Difference b/t Cardioversion and Defibrillator

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They both seem like they do the same thing - try to get the patient back into NSR. Are there any differences? If so, what are they? I've been searching online, found some stuff but still don't seem to get it! Hope someone can clarify for me.

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You cardiovert someone who is alive (SVT, rapid A-Fib)

You defibrillate someone who is dead (pulseless V-tach, V-fib.)

cardioversion is synched and defibrillation is immediate.

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They are basically the same. Most notable difference is that one delivers a charge through manual delivery and the other delivers the charge through mechanical delivery. Both need some sort of electrical activity from the heart in order to shock the heart. Without electrical activity, there is nothing to shock.

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No, they are not basically the same. Cardioversion requires you to synchronise the shock on the R wave in a patient with a pulse. This is to avoid delivering the shock during the absolute refractory period of the cardiac cycle. Doing so could result in ventricular fibrillation through a R on T type of mechanism. Defibrillation is an unsynchronised shock and is used to treat the cardiac arrest rhythms ventricular tachycardia and ventricular fibrillation.

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Asystole (dead) is not a shockable rhythm. VF or pulseless VT is shockable...

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There's also a big difference in how much electricity is used for each.

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Specializes in ER.

Cardioversion is usually a small "shock"- usually 30 joules. It is used to try to convert people who are in an uncontrolled atrial fib into a NSR. Defibrillation is done during a code situation when a patient is in PULSELESS V-tach/v-fib, and can require a much higher shock. Pt.s can be in V-tach with a pule- then shocking the pt is not indicated.

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Specializes in Med/Surg, Ortho, ASC.
They are basically the same. Most notable difference is that one delivers a charge through manual delivery and the other delivers the charge through mechanical delivery. Both need some sort of electrical activity from the heart in order to shock the heart. Without electrical activity, there is nothing to shock.

Disagree.

Cardioversion captures a rhythm and delivers the shock at a rhythm-sensitive appropriate time.

Defibrillation shocks whatever rhythm is occuring back into a "normal" rhythm (best case scenario).

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Thanks guys! Now it all makes sense. I'm a nursing student. My patient today was in SVT and had a pulse. The nurses and doctor cardioverted him with a single shock and went back into NSR.

So let me get this straight....

Cardioversion are for people with tachy rhythms WITH pulses to try to get them into NSR. and Defib is for patients who are pulse-less with a lethal rhythm?

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Specializes in Peri-Op.

So let me get this straight....

Cardioversion are for people with tachy rhythms WITH pulses to try to get them into NSR. and Defib is for patients who are pulse-less with a lethal rhythm?

that is correct. typically you will start a cardioversion at about 200 joules on a normal patient. We have done first shock at 360 joules on really big people. The people up in this thread that think they are the same thing need to educate themselves before they kill someone...... you do an unsynchronized cardioversion shock on someone and you just might stop their heart.

This stuff hurts to have done to you too. Typically we will get everything hooked up and synched, have the patient hold their hand up, sedate them and when their hand falls we will shock them, synchronized cardioversion....

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Specializes in Cath Lab/ ICU.
They are basically the same. Most notable difference is that one delivers a charge through manual delivery and the other delivers the charge through mechanical delivery. Both need some sort of electrical activity from the heart in order to shock the heart. Without electrical activity, there is nothing to shock.

:eek:

Eeks!! So wrong. And what the heck is manual delivery VS mechanical delivery??? Talk about completely misinformed!!

Op: we don't defib people to get them into NSR, we defib to get them OUT of VT/VF. We will take any rhythm that we get (except asystole), even CHB over VT/VF because those rhythms are lethal. Now, if we get a NSR after defib, then great! But that's not the goal. The goal is to prevent death...

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