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Preliminary Reports

A New Defibrillator Mode to Reduce Chest Compression Interruptions for Health Care Professionals and Lay Rescuers: A Pilot Study in Manikins

, MD, , BS, NREMT-P, , PhD & , PhD
Pages 88-97 | Received 20 Sep 2010, Accepted 01 Oct 2010, Published online: 16 Feb 2011
 

Abstract

Background. Chest compression interruptions are detrimental during the resuscitation of cardiac arrest patients, especially immediately prior to shock delivery. Objective. To evaluate the effect of use of a new defibrillator technology, which filters compression-induced artifact and provides reliable rhythm analysis with automatic defibrillator charging during chest compressions, on preshock chest compression interruption. Methods. Thirty subjects (20 basic life support [[BLS]]; 10 advanced life support [[ALS]]) worked in pairs to perform two randomly ordered simulated cardiac resuscitations with the defibrillator operating in either standard mode (ALS == manual; BLS == automated external defibrillator [[AED]]) or the new Analysis and Charging during CPR (AC-CPR) mode. During each resuscitation simulation, rescuers switched roles as chest compressor and defibrillator operator every two segments of CPR (one segment == 2 minutes of chest compressions, rhythm analysis, and shock delivery, if appropriate), for eight total segments. The participants rested ≥30 minutes between trials and received brief AC-CPR training (BLS == 30 seconds; ALS == 5 minutes). Heart rate and perceived exertion were measured with pulse oximetry and the Borg scale, respectively. Results. Mean (± standard deviation) preshock chest compression pause time was considerably shorter in each CPR segment with AC-CPR versus standard defibrillator operation (2.13 ± 0.99 sec vs. 10.93 ± 1.33, p < 0.0001), demonstrating effective use of AC-CPR with minimal training. Despite reduced chest compression interruption with AC-CPR, rescuer fatigue and perceived exertion did not differ in any CPR segment with standard defibrillator operation versus AC-CPR (p == 0.2–1.0). Conclusions. Preshock pause time is reduced by 80%% utilizing a novel technology that employs automated analysis and charging during chest compression. Although chest compression pause time is reduced with the use of the new technology, participants do not excessively fatigue.

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