Nurses Defibrillating???

EricJRN, MSN, RN · Mar 19, 2008

yeah you are right you do not have to be ACLS to use AED

The flip side of that is that just because something was covered or tested in your ACLS/PALS/NRP/other alphabet soup class, it doesn't automatically become included in your scope of practice.

I do agree with my hospital's current policy. RN's in critical care areas can operate the manual defibrillator, while nurses from other areas must leave the LP12 in AED mode.

My unit is unique to the rest of the hospital though. In the NICU, our nurses don't defibrillate babies. In a non-cardiac NICU, neonatal defibrillation is extremely rare anyway. In the event that we need to cardiovert a persistent SVT (above 220/min after adenosine), our unit policy is that we can turn the knobs and press the buttons only at the MD's direction.

Miami NightNurse · Mar 19, 2008

Believe me, Im acls, pals, yata, yata yata, I just wanted to know opinions, thats all. And yes I defib., People all the time, the fact Im on the code team and trauma team, and the great and wonderful rapid response team-lol.

OH good I was worried you were one of those people on ths site pretending to be a nurse. The way you worded the start of this thread I thought you were askng if it was in our scope of practice not what we thought of it--Sorry. Oh and I think it should be something nurses should do. Can you imagine how many people would die if we had to wait on a doc?

The flip side of that is that just because something was covered or tested in your ACLS/PALS/NRP/other alphabet soup class, it doesn't automatically become included in your scope of practice.
I do agree with my hospital's current policy. RN's in critical care areas can operate the manual defibrillator, while nurses from other areas must leave the LP12 in AED mode.
My unit is unique to the rest of the hospital though. In the NICU, our nurses don't defibrillate babies. In a non-cardiac NICU, neonatal defibrillation is extremely rare anyway. In the event that we need to cardiovert a persistent SVT (above 220/min after adenosine), our unit policy is that we can turn the knobs and press the buttons only at the MD's direction.

When it comes to babies I think I'd want the Doctor there too

nservice · Mar 19, 2008

Speaking of defibing babies...

I got a request from the newborn nursery a few weeks ago requesting an inservice on how to work the defibrilator. It seems they had to cardiovert and had quite a time figuring things out. Since my own child will be delivered in this hospital in about 5 weeks, I was MORE than happy to privide this education!!

The problem with using the defibrillator, as well as ACLS, is that you get recertified every two years and then might not have to use this skill in the interim. I encourage nurses to play with the defibrillator on a regular basis. We crack the cart and have mock codes or just refresh our memory on where things are and how things work when defibing, cardioverting, pacing...etc. At first, the nurses are reluctant to participate because they are either busy or uncomfortable with the equipment. When we are finished they are glad they had the review and without fail, request more frequent inservices like that.

ICU_nurse · Mar 20, 2008

Only if you are ALS accredited. RN's on the MET (Medical Emergency Team) take the defib on MET calls. We dont have defibs on resus trolleys in the wards (as odd as that sounds)

if a pt was to arrest (on the ward), you commence BLS and phone a MET (team based in ICU, call goes out for an arrest/pt deterioration, 1x ICU RN and 1x Registrar turn up to the ward) And yes, if the RN makes it to the ward before the Reg, they can shock as per protocol (as was the case a fortnight ago, nurse managed to revert a lady from a witnessed VF arrest all before the doc got there!)

nursejill155 · Mar 21, 2008

Of course, that is what ACLS is for! If you don't know what you are doing, don't do it, but it is in the scope of practice if you have ACLS.

Critical_Care_RN · Sep 14, 2008

:nurse:Do you think properly trained nurses should defib.? Is this in our scope?

It is absolutely within our scope of practice. Having said that, I will tell you that, in the facility where I work, most nurses wouldn't be comfortable doing so. There are only 3 units in our hospital that require ACLS training(ER, CCU, Telemetry). The docs run the codes in ER and do all the defibrillating there. If a patient codes on any other floor INCLUDING the tele floor, the nurse begins cpr and calls the code. They get the crash cart to the room, hook the pt up on the crash cart monitor, and by that time, the code team is usually there and will take over. The CCU nurse(s) is/are responsible for pushing meds and, if the patient is in a shockable rhythm, providing said shock unless the doc wants to do it, which he usually doesn't. The ER nurse may share the responsibility of meds and defibrillation, depending on the situation.

MBCRNA · Sep 18, 2008

Yes, ALL nurses should be able to defibrillate. CPR with AED training (REQUIRED) for this purpose. Research has shown time and time again how important defibrillation is. Just lke a prior post states, AED is used outside the hospital and it is "dumby-proof" for the inexperienced person to use it in the community. This is a small and easy skill to achieve. It doesn't say much for a healthcare provider who isn't able to perform this skill safely.

pH7.40, LPN · Dec 8, 2008

There is a difference between an AED and when a nurse who is ACLS trained defibrillates. An AED reads the rhythm and decides for its mechanical self if a shock is appropriate and then either shocks or standby. An ACLS nurse reads the EKG and determines if a shock is appropriate. The difference is that the nurse is a living, thinking being with critical thinking skills and the AED is just a machine reading a strip without other clinical assessments and observations.

MaryAnn_RN · Dec 8, 2008

Here in the UK if the nurse was appropriately trained and kept up to date they can defib, Agree with Sherrie if properly trained you give the patient a better chance and research has stated this. I know we are seeing more and more defibs in local areas like shopping centers

We recently had a patient who survived cardiac arrest precisely because someone had been appropriately trained to defib. He arrested at work.

mmutk, BSN, RN, EMT-I · Dec 8, 2008

And now days it's getting even easier to defib. Have you all seen the new Physio defibs that detect how big the patient is when you put the pads on and it automatically adjusts the voltage for you.

Crazy!