Thursday, February 17, 2011
Everyone has seen somebody on tv yell "Clear" when a patient is shocked. I had the luxury of doing this yesterday. It was very exciting! A patient with atrial fibrillation had failed medical therapy and needed cardioversion to convert his heart back to sinus rhythm. Dr. T told me that I would get to do the case, as long as I knew the complications and how to treat them. I spent a good amount of time preparing all the possible complications and the treatment because I didn't want to risk not having the answers and therefore not getting the case. The biggest risk is asystole: completely stopping the heart. That's all he wanted to hear. So I was over prepared; but that is always better than being under prepared. So we set the patient up, the anesthesiologist sedated him and I started the defibrillator. On the machine, there is a strip where the heart rhythm is displayed. Dr. T warned me that while doing the shock, I needed to keep my eyes on the strip and not on the patient (who would jump off the table) to make sure that he didn't go into asystole. So, I set the energy to 100 joules, got the patient synced, charged the defibrillator up, and said "clear" and shocked the patient. I made sure to not even glance away from the strip. Luckily, he converted to sinus, and the cardioversion was a success!