Abstract 125: Cardiac Rhythm Analysis and Charging During Chest Compressions Reduces Length of Chest Compression Pauses
Background: Interruptions in external chest compressions, particularly immediately preceding and following defibrillation, have been shown to reduce survival in cardiac arrest.
Objective: To assess a new technology (Analysis during Compressions with Fast Reconfirmation: ADC-FR), which features cardiac rhythm analysis during compressions, automated defibrillator charging, and rapid automated reconfirmation of cardiac rhythm when compressions are halted.
Methods: In this prospective observational study, 16 BLS-certified prehospital health care providers worked in pairs to perform 2 randomly assigned simulated cardiac resuscitations on a manikin, one with the defibrillator (X Series, ZOLL Medical) operating in standard AED mode and the other in ADC-FR mode. Each simulated resuscitation consisted of 8 two-minute intervals of continuous chest compressions, 4 randomly assigned with shockable and 4 with non-shockable rhythms. Chest compression pauses after each 2-minute interval (time from compression stop until compression resumption after shock delivered or “no-shock advised” message) were measured. Mean chest compression depth and rate were also assessed during all cycles. Data were analyzed using descriptive statistics and paired t-tests.
Results: Subjects were 28±6 years, 81% male, with 7±4 years of CPR certification. After excluding 16 of 128 total compression intervals due to technical limitations, 57 AED and 55 ADC-FR intervals were included in the analysis. Overall, chest compression pauses were 7.8±0.5 sec with AED mode vs. 5.0±0.6 sec with ADC-FR mode, p<0.001. Pre-shock pauses were 7.7±0.7 sec for AED mode vs. 4.4±0.4 sec ADC-FR, p<0.001. There was no difference in post-shock pause, 1.1±0.4 sec AED vs. 1.0±0.8 sec ADC-FR, p=0.6. Pauses for non-shockable rhythms were also shorter with the ADC-FR mode (6.9±0.4 sec AED vs. 4.5±0.5 sec ADC-FR, p<0.001).
Conclusions: Use of the ADC-FR technology reduces the length of chest compression pauses at the end of compression intervals with both “shock advised” and “no-shock advised.” Larger trials are required to determine whether this technology can reduce time of chest compression interruptions in human subjects and improve survival from cardiac arrest.
- © 2012 by American Heart Association, Inc.