• Resuscitation · Dec 2021

    Pre-charging the defibrillator before rhythm analysis reduces hands-off time in patients with out-of-hospital cardiac arrest with shockable rhythm.

    • IversenBo NeesBNPrehospital Emergency Medical Services, Central Denmark Region, Oluf Palmes Allé 34, 8200 Aarhus N, Denmark; Department of Research and Development, Prehospital Emergency Medical Services, Oluf Palmes Allé 34, 8200 Aarhus N, Denmark; Depar, Carsten Meilandt, Ulla Væggemose, Christian Juhl Terkelsen, Hans Kirkegaard, and Jesper Fjølner.
    • Prehospital Emergency Medical Services, Central Denmark Region, Oluf Palmes Allé 34, 8200 Aarhus N, Denmark; Department of Research and Development, Prehospital Emergency Medical Services, Oluf Palmes Allé 34, 8200 Aarhus N, Denmark; Department of Anaesthesia and Operation 1, Aarhus University Hospital, Palle Juul-Jensens Boulevard 99, 8200 Aarhus N, Denmark.
    • Resuscitation. 2021 Dec 1; 169: 23-30.

    AimTo evaluate the effect of pre-charging the defibrillator before rhythm analysis on hands-off time in patients suffering from out-of-hospital cardiac arrest with shockable rhythm.MethodsPre-charging was implemented in the Emergency Medical Service in the Central Denmark Region in June 2018. Training consisted of hands-on simulation scenarios, e-learning material, and written instructions. Data were extracted from the Danish Cardiac Arrest Registry for a 14-month period spanning the implementation of pre-charging. Patients having received at least one shock were included. Transthoracic impedance data were analysed. We recorded hands-off time and peri-shock pauses for all defibrillation procedures and the total hands-off fraction for all cardiac arrests.ResultsImpedance and outcome data were available for 178 patients. 523 defibrillation procedures were analysed. The pre-charge method was associated with shorter median hands-off time per defibrillation procedure (7.6 (IQR 5.8-9.9) vs. 12.6 (IQR 10-16.4) seconds, p < 0.001) but longer pre-shock pause (4 (IQR 2.7-6.1) vs 1.7 (IQR 1.2-3) seconds, p < 0.001) when compared to the current guideline-recommended defibrillation method. The total hands-off fraction per cardiac arrest was reduced after implementation of the pre-charge method (16.5% vs. 20.4%, p = 0.003). No increase in shocks to non-shockable rhythms or personnel was registered. Patients who received only pre-charge defibrillations had an increased odds ratio of return of spontaneous circulation (aOR 2.91; 95%CI 1.09-7.8, p = 0.03).ConclusionPre-charging the defibrillator reduced hands-off time during defibrillation procedures, reduces the total hands-off fraction and may be associated with increased return of spontaneous circulation in out-of-hospital cardiac arrest with shockable rhythm.Copyright © 2021 The Author(s). Published by Elsevier B.V. All rights reserved.

      Pubmed     Free full text   Copy Citation     Plaintext  

      Add institutional full text...

    Notes

     
    Knowledge, pearl, summary or comment to share?
    300 characters remaining
    help        
    You can also include formatting, links, images and footnotes in your notes
    • Simple formatting can be added to notes, such as *italics*, _underline_ or **bold**.
    • Superscript can be denoted by <sup>text</sup> and subscript <sub>text</sub>.
    • Numbered or bulleted lists can be created using either numbered lines 1. 2. 3., hyphens - or asterisks *.
    • Links can be included with: [my link to pubmed](http://pubmed.com)
    • Images can be included with: ![alt text](https://bestmedicaljournal.com/study_graph.jpg "Image Title Text")
    • For footnotes use [^1](This is a footnote.) inline.
    • Or use an inline reference [^1] to refer to a longer footnote elseweher in the document [^1]: This is a long footnote..

    hide…