Skill Checklists for Taylor's Clinical Nursing Skills: A Nursing Process Approach

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Skill Checklists for Taylor's Clinical Nursing Skills:
A Nursing Process Approach, 3rd edition

Name Date

Unit Position

Instructor/Evaluator: Position

SKILL 16-7

Performing Emergency Manual External

Defibrillation (Asynchronous)

Goal:The procedure is performed correctly without adverse

effect to the patient; and the patient regains signs of circulation. Comments

1. Assess responsiveness. If the patient is not responsive, call
   for help and pull call bell, and call the facility emergency
   response number. Call for the AED. Put on gloves, if avail-
   able. Perform cardiopulmonary resuscitation (CPR) until
   the defibrillator and other emergency equipment arrive.


2. Turn on the defibrillator.


3. If the defibrillator has “quick-look” capability, place the
   paddles on the patient’s chest. Otherwise, connect the
   monitoring leads of the defibrillator to the patient and
   assess the cardiac rhythm.


4. Expose the patient’s chest, and apply conductive pads at the
   paddle placement positions. For anterolateral placement,
   place one pad to the right of the upper sternum, just below
   the right clavicle, and the other over the fifth or sixth inter-
   costal space at the left anterior axillary line. ‘Hands-free’
   defibrillator pads can be used with the same placement posi-
   tions, if available. For anteroposterior placement, place the
   anterior paddle directly over the heart at the precordium, to
   the left of the lower sternal border. Place the flat posterior
   paddle under the patient’s body beneath the heart and
   immediately below the scapulae (but not on the vertebral
   column).


5. Set the energy level for 360 J (joules) for an adult patient
   when using a monophasic defibrillator. Use clinically
   appropriate energy levels for biphasic defibrillators,
   beginning with 150 to 200 J (AHA, 2005b).


6. Charge the paddles by pressing the charge buttons, which
   are located either on the machine or on the paddles them-
   selves.
   7.Place the paddles over the conductive pads and press
   firmly against the patient’s chest, using 25 pound (11 kg)
   of pressure. If using hands-off pads, do not touch the
   paddles.


7. Reassess the cardiac rhythm.

Copyright © 2011 by Wolters Kluwer Health | Lippincott Williams & Wilkins. Skill Checklists for Taylor's Clinical Nursing Skills:

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