605:). 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.
1257:
635:
897:
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.
51:
655:
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.
1233:
667:
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246:
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529:
318:
1007:– "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."
799:
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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
441:
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.
1149:
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
982:, 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
735:
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
654:
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
642:
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
455:
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
440:
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
436:
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
303:
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
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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.
718:
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
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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
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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
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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
905:
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
674:
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
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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
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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
914:. 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
841:
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
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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
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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
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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
231:
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
747:
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
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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
514:
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
651:. 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.
475:(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
506:
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
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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.
1981:
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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
491:. 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.
414:. 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
223:, 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.
2391: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.
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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.).
379:, 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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873:) 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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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.
989:
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
444:
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
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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
777:
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
1372:
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%.
498:, 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
802:
A circuit diagram showing the simplest (non-electronically controlled) defibrillator design, depending on the inductor (damping), producing a Lown, Edmark or Gurvich Waveform
1885:
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).
256:
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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".
1456:
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.
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715:, 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%.
180:(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
2500:
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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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203:(CPR). CPR is an algorithm-based intervention aimed to restore cardiac and pulmonary function. Defibrillation is indicated only in certain types of
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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
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2005:
1949:"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).
1563:
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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597:, 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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1153:). This is not normal medical practice, as the heart cannot be restarted by the defibrillator itself. Only the cardiac arrest rhythms
407:
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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286:
1832:"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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2409: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.
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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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142:(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
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A further development in defibrillation came with the invention of the implantable device, known as an
704:
50:
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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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790:) in the mid-1950s. The duration of AC shocks was typically in the range of 100–150 milliseconds.
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2363:"Apparatus for defibrillation or cardioversion with a waveform optimized in the frequency domain"
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1998:
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91:
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2131:"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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2255:"Restoration of the Functions of the Heart and Central Nervous System after Complete Anemia"
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127:
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471:, also known as automatic internal cardiac defibrillator (AICD), are implants similar to
2708:
1968:
1850:
1393:"Basic principles and technique of external electrical cardioversion and defibrillation"
622:), 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.
648:
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150:
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1665:"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.
411:
131:
31:
2617:
2479:
1546:"Cardiopulmonary Resuscitation (CPR): Practice Essentials, Preparation, Technique"
2461:"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"
1887:"Automated external defibrillators and survival after in-hospital cardiac arrest"
930:
Until the mid 1990s, external defibrillators delivered a Lown type waveform (see
176:), depending on the type of device used or needed. Some external units, known as
67:
2943:
2907:
2146:
1783:"Public-Access Defibrillation and Survival after Out-of-Hospital Cardiac Arrest"
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452:, such as firefighters, policemen, and security guards, are equipped with them.
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Principles of Biomedical Instrumentation and Measurement: International Edition
1696:"External Defibrillators – External Defibrillator Improvement Initiative Paper"
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138:(flatline) cannot be restarted by a defibrillator; it would be treated only by
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2183:"Defibrillation of the heart: insights into mechanisms from modelling studies"
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35:
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Yeung, Joyce; Okamoto, Deems; Soar, Jasmeet; Perkins, Gavin D. (2011-06-01).
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1492:"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
1608:"Regional Variation in Out-of-Hospital Cardiac Arrest Incidence and Outcome"
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1977:
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853:
commenced research in his animal laboratory in collaboration with engineer
2636:"Dr Karl's Great Moments In Science, Flatline and defibrillator (Part II)"
2609:
1576:
2948:
2938:
2933:
1799:
1150:
753:
736:
a dog, like Prévost and Batelli. The first use on a human was in 1947 by
380:
216:
135:
1076: in this section. Unsourced material may be challenged and removed.
911:
827:
783:
749:
342: in this section. Unsourced material may be challenged and removed.
1782:
77:
2818:
2718:
970:
by a team that included Stephen Heilman, Alois Langer, Jack Lattuca,
862:
503:
2345:
1781:
Investigators, The Public Access Defibrillation Trial (2004-08-12).
