what would happen if you defibrillated a pt w/ a pacemaker?

Nurses General Nursing

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Hi all!

This has been bugging me, and no one can seem to answer this Q. I have looked on the site, but I haven't found an answer. We once had a patient with an AICD/pacemaker - but he was obese and we didn't know until a day later when a pcxr was done (no family/pt didn't mention it when questioned). I was just curious - hypothetically, what would have happened if we'd thought we needed to shock him? Can anyone answer that? I'm guessing it would fry the AICD, but what would happen to the patient? Also, what do you do when a pt with an AICD goes into runs of V-tach, but the AICD isn't kicking in? We don't get many up here, so please forgive me if these seem like silly questions.

Thanks so much!

Specializes in Med-surg, ICU.
Shock away! Just dont put the pads on the pacer or be ready for some fun.

Yeah, fun is the right word to use in defibrillating patients.

In filipino movies and tv shows, people who have a flatline ALWAYS receives a shock from the good 'ol nurses. (random thought)

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Ok, so - funny enough, we have another man with a PM/AICD - in his late 70s and he has been in and out of (paced?!) V-tach all day! So just to be clear, is he getting shocked back into a normal rhythm when he converts? He is completely asymptomatic as this happens, and his electrolytes are fine. The V-tach rhythm is exactly steady when it happens. And the wierd thing is, when he first came, and we put him on the monitor, all his complexes were wide, but paced (I'm guessing, as we couldn't see any pacer spikes, but ours don't always pick them up.) I come back a day later, and he has normal looking QRSes. What gives? And what is all this stinking V-tach?! (sorry - frustrated - but grateful he converts!)

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He would kow if it shocked him. It was probably out pacing the tach, and converting him to NSR-ST.

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Just renewed my cpr last week I was told still shock just put the pads at least an inch away from the pacemaker

ding ding ding! There is your answer.

(I also just renewed last month)

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