594:). Solid-gel is more convenient, because there is no need to clean the used gel off the person's skin after defibrillation. However, the use of solid-gel presents a higher risk of burns during defibrillation, since wet-gel electrodes more evenly conduct electricity into the body. Paddle electrodes, which were the first type developed, come without gel, and must have the gel applied in a separate step. Self-adhesive electrodes come prefitted with gel. There is a general division of opinion over which type of electrode is superior in hospital settings; the American Heart Association favors neither, and all modern manual defibrillators used in hospitals allow for swift switching between self-adhesive pads and traditional paddles. Each type of electrode has its merits and demerits.
1246:
624:
886:
exponentially decaying DC voltage is reversed in polarity about halfway through the shock time, then continues to decay for some time after which the voltage is cut off, or truncated. The studies showed that the biphasic truncated waveform could be more efficacious while requiring the delivery of lower levels of energy to produce defibrillation. An added benefit was a significant reduction in weight of the machine. The BTE waveform, combined with automatic measurement of transthoracic impedance, is the basis for modern defibrillators.
40:
1222:
656:
1210:
1234:
235:
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of the operator coming into physical (and thus electrical) contact with the patient as the shock is delivered by allowing the operator to be up to several feet away. (The risk of electrical shock to others remains unchanged, as does that of shock due to operator misuse.) Self-adhesive electrodes are single-use only. They may be used for multiple shocks in a single course of treatment, but are replaced if (or in case) the patient recovers then reenters cardiac arrest.
3129:
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1041:
518:
307:
996:– "The very rare patient who has frequent bouts of ventricular fibrillation is best treated in a coronary care unit and is better served by an effective antiarrhythmic program or surgical correction of inadequate coronary blood flow or ventricular malfunction. In fact, the implanted defibrillator system represents an imperfect solution in search of a plausible and practical application."
788:
603:
shocks is delivered. Paddles offer a few advantages over self-adhesive pads. Many hospitals in the United States continue the use of paddles, with disposable gel pads attached in most cases, due to the inherent speed with which these electrodes can be placed and used. This is critical during cardiac arrest, as each second of
430:
delay delivery of effective CPR. For diagnosis of rhythm, AEDs often require the stopping of chest compressions and rescue breathing. For these reasons, certain bodies, such as the
European Resuscitation Council, recommend using manual external defibrillators over AEDs if manual external defibrillators are readily available.
1138:
patient. The pad placement is also shown wrong, along with sudden rising of patient to large height when shock is given. In reality, while the muscles may contract, such dramatic patient presentation is rare. Similarly, medical providers are often depicted defibrillating patients with a "flat-line" ECG rhythm (also known as
971:, with the help of industrial collaborator Intec Systems of Pittsburgh. Mirowski teamed up with Mower and Staewen, and together they commenced their research in 1969. However, it was 11 years before they treated their first patient. Similar developmental work was carried out by Schuder and colleagues at the
724:
in 1930. Kouwenhoven studied the relationship between electric shocks and their effects on the human heart when he was a student at Johns
Hopkins University School of Engineering. His studies helped him invent a device to externally jump start the heart. He invented the defibrillator and tested it on
643:
Pads also offer an advantage to the untrained user, and to medics working in the sub-optimal conditions of the field. Pads do not require extra leads to be attached for monitoring, and they do not require any force to be applied as the shock is delivered. Thus, adhesive electrodes minimize the risk
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Newer types of resuscitation electrodes are designed as an adhesive pad, which includes either solid or wet gel. These are peeled off their backing and applied to the patient's chest when deemed necessary, much the same as any other sticker. The electrodes are then connected to a defibrillator, much
444:
AEDs can be fully automatic or semi-automatic. A semi-automatic AED automatically diagnoses heart rhythms and determines if a shock is necessary. If a shock is advised, the user must then push a button to administer the shock. A fully automated AED automatically diagnoses the heart rhythm and advises
429:
Trained health professionals have more limited use for AEDs than manual external defibrillators. Recent studies show that AEDs does not improve outcome in patients with in-hospital cardiac arrests. AEDs have set voltages and does not allow the operator to vary voltage according to need. AEDs may also
425:
Automated external defibrillators (AEDs) are designed for use by untrained or briefly trained laypersons. AEDs contain technology for analysis of heart rhythms. As a result, it does not require a trained health provider to determine whether or not a rhythm is shockable. By making these units publicly
292:
in North
America are poor, often less than 10%. Outcome for in-hospital cardiac arrests are higher at 20%. Within the group of people presenting with cardiac arrest, the specific cardiac rhythm can significantly impact survival rates. Compared to people presenting with a non-shockable rhythm (such as
910:
Gradual improvements in the design of defibrillators, partly based on the work developing implanted versions (see below), have led to the availability of
Automated External Defibrillators. These devices can analyse the heart rhythm by themselves, diagnose the shockable rhythms, and charge to treat.
