The Zoll Defibrillator for dummies: explain this thing!

nurseprnRN, BSN, RN · Dec 25, 2013

I've been on a medsurg/tele floor for years. At the onset of a code we all know how to hook it up, okay. Now what? We take ACLS every 2 years but that's not the ACLS class of the past where nobody could pass. I've asked my coworkers and nobody knows what to do with the thing, how to stack shocks, what voltage to start, how to pace, none of it.
In another thread I saw someone post the website with Zoll directions. And the info that we can have an educator educate us on it. As I've said, we take ACLS every 2 years and it doesn't sink in, so we need more than an educator. And reading the directions is not going to help, we need hands on and repetition.
So my question: does anyone know of a site where one can learn it through scenarios, testing, retesting? How can we learn this Zoll and make it stick?

If your staff development people can't get it together to provide you with better training scenarios more frequently, they can at least call the Zoll rep and have him or her come to do retraining annually or q 8 months or somesuch. They are great folks and will be happy to help. You could help them prepare by imagining some scenarios where the different features might be needed, so they can help you work through the processes involved.

liberated847 · Dec 25, 2013

This is a very dangerous situation and a tragedy waiting to happen. Talk to your manager and get the Zoll rep. To come in for an inservice ASAP!

applewhitern, BSN, RN · Dec 25, 2013

ACLS has been "dumbed down" so much! I remember when it was a 2 day long learning experience, when we intubated, placed I&O caths, etc. Now it is so easy. We are using only the little defibrillators (that tell you what to do) in our ACLS classes now, so I understand your frustration. Yes, you really need to get this situation rectified. If your education department can't help, they need to get someone in who can.

applewhitern, BSN, RN · Dec 25, 2013

Back in the day, we used to have mock codes. I guess hospitals don't do that anymore, either. It was a "stop, drop, and roll" type thing, to see how prepared we were for codes, in addition to ACLS, PALS, etc.

PacoUSA, BSN, RN · Dec 26, 2013

I laugh at what our unit calls mock codes. They basically call us over to a pillow and ask us to show them how to place Zoll pads on as if the pillow were a torso. End of mock code. I have requested time and time again that we be provided a REAL mock code with a dummy in bed and a training code cart and defibrillator. Hopefully they will listen, because all I feel really competent in is doing compressions (which I have done once on a real patient). I guess taking ACLS will help a lot, will be doing that in a few months.

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Anna Flaxis, BSN, RN · Dec 26, 2013

Unfortunately, some people take ACLS and then never review the material until it's time to recertify. It's really important to review your algorithms regularly. Also, it's important to look at the crash cart on a regular basis and just be familiar with it. Look at the defibrillator. Do you keep pads attached or will you have to connect them? Look at the suction device. Is it set up and ready to go? Where is the O2 tank? Which drawer are the drugs in? Where are the intubation supplies?

Most defibrillators work the same way. You put the pads on the patient, turn on the defibrillator, analyze the rhythm and if it's shockable, select your energy level, charge and make everyone stand clear, then defibrillate. The knobs and buttons for these functions are well labeled, and often have numbers next to them that represent the order in which to perform each step.

ACLS class should be taught using the equipment that you will most likely be using, and the instructor should be knowledgeable in its use and make sure each participant gets hands on instruction.

However, I've attended some ACLS and PALS classes where, while the instructor was knowledgeable, some of the people who passed really shouldn't have because they struggled so much with just the basics, so I can see how your co-workers could get through ACLS and still not know how to operate a defibrillator.

If you have a unit educator, clinical coordinator, or someone in that vein, this is where I would start. Ask about having an inservice on the crash cart.

But if your co-workers don't even have a basic grasp of what ACLS entails, there is more education needed. In the meantime, best to focus on delivering high quality CPR until the code team arrives and takes over.

As an aside, the unit of energy used is joules, not volts, and we no longer deliver stacked shocks.

Good luck with your situation.

classicdame, MSN, EdD · Dec 26, 2013

as an Educator, I have seen the "other" side of ACLS/PALS courses. We follow the AHA guidelines. But just last week a nurse complained about not passing ACLS. She admitted she had never attended the recommended dysrhythmia course, did not do the pre-course practice with an Educator and did not even read the book. But she sure thought she deserved the card because of all the time she spent in class. Seriously.

Esme12, ASN, BSN, RN · Dec 26, 2013

I've been on a medsurg/tele floor for years. At the onset of a code we all know how to hook it up, okay. Now what? We take ACLS every 2 years but that's not the ACLS class of the past where nobody could pass. I've asked my coworkers and nobody knows what to do with the thing, how to stack shocks, what voltage to start, how to pace, none of it.
In another thread I saw someone post the website with Zoll directions. And the info that we can have an educator educate us on it. As I've said, we take ACLS every 2 years and it doesn't sink in, so we need more than an educator. And reading the directions is not going to help, we need hands on and repetition.
So my question: does anyone know of a site where one can learn it through scenarios, testing, retesting? How can we learn this Zoll and make it stick?

Are you looking how to use the Zoll itself? Which model? or how a biphasic defibrillator works and why?

delilas · Dec 27, 2013

On a unit I was a charge nurse for, we'd occasionally pull people aside as we checked our crash carts each morning and run them through it. "How do you pace? how do you change the joules?" etc, and have them flip the switches and show me. It's not necessarily as useful as a good mock code, but even just running through what buttons to push a couple times a week keeps things fresh.

HERE is a link to the mock codes Zoll uses, with some useful diagrams on a couple different defibs. I don't know how useful it will be, but might be better than nothing.

bebbercorn · Dec 27, 2013

The only way to get comfortable with it is to use it. I'd recommend doing some mock codes with your floor at least twice a year. Get comfortable turning it on, setting it to pace, monitor and defib. Maybe your educator would not be opposed to you setting up some education? It'd not only help your unit but it'd look great on your resume? I once did a unit based education project on the use of restraints and it was very well received... and looks good on my resume!

Editorial Team / Admin · Dec 27, 2013

Part of our daily crash cart check includes checking the defibrillator, the O2 tank level, and I always unplug the suction and verify that it works WITHOUT being plugged in.

As I work in a Cardiology department, we use our defibs frequently for cardioversions and we also place the pads on patients who will undergo coronary stenting. Or on patients in 3rd degree heart block who are in our room for a pacemaker or ICD implant.

Agree, call the Zoll rep to help get the ball rolling and then organize some mock codes. Such a great learning experience!

Good luck!