Als specialized service disposable supplies; defibrillation (to be used only in jurisdictions where defibrillation cannot be performed in bls ambulances)
HCPCS code
Name of the Procedure:
Defibrillation Specialized Service Disposable Supplies
- Technical Term: Advanced Life Support (ALS) Specialized Service Disposable Supplies for Defibrillation (HCPCS Code A0392)
Summary
Defibrillation involves using a device called a defibrillator to send an electric shock to the heart to restore a normal heartbeat. This procedure is used in emergency situations where the heart is experiencing a life-threatening arrhythmia, such as ventricular fibrillation or pulseless ventricular tachycardia. It is performed by trained healthcare providers and requires specialized disposable supplies.
Purpose
Medical Conditions Addressed:
- Cardiac arrest due to ventricular fibrillation or pulseless ventricular tachycardia.
Goals:
- To restore a normal heart rhythm and prevent sudden cardiac death.
Indications
Symptoms or Conditions:
- Sudden collapse
- No heartbeat detected
- Loss of consciousness
- No pulse
Patient Criteria:
- Individuals in cardiac arrest with specific types of arrhythmias.
- Cases where defibrillation is necessary and cannot be performed by Basic Life Support (BLS) providers.
Preparation
Pre-procedure Instructions:
- As this is an emergency procedure, no prior preparation by the patient is required.
Diagnostic Tests:
- Rapid assessment of heart rhythm using an ECG monitor.
Procedure Description
- Assessment: Verify unconsciousness and lack of pulse.
- Activate ALS Protocol: Call for Advanced Life Support if not already on scene.
- Attach Defibrillator Pads: Apply disposable defibrillator pads to the patient's chest.
- Analyze Heart Rhythm: The defibrillator will analyze and identify if the heart rhythm is shockable.
- Deliver Shock: If indicated, deliver an electric shock through the defibrillator.
- Post-Shock Monitoring: Continue to monitor and provide follow-up shocks if necessary according to ALS protocols.
Tools and Equipment:
- Automated or manual defibrillator
- Electrocardiogram (ECG) monitor
- Disposable defibrillator pads
Anesthesia or Sedation:
- Not applicable, as patient is usually unconscious.
Duration
- The procedure typically takes a few minutes but may be repeated as needed during resuscitation efforts.
Setting
- Emergency settings such as ambulances, hospitals, or wherever an ALS unit operates.
Personnel
- Paramedics or other trained ALS providers.
Risks and Complications
Common Risks:
- Minor skin burns at pad sites.
- Muscle soreness from chest compressions if CPR is performed in conjunction.
Rare Risks:
- Rib fractures from associated CPR.
- Electric burns if pads are improperly applied.
Complication Management:
- Follow-up medical evaluation and treatment in hospital.
Benefits
- Immediate restoration of a normal heart rhythm.
- Increased survival chances from sudden cardiac arrest.
Recovery
Post-procedure Care:
- Continuous monitoring in a hospital ICU.
- Follow-up cardiac care and potential rehabilitation.
Recovery Time:
- Varies depending on individual response and underlying health conditions.
Restrictions and Follow-up:
- Activity limitations will be advised based on recovery progress.
- Regular follow-up appointments with a cardiologist.
Alternatives
Other Treatment Options:
- CPR alone if defibrillation is not available.
- Administration of cardiac arrest medications (e.g., epinephrine).
Pros and Cons:
- CPR can sustain circulation but is less effective in restoring normal rhythm compared to defibrillation.
- Medications can support, but usually are not definitive treatments without defibrillation.
Patient Experience
During the Procedure:
- Patient is unconscious and will not feel the procedure.
After the Procedure:
- Possible soreness and minor burns at the pad sites.
- Emotional and physical fatigue as recovery progresses.
Pain Management:
- Pain relief medications as needed.
- Supportive care and comfort measures in the hospital setting.