707:
In 1933, Dr. Albert Hyman, heart specialist at the Beth Davis
Hospital of New York City and C. Henry Hyman, an electrical engineer, looking for an alternative to injecting powerful drugs directly into the heart, came up with an invention that used an electrical shock in place of drug injection. This
602:
The most well-known type of electrode (widely depicted in films and television) is the traditional metal "hard" paddle with an insulated (usually plastic) handle. This type must be held in place on the patient's skin with approximately 25 lbs (11.3 kg) of force while a shock or a series of
667:
The anterior-apex scheme (anterior-lateral position) can be used when the anterior-posterior scheme is inconvenient or unnecessary. In this scheme, the anterior electrode is placed on the right, below the clavicle. The apex electrode is applied to the left side of the patient, just below and to the
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These early defibrillators used the alternating current from a power socket, transformed from the 110–240 volts available in the line, up to between 300 and 1000 volts, to the exposed heart by way of "paddle" type electrodes. The technique was often ineffective in reverting VF while morphological
683:
The exact mechanism of defibrillation is not well understood. One theory is that successful defibrillation affects most of the heart, resulting in insufficient remaining heart muscle to continue the arrhythmia. Recent mathematical models of defibrillation are providing new insight into how cardiac
894:
A major breakthrough was the introduction of portable defibrillators used out of the hospital. Already Peleška's Prema defibrillator was designed to be more portable than original
Gurvich's model. In Soviet Union, a portable version of Gurvich's defibrillator, model ДПА-3 (DPA-3), was reported in
663:
Resuscitation electrodes are placed according to one of two schemes. The anterior-posterior scheme is the preferred scheme for long-term electrode placement. One electrode is placed over the left precordium (the lower part of the chest, in front of the heart). The other electrode is placed on the
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medication (and even these are rarely successful in cases of asystole). A useful analogy to remember is to think of defibrillators as power-cycling, rather than jump-starting, the heart. There are also several heart rhythms that can be "shocked" when the patient is not in cardiac arrest, such as
1026:
People can live long normal lives with the devices. Many patients have multiple implants. A patient in
Houston, Texas had an implant at the age of 18 in 1994 by the recent Dr. Antonio Pacifico. He was awarded "Youngest Patient with Defibrillator" in 1996. Today these devices are implanted into
927:
impulse having a mainly uniphasic characteristic. Biphasic defibrillation alternates the direction of the pulses, completing one cycle in approximately 12 milliseconds. Biphasic defibrillation was originally developed and used for implantable cardioverter-defibrillators. When applied to external
903:. Today portable defibrillators are among the many very important tools carried by ambulances. They are the only proven way to resuscitate a person who has had a cardiac arrest unwitnessed by Emergency Medical Services (EMS) who is still in persistent ventricular fibrillation or ventricular
830:
and among other things he visited the Moscow
Institute of Reanimatology, where, among others, he met with Gurvich. Humphrey immediately recognized importance of reanimation research and after that a number of American doctors visited Gurvich. At the same time, Humphrey worked on establishing a
770:
source derived from standard AC power, delivered to the sides of the exposed heart by "paddle" electrodes where each electrode was a flat or slightly concave metal plate of about 40 mm diameter. The closed-chest defibrillator device which applied an alternating voltage of greater than 1000
1150:
are normally defibrillated. The purpose of defibrillation is to depolarize the entire heart all at once so that it is synchronized, effectively inducing temporary asystole, in the hope that in the absence of the previous abnormal electrical activity, the heart will spontaneously resume beating
1137:
As devices that can quickly produce dramatic improvements in patient health, defibrillators are often depicted in movies, television, video games and other fictional media. Their function, however, is often exaggerated with the defibrillator inducing a sudden, violent jerk or convulsion by the
220:
A defibrillation device that is often available outside of medical centers is the automated external defibrillator (AED), a portable machine that can be used with no previous training. That is possible because the machine produces pre-recorded voice instructions that guide the user. The device
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The Lown-Berkovits waveform, as it was known, was the standard for defibrillation until the late 1980s. Earlier in the 1980s, the "MU lab" at the
University of Missouri had pioneered numerous studies introducing a new waveform called a biphasic truncated waveform (BTE). In this waveform an
736:
Beck's theory was that ventricular fibrillation often occurred in hearts that were fundamentally healthy, in his terms "Hearts that are too good to die", and that there must be a way of saving them. Beck first used the technique successfully on a 14-year-old boy who was having his
632:
as the paddles would be. If defibrillation is required, the machine is charged, and the shock is delivered, without any need to apply any additional gel or to retrieve and place any paddles. Most adhesive electrodes are designed to be used not only for defibrillation, but also for
503:
is a portable external defibrillator that can be worn by at-risk patients. The unit monitors the patient 24 hours a day and can automatically deliver a biphasic shock if VF or VT is detected. This device is mainly indicated in patients who are not immediate candidates for ICDs.
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because of a congenital growth disorder, causing breathing problems. The boy's chest was surgically opened, and manual cardiac massage was undertaken for 45 minutes until the arrival of the defibrillator. Beck used internal paddles on either side of the heart, along with
640:. These adhesive pads are found on most automated and semi-automated units and are replacing paddles entirely in non-hospital settings. In hospital, for cases where cardiac arrest is likely to occur (but has not yet), self-adhesive pads may be placed prophylactically.
464:(and many can also perform the pacemaking function). They constantly monitor the patient's heart rhythm, and automatically administer shocks for various life-threatening arrhythmias, according to the device's programming. Many modern devices can distinguish between
495:
to place over the device, which effectively disables the shock function of the device while still allowing the pacemaker to function (if the device is so equipped). If the device is shocking frequently, but appropriately, EMS personnel may administer sedation.
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The problems to be overcome were the design of a system which would allow detection of ventricular fibrillation or ventricular tachycardia. Despite the lack of financial backing and grants, they persisted and the first device was implanted in
February 1980 at
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and G. S. Yunyev in 1939. In 1947 their works were reported in western medical journals. Serial production of Gurvich's pulse defibrillator started in 1952 at the electromechanical plant of the institute, and was designated model ИД-1-ВЭИ
614:
Paddles are reusable, being cleaned after use and stored for the next patient. Gel is therefore not preapplied, and must be added before these paddles are used on the patient. Paddles are generally only found on manual external units.
1970:
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where a hollow needle is used to pass an insulated wire to the heart area to deliver the electrical shock. The hollow steel needle acted as one end of the circuit and the tip of the insulated wire the other end. Whether the
480:. Some devices may attempt overdrive pacing prior to synchronised cardioversion. When the life-threatening arrhythmia is ventricular fibrillation, the device is programmed to proceed immediately to an unsynchronized shock.
403:. The electrodes consist of round metal plates that come in direct contact with the myocardium. Manual internal defibrillators deliver the shock through paddles placed directly on the heart. They are mostly used in the
212:, defibrillation is not indicated. Defibrillation is also not indicated if the patient is conscious or has a pulse. Improperly given electrical shocks can cause dangerous dysrhythmias, such as ventricular fibrillation.
2380:Гурвич Н.Л., Юньев Г.С. О восстановлении нормальной деятельности фибриллирующего сердца теплокровных посредством конденсаторного разряда // Бюллетень экспериментальной биологии и медицины, 1939, Т. VIII, № 1, С. 55–58
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studies showed damage to the cells of the heart muscle post-mortem. The nature of the AC machine with a large transformer also made these units very hard to transport, and they tended to be large units on wheels.
