Internal Defibs

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Specializes in Education, Acute, Med/Surg, Tele, etc.

So I have this patient...she is in her late 70's and basically a medical train wreck sorry to say...

Brittle diabetic (noncompliant of course despite great efforts), was a canidate for dialysis for about 5 years before they actually chose to put in a shunt (when she went into renal failure...a little to little too late scenero), that shunt infected..so next one took. Then she started going to dialysis and it was working but they only had her go once a week and with that infection that occured and not enough dialysis...well, heart complications...poor thing!

So they put in a internal defib r/t bouts of v-tack or even bradycardia episodes...okay stands to reason there...

This week she complained that it went off...okay I didn't panic..that is what they put them in for right?!?!? So I charted and monitored her closely...all vs were wnl (actually better than a month ago!).

But then it went off another time in the middle of the night and the Night Nurse paniced! She called 9-11 and they rushed her to the hospital....

Okay..am I wrong or isn't that why they put the defib in in the first place...to correct arrythmias as they occur??? They are going to go off till things are either corrected (med or surgery) or they just get to keep getting shocked...

I have had patients that have had these things go off a few times a day every day in their lives...so I don't get the reason for the panic!

Well..there was a good thing that occured, the other shunt infected so she is in the hospital to get another one, and deal with the infection...so there is a good point...

...BUT sending a patient in because it went off twice???

Comments appreciated...I don't want to sound like I don't care, but I don't understand this. It is like calling 9-11 because someones heart medications slowed the heart to normal but this is out of norm for the patient...uhggggg!

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In my practice I usually only see the PCDs admitted because either the defib failed to activate or is activating too frequently, i.e. several times per day. The idea is to treat the arrhythmia with meds and the debif handles what breaks through. No, they probably don't need to be admitted because it shocked the patient twice. But multiple times is scary--and it hurts! And something needs to be fixed.

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Specializes in Education, Acute, Med/Surg, Tele, etc.
In my practice I usually only see the PCDs admitted because either the defib failed to activate or is activating too frequently, i.e. several times per day. The idea is to treat the arrhythmia with meds and the debif handles what breaks through. No, they probably don't need to be admitted because it shocked the patient twice. But multiple times is scary--and it hurts! And something needs to be fixed.

Thank you very much for responding...I think it if activated more than twice in 48 hours I would worry a bit more..but 2 times...come on, no reason to actually panic!

I really appeciate your imput...I kinda felt like the odd man out by not freaking out like all the other nurses. You see...all the nurses I work with are vetran LTC nurses and I am a 'baby' nurse to them only 5 years out...I struggle with their ideals and mine..and defibs...heck they are going to fire..kinda the reason they are put in....

THanks!!!!!!

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Specializes in Critical Care.

If they are concerned about the frequency of the defib going off they can always call into the doctor responsible for the patient make them aware. Also, there should be a pacemaker clinic that is involved that can do a phone check and see if it's going off erroneously or if it is due to an arrhythmia.

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not sure they needed to be admitted but the doc needed to be notified at least. with her being a dialysis pt her lytes may have been out of whack contributing to or causing her arrythmia. it wouldn't hurt to get the doc to order some lab draws.

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