1361:(13th ed.). New York: McGraw-Hill – via AccessMedicine.
1176:
906:
1959. In the west this was pioneered in the early 1960s by Prof.
866:
813:Импульсный Дефибриллятор 1, Всесоюзный Электротехнический Институт
798:
797:
665:
633:
111:
1329:
Tintinalli's Emergency Medicine: A Comprehensive Study Guide, 8e
778:
2722:
2714:
FDA Heart Health Online: Automated External Defibrillator (AED)
1262:
Implantable cardioverter-defibrillator with its lead (ex vivo)
1163:
1045:
522:
457:
311:
239:
2232:"Some Effects of Electric Discharge on the Hearts of Mammals"
2704:
Center for Integration of Medicine and Innovative Technology
2698:
1391:
Knight, Bradley P. Page, Richard L; Downey, Brian C (eds.).
418:
and, in rare circumstances, in the emergency room during an
817:
Pulse Defibrillator 1, All-Union Electrotechnical Institute
2105:"What is the Difference Between Adult and Pediatric Pads"
765:
drug, and achieved return of a perfusing cardiac rhythm.
618:
means tissue loss. Modern paddles allow for monitoring (
593:
gel in order to ensure a good connection and to minimize
255:
deal primarily with North America and do not represent a
670:
Anterior-apex placement of electrodes for defibrillation
2703:
2055:
Adler, Arnon; Halkin, Amir; Viskin, Sami (2013-02-19).
1776:
1774:
264:
145:
In contrast to defibrillation, synchronized electrical
857:
into a technique which involved charging of a bank of
157:, cardioversion normally aims to end poorly perfusing
55:
View of defibrillator electrode position and placement
2709:
American Red Cross: Saving a Life is as Easy as A-E-D
2573:"Pacemaker Failure following External Defibrillation"
819:). It is described in detail in Gurvich's 1957 book,
149:
is an electrical shock delivered in synchrony to the
2470:(Portable defibrillator with universal power supply)
1421:. New York: McGraw-Hill – via Access Medicine.
3112:
3025:
2967:
2916:
2827:
2756:
946:Ventricular fibrillation (VF) could be returned to
190:
Cardiopulmonary_resuscitation § Defibrillators
60:
43:
1031:, cardioversion, and defibrillation capabilities.
703:Defibrillators were first demonstrated in 1899 by
122:, ending the arrhythmia. Subsequently, the body's
27:Treatment for life-threatening cardiac arrhythmias
2302:. Case Western Reserve University. Archived from
1517:"How to use an automated external defibrillator"
168:Defibrillators can be external, transvenous, or
2977:International Federation for Emergency Medicine
2531:on 2013-01-05 – via Wiley Online Library.
2499:Gold, Michael; Nisam, Seah (January 21, 2002).
2176:
2174:
2981:International Conference on Emergency Medicine
1432:
1430:
1428:
1179:; this more-complicated procedure is known as
695:tissue responds to a strong electrical shock.
114:. Although not fully understood, this process
2734:
253:The examples and perspective in this section
215:. If the heart has completely stopped, as in
199:Defibrillation is often an important step in
102:(V-Tach). A defibrillator delivers a dose of
8:
2997:Canadian Association of Emergency Physicians
2674:"School defibrillators could be a lifesaver"
1999:"Benefits of Fully Automated Defibrillators"
1942:
1940:
1938:
1694:Center for Devices and Radiological Health.
1419:Principles and Practice of Hospital Medicine
1322:
1320:
1318:
1316:
1314:
1175:and ventricular tachycardia that produces a
130:of the heart is able to re-establish normal
3103:Care of the Critically Ill Surgical Patient
2992:Australasian College for Emergency Medicine
1539:
1537:
1250:Close-up of a pair of defibrillator paddles
638:Self-adhesive electrodes of a defibrillator
557:. Unsourced material may be challenged and
2741:
2727:
2719:
2357:
2355:
1722:
1720:
918:at the arrival of pre-hospital providers.
271:, or create a new section, as appropriate.
