Remembering to Re-Activate a Patients Defibrillator (Apr 08)

A recent FDA article in the journal "Nursing2008" describes the case of a patient who died, possibly of ventricular fibrillation, following elective surgery. This happened because after the procedure, his implantable cardioverter defibrillator (ICD) wasn't reactivated.

ICDs are subject to interference from MRI and CT machines, and also from sources such as electrocautery devices. This interference can cause inappropriate shocks to the patient, and so ICDs are often turned off prior to medical and surgical procedures. But unless they're turned back on immediately afterwards, the patient will be unprotected against potentially lethal arrhythmias.

To prevent these kinds of errors, here's what the article recommends:

• Document information about the patient's ICD in the medical record.

• As the patient moves through the system, be sure other personnel know that the patient has an ICD and whether it is on or off.

• While the ICD is inactivated, provide continuous cardiac monitoring and have emergency equipment close by.

• Ensure that the ICD is reactivated after the medical or surgical procedure is finished.

Additional Information:

Sullivan, R and Ferriter, A. "Prevent life-threatening communication breakdowns". Nursing2008. Volume 38, Issue 2, p. 17. February 2008.
http://www.fda.gov/cdrh/medicaldevicesafety/tipsarticles/breakdowns.html

Category:

News & Politics

Tags:

• Defibrillator
• FDA
• Ventricular
• Fibrillation
• ICD
• MRI
• CT

[kmurnane1]

"Document that the patieny has an ICD?!" That's not already standard protocol?! Shit, I am never having elective surgery!