i am studying for acls and have a hypothetical question about defibrillation:
let's say you have an 8 month pregnant patient who is in v-fib. in my study book, it says that only about 4% to 20% of the total current of the shock actually reaches the heart due to factors affecting transthoracic resistance. my question is.... what is the net effect to the baby? ... especially if the mom were to receive 3 progressive (high voltage) shocks?
and -- do you use the standard paddle positioning of apex-anterior ... or, try other positioning to minimize exposure to the baby
? ... eg.. would you position paddles in the apex-posterior position?
i just pray that i never have to be in on this type of code.
... but what do you guys do???
and, just fyi - i will start nursing school in may. i work in the blood bank (and have for 12 years). the acls instructor where i work said that if i take the class and pass the test, then she will let me get my certification, but she warned me that it will be hard for me (without the nursing background yet). i am up for the challenge! and i appreciate all of your input. (i posted this in the cardiac critical care forum also)
Feb 13, '05
I too am unaware of what the effect of electricity will have on the baby...however, it is safe to say (as Angie did) that if the shocks are not delivered, neither will live (or the mother may pass on and the baby can be c-sectioned out quickly)...I would say the only choice is to defibrillate...and hope that the defib works and you don't have to do rounds of drugs too...As for patch placement, I would go with the normal configuration (but have not looked for any information otherwise)...Hopefully, I will never encounter this situation...
Edited to add: Just read the site that another poster directed you to...lots of good information!! Defibrillate is still first line...
Last edit by zambezi on Feb 13, '05