A new defibrillator mode to reduce chest compression interruptions for health care professionals and lay rescuers: a pilot study in manikins.

BACKGROUND

Chest compression interruptions are detrimental during the resuscitation of cardiac arrest patients, especially immediately prior to shock delivery.

OBJECTIVE

To evaluate the effect of use of a new defibrillator technology, which filters compression-induced artifact and provides reliable rhythm analysis with automatic defibrillator charging during chest compressions, on preshock chest compression interruption.

METHODS

Thirty subjects (20 basic life support [BLS]; 10 advanced life support [ALS]) worked in pairs to perform two randomly ordered simulated cardiac resuscitations with the defibrillator operating in either standard mode (ALS = manual; BLS = automated external defibrillator [AED]) or the new Analysis and Charging during CPR (AC-CPR) mode. During each resuscitation simulation, rescuers switched roles as chest compressor and defibrillator operator every two segments of CPR (one segment = 2 minutes of chest compressions, rhythm analysis, and shock delivery, if appropriate), for eight total segments. The participants rested ≥30 minutes between trials and received brief AC-CPR training (BLS = 30 seconds; ALS = 5 minutes). Heart rate and perceived exertion were measured with pulse oximetry and the Borg scale, respectively.

RESULTS

Mean (± standard deviation) preshock chest compression pause time was considerably shorter in each CPR segment with AC-CPR versus standard defibrillator operation (2.13 ± 0.99 sec vs. 10.93 ± 1.33, p < 0.0001), demonstrating effective use of AC-CPR with minimal training. Despite reduced chest compression interruption with AC-CPR, rescuer fatigue and perceived exertion did not differ in any CPR segment with standard defibrillator operation versus AC-CPR (p = 0.2-1.0).

CONCLUSIONS

Preshock pause time is reduced by 80% utilizing a novel technology that employs automated analysis and charging during chest compression. Although chest compression pause time is reduced with the use of the new technology, participants do not excessively fatigue.