TY - CHAP M1 - Book, Section TI - Defibrillation and Cardioversion A1 - Gomella, Tricia Lacy A1 - Eyal, Fabien G. A1 - Bany-Mohammed, Fayez PY - 2020 T2 - Gomella's Neonatology: Management, Procedures, On-Call Problems, Diseases, and Drugs, 8e AB - Defibrillation and cardioversion are procedures that involve giving a controlled electrical shock to the heart through the chest wall and are used for rapid termination of a tachyarrhythmia (a fast, abnormal rhythm originating either in the atrium or ventricle) that is unresponsive to baseline treatment or is causing the patient to have cardiovascular compromise (inadequate systemic perfusion). Baseline treatment consists of correcting metabolic problems, use of vagal maneuvers which work by stimulating the vagal tone that slows the heart rate (eg, diving reflex, bag filled with ice and cold water applied on the whole face for 15–30 seconds without obstructing the airway, rectal stimulation using a thermometer, bending legs and bringing the knees to the chest for 15–30 seconds), use of medications (adenosine, digoxin, propranolol, verapamil, amiodarone, procainamide, lidocaine, or magnesium sulfate), or transesophageal pacing. It is best to try these maneuvers or medical therapy if intravenous access is available. Neonatal arrhythmias are rare, and the majority can be treated with these initial measures. SN - PB - McGraw-Hill Education CY - New York, NY Y2 - 2024/03/28 UR - accesspediatrics.mhmedical.com/content.aspx?aid=1168356330 ER -