Gibbs W, Eisenberg M, Damon S K
Center for Evaluation of Emergency Medical Services, King County Health Department, Washington, Seattle 98104.
Am J Emerg Med. 1990 Mar;8(2):101-4. doi: 10.1016/0735-6757(90)90193-4.
There have been no studies of the nature of defibrillatory shocks or risks to persons, providing them other than one individual case report and a number of incidental accounts. In this study, the severity and nature of injuries to prehospital emergency personnel in King County, Washington are reported. In addition, the types of injuries occurring to defibrillator operators throughout the United States, as voluntarily reported to the Food and Drug Administration (FDA), are described. In King County, prehospital emergency personnel reported eight accidental shocks. One individual was admitted to the hospital for 3 days and required lidocaine for premature ventricular contractions. Most injuries were the result of accidental contact with the patient rather than equipment failure, but the most serious case was caused by equipment failure. There were 13 injuries reported to the FDA over a 3 1/2-year period, and most injuries involved a mild shock or burn. Three patients were admitted to the hospital for observation. Two cases involved equipment failure. The rate of injury for paramedics was 1 per 1,700 defibrillatory shocks, and the rate of injury for emergency medical technician-defibrillator personnel was 1 per 1,000 defibrillatory shocks. These rates probably overestimate the real risk. Emphasis on safety and incorporation of safety procedures into resuscitation protocols can make the rate of injury even lower.
除了一份个案报告和一些偶然记录外，尚无关于除颤电击的性质或对人员风险的研究。在本研究中，报告了华盛顿州金县院前急救人员受伤的严重程度和性质。此外，还描述了全美国自动向食品药品监督管理局（FDA）报告的除颤器操作人员所受伤害的类型。在金县，院前急救人员报告了8起意外电击事件。一名患者住院3天，因室性早搏需要使用利多卡因。大多数伤害是与患者意外接触造成的，而非设备故障，但最严重的情况是由设备故障引起的。在3年半的时间里，FDA共收到13起伤害报告，大多数伤害为轻度电击或烧伤。3名患者住院观察。2起案例涉及设备故障。护理人员的受伤率为每1700次除颤电击1例，急救医疗技术员 - 除颤器人员的受伤率为每1000次除颤电击1例。这些比率可能高估了实际风险。强调安全并将安全程序纳入复苏方案可使受伤率更低。
