RT Book, Section
A1 Gomella, Tricia Lacy
A1 Eyal, Fabien G.
A1 Bany-Mohammed, Fayez
SR Print(0)
ID 1168356330
T1 Defibrillation and Cardioversion
T2 Gomella's Neonatology: Management, Procedures, On-Call Problems, Diseases, and Drugs, 8e
YR 2020
FD 2020
PB McGraw-Hill Education
PP New York, NY
SN 9781259644818
LK accesspediatrics.mhmedical.com/content.aspx?aid=1168356330
RD 2024/04/24
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.