Document Detail


The impact of manual defibrillation technique on no-flow time during simulated cardiopulmonary resuscitation.
MedLine Citation:
PMID:  17223245     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
INTRODUCTION: Rapid defibrillation is the most effective strategy for establishing return of spontaneous circulation following cardiac arrest due to ventricular fibrillation. The aim of this study is to measure the delay due to of charging the defibrillator during chest compression in an attempt to reduce the duration of the pre-shock pause in between cessation of chest compressions and shock delivery as advocated by the American Heart Association (AHA) guidelines compared to charging the defibrillator immediately following rhythm analysis without resuming chest compressions as recommended by the European Resuscitation Council (ERC). METHODS: This was a randomised controlled cross over trial comparing pre-shock pause times when defibrillation was performed on a manikin according to the AHA and ERC guidelines using paddles and hands free defibrillation systems. RESULTS: The pre-shock pause between cessation of chest compression and shock delivery was significantly different between techniques (Friedman test, P<0.0001). ERC paddles technique had the greatest pre-shock pause (7.4 s [6.7-11.2]) followed by ERC hands free (7.0 s [6.5-8.5]) and AHA paddles (1.6 s [1.1-2.3]). AHA hands free took the least amount of time (1.5 s [0.8-1.5]). Extrapolating these data to older defibrillators with longer charge times saw pre-shock pause intervals of 9 s (Codemaster XL) and 12 s (Lifepak 20) with the ERC approach. CONCLUSION: This study demonstrated clinically significant delays to defibrillation by analysing and charging the defibrillator without performing concurrent chest compressions. In a simulated scenario, charging the defibrillator whilst performing chest compressions was perceived as safe and significantly reduced the pre-shock pause between cessation of chest compression and shock delivery.
Authors:
Gavin D Perkins; Robin P Davies; Jasmeet Soar; David R Thickett
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Publication Detail:
Type:  Journal Article; Randomized Controlled Trial     Date:  2007-01-16
Journal Detail:
Title:  Resuscitation     Volume:  73     ISSN:  0300-9572     ISO Abbreviation:  Resuscitation     Publication Date:  2007 Apr 
Date Detail:
Created Date:  2007-03-09     Completed Date:  2007-06-13     Revised Date:  2009-08-25    
Medline Journal Info:
Nlm Unique ID:  0332173     Medline TA:  Resuscitation     Country:  Ireland    
Other Details:
Languages:  eng     Pagination:  109-14     Citation Subset:  IM    
Affiliation:
University of Birmingham, Birmingham B15 2TT, United Kingdom.
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MeSH Terms
Descriptor/Qualifier:
Adult
Cardiopulmonary Resuscitation*
Clinical Competence
Cross-Over Studies
Electric Countershock / methods*
Female
Heart Arrest / etiology,  therapy
Humans
Male
Manikins
Time Factors
Ventricular Fibrillation / complications

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


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