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Emergencies and resuscitation

How to do synchronized cardioversion

Other platforms explain it with text and video. In Making Synapses you practice it on the patient.

MD / DOPAEMS (NREMT)
Practice it in VR with Blocky

Cardioversion times the shock to the R wave. Sync must be on.

Step by step

  1. Indication

    Unstable tachycardia with a pulse. [1]

  2. Sedate

    If time allows. [1]

  3. Pads

    Per device. [1]

  4. Sync on

    Check markers on each R wave. [1]

  5. Energy

    Per device and rhythm guidance. [1]

  6. Clear and shock

    Hold the button until it fires; re-sync before each further shock. [1]

Common errors

Practice it in Making Synapses

In Making Synapses you do this on the patient, not on paper: every step goes on the checklist with a score, and in Teach mode Blocky tells you what comes next.

Making Synapses cases that train this skill

7 Making Synapses cases train this skill: open the case library

Sources

  1. NASEMSO National Model EMS Clinical Guidelines
  2. NREMT psychomotor skill sheets (EMT and Paramedic)

Facts and steps follow NASEMSO National Model EMS Clinical Guidelines; NREMT psychomotor skill sheets (EMT and Paramedic). Making Synapses is not affiliated with these organizations. Updated: 2026-10-11.