Manual Defibrillation

■ Power:Turn on and verify all cables are connected.
■ Lead select:Turn “lead select” to “paddles” or “defibrillator.”
■ Energy: Biphasic: 200 J; monophasic: 360 J.
■ Paddles: Sternum; upper right sternal border–cardiac apex.
■ *Hands-free defibrillation pads: Sternum–cardiac apex.
■ Verify rhythm: Confirm V-Fib or pulseless VT.
■ Charge defibrillator: Say, “Charging defibrillator, stand clear!”
■ Clear: Say, “I’m going to shock on three. One, I’m clear, two, you’re clear, three, everybody’s clear.”
■ Defibrillate: Biphasic: 200 J; monophasic: 360 J reassess rhythm refer to appropriate algorithm for resulting rhythm and ongoing intervention.
*ET administration: 2–2.5 normal dose. Follow with an NS flush.

Hand-Held Paddles: 
Apply 25 lb of pressure to both paddles and depress both paddle discharge buttons simultaneously.

Hands-Free Defibrillation Pads: 
Depending on type of defibrillator, either press the “shock” button on the defibrillator or depress both paddle (docked in defibrillator) discharge buttons simultaneously.

Paddle Placement