49:
2591:
2236:Comptes Rendus de l'Académie des Sciences
2198:
2154:
2072:
1967:
1918:
1880:
1878:
1876:
1798:
1639:
1136:Learn how and when to remove this message
577:Learn how and when to remove this message
358:Learn how and when to remove this message
287:Learn how and when to remove this message
2987:American College of Emergency Physicians
1352:
1350:
1348:
1346:
1344:
1342:
3007:European Society for Emergency Medicine
2276:Corporation, Bonnier (1 October 1933).
1310:
1238:State-of-the-art defibrillator (manual)
1216:
502:personnel are now equipped with a ring
469:Implantable cardioverter-defibrillators
3017:American Academy of Emergency Medicine
2517:10.1046/j.1460-9592.2002.t01-1-00876.x
2442:New York, Time, Inc., 1959, pp. 80–91.
2373:from the original on 24 September 2015
2057:"Wearable Cardioverter-Defibrillators"
1001:. In 1972, Lown stated in the journal
960:implantable cardioverter-defibrillator
174:implantable cardioverter-defibrillator
40:
2505:Pacing and Clinical Electrophysiology
2300:"Claude Beck, defibrillation and CPR"
1729:The Journal of Cardiovascular Nursing
1675:from the original on January 23, 2017
821:Heart Fibrillation and Defibrillation
100:non-perfusing ventricular tachycardia
7:
3012:Asian Society for Emergency Medicine
2423:Elektrická kardioverze a defibrilace
1199:Ambulance Service of New South Wales
1074:adding citations to reliable sources
861:to approximately 1000 volts with an
555:adding citations to reliable sources
340:adding citations to reliable sources
90:is a treatment for life-threatening
3097:Advanced Life Support in Obstetrics
3002:Royal College of Emergency Medicine
2640:Australian Broadcasting Corporation
2326:Sovetskoe Zdravookhranenie Kirgizii
1969:10.1016/j.resuscitation.2015.07.015
1851:10.1016/j.resuscitation.2011.02.035
1299:Wearable cardioverter defibrillator
512:wearable cardioverter defibrillator
483:, and more benign arrhythmias like
299:Survival rates for out-of-hospital
221:pulseless electrical activity (PEA)
153:. Although the person may still be
73:
2011:from the original on 29 March 2012
1038:small babies shortly after birth.
25:
2230:Prevost J.L., Batelli F. (1899).
2074:10.1161/CIRCULATIONAHA.112.146530
962:(or ICD). This was pioneered at
426:Automated external defibrillators
213:pulseless ventricular tachycardia
178:automated external defibrillators
3150:
3139:
3138:
2794:International emergency medicine
2699:Sudden Cardiac Arrest Foundation
2427:Intervenční a akutní kardiologie
1987:from the original on 2016-12-20.
1741:10.1097/00005082-200411000-00009
1552:from the original on 2016-12-07.
1279:Automated external defibrillator
1255:
1243:
1231:
1219:
1201:in order that all ambulances in
1050:
527:
432:Automated external defibrillator
316:
244:
3151:
3091:Pediatric Advanced Life Support
2804:Pre-hospital emergency medicine
2646:from the original on 2012-11-10
1787:New England Journal of Medicine
1706:from the original on 2016-11-10
1374:Prehospital Emergency Care, 10e
1061:needs additional citations for
1023:. Modern ICDs do not require a
742:Case Western Reserve University
327:needs additional citations for
3079:Acute Care of at-Risk Newborns
3073:Neonatal Resuscitation Program
2200:10.1113/expphysiol.2005.030973
2033:. Zoll Lifecor. Archived from
1:
3061:Advanced cardiac life support
3044:Cardiopulmonary resuscitation
1606:Nichol, Graham (2008-09-24).
1274:Advanced cardiac life support
1226:Early defibrillator from 1947
201:cardiopulmonary resuscitation
140:cardiopulmonary resuscitation
3188:Emergency medical procedures
3085:Pediatric basic life support
3067:Advanced trauma life support
3050:Mouth-to-mouth resuscitation
2799:Pediatric emergency medicine
2662:General and cited references
2338:10.1016/0006-291x(75)90518-5
2253:Lockyer, Sir Norman (1900).
