Current practice and perspective of hands-free defibrillation in Hungary — Investigating the obstacles of implementation

Abstract

Defibrillation with self-adhesive pads is the gold standard method during resuscitation as it allows minimal interruptions of chest compressions. Unfortunately, the implementation of the new recommendations often requires the purchase of new equipment. We have conducted a nationwide survey by telephone interviews with senior clinicians in order to investigate the current position of the implementation and to identify possible obstacles. We have audited 56 hospitals and 92 departments across the country and interviewed the senior consultants of the intensive care units (ICUs) and emergency departments (EDs). Only 6.5% of all responders were using hands-free defibrillation routinely at the time of the survey. According to 67.4% of respondents, purchasing of new equipment was not likely within 2 years. The major obstacle was the perceived higher costs (59.8%); however, the majority of clinicians (92.4%) were aware of the potential benefits of hands-free defibrillation. Our results suggest that the implementation of the new guidelines is slower than expected due to the unavailability of hands-free defibrillators. The major obstacle is the perceived cost-efficiency concerns. The need for an interim recommendation for safe delivery of defibrillation using hard paddles might be considered to enhance the chance of survival for a large number of patients.

Barriers in the implementation of the Resuscitation Guidelines: European survey of defibrillation techniques

“…In countries with low adhesive pads usage, we see signs of growing use of adhesive pads in the pre-hospital area, which may be associated with awareness of the guidelines in this group of healthcare providers which changes the former defibrillation practice [ 11 – 13 ]. In the recently published study from Hungary only 6,5 % of the interviewed senior consultants of the intensive care units and emergency departments from audited 56 hospitals declared the use of adhesive pads routinely at the time of the survey [ 15 ].…”

“…Resistance to using adhesive pads and the tradition of using manual paddles are still important barriers in guideline implementation. The Hungarian study also revealed that the major obstacle for adhesive pads use which were the perceived cost-efficiency concerns declared in 60 % of responds, however, the majority of clinicians (92 %) were aware of the benefits of adhesive pads use [ 15 ].…”