Manual defibrillation using paddles—Which is the best technique?

Cebula, Grzegorz; Krawczyk, Paweł; Kononowicz, Andrzej A.; Koszowski, Marcin; Odrzywolek, Ryszard; Andres, Janusz

doi:10.1016/j.resuscitation.2012.01.008

Cited by 3 publications

(5 citation statements)

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“…There are discrepancies in the use of adhesive pads between the countries and the location of the healthcare service (pre- and in-hospital areas). 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 ].…”

Section: Discussionmentioning

confidence: 99%

“…Additional questions were asked in regard to manual paddles use (indications, coupling medium usage, technique of manual defibrillation). The study questionnaire was created based on results and conclusions of the previous studies [ 11 – 13 ] and after consulting it with the then ERC Director of Science and Research. In case of no response within one week we sent up to 3 reminders.…”

Section: Methodsmentioning

confidence: 99%

“…The ERC Guidelines for Resuscitation 2015 recognize that defibrillator paddles are used in some settings [ 1 ]. The use of paddles is still common in many European countries [ 11 – 13 ], however, it is not known what the most common defibrillation technique is in each country or what the potential barriers in implementation of the guidelines are.…”

Section: Introductionmentioning

confidence: 99%

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

Krawczyk

Kononowicz

Andres

2016

Scand J Trauma Resusc Emerg Med

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Background: The European Resuscitation Council (ERC) Guidelines recommend providing chest compressions during defibrillator charging and using adhesive pads for defibrillation to increase the effectiveness of resuscitation. However, the most common defibrillation technique in each European country is unknown, as are the potential barriers in implementation of the guidelines. The aim of this study was to assess the techniques of defibrillation procedures performed by professional European healthcare providers and to estimate how frequently adhesive pads are used. Methods: We sent an online questionnaire to the ERC National Representatives that contained 12 questions regarding the techniques of defibrillation and monitoring heart rhythm during cardiac arrest. We also evaluated the frequency and indications of manual paddles use. Results: We collected questionnaires from 27 out of 33 invited ERC member countries. The response rate was 82 %. Seventeen (17/27; 63 %) declared the use of adhesive pads. The leading cause for not using adhesive pads was economic reason (9/17; 53 %). Some respondents declared resistance to using adhesive pads by healthcare providers or tradition connected with manual paddles use. We found three leading techniques of defibrillation with manual paddles: Charging paddles keeping them on the defibrillator during chest compressions being delivered (9/21; 43 %), Charging paddles keeping them on the patient chest during chest compressions being delivered (6/21; 29 %), Charging paddles on the patient chest without chest compressions (5/21; 24 %). Respondents from 11 countries declared the use of gel or electrode pastes during defibrillation with manual paddles. Discussion: This study collected preliminary data showing how defibrillation is performed in Europe. It revealed the recommeded techniques underuse and identyfied barriers in the Resuscitation Guidelines implementation. The survey should be open to a wider group of respondents. in each country in future. Conclusions: There are limitations and barriers in the implementation of the defibrillation technique guidelines. There are still countries where the use of adhesive pads is low due to economic and traditional reasons. There is a need for further efforts focused on guidelines implementation.

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Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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

Krawczyk

Kononowicz

Andres

2016

Scand J Trauma Resusc Emerg Med

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“…It has been recognized already that implementation of the 2010 ERC Guideline in terms of defi brillation has suff ered from the lack of universal availability of equipment [4] and consensus of an alternative safe technique [5,6]. Though it potentially aff ects millions of people in Europe, the literature of this issue is rather scarce and recommendations are still lacking.…”

Section: Discussionmentioning

confidence: 99%

“…It is not clear how these providers would try to implement the new guideline and minimize the interruptions while delivering safe defi brillation at the same time. Krawczyk et al observed a number of diff erent methods in the clinical practice and that some of them could even be unsafe [5,6]. Also, a number of providers simply follow the safe defi brillation practice of the previous guideline interrupting chest compressions during charging which then leaves patients in risk of loosing chance for survival.…”

Section: Introductionmentioning

confidence: 99%

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

Diószeghy

Molnár

2014

IMAS

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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.

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