1519:. 2011-06-23. Archived from
1494:. 2011-06-23. Archived from
1173:supraventricular tachycardia
844:National Institute of Health
647:and synchronized electrical
485:supraventricular tachycardia
163:supraventricular tachycardia
2571:Giedwoyn, Jerzy O. (1972).
2147:10.1016/j.hrthm.2008.01.018
1544:Borke, Jesse (2016-11-03).
889:in the technique known as "
464:Cardioverter-defibrillators
267:, discuss the issue on the
3209:
2769:Emergency medical services
2548:Merrill Publishing Company
1209:called "Packer Whackers".
740:, professor of surgery at
728:was a success is unknown.
707:and Frédéric Batelli, two
500:emergency medical services
429:
187:
29:
3183:Cardiac electrophysiology
3133:
2288:– via Google Books.
1480:– via JAMA Network.
719:invention was called the
74:
48:
2944:Epinephrine / Adrenaline
2004:. Physio-Control. 2011.
1671:. Prog Cardiovasc Nurs.
1624:10.1001/jama.300.12.1423
1155:ventricular fibrillation
993:introduced the external
630:Self-adhesive electrodes
477:ventricular fibrillation
209:ventricular fibrillation
96:ventricular fibrillation
30:Not to be confused with
2593:10.1161/01.cir.44.2.293
2542:Aston, Richard (1991).
2187:Experimental Physiology
2031:"What is the LifeVest?"
1470:10.1001/jama.285.9.1193
1159:ventricular tachycardia
885:, and supraventricular
842:federal program in the
601:) or solid (similar to
591:electrically conductive
481:ventricular tachycardia
387:. For instance, every
1903:10.1001/jama.2010.1576
1443:McGraw-Hill (New York)
1333:McGraw-Hill (New York)
1183:, not defibrillation.
1013:Johns Hopkins Hospital
984:University of Missouri
803:
671:
639:
134:. A heart which is in
118:a large amount of the
3125:Injury Severity Score
2896:Nasopharyngeal airway
2869:Intraosseous infusion
2280:. Bonnier Corporation
1577:10.1001/jama.295.1.50
1294:Myocardial infarction
801:
794:Direct current method
669:
645:transcutaneous pacing
637:
595:electrical resistance
184:Use of defibrillators
2902:Oropharyngeal airway
2779:Emergency psychiatry
2764:Emergency department
2413:, 1957, pp. 229–233.
2181:Trayanova N (2006).
1800:10.1056/NEJMoa040566
1663:Beaumont, E (2001).
1070:improve this article
934:), a heavily damped
833:In 1958, US senator
713:University of Geneva
551:improve this section
420:open heart procedure
336:improve this article
265:improve this section
205:cardiac dysrhythmias
3178:American inventions
2881:Tracheal intubation
2875:Intravenous therapy
1380:, Inc. p. 425.
1042:Society and culture
954:Implantable devices
879:atrial fibrillation
865:content of 100–200
773:Closed-chest method
752:separated from his
733:William Kouwenhoven
620:electrocardiography
489:atrial fibrillation
159:cardiac arrhythmias
92:cardiac arrhythmias
3055:Basic life support
2959:Sodium bicarbonate
2757:Emergency medicine
2750:Emergency medicine
2678:The Globe and Mail
2485:2007-06-16 at the
2466:2014-11-29 at the
835:Hubert H. Humphrey
804:
705:Jean-Louis Prévost
672:
640:
599:surgical lubricant
446:basic life support
227:Application method
3165:
3164:
2954:Magnesium sulfate
2863:Electrocardiogram
2789:Medical emergency
2774:Emergency nursing
2632:Karl Kruszelnicki
2557:978-0-02-946562-2
2278:"Popular Science"
1897:(19): 2129–2136.