1405:
Hoskins, MH; De Lurgio, DB (2012). "Chapter 129. Pacemakers, Defibrillators, and Cardiac Resynchronization Devices in Hospital Medicine". In McKean SC; Ross JJ; Dressler DD; Brotman DJ; Ginsberg JS (eds.).
368:, which can be separate or built-in. A healthcare provider first diagnoses the cardiac rhythm and then manually determine the voltage and timing for the electrical shock. These units are primarily found in
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862:) to the heart by way of paddle electrodes. This team further developed an understanding of the optimal timing of shock delivery in the cardiac cycle, enabling the application of the device to
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1937:
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had a cardiac arrest due to a heart attack and, purely by chance, the ambulance that responded to the call carried a defibrillator. After recovering, Kerry Packer donated a large sum to the
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The invention of implantable units is invaluable to some people with regular heart problems, although they are generally only given to those people who have already had a cardiac episode.
978:
The work was commenced, despite doubts amongst leading experts in the field of arrhythmias and sudden death. There was doubt that their ideas would ever become a clinical reality. In 1962
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volts, conducted by means of externally applied electrodes through the chest cage to the heart, was pioneered by Dr V. Eskin with assistance by A. Klimov in Frunze, USSR (today known as
433:
As early defibrillation can significantly improve VF outcomes, AEDs have become publicly available in many easily accessible areas. AEDs have been incorporated into the algorithm for
2440:
Humphrey H.H. "An important phase of world medical research: Let's compete with U.S.S.R. in research on reversibility of death." Congressional Records, October 13, 1962; A7837–A7839
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The first Czechoslovak "universal defibrillator Prema" was manufactured in 1957 by the company Prema, designed by Dr. Bohumil Peleška. In 1958 his device was awarded Grand Prix at
766:
Until the early 1950s, defibrillation of the heart was possible only when the chest cavity was open during surgery. The technique used an alternating voltage from a 300 or greater
1361:
Werman, Howard A.; Karren, K; Mistovich, Joseph (2014). "Automated External Defibrillation and Cardiopulmonary Resuscitation". In Werman A. Howard; Mistovich J; Karren K (eds.).
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in 60% of cardiac arrest patients treated with a single shock from a monophasic defibrillator. Most biphasic defibrillators have a first shock success rate of greater than 90%.
487:, as it depletes the device's battery life, causes significant discomfort and anxiety to the patient, and in some cases may actually trigger life-threatening arrhythmias. Some
791:
A circuit diagram showing the simplest (non-electronically controlled) defibrillator design, depending on the inductor (damping), producing a Lown, Edmark or Gurvich Waveform
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Chan, Paul S.; Krumholz, Harlan M.; Spertus, John A.; Jones, Philip G.; Cram, Peter; Berg, Robert A.; Peberdy, Mary Ann; Nadkarni, Vinay; Mancini, Mary E. (2010-11-17).
2313:
Sov Zdravookhr Kirg. (1975). "Some results with the use of the DPA-3 defibrillator (developed by V. Ia. Eskin and A. M. Klimov) in the treatment of terminal states".
1445:
Marenco, JP; Wang, PJ; Link, MS; Homoud, MK; Estes III, NAM (2001). "Improving Survival From Sudden Cardiac ArrestThe Role of the Automated External Defibrillator".
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automatically checks the patient's condition and applies the correct electric shocks. There also exist written instructions that explain the procedure step-by-step.
704:, Switzerland. They discovered that small electrical shocks could induce ventricular fibrillation in dogs, and that larger charges would reverse the condition.
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asystole or PEA), people with a shockable rhythm (such as VF or pulseless ventricular tachycardia) have improved survival rates, ranging between 21 and 50%.
169:(AEDs), automate the diagnosis of treatable rhythms, meaning that lay responders or bystanders are able to use them successfully with little or no training.
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defibrillators, biphasic defibrillation significantly decreases the energy level necessary for successful defibrillation, decreasing the risk of burns and
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Kerber, RE (2011). "Chapter 46. Indications and Techniques of Electrical Defibrillation and Cardioversion". In Fuster V; Walsh RA; Harrington RA (eds.).
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192:(CPR). CPR is an algorithm-based intervention aimed to restore cardiac and pulmonary function. Defibrillation is indicated only in certain types of
2965:
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Powell, Judy; Van Ottingham, Lois; Schron, Eleanor (2016-12-01). "Public defibrillation: increased survival from a structured response system".
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the user to stand back while the shock is automatically given. Some types of AEDs come with advanced features, such as a manual override or an
245:
1994:
1938:"European Resuscitation Council Guidelines for Resuscitation 2015 Section 2. Adult basic life support and automated external defibrillation"
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Perkins, GD; Handley, AJ; Koster, RW; Castren, M; Smyth, T; Monsieurs, KG; Raffay, V; Grasner, JT; Wenzel, V; Ristagno, G; Soar, J (2015).
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Nadkarni, Vinay M. (2006-01-04). "First Documented Rhythm and Clinical Outcome From In-Hospital Cardiac Arrest Among Children and Adults".
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586:, also called chest impedance (despite the DC discharge) which would burn the patient. Gel may be either wet (similar in consistency to
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My marathon talk with Russia's boss: Senator Humphrey reports in full on Khrushchev – his threats, jokes, criticism of China's communes
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1142:). This is not normal medical practice, as the heart cannot be restarted by the defibrillator itself. Only the cardiac arrest rhythms
396:
are trained to recognize lethal arrhythmias and deliver appropriate electrical therapy with a manual defibrillator when appropriate.
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defibrillator. This device applied a direct current from a discharging capacitor through the chest wall into the heart to stop heart
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1821:"AED training and its impact on skill acquisition, retention and performance – a systematic review of alternative training methods"
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back, behind the heart in the region between the scapula. This placement is preferred because it is best for non-invasive pacing.
