Before synchronized cardioversion, what should be planned?

• A. Ensure pads are in place and patient safety confirmed.
• B. Obtain informed consent for electrical therapy.
• C. Sync mode and anticoagulation considerations.
• D. Begin immediate defibrillation without synchronization.

Answer: (A)

Before synchronized cardioversion, the most important step is to verify that the pads are correctly placed and that patient safety is assured. Proper pad placement ensures the shock is delivered through the heart along the intended pathway, which makes the energy delivery effective and reduces the risk of skin burns or poor transmission. Safety checks mean ensuring the area around the patient is clear, no one is touching the patient during shock, any jewelry or conductive materials are removed, and monitoring and equipment are ready to go. Consent is important in many situations, but in urgent scenarios the immediate goal is safe, effective energy delivery, which depends on proper setup. Anticoagulation matters for longer-term rhythm management and stroke risk, not the immediate pre-shock preparation. Using synchronization is essential for cardioversion, while delivering a shock without synchronization is appropriate only for pulseless rhythms, not in this planned synchronized context.