Abstract 107: Performing Hands-on Defibrillation in Out-of-Hospital Cardiac Arrest Can Result in the Mild, Subjective Perception of Current to Providers
Introduction: Minimizing interruptions in chest compressions during cardiac arrest has been shown to improve defibrillation success and survival. Recent data suggest hands-on defibrillation (HOD) is safe to providers. Starting in September 2011, Salt Lake City EMS providers were retrained with revised ACLS protocols to include the voluntary option of HOD with nitrile gloves and a foam-padded acclerometer acting as barrier.
Objective: Nine months after retraining, we sought to quantify prehospital provider experience with HOD.
Methods: Unique ID closed and open response electronic surveys were sent to all 478 EMS providers regarding HOD experience since retraining.
Results: 348 (73%) providers responded with 70 (20%) reporting HOD experience since retraining, including 43/70 (61%) who reported multiple HOD experiences (Figure). 10 (14%) had been on the chest unintentionally when a shock was delivered, while 57 (81%) reported intentional HOD and 3 reported both intentional and unintentional HOD experiences. 5/70 (7%) reported an episode of HOD in which they perceived current as a mild sensation lasting seconds during intentional HOD. Only 1/5 (20%) reported that the sensation of current was unpleasant enough to cause reluctance to perform HOD in the future. No serious adverse events were reported either in the survey or through formal reporting mechanisms.
Conclusions: In the setting of out-of-hospital cardiac arrest, 7% of providers reported a mild, brief, subjective perception of current during HOD. Ammeters attached to providers during HOD might help separate the relative contribution of actual current flow from prior conditioning regarding defibrillation safety.
- © 2012 by American Heart Association, Inc.