How do we limit the interruptions of chest compression during defibrillation? The three-in-one method

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• 作者：N. Clausen Groes ; C. Jeppsen ; M. Brabr
• 关键词：High-temperature gas nitriding ; AISI 430 ferritic stainless steel ; Chromium nitride ; Tempering
• 刊名：Resuscitation
• 出版年：2008
• 出版时间：May 2008
• 年：2008
• 卷：77
• 期：Supplement 1
• 页码：S44-S45
• 全文大小：55 K

文摘

Sixteen pairs of ambulance personnel operated the defibrillator (Lifepak^®12) in both semi-automatic (AED) and manual (MED) mode in a randomised, cross-over manikin CPR study, following the ERC 2000 Guidelines.

Results

Median time from last chest compression to shock delivery (with interquartile range) was 17 s (13, 18) versus 11 s (6, 15) (mean difference (95 % CI) 6 s (2, 10), p = 0.004). Similarly, median time from shock delivery to resumed chest compressions was 25 s (22, 26) versus 8 s (7, 12) (median difference 13 s, p = 0.001) in the AED and MED groups, respectively. While sensitivity for identifying ventricular fibrillation (VF) in both modes and specificity in the AED mode were 100 % , specificity was 89 % in manual mode. Thus, some unwarranted shocks resulting in hands-off time (time without chest compressions) were given in manual mode. However, mean hands-off-ratio (time without chest compressions divided by total resuscitation time) was still lower, 0.2 s (0.1, 0.3) versus 0.3 s (0.28, 0.32) in manual mode, mean difference 0.10 s (0.05, 0.15), p = 0.001.

Conclusion

Paramedics performed CPR with less hands-off time before and after shocks on a manikin with manual compared to semi-automatic defibrillation following the 2000 Guidelines. However, 12 % of the shocks given manually were inappropriate.