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2398:Аппарат для дефибрилляции сердца одиночным электрическим импульсо,м in: Гурвич Н.Л. Фибрилляция и дефибрилляция сердца. Moscow,
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Gurvich NL, Yunyev GS. Restoration of a regular rhythm in the mammalian fibrillating heart // Am Rev Sov Med. 1946 Feb;3:236–239
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Early successful experiments of successful defibrillation by the discharge of a capacitor performed on animals were reported by
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then delivering the charge through an inductance such as to produce a heavily damped sinusoidal wave of finite duration (~5
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left of the pectoral muscle. This scheme works well for defibrillation and cardioversion, as well as for monitoring an ECG.
178:
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up until the 1990s it was relatively rare for ambulances to carry defibrillators. This changed in 1990 after Australian
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Manual external defibrillators require the expertise of a healthcare professional. They are used in conjunction with an
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This means that no clinical skill is required in their use, allowing lay people to respond to emergencies effectively.
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Jolley, Matthew; Stinstra, Jeroen; Pieper, Steve; MacLeod, Rob; Brooks, Dana; Cecchin, Frank; Triedman, John (2008).
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Ong, ME; Lim, S; Venkataraman, A (2016). "Defibrillation and cardioversion". In Tintinalli JE; et al. (eds.).
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in physiology and medicine, telling Congress: "Let's compete with U.S.S.R. in research on reversibility of death".
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The connection between the defibrillator and the patient consists of a pair of electrodes, each provided with
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normally. Someone who is already in asystole cannot be helped by electrical means, and usually needs urgent
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An internal defibrillator is often used to defibrillate the heart during or after cardiac surgery such as a
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131:(CPR) and medication, and then by cardioversion or defibrillation if it converts into a shockable rhythm.
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should be fitted with a personal defibrillator, which is why defibrillators in Australia are sometimes
947:
A further development in defibrillation came with the invention of the implantable device, known as an
488:
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Venegas-Borsellino, C; Bangar, MD (2016). "CPR and ACLS Updates". In Orpello JM; et al. (eds.).
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There are cases where the patient's ICD may fire constantly or inappropriately. This is considered a
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is equipped with a manual defibrillator for use by the attending paramedics and technicians. In the
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779:) in the mid-1950s. The duration of AC shocks was typically in the range of 100–150 milliseconds.
2352:"Apparatus for defibrillation or cardioversion with a waveform optimized in the frequency domain"
1987:
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88:
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2120:"A Computer Modeling Tool for Comparing Novel ICD Electrode Orientations in Children and Adults"
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Special pads are used for children under the age of 8 or those under 55 lbs. (22 kg).
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2244:"Restoration of the Functions of the Heart and Central Nervous System after Complete Anemia"
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460:, also known as automatic internal cardiac defibrillator (AICD), are implants similar to
257:
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1957:
1839:
1382:"Basic principles and technique of external electrical cardioversion and defibrillation"
611:), though in hospital situations, separate monitoring leads are often already in place.
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Researchers have created a software modeling system capable of mapping an individual's
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The external defibrillator, as it is known today, was invented by electrical engineer
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and determining the best position for an external or internal cardiac defibrillator.
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1654:"Teaching Colleagues and the General Public about Automatic External Defibrillators"
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available, AEDs have improved outcomes for sudden out-of-hospital cardiac arrests.
92:
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1535:"Cardiopulmonary Resuscitation (CPR): Practice Essentials, Preparation, Technique"
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2450:"П О РТА ТИ ВН Ы Й Д Е Ф И Б Р И Л Л Я Т О Р С У Н И В Е РС А Л Ь Н Ы М ПИТАНИЕМ"
1876:"Automated external defibrillators and survival after in-hospital cardiac arrest"
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Until the mid 1990s, external defibrillators delivered a Lown type waveform (see
896:
165:), depending on the type of device used or needed. Some external units, known as
116:
56:
2135:
1772:"Public-Access Defibrillation and Survival after Out-of-Hospital Cardiac Arrest"
441:, such as firefighters, policemen, and security guards, are equipped with them.
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Principles of Biomedical Instrumentation and Measurement: International Edition
1685:"External Defibrillators – External Defibrillator Improvement Initiative Paper"
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127:(flatline) cannot be restarted by a defibrillator; it would be treated only by
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2172:"Defibrillation of the heart: insights into mechanisms from modelling studies"
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Yeung, Joyce; Okamoto, Deems; Soar, Jasmeet; Perkins, Gavin D. (2011-06-01).
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1481:"What is an automated external defibrillator? Defibrillators, cardiac arrest"
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Heart Smarter: EMS Implications of the 2005 AHA Guidelines for ECC & CPR
1597:"Regional Variation in Out-of-Hospital Cardiac Arrest Incidence and Outcome"
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commenced research in his animal laboratory in collaboration with engineer
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2625:"Dr Karl's Great Moments In Science, Flatline and defibrillator (Part II)"
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a dog, like Prévost and Batelli. The first use on a human was in 1947 by
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2917:
2831:
1065: in this section. Unsourced material may be challenged and removed.
929:
924:
776:
393:
331: in this section. Unsourced material may be challenged and removed.
24:
1771:
1682:
66:
3027:
2912:
2879:
2707:
1272:
1176:
968:
959:
by a team that included Stephen Heilman, Alois Langer, Jack Lattuca,
956:
847:
604:
373:
2334:
1770:
Investigators, The Public Access Defibrillation Trial (2004-08-12).
1040:
517:
306:
2937:
2927:
2922:
1139:
742:
369:
205:
124:
1350:(13th ed.). New York: McGraw-Hill – via AccessMedicine.
895:
1959. In the west this was pioneered in the early 1960s by Prof.
802:Импульсный Дефибриллятор 1, Всесоюзный Электротехнический Институт
900:
816:
772:
738:
1318:
Tintinalli's Emergency Medicine: A Comprehensive Study Guide, 8e
2807:
2703:
FDA Heart Health Online: Automated External Defibrillator (AED)
851:
492:
1251:
Implantable cardioverter-defibrillator with its lead (ex vivo)
2221:"Some Effects of Electric Discharge on the Hearts of Mammals"
1165:
855:
100:
2693:
Center for Integration of Medicine and Innovative Technology
2687:
1380:
Knight, Bradley P. Page, Richard L; Downey, Brian C (eds.).