1618:(12): 1423–1431.
1378:Pearson Education
1359:Hurst's The Heart
1146:
1145:
1138:
1120:
839:Nikita Khrushchev
815:, or in English,
609:Paddle electrodes
587:
586:
579:
496:medical emergency
391:ambulance in the
377:electrocardiogram
368:
367:
360:
297:
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124:natural pacemaker
85:
84:
16:(Redirected from
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2628:
2622:
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2577:
2568:
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2533:
2532:
2527:. Archived from
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2420:
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2369:. 21 June 2006.
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1464:(9): 1193–1200.
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1085:"Defibrillation"
1078:
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1019:Jr. assisted by
855:Barouh Berkovits
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450:first responders
399:, many advanced
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106:(often called a
104:electric current
78:edit on Wikidata
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976:Michel Mirowski
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908:Frank Pantridge
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2848:Defibrillation
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2693:External links
2691:
2689:
2688:
2672:(2007-04-27).
2665:
2663:
2660:
2657:
2656:
2634:(2008-08-08).
2623:
2563:
2556:
2534:
2501:"Jack Lattuca"
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2444:
2438:Humphrey H H.
2431:
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2393:
2384:
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2328:(in Russian).
2316:
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2193:(2): 323–337.
2170:
2141:(4): 565–572.
2121:
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2067:(7): 854–860.
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1157:and pulseless
1144:
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964:Sinai Hospital
955:
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901:Portable units
899:
883:atrial flutter
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430:Main article:
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393:United Kingdom
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259:of the subject
257:worldwide view
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188:Main article:
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88:Defibrillation
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44:Defibrillation
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18:Defibrillators
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2969:Organisations
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2814:Trauma center
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2670:Picard, André
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2429:, 2011; 10(1)
2428:
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2320:
2317:
2306:on 2007-10-24
2305:
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2097:
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2058:
2051:
2048:
2037:on 2008-11-21
2036:
2032:
2026:
2023:
2007:
2000:
1994:
1991:
1983:
1979:
1975:
1970:
1965:
1961:
1957:
1956:Resuscitation
1950:
1943:
1941:
1939:
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1839:Resuscitation
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1547:
1540:
1538:
1534:
1523:on 2011-06-23
1522:
1518:
1512:
1509:
1498:on 2011-06-23
1497:
1493:
1487:
1484:
1479:
1475:
1471:
1467:
1463:
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1449:
1444:
1440:
1439:Critical Care
1433:
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1289:Cardioversion
1287:
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1181:cardioversion
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1118:
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1111:
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1097:
1094:
1090:
1087: –
1086:
1082:
1081:Find sources:
1075:
1071:
1065:
1064:
1059:This section
1057:
1053:
1048:
1047:
1041:
1039:
1035:
1032:
1030:
1026:
1022:
1021:Vivien Thomas
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891:cardioversion
888:
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856:
852:
847:
845:
840:
836:
831:
829:
824:
822:
818:
814:
809:
808:N. L. Gurvich
800:
793:
791:
789:
785:
780:
772:
770:
766:
764:
760:
755:
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745:
743:
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729:
727:
722:
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709:physiologists
706:
698:
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689:
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668:
661:
659:
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649:cardioversion
646:
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606:
604:
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596:
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581:
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546:
545:
541:
536:This section
534:
530:
525:
524:
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508:
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398:
397:United States
394:
390:
386:
382:
378:
371:Manual models
370:
362:
359:
351:
341:
337:
331:
330:
325:This section
323:
319:
314:
313:
307:
305:
302:
291:
288:
280:
277:December 2023
270:
266:
260:
258:
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210:
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194:
191:
183:
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152:
151:cardiac cycle
148:
147:cardioversion
143:
141:
137:
133:
129:
125:
121:
117:
113:
109:
108:counter-shock
105:
101:
97:
93:
89:
79:
69:
65:
63:
59:
52:
47:
42:
37:
33:
19:
3149:
3137:
3031:Life support
2847:
2809:Major trauma
2681:. Retrieved
2677:
2648:. Retrieved
2626:
2583:
2579:
2566:
2543:
2537:
2529:the original
2508:
2504:
2494:
2475:
2456:
2447:
2439:
2434:
2426:
2418:
2405:
2396:
2387:
2377:22 September
2375:. Retrieved
2366:
2332:(4): 23–25.
