Lyster Tom, Jorgenson Dawn, Morgan Carl
Philips Medical Systems, Seattle, Washington 98121, USA.
Prehosp Emerg Care. 2003 Jul-Sep;7(3):307-11. doi: 10.1080/10903120390936473.
There has been concern regarding potential shock hazards for rescuers or bystanders when a defibrillator is used in a wet environment and the recommended safety procedure, moving the patient to a dry area, is not followed.
To measure the electrical potentials associated with the use of an automated external defibrillator (AED) in a realistically modeled wet environment.
A raw processed turkey was used as a patient surrogate. The turkey was placed on a cement floor while pool water was applied to the surrounding area. To simulate a rescuer or bystander in the vicinity of a patient, a custom sense probe was constructed. Defibrillation shocks were delivered to the turkey and the probe was used to measure the voltage an operator/bystander would receive at different points surrounding the surrogate. The test was repeated with salt water.
The maximum voltage occurred approximately 15 cm from the simulated patient and measured 14 V peak (current 14 mA peak) in the case of pool water, and 30 V peak (current 30 mA peak) in the case of salt water.
Thirty volts may result in some minor sensation by the operator or bystander, but is considered unlikely to be hazardous under these circumstances. The maximum currents were lower than allowed by safety standards. Although defibrillation in a wet environment is not recommended practice, our simulation of a patient and a rescuer/bystander in a wet environment did not show significant risk should circumstances demand it.
当在潮湿环境中使用除颤器且未遵循将患者转移到干燥区域这一推荐的安全程序时,救援人员或旁观者可能面临电击危险。
测量在逼真模拟的潮湿环境中使用自动体外除颤器(AED)时相关的电位。
用一只经过初步处理的火鸡作为患者替身。将火鸡放在水泥地面上,同时在其周围区域浇上泳池水。为模拟患者附近的救援人员或旁观者,制作了一个定制的传感探头。向火鸡施加除颤电击,并使用探头测量操作员/旁观者在替身周围不同点处会接收到的电压。用盐水重复该测试。
在泳池水的情况下,最大电压出现在距模拟患者约15厘米处,峰值为14伏(峰值电流14毫安);在盐水的情况下,峰值为30伏(峰值电流30毫安)。
30伏的电压可能会使操作员或旁观者有一些轻微感觉,但在这些情况下被认为不太可能有危险。最大电流低于安全标准允许值。虽然不建议在潮湿环境中进行除颤,但我们对潮湿环境中的患者及救援人员/旁观者的模拟表明,在必要情况下并无显著风险。