407:
and, in rare circumstances, in the emergency room during an
2117:
1935:
806:
Pulse Defibrillator 1, All-Union Electrotechnical Institute
767:
2094:"What is the Difference Between Adult and Pediatric Pads"
1715:
1152:
787:
754:
drug, and achieved return of a perfusing cardiac rhythm.
607:
means tissue loss. Modern paddles allow for monitoring (
582:
gel in order to ensure a good connection and to minimize
446:
244:
deal primarily with North America and do not represent a
2218:
1873:
1425:
659:
Anterior-apex placement of electrodes for defibrillation
2692:
2044:
Adler, Arnon; Halkin, Amir; Viskin, Sami (2013-02-19).
1818:
1765:
1763:
134:
In contrast to defibrillation, synchronized electrical
846:
into a technique which involved charging of a bank of
146:, cardioversion normally aims to end poorly perfusing
44:
View of defibrillator electrode position and placement
2698:
American Red Cross: Saving a Life is as Easy as A-E-D
2562:"Pacemaker Failure following External Defibrillation"
1444:
1360:
808:). It is described in detail in Gurvich's 1957 book,
138:
is an electrical shock delivered in synchrony to the
2459:(Portable defibrillator with universal power supply)
2312:
1760:
1410:. New York: McGraw-Hill – via Access Medicine.
414:
935:Ventricular fibrillation (VF) could be returned to
179:
Cardiopulmonary_resuscitation § Defibrillators
1315:
1020:, cardioversion, and defibrillation capabilities.
692:Defibrillators were first demonstrated in 1899 by
111:, ending the arrhythmia. Subsequently, the body's
16:Treatment for life-threatening cardiac arrhythmias
2619:
2443:
2291:. Case Western Reserve University. Archived from
2043:
3158:
1506:"How to use an automated external defibrillator"
1404:
157:Defibrillators can be external, transvenous, or
2966:International Federation for Emergency Medicine
2650:
2520:on 2013-01-05 – via Wiley Online Library.
2488:Gold, Michael; Nisam, Seah (January 21, 2002).
2165:
2163:
2970:International Conference on Emergency Medicine
1980:
1421:
1419:
1417:
1168:; this more-complicated procedure is known as
684:tissue responds to a strong electrical shock.
452:
103:. Although not fully understood, this process
2723:
2434:
2421:
1769:
242:The examples and perspective in this section
204:. If the heart has completely stopped, as in
188:Defibrillation is often an important step in
91:(V-Tach). A defibrillator delivers a dose of
2986:Canadian Association of Emergency Physicians
2663:"School defibrillators could be a lifesaver"
2613:
2160:
1988:"Benefits of Fully Automated Defibrillators"
1931:
1929:
1927:
1683:Center for Devices and Radiological Health.
1408:Principles and Practice of Hospital Medicine
1311:
1309:
1307:
1305:
1303:
1164:and ventricular tachycardia that produces a
119:of the heart is able to re-establish normal
3092:Care of the Critically Ill Surgical Patient
2981:Australasian College for Emergency Medicine
2264:
2169:
1528:
1526:
1414:
1239:Close-up of a pair of defibrillator paddles
627:Self-adhesive electrodes of a defibrillator
618:
546:. Unsourced material may be challenged and
2730:
2716:
2346:
2344:
1711:
1709:
907:at the arrival of pre-hospital providers.
260:, or create a new section, as appropriate.
38:
2580:
2487:
2225:Comptes Rendus de l'Académie des Sciences
2187:
2143:
2061:
1956:
1924:
1907:
1869:
1867:
1865:
1787:
1628:
1300:
1125:Learn how and when to remove this message
566:Learn how and when to remove this message
347:Learn how and when to remove this message
276:Learn how and when to remove this message
2976:American College of Emergency Physicians
2559:
2553:
2258:
1651:
1645:
1551:
1545:
1523:
1341:
1339:
1337:
1335:
1333:
1331:
786:
782:
654:
622:
172:
2996:European Society for Emergency Medicine
2405:
2374:
2341:
2265:Corporation, Bonnier (1 October 1933).
2241:
2235:
2212:
1706:
1227:State-of-the-art defibrillator (manual)
491:personnel are now equipped with a ring
458:Implantable cardioverter-defibrillators
3159:
3006:American Academy of Emergency Medicine
2737:
2657:
2506:10.1046/j.1460-9592.2002.t01-1-00876.x
2431:New York, Time, Inc., 1959, pp. 80–91.
2392:
2383:
2362:from the original on 24 September 2015
2111:
2046:"Wearable Cardioverter-Defibrillators"
1862:
1594:
1588:
1438:
1398:
1345:
1030:
990:. In 1972, Lown stated in the journal
949:implantable cardioverter-defibrillator
942:
761:
163:implantable cardioverter-defibrillator
2711:
2530:
2524:
2494:Pacing and Clinical Electrophysiology
2481:
2289:"Claude Beck, defibrillation and CPR"
2037:
1812:
1718:The Journal of Cardiovascular Nursing
1664:from the original on January 23, 2017
1532:
1354:
1328:
810:Heart Fibrillation and Defibrillation
215:
89:non-perfusing ventricular tachycardia
3001:Asian Society for Emergency Medicine
2462:
2412:Elektrická kardioverze a defibrilace
2306:
2281:
2012:
1188:Ambulance Service of New South Wales
1063:adding citations to reliable sources
1034:
850:to approximately 1000 volts with an
597:
544:adding citations to reliable sources
511:
329:adding citations to reliable sources
300:
228:
79:is a treatment for life-threatening
3086:Advanced Life Support in Obstetrics
2991:Royal College of Emergency Medicine
2629:Australian Broadcasting Corporation
2315:Sovetskoe Zdravookhranenie Kirgizii
1958:10.1016/j.resuscitation.2015.07.015
1840:10.1016/j.resuscitation.2011.02.035
1676:
1288:Wearable cardioverter defibrillator
501:wearable cardioverter defibrillator
472:, and more benign arrhythmias like
288:Survival rates for out-of-hospital
210:pulseless electrical activity (PEA)
142:. Although the person may still be
13:
2000:from the original on 29 March 2012
1379:
1027:small babies shortly after birth.
