Abstract 155: Duration of Pre-shock Compression Pause Does Not Affect Defibrillation Success in Out-of-Hospital Cardiac Arrest Treated With Either Manual or Load-Distributing Band Compressions
Background: Guidelines emphasize minimizing pre-shock chest compression pauses prior to a defibrillation attempt. Study results on the influence of pre-shock pauses on first shock defibrillation failure are inconclusive. We wanted to study how pre-shock pauses influenced shock success for manual and load-distributing band compressions prior to shocks (M-c and LDB-c) in the Circulation Improving Resuscitation Care (CIRC) study database.
Methods: Initial rhythm, pre-shock rhythm, rhythm 5 sec after shock, M-c or LDB-c, and number of shocks were recorded based on ECG and transthoracic impedance. Shock success was defined as VF/VT termination at least 5 sec after shock. Shocks without analyzable pre-shock pause, post-shock rhythm, or compressions prior to shock, and shocks not indicated were excluded. Pre-shock pauses were measured from the last compression to shock delivered, and divided into 5 groups: Group A shock during compressions (LDB-c only), group B pre-shock time <10 sec (excluding shock during compressions), group C 10-19 sec, group D 20-29 sec, and group E ≥30 sec. Differences between groups were calculated using chi-square test.
Results: We included 2807 of 2969 M-c and 1715 of 1791 LDB-c shocks. Median pre-shock time was 4 seconds (IQR 3-16) for M-c, and 0 seconds (IQR 0-6) for LDB-c. The table shows first shock success for M-c and LDB-c related to initial VF/VT, and all initial rhythms and all shocks for the five pre-shock pause groups.
Conclusion: Different pre-shock pauses or shock during compressions did not affect shock success for M-c or LDB-c. However, the impact on ROSC and neurologic outcome requires further investigation.
- © 2013 by American Heart Association, Inc.