Abstract 246: The Impact of ECG Filtration Software on Minimizing the Interval to Defibrillation for Inpatient Cardiopulmonary Arrest
Background: Minimizing pre- and post-shock compression pauses improves the likelihood of successful defibrillation. However, rhythm analysis prior to and immediately following defibrillation attempts may prolong these intervals. ECG filtration software may decrease pre- and post-shock pause intervals.
Objective: To describe the impact of ECG filtration software in minimizing pre- and post-shock pauses for inpatient cardiopulmonary arrest (CPA).
Methods: This study was conducted in two urban university hospitals following implementation of ECG filtration software in May 2009. We routinely export defibrillator data from all CPAs. For this analysis, pre- and post-shock compression pauses were quantified. In addition, two physicians independently evaluated the pre-shock rhythm. This data was reported descriptively.
Results: A total of 98 defibrillation attempts in 38 patients were included. Pre-shock intervals ranged from 0-39 seconds; the majority (75%) were <5 sec. The vast majority (94%) of post-shock intervals were <5 sec. The majority (63%) of pre-shock rhythms were ventricular fibrillation/ventricular tachycardia; 23% were pulseless electrical activity (PEA); 3% were asystole; and 10% could not be determined. For PEA defibrillation attempts, 74% had a pre-shock pause <2 sec, and 26% were administered at the end of prolonged codes. Mean chest compression fraction (CCF) were 89%.
Conclusions: ECG filtration software appears to minimize pre- and post-shock intervals. A small but measurable incidence of PEA defibrillation was observed with very brief pre-shock intervals. This may warrant a brief pause to confirm VF/VT prior to defibrillator charge.
- © 2011 by American Heart Association, Inc.