Cardioversion vs Pacing

This video contrasts two procedures (cardioversion and pacing) on the Lifepak 15 Monitor/Defibrillator. Some of the apparent similarities between these two procedures sometimes get people confused... Hopefully this video helps.

[@jeremyjackson4087]

thanks for the vid! exactly what I needed 👍👍👍

[@deogettic]

This was very helpful. Great demonstration tutorial. Thank you Blair. Exactly what i also needed

[@annakasm6553]

amazing! thank you for the crystal clear explanation

[@xXdieTussiXx]

Thanks for explaining!
Greets from Germany!

[@ST-sm8kj]

great details. thank you

[@Poweredparachuteman96]

Very good video! Very informational!

[@jesusreignsoveraustralia]

Thank you, that really helped

[@PG-to3yp]

very helpful. thank you

[@gauchier11]

"PT is in a tachycardia of the ventricles some call ventricular tachycardia" damn I miss your classes hahaha

[@Medicbobs]

From Florida. Great explanation! Might be a stupid question, but what if you don't have mechanical capture, but have electrical. What's your next go to?

[@BlairLindsayParamedic]

No - a good question. If no mechanical capture is achieved, we would have to resort to atropine, dopamine or norepinephrine to hopefully achieve pharmacologically what we couldn't electrically...

[@Medicbobs]

Blair Lindsay awesome, thanks!

[@michaelnielsen3672]

so good thank you!!! right at the end you talk about electrical capture vs mechanical capture. if you have electrical capture but no mechanical capture, what are the next steps?

[@BlairLindsayParamedic]

You can continue to increase milliamps, Sometimes mechanical capture occurs at relatively higher energy level vs electrical capture. The monitors we use go up to 200 mA (and a great deal of pain).

[@christophera.1783]

Thank u!!

[@user-ow8lf9ps2j]

Helpful tnx

[@LiveFreeNDieHard1]

good video. thank you.

[@Mimi-6798]

Thank you!!!

[@K1ngDre-DMZ]

while pacing, the mechanical pulse doesn't change and match electrical capture, it's still Brady at 40bpm. What treatment would you do next?

[@BlairLindsayParamedic]

Sinus bradycardias, 1 degree blocks and second degree type I blocks often respond well to atropine... 2nd degree type 2s and third degree blocks less so because atropine depends on blocking parasympathetic innervation and the ventricles generally don't have much of that, so depending on the underlying arrhythmia, either atropine or a pressor...

[@user-ti6vf3qt8m]

Super

[@kellyruddy6064]

Does it hurt?

[@BlairLindsayParamedic]

Quite a lot for most people, depending on the energy level used.

[@rigus8]

could You also answer what drugs need to be use in this both cases?

[@BlairLindsayParamedic]

Bradycardias that occur in parts of the heart that are innervated by the parasympathetic nervous system (sinus bradys, first degree blocks and second degree type I for instance) often respond to atropine. If that doesn't work a pressor drip may be helpful till either an internal pacemaker can be placed or the affected coronary can be reperfused. An amiodarone infusion can be used in stable VT but it's falling out of favor somewhat. Procainamide and lidocaine may also terminate a VT. Much more detail available here www.ahajournals.org/doi/10.1161/CIR.0000000000000261

[@rigus8]

Hey Thank You. I was thinking more about how to cede a patient. For example which better for VT and for brady? Midanium(midazolam) 5mg?

[@BlairLindsayParamedic]

Ahh... yes we'd generally use midazolam or very occasionally ketamine here... Propofol is popular too.