Cardioversion without 5-lead monitoring with Phillips Heartstart Mrx?

[matthewjdouma]

Hi Everyone,

I've been through a few monitors in my career now, codemaster, LP12, Zoll and now Phillips Heartstart MRX. This is the first monitor/defib that I've ever used where our education team is telling us it can provide syncronized cardioversion without simultaneous 5-Lead monitoring. The rationale in the past was to have the 5 leads attached so the computer can properly identify the correct phase of the cardiac cycle to administer the shock to. Is anyone using this monitor, can you chime in? Phillips hasn't returned my emails.

Thanks

Matt

[getoverit, BSN, RN, EMT-P]

interesting. I don't know about Phillips specifically, but a monitor shouldn't need the leads in order to cardiovert. In my experience you only need the leads attached when you're going to pace.

I've cardioverted plenty of people with an old LP10 and only used the paddles, no leads attached until after the shock was given. An EKG can't deliver electricity and monitor the rhythm at the same time.

Let me know if you get any more definitive answer.

[matthewjdouma]

Without the leads the pads must identify the cycle and deliver shock, then continue to monitor. I'll keep you posted, thanks for your reply.

[getoverit, BSN, RN, EMT-P]

correct, they do that in a fraction of a second and then continue to monitor the rhythm. that's how they work.

the difference comes when you use the pacer and it's not able to continuously monitor as well as deliver electricity simultaneously. i've only been an ACLS instructor since 1994 and my experience is limited to about 250+ cardioversions (albeit none with a Phillips product), most of them emergent and >50% did not have any leads attached, just paddles or the hands-free patches after they were introduced....everytime it delivered the shock as it was supposed to.

[matthewjdouma]

Thanks so much for your reply. I love learning new stuff and challenging prior conceptions.

Matt