Hands-on defibrillation: An analysis of electrical current flow through rescuers in direct contact with patients during biphasic external defibrillation

Circulation

Volumn 117, Issue 19, 2008, Pages 2510-2514

  Lloyd, Michael S ^a,b   Heeke, Brian ^a   Walter, Paul F ^a   Langberg, Jonathan J ^a  

^a EMORY UNIVERSITY HOSPITAL   (United States)

^b EMORY UNIVERSITY   (United States)

Author keywords

Cardiopulmonary resuscitation; Defibrillation; Electrical stimulation; Resuscitation

Indexed keywords

ARTICLE; CLINICAL ARTICLE; COMPRESSION; DEFIBRILLATION; ELECTRIC CURRENT; ELECTRIC POTENTIAL; FEASIBILITY STUDY; HUMAN; PRIORITY JOURNAL; RESUSCITATION; SAFETY; SHOCK WAVE; SHOULDER; SKIN ELECTRODE; THIGH; THORAX; WRIST;

ELECTRIC COUNTERSHOCK; ELECTRIC INJURIES; HAND; HEART ARREST; HEART MASSAGE; HUMANS; RESUSCITATION; TACHYCARDIA, VENTRICULAR;

EID: 43449089813     PISSN: 00097322     EISSN: None     Source Type: Journal    
DOI: 10.1161/CIRCULATIONAHA.107.763011     Document Type: Article

References (23)

1. Gibbs W, Eisenberg M, Damon SK. Dangers of defibrillation: injuries to emergency personnel during patient resuscitation. Am J Emerg Med. 1990;8:101-104.
2. ECC Committee, Subcommittees, and Task Forces of the American Heart Association. 2005 American Heart Association guidelines for cardiopulmonary resuscitation and emergency cardiovascular care, part 5: electrical therapies: automated external defibrillators, defibrillation, cardioversion, and pacing. Circulation. 2005;112(suppl):IV-35-IV-46.
3. Hummel RS III, Ornato JP, Weinberg SM, Clarke AM. Spark-generating properties of electrode gels used during defibrillation: a potential fire hazard. JAMA. 1988;260:3021-3024.
4. Theodorou AA, Gutierrez JA, Berg RA. Fire attributable to a defibrillation attempt in a neonate. Pediatrics. 2003;112:677-679.
5. ECC Committee, Subcommittees, and Task Forces of the American Heart Association. 2005 American Heart Association guidelines for cardiopulmonary resuscitation and emergency cardiovascular care, part 7.2: management of cardiac arrest. Circulation. 2005;112(suppl):IV-58-IV-66.
6. Wik L, Hansen TB, Fylling F, Steen T, Vaagenes P, Auestad BH, Steen PA. Delaying defibrillation to give basic cardiopulmonary resuscitation to patients with out-of-hospital ventricular fibrillation: a randomized trial. JAMA. 2003;289:1389-1395.
7. Yu T, Weil MH, Tang W, Sun S, Klouche K, Povoas H, Bisera J. Adverse outcomes of interrupted precordial compression during automated defibrillation. Circulation. 2002;106:368-372.
8. Sato Y, Weil MH, Sun S, Tang W, Xie J, Noc M, Bisera J. Adverse effects of interrupting precordial compression during cardiopulmonary resuscitation. Crit Care Med. 1997;25:733-736.
9. Steen S, Liao Q, Pierre L, Paskevicius A, Sjoberg T. The critical importance of minimal delay between chest compressions and subsequent defibrillation: a haemodynamic explanation. Resuscitation. 2003;58:249-258.
10. Blackburn GE. UL-1950: an IEC-950-based US standard for information technology equipment including electrical business equipment. IEEE Trans Ind Appl. 1992;28:228-232.
11. Hallstrom A, Rea TD, Sayre MR, Christenson J, Anton AR, Mosesso VN Jr, Van OL, Olsufka M, Pennington S, White LJ, Yahn S, Husar J, Morris MF, Cobb LA. Manual chest compression vs use of an automated chest compression device during resuscitation following out-of-hospital cardiac arrest: a randomized trial. JAMA. 2006;295:2620-2628.
12. Berg RA, Sanders AB, Kern KB, Hilwig RW, Heidenreich JW, Porter ME, Ewy GA. Adverse hemodynamic effects of interrupting chest compressions for rescue breathing during cardiopulmonary resuscitation for ventricular fibrillation cardiac arrest. Circulation. 2001;104:2465-2470.
13. Wik L, Kramer-Johansen J, Myklebust H, Sorebo H, Svensson L, Fellows B, Steen PA. Quality of cardiopulmonary resuscitation during out-of-hospital cardiac arrest. JAMA. 2005;293:299-304.
14. Kerber RE, Grayzel J, Hoyt R, Marcus M, Kennedy J. Transthoracic resistance in human defibrillation: influence of body weight, chest size, serial shocks, paddle size and paddle contact pressure. Circulation. 1981;63:676-682.
15. Niwano S, Kojima J, Inuo K, Saito J, Kashiwa T, Suyama M, Toyoshima T, Aizawa Y, Izumi T. Measurement of body surface energy leakage of defibrillation shock by an implantable cardioverter defibrillator. Pacing Clin Electrophysiol. 2002;25:1212-1218.
16. Niwano S, Kitano Y, Moriguchi M, Yoshizawa N, Kashiwa T, Suyama M, Toyoshima T, Izumi T. Leakage of energy to the body surface during defibrillation shock by an implantable cardioverter-defibrillator (ICD) system: experimental evaluation during defibrillation shocks through the right ventricular lead and the subcutaneous active-can in canines. Jpn Circ J. 2001;65:219-225.
17. Laks MM, Arzbaecher R, Bailey JJ, Geselowitz DB, Berson AS. Recommendations for safe current limits for electrocardiographs: a statement for healthcare professionals from the Committee on Electrocardiography, American Heart Association. Circulation. 1996;93:837-839.
18. Laks MM, Arzbaecher R, Geselowitz D, Bailey JJ, Berson A. Revisiting the question: will relaxing safe current limits for electromedical equipment increase hazards to patients? Circulation. 2000;102:823-825.
19. Swerdlow CD, Olson WH, O'Connor ME, Gallik DM, Malkin RA, Laks M. Cardiovascular collapse caused by electrocardiographically silent 60-Hz intracardiac leakage current: implications for electrical safety. Circulation. 1999;99:2559-2564.
20. Martinsen OG, Grimnes S, Piltan H. Cutaneous perception of electrical direct current. ITBM-RBM. 2004;25:240-243.
21. Summers RL, Shoemaker WC, Peacock WF, Ander DS, Coleman TG. Bench to bedside: electrophysiologic and clinical principles of noninvasive hemodynamic monitoring using impedance cardiography. Acad Emerg Med. 2003;10:669-680.
22. Altman LK. Who Goes First? The Story of Self-Experimentation in Medicine. 1st ed. Berkeley, Calif: University of California Press; 1998.
23. Dodd TE, Deakin CD, Petley GW, Clewlow F. External defibrillation in the left lateral position: a comparison of manual paddles with self-adhesive pads. Resuscitation. 2004;63:283-286.