Defibrillation in clinical practice

Current Opinion in Critical Care

Volumn 15, Issue 3, 2009, Pages 209-215

  Nolan, Jerry P ^a   Soar, Jasmeet ^b  

^a ROYAL UNITED HOSPITAL   (United Kingdom)

^b SOUTHMEAD HOSPITAL   (United Kingdom)

Author keywords

Cardiopulmonary resuscitation; Defibrillation; Preshock pause; Ventricular fibrillation

Indexed keywords

CARDIOVERSION; CLINICAL PRACTICE; COMPRESSION; DEFIBRILLATION; DEFIBRILLATOR; ELECTROCUTION; ENERGY; HEALTH CARE PERSONNEL; HEART ARREST; HEART RHYTHM; HEART VENTRICLE FIBRILLATION; HEART VENTRICLE TACHYCARDIA; HUMAN; OCCUPATIONAL ACCIDENT; PRACTICE GUIDELINE; PRODUCTIVITY; RESCUE PERSONNEL; RESUSCITATION; REVIEW; RISK; SHOCK; TASK PERFORMANCE; THORAX;

CARDIOPULMONARY RESUSCITATION; CHEST WALL OSCILLATION; ELECTRIC COUNTERSHOCK; GUIDELINES AS TOPIC; HEART ARREST; HUMANS; PHYSICIAN'S PRACTICE PATTERNS; TREATMENT OUTCOME; VENTRICULAR FIBRILLATION;

EID: 68049142924     PISSN: 10705295     EISSN: 15317072     Source Type: Journal    
DOI: 10.1097/MCC.0b013e32832931cb     Document Type: Review

References (35)

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29. Berger RD, Palazzolo J, Halperin H. Rhythm discrimination during uninterrupted CPR using motion artifact reduction system. Resuscitation 2007; 75:145-152. In this swine study, a technique of adaptive noise cancellation was used to reduce motion artefact during mechanical CPR, enabling recognition of ventricular fibrillation without interrupting CPR.
30. Cobb LA, Fahrenbruch CE, Walsh TR, et al. Influence of cardiopulmonary resuscitation prior to defibrillation in patients with out-of-hospital ventricular fibrillation. JAMA 1999; 281:1182-1188.
31. Wik L, Hansen TB, Fylling F, et al. Delaying defibrillation to give basic cardiopulmonary resuscitation to patients with out-of-hospital ventricular fibrillation: a randomized trial. JAMA 2003; 289:1389-1395.
32. Bobrow BJ, Clark LL, Ewy GA, et al. Minimally interrupted cardiac resuscitation by emergency medical services for out-of-hospital cardiac arrest. JAMA 2008; 299:1158-1165. This important before and after study showed dramatically better survival rates after implementation of a new CPR protocol designed to minimize interruptions in chest compressions during resuscitation following out-of-hospital cardiac arrest.
33. Stiell IG, Walker RG, Nesbitt LP, et al. BIPHASIC Trial: a randomized comparison of fixed lower versus escalating higher energy levels for defibrillation in out-of-hospital cardiac arrest. Circulation 2007; 115:1511-1517. This study showed that for patients requiring more than one shock, ventricular fibrillation, conversion and termination rates were significantly higher when using escalating (200-300-360 J) stacked higher biphasic energy levels compared with fixed lower biphasic energy levels (150-150-150 J). It is not clear whether the findings from this study apply to defibrillators that use different biphasic waveforms to those used in this study.
34. Cayla G, Macia JC, Pasquie JL. Images in cardiovascular medicine. Precordial thump in the catheterization laboratory experimental evidence for commotio cordis. Circulation 2007; 115:e332. Anecdotal evidence from a catheter laboratory showing that ventricular fibrillation can be precipitated by a precordial thump when given to a patient with a perfusing rhythm.
35. Amir O, Schliamser JE, Nemer S, et al. Ineffectiveness of precordial thump for cardioversion of malignant ventricular tachyarrhythmias. Pacing Clin Electrophysiol 2007; 30:153-156. Another study from an electrophysiology laboratory that shows the ineffectiveness of the precordial thump for terminating ventricular arrhythmia; it was effective in just one out of 80 patients.