914:
14:
3193:
2681:
2219:Prevost J.L., Batelli F. (1899).
2063:10.1161/CIRCULATIONAHA.112.146530
951:(or ICD). This was pioneered at
889:
415:Automated external defibrillators
202:pulseless ventricular tachycardia
167:automated external defibrillators
3139:
3128:
3127:
2783:International emergency medicine
2688:Sudden Cardiac Arrest Foundation
2416:Intervenční a akutní kardiologie
1976:from the original on 2016-12-20.
1730:10.1097/00005082-200411000-00009
1541:from the original on 2016-12-07.
1268:Automated external defibrillator
1244:
1232:
1220:
1208:
1190:in order that all ambulances in
1039:
516:
421:Automated external defibrillator
359:
305:
233:
3140:
3080:Pediatric Advanced Life Support
2793:Pre-hospital emergency medicine
2635:from the original on 2012-11-10
2086:
1776:New England Journal of Medicine
1695:from the original on 2016-11-10
1363:Prehospital Emergency Care, 10e
1050:needs additional citations for
1012:. Modern ICDs do not require a
731:Case Western Reserve University
316:needs additional citations for
3068:Acute Care of at-Risk Newborns
3062:Neonatal Resuscitation Program
2189:10.1113/expphysiol.2005.030973
2022:. Zoll Lifecor. Archived from
1498:
1473:
183:
1:
3050:Advanced cardiac life support
3033:Cardiopulmonary resuscitation
1595:Nichol, Graham (2008-09-24).
1263:Advanced cardiac life support
1215:Early defibrillator from 1947
190:cardiopulmonary resuscitation
129:cardiopulmonary resuscitation
3177:Emergency medical procedures
3074:Pediatric basic life support
3056:Advanced trauma life support
3039:Mouth-to-mouth resuscitation
2788:Pediatric emergency medicine
2651:General and cited references
2327:10.1016/0006-291x(75)90518-5
2242:Lockyer, Sir Norman (1900).
1508:. 2011-06-23. Archived from
1483:. 2011-06-23. Archived from
1293:
1162:supraventricular tachycardia
833:National Institute of Health
678:
650:
636:and synchronized electrical
507:
474:supraventricular tachycardia
152:supraventricular tachycardia
7:
2560:Giedwoyn, Jerzy O. (1972).
2136:10.1016/j.hrthm.2008.01.018
1533:Borke, Jesse (2016-11-03).
1256:
878:in the technique known as "
453:Cardioverter-defibrillators
256:, discuss the issue on the
224:
10:
3198:
2758:Emergency medical services
2537:Merrill Publishing Company
1201:
1198:called "Packer Whackers".
729:, professor of surgery at
717:was a success is unknown.
696:and Frédéric Batelli, two
687:
489:emergency medical services
418:
176:
18:
3172:Cardiac electrophysiology
3122:
3101:
3014:
2956:
2905:
2816:
2745:
2277:– via Google Books.
1469:– via JAMA Network.
708:invention was called the
63:
49:
37:
32:
2933:Epinephrine / Adrenaline
1993:. Physio-Control. 2011.
1660:. Prog Cardiovasc Nurs.
1613:10.1001/jama.300.12.1423
1144:ventricular fibrillation
982:introduced the external
619:Self-adhesive electrodes
466:ventricular fibrillation
296:
198:ventricular fibrillation
85:ventricular fibrillation
19:Not to be confused with
2582:10.1161/01.cir.44.2.293
2531:Aston, Richard (1991).
2176:Experimental Physiology
2020:"What is the LifeVest?"
1459:10.1001/jama.285.9.1193
1148:ventricular tachycardia
874:, and supraventricular
831:federal program in the
590:) or solid (similar to
580:electrically conductive
470:ventricular tachycardia
376:. For instance, every
1892:10.1001/jama.2010.1576
1432:McGraw-Hill (New York)
1322:McGraw-Hill (New York)
1172:, not defibrillation.
1002:Johns Hopkins Hospital
973:University of Missouri
792:
660:
628:
123:. A heart which is in
107:a large amount of the
3114:Injury Severity Score
2885:Nasopharyngeal airway
2858:Intraosseous infusion
2269:. Bonnier Corporation
1566:10.1001/jama.295.1.50
1283:Myocardial infarction
790:
783:Direct current method
658:
634:transcutaneous pacing
626:
584:electrical resistance
173:Use of defibrillators
2891:Oropharyngeal airway
2768:Emergency psychiatry
2753:Emergency department
2402:, 1957, pp. 229–233.
2170:Trayanova N (2006).
1789:10.1056/NEJMoa040566
1652:Beaumont, E (2001).
1059:improve this article
923:), a heavily damped
822:In 1958, US senator
702:University of Geneva
540:improve this section
409:open heart procedure
325:improve this article
254:improve this section
194:cardiac dysrhythmias
3167:American inventions
2870:Tracheal intubation
2864:Intravenous therapy
1369:, Inc. p. 425.
1031:Society and culture
943:Implantable devices
868:atrial fibrillation
854:content of 100–200
762:Closed-chest method
741:separated from his
722:William Kouwenhoven
609:electrocardiography
478:atrial fibrillation
148:cardiac arrhythmias
81:cardiac arrhythmias
3044:Basic life support
2948:Sodium bicarbonate
2746:Emergency medicine
2739:Emergency medicine
2667:The Globe and Mail
2474:2007-06-16 at the
2455:2014-11-29 at the
824:Hubert H. Humphrey
793:
694:Jean-Louis Prévost
661:
629:
588:surgical lubricant
435:basic life support
216:Application method
3154:
3153:
2943:Magnesium sulfate
2852:Electrocardiogram
2778:Medical emergency
2763:Emergency nursing
2621:Karl Kruszelnicki
2546:978-0-02-946562-2
2267:"Popular Science"
1886:(19): 2129–2136.
1607:(12): 1423–1431.
