Synchronized Cardioversion ACLS Cheat Sheet: 5 Facts You Need to Know

Synchronized cardioversion is a medical procedure that delivers a low-energy electrical shock to reset an irregular heart rhythm. The electrical shock is carefully synchronized to occur at a specific point in the QRS complex.

Because synchronized cardioversion is an effective treatment for certain cardiac arrhythmias, it is important to have a basic understanding of it before taking your ACLS certification exam.

Here are 5 key facts you need to know about synchronized cardioversion.

1) In the unstable patient, indicators that emergency synchronized cardioversion should be performed include:

• Atrial flutter
• Symptomatic ventricular tachycardia
• Paroxysmal supraventricular tachycardia
• Rapid atrial fibrillation

2) The three types of paddle-skin interface used include:

• Pre-packaged gel pads
• Saline-soaked pads
• Cream or paste

3) Common premedication options for synchronized cardioversion include:

• Midazolam (IV or IN - 1.0 to 2.5 mg)
• Diazepam (slow IV - 5 mg)
• Morphine (IV 2 to 4 mg)

4) Transthoracic pad placement is the recommended placement for all emergency situations for both adult and pediatric patients.

5) The countershock is programmed to occur during the QRS complex, at the peak of the R wave.