Document Detail

Increase in pre-shock pause caused by drug administration before defibrillation: an observational, full-scale simulation study.
MedLine Citation:
PMID:  20083336     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: The importance of circulation during cardiopulmonary resuscitation has led to efforts to decrease time without chest compressions ("no-flow time"). The no-flow time from the interruption of chest compressions until defibrillation is referred to as the "pre-shock pause". A shorter pre-shock pause increases the chance of successful defibrillation. It is unclear whether drug administration affects the length of the pre-shock pause. Our study compares pre-shock pause with and without drug administration in a full-scale simulation. METHODS: This was an observational study in an ambulance including 72 junior physicians and a cardiac arrest scenario. Data were extracted by reviewing video recordings of the resuscitation. Sequences including defibrillation and/or drug administration were identified and assigned to one out of four categories: Defibrillation only (DC-only) and drug administration just prior to defibrillation (Drug+DC) for which the pre-shock pause was calculated, and drug administration alone (Drug-only) for which pre-drug time was calculated. RESULTS: DC-only sequences were identified in 68/72 simulations, Drug+DC in 24/72, and Drug-only in 33/72. Median pre-shock pauses were 18s (DC-only) and 32 (Drug+DC), and median pre-drug pause 6. The variation between pauses was statistically significant (p<<0.001). DC-only and Drug+DC sequences was found in 22/72 simulations. A statistically significant difference of 8s was found between the median pre-shock pauses: 17s (DC-only) and 25 (Drug+DC) (p<<0.001). For un-paired observations, the pre-shock pause increased with 78% and for paired observations 47%. CONCLUSIONS: Drug administration prior to defibrillation was associated with significant increases in pre-shock pauses in this full-scale simulation study.
Christian Bjerre H?yer; Erika F Christensen; Berit Eika
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Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, Non-U.S. Gov't     Date:  2010-01-18
Journal Detail:
Title:  Resuscitation     Volume:  81     ISSN:  1873-1570     ISO Abbreviation:  Resuscitation     Publication Date:  2010 Mar 
Date Detail:
Created Date:  2010-02-17     Completed Date:  2010-05-04     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0332173     Medline TA:  Resuscitation     Country:  Ireland    
Other Details:
Languages:  eng     Pagination:  343-7     Citation Subset:  IM    
Copyright Information:
Copyright 2010 Elsevier Ireland Ltd. All rights reserved.
Centre for Medical Education, Faculty of Health Sciences, University of Aarhus, Aarhus N, Denmark.
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MeSH Terms
Acute Coronary Syndrome / complications,  therapy
Cardiopulmonary Resuscitation / methods*
Cardiotonic Agents / administration & dosage*
Computer Simulation
Coronary Circulation*
Drug Administration Schedule
Electric Countershock*
Heart Arrest / etiology,  physiopathology*,  therapy*
Heart Massage*
Injections, Intravenous
Time Factors
Ventricular Fibrillation / etiology,  therapy
Videotape Recording
Reg. No./Substance:
0/Cardiotonic Agents

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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