1367:Pearson Education
1348:Hurst's The Heart
1135:
1134:
1127:
1109:
828:Nikita Khrushchev
804:, or in English,
598:Paddle electrodes
576:
575:
568:
485:medical emergency
380:ambulance in the
366:electrocardiogram
357:
356:
349:
286:
285:
278:
113:natural pacemaker
74:
73:
3189:
3143:
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2676:
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2673:
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2641:
2640:
2617:
2611:
2610:
2584:
2566:
2557:
2551:
2550:
2528:
2522:
2521:
2516:. Archived from
2485:
2479:
2466:
2460:
2447:
2441:
2438:
2432:
2425:
2419:
2409:
2403:
2396:
2390:
2387:
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2369:
2367:
2358:. 21 June 2006.
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1521:
1520:
1518:
1517:
1502:
1496:
1495:
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1471:
1470:
1453:(9): 1193–1200.
1442:
1436:
1435:
1423:
1412:
1411:
1402:
1396:
1395:
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1392:
1377:
1371:
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1313:
1248:
1236:
1224:
1212:
1130:
1123:
1119:
1116:
1110:
1108:
1074:"Defibrillation"
1067:
1043:
1035:
1008:Jr. assisted by
844:Barouh Berkovits
571:
564:
560:
557:
551:
520:
512:
439:first responders
388:, many advanced
352:
345:
341:
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332:
309:
301:
281:
274:
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237:
236:
229:
95:(often called a
93:electric current
67:edit on Wikidata
59:
42:
30:
29:
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3182:Medical devices
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3102:Scoring systems
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2486:
2482:
2476:Wayback Machine
2467:
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2457:Wayback Machine
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1192:New South Wales
1131:
1120:
1114:
1111:
1068:
1066:
1056:
1044:
1033:
965:Michel Mirowski
945:
917:
915:Waveform change
897:Frank Pantridge
892:
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764:
690:
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621:
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537:
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290:cardiac arrests
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196:, specifically
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117:sinoatrial node
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2875:Laryngeal tube
2872:
2867:
2861:
2855:
2849:
2843:
2837:Defibrillation
2834:
2829:
2826:Bag valve mask
2822:
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2814:
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2800:
2795:
2790:
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2706:
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2700:
2695:
2690:
2683:
2682:External links
2680:
2678:
2677:
2661:(2007-04-27).
2654:
2652:
2649:
2646:
2645:
2623:(2008-08-08).
2612:
2552:
2545:
2523:
2490:"Jack Lattuca"
2480:
2461:
2442:
2433:
2427:Humphrey H H.
2420:
2404:
2391:
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2373:
2340:
2317:(in Russian).
2305:
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2257:
2234:
2211:
2182:(2): 323–337.
2159:
2130:(4): 565–572.
2110:
2085:
2056:(7): 854–860.
2036:
2011:
1979:
1923:
1861:
1834:(6): 657–664.
1811:
1782:(7): 637–646.
1759:
1724:(6): 384–389.
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1146:and pulseless
1133:
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1047:
1045:
1038:
1032:
1029:
953:Sinai Hospital
944:
941:
916:
913:
891:
890:Portable units
888:
872:atrial flutter
784:
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248:of the subject
246:worldwide view
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177:Main article:
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144:critically ill
77:Defibrillation
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33:Defibrillation
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2958:Organisations
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2295:on 2007-10-24
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2059:
2055:
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2047:
2040:
2026:on 2008-11-21
2025:
2021:
2015:
1996:
1989:
1983:
1972:
1968:
1964:
1959:
1954:
1950:
1946:
1945:Resuscitation
1939:
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1930:
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1828:Resuscitation
1822:
1815:
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1512:on 2011-06-23
1511:
1507:
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1487:on 2011-06-23
1486:
1482:
1476:
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1456:
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1428:Critical Care
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1278:Cardioversion
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1170:cardioversion
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1086:
1083:
1079:
1076: –
1075:
1071:
1070:Find sources:
1064:
1060:
1054:
1053:
1048:This section
1046:
1042:
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1036:
1028:
1024:
1021:
1019:
1015:
1011:
1010:Vivien Thomas
1007:
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880:cardioversion
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845:
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836:
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798:
797:N. L. Gurvich
789:
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723:
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699:
698:physiologists
695:
685:
676:
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648:
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638:cardioversion
635:
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386:United States
383:
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375:
371:
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360:Manual models
351:
348:
340:
330:
326:
320:
319:
314:This section
312:
308:
303:
302:
294:
291:
280:
277:
269:
266:December 2023
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140:cardiac cycle
137:
136:cardioversion
132:
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110:
106:
102:
98:
97:counter-shock
94:
90:
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82:
78:
68:
62:
58:
54:
52:
48:
41:
36:
31:
26:
22:
3138:
3126:
3020:Life support
2836:
2798:Major trauma
2670:. Retrieved
2666:
2637:. Retrieved
2615:
2572:
2568:
2555:
2532:
2526:
2518:the original
2497:
2493:
2483:
2464:
2445:
2436:
2428:
2423:
2415:
2407:
2394:
2385:
2376:
2366:22 September
2364:. Retrieved
2355:
2321:(4): 23–25.
2318:
2314:
2308:
2297:. Retrieved
2293:the original
2283:
2271:. Retrieved
2260:
2251:
2247:
2237:
2231:: 1267–1268.
2228:
2224:
2214:
2179:
2175:
2127:
2124:Heart Rhythm
2123:
2113:
2102:. Retrieved
2100:. 2018-05-16
2097:
2088:
2053:
2049:
2039:
2028:. Retrieved
2024:the original
2014:
2002:. Retrieved
1982:
1948:
1944:
1883:
1879:
1831:
1827:
1814:
1779:
1775:
1721:
1717:
1697:. Retrieved
1688:
1678:
1666:. Retrieved
1657:
1647:
1604:
1600:
1590:
1560:(1): 50–57.
