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Delays in defibrillation : influence of different monitoring techniques
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Perkins, Gavin D., Roberts, C. and Gao, F. (2002) Delays in defibrillation : influence of different monitoring techniques. British Journal of Anaesthesia, 89 (3). pp. 405-408. doi:10.1093/bja/89.3.405
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Official URL: http://dx.doi.org/10.1093/bja/89.3.405
Abstract
Background. Rapid defibrillation is the most important intervention required for a patient in cardiac arrest due to ventricular fibrillation or ventricular tachycardia. Isolated case reports of spurious asystole may have seen a change in practice, moving away from monitoring through defibrillator paddles and gel pads in favour of attaching electrocardiograph (ECG) leads for the initial monitoring of a collapsed patient. We surveyed current preferences for initial monitoring and estimated the difference in time taken to deliver the first shock with the following three monitoring techniques: defibrillator paddles and gel pads, ECG leads and hands-free adhesive pads. Methods. Sixty Advanced Life Support (ALS) course directors, selected at random, were questioned to establish their current practice. Twenty ALS providers received 5 min revision in the three techniques for the initial monitoring of a collapsed patient and were then randomly tested to measure the time from confirmation of arrest to the first shock. Results. Forty-two directors indicated their preferred methods for initial monitoring as 74% leads, 21% paddles and 5% hands-free adhesive pads. Before testing, 10 providers preferred paddles and 10 preferred leads. Monitoring through leads 54 (range 49-65) s was significantly slower than paddles 28 (24-31) s, P<0.01 and adhesive pads 23 (19-27) s, P<0.01. There was no significant difference in the time taken between paddles and adhesive pads. Conclusion. The current practice of monitoring through leads delays the time to deliver the first shock. We recommend that initial monitoring through leads be discontinued in favour of hands-free adhesive pads or defibrillator paddles/gel pads.
| Item Type: | Journal Article | ||||
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| Subjects: | R Medicine > R Medicine (General) | ||||
| Divisions: | Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School > Clinical Trials Unit Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School > Health Sciences Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School |
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| Journal or Publication Title: | British Journal of Anaesthesia | ||||
| Publisher: | Oxford University Press | ||||
| ISSN: | 00070912 | ||||
| Official Date: | 20 April 2002 | ||||
| Dates: |
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| Volume: | 89 | ||||
| Number: | 3 | ||||
| Page Range: | pp. 405-408 | ||||
| DOI: | 10.1093/bja/89.3.405 | ||||
| Status: | Peer Reviewed | ||||
| Publication Status: | Published | ||||
| Access rights to Published version: | Open Access | ||||
| Open Access Version: |
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