Synchronized Cardioversion; To Initiate Synchronized Cardioversion Procedure - Escort Prism 20401 Reference Manual

7. Observe the patient and check Prism monitor to determine results. If repeat defibrillation is
necessary, readjust the energy level as prescribed by ACLS (Advanced Cardiac Life Support)
protocol, and repeat the above steps.

Synchronized Cardioversion

Synchronized cardioversion is the delivery of a defibrillator shock synchronized with the
patient's R-wave in order to convert abnormal rhythms to a normal sinus rhythm.
Certain rhythms such as atrial fibrillation/flutter or ventricular tachycardia (with a pulse) require
defibrillation discharge synchronized with the ECG R-wave to avoid inducing ventricular
fibrillation. In SYNC mode, when the discharge buttons are pressed, the defibrillator discharges
with the next detected R-wave to avoid the vulnerable T-wave segment of the cardiac cycle.
When discharge buttons are pressed, a marker pulse is superimposed on the ECG waveform to
mark the time that discharge will occur.

To Initiate Synchronized Cardioversion Procedure:

1. Prepare the patient by connecting a standard 3-lead ECG cable with proper electrodes.
2. On the monitor, select desired ECG lead to maximize R-wave amplitude while minimizing P-
and T-wave amplitudes and adjust ECG size as necessary.
3. Select LEADS using the ECG source key on the front panel of the defibrillator and confirm
that the indicator is illuminated.
NOTE: It is recommended that LEADS be selected as the ECG source.
A standard 3-lead ECG cable with proper electrodes should be used.
Although PADDLE can be selected as the ECG source during
synchronized cardioversion, artifact induced by paddle motion could
resemble an R-wave and trigger a discharge.
4. Select SYNC mode by pressing the SYNC key on the front of the defibrillator. A green LED
will flash synchronously with each detected R-wave to ensure that the SYNC mode is
operating correctly.
5. Confirm via ECG display and recording that the SYNC marker pulse, a pulse extending to the
baseline, falls on or immediately after an R-wave and not on a T-wave. If necessary, select
another ECG lead or adjust ECG size to improve ECG quality and synchronization.
8-11