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Comparative performance assessment of commercially available automatic external defibrillators: A simulation and real-life measurement study of hands-off time


Savastano, Simone; Vanni, Vincenzo; Burkart, Roman; Raimondi, Maurizio; Canevari, Fabrizio; Molinari, Simone; Baldi, Enrico; Danza, Aurora I; Caputo, Maria Luce; Mauri, Romano; Regoli, Francois; Conte, Giulio; Benvenuti, Claudio; Auricchio, Angelo (2017). Comparative performance assessment of commercially available automatic external defibrillators: A simulation and real-life measurement study of hands-off time. Resuscitation, 110:12-17.

Abstract

PURPOSE Early and good quality cardiopulmonary resuscitation (CPR) and the use of automated external defibrillators (AEDs) improve cardiac arrest patients' survival. However, AED peri- and post-shock/analysis pauses may reduce CPR effectiveness. METHODS The time performance of 12 different commercially available AEDs was tested in a manikin based scenario; then the AEDs recordings from the same tested models following the clinical use both in Pavia and Ticino were analyzed to evaluate the post-shock and post-analysis time. RESULTS None of the AEDs was able to complete the analysis and to charge the capacitors in less than 10s and the mean post-shock pause was 6.7±2.4s. For non-shockable rhythms, the mean analysis time was 10.3±2s and the mean post-analysis time was 6.2±2.2s. We analyzed 154 AED records [104 by Emergency Medical Service (EMS) rescuers; 50 by lay rescuers]. EMS rescuers were faster in resuming CPR than lay rescuers [5.3s (95%CI 5-5.7) vs 8.6s (95%CI 7.3-10). CONCLUSIONS AEDs showed different performances that may reduce CPR quality mostly for those rescuers following AED instructions. Both technological improvements and better lay rescuers training might be needed.

Abstract

PURPOSE Early and good quality cardiopulmonary resuscitation (CPR) and the use of automated external defibrillators (AEDs) improve cardiac arrest patients' survival. However, AED peri- and post-shock/analysis pauses may reduce CPR effectiveness. METHODS The time performance of 12 different commercially available AEDs was tested in a manikin based scenario; then the AEDs recordings from the same tested models following the clinical use both in Pavia and Ticino were analyzed to evaluate the post-shock and post-analysis time. RESULTS None of the AEDs was able to complete the analysis and to charge the capacitors in less than 10s and the mean post-shock pause was 6.7±2.4s. For non-shockable rhythms, the mean analysis time was 10.3±2s and the mean post-analysis time was 6.2±2.2s. We analyzed 154 AED records [104 by Emergency Medical Service (EMS) rescuers; 50 by lay rescuers]. EMS rescuers were faster in resuming CPR than lay rescuers [5.3s (95%CI 5-5.7) vs 8.6s (95%CI 7.3-10). CONCLUSIONS AEDs showed different performances that may reduce CPR quality mostly for those rescuers following AED instructions. Both technological improvements and better lay rescuers training might be needed.

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Additional indexing

Item Type:Journal Article, refereed, original work
Communities & Collections:04 Faculty of Medicine > Cardiocentro Ticino
Dewey Decimal Classification:610 Medicine & health
Language:English
Date:22 October 2017
Deposited On:30 Dec 2016 15:09
Last Modified:31 Jan 2017 08:31
Publisher:Elsevier
ISSN:0300-9572
Publisher DOI:https://doi.org/10.1016/j.resuscitation.2016.10.006
PubMed ID:27780740

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