2329:
2325:
2319:
2308:. Retrieved
2304:the original
2294:
2282:. Retrieved
2271:
2262:
2258:
2248:
2242:: 1267–1268.
2239:
2235:
2225:
2190:
2186:
2138:
2135:Heart Rhythm
2134:
2124:
2113:. Retrieved
2111:. 2018-05-16
2108:
2099:
2064:
2060:
2050:
2039:. Retrieved
2035:the original
2025:
2013:. Retrieved
1993:
1959:
1955:
1894:
1890:
1842:
1838:
1825:
1790:
1786:
1732:
1728:
1708:. Retrieved
1699:
1689:
1677:. Retrieved
1668:
1658:
1615:
1611:
1601:
1571:(1): 50–57.
1568:
1564:
1558:
1525:. Retrieved
1521:the original
1511:
1500:. Retrieved
1496:the original
1486:
1461:
1457:
1451:
1438:
1418:
1411:
1400:. Retrieved
1396:
1386:
1373:
1367:
1358:
1328:
1207:colloquially
1195:Kerry Packer
1185:
1147:
1132:
1123:
1113:
1106:
1099:
1092:
1080:
1068:Please help
1063:verification
1060:
1036:
1033:
1027:and possess
1017:Levi Watkins
1009:
1002:
999:fibrillation
991:Bernard Lown
988:
972:Morton Mower
957:
948:sinus rhythm
945:
932:Bernard Lown
929:
920:
904:
895:
887:tachycardias
871:milliseconds
851:Bernard Lown
848:
832:
825:
820:
816:
812:
805:
776:
767:
759:procainamide
746:
730:
725:
720:
717:
702:
693:
681:
677:
673:
657:
653:
641:
624:
616:nonperfusion
612:
588:
573:
564:
549:Please help
537:
509:
493:
467:
454:
448:(BLS). Many
443:
439:
435:
412:heart bypass
409:
383:and on some
374:
354:
345:
334:Please help
329:verification
326:
298:
283:
274:
254:
230:
198:
167:
144:
132:sinus rhythm
120:heart muscle
107:
98:(V-Fib) and
87:
86:
32:infibulation
2908:Pocket mask
2784:Golden hour
2580:Circulation
2061:Circulation
2015:12 December
1700:www.fda.gov
1679:December 8,
1192:media mogul
1168:intravenous
1025:thoracotomy
1004:Circulation
916:tachycardia
875:arrhythmias
738:Claude Beck
603:gummi candy
567:August 2014
348:August 2014
195:Indications
116:depolarizes
3172:Categories
3120:NACA score
2929:Amiodarone
2843:Chest tube
2683:2015-07-23
2650:2011-12-21
2586:(2): 293.
2511:(5): 876.
2310:2007-06-15
2115:2021-08-06
2109:AED Brands
2041:2009-02-09
1710:2016-12-08
1527:2024-05-09
1502:2021-11-08
1402:2019-07-24
1096:newspapers
941:myocardial
936:sinusoidal
859:capacitors
788:Kyrgyzstan
750:breastbone
726:Hyman Otor
721:Hyman Otor
473:pacemakers
405:paramedics
385:ambulances
161:, such as
36:Defibrator
3039:First aid
2924:Adenosine
2891:Combitube
2865:(ECG/EKG)
2829:Equipment
2602:1524-4539
2525:222087116
2083:0009-7322
1962:: 81–99.
1911:1538-3598
1859:1873-1570
1809:0028-4793
1749:0889-4655
1632:0098-7484
1585:0098-7484
1305:Citations
1284:Ambulance
1188:Australia
1126:June 2021
980:Mir Imran
968:Baltimore
711:from the
690:Mechanism
662:Placement
538:does not
519:Interface
460:display.