1557:
1553:
1547:
1514:. Retrieved
1510:the original
1500:
1489:. Retrieved
1485:the original
1475:
1450:
1446:
1440:
1427:
1407:
1400:
1389:. Retrieved
1385:
1375:
1362:
1356:
1347:
1317:
1196:colloquially
1184:Kerry Packer
1174:
1136:
1121:
1112:
1102:
1095:
1088:
1081:
1069:
1057:Please help
1052:verification
1049:
1025:
1022:
1016:and possess
1006:Levi Watkins
998:
991:
988:fibrillation
980:Bernard Lown
977:
961:Morton Mower
946:
937:sinus rhythm
934:
921:Bernard Lown
918:
909:
893:
884:
876:tachycardias
860:milliseconds
840:Bernard Lown
837:
821:
814:
809:
805:
801:
794:
765:
756:
748:procainamide
735:
719:
714:
709:
706:
691:
682:
670:
666:
662:
646:
642:
630:
613:
605:nonperfusion
601:
577:
562:
553:
538:Please help
526:
498:
482:
456:
443:
437:(BLS). Many
432:
428:
424:
401:heart bypass
398:
372:and on some
363:
343:
334:
323:Please help
318:verification
315:
287:
272:
263:
243:
219:
187:
156:
133:
121:sinus rhythm
109:heart muscle
96:
87:(V-Fib) and
76:
75:
21:infibulation
2897:Pocket mask
2773:Golden hour
2569:Circulation
2050:Circulation
2004:12 December
1689:www.fda.gov
1668:December 8,
1181:media mogul
1157:intravenous
1014:thoracotomy
993:Circulation
905:tachycardia
864:arrhythmias
727:Claude Beck
592:gummi candy
556:August 2014
337:August 2014
184:Indications
105:depolarizes
3161:Categories
3109:NACA score
2918:Amiodarone
2832:Chest tube
2672:2015-07-23
2639:2011-12-21
2575:(2): 293.
2500:(5): 876.
2299:2007-06-15
2104:2021-08-06
2098:AED Brands
2030:2009-02-09
1699:2016-12-08
1516:2024-05-09
1491:2021-11-08
1391:2019-07-24
1085:newspapers
930:myocardial
925:sinusoidal
848:capacitors
777:Kyrgyzstan
739:breastbone
715:Hyman Otor
710:Hyman Otor
462:pacemakers
394:paramedics
374:ambulances
150:, such as
25:Defibrator
3028:First aid
2913:Adenosine
2880:Combitube
2854:(ECG/EKG)
2818:Equipment
2591:1524-4539
2514:222087116
2072:0009-7322
1951:: 81–99.
1900:1538-3598
1848:1873-1570
1798:0028-4793
1738:0889-4655
1621:0098-7484
1574:0098-7484
1294:Citations
1273:Ambulance
1177:Australia
1115:June 2021
969:Mir Imran
957:Baltimore
700:from the
679:Mechanism
651:Placement
527:does not
508:Interface
449:display.
370:hospitals
258:talk page
200:(VF) and
159:implanted
99:) to the
3133:Category
3094:(CCrISP)
2938:Naloxone
2928:Dopamine
2923:Atropine
2633:Archived
2478:pp 15-16
2472:Archived
2453:Archived
2360:Archived
2206:29999829
2198:16469820
2154:18362024
2080:23429896
1995:Archived
1971:Archived
1967:26477420
1918:21078809
1856:21458137
1806:15306665
1754:28998226
1746:15529059
1693:Archived
1662:Archived
1658:Medscape
1639:18812533
1582:16391216
1539:Archived
1467:11231750
1386:UpToDate
1257:See also
1140:asystole
932:damage.
866:such as
838:In 1959
826:visited
392:and all
252:You may
225:Outcomes
206:asystole
125:asystole
3145:Outline
3070:(ACoRN)
3016:Courses
2599:5562564
2356:Patents
2145:2745086
1909:3587791
1630:3187919
1202:Gallery
1099:scholar
1004:by Dr.
901:Belfast
817:Expo 58
773:Bishkek
688:History
548:removed
533:sources
115:in the
57:D047548
3088:(ALSO)
3082:(PALS)
3076:(PBLS)
3058:(ATLS)
3052:(ACLS)
2808:Triage
2607:608076
2605:
2597:
2589:
2543:
2512:
2400:Medgiz
2333:
2254:: 532.
2248:Nature
2204:
2196:
2152:
2142:
2078:
2070:
1965:
1916:
1906:
1898:
1854:
1846:
1804:
1796:
1752:
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1736:
1637:
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1619:
1580:
1572:
1465:
1101:
1094:
1087:
1080:
1072:
1018:pacing
967:, and
856:joules
852:energy
493:magnet
3064:(NRP)
3046:(BLS)
3035:(CPR)
2906:Drugs
2893:(OPA)
2887:(NPA)
2828:(BVM)
2603:S2CID
2565:(PDF)
2510:S2CID
2273:2 May
2202:S2CID
1998:(PDF)
1991:(PDF)
1974:(PDF)
1941:(PDF)
1824:(PDF)
1750:S2CID
1166:pulse
1106:JSTOR
1092:books
750:, an
673:chest
297:Types
101:heart
65:[
2866:(IV)
2860:(IO)
2595:PMID
2587:ISSN
2541:ISBN
2368:2014
2331:PMID
2275:2018
2194:PMID
2150:PMID
2076:PMID
2068:ISSN
2006:2016
1963:PMID
1914:PMID
1896:ISSN
1880:JAMA
1852:PMID
1844:ISSN
1802:PMID
1794:ISSN
1742:PMID
1734:ISSN
1670:2016
1635:PMID
1617:ISSN
1601:JAMA
1578:PMID
1570:ISSN
1554:JAMA
1463:PMID
1447:JAMA
1155:and
1078:news
768:volt
743:ribs
733:.
531:any
529:cite
476:and
390:EMTs
51:MeSH
2846:ICD
2841:AED
2577:doi
2502:doi
2323:doi
2229:129
2184:doi
2140:PMC
2132:doi
2058:doi
2054:127
1953:doi
1904:PMC
1888:doi
1884:304
1836:doi
1784:doi
1780:351
1726:doi
1625:PMC
1609:doi
1605:300
1562:doi
1558:295
1455:doi
1451:285
1175:In
1153:CPR
1061:by
955:in
899:in
882:".
542:by
447:ECG
378:NHS
327:by
208:or
23:or
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