Editing Defibrillation (section)

=== Manual models ===
Manual external defibrillators require the expertise of a healthcare professional.<ref name="Beaumont" /><ref name="FDA" /> They are used in conjunction with an [[electrocardiogram]], which can be separate or built-in. A healthcare provider first diagnoses the cardiac rhythm and then manually determine the voltage and timing for the electrical shock. These units are primarily found in [[hospital]]s and on some [[ambulance]]s.  For instance, every [[National Health Service|NHS]] ambulance in the [[United Kingdom]] is equipped with a manual defibrillator for use by the attending paramedics and technicians. {{Citation needed|date=December 2016}} In the [[United States]], many advanced [[Emergency medical technician|EMTs]] and all [[paramedics]] are trained to recognize lethal arrhythmias and deliver appropriate electrical therapy with a manual defibrillator when appropriate. {{Citation needed|date=December 2016}}

An internal defibrillator is often used to defibrillate the heart during or after cardiac surgery such as a [[heart bypass]]. The electrodes consist of round metal plates that come in direct contact with the myocardium. Manual internal defibrillators deliver the shock through paddles placed directly on the heart.<ref name="Tintinalli" /> They are mostly used in the [[operating theater|operating room]] and, in rare circumstances, in the emergency room during an [[thoracotomy|open heart procedure]].