381:hospitals
269:talk page
211:(VF) and
170:implanted
110:) to the
3144:Category
3105:(CCrISP)
2949:Naloxone
2939:Dopamine
2934:Atropine
2644:Archived
2489:pp 15-16
2483:Archived
2464:Archived
2371:Archived
2217:29999829
2209:16469820
2165:18362024
2091:23429896
2006:Archived
1982:Archived
1978:26477420
1929:21078809
1867:21458137
1817:15306665
1765:28998226
1757:15529059
1704:Archived
1673:Archived
1669:Medscape
1650:18812533
1593:16391216
1550:Archived
1478:11231750
1397:UpToDate
1268:See also
1151:asystole
943:damage.
877:such as
849:In 1959
837:visited
403:and all
263:You may
236:Outcomes
217:asystole
136:asystole
3156:Outline
3081:(ACoRN)
3027:Courses
2610:5562564
2367:Patents
2156:2745086
1920:3587791
1641:3187919
1213:Gallery
1110:scholar
1015:by Dr.
912:Belfast
828:Expo 58
784:Bishkek
699:History
559:removed
544:sources
126:in the
68:D047548
3099:(ALSO)
3093:(PALS)
3087:(PBLS)
3069:(ATLS)
3063:(ACLS)
2819:Triage
2618:608076
2616:
2608:
2600:
2554:
2523:
2411:Medgiz
2344:
2265:: 532.
2259:Nature
2215:
2207:
2163:
2153:
2089:
2081:
1976:
1927:
1917:
1909:
1865:
1857:
1815:
1807:
1763:
1755:
1747:
1648:
1638:
1630:
1591:
1583:
1476:
1112:
1105:
1098:
1091:
1083:
1029:pacing
978:, and
867:joules
863:energy
504:magnet
3075:(NRP)
3057:(BLS)
3046:(CPR)
2917:Drugs
2904:(OPA)
2898:(NPA)
2839:(BVM)
2614:S2CID
2576:(PDF)
2521:S2CID
2284:2 May
2213:S2CID
2009:(PDF)
2002:(PDF)
1985:(PDF)
1952:(PDF)
1835:(PDF)
1761:S2CID
1177:pulse
1117:JSTOR
1103:books
761:, an
684:chest
308:Types
112:heart
76:[
2877:(IV)
2871:(IO)
2606:PMID
2598:ISSN
2552:ISBN
2379:2014
2342:PMID
2286:2018
2205:PMID
2161:PMID
2087:PMID
2079:ISSN
2017:2016
1974:PMID
1925:PMID
1907:ISSN
1891:JAMA
1863:PMID
1855:ISSN
1813:PMID
1805:ISSN
1753:PMID
1745:ISSN
1681:2016
1646:PMID
1628:ISSN
1612:JAMA
1589:PMID
1581:ISSN
1565:JAMA
1474:PMID
1458:JAMA
1166:and
1089:news
779:volt
754:ribs
744:.
542:any
540:cite
487:and
401:EMTs
62:MeSH
2857:ICD
2852:AED
2588:doi
2513:doi
2334:doi
2240:129
2195:doi
2151:PMC
2143:doi
2069:doi
2065:127
1964:doi
1915:PMC
1899:doi
1895:304
1847:doi
1795:doi
1791:351
1737:doi
1636:PMC
1620:doi
1616:300
1573:doi
1569:295
1466:doi
1462:285
1186:In
1164:CPR
1072:by
966:in
910:in
893:".
553:by
458:ECG
389:NHS
338:by
219:or
34:or
3174::
3029:/
2676:.
2642:.
2638:.
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2604:.
2596:.
2584:44
2582:.
2578:.
2550:.
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2519:.
2509:25
2507:.
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2191:91
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1980:.
1972:.
1960:95
1958:.
1954:.
1937:^
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Text is available under the Creative Commons Attribution-ShareAlike License. Additional terms may apply.
