TERAPI LISTRIK PADA HENTI

JANTUNG PARU

Dr. Wiza Erlanda, SpJP

FK UNAND/RSUP DR.M.DJAMIL PADANG
2022
Pendahuluan

 Biasa disebut Defibrilator

 Bedakan dengan Cadioversi
 Tidak semua Cardiac Arrest dapat diberikan terapi listrik jantung
(Defibrilator)
 Monophasic atau Biphasic
 Pengertian

 Defibrillation is used to deliver a large amount of electric

current to a patient over a brief period of time.
 Standard treatment for VF and pulseless VT
 Aims to temporarily depolarize the heart when the rhythm is
chaotic.
 completely depolarizing the myocardium, producing a
momentary asystole.
 This provides an opportunity for the heart’s natural pacemaker
centers to restore a normal rhythm.
 Defibrillation is significantly more effective when VF
is recognized and treated quickly.
 When performed within the first 5 minutes of cardiac
arrest  survival rate is 50%.
 Decreases by 7% to 10% for each minute that the
patient is in VF.
 Defibrillation  automated external defibrillator
(AED) or a conventional defibrillator.
 5

AHA Guidelines Update for CPR

and Emergency Cardiovascular Care (ECC) 2020
Automated external defibrillators (AED)
 The AED is a portable defibrillator with a microcomputer that
senses and analyzes a patient’s heart rhythm
Form and function
 All AED models have the same basic functions but offer different
operating options.
 For example, all AEDs communicate directions by displaying
messages on a screen, giving voice commands, or both.
 Some AEDs simultaneously display a patient’s heart rhythm.
 All devices record your interactions with the patient during
defibrillation and some may have an integral printer for
immediate event documentation.
 Two types of AEDs:
• the fully automated AED, which delivers a shock if VF is present
• the semiautomatic AED, which requires you to press an ANALYZE
control to start the rhythm analysis; it then audibly or visually
prompts you to press a SHOCK control to deliver a shock if
warranted.

 Electrical shock is delivered through two adhesive electrode pads

applied to the patient (upperright sternal border, lower-left ribs
over the cardiac apex).
 The adhesive pads have two functions: to transmit the patient’s
rhythm and to deliver the shock.
• Contain cardiac rhythm analysis systems
• May be fully or semiautomated
• For patients with no pulse and no respirations
• Less training needed to operate
• Faster speed of operation and delivery
• Hands-free-technique
• Energy level = 200 (Biphasic) to 360 joules
(monophasic)
Conventional defibrillators

 commonly used in most health care facilities.

 It requires you to analyze the rhythm, select the
energy level to be administered, apply the
paddles or “hands off” pads to the patient’s
chest, and discharge the current by pressing both
paddle buttons simultaneously or by pressing the
SHOCK button on the defibrillator.
 Two types of conventional defibrillators:
monophasic (360 J) and biphasic (200 J)
 Monophasic defibrillators deliver a
single current of electricity that travels in
one direction between the two pads or
paddles on the patient’s chest.
 To be effective, a large amount of
electrical current is required for
monophasic defibrillation (360 J)
 biphasic defibrillators
 Delivering two currents of
electricity.
 Using two currents lowers the
defibrillation threshold of the heart
muscle, increasing the likelihood
for successful defibrillation of
ventricular fibrillation with smaller
amounts of energy.
 Biphasic defibrillators also adjust
for differences in impedance or
resistance, which reduces the
number of shocks needed.
TERIMA KASIH