Open AccessHands‐On Defibrillation Has the Potential to Improve the Quality of Cardiopulmonary Resuscitation and Is Safe for Rescuers— A Preclinical Study
Author(s) -
Neumann Tobias,
Gruenewald Matthias,
Lauenstein Christoph,
Drews Tobias,
Iden Timo,
Meybohm Patrick
Publication year - 2012
Publication title -
journal of the american heart association
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.494
H-Index - 85
ISSN - 2047-9980
DOI - 10.1161/jaha.112.001313
Subject(s) - defibrillation , medicine , cardiopulmonary resuscitation , ventricular fibrillation , cardioversion , coronary perfusion pressure , automated external defibrillator , resuscitation , anesthesia , cardiology , atrial fibrillation
Background Recently, it has been demonstrated that rescuers could safely provide a low, static downward force in direct contact with patients during elective cardioversion. The purpose of our experimental study was to investigate whether shock delivery during uninterrupted chest compressions may have an impact on cardiopulmonary resuscitation ( CPR ) quality and can be safely performed in a realistic animal model of CPR . Methods and Results Twenty anesthetized swine were subjected to 7 minutes of ventricular fibrillation followed by CPR according to the 2010 A merican H eart A ssociation G uidelines. Pregelled self‐adhesive defibrillation electrodes were attached onto the torso in the ventrodorsal direction and connected to a biphasic defibrillator. Animals were randomized either to (1) hands‐on defibrillation, where rescuers wore 2 pairs of polyethylene gloves and shocks were delivered during ongoing chest compressions, or (2) hands‐off defibrillation, where hands were taken off during defibrillation. CPR was successful in 9 out of 10 animals in the hands‐on group (versus 8 out of 10 animals in the hands‐off group; not significant). In the hands‐on group, chest compressions were interrupted for 0.8% [0.6%; 1.4%] of the total CPR time (versus 8.2% [4.2%; 9.0%]; P =0.0003), and coronary perfusion pressure was earlier restored to its pre‐interruption level ( P =0.0205). Also, rescuers neither sensed any kind of electric stimulus nor did H olter ECG reveal any serious cardiac arrhythmia. Conclusions Hands‐on defibrillation may improve CPR quality and could be safely performed during uninterrupted chest compressions in our standardized porcine model.