. The R-wave is seen as marked on the monitor. The energy level in cardioversion is lower than the energy level in defibrillation. If, instead of being synchronized, this low dose of energy is delivered as in defibrillation and during the re-polarization of the cardiac cycle, it may lead to VF. If cardioversion leads to VF, defibrillation should be applied immediately

While unsynchronized defibrillation delivers an electric current at any point in the cardiac cycle, cardioversion delivers an electric current at the large R waves or synchronously with the QRS complex.

* After the discharge of electrical energy, it gives two-way current, in positive direction and then in negative direction.

* That is, it transmits the electric current in both directions. In the first phase, the current flows from one electrode to another, as in the monophasic defibrillator. In the second phase, the current starts to flow in the opposite direction.

* Biphasic waves were found to provide successful defibrillation with less energy and less harmful than monophasic waves.

* Undesirable side effects, such as burns, have been reduced since less energy is used.

* Monophasic defibrillator sends the shock wave in one direction.

* Electric current flows from one electrode to another.

* For this waveform to be effective, a high-level shock wave must be applied to the patient.

* High-level shock wave has undesirable side effects, such as burning the patient’s chest

It is found that biphasic waveform provides successful defibrillation with lower energy and less harmful than monophasic waveform. In addition, the same result can be achieved with lower energy use, and it has been observed that undesirable side effects such as damage to the heart muscles and burns are reduced. However, the benefit / harm / effect relationship of biphasic and monophasic wave forms is still being discussed.

When the patient’s heart stops or ceases to contract regularly, the defibrillator delivers an electric shock from the chest wall that can restore the patient’s normal heart rhythm. Technically, it actually stops the heart for a short time, allowing the heart to continue its normal electrical activity (contraction). Defibrillators have features such as the patient’s heart rate, ECG analysis systems, the amount of oxygen in the blood, pacemaker or blood pressure.

An average of 1500 – 2000 volts of energy is charged for 200 joules in defibrillators. Therefore, it is not convenient to compare power parameters between different devices. The amount of current applied to the heart is a function of two factors: voltage and impedance. For an effective defibrillation, as the patient’s impedance increases, the applied volts should be increased.

During fibrillation, a life-threatening cardiac arrhythmia is removed with a DC pulse.

The ERC (European Resuscitation Council) identifies the absence of the original rhythm disorder 5 seconds after the shock was delivered as a successful defibrillation. Otherwise, it is necessary to mention a defibrillation attempt that is not commonly used in the spoken language. This is because defibrillation can only be explained when shock delivery is successful.