Stults K R, Brown D D, Cooley F, Kerber R E
Ann Emerg Med. 1987 Aug;16(8):872-7. doi: 10.1016/s0196-0644(87)80525-5.
We compared self-adhesive, dual-function monitor/defibrillation electrode pads to standard chest monitoring leads and hand-held electrode paddles in the management of prehospital ventricular fibrillation in a single urban paramedic service. Shocks were delivered more quickly following paramedic arrival with self-adhesive pads than with hand-held paddles (1.6 vs 2.5 min; P less than .001). Ventricular fibrillation was terminated more frequently when shocks were delivered using the self-adhesive pads (55 of 58 patients, 95%) than when shocks were delivered using hand-held paddles (49 of 69 patients, 71%; P less than .005). Initial shocks delivered with self-adhesive pads were especially effective, converting 40 of 58 (69%) patients to an organized rhythm on the first or second shock; this was true of only 24 of 69 (35%) patients shocked with hand-held paddles (P less than .001). Patient survival to hospital admission improved when self-adhesive pads were used: 30 of the 58 (52%) patients shocked with self-adhesive pads achieved hospital admission, while only 21 of 69 patients (30%; P less than .025) survived to admission when hand-held paddles were used. In addition, electrical artifact that interfered with accurate rhythm interpretation was far more prevalent when standard monitoring electrodes were used, including artifact that resulted in inappropriate shock delivery (23% of patients monitored with standard electrodes vs 3% of patients monitored with self-adhesive pads; P less than .005). Self-adhesive monitor/defibrillation pads are superior to standard monitoring leads and hand-held electrode paddles in the management of prehospital ventricular fibrillation.
在一个城市急救服务中，我们比较了自粘式双功能监护/除颤电极片与标准胸部监护导联及手持电极板在院前心室颤动处理中的效果。急救人员到达后，使用自粘式电极片电击比使用手持电极板电击更快（1.6分钟对2.5分钟；P小于0.001）。使用自粘式电极片电击时，心室颤动终止的频率更高（58例患者中的55例，95%），而使用手持电极板电击时为（69例患者中的49例，71%；P小于0.005）。使用自粘式电极片进行的首次电击尤其有效，58例患者中有40例（69%）在第一次或第二次电击后转为有组织的心律；而使用手持电极板电击的69例患者中只有24例（35%）如此（P小于0.001）。使用自粘式电极片时患者入院存活率提高：58例接受自粘式电极片电击的患者中有30例（52%）入院，而使用手持电极板时69例患者中只有21例（30%；P小于0.025）存活至入院。此外，使用标准监护电极时，干扰准确心律解读的电伪迹更为普遍，包括导致不适当电击发放的伪迹（使用标准电极监护的患者中有23%，而使用自粘式电极片监护的患者中有3%；P小于0.005）。在院前心室颤动的处理中，自粘式监护/除颤电极片优于标准监护导联和手持电极板。
